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Sample records for service integration affect

  1. 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,…

  2. 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…

  3. Factors Affecting Medical Service Quality.

    PubMed

    Mosadeghrad, Ali Mohammad

    2014-02-01

    A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians. Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Individual, organizational and environmental factors enhance or inhibit the quality of medical services. Quality of medical services depends on the personal factors of the physician and patient, and factors pertaining to the healthcare setting and the broader environment. Differences in internal and external factors such as availability of resources, patient cooperation and collaboration among providers affect the quality of medical services and patient outcomes. Supportive leadership, proper planning, education and training and effective management of resources and processes improve the quality of medical services. This article contributes to healthcare theory and practice by developing a conceptual framework for understanding factors that influence medical services quality.

  4. '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.

  5. Factors affecting dental service quality.

    PubMed

    Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia

    2015-01-01

    Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients' viewpoint. This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml's model of service quality which consisted of two parts: the patients' demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor. Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality. The Parasuraman and Zeithaml's model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model. This is a pioneering study that uses Parasuraman and Zeithaml's model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.

  6. Integrated Services Digital Network

    DTIC Science & Technology

    1992-01-01

    users. " Pair Gain • ISDN’s capability to deliver multiple communications channels over a limited set of wires (as in 2B+D service or pasive bus...configuration commands to devices encountered in a communications path, is not yet a reality at Redstone. But for that matter , transparent connectivity

  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. 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

  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. 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.

  11. Multigranular integrated services optical network

    NASA Astrophysics Data System (ADS)

    Yu, Oliver; Yin, Leping; Xu, Huan; Liao, Ming

    2006-12-01

    Based on all-optical switches without requiring fiber delay lines and optical-electrical-optical interfaces, the multigranular optical switching (MGOS) network integrates three transport services via unified core control to efficiently support bursty and stream traffic of subwavelength to multiwavelength bandwidth. Adaptive robust optical burst switching (AR-OBS) aggregates subwavelength burst traffic into asynchronous light-rate bursts, transported via slotted-time light paths established by fast two-way reservation with robust blocking recovery control. Multiwavelength optical switching (MW-OS) decomposes multiwavelength stream traffic into a group of timing-related light-rate streams, transported via a light-path group to meet end-to-end delay-variation requirements. Optical circuit switching (OCS) simply converts wavelength stream traffic from an electrical-rate into a light-rate stream. The MGOS network employs decoupled routing, wavelength, and time-slot assignment (RWTA) and novel group routing and wavelength assignment (GRWA) to select slotted-time light paths and light-path groups, respectively. The selected resources are reserved by the unified multigranular robust fast optical reservation protocol (MG-RFORP). Simulation results show that elastic traffic is efficiently supported via AR-OBS in terms of loss rate and wavelength utilization, while connection-oriented wavelength traffic is efficiently supported via wavelength-routed OCS in terms of connection blocking and wavelength utilization. The GRWA-tuning result for MW-OS is also shown.

  12. 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.

  13. 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

  14. 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…

  15. 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

  16. 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.

  17. Dental services advertising: does it affect consumers?

    PubMed

    Sanchez, P M; Bonner, P G

    1989-12-01

    Dental services advertising appears to be increasing. Despite their negative attitude toward advertising, as many as 20% of all dentists may now be advertising to meet changing conditions in a highly competitive market. Research on dental services advertising has provided a useful starting point for developing dental advertising strategies. However, it affords little understanding of how consumers may respond to the many types of information provided in dental services advertisements. The authors extend knowledge in this area by examining consumer response to dental advertising in an experimental setting.

  18. Integrated musculoskeletal service design by GP consortia

    PubMed Central

    2011-01-01

    Background Musculoskeletal conditions are common in primary care and are associated with significant co-morbidity and impairment of quality of life. Traditional care pathways combined community-based physiotherapy with GP referral to hospital for a consultant opinion. Locally, this model led to only 30% of hospital consultant orthopaedic referrals being listed for surgery, with the majority being referred for physiotherapy. The NHS musculoskeletal framework proposed the use of interface services to provide expertise in diagnosis, triage and management of musculoskeletal problems not requiring surgery. The White Paper Equity and Excellence: Liberating the NHS has replaced PCT commissioning with GP consortia, who will lead future service development. Setting Primary and community care, integrated with secondary care, in the NHS in England. Question How can GP consortia lead the development of integrated musculoskeletal services? Review: The Ealing experience We explore here how Ealing implemented a ‘See and Treat’ interface clinic model to improve surgical conversion rates, reduce unnecessary hospital referrals and provide community treatment more efficiently than a triage model. A high-profile GP education programme enabled GPs to triage in their practices and manage patients without referral. Conclusion In Ealing, we demonstrated that most patients with musculoskeletal conditions can be managed in primary care and community settings. The integrated musculoskeletal service provides clear and fast routes to secondary care. This is both clinically effective and cost-effective, reserving hospital referral for patients most likely to need surgery. GP consortia, in conjunction with strong clinical leadership, inbuilt organisational and professional learning, and a GP champion, are well placed to deliver service redesign by co-ordinating primary care development, local commissioning of community services and the acute commissioning vehicles responsible for secondary

  19. Air ambulance services--integrated emergency care.

    PubMed

    Ferdinand, M

    1994-10-01

    In the name of cost-conscious care, air ambulance program directors and service contractors are seeing the dawn of integrated networks as a boon to their business. As integrated networks form, facilities will become increasingly specialized in the types of services they provide. Patients will need to be moved around the system, resulting in more frequent patient transport and more points of transfer. Many programs are considering aircraft replacement and additions, rather than leasing. Financial benefits could come on depreciation and the high resale value of aircraft. Unless reimbursement levels increase, more program mergers and affiliations may take place to spread and reduce cost. Air ambulance services will increasingly become part of a facility's strategic plan.

  20. 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.

  1. Integrating mental health services: the Finnish experience

    PubMed Central

    Lehtinen, Ville; Taipale, Vappu

    2001-01-01

    Abstract The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in which mental

  2. Patient expectations of dental services. Image affects expectations, and expectations affect perceived service quality.

    PubMed

    Clow, K E; Fischer, A K; O'Bryan, D

    1995-01-01

    The authors construct a theoretical model of the antecedents of expectations for dental services by analyzing survey responses from 240 dental patients. The patients' image of the dentist, tangible cues, situational factors, and patient satisfaction with prior service encounters have the greatest influence on expectations of service, whereas marketing variables, such as price and advertising, appear to have no effect.

  3. Affect integration and reflective function: clarification of central conceptual issues.

    PubMed

    Solbakken, Ole André; Hansen, Roger Sandvik; Monsen, Jon Trygve

    2011-07-01

    The importance of affect regulation, modulation or integration for higher-order reflection and adequate functioning is increasingly emphasized across different therapeutic approaches and theories of change. These processes are probably central to any psychotherapeutic endeavor, whether explicitly conceptualized or not, and in recent years a number of therapeutic approaches have been developed that explicitly target them as a primary area of change. However, there still is important lack of clarity in the field regarding the understanding and operationalization of affect integration, particularly when it comes to specifying underlying mechanisms, the significance of different affect states, and the establishment of operational criteria for measurement. The conceptual relationship between affect integration and reflective function thus remains ambiguous. The present article addresses these topics, indicating ways in which a more complex and exhaustive understanding of integration of affect, cognition and behavior can be attained.

  4. Integrating family planning with other social services.

    PubMed

    Bernales, E H

    1982-01-01

    Family planning outreach workers in the 43 municipalities of Iloilo Province, Western Visayas, the Philippines, have provided their communities with health, nutrition, educational, and agricultural services since 1973, when the Provincial Development Staff (PDS) began attempting to integrate services. The early work of the PDS was aided by the launching of the National Population and Family Planning Outreach Project in rural areas in 1976 and the creation of the Provincial Population Office (PPO) in 1977. 43% of the Outreach Project cost is borne by the local government, with the Commission on Population covering the rest. It is anticipated that the local goverment will eventually absorb the full cost. The Outreach officers have become an integral part of the planning body of the provincial government, largely due to the creation of the Provincial Consultative Committee on Population (PCCP) in 1979. The PCCP, composed of 22 governmental and private agencies involved in population-related activities, is charged with implementing the national population program in order to utilize all possible resources for provincial development. Its Integrated Provincial Population Plan has become part of the total provincial development plan. The Municipal Population Planning Actions Teams, whose functions are patterned on those of the PCCPs, further strengthen local planning at the municipal level. Full-Time Outreach Workers participate as well in planning at the barangay level. The various community-based projects initiated by the Outreach staff in Iloilo demonstrate a concern with making the population program responsive to the immediate needs of the provincial population. Organizations which teach better farming methods and undertake community projects emphasize local initiative and solutions to problems, and demonstrate the committment of population workers to broader development efforts. Outreach workers are involved in primary health care, social service delivery, income

  5. 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.

  6. 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

  7. 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

  8. Affective Aspects of an Age-Integrated Water Exercise Program.

    ERIC Educational Resources Information Center

    Weiss, Caroline R.; Jamieson, Nancy B.

    1987-01-01

    Surveyed 88 female participants of community-based age-integrated water exercise program designed to enhance comfort and social interaction. Affective measures and observation of membership as a support group elicited few differences by age. Members endorsed having age integration in classes and there was little indication that subgroups of…

  9. Factors affecting the implementation of clinical pharmacy services in China.

    PubMed

    Penm, Jonathan; Moles, Rebekah; Wang, Holly; Li, Yan; Chaar, Betty

    2014-03-01

    New policies in China have recently led to the implementation of clinical pharmacy services in hospitals. We explored the views of hospital administrators, pharmacy directors, clinical pharmacists, and dispensing pharmacists about the factors affecting clinical pharmacy services in China, using the framework approach and organizational theory. We conducted 30 interviews with 130 participants at 29 hospitals (both secondary and tertiary) in Beijing, Zhengzhou, Luoyang, and Shanghai. We found that the barriers to and facilitators of implementation of clinical pharmacy services slotted into the environment and participant dimensions of Scott's adapted version of Leavitt's organizational model. External support from government was perceived as crucial to promoting pharmacy services. It is proposed that the internationally recognized Basel Statements of the International Pharmaceutical Federation also provide a strong foundation for guiding China in implementing clinical pharmacy services.

  10. 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

  11. 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.

  12. 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.

  13. Illustrating Services Integration from Categorical Bases. Human Services Monograph Series No. 3.

    ERIC Educational Resources Information Center

    Horton, Gerald T.; And Others

    This report focuses on one method of human services integration--starting with a categorical funding and program base which is expanded to integrate complementary services and resources into a comprehensive service package. The four projects examined illustrate the following initial categorical bases: Community mental health services, primarily…

  14. 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...

  15. Factors Affecting Differences in Medicare Reimbursements for Physicians' Services

    PubMed Central

    Gornick, Marian; Newton, Marilyn; Hackerman, Carl

    1980-01-01

    Under Medicare's Part B program, wide variations are found in average reimbursements for physicians' services by demographic and geographic characteristics of the beneficiaries. Average reimbursements per beneficiary enrolled In the program depend upon the percentage of enrolled persons who exceed the deductible and receive reimbursements, the average allowed charge per service, and the number of services used. This study analyzes differences in average reimbursements per beneficiary for physicians' services In 1975 and discusses allowed charges and use factors that affect average reimbursements. Differences in the level of allowed charges and their impact on meeting the annual deductible are also discussed. The study indicates that average reimbursements per beneficiary are likely to continue to vary significantly year after year under the present Part B cost-sharing and reimbursement mechanisms. PMID:10309221

  16. 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

  17. Human Services in Montgomery County, Ohio: Service Integration Writ Large.

    ERIC Educational Resources Information Center

    Ragan, Mark

    The most striking characteristic of the human service system in Montgomery County, Ohio, is the size and scope of its job center. The center occupies 5.5 acres of office space, has ample parking, is well served by the public transportation system, and is the locus of many human service and employment programs and service providers. The county's…

  18. 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.

  19. 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…

  20. 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…

  1. 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…

  2. Flexible Web services integration: a novel personalised social approach

    NASA Astrophysics Data System (ADS)

    Metrouh, Abdelmalek; Mokhati, Farid

    2018-05-01

    Dynamic composition or integration remains one of the key objectives of Web services technology. This paper aims to propose an innovative approach of dynamic Web services composition based on functional and non-functional attributes and individual preferences. In this approach, social networks of Web services are used to maintain interactions between Web services in order to select and compose Web services that are more tightly related to user's preferences. We use the concept of Web services community in a social network of Web services to reduce considerably their search space. These communities are created by the direct involvement of Web services providers.

  3. Integrated service delivery networks for seniors

    PubMed Central

    Milette, Linda; Hébert, Réjean; Veil, Anne

    2005-01-01

    OBJECTIVE To document the early perceptions of family physicians regarding integrated service delivery (ISD) networks a few weeks before and 6 months after establishing these networks and to identify obstacles to using case managers. DESIGN Cross-sectional survey with two questionnaires mailed 6 months apart. SETTING Three regional municipalities (one urban and two rural) in the Eastern Townships of Quebec. PARTICIPANTS All family physicians in the three areas (n = 267). A total of 124 physicians (of 206 eligible; 60% response rate) answered the first questionnaire, and 104 of these the second (86% response rate). MAIN OUTCOME MEASURES The first questionnaire asked what family physicians thought about ISD networks and the emerging case management function, and whether they were interested in participating in ISD networks. The second measured physicians’ participation in ISD networks, asked whether their perceptions of case management had changed, and identified obstacles to using case managers. RESULTS Nearly all (98%) respondents to the preimplementation questionnaire believed that family physicians will increasingly have to belong to ISD networks. Very few (8.2%), however, felt involved or consulted in decisions about developing and implementing these networks. More than one quarter (27%) did not know that an ISD network for older people would be established in their area, and 84.3% did not feel sufficiently informed to be involved. Most family physicians (85.7%) said they were interested in using case managers. Six months after implementation, 70.2% of physicians knew that case managers were available; 35.6% had used a case manager. During implementation, physicians’ opinions about case management were slightly less positive than they had been. The three main obstacles to using case managers were forgetting to use them (69.1%), the habit of using social workers instead (63.6%), and not knowing how to contact them (59.4%). CONCLUSION Physicians are interested

  4. 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…

  5. 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

  6. Educational and Service Outcomes of a Service Integration Effort.

    ERIC Educational Resources Information Center

    Greene, David; Diehm, Gwen

    1995-01-01

    Study investigated the effects of a service-learning component in an undergraduate occupational therapy course. Comparisons were made between students involved in service-learning and those not involved of how they perceived institutionalized older adults' perspectives on disease and aging. Also evaluated were weekly journal entries of the…

  7. 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

  8. 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.

  9. 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…

  10. 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...

  11. 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)…

  12. Case Management and the Integration of Services: How Service Delivery Systems Shape Case Management.

    ERIC Educational Resources Information Center

    Moore, Stephen

    1992-01-01

    Notes that primary role that case management plays in coordination of services is determined by level of service integration and by level of resources in service delivery system. Describes conditions under which case management serves as mechanism for rationing services, marketing function, brokering function, or development role. Discusses…

  13. 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...

  14. 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)

  15. Affective picture processing: An integrative review of ERP findings

    PubMed Central

    Olofsson, Jonas K.; Nordin, Steven; Sequeira, Henrique; Polich, John

    2008-01-01

    The review summarizes and integrates findings from 40 years of event-related potential (ERP) studies using pictures that differ in valence (unpleasant-to-pleasant) and arousal (low-to-high) and that are used to elicit emotional processing. Affective stimulus factors primarily modulate ERP component amplitude, with little change in peak latency observed. Arousal effects are consistently obtained, and generally occur at longer latencies. Valence effects are inconsistently reported at several latency ranges, including very early components. Some affective ERP modulations vary with recording methodology, stimulus factors, as well as task-relevance and emotional state. Affective ERPs have been linked theoretically to attention orientation for unpleasant pictures at earlier components (< 300 ms). Enhanced stimulus processing has been associated with memory encoding for arousing pictures of assumed intrinsic motivational relevance, with task-induced differences contributing to emotional reactivity at later components (> 300 ms). Theoretical issues, stimulus factors, task demands, and individual differences are discussed. PMID:18164800

  16. 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.

  17. A state policy framework for integrating health and social services.

    PubMed

    McGinnis, Tricia; Crawford, Maia; Somers, Stephen A

    2014-07-01

    Recognizing that health is determined by a variety of interrelated factors, states are looking to connect health care, public health, and social services to help achieve improved population health, better care, and reduced cost of care. This issue brief describes three essential components for integrating health, including physical and behavioral health services and public health, and social services: (1) a coordinating mechanism, (2) quality measurement and data-sharing tools, and (3) aligned financing and payment. It also presents a five-step policy framework to help states move beyond isolated pilot efforts and establish the infrastructure necessary to support ongoing integration of health and social services, particularly for Medicaid beneficiaries.

  18. Distributed spatial information integration based on web service

    NASA Astrophysics Data System (ADS)

    Tong, Hengjian; Zhang, Yun; Shao, Zhenfeng

    2008-10-01

    Spatial information systems and spatial information in different geographic locations usually belong to different organizations. They are distributed and often heterogeneous and independent from each other. This leads to the fact that many isolated spatial information islands are formed, reducing the efficiency of information utilization. In order to address this issue, we present a method for effective spatial information integration based on web service. The method applies asynchronous invocation of web service and dynamic invocation of web service to implement distributed, parallel execution of web map services. All isolated information islands are connected by the dispatcher of web service and its registration database to form a uniform collaborative system. According to the web service registration database, the dispatcher of web services can dynamically invoke each web map service through an asynchronous delegating mechanism. All of the web map services can be executed at the same time. When each web map service is done, an image will be returned to the dispatcher. After all of the web services are done, all images are transparently overlaid together in the dispatcher. Thus, users can browse and analyze the integrated spatial information. Experiments demonstrate that the utilization rate of spatial information resources is significantly raised thought the proposed method of distributed spatial information integration.

  19. Distributed spatial information integration based on web service

    NASA Astrophysics Data System (ADS)

    Tong, Hengjian; Zhang, Yun; Shao, Zhenfeng

    2009-10-01

    Spatial information systems and spatial information in different geographic locations usually belong to different organizations. They are distributed and often heterogeneous and independent from each other. This leads to the fact that many isolated spatial information islands are formed, reducing the efficiency of information utilization. In order to address this issue, we present a method for effective spatial information integration based on web service. The method applies asynchronous invocation of web service and dynamic invocation of web service to implement distributed, parallel execution of web map services. All isolated information islands are connected by the dispatcher of web service and its registration database to form a uniform collaborative system. According to the web service registration database, the dispatcher of web services can dynamically invoke each web map service through an asynchronous delegating mechanism. All of the web map services can be executed at the same time. When each web map service is done, an image will be returned to the dispatcher. After all of the web services are done, all images are transparently overlaid together in the dispatcher. Thus, users can browse and analyze the integrated spatial information. Experiments demonstrate that the utilization rate of spatial information resources is significantly raised thought the proposed method of distributed spatial information integration.

  20. Spatial Updating Strategy Affects the Reference Frame in Path Integration.

    PubMed

    He, Qiliang; McNamara, Timothy P

    2018-06-01

    This study investigated how spatial updating strategies affected the selection of reference frames in path integration. Participants walked an outbound path consisting of three successive waypoints in a featureless environment and then pointed to the first waypoint. We manipulated the alignment of participants' final heading at the end of the outbound path with their initial heading to examine the adopted reference frame. We assumed that the initial heading defined the principal reference direction in an allocentric reference frame. In Experiment 1, participants were instructed to use a configural updating strategy and to monitor the shape of the outbound path while they walked it. Pointing performance was best when the final heading was aligned with the initial heading, indicating the use of an allocentric reference frame. In Experiment 2, participants were instructed to use a continuous updating strategy and to keep track of the location of the first waypoint while walking the outbound path. Pointing performance was equivalent regardless of the alignment between the final and the initial headings, indicating the use of an egocentric reference frame. These results confirmed that people could employ different spatial updating strategies in path integration (Wiener, Berthoz, & Wolbers Experimental Brain Research 208(1) 61-71, 2011), and suggested that these strategies could affect the selection of the reference frame for path integration.

  1. Modelling audiovisual integration of affect from videos and music.

    PubMed

    Gao, Chuanji; Wedell, Douglas H; Kim, Jongwan; Weber, Christine E; Shinkareva, Svetlana V

    2018-05-01

    Two experiments examined how affective values from visual and auditory modalities are integrated. Experiment 1 paired music and videos drawn from three levels of valence while holding arousal constant. Experiment 2 included a parallel combination of three levels of arousal while holding valence constant. In each experiment, participants rated their affective states after unimodal and multimodal presentations. Experiment 1 revealed a congruency effect in which stimulus combinations of the same extreme valence resulted in more extreme state ratings than component stimuli presented in isolation. An interaction between music and video valence reflected the greater influence of negative affect. Video valence was found to have a significantly greater effect on combined ratings than music valence. The pattern of data was explained by a five parameter differential weight averaging model that attributed greater weight to the visual modality and increased weight with decreasing values of valence. Experiment 2 revealed a congruency effect only for high arousal combinations and no interaction effects. This pattern was explained by a three parameter constant weight averaging model with greater weight for the auditory modality and a very low arousal value for the initial state. These results demonstrate key differences in audiovisual integration between valence and arousal.

  2. An Integrated Approach to Student Services.

    ERIC Educational Resources Information Center

    Kelly, Rob

    2001-01-01

    Describes the comprehensive, coordinated approach to student support services at the University of Wisconsin Learning Innovations, an electronic learning consultation utility that develops online programs for distance learning. Topics include the Learner Relationship Management System, advising opportunities, help desk, administrative Web site,…

  3. Web Services Integration on the Fly

    DTIC Science & Technology

    2008-12-01

    NETBEANS 6.1 AND VERSION CONTROL............................................28 1. NetBeans Integrated Development Environment (IDE) ................28 2...Forward and Reverse Engineering...................................................28 3. Implementation using NetBeans ...29 4. Subversion (SVN) for Version Control in NetBeans ......................29 O. PROTÉGÉ AUTHORING TOOL FOR SEMANTIC WEB

  4. 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.

  5. 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.

  6. 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)…

  7. Frail elderly patients. New model for integrated service delivery.

    PubMed Central

    Hébert, Rejean; Durand, Pierre J.; Dubuc, Nicole; Tourigny, André

    2003-01-01

    PROBLEM BEING ADDRESSED: Given the complex needs of frail older people and the multiplicity of care providers and services, care for this clientele lacks continuity. OBJECTIVE OF PROGRAM: Integrated service delivery (ISD) systems have been developed to improve continuity and increase the efficacy and efficiency of services. PROGRAM DESCRIPTION: The Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA) is an innovative ISD model based on coordination. It includes coordination between decision makers and managers of different organizations and services; a single entry point; a case-management process; individualized service plans; a single assessment instrument based on clients' functional autonomy, coupled with a case-mix classification system; and a computerized clinical chart for communicating between institutions and professionals for client monitoring. CONCLUSION: Preliminary results on the efficacy of this model showed a decreased incidence of functional decline, a decreased burden for caregivers, and a smaller proportion of older people wishing to enter institutions. PMID:12943358

  8. 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

  9. 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

  10. Service Integration: Challenging Systems To Meet Families' Needs.

    ERIC Educational Resources Information Center

    Ward, Elie

    This report offers an evaluation of services for families in New York State, finds that system is in chaos, and proposes a 5-year commitment to integrate programs and funding in six agencies. The report finds that billions of federal, state, local, and private dollars are committed annually to support separate service systems with no imperative…

  11. 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…

  12. 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…

  13. 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…

  14. Integrating cervical cancer with HIV healthcare services: A systematic review

    PubMed Central

    Sigfrid, Louise; Murphy, Georgina; Haldane, Victoria; Chuah, Fiona Leh Hoon; Ong, Suan Ee; Cervero-Liceras, Francisco; Watt, Nicola; Alvaro, Alconada; Otero-Garcia, Laura; Balabanova, Dina; Hogarth, Sue; Maimaris, Will; Buse, Kent; Mckee, Martin; Piot, Peter; Perel, Pablo

    2017-01-01

    Background Cervical cancer is a major public health problem. Even though readily preventable, it is the fourth leading cause of death in women globally. Women living with HIV are at increased risk of invasive cervical cancer, highlighting the need for access to screening and treatment for this population. Integration of services has been proposed as an effective way of improving access to cervical cancer screening especially in areas of high HIV prevalence as well as lower resourced settings. This paper presents the results of a systematic review of programs integrating cervical cancer and HIV services globally, including feasibility, acceptability, clinical outcomes and facilitators for service delivery. Methods This is part of a larger systematic review on integration of services for HIV and non-communicable diseases. To be considered for inclusion studies had to report on programs to integrate cervical cancer and HIV services at the level of service delivery. We searched multiple databases including Global Health, Medline and Embase from inception until December 2015. Articles were screened independently by two reviewers for inclusion and data were extracted and assessed for risk of bias. Main results 11,057 records were identified initially. 7,616 articles were screened by title and abstract for inclusion. A total of 21 papers reporting interventions integrating cervical cancer care and HIV services met the criteria for inclusion. All but one study described integration of cervical cancer screening services into existing HIV services. Most programs also offered treatment of minor lesions, a ‘screen-and-treat’ approach, with some also offering treatment of larger lesions within the same visit. Three distinct models of integration were identified. One model described integration within the same clinic through training of existing staff. Another model described integration through co-location of services, with the third model describing programs of integration

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

    DTIC Science & Technology

    2017-10-01

    physical and mental health needs of these communities. This project includes LGBT service members from all four services: Army, Air Force, Navy and Marine...within the military • Hazing • Bullying • Overall health • Healthcare utilization • Lost duty days • Sick call visits • Physical health symptoms...Award Numbers: W81XWH-15-1-0701 Title: Improving Acceptance, Integration, and Health Among LGBT Service Members Principal Investigators

  16. 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.

  17. Integrating emergency services in an urban health system.

    PubMed

    Radloff, D; Blouin, A S; Larsen, L; Kripp, M E

    2000-03-01

    When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.

  18. Overcoming Barriers to Integrating Behavioral Health and Primary Care Services

    PubMed Central

    Grazier, Kyle L.; Smiley, Mary L.; Bondalapati, Kirsten S.

    2016-01-01

    Objective: Despite barriers, organizations with varying characteristics have achieved full integration of primary care services with providers and services that identify, treat, and manage those with mental health and substance use disorders. What are the key factors and common themes in stories of this success? Methods: A systematic literature review and snowball sampling technique was used to identify organizations. Site visits and key informant interviews were conducted with 6 organizations that had over time integrated behavioral health and primary care services. Case studies of each organization were independently coded to identify traits common to multiple organizations. Results: Common characteristics include prioritized vulnerable populations, extensive community collaboration, team approaches that included the patient and family, diversified funding streams, and data-driven approaches and practices. Conclusions: While significant barriers to integrating behavioral health and primary care services exist, case studies of organizations that have successfully overcome these barriers share certain common factors. PMID:27380923

  19. 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.

  20. MAPI: towards the integrated exploitation of bioinformatics Web Services.

    PubMed

    Ramirez, Sergio; Karlsson, Johan; Trelles, Oswaldo

    2011-10-27

    Bioinformatics is commonly featured as a well assorted list of available web resources. Although diversity of services is positive in general, the proliferation of tools, their dispersion and heterogeneity complicate the integrated exploitation of such data processing capacity. To facilitate the construction of software clients and make integrated use of this variety of tools, we present a modular programmatic application interface (MAPI) that provides the necessary functionality for uniform representation of Web Services metadata descriptors including their management and invocation protocols of the services which they represent. This document describes the main functionality of the framework and how it can be used to facilitate the deployment of new software under a unified structure of bioinformatics Web Services. A notable feature of MAPI is the modular organization of the functionality into different modules associated with specific tasks. This means that only the modules needed for the client have to be installed, and that the module functionality can be extended without the need for re-writing the software client. The potential utility and versatility of the software library has been demonstrated by the implementation of several currently available clients that cover different aspects of integrated data processing, ranging from service discovery to service invocation with advanced features such as workflows composition and asynchronous services calls to multiple types of Web Services including those registered in repositories (e.g. GRID-based, SOAP, BioMOBY, R-bioconductor, and others).

  1. 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.

  2. Visioning services for children affected by HIV and AIDS through a family lens.

    PubMed

    Richter, Linda; Beyrer, Chris; Kippax, Susan; Heidari, Shirin

    2010-06-23

    The HIV epidemic continues to place a great burden on children, from loss of parents and income to severe disruptions of their homes and families. Underpinned by the understanding that a healthy family constitutes the foundation for a child's wellbeing, the importance of family-centred care and services for children is increasingly recognized. It is not enough to merely provide antiretrovirals: it is of pivotal importance that treatment and care for children are integrated into the broader context of family-support schemes. However, despite growing evidence of the benefits of family-centred services, reforms in favour of family oriented HIV interventions have been slow to emerge. Treatment, prevention and care interventions often target individuals, and not families and communities.For the first time, this supplement to the Journal of the International AIDS Society brings together in one place the rationale for family-centred services for children affected by HIV and AIDS and some of the available evidence for the effectiveness of doing so. We hope this constitutes a beginning of what could be a groundswell of interest in family-centred services for children affected by HIV and AIDS.

  3. Visioning services for children affected by HIV and AIDS through a family lens

    PubMed Central

    2010-01-01

    The HIV epidemic continues to place a great burden on children, from loss of parents and income to severe disruptions of their homes and families. Underpinned by the understanding that a healthy family constitutes the foundation for a child's wellbeing, the importance of family-centred care and services for children is increasingly recognized. It is not enough to merely provide antiretrovirals: it is of pivotal importance that treatment and care for children are integrated into the broader context of family-support schemes. However, despite growing evidence of the benefits of family-centred services, reforms in favour of family oriented HIV interventions have been slow to emerge. Treatment, prevention and care interventions often target individuals, and not families and communities. For the first time, this supplement to the Journal of the International AIDS Society brings together in one place the rationale for family-centred services for children affected by HIV and AIDS and some of the available evidence for the effectiveness of doing so. We hope this constitutes a beginning of what could be a groundswell of interest in family-centred services for children affected by HIV and AIDS. PMID:20573282

  4. Snapshot of an integrated psychosocial gastroenterology service

    PubMed Central

    Kinsinger, Sarah W; Ballou, Sarah; Keefer, Laurie

    2015-01-01

    AIM: To characterize the patients utilizing a gastroenterology behavioral medicine service and examine the effect of treatment on health care utilization. METHODS: Patients were referred by their gastroenterologists for psychological treatment during a 15 mo period. Patients seen for an intake with a psychologist completed the Brief Symptom Inventory (BSI) and a checklist of psychosocial concerns. A subset of patients with functional bowel disorders also completed a disease specific quality of life measure. Chart review was conducted to obtain information on type and frequency of sessions with the psychologist, the number of outpatient gastroenterology visits, and number of gastroenterology-related medical procedures during the 6 mo following psychological intake. RESULTS: Of 259 patients referred for treatment, 118 (46%) completed an intake with a psychologist. Diagnoses included: irritable bowel syndrome (42%), functional dyspepsia (20%), inflammatory bowel diseases (20%), esophageal symptoms (10%), and “other” (8%). Demographic variables and disease type did not differentiate between those who did and did not schedule an intake. Mean t-scores for the BSI global score index and the depression, anxiety, and somatization subscales fell below the cutoff for clinical significance (t = 63). Treatments were predominantly gut-directed hypnosis (48%) and cognitive behavioral therapy (44%). Average length of treatment was 4 sessions. Among functional gastrointestinal (GI) patients, those patients who initiated treatment received significantly fewer GI-related medical procedures during the 6 mo following the referral than patients who did not schedule an intake [t (197) = 2.69, P < 0.01]. CONCLUSION: Patients are receptive to psychological interventions for GI conditions and there is preliminary evidence that treatment can decrease health-care utilization among patients with functional GI conditions. PMID:25684957

  5. Snapshot of an integrated psychosocial gastroenterology service.

    PubMed

    Kinsinger, Sarah W; Ballou, Sarah; Keefer, Laurie

    2015-02-14

    To characterize the patients utilizing a gastroenterology behavioral medicine service and examine the effect of treatment on health care utilization. Patients were referred by their gastroenterologists for psychological treatment during a 15 mo period. Patients seen for an intake with a psychologist completed the Brief Symptom Inventory (BSI) and a checklist of psychosocial concerns. A subset of patients with functional bowel disorders also completed a disease specific quality of life measure. Chart review was conducted to obtain information on type and frequency of sessions with the psychologist, the number of outpatient gastroenterology visits, and number of gastroenterology-related medical procedures during the 6 mo following psychological intake. Of 259 patients referred for treatment, 118 (46%) completed an intake with a psychologist. Diagnoses included: irritable bowel syndrome (42%), functional dyspepsia (20%), inflammatory bowel diseases (20%), esophageal symptoms (10%), and "other" (8%). Demographic variables and disease type did not differentiate between those who did and did not schedule an intake. Mean t-scores for the BSI global score index and the depression, anxiety, and somatization subscales fell below the cutoff for clinical significance (t = 63). Treatments were predominantly gut-directed hypnosis (48%) and cognitive behavioral therapy (44%). Average length of treatment was 4 sessions. Among functional gastrointestinal (GI) patients, those patients who initiated treatment received significantly fewer GI-related medical procedures during the 6 mo following the referral than patients who did not schedule an intake [t (197) = 2.69, P < 0.01]. Patients are receptive to psychological interventions for GI conditions and there is preliminary evidence that treatment can decrease health-care utilization among patients with functional GI conditions.

  6. 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

  7. 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.

  8. Implicit affective cues and attentional tuning: an integrative review.

    PubMed

    Friedman, Ronald S; Förster, Jens

    2010-09-01

    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 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, the authors propose 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 and 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 vs. 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.

  9. How Source Affects Response to Public Service Advertising.

    ERIC Educational Resources Information Center

    Lynn, Jerry R.; And Others

    1978-01-01

    Reports that public service advertising attributed to the Advertising Council elicited higher message ratings than did public service advertising attributed to a commercial source, a noncommercial source, or no source; however, it produced the lowest behavioral responses. (GT)

  10. Bioinformatics data distribution and integration via Web Services and XML.

    PubMed

    Li, Xiao; Zhang, Yizheng

    2003-11-01

    It is widely recognized that exchange, distribution, and integration of biological data are the keys to improve bioinformatics and genome biology in post-genomic era. However, the problem of exchanging and integrating biology data is not solved satisfactorily. The eXtensible Markup Language (XML) is rapidly spreading as an emerging standard for structuring documents to exchange and integrate data on the World Wide Web (WWW). Web service is the next generation of WWW and is founded upon the open standards of W3C (World Wide Web Consortium) and IETF (Internet Engineering Task Force). This paper presents XML and Web Services technologies and their use for an appropriate solution to the problem of bioinformatics data exchange and integration.

  11. A service-based framework for pharmacogenomics data integration

    NASA Astrophysics Data System (ADS)

    Wang, Kun; Bai, Xiaoying; Li, Jing; Ding, Cong

    2010-08-01

    Data are central to scientific research and practices. The advance of experiment methods and information retrieval technologies leads to explosive growth of scientific data and databases. However, due to the heterogeneous problems in data formats, structures and semantics, it is hard to integrate the diversified data that grow explosively and analyse them comprehensively. As more and more public databases are accessible through standard protocols like programmable interfaces and Web portals, Web-based data integration becomes a major trend to manage and synthesise data that are stored in distributed locations. Mashup, a Web 2.0 technique, presents a new way to compose content and software from multiple resources. The paper proposes a layered framework for integrating pharmacogenomics data in a service-oriented approach using the mashup technology. The framework separates the integration concerns from three perspectives including data, process and Web-based user interface. Each layer encapsulates the heterogeneous issues of one aspect. To facilitate the mapping and convergence of data, the ontology mechanism is introduced to provide consistent conceptual models across different databases and experiment platforms. To support user-interactive and iterative service orchestration, a context model is defined to capture information of users, tasks and services, which can be used for service selection and recommendation during a dynamic service composition process. A prototype system is implemented and cases studies are presented to illustrate the promising capabilities of the proposed approach.

  12. 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.

  13. 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.

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

    DTIC Science & Technology

    2017-10-01

    very little data available on the unique physical and mental health needs of these communities. This project includes LGBT service members from...Sick call visits • Physical health symptoms • Sexual/gender identity disclosure • Depressive symptoms • Suicidality • PTSD symptoms • Sexual...Award Numbers: W81XWH-15-1-0700 Title: Improving Acceptance, Integration, and Health Among LGBT Service Members Principal Investigators

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

    DTIC Science & Technology

    2017-10-01

    these stressors on LGBT service members is poorly understood, with very little data available on the unique physical and mental health needs of these...Bullying • Overall health • Healthcare utilization • Lost duty days • Sick call visits • Physical health symptoms • Sexual/gender identity disclosure...Award Numbers: W81XWH-15-1-0699 Title: Improving Acceptance, Integration and Health among LGBT Service Members Principal Investigators: Jeremy

  16. 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.

  17. Systematic review of youth mental health service integration research.

    PubMed

    Kinchin, Irina; Tsey, Komla; Heyeres, Marion; Cadet-James, Yvonne

    2016-01-01

    Quality mental health care is based on the integration of care across organisations and disciplines. The aims of this study were, first, to assess the extent, characteristics and reported outcomes of publications concerned with youth mental health service integration in Australia and internationally; and second, to investigate the study design quality of evaluative interventions and determine whether the studies report on the cost-effectiveness of the integration in order to inform the reform of youth mental health services by Queensland Health. A systematic search of the peer-reviewed literature and a narrative synthesis were undertaken of English language publications from 21 electronic databases. Inclusion criteria were: published 1998-2014 (inclusive); peer-reviewed research; focused on mental health services integration; reported data for youth aged 12-25 years. The methodological quality of evaluative interventions was assessed using the Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice Project (EPHPP). Twenty-five studies met the inclusion criteria: one (4%) was classified as a measurement research, 13 (52%) as descriptive, and 11 (44%) as interventions including five (45%) evaluative interventions. Four out of the five evaluative interventions reported positive effects of youth mental health service integration. Particular problems included ambiguity of definitions, absence of economic or cost analyses and insufficient consumer involvement. The methodological quality of the interventions was variable with, on average, a moderate level of selection bias and study design. Despite a slight increase in the number of studies in the last couple of years, there are important gaps in the evidence base for youth mental health service integration processes. The relatively small number of evaluative studies and lack of economic evaluations point to the need for additional research in this important area.

  18. jORCA: easily integrating bioinformatics Web Services.

    PubMed

    Martín-Requena, Victoria; Ríos, Javier; García, Maximiliano; Ramírez, Sergio; Trelles, Oswaldo

    2010-02-15

    Web services technology is becoming the option of choice to deploy bioinformatics tools that are universally available. One of the major strengths of this approach is that it supports machine-to-machine interoperability over a network. However, a weakness of this approach is that various Web Services differ in their definition and invocation protocols, as well as their communication and data formats-and this presents a barrier to service interoperability. jORCA is a desktop client aimed at facilitating seamless integration of Web Services. It does so by making a uniform representation of the different web resources, supporting scalable service discovery, and automatic composition of workflows. Usability is at the top of the jORCA agenda; thus it is a highly customizable and extensible application that accommodates a broad range of user skills featuring double-click invocation of services in conjunction with advanced execution-control, on the fly data standardization, extensibility of viewer plug-ins, drag-and-drop editing capabilities, plus a file-based browsing style and organization of favourite tools. The integration of bioinformatics Web Services is made easier to support a wider range of users. .

  19. 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.

  20. 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.

  1. Models for Integrating Human Services into the School.

    ERIC Educational Resources Information Center

    Dolan, Lawrence J.

    This report examines five models of school-based integrated human service programs to evaluate the effects of the programs in light of the growing support for and implementation of these programs. The study examined the following programs: (1) school-based health clinics in Baltimore (Maryland); (2) Success for All (an elementary school-level…

  2. Integrating Service and Experience: When Education Meets Admissions

    ERIC Educational Resources Information Center

    Stafne, Marcos

    2010-01-01

    In the past five years the Rubin Museum of Art has had significant shifts in the organizational structure and interrelation of visitor services and education due to various financial and administrative changes. Though varying levels of integration have existed in the institution's history, due to budget constraints in early 2009, the two separate…

  3. Service-Learning Integrated throughout a College of Engineering (SLICE)

    ERIC Educational Resources Information Center

    Duffy, John; Barrington, Linda; West, Cheryl; Heredia, Manuel; Barry, Carol

    2011-01-01

    In the fall of 2004 a college began a program to integrate service-learning (S-L) projects into required engineering courses throughout the curriculum, so that students would be exposed to S-L in at least one course in each of eight semesters. The ultimate goal is to graduate better engineers and more engaged citizens and to improve communities,…

  4. 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…

  5. Needs Assessments: An Integrated Assignment in Civic Service

    ERIC Educational Resources Information Center

    Norris, Debra S.; Schwartz, Charles L.

    2009-01-01

    An undergraduate social work program developed a service-learning experience in partnership with a local United Way organization to complete a community needs assessment project. The experience integrated the curricula of a social work research methods course and a generalist-macro practice course with the principles and actions of experiential…

  6. 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.

  7. 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…

  8. Integrated Services Digital Networks: Concepts, Policies, and Emerging Issues.

    ERIC Educational Resources Information Center

    Wigand, Rolf T.

    1988-01-01

    Describes the nature and operations of Integrated Services Digital Networks (ISDN). Argues that while Western European nations have advanced centralized planning for the introduction of ISDN, the United States is proceeding slowly because of a lack of universal standards and the state of deregulatory policy. (MM)

  9. Analyzing Morton's Typology of Service Paradigms and Integrity

    ERIC Educational Resources Information Center

    Bringle, Robert G.; Hatcher, Julie A.; McIntosh, Rachel E.

    2006-01-01

    Research on college students found limited support for Morton's (1995) hypothesis that students have a preference for one distinct type of service orientation (i.e., charity, project, social change). The findings did replicate previous findings that college students prefer the charity paradigm. A measure of integrity was developed and two…

  10. A Model for Integrating Low Vision Services into Educational Programs.

    ERIC Educational Resources Information Center

    Jose, Randall T.; And Others

    1988-01-01

    A project integrating low-vision services into children's educational programs comprised four components: teacher training, functional vision evaluations for each child, a clinical examination by an optometrist, and follow-up visits with the optometrist to evaluate the prescribed low-vision aids. Educational implications of the project and project…

  11. University Educational Service Delivery Strategy in a Changing World: Implications for Ethical Values and Leadership Integrity in Nigeria

    ERIC Educational Resources Information Center

    Akintayo, D. I.

    2008-01-01

    This paper examined university educational service delivery strategy in a changing world as it affects ethical values and leadership integrity in Nigeria. This was for the purpose of determining appropriate strategies for improving the quality of service delivery system in Nigerian universities. The paper submits that the quality and quantity of…

  12. A Service Portal for the Integrated SCaN Network

    NASA Technical Reports Server (NTRS)

    Marx, Sarah R.

    2012-01-01

    The Space Communication and Navigation (SCaN) program office owns the assets and services provided by the Deep Space Network (DSN), Near Earth Network (NEN), and Space Network (SN). At present, these individual networks are operated by different NASA centers--JPL for DSN--and Goddard Space Flight Center (GSFC) for NEN and SN--with separate commitments offices for each center. In the near future, SCaN's program office would like to deploy an integrated service portal which would merge the two commitments offices with the goal of easing the task of user planning for space missions requiring services of two or more of these networks. Following interviews with subject matter experts in this field, use cases were created to include the services and functionality mission users would like to see in this new integrated service portal. These use cases provide a guideline for a mock-up of the design of the user interface for the portal. The benefit of this work will ease the time required and streamline/standardize the process for planning and scheduling SCAN's services for future space missions.

  13. Autonomous Preference-Aware Information Services Integration for High Response in Integrated Faded Information Field Systems

    NASA Astrophysics Data System (ADS)

    Lu, Xiaodong; Mori, Kinji

    The market and users' requirements have been rapidly changing and diversified. Under these heterogeneous and dynamic situations, not only the system structure itself, but also the accessible information services would be changed constantly. To cope with the continuously changing conditions of service provision and utilization, Faded Information Field (FIF) has been proposed, which is a agent-based distributed information service system architecture. In the case of a mono-service request, the system is designed to improve users' access time and preserve load balancing through the information structure. However, with interdependent requests of multi-service increasing, adaptability and timeliness have to be assured by the system. In this paper, the relationship that exists among the correlated services and the users' preferences for separate and integrated services is clarified. Based on these factors, the autonomous preference-aware information services integration technology to provide one-stop service for users multi-service requests is proposed. As compared to the conventional system, we show that proposed technology is able to reduce the total access time.

  14. Upstairs downstairs: vertical integration of a pediatric service.

    PubMed

    Racine, A D; Stein, R E; Belamarich, P F; Levine, E; Okun, A; Porder, K; Rosenfeld, J L; Schechter, M

    1998-07-01

    The combined effects of recent changes in health care financing and training priorities have compelled academic medical centers to develop innovative structures to maintain service commitments yet conform to health care marketplace demands. In 1992, a municipal hospital in the Bronx, New York, affiliated with a major academic medical center reorganized its pediatric service into a vertically integrated system of four interdependent practice teams that provided comprehensive care in the ambulatory as well as inpatient settings. One of the goals of the new system was to conserve inpatient resources. To describe the development of a new vertically integrated pediatric service at an inner-city municipal hospital and to test whether its adoption was associated with the use of fewer inpatient resources. A descriptive analysis of the rationale, goals, implementation strategies, and structure of the vertically integrated pediatric service combined with a before-and-after comparison of in-hospital resource consumption. A before-and-after comparison was conducted for two periods: the period before vertical integration, from January 1989 to December 1991, and the period after the adoption of vertical integration, from July 1992 to December 1994. Four measures of inpatient resource use were compared after adjustment for case mix index: mean certified length of stay per case, mean number of radiologic tests per case, mean number of ancillary tests per case, and mean number of laboratory tests per case. Difference-in-differences-in-differences estimators were used to control for institution-wide trends throughout the time period and regional trends in inpatient pediatric practice occurring across institutions. Results. In 1992, the Department of Pediatrics at the Albert Einstein College of Medicine reorganized the pediatric service at Jacobi Medical Center, one of its principal municipal hospital affiliates, into a vertically integrated pediatric service that combines ambulatory

  15. Career Education for Mental Health Workers. Integrative Seminar in Human Service. Human Service Instructional Series. Module No. 5.

    ERIC Educational Resources Information Center

    Redcay, Shirley

    This module on an integrative seminar in human service is one of a set of six developed to prepare human services workers for the changing mental health service delivery system. A total of eight objectives are included to help students integrate previously learned knowledge and skills into a process of assessing service need, developing treatment…

  16. 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.

  17. Integration of family planning with national health services. Integration de la planification familiale aux services nationaux de sante.

    PubMed

    Mandara, N

    1984-09-01

    After independence in the 1960s, most African government inherited health structures that were curative oriented, costly, and directed toward the urban population. Primary health care, oriented toward prevention, promotion, improvement of the environment, cure, and rehabilitation, has since been adopteed as a better approach to health in Africa. This approach aims to integrate health care with thee activities of other seectors and places relicance on available community resources. An unexpected change has been the transformation of social and political attitudes toward family planning as a basic human right, a concomitant to heealth, and an integral part of socioeconomic development. Family planning is gradually being integrated into the maternal and child health services of all countries in Sub-Saharan Africa. In some cases, the government has assumed service delivery responsibilities previously carried out by family planning associations, thereby changing the association's role to that of education and motivation. Other countries have faced duplication of services and wastage of resources as a result of integration. There is a need for an overall evaluation of the integrated family planning-maternal and child heath services to determine future priorities and strategies. Problems so far encountered have included coverage, acceptability, accessibility, quality and continuity of care, data collection, and limited resources. However, cost factors, the shortage of trained manpower, the lack of facilities, and prevailing cultural and religious attitudes suggest the advisibility of integrated rather than vertical health programs in Africa. For both planning and administrative purposes, it is necessary to have a central Maternal and Child Health-Family Planning unit within the Ministry of Health as well as regional and district units.

  18. 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

  19. Integrating complementary medicine and health care services into practice.

    PubMed Central

    LaValley, J W; Verhoef, M J

    1995-01-01

    Complementary medicine and health care services constitute a significant proportion of the use of health care services in Canada, despite a history of limited acceptance of these therapies by the medical profession. However, physician attitudes appear to be changing. A survey of a random sample of general practitioners in Quebec (see page 29 of this issue) shows that four out of five general practitioners perceive at least one of three complementary health care services to be useful. Similar surveys of samples in Alberta and Ontario suggest that physicians there, although somewhat less enthusiastic than their counterparts in Quebec, have also begun to be more open-minded about these types of therapies. However, physicians have reported little understanding of complementary health care services, which suggests the need for more research on and education about these services. The Medical Society of Nova Scotia has responded to this need by establishing a Section of Complementary Medicine. The authors believe that fair, accountable, scientific and rigorous research on complementary therapies will benefit physicians and patients. The problems inherent in applying reductionist analysis to a holistic approach to care can be largely circumvented by focusing on outcomes research. In light of the popularity of these therapies, inquiry into patient use of complementary health care services should become a part of a complete patient history. This measure would promote greater patient-physician communication and integration of complementary health care services into patient care. PMID:7796375

  20. Barriers and enablers to integrating maternal and child health services to antenatal care in low and middle income countries.

    PubMed

    de Jongh, T E; Gurol-Urganci, I; Allen, E; Jiayue Zhu, N; Atun, R

    2016-03-01

    Antenatal care (ANC) represents a delivery platform for a broad range of health services; however, these opportunities are insufficiently utilised. This review explores key barriers and enablers for successful integration of health s"ervices with ANC in different contexts. Data from peer-reviewed and grey literature were organised using the SURE checklist. We identified 46 reports focusing on integration of HIV, tuberculosis, malaria, syphilis or nutrition services with ANC from Asia, Africa and the Pacific. Perspectives of service users and providers, social and political factors, and health system characteristics (such as resource availability and organisational structures) affected ease of integration. Health system factors, context and stakeholders must be considered for integrated antenatal care services. © 2016 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  1. Integrated mental health services in England: a policy paradox

    PubMed Central

    England, Elizabeth; Lester, Helen

    2005-01-01

    Abstract Purpose The purpose of this paper is to examine the effects of health care policy on the development of integrated mental health services in England. Data sources Drawing largely from a narrative review of the literature on adult mental health services published between January 1997 and February 2003 undertaken by the authors, we discuss three case studies of integrated care within primary care, secondary care and across the primary/secondary interface for people with serious mental illness. Conclusion We suggest that while the central thrust of a raft of recent Government policies in England has been towards integration of different parts of the health care system, policy waterfalls and implementation failures, the adoption of ideas before they have been thoroughly tried and tested, a lack of clarity over roles and responsibilities and poor communication have led to an integration rhetoric/reality gap in practice. This has particular implications for people with serious mental health problems. Discussion We conclude with suggestions for strategies that may facilitate more integrated working. PMID:16773165

  2. Mutual benefits in academic-service partnership: An integrative review.

    PubMed

    Sadeghnezhad, Maliheh; Heshmati Nabavi, Fatemeh; Najafi, Fereshteh; Kareshki, Hossein; Esmaily, Habibollah

    2018-05-30

    Academic and service institutions involve with many challenges. Partnership programs are a golden opportunity to achieve mutual benefits to overcome these challenges. Identifying mutual benefits is the cornerstone of forming a successful partnership and guarantee to its continuity. There are definitions and instances of mutual benefits in the literature related to partnership programs, but there is no coherent evidence and clear picture of these benefits. This study is conducted to identify mutual benefits in academic-service partnership by analyzing the definitions and instances of it in the literature. An integrative review of key papers regarding mutual benefits in academic-service partnership was undertaken. This review was guided by the framework described by Whittemore and Knafl. Search of the following databases was conducted: MEDLINE, ERIC, Google Scholar, Emerald Insight and Science Direct. The search terms were mutual benefits, mutual gains, mutual interest, mutual expectations, mutual goals, mutual demand, partnership, collaboration, academic-service partnership and academic service collaboration. Cooper's five-stage integrative review method was used. Quality evaluation of articles was conducted. Data were abstracted from included articles. The analysis was conducted based on the qualitative content analysis of the literature suggested by Zhang and Wildemuth. 28 articles were included in this review. Mutual benefits are described in four categories include: synergy in training and empowerment of human resources, education improvement, access to shared resources, facilitate production and application of beneficial knowledge into practice. Mutual benefits in the academic-service partnership include a range of goals, interests, expectations, and needs of partner organizations that is achievable and measurable through joint planning and collaboration. We suggest academic and service policymakers to consider these benefits in the planning and evaluating

  3. 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

  4. 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…

  5. LEOPACK The integrated services communications system based on LEO satellites

    NASA Astrophysics Data System (ADS)

    Negoda, A.; Bunin, S.; Bushuev, E.; Dranovsky, V.

    LEOPACK is yet another LEO satellite project which provides global integrated services for 'business' communications. It utilizes packet rather then circuit switching in both terrestrial and satellite chains as well as cellular approach for frequencies use. Original multiple access protocols and decentralized network control make it possible to organize regionally or logically independent and world-wide networks. Relatively small number of satellites (28) provides virtually global network coverage.

  6. 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.

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

    PubMed

    Griffith, Karen; Strasser, Patricia B

    2010-12-01

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

  8. 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.

  9. Implementing PEHR: Design and Integration of a Consent Creator Service.

    PubMed

    Weiss, Nicolas; Aguduri, Lakshmi S; Yüksekogul, Nilay; Schreiweis, Björn; Brandner, Antje; Bronsch, Tobias; Pensold, Peter; Stein, Katharina E; Bergh, Björn; Heinze, Oliver

    2016-01-01

    Giving the patient full control over his medical data electronically remains one of the most discussed topics in healthcare today. The INFOPAT project in the Rhine-Neckar region focuses on a personal cross-enterprise electronic health record (PEHR) in which the patient plays a major role. Thus, he should be provided with the possibility of granting access to his medical data which could be realized using a consent creator service. This paper presents a user interface concept for such a service as well as aspects for the technical implementation. In addition, a pattern for integrating the service into an existing IHE based infrastructure is shown. These concepts could be further adapted for improving patient empowerment in health care projects.

  10. 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

  11. Integrating service development with evaluation in telehealthcare: an ethnographic study

    PubMed Central

    Finch, Tracy; May, Carl; Mair, Frances; Mort, Maggie; Gask, Linda

    2003-01-01

    Objectives To identify issues that facilitate the successful integration of evaluation and development of telehealthcare services. Design Ethnographic study using various qualitative research techniques to obtain data from several sources, including in-depth semistructured interviews, project steering group meetings, and public telehealthcare meetings. Setting Seven telehealthcare evaluation projects (four randomised controlled trials and three pragmatic service evaluations) in the United Kingdom, studied over two years. Projects spanned a range of specialties—dermatology, psychiatry, respiratory medicine, cardiology, and oncology. Participants Clinicians, managers, technical experts, and researchers involved in the projects. Results and discussion Key problems in successfully integrating evaluation and service development in telehealthcare are, firstly, defining existing clinical practices (and anticipating changes) in ways that permit measurement; secondly, managing additional workload and conflicting responsibilities brought about by combining clinical and research responsibilities (including managing risk); and, thirdly, understanding various perspectives on effectiveness and the limitations of evaluation results beyond the context of the research study. Conclusions Combined implementation and evaluation of telehealthcare systems is complex, and is often underestimated. The distinction between quantitative outcomes and the workability of the system is important for producing evaluative knowledge that is of practical value. More pragmatic approaches to evaluation, that permit both quantitative and qualitative methods, are required to improve the quality of such research and its relevance for service provision in the NHS. PMID:14630758

  12. Integrating service development with evaluation in telehealthcare: an ethnographic study.

    PubMed

    Finch, Tracy; May, Carl; Mair, Frances; Mort, Maggie; Gask, Linda

    2003-11-22

    To identify issues that facilitate the successful integration of evaluation and development of telehealthcare services. Ethnographic study using various qualitative research techniques to obtain data from several sources, including in-depth semistructured interviews, project steering group meetings, and public telehealthcare meetings. Seven telehealthcare evaluation projects (four randomised controlled trials and three pragmatic service evaluations) in the United Kingdom, studied over two years. Projects spanned a range of specialties-dermatology, psychiatry, respiratory medicine, cardiology, and oncology. Clinicians, managers, technical experts, and researchers involved in the projects. Key problems in successfully integrating evaluation and service development in telehealthcare are, firstly, defining existing clinical practices (and anticipating changes) in ways that permit measurement; secondly, managing additional workload and conflicting responsibilities brought about by combining clinical and research responsibilities (including managing risk); and, thirdly, understanding various perspectives on effectiveness and the limitations of evaluation results beyond the context of the research study. Combined implementation and evaluation of telehealthcare systems is complex, and is often underestimated. The distinction between quantitative outcomes and the workability of the system is important for producing evaluative knowledge that is of practical value. More pragmatic approaches to evaluation, that permit both quantitative and qualitative methods, are required to improve the quality of such research and its relevance for service provision in the NHS.

  13. Factors Affecting Post-Service Wage Growth for Veterans

    DTIC Science & Technology

    1991-12-01

    Labor economics is primarily concerned with how employers and employees respond to changes in wages, prices, profits, and the non-pecuniary aspects...of the employment reLaticnship [Ref: 4, pg. 31 Two of the basic assumptions underlying labor economics are Lhat resources are scarce, and that people...Retiree’ Post-Service Earnigs and Empjoyment, February 1981, Fand Corporation. 4. Ehrenberq, R. G. and Smith, R. S., Modern Labor Economics . 3ra Edit on

  14. 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...

  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. 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…

  17. Factors affecting social integration of noninstitutionalized mentally retarded adults.

    PubMed

    Reiter, S; Levi, A M

    1980-07-01

    The social integration of noninstitutionalized moderately and mildly mentally retarded young adults was investigated. A group of moderately and mildly retarded adults (study group) was compared with a group of borderline retarded (control group) adults on employability, behavior at work, social integration and social skills, personality, and self-concept. Findings indicated that the study group was less well integrated at work and in society than was the control group and showed lack of social skills. The retarded adults who had nonretarded friends showed better social-educational skills than did the other subjects. Findings suggest that even retarded individuals who grow up in the community need help in order to become socially independent. The existence of a special social club for retarded adults was found to fulfill the functions of a sheltered framework. Participants in the club showed more positive self-concepts; however, the club did not seem to prepare them for social integration in the general community.

  18. 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

  19. Nurses' Needs for Care Robots in Integrated Nursing Care Services.

    PubMed

    Lee, Jai-Yon; Song, Young Ae; Jung, Ji Young; Kim, Hyun Jeong; Kim, Bo Ram; Do, Hyun-Kyung; Lim, Jae-Young

    2018-05-13

    To determine the need for care robots among nurses and to suggest how robotic care should be prioritized in an integrated nursing care services. Korea is expected to be a super-aged society by 2030. To solve care issues with elderly inpatient caused by informal caregivers, the government introduced 'integrated nursing care services'; these are comprehensive care systems staffed by professionally trained nurses. To assist them, a care robot development project has been launched. The study applied a cross-sectional survey. In 2016, we conducted a multi-center survey involving 302 registered nurses in five hospitals including three tertiary and two secondary hospitals in Korea. The questionnaire consisted of general characteristics of nurses and their views on and extents of agreement about issues associated with robotic care. Trial center nurses and those with ≥10 years of experience reported positively on the prospects for robotic care. The top three desired primary roles for care robots were 'measuring/monitoring', 'mobility/activity' and 'safety care'. 'Reduction in workload', especially in terms of 'other nursing services' which were categorized as non-value-added nursing activities, was the most valued feature. The nurses approved of the aid by care robots but were concerned about device malfunction and interruption of rapport with patients. Care robots are expected to be effective in integrated nursing care services, particularly in 'measuring/monitoring'. Such robots should decrease nurses' workload and minimize non-value-added nursing activities efficiently. No matter how excellent care robots are, they must co-operate with and be controlled by nurses. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  20. Evaluating the Impact of Integrated Care on Service Utilization in Serious Mental Illness.

    PubMed

    Waters, Heidi C; Furukawa, Michael F; Jorissen, Shari L

    2018-06-14

    Serious mental illness (SMI) affects 5% of the United States population and is associated with increased morbidity and mortality, and use of high-cost healthcare services including hospitalizations and emergency department visits. Integrating behavioral and physical healthcare may improve care for consumers with SMI, but prior research findings have been mixed. This quantitative retrospective cohort study assessed whether there was a predictive relationship between integrated healthcare clinic enrollment and inpatient and emergency department utilization for consumers with SMI when controlling for demographic characteristics and disease severity. While findings indicated no statistically significant impact of integrated care clinic enrollment on utilization, the sample had lower levels of utilization than would have been expected. Since policy and payment structures continue to support integrated care models, further research on different programs are encouraged, as each setting and practice pattern is unique.

  1. Integrating the provision of ecosystem services and trawl fisheries for the management of the marine environment.

    PubMed

    Muntadas, Alba; de Juan, Silvia; Demestre, Montserrat

    2015-02-15

    The species interaction and their biological traits (BT) determine the function of benthic communities and, hence, the delivery of ecosystem services. Therefore, disturbance of benthic communities by trawling may compromise ecosystem service delivery, including fisheries' catches. In this work, we explore 1) the impact of trawling activities on benthic functional components (after the BTA approach) and 2) how trawling impact may affect the ecosystem services delivered by benthic communities. To this aim, we assessed the provision of ecosystem services by adopting the concept of Ecosystem Service Providers (ESP), i.e. ecological units that perform ecosystem functions that will ultimately deliver ecosystem services. We studied thirteen sites subjected to different levels of fishing effort in the Mediterranean. From a range of environmental variables included in the study, we found ESPs to be mainly affected by fishing effort and grain size. Our results suggested that habitat type has significant effects on the distribution of ESPs and this natural variability influences ESP response to trawling at a specific site. In order to summarize the complex relationships between human uses, ecosystem components and the demand for ecosystem services in trawling grounds, we adapted a DPSIR (Drivers-Pressures-State Change-Impact-Response) framework to the study area, emphasizing the role of society as Drivers of change and actors demanding management Responses. This integrative framework aims to inform managers about the interactions between all the elements involved in the management of trawling grounds, highlighting the need for an integrated approach in order to ensure ecosystem service provision. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. A systematic approach to the planning, implementation, monitoring, and evaluation of integrated health services.

    PubMed

    Reynolds, Heidi W; Sutherland, Elizabeth G

    2013-05-06

    Because of the current emphasis and enthusiasm focused on integration of health systems, there is a risk of piling resources into integrated strategies without the necessary systems in place to monitor their progress adequately or to measure impact, and to learn from these efforts. The rush to intervene without adequate monitoring and evaluation will continue to result in a weak evidence base for decision making and resource allocation. Program planning and implementation are inextricability linked to monitoring and evaluation. Country level guidance is needed to identify country-specific integrated strategies, thereby increasing country ownership. This paper focuses on integrated health services but takes into account how health services are influenced by the health system, managed by programs, and made up of interventions. We apply the principles in existing comprehensive monitoring and evaluation (M&E) frameworks in order to outline a systematic approach to the M&E of integration for the country level. The approach is grounded by first defining the country-specific health challenges that integration is intended to affect. Priority points of contact for care can directly influence health, and essential packages of integration for all major client presentations need to be defined. Logic models are necessary to outline the plausible causal pathways and define the inputs, roles and responsibilities, indicators, and data sources across the health system. Finally, we recommend improvements to the health information system and in data use to ensure that data are available to inform decisions, because changes in the M&E function to make it more integrated will also facilitate integration in the service delivery, planning, and governance components. This approach described in the paper is the ideal, but its application at the country level can help reveal gaps and guide decisions related to what health services to prioritize for integration, help plan for how to

  3. Integrating adaptive management and ecosystem services concepts to improve natural resource management: Challenges and opportunities

    USGS Publications Warehouse

    Epanchin-Niell, Rebecca S.; Boyd, James W.; Macauley, Molly K.; Scarlett, Lynn; Shapiro, Carl D.; Williams, Byron K.

    2018-05-07

    Executive Summary—OverviewNatural resource managers must make decisions that affect broad-scale ecosystem processes involving large spatial areas, complex biophysical interactions, numerous competing stakeholder interests, and highly uncertain outcomes. Natural and social science information and analyses are widely recognized as important for informing effective management. Chief among the systematic approaches for improving the integration of science into natural resource management are two emergent science concepts, adaptive management and ecosystem services. Adaptive management (also referred to as “adaptive decision making”) is a deliberate process of learning by doing that focuses on reducing uncertainties about management outcomes and system responses to improve management over time. Ecosystem services is a conceptual framework that refers to the attributes and outputs of ecosystems (and their components and functions) that have value for humans.This report explores how ecosystem services can be moved from concept into practice through connection to a decision framework—adaptive management—that accounts for inherent uncertainties. Simultaneously, the report examines the value of incorporating ecosystem services framing and concepts into adaptive management efforts.Adaptive management and ecosystem services analyses have not typically been used jointly in decision making. However, as frameworks, they have a natural—but to date underexplored—affinity. Both are policy and decision oriented in that they attempt to represent the consequences of resource management choices on outcomes of interest to stakeholders. Both adaptive management and ecosystem services analysis take an empirical approach to the analysis of ecological systems. This systems orientation is a byproduct of the fact that natural resource actions affect ecosystems—and corresponding societal outcomes—often across large geographic scales. Moreover, because both frameworks focus on

  4. Optimizing the interventional cardiology facility: services integration in routine workflow.

    PubMed

    Gortzis, Lefteris; Kalogeropoulos, A; Alexopoulos, D; Nikiforidis, G

    2007-01-01

    Integration of administrative and clinical data, imaging, and expert services, although challenging,is a key requirement in contemporary interventional cardiology facilities (ICF). We propose a workflow-oriented hybrid system to support the ICF and investigate its feasibility and effectiveness ina referral medical center. We have developed a Java-powered hybrid system (NetCARDIO), able to support over web synchronous and asynchronous data management, realtime multimedia data telemonitoring and continuous telementoring. Data regarding procedural rates, treatment planning and radiation exposure were collected over a two-year period of routine NetCARDIO implementation(July 2002 to June 2004) and compared with data from an immediately preceding period of equal duration (January 2000 to December 2001). During the NetCARDIO period, 163 +/- 17 coronary procedures per month were performed vs.77 +/- 15 during the control period (p <0.001). Percutaneous coronary intervention was delivered 'ad hoc' in 88% of eligible patients vs. 45% (p <0.001). Mean fluoroscopy time per coronary lesion treated decreased from 594 +/- 82 s to 540 +/- 94 s(p < 0.001). Annual radiation exposure of expert interventionists was decreased by 22%. Electronic storage significantly reduced archiving costs. Real-time multimodal services sharing combined with powerful database capabilities is feasible through a web-based structure, significantly enhancing performance and cost-effectiveness of ICF. Further research is needed to promote integration of additional data sources and services.

  5. 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

  6. Integration of High-Performance Computing into Cloud Computing Services

    NASA Astrophysics Data System (ADS)

    Vouk, Mladen A.; Sills, Eric; Dreher, Patrick

    High-Performance Computing (HPC) projects span a spectrum of computer hardware implementations ranging from peta-flop supercomputers, high-end tera-flop facilities running a variety of operating systems and applications, to mid-range and smaller computational clusters used for HPC application development, pilot runs and prototype staging clusters. What they all have in common is that they operate as a stand-alone system rather than a scalable and shared user re-configurable resource. The advent of cloud computing has changed the traditional HPC implementation. In this article, we will discuss a very successful production-level architecture and policy framework for supporting HPC services within a more general cloud computing infrastructure. This integrated environment, called Virtual Computing Lab (VCL), has been operating at NC State since fall 2004. Nearly 8,500,000 HPC CPU-Hrs were delivered by this environment to NC State faculty and students during 2009. In addition, we present and discuss operational data that show that integration of HPC and non-HPC (or general VCL) services in a cloud can substantially reduce the cost of delivering cloud services (down to cents per CPU hour).

  7. 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.

  8. 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

  9. 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.

  10. A service platform architecture design towards a light integration of heterogeneous systems in the wellbeing domain.

    PubMed

    Yang, Yaojin; Ahtinen, Aino; Lahteenmaki, Jaakko; Nyman, Petri; Paajanen, Henrik; Peltoniemi, Teijo; Quiroz, Carlos

    2007-01-01

    System integration is one of the major challenges for building wellbeing or healthcare related information systems. In this paper, we are going to share our experiences on how to design a service platform called Nuadu service platform, for providing integrated services in occupational health promotion and health risk management through two heterogeneous systems. Our design aims for a light integration covering the layers, from data through service up to presentation, while maintaining the integrity of the underlying systems.

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

    PubMed Central

    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

    Background 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. Methods and Findings 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”. Conclusions 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. PMID:26800517

  12. 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

  13. 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

  14. Integrating Human and Ecosystem Health Through Ecosystem Services Frameworks.

    PubMed

    Ford, Adriana E S; Graham, Hilary; White, Piran C L

    2015-12-01

    The pace and scale of environmental change is undermining the conditions for human health. Yet the environment and human health remain poorly integrated within research, policy and practice. The ecosystem services (ES) approach provides a way of promoting integration via the frameworks used to represent relationships between environment and society in simple visual forms. To assess this potential, we undertook a scoping review of ES frameworks and assessed how each represented seven key dimensions, including ecosystem and human health. Of the 84 ES frameworks identified, the majority did not include human health (62%) or include feedback mechanisms between ecosystems and human health (75%). While ecosystem drivers of human health are included in some ES frameworks, more comprehensive frameworks are required to drive forward research and policy on environmental change and human health.

  15. Integration services to enable regional shared electronic health records.

    PubMed

    Oliveira, Ilídio C; Cunha, João P S

    2011-01-01

    eHealth is expected to integrate a comprehensive set of patient data sources into a coherent continuum, but implementations vary and Portugal is still lacking on electronic patient data sharing. In this work, we present a clinical information hub to aggregate multi-institution patient data and bridge the information silos. This integration platform enables a coherent object model, services-oriented applications development and a trust framework. It has been instantiated in the Rede Telemática de Saúde (www.RTSaude.org) to support a regional Electronic Health Record approach, fed dynamically from production systems at eight partner institutions, providing access to more than 11,000,000 care episodes, relating to over 350,000 citizens. The network has obtained the necessary clearance from the Portuguese data protection agency.

  16. Integrating child welfare, juvenile justice, and other agencies in a continuum of services.

    PubMed

    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 infrastructure facilitates integrated service delivery.

  17. Effect of organizational and environmental factors on service differentiation strategy of integrated healthcare networks.

    PubMed

    Lin, Y J; Wan, T T

    2001-02-01

    During the past decade, the missions/goals of medical providers of healthcare services in the United States have shifted--from emphasizing individual, independent illness treatments to focusing on the continuum of care, population-based wellness, and providing the appropriate care in the most efficient way. Integrated healthcare networks (IHNs)--or integrated healthcare delivery systems--have been focusing heavily on their level of various partnership integration (i.e. service differentiation strategy) in order to offer a full continuum of care. The aim of this study, using the individual IHN as the unit of analysis, was to identify organizational and environmental factors that influence IHN administrators to focus on their service differentiation of market lines, including the establishment of third-party payers' contracts, the affiliation of managed-care organizations, and the alliances of various nonhospital medical providers, to provide a continuum of care. The study findings show that tax status of an IHN, its age, and market competition affect its service differentiation strategy in the provision of a full continuum of care.

  18. The influence of nursing care integration services on nurses' work satisfaction and quality of nursing care.

    PubMed

    Ryu, Jeong-Im; Kim, Kisook

    2018-06-20

    To investigate differences in work satisfaction and quality of nursing services between nurses from the nursing care integration service and general nursing units in Korea. The nursing care integration service was recently introduced in Korea to improve patient health outcomes through the provision of high quality nursing services and to relieve the caregiving burden of patients' families. In this cross-sectional study, data were collected from a convenience sample of 116 and 156 nurses working in nursing care integration service and general units, respectively. The data were analysed using descriptive statistics, t tests and one-way analysis of variance. Regarding work satisfaction, nursing care integration service nurses scored higher than general unit nurses on professional status, autonomy and task requirements, but the overall scores showed no significant differences. Scores on overall quality of nursing services, responsiveness and assurance were higher for nursing care integration service nurses than for general unit nurses. Nursing care integration service nurses scored higher than general unit nurses on some aspects of work satisfaction and quality of nursing services. Further studies with larger sample sizes will contribute to improving the quality of nursing care integration service units. These findings can help to establish strategies for the implementation and efficient operation of the nursing care integration service system, for the improvement of the quality of nursing services, and for successfully implementing and expanding nursing care integration service services in other countries. © 2018 John Wiley & Sons Ltd.

  19. 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.

  20. 75 FR 20388 - International Business Machines Corporation, Global Technology Services Business Unit, Integrated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-19

    ... Expense Team, Working From Various States in the United States, Including On-Site Leased Workers From... Technology Services Business Unit, Integrated Technology Services, Cost and Expense Team working from various... Technology Services Business Unit, Integrated Technology Services, Cost and Expense Team. The Department has...

  1. Maternal and child health and family planning service utilization in Guatemala: implications for service integration.

    PubMed

    Seiber, Eric E; Hotchkiss, David R; Rous, Jeffrey J; Berruti, Andrés A

    2005-07-01

    Does the utilization of modern maternal and child health (MCH) services influence subsequent contraceptive use? The answer to this question holds important implications for proposals which advocate MCH and family planning service integration. This study uses data from the 1995/6 Guatemalan Demographic Health Survey and its 1997 Providers Census to test the influence of MCH service utilization on individual contraceptive use decisions. We use a full-information maximum likelihood regression model to control for unobserved heterogeneity. This model produces estimates of the MCH effect, independent of individual women's underlying receptiveness to MCH and contraceptive messages. The results of the analysis indicate that the intensity of MCH service use is indeed positively associated with subsequent contraceptive use among Guatemalan women, even after controlling for observed and unobserved individual- , household- , and community-level factors. Importantly, this finding holds even after controlling for the unobserved factors that 'predispose' some women to use both types of services. Simulations reveal that, for these Guatemalan women, key determinants such as age and primary schooling work indirectly through MCH service use to increase contraceptive utilization.

  2. 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.

  3. An introduction to family-centred services for children affected by HIV and AIDS.

    PubMed

    Richter, Linda

    2010-06-23

    Family-centred services in the context of HIV/AIDS acknowledge a broad view of a "family system" and ideally include comprehensive treatment and care, community agencies and coordinated case management. The importance of family-centred care for children affected by HIV/AIDS has been recognized for some time. There is a clear confluence of changing social realities and the needs of children in families affected by HIV and AIDS, but a change of paradigm in rendering services to children through families, in both high-prevalence and concentrated epidemic settings, has been slow to emerge.Despite a wide variety of model approaches, interventions, whether medical or psychosocial, still tend to target individuals rather than families. It has become clear that an individualistic approach to children affected by HIV and AIDS leads to confusion and misdirection of the global, national and local response. The almost exclusive focus on orphans, defined initially as a child who had lost one or both parents to AIDS, has occluded appreciation of the broader impact on children exposed to risk in other ways and the impact of the epidemic on families, communities and services for children. In addition, it led to narrowly focused, small-scale social welfare and case management approaches with little impact on government action, global and national policy, integration with health and education interventions, and increased funding.National social protection programmes that strengthen families are now established in several countries hard hit by AIDS, and large-scale pilots are underway in others. These efforts are supported by international and national development agencies, increasingly by governments and, more recently, by UNAIDS and the global AIDS community.There is no doubt that this is the beginning of a road and that there is still a long way to go, including basic research on families, family interventions, and effectiveness and costs of family-centred approaches. It is also

  4. 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.

  5. 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.

  6. 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.

  7. Service design attributes affecting diabetic patient preferences of telemedicine in South Korea.

    PubMed

    Park, Hayoung; Chon, Yucheong; Lee, Jongsu; Choi, Ie-Jung; Yoon, Kun-Ho

    2011-01-01

    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. 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. 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. 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.

  8. 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

  9. 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

  10. The EPOS Architecture: Integrated Services for solid Earth Science

    NASA Astrophysics Data System (ADS)

    Cocco, Massimo; Consortium, Epos

    2013-04-01

    The European Plate Observing System (EPOS) represents a scientific vision and an IT approach in which innovative multidisciplinary research is made possible for a better understanding of the physical processes controlling earthquakes, volcanic eruptions, unrest episodes and tsunamis as well as those driving tectonics and Earth surface dynamics. EPOS has a long-term plan to facilitate integrated use of data, models and facilities from existing (but also new) distributed research infrastructures, for solid Earth science. One primary purpose of EPOS is to take full advantage of the new e-science opportunities coming available. The aim is to obtain an efficient and comprehensive multidisciplinary research platform for the Earth sciences in Europe. The EPOS preparatory phase (EPOS PP), funded by the European Commission within the Capacities program, started on November 1st 2010 and it has completed its first two years of activity. EPOS is presently mid-way through its preparatory phase and to date it has achieved all the objectives, milestones and deliverables planned in its roadmap towards construction. The EPOS mission is to integrate the existing research infrastructures (RIs) in solid Earth science warranting increased accessibility and usability of multidisciplinary data from monitoring networks, laboratory experiments and computational simulations. This is expected to enhance worldwide interoperability in the Earth Sciences and establish a leading, integrated European infrastructure offering services to researchers and other stakeholders. The Preparatory Phase aims at leveraging the project to the level of maturity required to implement the EPOS construction phase, with a defined legal structure, detailed technical planning and financial plan. We will present the EPOS architecture, which relies on the integration of the main outcomes from legal, governance and financial work following the strategic EPOS roadmap and according to the technical work done during the

  11. Service Learning with Children Affected by Poverty: Facilitating Multicultural Competence in Counseling Education Students

    ERIC Educational Resources Information Center

    Baggerly, Jennifer

    2006-01-01

    The author defines and presents a rationale for service learning, provides procedures for implementing service learning with children affected by poverty, and describes methods of facilitating multicultural counseling competence. Examples are provided from a graduate counseling class that conducted group play therapy with 11 African American…

  12. 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

  13. Structural and leakage integrity of tubes affected by circumferential cracking

    SciTech Connect

    Hernalsteen, P.

    1997-02-01

    In this paper the author deals with the notion that circumferential cracks are generally considered unacceptable. He argues for the need to differentiate two facets of such cracks: the issue of the size and growth rate of a crack; and the issue of the structural strength and leakage potential of the tube in the presence of the crack. In this paper the author tries to show that the second point is not a major concern for such cracks. The paper presents data on the structural strength or burst pressure characteristics of steam generator tubes derived from models and data basesmore » of experimental work. He also presents a leak rate model, and compares the performance of circumferential and axial cracks as far as burst strength and leak rate. The final conclusion is that subject to improvement in NDE capabilities (sizing, detection, growth), that Steam Generator Defect Specific Management can be used to allow circumferentially degraded tubes to remain in service.« less

  14. Collinear integration affects visual search at V1.

    PubMed

    Chow, Hiu Mei; Jingling, Li; Tseng, Chia-huei

    2013-08-29

    Perceptual grouping plays an indispensable role in figure-ground segregation and attention distribution. For example, a column pops out if it contains element bars orthogonal to uniformly oriented element bars. Jingling and Tseng (2013) have reported that contextual grouping in a column matters to visual search behavior: When a column is grouped into a collinear (snakelike) structure, a target positioned on it became harder to detect than on other noncollinear (ladderlike) columns. How and where perceptual grouping interferes with selective attention is still largely unknown. This article contributes to this little-studied area by asking whether collinear contour integration interacts with visual search before or after binocular fusion. We first identified that the previously mentioned search impairment occurs with a distractor of five or nine elements but not one element in a 9 × 9 search display. To pinpoint the site of this effect, we presented the search display with a short collinear bar (one element) to one eye and the extending collinear bars to the other eye, such that when properly fused, the combined binocular collinear length (nine elements) exceeded the critical length. No collinear search impairment was observed, implying that collinear information before binocular fusion shaped participants' search behavior, although contour extension from the other eye after binocular fusion enhanced the effect of collinearity on attention. Our results suggest that attention interacts with perceptual grouping as early as V1.

  15. 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

  16. 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

  17. 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

  18. Immunization coverage in India for areas served by the Integrated Child Development Services programme. The Integrated Child Development Services Consultants.

    PubMed

    Tandon, B N; Gandhi, N

    1992-01-01

    The Integrated Child Development Services (ICDS) programme was launched by the Indian government in October 1975 to provide a package of health, nutrition and informal educational services to mothers and children. In 1988 we studied the impact of ICDS on the immunization coverage of children aged 12-24 months and of mothers of infants in 19 rural, 8 tribal, and 9 urban ICDS projects that had been operational for more than 5 years. Complete coverage with BCG, diphtheria-pertussis-tetanus (DPT) and poliomyelitis vaccines was recorded for 65%, 63%, and 64% of children, respectively, in the ICDS population. By comparison, the coverage in the non-ICDS group was only 22% for BCG, 28% for DPT, and 27% for poliomyelitis. Complete immunization with tetanus toxoid was recorded for 68% of the mothers in the ICDS group and for 40% in the non-ICDS group. Coverage was greater in the urban and lower in the tribal projects. Scheduled castes, scheduled tribes, backward communities, and minorities (groups that have a high priority for social services) had immunization coverages in ICDS projects that were similar to those of higher castes.

  19. 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.

  20. 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

  1. 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…

  2. Service system integration, access to services, and housing outcomes in a program for homeless persons with severe mental illness.

    PubMed

    Rosenheck, R; Morrissey, J; Lam, J; Calloway, M; Johnsen, M; Goldman, H; Randolph, F; Blasinsky, M; Fontana, A; Calsyn, R; Teague, G

    1998-11-01

    This study evaluated the hypothesis that greater integration and coordination between agencies within service systems is associated with greater accessibility of services and improved client housing outcomes. As part of the Access to Community Care and Effective Services and Supports program, data were obtained on baseline client characteristics, service use, and 3-month and 12-month outcomes from 1832 clients seen at 18 sites during the first year of program operation. Data on interorganizational relationships were obtained from structured interviews with key informants from relevant organizations in each community (n = 32-82 at each site). Complete follow-up data were obtained from 1340 clients (73%). After control for baseline characteristics, service system integration was associated with superior housing outcomes at 12 months, and this relationship was mediated through greater access to housing agencies. Service system integration is related to improved access to housing services and better housing outcomes among homeless people with mental illness.

  3. 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).

  4. Integrated telemedicine applications and services for oncological positron emission tomography.

    PubMed

    Kontaxakis, George; Visvikis, Dimitris; Ohl, Roland; Sachpazidis, Ilias; Suarez, Juan Pablo; Selby, Peter; Cheze-Le Rest, Catherine; Santos, Andres; Ortega, Fernando; Diaz, Javier; Pan, Leyun; Strauss, Ludwig; Dimitrakopoulou-Strauss, Antonia; Sakas, Georgios; Pozo, Miguel Angel

    2006-01-01

    TENPET (Trans European Network for Positron Emission Tomography) aims to evaluate the provision of integrated teleconsultation and intelligent computer supported cooperative work services for clinical positron emission tomography (PET) in Europe at its current stage, as it is a multi-centre project financially supported by the European Commission (Information Society, eTEN Program). It addresses technological challenges by linking PET centres and developing supporting services that permit remote consultation between professionals in the field. The technological platform (CE-marked) runs on Win2000/NT/XP systems and incorporates advanced techniques for image visualization, analysis and fusion, as well as for interactive communication and message handling for off-line communications. Four PET Centres from Spain, France and Germany participate to the pilot system trials. The performance evaluation of the system is carried out via log files and user-filled questionnaires on the frequency of the teleconsultations, their duration and efficacy, quality of the images received, user satisfaction, as well as on privacy, ethical and security issues. TENPET promotes the co-operation and improved communication between PET practitioners that are miles away from their peers or on mobile units, offering options for second opinion and training and permitting physicians to remotely consult patient data if they are away from their centre. It is expected that TENPET will have a significant impact in the development of new skills by PET professionals and will support the establishment of peripheral PET units. To our knowledge, TENPET is the first telemedicine service specifically designed for oncological PET. This report presents the technical innovations incorporated in the TENPET platform and the initial pilot studies at real and diverse clinical environments in the field of oncology.

  5. Integration of RFID and web service for assisted living.

    PubMed

    Unluturk, Mehmet S; Kurtel, Kaan

    2012-08-01

    The number of people over 65 years old throughout most stable and prosperous countries in the world is increasing. Availability of their care in their own homes is imperative because of the economic reasons and their choices where to live (World Health Organization, Definition of an older or elderly person. http://www.who.int/healthinfo/survey/ageingdefnolder/en/ ; EQUIP-European Framework for Qualifications in Home Care Services for Older People, http://www.equip-project.com ; Salonen, 2009). "Recent advancement in wireless communications and electronics has enabled the development of low-cost sensor networks. The sensor networks can be utilized in various application areas." (Akyildiz, et al. 2002) These two statements show that there is a great promise in wireless technology and utilizing it in assisted living might be very beneficial to the elderly people. In this paper, we propose software architecture called Location Windows Service (LWS) which integrates the Radio Frequency Identification (RFID) technology and the web service to build an assisted living system for elderly people at home. This architecture monitors the location of elderly people without interfering in their daily activities. Location information messages that are generated as the elderly move from room to room indicate that the elderly person is fit and healthy and going about their normal life. The communication must be timely enough to follow elderly people as they move from room to room without missing a location. Unacknowledged publishing, subscription filtering and short location change messages are also included in this software model to reduce the network traffic in large homes. We propose some defense schemes being applied to the network environment of the assisted living system to prevent any external attacks.

  6. 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

  7. Development and Integration of WWW-Based Services in an Existing University Environment.

    ERIC Educational Resources Information Center

    Garofalakis, John; Kappos, Panagiotis; Tsakalidis, Athanasios; Tsaknakis, John; Tzimas, Giannis; Vassiliadis, Vassilios

    This paper describes the experience and the problems solved in the process of developing and integrating advanced World Wide Web-based services into the University of Patras (Greece) system. In addition to basic network services (e.g., e-mail, file transfer protocol), the final system will integrate the following set of advanced services: a…

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

    PubMed

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

    2006-10-01

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

  9. Collaborative Inquiry: Building Pre-Service Teachers' Capacity for ICT Pedagogical Integration

    ERIC Educational Resources Information Center

    Henderson, Michael; Cerovac, Milorad; Bellis, Natalie; Lancaster, Greg

    2013-01-01

    As part of the Teaching Teachers for the Future (TTF) project, Monash University initiated several strategies to assist pre-service teachers' integration of ICTs in their classroom practice. These included modelling of ICT pedagogical integration, assessment of ICT pedagogical integration, relocating pre-service teacher classes to a working…

  10. 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…

  11. Measuring the degree of integrated tuberculosis and HIV service delivery in Cape Town, South Africa.

    PubMed

    Uyei, Jennifer; Coetzee, David; Macinko, James; Weinberg, Sharon L; Guttmacher, Sally

    2014-01-01

    To address the considerable tuberculosis (TB)/HIV co-infected population in Cape Town, a number of clinics have made an effort of varying degrees to integrate TB and HIV services. This article describes the development of a theory-based survey instrument designed to quantify the extent to which services were integrated in 33 clinics and presents the results of the survey. Using principal factor analysis, eight factors were extracted and used to make comparisons across three types of clinics: co-located TB and antiretroviral therapy (ART) services, clinics with TB services only and clinics with ART only. Clinics with co-located services scored highest on measures related to integrated TB/ART service delivery compared to clinics with single services, but within group variability was high indicating that co-location of TB and ART services is a necessary but insufficient condition for integrated service delivery. In addition, we found almost all clinics with only TB services in our sample had highly integrated pre-ART services, suggesting that integration of these services across a large number of clinics is feasible and acceptable to clinic staff. TB clinics with highly integrated pre-ART services appear to be efficient sites for introducing ART given that co-infected patients are already engaged in care, and may potentially facilitate earlier access to treatment and minimize loss to follow-up.

  12. 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

  13. 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

  14. Factors affecting utilization of university health services in a tertiary institution in South-West Nigeria.

    PubMed

    Obiechina, G O; Ekenedo, G O

    2013-01-01

    Most university health services have extensive health infrastructures, for the provision of effective and efficient health services to the students. In this study, we have tried to determine student's perception of factors affecting their utilization. To determine students' perception of health care services provided in a tertiary institution and assess students' attitude towards utilization. Simple random sampling technique was used to select 540 respondents, comprising of 390 males and 150 females. A structured and self-administered questionnaire was the instrument used to collect data for the study, while data collected was analyzed using descriptive statistics of frequency count and percentage. High cost of drugs (72.0%), non availability of essential drugs (54.8%), time spent waiting for treatment (67.2%), inadequate referral services (81.7%), and satisfaction with services (60.6%) were considered by the respondents as factors affecting the utilization of university health services. Students-medical staff relationship and accessibility to health facility (77.6% and 74.3% respectively) were, however, not considered as factors that affect utilization of university health services. It is recommended that to improve utilization and cost of care, government should make necessary efforts to incorporate tertiary institution into National Health Insurance scheme so that students above the age of 18 years can benefit from free treatment.

  15. 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

  16. 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

  17. 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.

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

    PubMed

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

    2012-05-08

    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.

  19. 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

  20. The Potential Role of the School as a Site for Integrating Social Services. A Report.

    ERIC Educational Resources Information Center

    Baillie, Susan; And Others

    Physically integrating social services with schools might be a feasible way of providing social services at a lower cost and/or might lead to improved social services. Examination of 10 school/social service complexes reveals an attempt to redefine the neighborhood at the same time enlarging and rendering it less parochial. The rapidly expanding…

  1. 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…

  2. Integration of leprosy services into the General Health Service in Sri Lanka: overcoming challenges to implementation in a remote district.

    PubMed

    Wijesinghe, Thushanthi S; Wijesinghe, Pushpa Ranjan

    2013-01-01

    Sri Lanka took a policy decision to integrate leprosy services into the general health services (GHS) in 1999. This paper aims to summarize the emergence of new, specific challenges and how they were overcome during the integration of leprosy services to the GHS in a remote, leprosy endemic district in Sri Lanka. In this article, the regional epidemiologist as the team leader describes the principles used for transition to an effective integrated model of leprosy services from a centralized leprosy control model in the district. In addition, rationale for integration is viewed from the epidemiological and operational perspectives. National and district leprosy epidemiological data from secondary sources are also reviewed for corroborating the effectiveness of integration. Challenges surfaced were mainly related to the transfer of ownership of the programme, selection of appropriate service providing institutions easily accessible to clients, sustainability of leprosy services at the GHS, ensuring participation of all stakeholders in capacity building programmes and co-ordination of patient care in the absence of a dermatologist in the district. An empowered district team leader with specified roles and responsibilities, his sound technical and managerial know how and ability to translate 'team work' concept to practice were found to be essential for successful implementation of integration. Decision-making powers at the district level and flexibility to introduce new, area-specific changes to the centrally prepared core activities of integration were also vital to overcome locally surfaced challenges.

  3. 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.

  4. Ventromedial prefrontal cortex supports affective future simulation by integrating distributed knowledge.

    PubMed

    Benoit, Roland G; Szpunar, Karl K; Schacter, Daniel L

    2014-11-18

    Although the future often seems intangible, we can make it more concrete by imagining prospective events. Here, using functional MRI, we demonstrate a mechanism by which the ventromedial prefrontal cortex supports such episodic simulations, and thereby contributes to affective foresight: This region supports processes that (i) integrate knowledge related to the elements that constitute an episode and (ii) represent the episode's emergent affective quality. The ventromedial prefrontal cortex achieves such integration via interactions with distributed cortical regions that process the individual elements. Its activation then signals the affective quality of the ensuing episode, which goes beyond the combined affective quality of its constituting elements. The integrative process further augments long-term retention of the episode, making it available at later time points. This mechanism thus renders the future tangible, providing a basis for farsighted behavior.

  5. Ventromedial prefrontal cortex supports affective future simulation by integrating distributed knowledge

    PubMed Central

    Benoit, Roland G.; Szpunar, Karl K.; Schacter, Daniel L.

    2014-01-01

    Although the future often seems intangible, we can make it more concrete by imagining prospective events. Here, using functional MRI, we demonstrate a mechanism by which the ventromedial prefrontal cortex supports such episodic simulations, and thereby contributes to affective foresight: This region supports processes that (i) integrate knowledge related to the elements that constitute an episode and (ii) represent the episode’s emergent affective quality. The ventromedial prefrontal cortex achieves such integration via interactions with distributed cortical regions that process the individual elements. Its activation then signals the affective quality of the ensuing episode, which goes beyond the combined affective quality of its constituting elements. The integrative process further augments long-term retention of the episode, making it available at later time points. This mechanism thus renders the future tangible, providing a basis for farsighted behavior. PMID:25368170

  6. 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.

  7. 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/ .

  8. Factors affecting delays in first trimester pregnancy termination services in New Zealand.

    PubMed

    Silva, Martha; McNeill, Rob; Ashton, Toni

    2011-04-01

    To identify the factors affecting the timeliness of services in first trimester abortion service in New Zealand. Primary data were collected from all patients attending nine abortion clinics between February and May 2009. The outcome measured was delay between the first visit with a referring doctor and the date of the abortion procedure. Patient records (n=2,950) were audited to determine the timeline between the first point of entry to the health system and the date of abortion. Women were also invited to fill out a questionnaire identifying personal factors affecting access to services (n=1,086, response rate = 36.8%). Women who went to private clinic had a significantly shorter delay compared to public clinics. Controlling for clinic type, women who went to clinics that offered medical abortions or clinics that offered single day services experienced less delay. Also, women who had more than one visit with their referring doctor experienced a greater delay than those who had a single visit. The earlier in pregnancy women sought services the longer the delay. Women's decision-making did not have a significant effect on delay. Several clinic level and systemic factors are significantly associated with delay in first trimester abortion services. In order to ensure the best physical and emotional outcomes, timeliness of services must improve. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

  9. Service providers' perception of affective influences on decision-making about treatments for chronic pain.

    PubMed

    Brown, Cary A

    2004-01-07

    Service providers working with people who have complex health problems like chronic pain are considered at particular risk from the heavy emotional content of these interactions (frustration, guilt, hostility). For the good of service users and in the interests of healthcare workers' own health it is important for them to employ reflective practice acknowledging these issues. Service providers are inculcated to negate the affective domain of their practice despite the growing awareness that wellbeing can no longer be envisioned as a linear (cause and effect) process divorced from socio-cultural influences and attendant values and beliefs. The aim of this report is to examine to what degree service users (SU) and service providers (SP) believe their decisions about treatment importance are influenced by self-image and emotion. These results are extrapolated from a larger study based on a postal questionnaire that went to members of the Pain Society (UK Chapter of IASP) and service users belonging to chronic pain support groups in the North-West of England. The question of interest in this report asked participants to identify their level of agreement with statements about how four themes influence their decision-making about whether a treatment is important. The themes (coherence, purposiveness, self-image and affect) arise from Chapman's model of consciousness and pain. Only 20.5% of service providers rated the influence of self-image (what someone like me would think) as 3 (mostly) or 4 (completely). Service provider rating for the influence of affect (how this treatment makes me feel) were similarly low with only 19.4% of respondents selecting a rating of 3 or 4. In marked contrast, 73.3% of the service users selected self-image and 92.9% selected affect as a strong influence. Service providers felt that affect and self-image had little influence on their decision-making. However, there is growing evidence in the literature to suggest that it is not possible, nor

  10. 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…

  11. Effects of Affective Education Through Developmental Guidance Services: A One-Year Study.

    ERIC Educational Resources Information Center

    Stilwell, William E.; Barclay, James R.

    This is an evaluation of developmental guidance services' affective education program. Data was collected on children enrolled in Buerkle School and in a control school (Julia Shannon) in Stuttgart School District No. 22 (AR). Third- and fourth-grade level boys and girls who had been in the program for the full 1975-1976 year provided data for…

  12. 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/

  13. 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.

  14. 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.

  15. 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

  16. 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,…

  17. Considerations for Integration of Counseling and Health Services on College and University Campuses

    ERIC Educational Resources Information Center

    Journal of American College Health, 2010

    2010-01-01

    While the majority of college and university campuses have discrete mental health and medical services, the integration of the two areas has been subject of increased discussion among student health and counseling professionals. The push to integrate counseling and health services is motivated by a variety of reasons: a philosophical desire to…

  18. Implementation of Integrated Services--The Example of Family Centres in North Rhine-Westphalia

    ERIC Educational Resources Information Center

    Stöbe-Blossey, Sybille

    2013-01-01

    This paper deals with the implementation of integrated services providing early support for young children and their families. The integration of services is considered to have highly positive effects on the development of children and on the prevention of child neglect and maltreatment. Therefore, childcare centres have been developed into family…

  19. 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…

  20. 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…

  1. 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

  2. Factors affecting the integration of immigrant nurses into the nursing workforce: A double hermeneutic study.

    PubMed

    Xiao, Lily Dongxia; Willis, Eileen; Jeffers, Lesley

    2014-04-01

    Variations in nursing practice and communication difficulties pose a challenge for the successful integration into the workforce of immigrant nurses. Evidence for this is found in cultural clashes, interpersonal conflicts, communication problems, prejudiced attitudes and discrimination towards immigrant nurses. While the evidence shows that integrating immigrant nurses into the nursing workforce is shaped by factors that are socially constructed, studies that examine social structures affecting workforce integration are sparse. The aim of this study was to examine interplaying relationships between social structures and nurses' actions that either enabled or inhibited workforce integration in hospital settings. Giddens' Structuration Theory with double hermeneutic methodology was used to interpret 24 immigrant and 20 senior nurses' perceptions of factors affecting workforce integration. Four themes were identified from the data. These were: (1) employer-sponsored visa as a constraint on adaptation, (2) two-way learning and adaptation in multicultural teams, (3) unacknowledged experiences and expertise as barriers to integration, and (4) unquestioned sub-group norms as barriers for group cohesion. The themes presented a critical perspective that unsuitable social structures (policies and resources) constrained nurses' performance in workforce integration in the context of nurse immigration. The direction of structural changes needed to improve workforce integration is illustrated throughout the discussions of policies and resources required for workforce integration at national and organisational levels, conditions for positive group interactions and group cohesion in organisations. Our study reveals inadequate rules and resources used to recruit, classify and utilise immigrant nurses at national and healthcare organisational levels can become structural constraints on their adaptation to professional nursing practice and integration into the workforce in a host

  3. Integrated services plus drug treatment as a system alternative to crime control and parole.

    PubMed

    Danzer, Graham

    2012-01-01

    Integrated services have the potential to facilitate recovery in drug offenders as well as reduce criminal recidivism. This is significant given that prison overcrowding has led many drug offenders to be released from custody into society via the "reentry movement." Offenders incarcerated for many years often return to society with medical, mental health, behavioral, and drug abuse issues. These issues have been found in similar populations, including those with severe mental illness and the homeless, for which integrated services has shown to have a significant impact on improving functioning. Thus the argument of this article is that because integrated services have shown to be effective with somewhat similar populations, integrated services can be effective in treating paroled drug offenders. These benefits are expected to be to a greater degree than that achieved by current system policy regarding paroled drug offenders being supervised by parole officers rather than case managers facilitating integrated services.

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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…

  9. 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…

  10. 76 FR 5834 - International Business Machines Corporation, Global Technology Services Business Unit, Integrated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-02

    ... Expense Team, Payroll, Travel and Mobility Services Team, Working From Various States In the United States... Unit, Integrated Technology Services, Cost and Expense Team, working from various states in the United... reports that workers of the Payroll, Travel, and Mobility Services Team were part of the International...

  11. 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…

  12. 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.

  13. 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.

  14. 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…

  15. 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…

  16. 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

  17. Design of an Integrated Web Services Brokering System

    DTIC Science & Technology

    2009-01-01

    new Web service is corralled by the IWB, its service description is broken into lexemes and matched to terms in the ontology. The ontology is manually...such data for the atmosphere and ocean. NOAA, in particular, provides a wide range of data including weather information, ocean data on reefs , tides

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. 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

  4. Integrating HIV testing and care into tuberculosis services in Benin: programmatic aspects.

    PubMed

    Ferroussier, O; Dlodlo, R A; Capo-Chichi, D; Boillot, F; Gninafon, M; Trébucq, A; Fujiwara, P I

    2013-11-01

    Between 2005 and 2008, the diagnosis and care of human immunodeficiency virus (HIV) infection and tuberculosis (TB) services were integrated in Benin. The appointment of a TB-HIV Coordinator by the National Tuberculosis Control Programme and quarterly supervisory visits to TB clinics have bolstered the implementation of integrated HIV-TB activities. HIV testing and cotrimoxazole preventive therapy were integrated smoothly into the TB services. The strategy chosen to facilitate access of HIV-positive TB patients to antiretroviral treatment contributed to greater integration over time, but perpetuated, for some, the burden of attending two facilities. The integration and decentralisation of TB and HIV care services at national level in Benin resulted in a high uptake of HIV services among TB patients.

  5. Integrated sexual healthcare: the development and review of one model of service delivery.

    PubMed

    Dawson, S G; Callander, N; Roche, C; Kingsland, T; Desmond, N

    2000-07-01

    Sexual health is topical with many factors impacting upon its concept and hence provision. In 1995 the Sexual Health Service in East Berkshire was formed by the integration of the clinical services of Family Planning, Genitourinary and HIV Medicine with Sexual Health Promotion. The philosophy of the service is to provide holistic sexual healthcare in one visit, on one site by one clinical team. This article outlines the practical developments and the strengths and weaknesses of this model of service.

  6. Implementing and measuring the level of laboratory service integration in a program setting in Nigeria.

    PubMed

    Mbah, Henry; Negedu-Momoh, Olubunmi Ruth; Adedokun, Oluwasanmi; Ikani, Patrick Anibbe; Balogun, Oluseyi; Sanwo, Olusola; Ochei, Kingsley; Ekanem, Maurice; Torpey, Kwasi

    2014-01-01

    The surge of donor funds to fight HIV&AIDS epidemic inadvertently resulted in the setup of laboratories as parallel structures to rapidly respond to the identified need. However these parallel structures are a threat to the existing fragile laboratory systems. Laboratory service integration is critical to remedy this situation. This paper describes an approach to quantitatively measure and track integration of HIV-related laboratory services into the mainstream laboratory services and highlight some key intervention steps taken, to enhance service integration. A quantitative before-and-after study conducted in 122 Family Health International (FHI360) supported health facilities across Nigeria. A minimum service package was identified including management structure; trainings; equipment utilization and maintenance; information, commodity and quality management for laboratory integration. A check list was used to assess facilities at baseline and 3 months follow-up. Level of integration was assessed on an ordinal scale (0 = no integration, 1 = partial integration, 2 = full integration) for each service package. A composite score grading expressed as a percentage of total obtainable score of 14 was defined and used to classify facilities (≤ 80% FULL, 25% to 79% PARTIAL and <25% NO integration). Weaknesses were noted and addressed. We analyzed 9 (7.4%) primary, 104 (85.2%) secondary and 9 (7.4%) tertiary level facilities. There were statistically significant differences in integration levels between baseline and 3 months follow-up period (p<0.01). Baseline median total integration score was 4 (IQR 3 to 5) compared to 7 (IQR 4 to 9) at 3 months follow-up (p = 0.000). Partial and fully integrated laboratory systems were 64 (52.5%) and 0 (0.0%) at baseline, compared to 100 (82.0%) and 3 (2.4%) respectively at 3 months follow-up (p = 0.000). This project showcases our novel approach to measure the status of each laboratory on the integration continuum.

  7. 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

  8. 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

  9. Clinical service lines in integrated delivery systems: an initial framework and exploration.

    PubMed

    Parker, V A; Charns, M P; Young, G J

    2001-01-01

    The increasing pressures on integrated healthcare delivery systems (IDSs) to provide coordinated and cost-effective care focuses attention on the question of how to best integrate across multiple sites of care. One increasingly common approach to this issue is the development of clinical service lines that integrate specific bundles of services across the operating units of a system. This article presents a conceptual model of service lines and reports results from a descriptive investigation of service line development among members of the Industry Advisory Board--a research consortium comprising IDSs. The experiences of these IDSs (1) provide valuable insights into the range of organizational arrangements and implementation issues that are associated with service line management in healthcare systems and (2) suggest aspects of service line management worthy of further inquiry.

  10. 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.

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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

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

    PubMed Central

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

    2016-01-01

    Background 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. Methods 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. Results 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

  2. Service-learning: an integral part of undergraduate public health.

    PubMed

    Cashman, Suzanne B; Seifer, Sarena D

    2008-09-01

    In 2003, the Institute of Medicine (IOM) described public health as "an essential part of the training of citizens," a body of knowledge needed to achieve a public health literate citizenry. To achieve that end, the IOM recommended that "all undergraduates should have access to education in public health." Service-learning, a type of experiential learning, is an effective and appropriate vehicle for teaching public health and developing public health literacy. While relatively new to public health, service-learning has its historical roots in undergraduate education and has been shown to enhance students' understanding of course relevance, change student and faculty attitudes, encourage support for community initiatives, and increase student and faculty volunteerism. Grounded in collaborative relationships, service-learning grows from authentic partnerships between communities and educational institutions. Through emphasizing reciprocal learning and reflective practice, service-learning helps students develop skills needed to be effective in working with communities and ultimately achieve social change. With public health's enduring focus on social justice, introducing undergraduate students to public health through the vehicle of service-learning as part of introductory public health core courses or public health electives will help ensure that our young people are able to contribute to developing healthy communities, thus achieving the IOM's vision.

  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. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. Integration of hybrid wireless networks in cloud services oriented enterprise information systems

    NASA Astrophysics Data System (ADS)

    Li, Shancang; Xu, Lida; Wang, Xinheng; Wang, Jue

    2012-05-01

    This article presents a hybrid wireless network integration scheme in cloud services-based enterprise information systems (EISs). With the emerging hybrid wireless networks and cloud computing technologies, it is necessary to develop a scheme that can seamlessly integrate these new technologies into existing EISs. By combining the hybrid wireless networks and computing in EIS, a new framework is proposed, which includes frontend layer, middle layer and backend layers connected to IP EISs. Based on a collaborative architecture, cloud services management framework and process diagram are presented. As a key feature, the proposed approach integrates access control functionalities within the hybrid framework that provide users with filtered views on available cloud services based on cloud service access requirements and user security credentials. In future work, we will implement the proposed framework over SwanMesh platform by integrating the UPnP standard into an enterprise information system.

  10. 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....

  11. 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...

  12. 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…

  13. 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…

  14. Integrating Service-Learning into an Introduction to Entrepreneurship Course

    ERIC Educational Resources Information Center

    McCrea, Elizabeth A.

    2010-01-01

    Despite fairly widespread recognition that entrepreneurship occurs in both profit and nonprofit enterprises, a review of experiential learning techniques in entrepreneurship education does not explicitly mention service-learning. This omission may be because of a perceived lack of relevance of the pedagogy to entrepreneurship, the belief that…

  15. After the In-Service Course Challenges of Technology Integration

    ERIC Educational Resources Information Center

    Frederick, Gregory R.; Schweizer, Heidi; Lowe, Robert

    2006-01-01

    This case study chronicles one teacher's experience in the semester after an in-service course, Using Technology for Instruction and Assessment. Results suggest that success in the course and good intentions do not necessarily translate into dramatic change in methods or media of instruction. Student mobility and special needs, unexpected…

  16. 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.

  17. [Coordination between pharmaceutical services for integrated pharmacotherapy: the case of Catalonia].

    PubMed

    Costa, Karen Sarmento; Goldbaum, Moisés; Guayta-Escolies, Rafel; Modamio, Pilar; Mariño, Eduardo Luis; Tolsá, José Luis Segú

    2017-08-01

    Pharmaceutical policies have been considered strategies to contribute to the guarantee of care coordination and clinical integration. This study sought to describe the pharmaceutical services developed at different levels of care in the health network in Catalonia, as well as to identify and analyze the mechanisms and instruments that act as facilitators and/or barriers to the coordination of pharmacotherapy. This is a descriptive study of 12 cases of hospital pharmacy services, primary care and community pharmacies. Advances related to the perception, formalization and clinical and assistance coordination of the pharmaceutical services were identified. However, weaknesses and potential improvements in coordination were observed. The conclusion drawn was that the different tools and instruments implemented appear to facilitate a greater possibility of integration between pharmaceutical services and the latter with the health services network to contribute to integrated pharmacotherapy.

  18. Going the distance: spatial scale of athletic experience affects the accuracy of path integration.

    PubMed

    Smith, Alastair D; Howard, Christina J; Alcock, Niall; Cater, Kirsten

    2010-09-01

    Evidence suggests that athletically trained individuals are more accurate than untrained individuals in updating their spatial position through idiothetic cues. We assessed whether training at different spatial scales affects the accuracy of path integration. Groups of rugby players (large-scale training) and martial artists (small-scale training) participated in a triangle-completion task: they were led (blindfolded) along two sides of a right-angled triangle and were required to complete the hypotenuse by returning to the origin. The groups did not differ in their assessment of the distance to the origin, but rugby players were more accurate than martial artists in assessing the correct angle to turn (heading), and landed significantly closer to the origin. These data support evidence that distance and heading components can be dissociated. Furthermore, they suggest that the spatial scale at which an individual is trained may affect the accuracy of one component of path integration but not the other.

  19. Counselors and Physicians Providing Mental Health Services: An Integrated Approach

    ERIC Educational Resources Information Center

    Enochs, Wendy K; Young, Mark; Choate, Robert O.

    2006-01-01

    The authors argue that there is a clear link between mental and physical health issues. A wellness-based approach to integrated health care, such as the one described in this article, may allow older clients to be empowered to make lifestyle changes that can improve the quality of their lives and reduce physical illness.

  20. Does Integrating Family Planning into HIV Services Improve Gender Equitable Attitudes? Results from a Cluster Randomized Trial in Nyanza, Kenya.

    PubMed

    Newmann, Sara J; Rocca, Corinne H; Zakaras, Jennifer M; Onono, Maricianah; Bukusi, Elizabeth A; Grossman, Daniel; Cohen, Craig R

    2016-09-01

    This study investigated whether integrating family planning (FP) services into HIV care was associated with gender equitable attitudes among HIV-positive adults in western Kenya. Surveys were conducted with 480 women and 480 men obtaining HIV services from 18 clinics 1 year after the sites were randomized to integrated FP/HIV services (N = 12) or standard referral for FP (N = 6). We used multivariable regression, with generalized estimating equations to account for clustering, to assess whether gender attitudes (range 0-12) were associated with integrated care and with contraceptive use. Men at intervention sites had stronger gender equitable attitudes than those at control sites (adjusted mean difference in scores = 0.89, 95 % CI 0.03-1.74). Among women, attitudes did not differ by study arm. Gender equitable attitudes were not associated with contraceptive use among men (AOR = 1.06, 95 % CI 0.93-1.21) or women (AOR = 1.03, 95 % CI 0.94-1.13). Further work is needed to understand how integrating FP into HIV care affects gender relations, and how improved gender equity among men might be leveraged to improve contraceptive use and other reproductive health outcomes.

  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. 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.

  3. 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.

  4. Integrating telehealth services into a remote allied health service: A pilot study.

    PubMed

    O'Hara, Rebecca; Jackson, Sarah

    2017-02-01

    The continuity of care for people with neurological conditions in a remote northwest Queensland town as services are currently only available intermittently. Mixed methods design using questionnaires and staff review of the program and processes. Intermittent community rehabilitation service for clients with neurological conditions has been offered in Mount Isa and is supported by a similar fulltime service in Townsville. Both services use a unique client-centred, student-assisted, interprofessional model of care. Understanding participant experiences by obtaining feedback from clients, students and allied health professionals (AHPs) regarding their experiences of using telehealth in this setting. Previous clients of the North West Community Rehabilitation service were offered a review assessment using telehealth by an interprofessional team. Using telehealth enabled the client, remote AHP and students in Mount Isa to be connected to expert assistance in Townsville. The findings suggest that telehealth was useful in a community rehabilitation setting to provide review services for clients. This improved continuity of care for these clients because without this telehealth assessment, the clients would have had to wait up to 12 months for the next service period in Mount Isa or travel to a major urban centre to access a similar service. Feedback from clients, students and AHPs was positive; however, some challenges were identified. Recommendations for future service delivery using telehealth are outlined in the paper. © 2015 National Rural Health Alliance Inc.

  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. 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.

  7. 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…

  8. 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…

  9. 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…

  10. 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…

  11. 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…

  12. Do Integrated Children's Services Improve Children's Outcomes?: Evidence from England's Children's Trust Pathfinders

    ERIC Educational Resources Information Center

    O'Brien, Margaret; Bachmann, Max O.; Jones, Natalia R.; Reading, Richard; Thoburn, June; Husbands, Chris; Shreeve, Ann; Watson, Jacqueline

    2009-01-01

    Thirty-five children's trust pathfinders, local cross-sector partnerships, were introduced across England in 2003 to promote greater integration in children's services. Using administrative performance data, this paper tracks yearly trends in child service outputs and child well-being outcomes from 1997 to 2004 in these local areas, including the…

  13. 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…

  14. Integrating Community Services for Young Children and Their Families. Policy Briefs, Report 3, 1993.

    ERIC Educational Resources Information Center

    Kunesh, Linda G.; Farley, Joanne

    This policy brief reports on the status of state policies and programs that relate to integrating community services for children and families. Problems with the current service delivery system are discussed, and guidelines for creating a profamily system through effective collaboration are outlined. Information from a questionnaire on early…

  15. 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

  16. 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

  17. 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.

  18. 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,…

  19. Advancing the Field of Elder Mistreatment: A New Model for Integration of Social and Medical Services

    ERIC Educational Resources Information Center

    Mosqueda, Laura; Burnight, Kerry; Liao, Solomon; Kemp, Bryan

    2004-01-01

    Purpose: The purpose of this work is to describe the development and operation of a new model for integration of medical and social services. The Vulnerable Adult Specialist Team (VAST) provides Adult Protective Services (APS) and criminal justice agencies with access to medical experts who examine medical and psychological injuries of victims of…

  20. The Bilingual Academic Services and Integrated Career Systems Program: Project BASICS, 1987-1988. OREA Report.

    ERIC Educational Resources Information Center

    Berney, Tomi D.; Carey, Cecilia

    The Bilingual Academic Services and Integrated Career Systems Program (Project BASICS) is a federally-funded program of instructional and support services provided to 122 students at a Queens high school. The program's aim was to develop English literacy skills and appreciation of cultural diversity, and to prepare students for the psychosocial…

  1. Integrating cardiovascular diseases, hypertension, and diabetes with HIV services: a systematic review.

    PubMed

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

    2018-01-01

    Non-communicable diseases (NCDs), including cardiovascular diseases (CVD), hypertension and diabetes together with HIV infection are among the major public health concerns worldwide. Health services for HIV and NCDs require health systems that provide for people's chronic care needs, which present an opportunity to coordinate efforts and create synergies between programs to benefit people living with HIV and/or AIDS and NCDs. This review included studies that reported service integration for HIV and/or AIDS with coronary heart diseases, chronic CVD, cerebrovascular diseases (stroke), hypertension or diabetes. 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 7,616 after duplicate removal. After screening titles and abstracts, 14 papers addressing 17 distinct interventions met the inclusion criteria. We categorized integration models by diseases (HIV with diabetes, HIV with hypertension and diabetes, HIV with CVD and finally HIV with hypertension and CVD and diabetes). Models also looked at integration from micro (patient focused integration) to macro (system level integrations). Most reported integration of hypertension and diabetes with HIV and AIDS services and described multidisciplinary collaboration, shared protocols, and incorporating screening activities into community campaigns. Integration took place exclusively at the meso-level, with no micro- or macro-level integrations described. Most were descriptive studies, with one cohort study reporting evaluative outcomes. Several innovative initiatives were identified and studies showed that CVD and HIV service integration is feasible. Integration should build on existing protocols and use the community as a locus for advocacy and health services, while promoting multidisciplinary teams, including greater involvement of pharmacists. There is a need for robust and well

  2. Steam generator tubes integrity: In-service-inspection

    SciTech Connect

    Comby, R.J.

    1997-02-01

    The author`s approach to tube integrity is in terms of looking for flaws in tubes. The basis for this approach is that no simple rules can be fixed to adopt a universal inspection methodology because of various concepts related to experience, leak acceptance, leak before break approach, etc. Flaw specific management is probably the most reliable approach as a compromise between safety, availability and economic issues. In that case, NDE capabilities have to be in accordance with information required by structural integrity demonstration. The author discusses the types of probes which can be used to search for flaws in additionmore » to the types of flaws which are being sought, with examples of specific analysis experiences. The author also discusses the issue of a reporting level as it relates to avoiding false calls, classifying faults, and allowing for automation in analysis.« less

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

    SciTech Connect

    Heddleson, F.A.

    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.

  4. Preferred Instructional Design Strategies for Preparation of Pre-Service Teachers of Integrated STEM Education

    ERIC Educational Resources Information Center

    Roberts, Amanda Shackleford

    2013-01-01

    The purpose of this study was to identify the preferred instructional design strategies for the preparation of pre-service teachers who will deliver integrated STEM lessons. The research objectives were threefold and included identifying a preferred definition of integrated STEM education, developing its purpose statement, and creating a list of…

  5. 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…

  6. Integrated delivery systems focus on service delivery after capitation efforts stall.

    PubMed

    2005-03-01

    Integrated delivery systems focus on service delivery after capitation efforts stall. Integrated delivery systems are going through changes that are focusing the provider organizations more on delivering care than managing risk, says Dean C. Coddington, one of the leading researchers into capitated organizations and a senior consultant with McManis Consulting in Denver.

  7. 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…

  8. 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…

  9. "We are all in this together": integrated health service plans in Ontario.

    PubMed

    Eliasoph, Hy; Monaghan, Barry; Beaudoin, Rémy; Cushman, Robert; DuBois-Wing, Gwen; Emery, Marilyn J; Fenn, W Michael; Hanmer, Sandra J; Huras, Paul; Lowi-Young, Mimi; Mandy, Pat; Trimnell, Jean; Switzer, Garry; Woolgar, Tony; Butler, John

    2007-01-01

    Ontario's 14 Local Health Integration Networks (LHINs) produced their first major deliverable when they issued their integrated health service plans in October 2006. This article reviews the experience of LHINs in meeting this challenge, outlines the process and outcome dimensions of the plans and discusses eight opportunities for LHINs as they act on the basis of their plans.

  10. 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…

  11. Overview of Integrated Child Development Services Programme in India: Some Policy Implications for Nepal.

    ERIC Educational Resources Information Center

    Shrestha, Kishor

    This paper presents an overview of the Integrated Child Development Services (ICDS) program in India, discusses the context of Early Childhood Education (ECE) in Nepal, analyzes the best practices of the ICDS, and draws some policy implications for improving ECE in Nepal. The ICDS program is an integrated child development program with the…

  12. 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…

  13. 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…

  14. Single, Integrated, Service-Centric Model of Military Health System Governance

    DTIC Science & Technology

    and effectiveness of operational medical support. According to the Joint Concept for Health Services (JCHS), the need for integrated medical support...that keeps pace with the operational agility and organizational flexibility requirements to support globally integrated operations is clear. This

  15. 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…

  16. 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

  17. How does searching for health information on the Internet affect individuals' demand for health care services?

    PubMed

    Suziedelyte, Agne

    2012-11-01

    The emergence of the Internet made health information, which previously was almost exclusively available to health professionals, accessible to the general public. Access to health information on the Internet is likely to affect individuals' health care related decisions. The aim of this analysis is to determine how health information that people obtain from the Internet affects their demand for health care. I use a novel data set, the U.S. Health Information National Trends Survey (2003-07), to answer this question. The causal variable of interest is a binary variable that indicates whether or not an individual has recently searched for health information on the Internet. Health care utilization is measured by an individual's number of visits to a health professional in the past 12 months. An individual's decision to use the Internet to search for health information is likely to be correlated to other variables that can also affect his/her demand for health care. To separate the effect of Internet health information from other confounding variables, I control for a number of individual characteristics and use the instrumental variable estimation method. As an instrument for Internet health information, I use U.S. state telecommunication regulations that are shown to affect the supply of Internet services. I find that searching for health information on the Internet has a positive, relatively large, and statistically significant effect on an individual's demand for health care. This effect is larger for the individuals who search for health information online more frequently and people who have health care coverage. Among cancer patients, the effect of Internet health information seeking on health professional visits varies by how long ago they were diagnosed with cancer. Thus, the Internet is found to be a complement to formal health care rather than a substitute for health professional services. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. The Affective and Emotional Composite Temperament (AFECT) model and scale: a system-based integrative approach.

    PubMed

    Lara, Diogo R; Bisol, Luisa W; Brunstein, Miriam G; Reppold, Caroline T; de Carvalho, Hudson W; Ottoni, Gustavo L

    2012-09-01

    Based on many temperament frameworks, here we propose an integration of emotional and affective temperaments (the AFECT model), forming a common substrate for mood, behavior, personality and part of cognition. Temperament is conceived as a self-regulated system with six emotional dimensions: volition, anger, inhibition, sensitivity, coping and control. The different combinations of these emotional dimensions result in 12 affective temperament types, namely depressive, anxious, apathetic, obsessive, cyclothymic, dysphoric, irritable, volatile, disinhibited, hyperthymic and euphoric. We also developed and validated a self-report scale to evaluate this construct, the Affective and Emotional Composite Temperament Scale (AFECTS). Exploratory and confirmatory psychometric analyses were performed with the internet version of the AFECTS in 2947 subjects (72% females, 35±11years old). The factors interpreted as volition, anger, inhibition, sensitivity, coping and control showed very good Cronbach's alphas for 5 dimensions (0.87-0.90) and acceptable alpha for inhibition (0.75). Confirmatory factor analysis corroborated this 6-factor structure when considering inhibition as a second-order factor with fear and caution as first-order factors (SRMR=0.061; RMSEA=0.053). In the Affective section, all 12 categorical affective temperaments were selected in the categorical choice, with 99% of volunteers identifying at least one adequate description of their affective temperament. Only the internet version was used in a general population sample. The AFECT model provides an integrated framework of temperament as a self-regulated system, with implications for mental health, psychiatric disorders and their treatment. The AFECTS showed good psychometric properties to further study this model. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method

    PubMed Central

    Bahadori, Mohammadkarim; Ravangard, Ramin; Asghari, Baratali

    2013-01-01

    Background Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. Objectives This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. Patients and Methods This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision–making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. Results The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. Conclusions High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities. PMID:24578831

  20. Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method.

    PubMed

    Bahadori, Mohammadkarim; Ravangard, Ramin; Asghari, Baratali

    2013-08-01

    Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision-making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities.

  1. 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

  2. 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

  3. Integrating technology readiness into the expectation-confirmation model: an empirical study of mobile services.

    PubMed

    Chen, Shih-Chih; Liu, Ming-Ling; Lin, Chieh-Peng

    2013-08-01

    The aim of this study was to integrate technology readiness into the expectation-confirmation model (ECM) for explaining individuals' continuance of mobile data service usage. After reviewing the ECM and technology readiness, an integrated model was demonstrated via empirical data. Compared with the original ECM, the findings of this study show that the integrated model may offer an ameliorated way to clarify what factors and how they influence the continuous intention toward mobile services. Finally, the major findings are summarized, and future research directions are suggested.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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...

  11. 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.…

  12. An Architecture for Standardized Terminology Services by Wrapping and Integration of Existing Applications

    PubMed Central

    Cornet, Ronald; Prins, Antoon K.

    2003-01-01

    Research on terminology services has resulted in development of applications and definition of standards, but has not yet led to widespread use of (standardized) terminology services in practice. Current terminology services offer functionality both for concept representation and lexical knowledge representation, hampering the possibility of combining the strengths of dedicated (concept and lexical) services. We therefore propose an extensible architecture in which concept-related and lexicon-related components are integrated and made available through a uniform interface. This interface can be extended in order to conform to existing standards, making it possible to use dedicated (third-party) components in a standardized way. As a proof of concept and a reference implementation, a SOAP-based Java implementation of the terminology service is being developed, providing wrappers for Protégé and UMLS Knowledge Source Server. Other systems, such as the Description Logic-based reasoner RACER can be easily integrated by implementation of an appropriate wrapper. PMID:14728158

  13. A systematic review of integrated working between care homes and health care services

    PubMed Central

    2011-01-01

    Background In the UK there are almost three times as many beds in care homes as in National Health Service (NHS) hospitals. Care homes rely on primary health care for access to medical care and specialist services. Repeated policy documents and government reviews register concern about how health care works with independent providers, and the need to increase the equity, continuity and quality of medical care for care homes. Despite multiple initiatives, it is not known if some approaches to service delivery are more effective in promoting integrated working between the NHS and care homes. This study aims to evaluate the different integrated approaches to health care services supporting older people in care homes, and identify barriers and facilitators to integrated working. Methods A systematic review was conducted using Medline (PubMed), CINAHL, BNI, EMBASE, PsycInfo, DH Data, Kings Fund, Web of Science (WoS incl. SCI, SSCI, HCI) and the Cochrane Library incl. DARE. Studies were included if they evaluated the effectiveness of integrated working between primary health care professionals and care homes, or identified barriers and facilitators to integrated working. Studies were quality assessed; data was extracted on health, service use, cost and process related outcomes. A modified narrative synthesis approach was used to compare and contrast integration using the principles of framework analysis. Results Seventeen studies were included; 10 quantitative studies, two process evaluations, one mixed methods study and four qualitative. The majority were carried out in nursing homes. They were characterised by heterogeneity of topic, interventions, methodology and outcomes. Most quantitative studies reported limited effects of the intervention; there was insufficient information to evaluate cost. Facilitators to integrated working included care home managers' support and protected time for staff training. Studies with the potential for integrated working were longer in

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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…

  19. Factors affecting utilization of dental health services and satisfaction among adolescent females in Riyadh City.

    PubMed

    Al-Hussyeen, Al Johara A

    2010-01-01

    This study was conducted to determine factors affecting utilization of dental health services among intermediate female school students in Riyadh. In addition to assessing their satisfaction with the dental care received during the last dental visit. Self-administered questionnaires were distributed among students attending eight public and four private schools. These schools were selected randomly to represent the four different administrative zones in Riyadh. Of 600 questionnaires distributed, 531 were complete and suitable for analysis. Nearly three quarters of the students visited the dentist more than once during the last 2 years. A bout 75% had their treatment in private dental clinics and 63% made their visits for routine treatment. The quality of dental care was found to be the most encouraging factor for utilization of dental services, whereas, far geographic location of the dental clinics was the most discouraging factor. For those who received treatment in the government clinics, the most discouraging factor was post operative complications (P < 0.0001), while the most encouraging factor was the availability of friendly staff (P < 0.0001). The high cost of dental care was the most discouraging factor for utilizing the dental services for those who visited private clinics (P < 0.0001), while the high quality of dental care was the most encouraging factor (P < 0.009). Students who made their visits because of pain highly considered modern clinics and those recommended by friends as highly encouraging factors (P < 0.002), while they considered the high cost of dental care as discouraging factor for using dental services (P < 0.038). Students who visited the dentist for routine treatment gave the quality of dental care as encouraging for the use of dental clinics (P < 0.0001). Satisfaction with dental care was found to be significantly associated with high quality of dental care, convenient appointment, friendly staff, modern dental clinics

  20. Factors affecting utilization of dental health services and satisfaction among adolescent females in Riyadh City

    PubMed Central

    Al-Hussyeen, Al Johara A.

    2009-01-01

    Objectives This study was conducted to determine factors affecting utilization of dental health services among intermediate female school students in Riyadh. In addition to assessing their satisfaction with the dental care received during the last dental visit. Subjects and methods Self-administered questionnaires were distributed among students attending eight public and four private schools. These schools were selected randomly to represent the four different administrative zones in Riyadh. Results Of 600 questionnaires distributed, 531 were complete and suitable for analysis. Nearly three quarters of the students visited the dentist more than once during the last 2 years. A bout 75% had their treatment in private dental clinics and 63% made their visits for routine treatment. The quality of dental care was found to be the most encouraging factor for utilization of dental services, whereas, far geographic location of the dental clinics was the most discouraging factor. For those who received treatment in the government clinics, the most discouraging factor was post operative complications (P < 0.0001), while the most encouraging factor was the availability of friendly staff (P < 0.0001). The high cost of dental care was the most discouraging factor for utilizing the dental services for those who visited private clinics (P < 0.0001), while the high quality of dental care was the most encouraging factor (P < 0.009). Students who made their visits because of pain highly considered modern clinics and those recommended by friends as highly encouraging factors (P < 0.002), while they considered the high cost of dental care as discouraging factor for using dental services (P < 0.038). Students who visited the dentist for routine treatment gave the quality of dental care as encouraging for the use of dental clinics (P < 0.0001). Satisfaction with dental care was found to be significantly associated with high quality of dental care, convenient appointment

  1. 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

  2. Involvement of right STS in audio-visual integration for affective speech demonstrated using MEG.

    PubMed

    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.

  3. A four phase development model for integrated care services in the Netherlands

    PubMed Central

    Minkman, Mirella MN; Ahaus, Kees TB; Huijsman, Robbert

    2009-01-01

    Background Multidisciplinary and interorganizational arrangements for the delivery of coherent integrated care are being developed in a large number of countries. Although there are many integrated care programs worldwide, the process of developing these programs and interorganizational collaboration is described in the literature only to a limited extent. The purpose of this study is to explore how local integrated care services are developed in the Netherlands, and to conceptualize and operationalize a development model of integrated care. Methods The research is based on an expert panel study followed by a two-part questionnaire, designed to identify the development process of integrated care. Essential elements of integrated care, which were developed in a previous Delphi and Concept Mapping Study, were analyzed in relation to development process of integrated care. Results Integrated care development can be characterized by four developmental phases: the initiative and design phase; the experimental and execution phase; the expansion and monitoring phase; and the consolidation and transformation phase. Different elements of integrated care have been identified in the various developmental phases. Conclusion The findings provide a descriptive model of the development process that integrated care services can undergo in the Netherlands. The findings have important implications for integrated care services, which can use the model as an instrument to reflect on their current practices. The model can be used to help to identify improvement areas in practice. The model provides a framework for developing evaluation designs for integrated care arrangements. Further research is recommended to test the developed model in practice and to add international experiences. PMID:19261176

  4. 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

  5. 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

  6. The presence of human papillomavirus in semen does not affect the integrity of sperm DNA.

    PubMed

    Cortés-Gutiérrez, E I; Dávila-Rodríguez, M I; Fernández, J L; de la O-Pérez, L O; Garza-Flores, M E; Eguren-Garza, R; Gosálvez, J

    2017-12-01

    It remains unknown whether human papillomaviruses (HPVs) in semen affect sperm DNA integrity. We investigated whether the presence of these viruses in semen was associated with an elevated sperm DNA fragmentation index. Semen samples of 22 normozoospermic patients undergoing infertility treatment, nine fertile donors and seven fertile men with a risk of HPV infection (genital warts or condylomas) were included in the study. The samples were examined by an INNO-LiPA test PCR-based reverse hybridisation array that identifies 28 types of HPVs as simple or multiple infections. Sperm DNA integrity was determined by sperm chromatin dispersion assay (SCD). Our preliminary findings demonstrate an increase in HPV infection in infertile men with respect to fertile men. However, the sperm DNA fragmentation index was not increased in semen containing these viruses. © 2017 Blackwell Verlag GmbH.

  7. 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

  8. Changing Services to Children with Disabilities and Their Families through In-Service Training--Is the Organisation Affected?

    ERIC Educational Resources Information Center

    Karlsson, M.; Bjorck-AKesson, E.; Granlund, M.

    2008-01-01

    Professional development in family-centred services was given to professionals supporting children with disabilities and their families with the purpose to influence ways to perform working tasks. Is it possible to change ways of working through in-service training? In order to find answers to that question perceptions of in-service training at…

  9. Development and integration of pharmacist clinical services into the patient-centered medical home.

    PubMed

    Berdine, Hildegarde J; Skomo, Monica L

    2012-01-01

    To describe the development of pharmacist clinical services within a primary care physician practice using a standardized business plan, the extent of clinical pharmacy service integration into the patient-centered medical home (PCMH), and the clinical changes in the pharmacist's patient cohort. A two-physician primary care/occupational care practice in Pittsburgh, PA, from May 2007 to December 2011. Pharmacist-led clinic receives physician referrals for medication management, adherence, and disease management services. Pharmacist practice in a primary care setting with emphasis on integration of clinical services into the medical home model designed by the American Academy of Family Physicians. Characterization of the patient's pharmacist and services provided by the pharmacist. Glycosylated hemoglobin (A1C), body mass index (BMI), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, triglycerides, and blood pressure. The top five primary referral reasons were diabetes self-management, weight management, medication adherence, hypertension, and dyslipidemia management. Improvements in clinical parameters were demonstrated for lipids and A1C at 1 and 2 years after baseline. Statistically significant improvements in BMI also were observed. The pharmacist developed and integrated clinical services into a primary care practice, became an integral member of the clinical team in the two-physician PCMH, and improved patient outcomes.

  10. The influence of integrated tuberculosis and human immunodeficiency virus service delivery on patient outcomes.

    PubMed

    Uyei, J; Coetzee, D; Macinko, J; Weinberg, S L; Guttmacher, S

    2014-03-01

    Public health clinics in Cape Town, South Africa. To examine the influence of integrated tuberculosis (TB) and human immunodeficiency virus (HIV) service delivery on mortality, TB cure and successful treatment completion and loss to follow-up of TB-HIV co-infected patients on concurrent anti-tuberculosis and antiretroviral treatment (ART). A survey instrument was used to measure the degree to which TB and HIV services were jointly delivered, and patient data were collected retrospectively from clinic sites and the Department of Health. Six domains measuring integrated TB and HIV service delivery were modelled to assess their relationship with patient outcomes. Two domains, integrated TB and ART service delivery and the delivery of TB and HIV care by one clinical team, were associated with lowered odds of death. Care by the same clinical team was also associated with reduced loss to follow-up. Overall, these findings show that the organization and delivery of health services are important factors that influence health outcomes. These findings strongly support efforts by local governments to integrate TB and ART services, and may help to alleviate concerns that restructuring of TB programs could have a negative impact on long-standing gains.

  11. General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

    PubMed

    Appleby, N J; Dunt, D; Southern, D M; Young, D

    1999-08-01

    To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

  12. Emotional language processing: how mood affects integration processes during discourse comprehension.

    PubMed

    Egidi, Giovanna; Nusbaum, Howard C

    2012-09-01

    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 participants: endings incongruent with participants' moods demonstrated larger peaks. Happy and neutral moods exhibited larger peaks for negative endings, thus showing a similarity between negativity bias (neutral mood) and mood congruence (happy mood). Mood congruence resulted in differential processing of negative information: happy mood showed larger amplitudes for negative endings than neutral mood, and sad mood showed smaller amplitudes. N400 peaks were also sensitive to whether ending valence was communicated directly or as a result of inference. This effect was moderately modulated by mood. In conclusion, the notion of context for discourse processing should include comprehenders' affective states preceding language processing. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Newly identified protein Imi1 affects mitochondrial integrity and glutathione homeostasis in Saccharomyces cerevisiae.

    PubMed

    Kowalec, Piotr; Grynberg, Marcin; Pająk, Beata; Socha, Anna; Winiarska, Katarzyna; Fronk, Jan; Kurlandzka, Anna

    2015-09-01

    Glutathione homeostasis is crucial for cell functioning. We describe a novel Imi1 protein of Saccharomyces cerevisiae affecting mitochondrial integrity and involved in controlling glutathione level. Imi1 is cytoplasmic and, except for its N-terminal Flo11 domain, has a distinct solenoid structure. A lack of Imi1 leads to mitochondrial lesions comprising aberrant morphology of cristae and multifarious mtDNA rearrangements and impaired respiration. The mitochondrial malfunctioning is coupled to significantly decrease the level of intracellular reduced glutathione without affecting oxidized glutathione, which decreases the reduced/oxidized glutathione ratio. These defects are accompanied by decreased cadmium sensitivity and increased phytochelatin-2 level. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    PubMed

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

    2008-12-01

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

  15. 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

  16. The Semantic Automated Discovery and Integration (SADI) Web service Design-Pattern, API and Reference Implementation.

    PubMed

    Wilkinson, Mark D; Vandervalk, Benjamin; McCarthy, Luke

    2011-10-24

    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. 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. 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 very similar to data housed in

  17. 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.

  18. Selecting process quality indicators for the integrated care of vulnerable older adults affected by cognitive impairment or dementia.

    PubMed

    Kröger, Edeltraut; Tourigny, André; Morin, Diane; Côté, Lise; Kergoat, Marie-Jeanne; Lebel, Paule; Robichaud, Line; Imbeault, Shirley; Proulx, Solange; Benounissa, Zohra

    2007-11-29

    This study aimed at evaluating face and content validity, feasibility and reliability of process quality indicators developed previously in the United States or other countries. The indicators can be used to evaluate care and services for vulnerable older adults affected by cognitive impairment or dementia within an integrated service system in Quebec, Canada. A total of 33 clinical experts from three major urban centres in Quebec formed a panel representing two medical specialties (family medicine, geriatrics) and seven health or social services specialties (nursing, occupational therapy, psychology, neuropsychology, pharmacy, nutrition, social work), from primary or secondary levels of care, including long-term care. A modified version of the RAND(R)/University of California at Los Angeles (UCLA) appropriateness method, a two-round Delphi panel, was used to assess face and content validity of process quality indicators. The appropriateness of indicators was evaluated according to a) agreement of the panel with three criteria, defined as a median rating of 7-9 on a nine-point rating scale, and b) agreement among panellists, judged by the statistical measure of the interpercentile range adjusted for symmetry. Feasibility of quality assessment and reliability of appropriate indicators were then evaluated within a pilot study on 29 patients affected by cognitive impairment or dementia. For measurable indicators the inter-observer reliability was calculated with the Kappa statistic. Initially, 82 indicators for care of vulnerable older adults with cognitive impairment or dementia were submitted to the panellists. Of those, 72 (88%) were accepted after two rounds. Among 29 patients for whom medical files of the preceding two years were evaluated, 63 (88%) of these indicators were considered applicable at least once, for at least one patient. Only 22 indicators were considered applicable at least once for ten or more out of 29 patients. Four indicators could be measured

  19. Selecting process quality indicators for the integrated care of vulnerable older adults affected by cognitive impairment or dementia

    PubMed Central

    Kröger, Edeltraut; Tourigny, André; Morin, Diane; Côté, Lise; Kergoat, Marie-Jeanne; Lebel, Paule; Robichaud, Line; Imbeault, Shirley; Proulx, Solange; Benounissa, Zohra

    2007-01-01

    Background This study aimed at evaluating face and content validity, feasibility and reliability of process quality indicators developed previously in the United States or other countries. The indicators can be used to evaluate care and services for vulnerable older adults affected by cognitive impairment or dementia within an integrated service system in Quebec, Canada. Methods A total of 33 clinical experts from three major urban centres in Quebec formed a panel representing two medical specialties (family medicine, geriatrics) and seven health or social services specialties (nursing, occupational therapy, psychology, neuropsychology, pharmacy, nutrition, social work), from primary or secondary levels of care, including long-term care. A modified version of the RAND®/University of California at Los Angeles (UCLA) appropriateness method, a two-round Delphi panel, was used to assess face and content validity of process quality indicators. The appropriateness of indicators was evaluated according to a) agreement of the panel with three criteria, defined as a median rating of 7–9 on a nine-point rating scale, and b) agreement among panellists, judged by the statistical measure of the interpercentile range adjusted for symmetry. Feasibility of quality assessment and reliability of appropriate indicators were then evaluated within a pilot study on 29 patients affected by cognitive impairment or dementia. For measurable indicators the inter-observer reliability was calculated with the Kappa statistic. Results Initially, 82 indicators for care of vulnerable older adults with cognitive impairment or dementia were submitted to the panellists. Of those, 72 (88%) were accepted after two rounds. Among 29 patients for whom medical files of the preceding two years were evaluated, 63 (88%) of these indicators were considered applicable at least once, for at least one patient. Only 22 indicators were considered applicable at least once for ten or more out of 29 patients. Four

  20. 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

  1. 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

  2. Determining the Factors That Affect the Objectives of Pre-Service Science Teachers to Perform Outdoor Science Activities

    ERIC Educational Resources Information Center

    Karademir, Ersin; Erten, Sinan

    2013-01-01

    The purpose of this study is to determine whether pre-service teachers have an aim to perform outdoor education activities within the scope of science and technology course; by which factors this aim is affected, through The Theory of Planned Behaviour and the opinions of pre-service teachers. Accordingly, the study was designed as mixed research…

  3. 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.

  4. 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.

  5. 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.

  6. Interventions and approaches to integrating HIV and mental health services: a systematic review.

    PubMed

    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

    2017-11-01

    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. 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. 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. 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 outcomes when implemented within appropriate

  7. 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

  8. Improving community mental health services for people affected by political violence in Ayacucho, Perú.

    PubMed

    Rivera-Holguin, Miryam; Velazquez, Tesania; Custodio, Elba; Corveleyn, Jozef

    2018-01-01

    This study describes a model to intervene in communities affected by the political violence impacting the Ayacucho region of Peru since 1980s. Many community members still experience psychosocial consequences to this day due primarily to grief. Thirty-eight professionals from different sectors in the area received specialized training and implemented five community projects that were accompanied and monitored in the field by a team of community psychologists. This article is grounded on the principles of participation, building community capacity, and community strengthening. We present the analysis of five community action plans implemented over a period of 14 months. The results show a process of internal strengthening of community services and the identification of new social and community resources among the people involved in the action plans. The implications of capacity building for improving community mental health are discussed.

  9. 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.

  10. Bio-jETI: a service integration, design, and provisioning platform for orchestrated bioinformatics processes

    PubMed Central

    Margaria, Tiziana; Kubczak, Christian; Steffen, Bernhard

    2008-01-01

    Background 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. Methods 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. Conclusions 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. PMID:18460173

  11. 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

  12. How absent negativity relates to affect and motivation: an integrative relief model.

    PubMed

    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.

  13. 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.

  14. 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

  15. Reinforcing integrated psychiatric service attendance in an opioid-agonist program: a randomized and controlled trial.

    PubMed

    Kidorf, Michael; Brooner, Robert K; Gandotra, Neeraj; Antoine, Denis; King, Van L; Peirce, Jessica; Ghazarian, Sharon

    2013-11-01

    The benefits of integrating substance abuse and psychiatric care may be limited by poor service utilization. This randomized clinical trial evaluated the efficacy of using contingency management to improve utilization of psychiatric services co-located and integrated within a community-based methadone maintenance treatment program. Opioid-dependent outpatients (n=125) with any current psychiatric disorder were randomly assigned to: (1) reinforced on-site integrated care (ROIC), with vouchers (worth $25.00) contingent on full adherence to each week of scheduled psychiatric services; or (2) standard on-site integrated care (SOIC). All participants received access to the same schedule of psychiatrist and mental health counseling sessions for 12-weeks. ROIC participants attended more overall psychiatric sessions at month 1 (M=7.53 vs. 3.97, p<.001), month 2 (M=6.31 vs. 2.81, p<.001), and month 3 (M=5.71 vs. 2.44, p<.001). Both conditions evidenced reductions in psychiatric distress (p<.001) and similar rates of drug-positive urine samples. No differences in study retention were observed. These findings suggest that contingency management can improve utilization of psychiatric services scheduled within an on-site and integrated treatment model. Delivering evidenced-based mental health counseling, or modifying the contingency plan to include illicit drug use, may be required to facilitate greater changes in psychiatric and substance abuse outcomes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. 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…

  17. DIY-style GIS service in mobile navigation system integrated with web and wireless GIS

    NASA Astrophysics Data System (ADS)

    Yan, Yongbin; Wu, Jianping; Fan, Caiyou; Wang, Minqi; Dai, Sheng

    2007-06-01

    Mobile navigation system based on handheld device can not only provide basic GIS services, but also enable these GIS services to be provided without location limit, to be more instantly interacted between users and devices. However, we still see that most navigation systems have common defects on user experience like limited map format, few map resources, and unable location share. To overcome the above defects, we propose DIY-style GIS service which provide users a more free software environment and allow uses to customize their GIS services. These services include defining geographical coordinate system of maps which helps to hugely enlarge the map source, editing vector feature, related property information and hotlink images, customizing covered area of download map via General Packet Radio Service (GPRS), and sharing users' location information via SMS (Short Message Service) which establishes the communication between users who needs GIS services. The paper introduces the integration of web and wireless GIS service in a mobile navigation system and presents an implementation sample of a DIY-Style GIS service in a mobile navigation system.

  18. Graph-Based Semantic Web Service Composition for Healthcare Data Integration.

    PubMed

    Arch-Int, Ngamnij; Arch-Int, Somjit; Sonsilphong, Suphachoke; Wanchai, Paweena

    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.

  19. 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

  20. Open pre-schools at integrated health services-A program theory.

    PubMed

    Abrahamsson, Agneta; Samarasinghe, Kerstin

    2013-04-01

    Family centres in Sweden are integrated services that reach all prospective parents and parents with children up to their sixth year, because of the co-location of the health service with the social service and the open pre-school. The personnel on the multi-professional site work together to meet the needs of the target group. The article explores a program theory focused on the open pre-schools at family centres. A multi-case design is used and the sample consists of open pre-schools at six family centres. The hypothesis is based on previous research and evaluation data. It guides the data collection which is collected and analysed stepwise. Both parents and personnel are interviewed individually and in groups at each centre. The hypothesis was expanded to a program theory. The compliance of the professionals was the most significant element that explained why the open access service facilitated positive parenting. The professionals act in a compliant manner to meet the needs of the children and parents as well as in creating good conditions for social networking and learning amongst the parents. The compliance of the professionals in this program theory of open pre-schools at family centres can be a standard in integrated and open access services, whereas the organisation form can vary. The best way of increasing the number of integrative services is to support and encourage professionals that prefer to work in a compliant manner.

  1. 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.

  2. 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.

  3. ‘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

  4. '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.

  5. 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

  6. Integration of outpatient infectious diseases clinic pharmacy services and specialty pharmacy services for patients with HIV infection.

    PubMed

    Gilbert, Elise M; Gerzenshtein, Lana

    2016-06-01

    The integration of specialty pharmacy services and existing outpatient clinical pharmacy services within an infectious diseases (ID) clinic to optimize the care of patients with human immunodeficiency virus (HIV) infection is described. The management of HIV-infected patients is a highly specialized area of practice, often requiring use of complex medication regimens for reduction of HIV-associated morbidity and mortality prophylaxis and treatment of opportunistic infections, and prevention of HIV transmission. To maximize the effectiveness and safety of treatment with antiretroviral agents and associated pharmacotherapies, an interdisciplinary team is often involved in patient care. At Chicago-based Northwestern Medicine (NM), the outpatient ID clinic has long worked with an interdisciplinary care team including physicians, clinical pharmacists, nurses, and social workers to care for patients with HIV infection. In April 2014, specialty pharmacy services for patients with HIV infection were added to the NM ID clinic's care model to help maintain continuity of care and enhance patient follow-up. The care model includes well-defined roles for clinical pharmacists, pharmacy residents and students on rotation, and licensed pharmacy technicians. Specialty pharmacy services, including medication education, prescription fulfillment, assistance with medication access (e.g., navigation of financial assistance programs, completion of prior-authorization requests), and treatment monitoring, allow for closed-loop medication management of the HIV-infected patient population. Integration of specialty pharmacy services with the interdisciplinary care provided in the outpatient NM ID clinic has enhanced continuity of care for patients with HIV infection in terms of prescription filling, medication counseling, and adherence monitoring. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  7. Obstacles to the coordination of delivering integrated prenatal HIV, syphilis and hepatitis B testing services in Guangdong: using a needs assessment approach.

    PubMed

    Xia, Jianhong; Rutherford, Shannon; Ma, Yuanzhu; Wu, Li; Gao, Shuang; Chen, Tingting; Lu, Xiao; Zhang, Xiaozhuang; Chu, Cordia

    2015-03-24

    Integration of services for Prevention of Mother-To-Child Transmission of HIV (PMTCT) into routine maternal and child health care is promoted as a priority strategy by the WHO to facilitate the implementation of PMTCT. Integration of services emphasizes inter-sectoral coordination in the health systems to provide convenient services for clients. China has been integrating prenatal HIV, syphilis and hepatitis B testing services since 2009. However, as the individual health systems are complex, effective coordination among different health agencies is challenging. Few studies have examined the factors that affect the coordination of such complex systems. The aim of this study is to assess the effectiveness of and examine challenges for integrated service delivery. Findings will provide the basis for strategy development to enhance the effective delivery of integrated services. The research was conducted in Guangdong province in 2013 using a needs assessment approach that includes qualitative and quantitative methods. Quantitative data was collected through a survey and from routine monitoring for PMTCT and qualitative data was collected through stakeholder interviews. Routine monitoring data used to assess key indicators of coordination suggested numerous coordination problems. The rates of prenatal HIV (95%), syphilis (47%) and hepatitis B (47%) test were inconsistent. An average of only 20% of the HIV positive mothers was referred in the health systems. There were no regular meetings among different health agencies and the clients indicated complicated service processes. The major obstacles to the coordination of delivering these integrated services are lack of service resource integration; and lack of a mechanism for coordination of the health systems, with no uniform guidelines, clear roles or consistent evaluation. The key obstacles that have been identified in this study hinder the coordination of the delivery of integrated services. Our recommendations include

  8. 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

  9. Insights from a pilot program to integrate medical and social services.

    PubMed

    Meiners, Mark R; Mokler, Pamela M; Kasunic, Mary Lynn; Hawthornthwaite, Scott; Foster, Susan; Scheer, David; Maldonado, Anna Maria

    2014-01-01

    This study examines lessons learned from the design, implementation, and early results of an integrated managed care pilot program linking member benefits of a Medicare-Medicaid health care plan with community services and supports. The health plan's average monthly costs for members receiving an assessment and services declined by an economically meaningful, statistically significant amount in the postintervention period relative to the preintervention period compared with those who did not accept an assessment or services. The results along with the lesson learned from the pilot are viewed by the parties as supportive of further program development.

  10. 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

  11. 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.

  12. 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

  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. 39 CFR 230.26 - Do these rules affect the service of process requirements of the Federal Rules of Civil Procedure...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Do these rules affect the service of process....26 Do these rules affect the service of process requirements of the Federal Rules of Civil Procedure... Rules of Civil Procedure regarding service of process. ...

  15. 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.

  16. The effect of meaningfulness and integrative processing in expressive writing on positive and negative affect and life satisfaction.

    PubMed

    Schutte, Nicola S; Searle, Trudy; Meade, Stephen; Dark, Neill A

    2012-01-01

    Meaningfulness and integrative processing of expressive writing may influence the effect of expressive writing. Participants completed measures of positive affect, negative affect and life satisfaction before and after an expressive writing intervention. Participants were randomly assigned to one of four expressive writing instruction conditions, which combined higher and lower levels of meaning and integrative processing instructions. Meaningfulness and integrative processing instructions had significant effects in increasing positive affect and there was a significant interaction between meaningfulness instructions and integrative processing instructions; participants in the high meaningfulness and high integrative processing instruction condition showed the greatest increase in positive affect. Meaningfulness had a significant effect in decreasing negative affect. The intervention did not influence life satisfaction. Both meaningfulness and integrative processing instructions led to more self-reported personal meaningfulness of the writing and more cognitive, emotional, behavioural and situational changes. More self-reported meaningfulness of the writing and more cognitive, emotional, behavioural and situational changes made as a result of the writing were in turn associated with greater increases in positive affect. The results of the study affirm the importance of meaningfulness and processing in expressive writing and potentially provide information regarding how to increase the effectiveness of expressive writing.

  17. Integrative model of caregiving: how macro and micro factors affect caregivers of adults with severe and persistent mental illness.

    PubMed

    Mak, Winnie W S

    2005-01-01

    The study tested an integrative model of caregiving by examining the effects of sociocultural characteristics, interpersonal relations, mental health service structure, consumers' symptoms, objective burden, and evaluation of service systems on the subjective experiences of caregivers. The sample consisted of 428 caregivers of adults with severe and persistent mental illness. Results from multiple regression analyses indicated that ethnicity was the most significant sociocultural factor on caregivers' worry, personal growth, and benefits. Caregivers enrolled in managed care plans worried more about their consumers' welfare and felt less gratified by their experiences than their counterparts from fee-for-service plans. Implications to and partnerships among caregivers and mental health service systems were discussed.

  18. An Integrative Process Approach on Judgment and Decision Making: The Impact of Arousal, Affect, Motivation, and Cognitive Ability

    ERIC Educational Resources Information Center

    Roets, Arne; Van Hiel, Alain

    2011-01-01

    This article aims to integrate the findings from various research traditions on human judgment and decision making, focusing on four process variables: arousal, affect, motivation, and cognitive capacity/ability. We advocate a broad perspective referred to as the integrative process approach (IPA) of decision making, in which these process…

  19. 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

  20. Delivering high-quality family planning services in crisis-affected settings II: results.

    PubMed

    Curry, Dora Ward; Rattan, Jesse; Huang, Shuyuan; Noznesky, Elizabeth

    2015-02-04

    An estimated 43 million women of reproductive age experienced the effects of conflict in 2012. Already vulnerable from the insecurity of the emergency, women must also face the continuing risk of unwanted pregnancy but often are unable to obtain family planning services. The ongoing Supporting Access to Family Planning and Post-Abortion Care (SAFPAC) initiative, led by CARE, has provided contraceptives, including long-acting reversible contraceptives (LARCs), to refugees, internally displaced persons, and conflict-affected resident populations in Chad, the Democratic Republic of the Congo (DRC), Djibouti, Mali, and Pakistan. The project works through the Ministry of Health in 4 key areas: (1) competency-based training, (2) supply chain management, (3) systematic supervision, and (4) community mobilization to raise awareness and shift norms related to family planning. This article presents data on program results from July 2011 to December 2013 from the 5 countries. Project staff summarized monthly data from client registers using hard-copy forms and recorded the data electronically in Microsoft Excel for compilation and analysis. The initiative reached 52,616 new users of modern contraceptive methods across the 5 countries, ranging from 575 in Djibouti to 21,191 in Chad. LARCs have predominated overall, representing 61% of new modern method users. The percentage of new users choosing LARCs varied by country: 78% in the DRC, 72% in Chad, and 51% in Mali, but only 29% in Pakistan. In Djibouti, those methods were not offered in the country through SAFPAC during the period discussed here. In Chad, the DRC, and Mali, implants have been the most popular LARC method, while in Pakistan the IUD has been more popular. Use of IUDs, however, has comprised a larger share of the method mix over time in all 4 of these countries. These results to date suggest that it is feasible to work with the public sector in fragile, crisis-affected states to deliver a wide range of quality

  1. 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…

  2. 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…

  3. Preparing Pre-Service Teachers to Integrate Technology in Education: A Synthesis of Qualitative Evidence

    ERIC Educational Resources Information Center

    Tondeur, Jo; van Braak, Johan; Sang, Guoyuan; Voogt, Joke; Fisser, Petra; Ottenbreit-Leftwich, Anne

    2012-01-01

    This study reviewed qualitative studies that focused on strategies to prepare pre-service teachers to integrate technology into their lessons. A meta-ethnography approach was utilized to locate, critically appraise, and synthesize the results of these studies. Based on an extensive search in the Web of Science, 19 articles were included in this…

  4. 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.

  5. 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…

  6. Social Cognitive Predictors of Pre-Service Teachers' Technology Integration Performance

    ERIC Educational Resources Information Center

    Perkmen, Serkan; Pamuk, Sonmez

    2011-01-01

    The main objective of the study was to examine interrelationships among social cognitive variables (self-efficacy, outcome expectations, and performance goals) and their role in predicting pre-service teachers' technology integration performance. Although researchers have examined the role of these variables in the teacher-education context, the…

  7. 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…

  8. 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...

  9. 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…

  10. Integrated Services Digital Networks: How It Can Be Used for Distance Education.

    ERIC Educational Resources Information Center

    Saba, Farhad; Twitchell, David

    1989-01-01

    Describes Integrated Services Digital Networks (ISDN), which, combined with desktop workstations, will provide access to voice, text, and video telecommunications. Telecommunications technology is discussed, the use of desktop workstations to facilitate ISDN is described, and possible future uses of ISDN technology in distance education are…

  11. 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…

  12. The Use of Idea-Based Policy Instruments in Promoting School-Linked Service Integration.

    ERIC Educational Resources Information Center

    Cohen, Carolyn

    This paper analyzes the potential of a specific public policy tool to further principles of programs devoted exclusively to the Integration of Education and Human Services (IEHS). Section 1 describes the nature of the problem in establishing the need for IEHS. Section 2 describes policy tools currently used to implement IEHS, introducing the…

  13. Issues in the Linkage and Integration of Treatment and Rehabilitation Services for Chronically Mentally Ill Persons.

    ERIC Educational Resources Information Center

    Woy, J. Richard; Dellario, Donald J.

    1985-01-01

    Compares and contrasts characteristics of the mental health system and the Vocational Rehabilitation (VR) service system; examines environmental, intraorganizational, and interorganizational variables as they pertain to potential for linkages between mental health and VR providers; and discusses implications for improved integration of treatment…

  14. 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…

  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. Pre-Service Teachers' Practices towards Digital Game Design for Technology Integration into Science Classrooms

    ERIC Educational Resources Information Center

    Uluay, Gulsah; Dogan, Alev

    2016-01-01

    The main purpose of the study is to introduce Kodu Game Lab that is created by Microsoft as an example for technology integration into learning process to pre-service science teachers with MAGDAIRE framework. The participants were in a special teaching methods course at a university in Turkey during the fall 2015 semester. Mix method research…

  17. 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…

  18. An Integrated Parent-Teacher-Related Service Team Approach to Communication Intervention. Final Report.

    ERIC Educational Resources Information Center

    Stremel, Kathleen; Wilson, Rebecca

    This final report describes a federally funded 3-year project for integrating related services within educational objectives for children (ages 3-10) with dual vision and hearing impairments. A Training-Utilization model of inservice training and technical assistance was developed, implemented, and evaluated to address the communication needs of…

  19. 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...

  20. Integrating traditional nursing service orientation content with electronic medical record orientation.

    PubMed

    Harton, Brenda B; Borrelli, Larry; Knupp, Ann; Rogers, Necolen; West, Vickie R

    2009-01-01

    Traditional nursing service orientation classes at an acute care hospital were integrated with orientation to the electronic medical record to blend the two components in a user-friendly format so that the learner is introduced to the culture, processes, and documentation methods of the organization, with an opportunity to document online in a practice domain while lecture and discussion information is fresh.

  1. 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…

  2. Constructing an Integrated and Evidenced-Based Model for Residential Services

    ERIC Educational Resources Information Center

    Metzger, Jed

    2006-01-01

    There is paucity in both the literature and in the practice of integrated, evidence-based models of residential care for youth. This article describes the assessment and the process that led to the redesign of services at a residential center. The article describes how evidence-based models for each of the four major disciplines (residential…

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 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…

  8. 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.

  9. Specialist integrated haematological malignancy diagnostic services: an Activity Based Cost (ABC) analysis of a networked laboratory service model.

    PubMed

    Dalley, C; Basarir, H; Wright, J G; Fernando, M; Pearson, D; Ward, S E; Thokula, P; Krishnankutty, A; Wilson, G; Dalton, A; Talley, P; Barnett, D; Hughes, D; Porter, N R; Reilly, J T; Snowden, J A

    2015-04-01

    Specialist Integrated Haematological Malignancy Diagnostic Services (SIHMDS) were introduced as a standard of care within the UK National Health Service to reduce diagnostic error and improve clinical outcomes. Two broad models of service delivery have become established: 'co-located' services operating from a single-site and 'networked' services, with geographically separated laboratories linked by common management and information systems. Detailed systematic cost analysis has never been published on any established SIHMDS model. We used Activity Based Costing (ABC) to construct a cost model for our regional 'networked' SIHMDS covering a two-million population based on activity in 2011. Overall estimated annual running costs were £1 056 260 per annum (£733 400 excluding consultant costs), with individual running costs for diagnosis, staging, disease monitoring and end of treatment assessment components of £723 138, £55 302, £184 152 and £94 134 per annum, respectively. The cost distribution by department was 28.5% for haematology, 29.5% for histopathology and 42% for genetics laboratories. Costs of the diagnostic pathways varied considerably; pathways for myelodysplastic syndromes and lymphoma were the most expensive and the pathways for essential thrombocythaemia and polycythaemia vera being the least. ABC analysis enables estimation of running costs of a SIHMDS model comprised of 'networked' laboratories. Similar cost analyses for other SIHMDS models covering varying populations are warranted to optimise quality and cost-effectiveness in delivery of modern haemato-oncology diagnostic services in the UK as well as internationally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. 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

  11. 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.

  12. 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".

  13. Improving antiretroviral therapy scale-up and effectiveness through service integration and decentralization.

    PubMed

    Suthar, Amitabh B; Rutherford, George W; Horvath, Tara; Doherty, Meg C; Negussie, Eyerusalem K

    2014-03-01

    Current service delivery systems do not reach all people in need of antiretroviral therapy (ART). In order to inform the operational and service delivery section of the WHO 2013 consolidated antiretroviral guidelines, our objective was to summarize systematic reviews on integrating ART delivery into maternal, newborn, and child health (MNCH) care settings in countries with generalized epidemics, tuberculosis (TB) treatment settings in which the burden of HIV and TB is high, and settings providing opiate substitution therapy (OST); and decentralizing ART into primary health facilities and communities. A summary of systematic reviews. The reviewers searched PubMed, Embase, PsycINFO, Web of Science, CENTRAL, and the WHO Index Medicus databases. Randomized controlled trials and observational cohort studies were included if they compared ART coverage, retention in HIV care, and/or mortality in MNCH, TB, or OST facilities providing ART with MNCH, TB, or OST facilities providing ART services separately; or primary health facilities or communities providing ART with hospitals providing ART. The reviewers identified 28 studies on integration and decentralization. Antiretroviral therapy integration into MNCH facilities improved ART coverage (relative risk [RR] 1.37, 95% confidence interval [CI] 1.05-1.79) and led to comparable retention in care. ART integration into TB treatment settings improved ART coverage (RR 1.83, 95% CI 1.48-2.23) and led to a nonsignificant reduction in mortality (RR 0.55, 95% CI 0.29-1.05). The limited data on ART integration into OST services indicated comparable rates of ART coverage, retention, and mortality. Partial decentralization into primary health facilities improved retention (RR 1.05, 95% CI 1.01-1.09) and reduced mortality (RR 0.34, 95% CI 0.13-0.87). Full decentralization improved retention (RR 1.12, 95% CI 1.08-1.17) and led to comparable mortality. Community-based ART led to comparable rates of retention and mortality. Integrating ART

  14. Preference of methadone maintenance patients for the integrative and decentralized service delivery models in Vietnam.

    PubMed

    Tran, Bach Xuan; Nguyen, Long Hoang; Phan, Huong Thu Thi; Nguyen, Linh Khanh; Latkin, Carl A

    2015-09-17

    Integrating and decentralizing services are essential to increase the accessibility and provide comprehensive care for methadone patients. Moreover, they assure the sustainability of a HIV/AIDS prevention program by reducing the implementation cost. This study aimed to measure the preference of patients enrolling in a MMT program for integrated and decentralized MMT clinics and then further examine related factors. A cross-sectional study was conducted among 510 patients receiving methadone at 3 clinics in Hanoi. Structured questionnaires were used to collect data about the preference for integrated and decentralized MMT services. Covariates including socio-economic status; health-related quality of life (using EQ-5D-5 L instrument) and HIV status; history of drug use along with MMT treatment; and exposure to the discrimination within family and community were also investigated. Multivariate logistic regression with polynomial fractions was used to identify the determinants of preference for integrative and decentralized models. Of 510 patients enrolled, 66.7 and 60.8 % preferred integrated and decentralized models, respectively. The main reason for preferring the integrative model was the convenience of use of various services (53.2 %), while more privacy (43.5 %) was the primary reason to select stand-alone model. People preferred the decentralized model primarily because of travel cost reduction (95.0 %), while the main reason for not selecting the model was increased privacy (7.7 %). After adjusting for covariates, factors influencing the preference for integrative model were poor socioeconomic status, anxiety/depression, history of drug rehabilitation, and ever disclosed health status; while exposure to community discrimination inversely associated with this preference. In addition, people who were self-employed, had a longer duration of MMT, and use current MMT with comprehensive HIV services were less likely to select decentralized model. In conclusion

  15. 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

  16. 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.

  17. 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

  18. Discontinuous categories affect information-integration but not rule-based category learning.

    PubMed

    Maddox, W Todd; Filoteo, J Vincent; Lauritzen, J Scott; Connally, Emily; Hejl, Kelli D

    2005-07-01

    Three experiments were conducted that provide a direct examination of within-category discontinuity manipulations on the implicit, procedural-based learning and the explicit, hypothesis-testing systems proposed in F. G. Ashby, L. A. Alfonso-Reese, A. U. Turken, and E. M. Waldron's (1998) competition between verbal and implicit systems model. Discontinuous categories adversely affected information-integration but not rule-based category learning. Increasing the magnitude of the discontinuity did not lead to a significant decline in performance. The distance to the bound provides a reasonable description of the generalization profile associated with the hypothesis-testing system, whereas the distance to the bound plus the distance to the trained response region provides a reasonable description of the generalization profile associated with the procedural-based learning system. These results suggest that within-category discontinuity differentially impacts information-integration but not rule-based category learning and provides information regarding the detailed processing characteristics of each category learning system. ((c) 2005 APA, all rights reserved).

  19. 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.

  20. General practice, primary care, and health service psychology: concepts, competencies, and the Combined-Integrated model.

    PubMed

    Schulte, Timothy J; Isley, Elayne; Link, Nancy; Shealy, Craig N; Winfrey, LaPearl Logan

    2004-10-01

    The profession of psychology is being impacted profoundly by broader changes within the national system of health care, as mental and behavioral health services are being recognized as essential components of a comprehensive, preventive, and cost-efficient primary care system. To fully define and embrace this role, the discipline of professional psychology must develop a shared disciplinary identity of health service psychology and a generalized competency-based model for doctoral education and training. This very framework has been adopted by Combined-Integrated (C-I) doctoral programs in professional psychology, which train across the practice areas (clinical, counseling, and school psychology) to provide a general and integrative foundation for their students. Because C-I programs produce general practitioners who are competent to function within a variety of health service settings, this innovative training approach has great potential to educate and train psychologists for a changing health care marketplace. Copyright 2004 Wiley Periodicals, Inc.

  1. 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.

  2. 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

  3. 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

  4. Laccase-13 Regulates Seed Setting Rate by Affecting Hydrogen Peroxide Dynamics and Mitochondrial Integrity in Rice.

    PubMed

    Yu, Yang; Li, Quan-Feng; Zhang, Jin-Ping; Zhang, Fan; Zhou, Yan-Fei; Feng, Yan-Zhao; Chen, Yue-Qin; Zhang, Yu-Chan

    2017-01-01

    Seed setting rate is one of the most important components of rice grain yield. To date, only several genes regulating setting rate have been identified in plant. In this study, we showed that laccase-13 ( OsLAC13 ), a member of laccase family genes which are known for their roles in modulating phenylpropanoid pathway and secondary lignification in cell wall, exerts a regulatory function in rice seed setting rate. OsLAC13 expressed in anthers and promotes hydrogen peroxide production both in vitro and in the filaments and anther connectives. Knock-out of OsLAC13 showed significantly increased seed setting rate, while overexpression of this gene exhibited induced mitochondrial damage and suppressed sugar transportation in anthers, which in turn affected seed setting rate. OsLAC13 also induced H 2 O 2 production and mitochondrial damage in the root tip cells which caused the lethal phenotype. We also showed that high abundant of OsmiR397, the suppressor of OsLAC13 mRNA, increased the seed setting rate of rice plants, and restrains H 2 O 2 accumulation in roots during oxidative stress. Our results suggested a novel regulatory role of OsLAC13 gene in regulating seed setting rate by affecting H 2 O 2 dynamics and mitochondrial integrity in rice.

  5. Stress affects the neural ensemble for integrating new information and prior knowledge.

    PubMed

    Vogel, Susanne; Kluen, Lisa Marieke; Fernández, Guillén; Schwabe, Lars

    2018-06-01

    Prior knowledge, represented as a schema, facilitates memory encoding. This schema-related learning is assumed to rely on the medial prefrontal cortex (mPFC) that rapidly integrates new information into the schema, whereas schema-incongruent or novel information is encoded by the hippocampus. Stress is a powerful modulator of prefrontal and hippocampal functioning and first studies suggest a stress-induced deficit of schema-related learning. However, the underlying neural mechanism is currently unknown. To investigate the neural basis of a stress-induced schema-related learning impairment, participants first acquired a schema. One day later, they underwent a stress induction or a control procedure before learning schema-related and novel information in the MRI scanner. In line with previous studies, learning schema-related compared to novel information activated the mPFC, angular gyrus, and precuneus. Stress, however, affected the neural ensemble activated during learning. Whereas the control group distinguished between sets of brain regions for related and novel information, stressed individuals engaged the hippocampus even when a relevant schema was present. Additionally, stressed participants displayed aberrant functional connectivity between brain regions involved in schema processing when encoding novel information. The failure to segregate functional connectivity patterns depending on the presence of prior knowledge was linked to impaired performance after stress. Our results show that stress affects the neural ensemble underlying the efficient use of schemas during learning. These findings may have relevant implications for clinical and educational settings. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Implementing integrated services for people with epilepsy in primary care in Ethiopia: a qualitative study.

    PubMed

    Catalao, Raquel; Eshetu, Tigist; Tsigebrhan, Ruth; Medhin, Girmay; Fekadu, Abebaw; Hanlon, Charlotte

    2018-05-21

    In order to tackle the considerable treatment gap for epilepsy in many low- and middle-income countries (LMICs), a task sharing model is recommended whereby care is integrated into primary health services. However, there are limited data on implementation and impact of such services in LMICs. Our study aimed to explore the perspectives of service users and caregivers on the accessibility, experience and perceived impact of epilepsy treatment received in a task-shared model in a rural district of Ethiopia. A qualitative study was carried out using interviews with purposively sampled service users (n = 13) and caregivers (n = 3) from a community-ascertained cohort of people with epilepsy receiving integrated services in primary care in rural Ethiopia. Interviews followed a topic guide with questions regarding acceptability, satisfaction, barriers to access care, pathways through care and impact of services. Framework analysis was employed to analyse the data. Proximity of the new service in local primary health centers decreased the cost of transportation for the majority of service users thus improving access to services. First-hand experience of services was in some cases associated with a willingness to promote the services and inform others of the existence of effective biomedical treatment for epilepsy. However, most service users and their caregivers continued to seek help from traditional healers alongside biomedical care. Most of the care received was focused on medication provision with limited information provided on how to manage their illness and its effects. Caregivers and service users spoke about the high emotional and financial burden of the disease and lack of ongoing practical and emotional support. The majority of participants reported clinical improvement on medication, which in over half of the participants was associated with ability to return to money generating activities. Task-sharing improved the accessibility of epilepsy care for

  7. Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

    PubMed

    Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

    2014-01-01

    Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

  8. Multi-actor involvement for integrating ecosystem services in strategic environmental assessment of spatial plans

    SciTech Connect

    Rozas-Vásquez, Daniel, E-mail: danielrozas@gmail.com; Laboratorio de Planificación Territorial, Universidad Católica de Temuco, Rudecindo ortega, 02950 Temuco; Fürst, Christine

    Integrating an ecosystem services (ES) approach into Strategic Environmental Assessment (SEA) of spatial plans potentially enhances the consideration of the value of nature in decision making and policy processes. However, there is increasing concern about the institutional context and a lack of a common understanding of SEA and ecosystem services for adopting them as an integrated framework. This paper addresses this concern by analysing the current understanding and network relations in a multi-actor arrangement as a first step towards a successful integration of ES in SEA and spatial planning. Our analysis focuses on a case study in Chile, where wemore » administered a questionnaire survey to some of the main actors involved in the spatial planning process. The questionnaire focused on issues such as network relations among actors and on conceptual understanding, perceptions and challenges for integrating ES in SEA and spatial planning, knowledge on methodological approaches, and the connections and gaps in the science-policy interface. Our findings suggest that a common understanding of SEA and especially of ES in a context of multiple actors is still at an initial stage in Chile. Additionally, the lack of institutional guidelines and methodological support is considered the main challenge for integration. We conclude that preconditions exist in Chile for integrating ES in SEA for spatial planning, but they strongly depend on appropriate governance schemes that promote a close science-policy interaction, as well as collaborative work and learning. - Highlights: • Linking ecosystem services in SEA is an effective framework for sustainability. • Multi-actor understanding and networks in ecosystem services and SEA were analyzed. • Understanding of SEA and especially of ES is still in an initial stage in Chile. • A lack of institutional guidelines is one of the key challenges for this link.« less

  9. Progress of Geomagnetism towards integration of data and services in EPOS

    NASA Astrophysics Data System (ADS)

    Flower, Simon; Hejda, Pavel; Chambodut, Aude; Curto, Juan-Jose; Matzka, Jürgen; Thomson, Alan; Korja, Toivo; Rasmussen, Thorkild; Smirnov, Maxim; Viljanen, Ari; Kauristie, Kirsti

    2017-04-01

    The geomagnetism community is involved in the European Plate Observing System (EPOS), a European Research Infrastructure through which science communities will offer a number of services that will integrate to simplify cross-disciplinary research. The Geomagnetism community will provide data from geomagnetic observatories, from producers of geomagnetic indices and events, from geomagnetic models and from magneto-telluric observations. A number of these services (data from the INTERMAGNET network and the World Data Centre, indices and events from the International Service of Geomagnetic Indices and the access to the International Geomagnetic Reference Field and World Magnetic Model) will be integrated into EPOS systems in the first wave of services to be connected. This poster will describe the contribution from geomagnetism to EPOS. It will include a description of the data and services that the geomagnetic community will provide and also discuss how metadata will be made available from the community to the EPOS core IT systems. Finally it will describe how the provision of geomagnetic services in EPOS will be guided and governed by members of the community .

  10. 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

  11. Impact of integration of sexual and reproductive health services on consultation duration times: results from the Integra Initiative.

    PubMed

    Siapka, Mariana; Obure, Carol Dayo; Mayhew, Susannah H; Sweeney, Sedona; Fenty, Justin; Vassall, Anna

    2017-11-01

    The lack of human resources is a key challenge in scaling up of HIV services in Africa's health care system. Integrating HIV services could potentially increase their effectiveness and optimize the use of limited resources and clinical staff time. We examined the impact of integration of provider initiated HIV counselling and testing (PITC) and family planning (FP counselling and FP provision) services on duration of consultation to assess the impact of PITC and FP integration on staff workload. This study was conducted in 24 health facilities in Kenya under the Integra Initiative, a non-randomized, pre/post intervention trial to evaluate the impact of integrated HIV and sexual and reproductive health services on health and service outcomes. We compared the time spent providing PITC-only services, FP-only services and integrated PITC/FP services. We used log-linear regression to assess the impact of plausible determinants on the duration of clients' consultation times. Median consultation duration times were highest for PITC-only services (30 min), followed by integrated services (10 min) and FP-only services (8 min). Times for PITC-only and FP-only services were 69.7% higher (95% Confidence Intervals (CIs) 35.8-112.0) and 43.9% lower (95% CIs -55.4 to - 29.6) than times spent on these services when delivered as an integrated service, respectively. The reduction in consultation times with integration suggests a potential reduction in workload. The higher consultation time for PITC-only could be because more pre- and post-counselling is provided at these stand-alone services. In integrated PITC/FP services, the duration of the visit fell below that required by HIV testing guidelines, and service mix between counselling and testing substantially changed. Integration of HIV with FP services may compromise the quality of services delivered and care must be taken to clearly specify and monitor appropriate consultation duration times and procedures during the

  12. Impact of integration of sexual and reproductive health services on consultation duration times: results from the Integra Initiative

    PubMed Central

    Siapka, Mariana; Obure, Carol Dayo; Mayhew, Susannah H; Fenty, Justin; Initiative, Integra; Vassall, Anna

    2017-01-01

    Abstract The lack of human resources is a key challenge in scaling up of HIV services in Africa’s health care system. Integrating HIV services could potentially increase their effectiveness and optimize the use of limited resources and clinical staff time. We examined the impact of integration of provider initiated HIV counselling and testing (PITC) and family planning (FP counselling and FP provision) services on duration of consultation to assess the impact of PITC and FP integration on staff workload. This study was conducted in 24 health facilities in Kenya under the Integra Initiative, a non-randomized, pre/post intervention trial to evaluate the impact of integrated HIV and sexual and reproductive health services on health and service outcomes. We compared the time spent providing PITC-only services, FP-only services and integrated PITC/FP services. We used log-linear regression to assess the impact of plausible determinants on the duration of clients’ consultation times. Median consultation duration times were highest for PITC-only services (30 min), followed by integrated services (10 min) and FP-only services (8 min). Times for PITC-only and FP-only services were 69.7% higher (95% Confidence Intervals (CIs) 35.8–112.0) and 43.9% lower (95% CIs −55.4 to − 29.6) than times spent on these services when delivered as an integrated service, respectively. The reduction in consultation times with integration suggests a potential reduction in workload. The higher consultation time for PITC-only could be because more pre- and post-counselling is provided at these stand-alone services. In integrated PITC/FP services, the duration of the visit fell below that required by HIV testing guidelines, and service mix between counselling and testing substantially changed. Integration of HIV with FP services may compromise the quality of services delivered and care must be taken to clearly specify and monitor appropriate consultation duration times and

  13. [Vertical integration and contracting-out in generic hospital services in Spain].

    PubMed

    Puig-Junoy, J; Pérez-Sust, P

    2002-01-01

    This study examines the factors that influence make or buy decisions corresponding to four generic services (housekeeping, laundry, food services, and maintenance and security) in Spanish hospitals (3,160 transactions in 790 hospitals). The empirical estimation of a logistic model based on hospital utility maximization is presented. Factors included in the model are not only those related to transaction costs, but also those related to public intervention and the political dimension. A total of 55.7% of hospitals contracted-out at least one of the generic services. The services most frequently contracted-out were housekeeping and maintenance and security(45.1 and 32.5%, respectively). In contrast, the services (94.3% and 80.1%, respectively). Hospital size (economies of scale), measured by the number of beds, was one of the most important factors influencing make or buy decisions. We find evidence that economies of scale are related to a higher level of vertical integration, while specialization and for-profit objectives favor the decision to contract-out. The choice of organizational model for laundry services presents a different pattern from that of the other three services. Empirical results show that some asset specificity could be present in laundry services.

  14. The individualized service plan as a clinical integration tool: qualitative analysis in the Quebec PRISMA experiment

    PubMed Central

    Somme, Dominique; Hébert, Réjean; Bravo, Gina; Blanchard, François; Saint-Jean, Olivier

    2007-01-01

    Introduction One aspect of clinical integration involves case managers' tools and particularly the individualized service plan. Methods We examined individualized service plan content and use in the PRISMA experiment. We analyzed 50 charts, and conducted and recorded interviews regarding individualized service plan use with all the case managers concerned (n=13). Results Delays between starting case management and writing the individualized service plan were long and varied (0–596 days, mean: 117 days). During the interviews, the individualized service plan was described as the ‘last step’ once the active planning phase was over. The reasons for formulating plans were mainly administrative. From a clinical viewpoint, individualized service plans were used as memoranda and not to describe services (842 interventions not mentioned in the plans) or needs (694 active problems not mentioned). Case managers felt uncomfortable with the individualized planning task and expected a tool more adapted to their needs. Conclusion Although a majority of the case managers' charts contained an individualized service plan, implementation of this tool seems tenuous. Because of the discrepancy between the potential usefulness expected by case managers and their actual use, a working committee was created to develop proposals for modifying the instrument. PMID:19503736

  15. 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.

  16. 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

  17. 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

    2018-05-01

    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.

  18. Quantitative Analysis of Contributing Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center

    DTIC Science & Technology

    2008-06-06

    Predictors of patient satisfaction for Brooke Army Medical Center Family Medicine Service primary care clinics was performed. Data was obtained from...Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center Presented to MAJ Eric Schmacker, Ph.D. In...study. All patients ’ medical information was protected at all times and under no circumstances will be discussed or released to any outside agency

  19. The impact of HIV/SRH service integration on workload: analysis from the Integra Initiative in two African settings.

    PubMed

    Sweeney, Sedona; Obure, Carol Dayo; Terris-Prestholt, Fern; Darsamo, Vanessa; Michaels-Igbokwe, Christine; Muketo, Esther; Nhlabatsi, Zelda; Warren, Charlotte; Mayhew, Susannah; Watts, Charlotte; Vassall, Anna

    2014-08-07

    There is growing interest in integration of HIV and sexual and reproductive health (SRH) services as a way to improve the efficiency of human resources (HR) for health in low- and middle-income countries. Although this is supported by a wealth of evidence on the acceptability and clinical effectiveness of service integration, there is little evidence on whether staff in general health services can easily absorb HIV services. We conducted a descriptive analysis of HR integration through task shifting/sharing and staff workload in the context of the Integra Initiative - a large-scale five-year evaluation of HIV/SRH integration. We describe the level, characteristics and changes in HR integration in the context of wider efforts to integrate HIV/SRH, and explore the impact of HR integration on staff workload. Improvements in the range of services provided by staff (HR integration) were more likely to be achieved in facilities which also improved other elements of integration. While there was no overall relationship between integration and workload at the facility level, HIV/SRH integration may be most influential on staff workload for provider-initiated HIV testing and counselling (PITC) and postnatal care (PNC) services, particularly where HIV care and treatment services are being supported with extra SRH/HIV staffing. Our findings therefore suggest that there may be potential for further efficiency gains through integration, but overall the pace of improvement is slow. This descriptive analysis explores the effect of HIV/SRH integration on staff workload through economies of scale and scope in high- and medium-HIV prevalence settings. We find some evidence to suggest that there is potential to improve productivity through integration, but, at the same time, significant challenges are being faced, with the pace of productivity gain slow. We recommend that efforts to implement integration are assessed in the broader context of HR planning to ensure that neither staff

  20. 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...

  1. Toward Integration of Reading and Service Learning through an Interdisciplinary Program

    ERIC Educational Resources Information Center

    Ho, Shun-yee; Lee, Vivien Man-wai

    2012-01-01

    This study examined the effect of an interdisciplinary program of reading and service learning on the cognitive and affective development of university students in Hong Kong. As Nussbaum (1997) stated, literature plays a vital role in educating citizens of the world through its narrative imagination and its power of promoting understanding and…

  2. Modeling and Detecting Feature Interactions among Integrated Services of Home Network Systems

    NASA Astrophysics Data System (ADS)

    Igaki, Hiroshi; Nakamura, Masahide

    This paper presents a framework for formalizing and detecting feature interactions (FIs) in the emerging smart home domain. We first establish a model of home network system (HNS), where every networked appliance (or the HNS environment) is characterized as an object consisting of properties and methods. Then, every HNS service is defined as a sequence of method invocations of the appliances. Within the model, we next formalize two kinds of FIs: (a) appliance interactions and (b) environment interactions. An appliance interaction occurs when two method invocations conflict on the same appliance, whereas an environment interaction arises when two method invocations conflict indirectly via the environment. Finally, we propose offline and online methods that detect FIs before service deployment and during execution, respectively. Through a case study with seven practical services, it is shown that the proposed framework is generic enough to capture feature interactions in HNS integrated services. We also discuss several FI resolution schemes within the proposed framework.

  3. 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…

  4. A Study of Teachers' Perceptions of School-Level Factors Affecting Transition Services

    ERIC Educational Resources Information Center

    Lazaroff, Kurt Charles

    2013-01-01

    The purpose of this study was to explore teacher perceptions of providing transition services to high school students with special needs and to understand the variables that act as facilitators or barriers to providing those services. A qualitative research method was used to understand the perceptions of school personnel of transition services in…

  5. 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,…

  6. 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.

  7. The Costs of Delivering Integrated HIV and Sexual Reproductive Health Services in Limited Resource Settings.

    PubMed

    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

    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. A retrospective facility based costing study conducted in 40 non-government organization and public health facilities in Kenya and Swaziland. 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. 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. 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.

  8. 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

  9. 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.

  10. Research on Disaster Early Warning and Disaster Relief Integrated Service System Based on Block Data Theory

    NASA Astrophysics Data System (ADS)

    Yang, J.; Zhang, H.; Wang, C.; Tang, D.

    2018-04-01

    With the continuous development of social economy, the interaction between mankind and nature has become increasingly evident. Disastrous global catastrophes have occurred from time to time, causing huge losses to people's lives and property. All governments recognize the importance of the establishment of disaster early warning and release mechanisms, and it is also an urgent issue to improve the comprehensive service level of emergency response and disaster relief. However, disaster early warning and emergency relief information is usually generated by different departments, and the diverse data sources, difficult integration, and limited release speed have always been difficult issues to be solved. Block data is the aggregation of various distributed (point data) and segmentation (data) big data on a specific platform and make them happen continuous polymerization effect, block data theory is a good solution to cross-sectoral, cross-platform Disaster information data sharing and integration problems. This paper attempts to discuss the integrated service mechanism of disaster information aggregation and disaster relief based on block data theory and introduces a location-based integrated service system for disaster early warning and disaster relief.

  11. Measuring Integration of Cancer Services to Support Performance Improvement: The CSI Survey

    PubMed Central

    Dobrow, Mark J.; Paszat, Lawrence; Golden, Brian; Brown, Adalsteinn D.; Holowaty, Eric; Orchard, Margo C.; Monga, Neerav; Sullivan, Terrence

    2009-01-01

    Objective: To develop a measure of cancer services integration (CSI) that can inform clinical and administrative decision-makers in their efforts to monitor and improve cancer system performance. Methods: We employed a systematic approach to measurement development, including review of existing cancer/health services integration measures, key-informant interviews and focus groups with cancer system leaders. The research team constructed a Web-based survey that was field- and pilot-tested, refined and then formally conducted on a sample of cancer care providers and administrators in Ontario, Canada. We then conducted exploratory factor analysis to identify key dimensions of CSI. Results: A total of 1,769 physicians, other clinicians and administrators participated in the survey, responding to a 67-item questionnaire. The exploratory factor analysis identified 12 factors that were linked to three broader dimensions: clinical, functional and vertical system integration. Conclusions: The CSI Survey provides important insights on a range of typically unmeasured aspects of the coordination and integration of cancer services, representing a new tool to inform performance improvement efforts. PMID:20676250

  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. Distributed Earth observation data integration and on-demand services based on a collaborative framework of geospatial data service gateway

    NASA Astrophysics Data System (ADS)

    Xie, Jibo; Li, Guoqing

    2015-04-01

    Earth observation (EO) data obtained by air-borne or space-borne sensors has the characteristics of heterogeneity and geographical distribution of storage. These data sources belong to different organizations or agencies whose data management and storage methods are quite different and geographically distributed. Different data sources provide different data publish platforms or portals. With more Remote sensing sensors used for Earth Observation (EO) missions, different space agencies have distributed archived massive EO data. The distribution of EO data archives and system heterogeneity makes it difficult to efficiently use geospatial data for many EO applications, such as hazard mitigation. To solve the interoperable problems of different EO data systems, an advanced architecture of distributed geospatial data infrastructure is introduced to solve the complexity of distributed and heterogeneous EO data integration and on-demand processing in this paper. The concept and architecture of geospatial data service gateway (GDSG) is proposed to build connection with heterogeneous EO data sources by which EO data can be retrieved and accessed with unified interfaces. The GDSG consists of a set of tools and service to encapsulate heterogeneous geospatial data sources into homogenous service modules. The GDSG modules includes EO metadata harvesters and translators, adaptors to different type of data system, unified data query and access interfaces, EO data cache management, and gateway GUI, etc. The GDSG framework is used to implement interoperability and synchronization between distributed EO data sources with heterogeneous architecture. An on-demand distributed EO data platform is developed to validate the GDSG architecture and implementation techniques. Several distributed EO data achieves are used for test. Flood and earthquake serves as two scenarios for the use cases of distributed EO data integration and interoperability.

  14. Improving service uptake and quality of care of integrated maternal health services: the Kenya Kwale District improvement collaborative.

    PubMed

    Mwaniki, Michael K; Vaid, Sonali; Chome, Isaac Mwamuye; Amolo, Dorcas; Tawfik, Youssef

    2014-09-21

    utilization of services and adherence to standards of care. Using the quality improvement methodology to target integrated health services is feasible. Longer follow-up periods are needed to gather more evidence on the sustainability of quality improvement initiatives in low-income countries.

  15. Web services as applications' integration tool: QikProp case study.

    PubMed

    Laoui, Abdel; Polyakov, Valery R

    2011-07-15

    Web services are a new technology that enables to integrate applications running on different platforms by using primarily XML to enable communication among different computers over the Internet. Large number of applications was designed as stand alone systems before the concept of Web services was introduced and it is a challenge to integrate them into larger computational networks. A generally applicable method of wrapping stand alone applications into Web services was developed and is described. To test the technology, it was applied to the QikProp for DOS (Windows). Although performance of the application did not change when it was delivered as a Web service, this form of deployment had offered several advantages like simplified and centralized maintenance, smaller number of licenses, and practically no training for the end user. Because by using the described approach almost any legacy application can be wrapped as a Web service, this form of delivery may be recommended as a global alternative to traditional deployment solutions. Copyright © 2011 Wiley Periodicals, Inc.

  16. Integrated Automatic Workflow for Phylogenetic Tree Analysis Using Public Access and Local Web Services.

    PubMed

    Damkliang, Kasikrit; Tandayya, Pichaya; Sangket, Unitsa; Pasomsub, Ekawat

    2016-11-28

    At the present, coding sequence (CDS) has been discovered and larger CDS is being revealed frequently. Approaches and related tools have also been developed and upgraded concurrently, especially for phylogenetic tree analysis. This paper proposes an integrated automatic Taverna workflow for the phylogenetic tree inferring analysis using public access web services at European Bioinformatics Institute (EMBL-EBI) and Swiss Institute of Bioinformatics (SIB), and our own deployed local web services. The workflow input is a set of CDS in the Fasta format. The workflow supports 1,000 to 20,000 numbers in bootstrapping replication. The workflow performs the tree inferring such as Parsimony (PARS), Distance Matrix - Neighbor Joining (DIST-NJ), and Maximum Likelihood (ML) algorithms of EMBOSS PHYLIPNEW package based on our proposed Multiple Sequence Alignment (MSA) similarity score. The local web services are implemented and deployed into two types using the Soaplab2 and Apache Axis2 deployment. There are SOAP and Java Web Service (JWS) providing WSDL endpoints to Taverna Workbench, a workflow manager. The workflow has been validated, the performance has been measured, and its results have been verified. Our workflow's execution time is less than ten minutes for inferring a tree with 10,000 replicates of the bootstrapping numbers. This paper proposes a new integrated automatic workflow which will be beneficial to the bioinformaticians with an intermediate level of knowledge and experiences. All local services have been deployed at our portal http://bioservices.sci.psu.ac.th.

  17. Integrated Automatic Workflow for Phylogenetic Tree Analysis Using Public Access and Local Web Services.

    PubMed

    Damkliang, Kasikrit; Tandayya, Pichaya; Sangket, Unitsa; Pasomsub, Ekawat

    2016-03-01

    At the present, coding sequence (CDS) has been discovered and larger CDS is being revealed frequently. Approaches and related tools have also been developed and upgraded concurrently, especially for phylogenetic tree analysis. This paper proposes an integrated automatic Taverna workflow for the phylogenetic tree inferring analysis using public access web services at European Bioinformatics Institute (EMBL-EBI) and Swiss Institute of Bioinformatics (SIB), and our own deployed local web services. The workflow input is a set of CDS in the Fasta format. The workflow supports 1,000 to 20,000 numbers in bootstrapping replication. The workflow performs the tree inferring such as Parsimony (PARS), Distance Matrix - Neighbor Joining (DIST-NJ), and Maximum Likelihood (ML) algorithms of EMBOSS PHYLIPNEW package based on our proposed Multiple Sequence Alignment (MSA) similarity score. The local web services are implemented and deployed into two types using the Soaplab2 and Apache Axis2 deployment. There are SOAP and Java Web Service (JWS) providing WSDL endpoints to Taverna Workbench, a workflow manager. The workflow has been validated, the performance has been measured, and its results have been verified. Our workflow's execution time is less than ten minutes for inferring a tree with 10,000 replicates of the bootstrapping numbers. This paper proposes a new integrated automatic workflow which will be beneficial to the bioinformaticians with an intermediate level of knowledge and experiences. The all local services have been deployed at our portal http://bioservices.sci.psu.ac.th.

  18. 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

  19. 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.

  20. '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

    2018-06-01

    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.

  1. PROTECT: A Pilot Program to Integrate Mental Health Treatment Into Elder Abuse Services for Older Women.

    PubMed

    Sirey, Jo Anne; Halkett, Ashley; Chambers, Stephanie; Salamone, Aurora; Bruce, Martha L; Raue, Patrick J; Berman, Jacquelin

    2015-01-01

    The goal of this pilot program was to test the usefulness of adapted Problem-Solving Therapy (PST) and anxiety management, called PROTECT, integrated into elder abuse services to reduce depression and improve self-efficacy. Depressed women victims were randomized to receive elder abuse resolution services combined with either PROTECT or a mental health referral. At follow-up, the PROTECT group showed greater reduction in depressive symptoms and endorsed greater improved self-efficacy in problem-solving when compared to those in the Referral condition. These preliminary findings support the potential usefulness of PROTECT to alleviate depressive symptoms and enhance personal resources among abused older women.

  2. The EPOS Implementation Phase: building thematic and integrated services for solid Earth sciences

    NASA Astrophysics Data System (ADS)

    Cocco, Massimo; Epos Consortium, the

    2015-04-01

    integrating RI elements. This integration requires a significant coordination between, among others, disciplinary (thematic) communities, national RIs policies and initiatives, as well as geo- and IT-scientists. The RIs that EPOS is coordinating include: i) regionally-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. Here we present the successful story of the EPOS Preparatory Phase and the progress towards the implementation of both integrated core services (ICS) and thematic core services (TCS) for the different communities participating to the integration plan. We aim to discuss the achieved results and the approach followed to design the implementation phase. The goal is to present and discuss the strategies adopted to foster the implementation of TCS, clarifying their crucial role as domain-specific service hubs for coordinating and harmonizing national resources/plans with the European dimension of EPOS, and their integration to develop the new ICS. We will present the prototype of the ICS central hub as a key contribution for providing multidisciplinary services for solid Earth sciences as well as the glue to keep ICT aspects integrated and rationalized across EPOS. Finally, we will discuss the well-defined role of the EPOS-ERIC Headquarter to coordinate and harmonize national RIs and EPOS services (through ICS and TCS) looking for an effective commitment by national governments. It will be an important and timely opportunity to discuss the EPOS roadmap toward the operation of the novel multidisciplinary platform for discoveries to foster scientific excellence in solid Earth sciences.

  3. Identification of Differentially Expressed Genes through Integrated Study of Alzheimer’s Disease Affected Brain Regions

    PubMed Central

    Berretta, Regina; Moscato, Pablo

    2016-01-01

    Background Alzheimer’s disease (AD) is the most common form of dementia in older adults that damages the brain and results in impaired memory, thinking and behaviour. The identification of differentially expressed genes and related pathways among affected brain regions can provide more information on the mechanisms of AD. In the past decade, several studies have reported many genes that are associated with AD. This wealth of information has become difficult to follow and interpret as most of the results are conflicting. In that case, it is worth doing an integrated study of multiple datasets that helps to increase the total number of samples and the statistical power in detecting biomarkers. In this study, we present an integrated analysis of five different brain region datasets and introduce new genes that warrant further investigation. Methods The aim of our study is to apply a novel combinatorial optimisation based meta-analysis approach to identify differentially expressed genes that are associated to AD across brain regions. In this study, microarray gene expression data from 161 samples (74 non-demented controls, 87 AD) from the Entorhinal Cortex (EC), Hippocampus (HIP), Middle temporal gyrus (MTG), Posterior cingulate cortex (PC), Superior frontal gyrus (SFG) and visual cortex (VCX) brain regions were integrated and analysed using our method. The results are then compared to two popular meta-analysis methods, RankProd and GeneMeta, and to what can be obtained by analysing the individual datasets. Results We find genes related with AD that are consistent with existing studies, and new candidate genes not previously related with AD. Our study confirms the up-regualtion of INFAR2 and PTMA along with the down regulation of GPHN, RAB2A, PSMD14 and FGF. Novel genes PSMB2, WNK1, RPL15, SEMA4C, RWDD2A and LARGE are found to be differentially expressed across all brain regions. Further investigation on these genes may provide new insights into the development of AD

  4. Identification of Differentially Expressed Genes through Integrated Study of Alzheimer's Disease Affected Brain Regions.

    PubMed

    Puthiyedth, Nisha; Riveros, Carlos; Berretta, Regina; Moscato, Pablo

    2016-01-01

    Alzheimer's disease (AD) is the most common form of dementia in older adults that damages the brain and results in impaired memory, thinking and behaviour. The identification of differentially expressed genes and related pathways among affected brain regions can provide more information on the mechanisms of AD. In the past decade, several studies have reported many genes that are associated with AD. This wealth of information has become difficult to follow and interpret as most of the results are conflicting. In that case, it is worth doing an integrated study of multiple datasets that helps to increase the total number of samples and the statistical power in detecting biomarkers. In this study, we present an integrated analysis of five different brain region datasets and introduce new genes that warrant further investigation. The aim of our study is to apply a novel combinatorial optimisation based meta-analysis approach to identify differentially expressed genes that are associated to AD across brain regions. In this study, microarray gene expression data from 161 samples (74 non-demented controls, 87 AD) from the Entorhinal Cortex (EC), Hippocampus (HIP), Middle temporal gyrus (MTG), Posterior cingulate cortex (PC), Superior frontal gyrus (SFG) and visual cortex (VCX) brain regions were integrated and analysed using our method. The results are then compared to two popular meta-analysis methods, RankProd and GeneMeta, and to what can be obtained by analysing the individual datasets. We find genes related with AD that are consistent with existing studies, and new candidate genes not previously related with AD. Our study confirms the up-regualtion of INFAR2 and PTMA along with the down regulation of GPHN, RAB2A, PSMD14 and FGF. Novel genes PSMB2, WNK1, RPL15, SEMA4C, RWDD2A and LARGE are found to be differentially expressed across all brain regions. Further investigation on these genes may provide new insights into the development of AD. In addition, we identified

  5. Integrating medical devices in the operating room using service-oriented architectures.

    PubMed

    Ibach, Bastian; Benzko, Julia; Schlichting, Stefan; Zimolong, Andreas; Radermacher, Klaus

    2012-08-01

    Abstract With the increasing documentation requirements and communication capabilities of medical devices in the operating room, the integration and modular networking of these devices have become more and more important. Commercial integrated operating room systems are mainly proprietary developments using usually proprietary communication standards and interfaces, which reduce the possibility of integrating devices from different vendors. To overcome these limitations, there is a need for an open standardized architecture that is based on standard protocols and interfaces enabling the integration of devices from different vendors based on heterogeneous software and hardware components. Starting with an analysis of the requirements for device integration in the operating room and the techniques used for integrating devices in other industrial domains, a new concept for an integration architecture for the operating room based on the paradigm of a service-oriented architecture is developed. Standardized communication protocols and interface descriptions are used. As risk management is an important factor in the field of medical engineering, a risk analysis of the developed concept has been carried out and the first prototypes have been implemented.

  6. Integrated care management: aligning medical call centers and nurse triage services.

    PubMed

    Kastens, J M

    1998-01-01

    Successful integrated delivery systems must aggressively design new approaches to managing patient care. Implementing a comprehensive care management model to coordinate patient care across the continuum is essential to improving patient care and reducing costs. The practice of telephone nursing and the need for experienced registered nurses to staff medical call centers, nurse triage centers, and outbound telemanagement is expanding as the penetration of full-risk capitated managed care contracts are signed. As health systems design their new care delivery approaches and care management models, medical call centers will be an integral approach to managing demand for services, chronic illnesses, and prevention strategies.

  7. 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

  8. 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

  9. Socioeconomic factors affecting patients’ utilization of primary care services at a Tertiary Teaching Hospital in Riyadh, Saudi Arabia

    PubMed Central

    Alsubaie, Abdulaziz M.; Almohaimede, Khaled A.; Aljadoa, Abdulrahman F.; Jarallah, Osamah J.; Althnayan, Yasser I.; Alturki, Yousef A.

    2016-01-01

    Background: Primary care services utilization is dependent on socioeconomic factors. It is proven that variation in socioeconomic factors result in discrepancies in the use of such services. Admittedly, research is limited on the socioeconomic factors affecting the utilization of primary care services in Saudi Arabia. Objectives: The aim of this research was to study the effect of the main socioeconomic factors affecting patients' utilization of primary care services at a tertiary teaching hospital, Riyadh, Saudi Arabia. Materials and Methods: A cross-sectional study was conducted from January to February 2014 in a primary care clinic of a tertiary teaching hospital in Riyadh city; subjects selected using a random consecutive sampling technique. A self-administered questionnaire in Arabic was given to the participants to collect the data which comprised sociodemographic data, utilization measures, and health needs. The data were analyzed using SPSS version 21. Results: A total of 358 subjects participated in the study. The main factors that best determine the utilization of primary health care clinic in a tertiary teaching hospital were the possession of a health insurance (P = 0.046, odds ratio [OR] = 8.333), and bad self-health-perception (P < 0.014, OR: 2.088). Chronic illness was also associated with higher utilization (OR = 2.003). Conclusion: Our results reveal that chronic health problems, self-health-perception, and health insurance are the most significant socioeconomic factors affecting the utilization of primary care services. PMID:26929723

  10. Quantifying causal mechanisms to determine how protected areas affect poverty through changes in ecosystem services and infrastructure.

    PubMed

    Ferraro, Paul J; Hanauer, Merlin M

    2014-03-18

    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 poverty alleviation in the context of a real environmental program have not yet been empirically estimated. Nearly two-thirds of the poverty reduction associated with the establishment of Costa Rican protected areas is causally attributable to opportunities afforded by tourism. Although protected areas reduced deforestation and increased regrowth, these land cover changes neither reduced nor exacerbated poverty, on average. Protected areas did not, on average, affect our measures of infrastructure and thus did not contribute to poverty reduction through this mechanism. We attribute the remaining poverty reduction to unobserved dimensions of our mechanisms or to other mechanisms. Our study empirically estimates previously unidentified contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program. We demonstrate that, with existing data and appropriate empirical methods, conservation scientists and policymakers can begin to elucidate the mechanisms through which ecosystem conservation programs affect human welfare.

  11. Use of ICT Technologies and Factors Affecting Pre-Service ELT Teachers' Perceived ICT Self-Efficacy

    ERIC Educational Resources Information Center

    Bozdogan, Derya; Özen, Rasit

    2014-01-01

    This study aims to identify both level and frequency of ICT technology use and factors affecting perceived self-efficacy levels of pre-service English Language Teaching (ELT) teachers' (n = 241) ICT self-efficacy. The data were collected through a survey (Çuhadar & Yücel, 2010) during the 2011-2012 academic year that includes items on the use…

  12. 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 poverty alleviation in the context of a real environmental program have not yet been empirically estimated. Nearly two-thirds of the poverty reduction associated with the establishment of Costa Rican protected areas is causally attributable to opportunities afforded by tourism. Although protected areas reduced deforestation and increased regrowth, these land cover changes neither reduced nor exacerbated poverty, on average. Protected areas did not, on average, affect our measures of infrastructure and thus did not contribute to poverty reduction through this mechanism. We attribute the remaining poverty reduction to unobserved dimensions of our mechanisms or to other mechanisms. Our study empirically estimates previously unidentified contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program. We demonstrate that, with existing data and appropriate empirical methods, conservation scientists and policymakers can begin to elucidate the mechanisms through which ecosystem conservation programs affect human welfare. PMID:24567397

  13. 39 CFR 3001.117 - Posting of documents by Postal Service for inspection by affected postal patrons.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PERSONNEL RULES OF PRACTICE AND PROCEDURE Rules Applicable to Appeals of Postal Service Determinations To... cause to be displayed prominently, in the post office or offices serving the patrons affected by the... display prominently any such document shall be deemed sufficient reason to suspend the effectiveness of...

  14. Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

    PubMed

    Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

    2015-01-28

    To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

  15. Factors Affecting Mental Health Service Utilization Among California Public College and University Students.

    PubMed

    Sontag-Padilla, Lisa; Woodbridge, Michelle W; Mendelsohn, Joshua; D'Amico, Elizabeth J; Osilla, Karen Chan; Jaycox, Lisa H; Eberhart, Nicole K; Burnam, Audrey M; Stein, Bradley D

    2016-08-01

    Unmet need for mental health treatment among college students is a significant public health issue. Despite having access to campus mental health providers and insurance to cover services, many college students do not receive necessary services. This study examined factors influencing college students' use of mental health services. Online survey data for 33,943 students and 14,018 staff and faculty at 39 college campuses in California were analyzed by using logistic regressions examining the association between students' use of mental health services and student characteristics, campus environment, and the presence of a formal network of campus mental health clinics. Nineteen percent of students reported current serious psychological distress in the past 30 days, and 11% reported significant mental health-related academic impairment in the past year. Twenty percent reported using mental health services while at their current college, 10% by using campus services and 10% off-campus services. Students on campuses with a formal network of mental health clinics were more likely than students at community colleges to receive mental health services (odds ratio [OR] range=1.68-1.69), particularly campus services (OR=3.47-5.72). Students on campuses that are supportive of mental health issues were more likely to receive mental health services (OR=1.22), particularly on campus (OR=1.65). Students with active (versus low) coping skills were consistently more likely to use mental health services. Establishing more campus mental health clinics, fostering supportive campus environments, and increasing students' coping skills may reduce unmet need for mental health services among college students.

  16. 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

  17. A fungal transcription factor essential for starch degradation affects integration of carbon and nitrogen metabolism

    SciTech Connect

    Xiong, Yi; Wu, Vincent W.; Lubbe, Andrea

    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

  18. Emotion malleability beliefs, emotion regulation, and psychopathology: Integrating affective and clinical science.

    PubMed

    Kneeland, Elizabeth T; Dovidio, John F; Joorma