Sample records for service provision based

  1. Evaluation of Drought Implications on Ecosystem Services: Freshwater Provisioning and Food Provisioning in the Upper Mississippi River Basin

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

    Li, Ping; Omani, Nina; Chaubey, Indrajeet

    Drought is one of the most widespread extreme climate events with a potential to alter freshwater availability and related ecosystem services. Given the interconnectedness between freshwater availability and many ecosystem services, including food provisioning, it is important to evaluate the drought implications on freshwater provisioning and food provisioning services. Studies about drought implications on streamflow, nutrient loads, and crop yields have been increased and these variables are all process-based model outputs that could represent ecosystem functions that contribute to the ecosystem services. However, few studies evaluate drought effects on ecosystem services such as freshwater and food provisioning and quantify thesemore » services using an index-based ecosystem service approach. In this study, the drought implications on freshwater and food provisioning services were evaluated for 14 four-digit HUC (Hydrological Unit Codes) subbasins in the Upper Mississippi River Basin (UMRB), using three drought indices: standardized precipitation index (SPI), standardized soil water content index (SSWI), and standardized streamflow index (SSI). The results showed that the seasonal freshwater provisioning was highly affected by the precipitation deficits and/or surpluses in summer and autumn. A greater importance of hydrological drought than meteorological drought implications on freshwater provisioning was evident for the majority of the subbasins, as evidenced by higher correlations between freshwater provisioning and SSI12 than SPI12. Food provisioning was substantially affected by the precipitation and soil water deficits during summer and early autumn, with relatively less effect observed in winter. A greater importance of agricultural drought effects on food provisioning was evident for most of the subbasins during crop reproductive stages. Results from this study may provide insights to help make effective land management decisions in responding to extreme climate conditions in order to protect and restore freshwater provisioning and food provisioning services in the UMRB.« less

  2. Evaluation of Drought Implications on Ecosystem Services: Freshwater Provisioning and Food Provisioning in the Upper Mississippi River Basin.

    PubMed

    Li, Ping; Omani, Nina; Chaubey, Indrajeet; Wei, Xiaomei

    2017-05-08

    Drought is one of the most widespread extreme climate events with a potential to alter freshwater availability and related ecosystem services. Given the interconnectedness between freshwater availability and many ecosystem services, including food provisioning, it is important to evaluate the drought implications on freshwater provisioning and food provisioning services. Studies about drought implications on streamflow, nutrient loads, and crop yields have been increased and these variables are all process-based model outputs that could represent ecosystem functions that contribute to the ecosystem services. However, few studies evaluate drought effects on ecosystem services such as freshwater and food provisioning and quantify these services using an index-based ecosystem service approach. In this study, the drought implications on freshwater and food provisioning services were evaluated for 14 four-digit HUC (Hydrological Unit Codes) subbasins in the Upper Mississippi River Basin (UMRB), using three drought indices: standardized precipitation index ( SPI ), standardized soil water content index ( SSWI ), and standardized streamflow index ( SSI ). The results showed that the seasonal freshwater provisioning was highly affected by the precipitation deficits and/or surpluses in summer and autumn. A greater importance of hydrological drought than meteorological drought implications on freshwater provisioning was evident for the majority of the subbasins, as evidenced by higher correlations between freshwater provisioning and SSI 12 than SPI 12. Food provisioning was substantially affected by the precipitation and soil water deficits during summer and early autumn, with relatively less effect observed in winter. A greater importance of agricultural drought effects on food provisioning was evident for most of the subbasins during crop reproductive stages. Results from this study may provide insights to help make effective land management decisions in responding to extreme climate conditions in order to protect and restore freshwater provisioning and food provisioning services in the UMRB.

  3. Evaluation of Drought Implications on Ecosystem Services: Freshwater Provisioning and Food Provisioning in the Upper Mississippi River Basin

    PubMed Central

    Li, Ping; Omani, Nina; Chaubey, Indrajeet; Wei, Xiaomei

    2017-01-01

    Drought is one of the most widespread extreme climate events with a potential to alter freshwater availability and related ecosystem services. Given the interconnectedness between freshwater availability and many ecosystem services, including food provisioning, it is important to evaluate the drought implications on freshwater provisioning and food provisioning services. Studies about drought implications on streamflow, nutrient loads, and crop yields have been increased and these variables are all process-based model outputs that could represent ecosystem functions that contribute to the ecosystem services. However, few studies evaluate drought effects on ecosystem services such as freshwater and food provisioning and quantify these services using an index-based ecosystem service approach. In this study, the drought implications on freshwater and food provisioning services were evaluated for 14 four-digit HUC (Hydrological Unit Codes) subbasins in the Upper Mississippi River Basin (UMRB), using three drought indices: standardized precipitation index (SPI), standardized soil water content index (SSWI), and standardized streamflow index (SSI). The results showed that the seasonal freshwater provisioning was highly affected by the precipitation deficits and/or surpluses in summer and autumn. A greater importance of hydrological drought than meteorological drought implications on freshwater provisioning was evident for the majority of the subbasins, as evidenced by higher correlations between freshwater provisioning and SSI12 than SPI12. Food provisioning was substantially affected by the precipitation and soil water deficits during summer and early autumn, with relatively less effect observed in winter. A greater importance of agricultural drought effects on food provisioning was evident for most of the subbasins during crop reproductive stages. Results from this study may provide insights to help make effective land management decisions in responding to extreme climate conditions in order to protect and restore freshwater provisioning and food provisioning services in the UMRB. PMID:28481311

  4. Evaluation of Drought Implications on Ecosystem Services: Freshwater Provisioning and Food Provisioning in the Upper Mississippi River Basin

    DOE PAGES

    Li, Ping; Omani, Nina; Chaubey, Indrajeet; ...

    2017-05-08

    Drought is one of the most widespread extreme climate events with a potential to alter freshwater availability and related ecosystem services. Given the interconnectedness between freshwater availability and many ecosystem services, including food provisioning, it is important to evaluate the drought implications on freshwater provisioning and food provisioning services. Studies about drought implications on streamflow, nutrient loads, and crop yields have been increased and these variables are all process-based model outputs that could represent ecosystem functions that contribute to the ecosystem services. However, few studies evaluate drought effects on ecosystem services such as freshwater and food provisioning and quantify thesemore » services using an index-based ecosystem service approach. In this study, the drought implications on freshwater and food provisioning services were evaluated for 14 four-digit HUC (Hydrological Unit Codes) subbasins in the Upper Mississippi River Basin (UMRB), using three drought indices: standardized precipitation index (SPI), standardized soil water content index (SSWI), and standardized streamflow index (SSI). The results showed that the seasonal freshwater provisioning was highly affected by the precipitation deficits and/or surpluses in summer and autumn. A greater importance of hydrological drought than meteorological drought implications on freshwater provisioning was evident for the majority of the subbasins, as evidenced by higher correlations between freshwater provisioning and SSI12 than SPI12. Food provisioning was substantially affected by the precipitation and soil water deficits during summer and early autumn, with relatively less effect observed in winter. A greater importance of agricultural drought effects on food provisioning was evident for most of the subbasins during crop reproductive stages. Results from this study may provide insights to help make effective land management decisions in responding to extreme climate conditions in order to protect and restore freshwater provisioning and food provisioning services in the UMRB.« less

  5. The research of service provision based on service-oriented architecture for NGN

    NASA Astrophysics Data System (ADS)

    Jie, Yin; Nian, Zhou; Qian, Mao

    2007-11-01

    Service convergence is an important characteristic of NGN(Next Generation Networking). How to integrate the service capabilities of telecommunication network and Internet. At first, this article puts forward the concepts and characteristics of SOA (Service-Oriented Architecture) and Web Service, then discusses relationship between them. Secondly, combined with five kinds of Service Provision in NGN, A service platform architecture design of NGN and a service development mode based on SOA are brought up. At last, a specific example is analyzed with BPEL (Business Process Execution Language) in order to describe service development flow based on SOA for NGN.

  6. A cross-sectional survey of the prevalence of environmental tobacco smoke preventive care provision by child health services in Australia

    PubMed Central

    2011-01-01

    Background Despite the need for a reduction in levels of childhood exposure to environmental tobacco smoke (ETS) being a recognised public health goal, the delivery of ETS preventive care in child health service settings remains a largely unstudied area. The purpose of this study was to determine the prevalence of ETS preventive care in child health services; differences in the provision of care by type of service; the prevalence of strategies to support such care; and the association between care support strategies and care provision. Method One-hundred and fifty-one (83%) child health service managers within New South Wales, Australia completed a questionnaire in 2002 regarding the: assessment of parental smoking and child ETS exposure; the provision of parental smoking cessation and ETS-exposure reduction advice; and strategies used to support the provision of such care. Child health services were categorised based on their size and case-mix, and a chi-square analysis was performed to compare the prevalence of ETS risk assessment and ETS prevention advice between service types. Logistic regression analysis was used to examine associations between the existence of care support strategies and the provision of ETS risk assessment and ETS exposure prevention advice. Results A significant proportion of services reported that they did not assess parental smoking status (26%), and reported that they did not assess the ETS exposure (78%) of any child. Forty four percent of services reported that they did not provide smoking cessation advice and 20% reported they did not provide ETS exposure prevention advice. Community based child and family health services reported a greater prevalence of ETS preventive care compared to other hospital based units. Less than half of the services reported having strategies to support the provision of ETS preventive care. The existence of such support strategies was associated with greater odds of care provision. Conclusions The existence of major gaps in recommended ETS preventive care provision suggests a need for additional initiatives to increase such care delivery. The low prevalence of strategies that support such care delivery suggests a potential avenue to achieve this outcome. PMID:21575273

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

    PubMed

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

    2005-10-01

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

  8. Providing written language services in the schools: the time is now.

    PubMed

    Fallon, Karen A; Katz, Lauren A

    2011-01-01

    The current study was conducted to investigate the provision of written language services by school-based speech-language pathologists (SLPs). Specifically, the study examined SLPs' knowledge, attitudes, and collaborative practices in the area of written language services as well as the variables that impact provision of these services. Public school-based SLPs from across the country were solicited for participation in an online, Web-based survey. Data from 645 full-time SLPs from 49 states were evaluated using descriptive statistics and logistic regression. Many school-based SLPs reported not providing any services in the area of written language to students with written language weaknesses. Knowledge, attitudes, and collaborative practices were mixed. A logistic regression revealed three variables likely to predict high levels of service provision in the area of written language. Data from the current study revealed that many struggling readers and writers on school-based SLPs' caseloads are not receiving services from their SLPs. Implications for SLPs' preservice preparation, continuing education, and doctoral preparation are discussed.

  9. Aftercare Services for Child Victims of Sex Trafficking: A Systematic Review of Policy and Practice.

    PubMed

    Muraya, Dorothy Neriah; Fry, Deborah

    2016-04-01

    To explore aftercare services provided to child victims of sex trafficking globally based on the results of a systematic review of published and unpublished research, organizational policy, and current practice. This systematic review serves as a first step toward developing best practices for aftercare service providers. A systematic search was conducted of four English language databases, two human trafficking resource libraries, and one Internet search engine for journal articles and "grey" literature published between January 2000 and May 2013 on the services offered to child sex trafficking victims globally. The search yielded 15 documents for inclusion in the review. The 15 documents emphasized the need for aftercare service provision to be founded on children's rights and trauma-informed service provision. They recommended delivery practices such as case management and multidisciplinary, multiagency and multinational coordination to ensure the child victims benefit fully from the services. The systematic review revealed that there are three phases to aftercare service provision: rescue, recover, and reintegration. Each of these phases is characterized by different needs and types of services provided. The recovery phase received the most attention compared to recovery and reintegration phases. The literature highlighted that aftercare service provision for child sex trafficking victims is a new area that needs an evidence base from which policy and practice can be formed. There is great need for further research and better documentation of service provision. While this research provides insight into this area, the gap in literature remains wide. The area of aftercare service provision for children who have been trafficked has experienced phenomenal growth within the last 10 years, and with more research and resources being directed to the area, the achievement of international minimum standards of care provision is possible. © The Author(s) 2015.

  10. Family-centered services for children with complex communication needs: the practices and beliefs of school-based speech-language pathologists.

    PubMed

    Mandak, Kelsey; Light, Janice

    2018-06-01

    This study used an online focus group to examine the beliefs and practices of school-based speech-language pathologists (SLPs) who served children with complex communication needs regarding their provision of family-centered services. Participants revealed that despite their desire for family involvement and reported beliefs in the importance of family-centered services, there were barriers in place that often limited family-centered service provision. Across the SLPs, many were dissatisfied with their current provision of family-centered services. The SLPs varied in their reported practices, with some reporting family-centered services and others, professional-centered services. Future research is recommended in order to investigate which factors contribute to the variation among SLPs and how the variation impacts children who require augmentative and alternative communication (AAC) and their families. Potential clinical implications for in-service and pre-service SLPs are discussed to improve future family-centered AAC services.

  11. Information analytics for healthcare service discovery.

    PubMed

    Sun, Lily; Yamin, Mohammad; Mushi, Cleopa; Liu, Kecheng; Alsaigh, Mohammed; Chen, Fabian

    2014-01-01

    The concept of being 'patient-centric' is a challenge to many existing healthcare service provision practices. This paper focuses on the issue of referrals, where multiple stakeholders, such as General Practitioners (GPs) and patients, are encouraged to make a consensual decision based on patients' needs. In this paper, we present an ontology-enabled healthcare service provision, which facilitates both patients and GPs in jointly deciding upon the referral decision. In the healthcare service provision model, we define three types of profiles which represent different stakeholders' requirements. This model also comprises a set of healthcare service discovery processes: articulating a service need, matching the need with the healthcare service offerings, and deciding on a best-fit service for acceptance. As a result, the healthcare service provision can carry out coherent analysis using personalised information and iterative processes that deal with requirements which change over time.

  12. Providing Written Language Services in the Schools: The Time Is Now

    ERIC Educational Resources Information Center

    Fallon, Karen A.; Katz, Lauren A.

    2011-01-01

    Purpose: The current study was conducted to investigate the provision of written language services by school-based speech-language pathologists (SLPs). Specifically, the study examined SLPs' knowledge, attitudes, and collaborative practices in the area of written language services as well as the variables that impact provision of these services.…

  13. Strong and nonlinear effects of fragmentation on ecosystem service provision at multiple scales

    NASA Astrophysics Data System (ADS)

    Mitchell, Matthew G. E.; Bennett, Elena M.; Gonzalez, Andrew

    2015-09-01

    Human actions, such as converting natural land cover to agricultural or urban land, result in the loss and fragmentation of natural habitat, with important consequences for the provision of ecosystem services. Such habitat loss is especially important for services that are supplied by fragments of natural land cover and that depend on flows of organisms, matter, or people across the landscape to produce benefits, such as pollination, pest regulation, recreation and cultural services. However, our quantitative knowledge about precisely how different patterns of landscape fragmentation might affect the provision of these types of services is limited. We used a simple, spatially explicit model to evaluate the potential impact of natural land cover loss and fragmentation on the provision of hypothetical ecosystem services. Based on current literature, we assumed that fragments of natural land cover provide ecosystem services to the area surrounding them in a distance-dependent manner such that ecosystem service flow depended on proximity to fragments. We modeled seven different patterns of natural land cover loss across landscapes that varied in the overall level of landscape fragmentation. Our model predicts that natural land cover loss will have strong and unimodal effects on ecosystem service provision, with clear thresholds indicating rapid loss of service provision beyond critical levels of natural land cover loss. It also predicts the presence of a tradeoff between maximizing ecosystem service provision and conserving natural land cover, and a mismatch between ecosystem service provision at landscape versus finer spatial scales. Importantly, the pattern of landscape fragmentation mitigated or intensified these tradeoffs and mismatches. Our model suggests that managing patterns of natural land cover loss and fragmentation could help influence the provision of multiple ecosystem services and manage tradeoffs and synergies between services across different human-dominated landscapes.

  14. Differentiated protection services with failure probability guarantee for workflow-based applications

    NASA Astrophysics Data System (ADS)

    Zhong, Yaoquan; Guo, Wei; Jin, Yaohui; Sun, Weiqiang; Hu, Weisheng

    2010-12-01

    A cost-effective and service-differentiated provisioning strategy is very desirable to service providers so that they can offer users satisfactory services, while optimizing network resource allocation. Providing differentiated protection services to connections for surviving link failure has been extensively studied in recent years. However, the differentiated protection services for workflow-based applications, which consist of many interdependent tasks, have scarcely been studied. This paper investigates the problem of providing differentiated services for workflow-based applications in optical grid. In this paper, we develop three differentiated protection services provisioning strategies which can provide security level guarantee and network-resource optimization for workflow-based applications. The simulation demonstrates that these heuristic algorithms provide protection cost-effectively while satisfying the applications' failure probability requirements.

  15. Healthcare professionals' perceptions related to the provision of clinical pharmacy services in the public health sector of Mexico: a case study.

    PubMed

    Díaz de León-Castañeda, Christian; Gutiérrez-Godínez, Jéssica; Colado-Velázquez, Juventino Iii; Toledano-Jaimes, Cairo

    2018-04-22

    In Mexico, the Modelo Nacional de Farmacia Hospitalaria (MNFH, or National Hospital Pharmacy Model), published in 2009, mainly aims to promote the provision of clinical pharmacy services in private and public hospitals. However, there is little scientific documentation about the quality of these services. To explore healthcare professionals' perceptions related to the quality of clinical pharmacy services provision. A case-study based on a qualitative approach was performed at the pharmaceutical services unit at a public hospital located in Mexico City, which operates under the administrative control of the Ministry of Health. Donabedian's conceptual model was adapted to explore health care professionals' perceptions of the quality of clinical pharmacy services provision. Semi-structured interviews were carried out with pharmacists, physicians and nurses and then transcribed and analyzed via discourse analysis and codification techniques, using the software package Atlas. ti. Limitations in pharmaceutical human resources were identified as the main factor affecting coverage and quality in clinical pharmacy services provision. However, the development in pharmacy staff of technical competences and skills for clinical pharmacy service provision were recognized. Significant improvements in the rational use of medicines were associated with clinical pharmacy services provision. The perception analysis performed in this study suggested that it is necessary to increase pharmacy staff in order to improve interprofessional relationships and the quality of clinical pharmacy services provision. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. 42 CFR 440.180 - Home or community-based services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Home or community-based services. 440.180 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.180 Home or community-based services. (a) Description and requirements for services. “Home or community-based services...

  17. 42 CFR 440.180 - Home or community-based services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Home or community-based services. 440.180 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.180 Home or community-based services. (a) Description and requirements for services. “Home or community-based services...

  18. 42 CFR 440.180 - Home or community-based services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Home or community-based services. 440.180 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.180 Home or community-based services. (a) Description and requirements for services. “Home or community-based services...

  19. Web-Based Self-Service Systems for Managed IT Support: Service Provider Perspectives of Stakeholder-Based Issues

    NASA Astrophysics Data System (ADS)

    Cooper, Vanessa A.; Lichtenstein, Sharman; Smith, Ross

    This chapter explores the provision of after-sales information technology (IT) support services using Web-based self-service systems (WSSs) in a business-to-business (B2B) context. A recent study conducted at six large multi-national IT support organisations revealed a number of critical success factors (CSFs) and stakeholder-based issues. To better identify and understand these important enablers and barriers, we explain how WSSs should be considered within a complex network of service providers, business partners and customer firms. The CSFs and stakeholder-based issues are discussed. The chapter highlights that for more successful service provision using WSSs, IT service providers should collaborate more effectively with enterprise customers and business partners and should better integrate their WSSs.

  20. Mitigating Provider Uncertainty in Service Provision Contracts

    NASA Astrophysics Data System (ADS)

    Smith, Chris; van Moorsel, Aad

    Uncertainty is an inherent property of open, distributed and multiparty systems. The viability of the mutually beneficial relationships which motivate these systems relies on rational decision-making by each constituent party under uncertainty. Service provision in distributed systems is one such relationship. Uncertainty is experienced by the service provider in his ability to deliver a service with selected quality level guarantees due to inherent non-determinism, such as load fluctuations and hardware failures. Statistical estimators utilized to model this non-determinism introduce additional uncertainty through sampling error. Inability of the provider to accurately model and analyze uncertainty in the quality level guarantees can result in the formation of sub-optimal service provision contracts. Emblematic consequences include loss of revenue, inefficient resource utilization and erosion of reputation and consumer trust. We propose a utility model for contract-based service provision to provide a systematic approach to optimal service provision contract formation under uncertainty. Performance prediction methods to enable the derivation of statistical estimators for quality level are introduced, with analysis of their resultant accuracy and cost.

  1. [Evaluation of ecosystem provisioning service and its economic value].

    PubMed

    Wu, Nan; Gao, Ji-Xi; Sudebilige; Ricketts, Taylor H; Olwero, Nasser; Luo, Zun-Lan

    2010-02-01

    Aiming at the fact that the current approaches of evaluating the efficacy of ecosystem provisioning service were lack of spatial information and did not take the accessibility of products into account, this paper established an evaluation model to simulate the spatial distribution of ecosystem provisioning service and its economic value, based on ArcGIS 9. 2 and taking the supply and demand factors of ecosystem products into account. The provision of timber product in Laojunshan in 2000 was analyzed with the model. In 2000, the total physical quantity of the timber' s provisioning service in Laojunshan was 11.12 x 10(4) m3 x a(-1), occupying 3.2% of the total increment of timber stock volume. The total provisioning service value of timber was 6669.27 x 10(4) yuan, among which, coniferous forest contributed most (90.41%). Due to the denser distribution of populations and roads in the eastern area of Laojunshan, some parts of the area being located outside of conservancy district, and forests being in scattered distribution, the spatial distribution pattern of the physical quantity of timber's provisioning service was higher in the eastern than in the western area.

  2. Opportunities in the Affordable Care Act to Advance Long-Term Services and Supports: The Role of Rehabilitation Counseling

    ERIC Educational Resources Information Center

    Caldwell, Joe; Alston, Reginald J.

    2012-01-01

    The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. This article discusses some of the major provisions, implementations, and implications…

  3. Cross-sector Service Provision in Health and Social Care: An Umbrella Review.

    PubMed

    Winters, Shannon; Magalhaes, Lilian; Anne Kinsella, Elizabeth; Kothari, Anita

    2016-04-08

    Meeting the complex health needs of people often requires interaction among numerous different sectors. No one service can adequately respond to the diverse care needs of consumers. Providers working more effectively together is frequently touted as the solution. Cross-sector service provision is defined as independent, yet interconnected sectors working together to better meet the needs of consumers and improve the quality and effectiveness of service provision. Cross-sector service provision is expected, yet much remains unknown about how it is conceptualised or its impact on health status. This umbrella review aims to clarify the critical attributes that shape cross-sector service provision by presenting the current state of the literature and building on the findings of the 2004 review by Sloper. Literature related to cross-sector service provision is immense, which poses a challenge for decision makers wishing to make evidence-informed decisions. An umbrella review was conducted to articulate the overall state of cross-sector service provision literature and examine the evidence to allow for the discovery of consistencies and discrepancies across the published knowledge base. Sixteen reviews met the inclusion criteria. Seven themes emerged: Focusing on the consumer, developing a shared vision of care, leadership involvement, service provision across the boundaries, adequately resourcing the arrangement, developing novel arrangements or aligning with existing relationships, and strengthening connections between sectors. Future research from a cross-organisational, rather than individual provider, perspective is needed to better understand what shapes cross-sector service provision at the boundaries. Findings aligned closely with the work done by Sloper and raise red flags related to reinventing what is already known. Future researchers should look to explore novel areas rather than looking into areas that have been explored at length. Evaluations of out-comes related to cross-sector service provision are still needed before any claims about effectiveness can be made.

  4. Cross-sector Service Provision in Health and Social Care: An Umbrella Review

    PubMed Central

    Magalhaes, Lilian; Anne Kinsella, Elizabeth; Kothari, Anita

    2016-01-01

    Introduction: Meeting the complex health needs of people often requires interaction among numerous different sectors. No one service can adequately respond to the diverse care needs of consumers. Providers working more effectively together is frequently touted as the solution. Cross-sector service provision is defined as independent, yet interconnected sectors working together to better meet the needs of consumers and improve the quality and effectiveness of service provision. Cross-sector service provision is expected, yet much remains unknown about how it is conceptualised or its impact on health status. This umbrella review aims to clarify the critical attributes that shape cross-sector service provision by presenting the current state of the literature and building on the findings of the 2004 review by Sloper. Methods: Literature related to cross-sector service provision is immense, which poses a challenge for decision makers wishing to make evidence-informed decisions. An umbrella review was conducted to articulate the overall state of cross-sector service provision literature and examine the evidence to allow for the discovery of consistencies and discrepancies across the published knowledge base. Findings: Sixteen reviews met the inclusion criteria. Seven themes emerged: Focusing on the consumer, developing a shared vision of care, leadership involvement, service provision across the boundaries, adequately resourcing the arrangement, developing novel arrangements or aligning with existing relationships, and strengthening connections between sectors. Future research from a cross-organisational, rather than individual provider, perspective is needed to better understand what shapes cross-sector service provision at the boundaries. Conclusion: Findings aligned closely with the work done by Sloper and raise red flags related to reinventing what is already known. Future researchers should look to explore novel areas rather than looking into areas that have been explored at length. Evaluations of out-comes related to cross-sector service provision are still needed before any claims about effectiveness can be made. PMID:27616954

  5. Dynamics of ecosystem services provided by subtropical ...

    EPA Pesticide Factsheets

    The trends in the provision of ecosystem services during restoration and succession of subtropical forests and plantations were quantified, in terms of both receiver and donor values, based on a case study of a 3-step secondary succession series that included a 400-year-old subtropical forest and a 23-year history of growth on 3 subtropical forest plantations in Southeastern China. The ‘People's Republic of China Forestry Standard: Forest Ecosystem Service Valuation Norms’ was revised and applied to quantify the receiver values of ecosystem services, which were then compared with the emergy-based, donor values of the services. The results revealed that the efficiencies of subtropical forests and plantations in providing ecosystem services were 2 orders of magnitude higher than similar services provided by the current China economic system, and these efficiencieskept increasing over the course of succession. As a result, we conclude that afforestation is an efficient way to accelerate both the ability and efficiency of subtropical forests to provide ecosystem services. This paper is significant because it examines the dynamics of the provision of ecosystem services by forests over a succession series that spans 400 years. The paper also examines the rate of increase of services during forest restoration over a period of 23 years. The emergy used in ecosystem services provision is compared to the provision of similar services by economic means in the Chinese e

  6. Dynamic Hop Service Differentiation Model for End-to-End QoS Provisioning in Multi-Hop Wireless Networks

    NASA Astrophysics Data System (ADS)

    Youn, Joo-Sang; Seok, Seung-Joon; Kang, Chul-Hee

    This paper presents a new QoS model for end-to-end service provisioning in multi-hop wireless networks. In legacy IEEE 802.11e based multi-hop wireless networks, the fixed assignment of service classes according to flow's priority at every node causes priority inversion problem when performing end-to-end service differentiation. Thus, this paper proposes a new QoS provisioning model called Dynamic Hop Service Differentiation (DHSD) to alleviate the problem and support effective service differentiation between end-to-end nodes. Many previous works for QoS model through the 802.11e based service differentiation focus on packet scheduling on several service queues with different service rate and service priority. Our model, however, concentrates on a dynamic class selection scheme, called Per Hop Class Assignment (PHCA), in the node's MAC layer, which selects a proper service class for each packet, in accordance with queue states and service requirement, in every node along the end-to-end route of the packet. The proposed QoS solution is evaluated using the OPNET simulator. The simulation results show that the proposed model outperforms both best-effort and 802.11e based strict priority service models in mobile ad hoc environments.

  7. Demand-based provision of housing, welfare and care services to elderly clients: from policy to daily practice through operations management.

    PubMed

    de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

    2009-03-01

    Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the daily routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation's policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes.

  8. Experimental demonstration of multi-dimensional resources integration for service provisioning in cloud radio over fiber network

    NASA Astrophysics Data System (ADS)

    Yang, Hui; Zhang, Jie; Ji, Yuefeng; He, Yongqi; Lee, Young

    2016-07-01

    Cloud radio access network (C-RAN) becomes a promising scenario to accommodate high-performance services with ubiquitous user coverage and real-time cloud computing in 5G area. However, the radio network, optical network and processing unit cloud have been decoupled from each other, so that their resources are controlled independently. Traditional architecture cannot implement the resource optimization and scheduling for the high-level service guarantee due to the communication obstacle among them with the growing number of mobile internet users. In this paper, we report a study on multi-dimensional resources integration (MDRI) for service provisioning in cloud radio over fiber network (C-RoFN). A resources integrated provisioning (RIP) scheme using an auxiliary graph is introduced based on the proposed architecture. The MDRI can enhance the responsiveness to dynamic end-to-end user demands and globally optimize radio frequency, optical network and processing resources effectively to maximize radio coverage. The feasibility of the proposed architecture is experimentally verified on OpenFlow-based enhanced SDN testbed. The performance of RIP scheme under heavy traffic load scenario is also quantitatively evaluated to demonstrate the efficiency of the proposal based on MDRI architecture in terms of resource utilization, path blocking probability, network cost and path provisioning latency, compared with other provisioning schemes.

  9. Experimental demonstration of multi-dimensional resources integration for service provisioning in cloud radio over fiber network.

    PubMed

    Yang, Hui; Zhang, Jie; Ji, Yuefeng; He, Yongqi; Lee, Young

    2016-07-28

    Cloud radio access network (C-RAN) becomes a promising scenario to accommodate high-performance services with ubiquitous user coverage and real-time cloud computing in 5G area. However, the radio network, optical network and processing unit cloud have been decoupled from each other, so that their resources are controlled independently. Traditional architecture cannot implement the resource optimization and scheduling for the high-level service guarantee due to the communication obstacle among them with the growing number of mobile internet users. In this paper, we report a study on multi-dimensional resources integration (MDRI) for service provisioning in cloud radio over fiber network (C-RoFN). A resources integrated provisioning (RIP) scheme using an auxiliary graph is introduced based on the proposed architecture. The MDRI can enhance the responsiveness to dynamic end-to-end user demands and globally optimize radio frequency, optical network and processing resources effectively to maximize radio coverage. The feasibility of the proposed architecture is experimentally verified on OpenFlow-based enhanced SDN testbed. The performance of RIP scheme under heavy traffic load scenario is also quantitatively evaluated to demonstrate the efficiency of the proposal based on MDRI architecture in terms of resource utilization, path blocking probability, network cost and path provisioning latency, compared with other provisioning schemes.

  10. Experimental demonstration of multi-dimensional resources integration for service provisioning in cloud radio over fiber network

    PubMed Central

    Yang, Hui; Zhang, Jie; Ji, Yuefeng; He, Yongqi; Lee, Young

    2016-01-01

    Cloud radio access network (C-RAN) becomes a promising scenario to accommodate high-performance services with ubiquitous user coverage and real-time cloud computing in 5G area. However, the radio network, optical network and processing unit cloud have been decoupled from each other, so that their resources are controlled independently. Traditional architecture cannot implement the resource optimization and scheduling for the high-level service guarantee due to the communication obstacle among them with the growing number of mobile internet users. In this paper, we report a study on multi-dimensional resources integration (MDRI) for service provisioning in cloud radio over fiber network (C-RoFN). A resources integrated provisioning (RIP) scheme using an auxiliary graph is introduced based on the proposed architecture. The MDRI can enhance the responsiveness to dynamic end-to-end user demands and globally optimize radio frequency, optical network and processing resources effectively to maximize radio coverage. The feasibility of the proposed architecture is experimentally verified on OpenFlow-based enhanced SDN testbed. The performance of RIP scheme under heavy traffic load scenario is also quantitatively evaluated to demonstrate the efficiency of the proposal based on MDRI architecture in terms of resource utilization, path blocking probability, network cost and path provisioning latency, compared with other provisioning schemes. PMID:27465296

  11. Service provision in the wake of a new funding model for community pharmacy.

    PubMed

    Smith, Alesha J; Scahill, Shane L; Harrison, Jeff; Carroll, Tilley; Medlicott, Natalie J

    2018-05-02

    Recently, New Zealand has taken a system wide approach providing the biggest reform to New Zealand community pharmacy for 70 years with the aim of providing more clinically orientated patient centred services through a new funding model. The aim of this study was to understand the types of services offered in New Zealand community pharmacies since introduction of the new funding model, what the barriers are to providing these services. A survey of all community pharmacies were undertaken between August, 2014 and February, 2015. Basic descriptive statistics were completed and group comparisons were made using the chi squared test with significance set at p < 0.05. 528 responses were received. Education and advice on prescription and non-prescription medicines were the two top listed services provided. There were no significant differences in service provision between rural and metro based pharmacies. Many pharmacies were considering introducing new patient centred services. Four of the top ten frequently provided services have no public funding attached. Costs and staff availability are the most common barriers to undertake services, more predominantly in patient centred services. This study was the first to provide an evaluation of service provision in response to a new funding model for New Zealand Community Pharmacies. A broad range of services are being undertaken in New Zealand community pharmacies including patient-centred services. A number of barriers to service provision were identified. This study provides a baseline for the current levels of service provision upon which future studies can compare to and evaluate any changes in service provision with differing funding models going forward.

  12. 77 FR 72431 - Shipping Coordinating Committee; Notice of Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-05

    ... GMDSS --Further development of the GMDSS master plan on shore-based facilities --Consideration of operational and technical coordination provisions of maritime safety information (MSI) services, including the... matters --Further development of the Global SAR Plan for the provision of maritime --SAR services...

  13. Community Reintegration for People with Psychiatric Disabilities: Challenging Systemic Barriers to Service Provision and Public Policy through Participatory Action Research

    ERIC Educational Resources Information Center

    Mirza, Mansha; Gossett, Andrea; Chan, Nathan Kai-Cheong; Burford, Larry; Hammel, Joy

    2008-01-01

    People with psychiatric disabilities represent a growing group within the population of nursing home residents in the USA. Despite a preference for living in community-based settings, the availability of supportive services for community living is hindered by barriers at both the service provision and public policy levels. Therefore, understanding…

  14. An Exploration of Costs of Community-Based Specialist Health Service Provision for the Management of Aggressive Behaviour in Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Unwin, Gemma; Deb, Shoumitro; Deb, Tanya

    2017-01-01

    Background: In the UK, people with intellectual disabilities who exhibit aggressive behaviour often receive community-based specialist health services from a community learning disability team (CLDT). Our aim was to estimate costs associated with this provision and to identify predictors of higher costs. Method: Costs were estimated for 60 adults…

  15. Did Project Liberty displace community-based medicaid services in New York?

    PubMed

    Gomes, Carla; McGuire, Thomas G; Foster, M Jameson; Donahue, Sheila A; Felton, Chip J; Essock, Susan M

    2006-09-01

    This study analyzed how the introduction of Project Liberty services after the September 11, 2001, terrorist attacks affected agencies' provision of community-based Medicaid mental health services in the New York metropolitan area. Provision of Medicaid mental health services was tracked between January 2000 and June 2003 for provider agencies participating in Project Liberty (N=164) and for a comparison group of mental health provider agencies that did not participate in this program (N=94). Overall, participation in Project Liberty did not significantly affect the volume of Medicaid services provided. However, for agencies with one site, a statistically significant difference was seen; compared with agencies in the comparison group, agencies that participated in Project Liberty claimed a mean+/-SE decrease of $4.66+/-3.57 less in Medicaid services per month per Project Liberty visit. Project Liberty permitted rapid expansion of the total volume of services provided by community-based organizations without interfering with the provision of traditional services, although a modest effect was seen for smaller agencies. Although the results do not imply that "supply side" planning for disaster needs would not improve system response, they do imply that implementation of flexible "demand side" financing can call forth a large volume of new services rapidly and without interfering with other community services.

  16. Managing obesity in pharmacy: the Australian experience.

    PubMed

    Um, Irene S I; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

    2010-12-01

    To explore pharmacists' opinions about the provision of weight management services in community pharmacy and their attitudes towards the establishment of an accredited training course in weight management in pharmacy. Interviews were conducted with practising pharmacists on site in various community pharmacies in metropolitan Sydney, Australia. In-depth, semi-structured interviews with twenty practising pharmacists were conducted. Of the twenty interviewed pharmacists, sixteen were involved in the provision of one or more pharmacy based weight management programs in their pharmacies. Interviews were audio-recorded, transcribed and analysed using the grounded theory approach. The data were thematically analysed to identify facilitators and perceived barriers to the provision of high quality services, and pharmacists' willingness to undertake training and accreditation. Participants clearly perceived a role for pharmacy in weight management. Key facilitators to provision of service were accessibility and the perception of pharmacists as trustworthy healthcare professionals. The pharmacists proposed collaboration with other healthcare professionals in order to provide a service incorporating diet, exercise and behavioural therapy. A program that was not-product-centred, and supported by ethical marketing was favoured. Appropriate training and accreditation were considered essential to assuring the quality of such services. Barriers to the provision of high quality services identified were: remuneration, pharmacy infrastructure, client demand and the current marketing of product-centred programs. Australian pharmacists believe there is a role for pharmacy in weight management, provided training in accredited programs is made available. A holistic, evidence-based, multi-disciplinary service model has been identified as ideal.

  17. 47 CFR 64.601 - Definitions and provisions of general applicability.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... a text telephone (TTY) and the public switched telephone network. (18) IP Relay access technology... used to make and receive an Internet-based TRS call. (20) Neutral Video Communication Service Platform... by the Neutral Video Communication Service Platform include the provision of a video link, user...

  18. 47 CFR 64.601 - Definitions and provisions of general applicability.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... a text telephone (TTY) and the public switched telephone network. (18) IP Relay access technology... used to make and receive an Internet-based TRS call. (20) Neutral Video Communication Service Platform... by the Neutral Video Communication Service Platform include the provision of a video link, user...

  19. Ecosystem services as a common language for coastal ecosystem-based management.

    PubMed

    Granek, Elise F; Polasky, Stephen; Kappel, Carrie V; Reed, Denise J; Stoms, David M; Koch, Evamaria W; Kennedy, Chris J; Cramer, Lori A; Hacker, Sally D; Barbier, Edward B; Aswani, Shankar; Ruckelshaus, Mary; Perillo, Gerardo M E; Silliman, Brian R; Muthiga, Nyawira; Bael, David; Wolanski, Eric

    2010-02-01

    Ecosystem-based management is logistically and politically challenging because ecosystems are inherently complex and management decisions affect a multitude of groups. Coastal ecosystems, which lie at the interface between marine and terrestrial ecosystems and provide an array of ecosystem services to different groups, aptly illustrate these challenges. Successful ecosystem-based management of coastal ecosystems requires incorporating scientific information and the knowledge and views of interested parties into the decision-making process. Estimating the provision of ecosystem services under alternative management schemes offers a systematic way to incorporate biogeophysical and socioeconomic information and the views of individuals and groups in the policy and management process. Employing ecosystem services as a common language to improve the process of ecosystem-based management presents both benefits and difficulties. Benefits include a transparent method for assessing trade-offs associated with management alternatives, a common set of facts and common currency on which to base negotiations, and improved communication among groups with competing interests or differing worldviews. Yet challenges to this approach remain, including predicting how human interventions will affect ecosystems, how such changes will affect the provision of ecosystem services, and how changes in service provision will affect the welfare of different groups in society. In a case study from Puget Sound, Washington, we illustrate the potential of applying ecosystem services as a common language for ecosystem-based management.

  20. Genetic service delivery: infrastructure, assessment and information.

    PubMed

    Kaye, C I

    2012-01-01

    Identification of genomic determinants of complex disorders such as cancer, diabetes and cardiovascular disease has prompted public health systems to focus on genetic service delivery for prevention of these disorders, adding to their previous efforts in birth defects prevention and newborn screening. This focus is consistent with previously identified obligations of the public health system as well as the core functions of public health identified by the Institute of Medicine. Models of service delivery include provision of services by the primary care provider in conjunction with subspecialists, provision of services through the medical home with co-management by genetics providers, provision of services in conjunction with disorder-specific treatment centers, and provision of services through a network of genetics clinics linked to medical homes. Whatever the model for provision of genetic services, tools to assist providers include facilities for outreach and telemedicine, information technology, just-in-time management plans, and emergency management tools. Assessment tools to determine which care is best are critical for quality improvement and development of best practices. Because the workforce of genetics providers is not keeping pace with the need for services, an understanding of the factors contributing to this lag is important, as is the development of an improved knowledge base in genomics for primary care providers. Copyright © 2012 S. Karger AG, Basel.

  1. Patient preferences for community pharmacy asthma services: a discrete choice experiment.

    PubMed

    Naik-Panvelkar, Pradnya; Armour, Carol; Rose, John M; Saini, Bandana

    2012-10-01

    Specialized community pharmacy services, involving the provision of disease state management and care by pharmacists, have been developed and trialled and have demonstrated very good health outcomes. Most of these services have been developed from a healthcare professional perspective. However, for the future uptake and long-term sustainability of these services as well as for better and sustained health outcomes for patients, it is vital to gain an understanding of patients' preferences. We can then structure healthcare services to match these preferences and needs rather than around clinical viewpoints alone. The aim of this study was to elicit patient preferences for pharmacy-based specialized asthma services using a discrete choice experiment and to explore the value/importance that patients place on the different attributes of the asthma service. The existence of preference heterogeneity in the population was also investigated. The study was conducted with asthma patients who had recently experienced a specialized asthma management service at their pharmacy in New South Wales, Australia. Pharmacists delivering the asthma service mailed out the discrete choice questionnaires to participating patients at the end of 6 months of service provision. A latent class (LC) model was used to investigate each patient's strength of preference and preference heterogeneity for several key attributes related to asthma service provision: frequency of visits, access to pharmacist, interaction with pharmacy staff, availability of a private area for consultation, provision of lung function testing, type and depth of advice provision, number of days with asthma symptoms and cost of service. Eighty useable questionnaires (of 170 questionnaires sent out) were received (response rate 47.1%). The study identified various key elements of asthma services important to patients. Further, the LC analysis revealed three classes with differing patient preferences for levels of asthma service provision. Patients in the Minimalistic Model class valued provision of lung function testing and preferred more frequent service visits. Cost of service had a negative effect on service preference for patients in this class. Patients in the Partial Model class mainly derived utility from the provision of lung function testing and comprehensive advice at the pharmacy and also wanted more frequent service visits. The Holistic Model class patients considered all attributes of the service to be important when making a choice. While the majority of the service attributes had a positive effect on preference for patients in this class, cost of service and days with symptoms of asthma had a negative effect on service preference. These patients also preferred fewer service visits. The study identified various key attributes that are important to patients with respect to community pharmacy-based asthma services. The results also demonstrate the existence of preference heterogeneity in the population. Asthma service providers need to take these findings into consideration in the design and development of future service models so as to increase their uptake and ensure their long-term sustainability.

  2. Agent-based user-adaptive service provision in ubiquitous systems

    NASA Astrophysics Data System (ADS)

    Saddiki, H.; Harroud, H.; Karmouch, A.

    2012-11-01

    With the increasing availability of smartphones, tablets and other computing devices, technology consumers have grown accustomed to performing all of their computing tasks anytime, anywhere and on any device. There is a greater need to support ubiquitous connectivity and accommodate users by providing software as network-accessible services. In this paper, we propose a MAS-based approach to adaptive service composition and provision that automates the selection and execution of a suitable composition plan for a given service. With agents capable of autonomous and intelligent behavior, the composition plan is selected in a dynamic negotiation driven by a utility-based decision-making mechanism; and the composite service is built by a coalition of agents each providing a component necessary to the target service. The same service can be built in variations for catering to dynamic user contexts and further personalizing the user experience. Also multiple services can be grouped to satisfy new user needs.

  3. Applying the ecosystem services framework to pasture-based livestock farming systems in Europe.

    PubMed

    Rodríguez-Ortega, T; Oteros-Rozas, E; Ripoll-Bosch, R; Tichit, M; Martín-López, B; Bernués, A

    2014-08-01

    The concept of 'Ecosystem Services' (ES) focuses on the linkages between ecosystems, including agroecosystems, and human well-being, referring to all the benefits, direct and indirect, that people obtain from ecosystems. In this paper, we review the application of the ES framework to pasture-based livestock farming systems, which allows (1) regulating, supporting and cultural ES to be integrated at the same level with provisioning ES, and (2) the multiple trade-offs and synergies that exist among ES to be considered. Research on livestock farming has focused mostly on provisioning ES (meat, milk and fibre production), despite the fact that provisioning ES strongly depends on regulating and supporting ES for their existence. We first present an inventory of the non-provisioning ES (regulating, supporting and cultural) provided by pasture-based livestock systems in Europe. Next, we review the trade-offs between provisioning and non-provisioning ES at multiple scales and present an overview of the methodologies for assessing biophysical trade-offs. Third, we present non-biophysical (economical and socio-cultural) methodologies and applications for ES valuation. We conclude with some recommendations for policy design.

  4. Supporting the scientific lifecycle through cloud services

    NASA Astrophysics Data System (ADS)

    Gensch, S.; Klump, J. F.; Bertelmann, R.; Braune, C.

    2014-12-01

    Cloud computing has made resources and applications available for numerous use cases ranging from business processes in the private sector to scientific applications. Developers have created tools for data management, collaborative writing, social networking, data access and visualization, project management and many more; either for free or as paid premium services with additional or extended features. Scientists have begun to incorporate tools that fit their needs into their daily work. To satisfy specialized needs, some cloud applications specifically address the needs of scientists for sharing research data, literature search, laboratory documentation, or data visualization. Cloud services may vary in extent, user coverage, and inter-service integration and are also at risk of being abandonend or changed by the service providers making changes to their business model, or leaving the field entirely.Within the project Academic Enterprise Cloud we examine cloud based services that support the research lifecycle, using feature models to describe key properties in the areas of infrastructure and service provision, compliance to legal regulations, and data curation. Emphasis is put on the term Enterprise as to establish an academic cloud service provider infrastructure that satisfies demands of the research community through continious provision across the whole cloud stack. This could enable the research community to be independent from service providers regarding changes to terms of service and ensuring full control of its extent and usage. This shift towards a self-empowered scientific cloud provider infrastructure and its community raises implications about feasability of provision and overall costs. Legal aspects and licensing issues have to be considered, when moving data into cloud services, especially when personal data is involved.Educating researchers about cloud based tools is important to help in the transition towards effective and safe use. Scientists can benefit from the provision of standard services, like weblog and website creation, virtual machine deployments, and groupware provision using cloud based app store-like portals. And, other than in an industrial environment, researchers will want to keep their existing user profile when moving from one institution to another.

  5. Citizen centered health and lifestyle management via interactive TV: The PANACEIA-ITV health system.

    PubMed

    Maglaveras, N; Chouvarda, I; Koutkias, V; Lekka, I; Tsakali, M; Tsetoglou, S; Maglavera, S; Leondaridis, L; Zeevi, B; Danelli, V; Kotis, T; De Moore, G; Balas, E A

    2003-01-01

    In the context of an IST European project with acronym PANACEIA-ITV, a home care service provisioning system is described, based on interactive TV technology. The purpose of PANACEIA-ITV is to facilitate essential lifestyle changes and to promote compliance with scientifically sound self-care recommendations, through the application of interactive digital television for family health maintenance. The means to achieve these goals are based on technological, health services and business models. PANACEIA-ITV is looking for communication of monitoring micro-devices with I-TV set-top-boxes using infrared technology, and embodiment of analogous H/W and S/W in the I-TV set-top-boxes. Intelligent agents are used to regulate data flow, user queries as well as service provisions from and to the household through the satellite digital platform, the portal and the back-end decision support mechanisms, using predominantly the Active Service Provision (ASP) model. Moreover, interactive digital TV services are developed for the delivery of health care in the home care environment.

  6. Survey of rehabilitation support for children 0-15 years in a rural part of Kenya.

    PubMed

    Bunning, Karen; Gona, Joseph K; Odera-Mung'ala, Victor; Newton, Charles R; Geere, Jo-Anne; Hong, Chia Swee; Hartley, Sally

    2014-01-01

    Information regarding the nature, availability and distribution of rehabilitation services for children with disabilities across developing countries is scarce, and data that do exist are of variable quality. If planning and development are to progress, information about service provision is vital. The aim was to establish the scope and nature of rehabilitation support available to children with disabilities (0-15 years) and their families in rural Kenya. A comprehensive sample comprising service provision in the health and special education sectors was established. Non-governmental and community-based organisations were also included. A survey of rehabilitation services was conducted through examination of service-related documentation and key informant interviews with the heads of services. Rehabilitation comprised hospital-based occupational therapy, physiotherapy and orthopaedic technology; and seven special education establishments plus an education assessment resource centre. There was one non-government organisation and one community-based organisation relevant to children with disabilities. Activities focused on assessment, diagnosis and raising community awareness. Provision was challenged by inadequate staffing, resources and transport. Government funding was supplemented variously by donations and self-sufficiency initiatives. Rehabilitation approaches appeared to be informed by professional background of practitioner, rather than the needs of child. Service documentation revealed use of inconsistent recording methods. The data highlight the challenges of rehabilitation, demanding greater investment in personnel and their training, more material resources, improved access to the community and better recording mechanisms. There needs to be greater investment in rehabilitation provision in developing countries. Consideration of community-based initiatives is required to support better access for all. In order to argue the case for improved resources, better skills and mechanisms for recording, monitoring and evaluating practice are needed.

  7. Provision of Personal Healthcare Services by Local Health Departments: 2008-2013.

    PubMed

    Luo, Huabin; Sotnikov, Sergey; Winterbauer, Nancy

    2015-09-01

    The scope of local health department (LHD) involvement in providing personal healthcare services versus population-based services has been debated for decades. A 2012 IOM report suggests that LHDs should gradually withdraw from providing personal healthcare services. The purpose of this study is to assess the level of LHD involvement in provision of personal healthcare services during 2008-2013 and examine the association between provision of personal healthcare services and per capita public health expenditures. Data are from the 2013 survey of LHDs and Area Health Resource Files. The number, ratio, and share of revenue from personal healthcare services were estimated. Both linear and panel fixed effects models were used to examine the association between provision of personal healthcare services and per capita public health expenditures. Data were analyzed in 2014. The mean number of personal healthcare services provided by LHDs did not change significantly in 2008-2013. Overall, personal services constituted 28% of total service items. The share of revenue from personal services increased from 16.8% in 2008 to 20.3% in 2013. Results from the fixed effect panel models show a positive association between personal healthcare services' share of revenue and per capita expenditures (b=0.57, p<0.001). A lower share of revenue from personal healthcare services is associated with lower per capita expenditures. LHDs, especially those serving <25,000 people, are highly dependent on personal healthcare revenue to sustain per capita expenditures. LHDs may need to consider strategies to replace lost revenue from discontinuing provision of personal healthcare services. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

  8. An Examination of Factors Associated with School Psychologists' Provision of Counseling Services

    ERIC Educational Resources Information Center

    DeFago, Jennifer Kelly

    2012-01-01

    The purpose of this study was to evaluate the factors that predict provision of counseling services by Ohio-based school psychologists. In order to address the research questions, a survey instrument was created and a sample of school psychologists working in Ohio completed a questionnaire regarding their counseling practices. The data were…

  9. Estimating the value of non-use benefits from small changes in the provision of ecosystem services.

    PubMed

    Dutton, Adam; Edwards-Jones, Gareth; Macdonald, David W

    2010-12-01

    The unit of trade in ecosystem services is usually the use of a proportion of the parcels of land associated with a given service. Valuing small changes in the provision of an ecosystem service presents obstacles, particularly when the service provides non-use benefits, as is the case with conservation of most plants and animals. Quantifying non-use values requires stated-preference valuations. Stated-preference valuations can provide estimates of the public's willingness to pay for a broad conservation goal. Nevertheless, stated-preference valuations can be expensive and do not produce consistent measures for varying levels of provision of a service. Additionally, the unit of trade, land use, is not always linearly related to the level of ecosystem services the land might provide. To overcome these obstacles, we developed a method to estimate the value of a marginal change in the provision of a non-use ecosystem service--in this case conservation of plants or animals associated with a given land-cover type. Our method serves as a tool for calculating transferable valuations of small changes in the provision of ecosystem services relative to the existing provision. Valuation is achieved through stated-preference investigations, calculation of a unit value for a parcel of land, and the weighting of this parcel by its ability to provide the desired ecosystem service and its effect on the ability of the surrounding land parcels to provide the desired service. We used the water vole (Arvicola terrestris) as a case study to illustrate the method. The average present value of a meter of water vole habitat was estimated at UK £ 12, but the marginal value of a meter (based on our methods) could range between £ 0 and £ 40 or more. © 2010 Society for Conservation Biology.

  10. Autonomous Information Fading and Provision to Achieve High Response Time in Distributed Information Systems

    NASA Astrophysics Data System (ADS)

    Lu, Xiaodong; Arfaoui, Helene; Mori, Kinji

    In highly dynamic electronic commerce environment, the need for adaptability and rapid response time to information service systems has become increasingly important. In order to cope with the continuously changing conditions of service provision and utilization, Faded Information Field (FIF) has been proposed. FIF is a distributed information service system architecture, sustained by push/pull mobile agents to bring high-assurance of services through a recursive demand-oriented provision of the most popular information closer to the users to make a tradeoff between the cost of information service allocation and access. In this paper, based on the analysis of the relationship that exists among the users distribution, information provision and access time, we propose the technology for FIF design to resolve the competing requirements of users and providers to improve users' access time. In addition, to achieve dynamic load balancing with changing users preference, the autonomous information reallocation technology is proposed. We proved the effectiveness of the proposed technology through the simulation and comparison with the conventional system.

  11. Online Pharmaceutical Care Provision: Full-Implementation of an eHealth Service Using Design Science Research.

    PubMed

    Gregório, João; Pizarro, Ângela; Cavaco, Afonso; Wipfli, Rolf; Lovis, Christian; Mira da Silva, Miguel; Lapão, Luís Velez

    2015-01-01

    Chronic diseases are pressing health systems to introduce reforms, focused on primary care and multidisciplinary models. Community pharmacists have developed a new role, addressing pharmaceutical care and services. Information systems and technologies (IST) will have an important role in shaping future healthcare provision. However, the best way to design and implement an IST for pharmaceutical service provision is still an open research question. In this paper, we present a possible strategy based on the use of Design Science Research Methodology (DSRM). The application of the DSRM six stages is described, from the definition and characterization of the problem to the evaluation of the artefact.

  12. National variability in provision of health services for major long-term conditions in New Zealand (a report from the ABCC NZ study).

    PubMed

    Connolly, Martin J; Kenealy, Timothy; Barber, P Alan; Carswell, Peter; Clinton, Janet; Dyall, Lorna; Devlin, Gerard; Doughty, Robert N; Kerse, Ngaire; Kolbe, John; Lawrenson, Ross; Moffitt, Allan; Sheridan, Nicolette

    2011-10-14

    Chronic illness is the leading cause of morbidity, mortality, and inequitable health outcomes in New Zealand. The ABCCNZ Stocktake aimed to identify extent of long-term conditions management evidence-based practices in stroke, cardiovascular disease, chronic obstructive pulmonary disease and congestive heart failure in New Zealand's District Health Boards (DHBs). Eleven 'dimensions' of care for long-term conditions, identified by literature review and confirmed at workshops with long-term conditions professionals, formed the basis of the Stocktake of all 21 DHBs. It comprised two questionnaires: a generic component capturing perceptions of practice; and a disease-specific component assessing service provision. Fifteen DHBs completed all or parts of the questionnaires. Data accrual was completed in July 2008. Although most DHBs had developed long-term conditions management strategies to a moderate degree, there was considerable variability of practice between DHBs. DHBs thought their PHOs had developed strategies in some areas to a low to moderate level, though cardiovascular disease provision rated more highly. Regarding disease-specific services, larger DHBs had greater long-term conditions management provision not only of tertiary services, but of standard care, leadership, self-management, case-management, and audit. There is considerable variability in perceptions of long-term conditions management service provision across DHBs. In many instances variability in actual disease-specific service provision appears to relate to DHB size.

  13. School-Based Mental Health Services: Definitions and Models of Effective Practice

    ERIC Educational Resources Information Center

    Doll, Beth; Nastasi, Bonnie K.; Cornell, Laura; Song, Samuel Y.

    2017-01-01

    School-based mental health services are those delivered by school-employed and community-employed providers in school buildings. With the implementation of provisions of the Patient Protection and Affordable Care Act (2010) that funds school-based health centers, school-based mental health services could become more broadly available in…

  14. Dynamic SLA Negotiation in Autonomic Federated Environments

    NASA Astrophysics Data System (ADS)

    Rubach, Pawel; Sobolewski, Michael

    Federated computing environments offer requestors the ability to dynamically invoke services offered by collaborating providers in the virtual service network. Without an efficient resource management that includes Dynamic SLA Negotiation, however, the assignment of providers to customer's requests cannot be optimized and cannot offer high reliability without relevant SLA guarantees. We propose a new SLA-based SERViceable Metacomputing Environment (SERVME) capable of matching providers based on QoS requirements and performing autonomic provisioning and deprovisioning of services according to dynamic requestor needs. This paper presents the SLA negotiation process that includes on-demand provisioning and uses an object-oriented SLA model for large-scale service-oriented systems supported by SERVME. An initial reference implementation in the SORCER environment is also described.

  15. Do hospitals cross-subsidize?

    PubMed Central

    David, Guy; Lindrooth, Richard C.; Helmchen, Lorens A.; Burns, Lawton R.

    2017-01-01

    Despite its salience as a regulatory tool to ensure the delivery of unprofitable medical services, cross-subsidization of services within hospital systems has been notoriously difficult to detect and quantify. We use repeated shocks to a profitable service in the market for hospital-based medical care to test for cross-subsidization of unprofitable services. Using patient-level data from general short-term hospitals in Arizona and Colorado before and after entry by cardiac specialty hospitals, we study how incumbent hospitals adjusted their provision of three uncontested services that are widely considered to be unprofitable. We estimate that the hospitals most exposed to entry reduced their provision of psychiatric, substance-abuse, and trauma care services at a rate of about one uncontested-service admission for every four cardiac admissions they stood to lose. Although entry by single-specialty hospitals may adversely affect the provision of unprofitable uncontested services, these findings warrant further evaluation of service-line cross-subsidization as a means to finance them. PMID:25062300

  16. Improving long-term care provision: towards demand-based care by means of modularity

    PubMed Central

    2010-01-01

    Background As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes. Methods Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Results Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services. Conclusion The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to elaborate on how to further enable demand-based provision of long-term care by means of modularity. PMID:20858256

  17. Improving long-term care provision: towards demand-based care by means of modularity.

    PubMed

    de Blok, Carolien; Luijkx, Katrien; Meijboom, Bert; Schols, Jos

    2010-09-21

    As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes. Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services. The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to elaborate on how to further enable demand-based provision of long-term care by means of modularity.

  18. An emergency department-based mental health nurse practitioner outpatient service: part 2, staff evaluation.

    PubMed

    Wand, Timothy; White, Kathryn; Patching, Joanna; Dixon, Judith; Green, Timothy

    2011-12-01

    The nurse practitioner role incorporates enhancing access to health-care services, particularly for populations that are underserved. This entails working collaboratively with colleagues across multidisciplinary teams and emphasizing a nursing model of practice within the nurse practitioner role. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based in the emergency department (ED) is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. One component of the evaluation involved semistructured interviews conducted with a random selection of study participants and a stratified sample of ED staff. This is the second of a two-part paper that presents an analysis of the qualitative data derived from the staff interviews (n = 20). Emergency staff were very supportive of the outpatient service, and perceived that it enhanced overall service provision and improved outcomes for patients. Moreover, staff expressed interest in receiving more formal feedback on the outcomes of the service. Staff also felt that service provision would be enhanced through additional mental health liaison nurses working in the department, especially after hours. An ED-based MHNP outpatient service expedites access to follow up to individuals with a broad range of problems, and supports ED staff in the provision of safe, effective, and more holistic care. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  19. Obesity Prevention: The Impact of Local Health Departments

    PubMed Central

    Chen, Zhuo (Adam); Roy, Kakoli; Gotway Crawford, Carol A

    2013-01-01

    Objective To examine the association between bodyweight status and provision of population-based prevention services. Data Sources The National Association of City and County Health Officials 2005 Profile survey data, linked with two cross-sections of the Behavioral Risk Factor Surveillance System (BRFSS) survey in 2004 and 2005. Study Design Multilevel logistic regressions were used to examine the association between provision of obesity-prevention services and the change in risk of being obese or morbidly obese among BRFSS respondents. The estimation sample was stratified by sex. Low-income samples were also examined. Falsification tests were used to determine whether there is counterevidence. Principal Findings Provision of population-based obesity-prevention services within the jurisdiction of local health departments and specifically those provided by the local health departments are associated with reduced risks of obesity and morbid obesity from 2004 to 2005. The magnitude of the association appears to be stronger among low-income populations and among women. Results of the falsification tests provide additional support of the main findings. Conclusions Population-based obesity-prevention services may be useful in containing the obesity epidemic. PMID:22816510

  20. Oral Health Services within Community-Based Organizations for Young Children with Special Health Care Needs

    PubMed Central

    Cruz, S; Chi, DL; Huebner, CE

    2016-01-01

    Purpose To identify the types of oral health services offered by community-based organizations to young children with special health care needs (CSHCN) and the barriers and facilitators to the provision of these in a non-fluoridated community. Methods Thirteen key informant interviews with representatives from early intervention agencies, advocacy groups, and oral health programs who provide services to CSHCN in Spokane county, Washington. We used a content analysis to thematically identify oral health services as proactive or incidental and the barriers and facilitators to their provision. Results We identified four types of oral health services: screenings, parent education, preventive dental care, and dental referrals. Barriers to providing all four services included limited agency resources, restrictive administrative and system-level policies, and low demand from parents. A barrier to providing education and preventive dental care was community disagreement regarding fluoride. A barrier to providing dental referrals was the perceived lack of dentists who could treat CSHCN. Facilitators included community partnerships among the organizations and utilization of the statewide oral health program. Conclusions Oral health services for young CSHCN are limited and often delivered in response to oral health problems. Coordinated efforts between community-based organizations, health providers, and advocates are necessary to ensure the provision of comprehensive care, including preventive and restorative services, to all young CSHCN. PMID:27028954

  1. Oral health services within community-based organizations for young children with special health care needs.

    PubMed

    Cruz, Stephanie; Chi, Donald L; Huebner, Colleen E

    2016-09-01

    To identify the types of oral health services offered by community-based organizations to young children with special health care needs (CSHCN) and the barriers and facilitators to the provision of these in a nonfluoridated community. Thirteen key informant interviews with representatives from early intervention agencies, advocacy groups, and oral health programs who provide services to CSHCN in Spokane county, Washington. We used a content analysis to thematically identify oral health services as proactive or incidental and the barriers and facilitators to their provision. We identified four types of oral health services: screenings, parent education, preventive dental care, and dental referrals. Barriers to providing all four services included limited agency resources, restrictive administrative and system-level policies, and low demand from parents. A barrier to providing education and preventive dental care was community disagreement regarding fluoride. A barrier to providing dental referrals was the perceived lack of dentists who could treat CSHCN. Facilitators included community partnerships among the organizations and utilization of the statewide oral health program. Oral health services for young CSHCN are limited and often delivered in response to oral health problems. Coordinated efforts between community-based organizations, health providers, and advocates are necessary to ensure the provision of comprehensive care, including preventive and restorative services, to all young CSHCN. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

  2. Social capital, collective efficacy and the provision of social support services and amenities by municipalities in the Netherlands.

    PubMed

    Waverijn, Geeke; Groenewegen, Peter P; de Klerk, Mirjam

    2017-03-01

    Differential provision of local services and amenities has been proposed as a mechanism behind the relationship between social capital and health. The aim of this study was to investigate whether social capital and collective efficacy are related to the provision of social support services and amenities in Dutch municipalities, against a background of decentralisation of long-term care to municipalities. We used data on neighbourhood social capital, collective efficacy (the extent to which people are willing to work for the common good), and the provision of services and amenities in 2012. We included the services municipalities provide to support informal caregivers (e.g. respite care), individual services and support (e.g. domiciliary help), and general and collective services and amenities (e.g. lending point for wheelchairs). Data for social capital were collected between May 2011 and September 2012. Social capital was measured by focusing on contacts between neighbours. A social capital measure was estimated for 414 municipalities with ecometric measurements. A measure of collective efficacy was constructed based on information about the experienced responsibility for the liveability of the neighbourhood by residents in 2012, average charity collection returns in municipalities in 2012, voter turnout at the municipal elections in 2010 and the percentage of blood donors in 2012. We conducted Poisson regression and negative binomial regression to test our hypotheses. We found no relationship between social capital and the provision of services and amenities in municipalities. We found an interaction effect (coefficient = 3.11, 95% CI = 0.72-5.51, P = 0.011) of social capital and collective efficacy on the provision of support services for informal caregivers in rural municipalities. To gain more insight in the relationship between social capital and health, it will be important to study the relationship between social capital and differential provision of services and amenities more extensively and in different contexts. © 2016 John Wiley & Sons Ltd.

  3. Towards comprehensive early abortion service delivery in high income countries: insights for improving universal access to abortion in Australia.

    PubMed

    Dawson, Angela; Bateson, Deborah; Estoesta, Jane; Sullivan, Elizabeth

    2016-10-22

    Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider education and training and the expansion of telemedicine for medical abortion. However, to implement such directives leadership is required from Australian medical, nursing, midwifery and pharmacy practitioners, academic faculties and their associated professional associations. In addition, political will is needed to nationally decriminalise abortion and ensure dedicated public provision that is based on comprehensive models tailored for all populations.

  4. A framework to assess welfare mix and service provision models in health care and social welfare: case studies of two prominent Italian regions.

    PubMed

    Longo, Francesco; Notarnicola, Elisabetta; Tasselli, Stefano

    2015-04-09

    The mechanisms through which the relationships among public institutions, private providers and families affect care and service provision systems are puzzling. How can we understand the mechanisms in these contexts? Which elements should we explore to capture the complexity of care provision? The aim of our study is to provide a framework that can help read and reframe these puzzling care provision mechanisms in a welfare mix context. First, we develop a theoretical framework for understanding how service provision occurs in care systems that are characterised by a variety of relationships between multiple actors, using an evidence-based approach that looks at both public and private expenditures and the number of users relative to the level of needs coverage and compared with declared values and political rhetoric. Second, we test this framework in two case studies built on data from two prominent Italian regions, Lombardy and Emilia-Romagna. We argue that service provision models depend on the interplay among six conceptual elements: policy values, governance rules, resources, nature of the providers, service standards and eligibility criteria. Our empirical study shows that beneath the relevant differences in values and political rhetoric between the case studies of the two Italian regions, there is a surprising isomorphism in service standards and the levels of covering the population's needs. The suggested framework appears to be effective and feasible; it fosters interdisciplinary approaches and supports policy-making discussions. This study may contribute to deepening knowledge about public care service provision and institutional arrangements, which can be used to promote more effective reforms and may advance future research. Although the framework was tested on the Italian welfare system, it can be used to assess many different systems.

  5. Virtual Reference Services--Down-Under: A Cautionary Tale.

    ERIC Educational Resources Information Center

    Wagner, Gulten S.

    Digital reference services at university libraries in Australia and New Zealand are a recent phenomena dating back to the late 1990s--following the developments in Web-based online library services. This paper examines the move towards the provision of e-mail reference services based on the study of 16 randomly chosen university libraries in…

  6. Capacity, pressure, demand, and flow: A conceptual framework for analyzing ecosystem service provision and delivery

    USGS Publications Warehouse

    Villamagna, Amy M.; Angermeier, Paul L.; Bennett, Elena M.

    2013-01-01

    Ecosystem services provide an instinctive way to understand the trade-offs associated with natural resource management. However, despite their apparent usefulness, several hurdles have prevented ecosystem services from becoming deeply embedded in environmental decision-making. Ecosystem service studies vary widely in focal services, geographic extent, and in methods for defining and measuring services. Dissent among scientists on basic terminology and approaches to evaluating ecosystem services create difficulties for those trying to incorporate ecosystem services into decision-making. To facilitate clearer comparison among recent studies, we provide a synthesis of common terminology and explain a rationale and framework for distinguishing among the components of ecosystem service delivery, including: an ecosystem's capacity to produce services; ecological pressures that interfere with an ecosystem's ability to provide the service; societal demand for the service; and flow of the service to people. We discuss how interpretation and measurement of these four components can differ among provisioning, regulating, and cultural services. Our flexible framework treats service capacity, ecological pressure, demand, and flow as separate but interactive entities to improve our ability to evaluate the sustainability of service provision and to help guide management decisions. We consider ecosystem service provision to be sustainable when demand is met without decreasing capacity for future provision of that service or causing undesirable declines in other services. When ecosystem service demand exceeds ecosystem capacity to provide services, society can choose to enhance natural capacity, decrease demand and/or ecological pressure, or invest in a technological substitute. Because regulating services are frequently overlooked in environmental assessments, we provide a more detailed examination of regulating services and propose a novel method for quantifying the flow of regulating services based on estimates of ecological work. We anticipate that our synthesis and framework will reduce inconsistency and facilitate coherence across analyses of ecosystem services, thereby increasing their utility in environmental decision-making.

  7. Reframing landscape fragmentation's effects on ecosystem services.

    PubMed

    Mitchell, Matthew G E; Suarez-Castro, Andrés F; Martinez-Harms, Maria; Maron, Martine; McAlpine, Clive; Gaston, Kevin J; Johansen, Kasper; Rhodes, Jonathan R

    2015-04-01

    Landscape structure and fragmentation have important effects on ecosystem services, with a common assumption being that fragmentation reduces service provision. This is based on fragmentation's expected effects on ecosystem service supply, but ignores how fragmentation influences the flow of services to people. Here we develop a new conceptual framework that explicitly considers the links between landscape fragmentation, the supply of services, and the flow of services to people. We argue that fragmentation's effects on ecosystem service flow can be positive or negative, and use our framework to construct testable hypotheses about the effects of fragmentation on final ecosystem service provision. Empirical efforts to apply and test this framework are critical to improving landscape management for multiple ecosystem services. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Cost analysis for the implementation of a medication review with follow-up service in Spain.

    PubMed

    Noain, Aranzazu; Garcia-Cardenas, Victoria; Gastelurrutia, Miguel Angel; Malet-Larrea, Amaia; Martinez-Martinez, Fernando; Sabater-Hernandez, Daniel; Benrimoj, Shalom I

    2017-08-01

    Background Medication review with follow-up (MRF) is a professional pharmacy service proven to be cost-effective. Its broader implementation is limited, mainly due to the lack of evidence-based implementation programs that include economic and financial analysis. Objective To analyse the costs and estimate the price of providing and implementing MRF. Setting Community pharmacy in Spain. Method Elderly patients using poly-pharmacy received a community pharmacist-led MRF for 6 months. The cost analysis was based on the time-driven activity based costing model and included the provider costs, initial investment costs and maintenance expenses. The service price was estimated using the labour costs, costs associated with service provision, potential number of patients receiving the service and mark-up. Main outcome measures Costs and potential price of MRF. Results A mean time of 404.4 (SD 232.2) was spent on service provision and was extrapolated to annual costs. Service provider cost per patient ranged from €196 (SD 90.5) to €310 (SD 164.4). The mean initial investment per pharmacy was €4594 and the mean annual maintenance costs €3,068. Largest items contributing to cost were initial staff training, continuing education and renting of the patient counselling area. The potential service price ranged from €237 to €628 per patient a year. Conclusion Time spent by the service provider accounted for 75-95% of the final cost, followed by initial investment costs and maintenance costs. Remuneration for professional pharmacy services provision must cover service costs and appropriate profit, allowing for their long-term sustainability.

  9. AmI and deployment considerations in AAL services provision for elderly independent living: the MonAMI project.

    PubMed

    Falcó, Jorge L; Vaquerizo, Esteban; Lain, Luis; Artigas, Jose Ignacio; Ibarz, Alejandro

    2013-07-12

    The MonAMI project aims to investigate the feasibility of the deployment of open platforms for Ambient Assisted Living (AAL) services provision based on Ambient Intelligence (AmI) and to test user acceptance and the usability of the services. Services were designed to provide support in the areas of environmental control, security, well-being and leisure. These services were installed and evaluated in a Spanish geriatric residence. The participants included elderly persons with disabilities, nursing home care givers and informal carers. The concept of the open platform proved to be satisfactory for the provision of the services in a context aware framework. Furthermore, the usability of the technology was viewed positively and the overall results indicate that this system has the potential to prolong independent living at home for elderly people with disabilities. Deployment was proven successful and awareness of open-platform AAL service delivery was raised in local communities throughout Europe.

  10. AmI and Deployment Considerations in AAL Services Provision for Elderly Independent Living: The MonAMI Project

    PubMed Central

    Falcó, Jorge L.; Vaquerizo, Esteban; Lain, Luis; Artigas, Jose Ignacio; Ibarz, Alejandro

    2013-01-01

    The MonAMI project aims to investigate the feasibility of the deployment of open platforms for Ambient Assisted Living (AAL) services provision based on Ambient Intelligence (AmI) and to test user acceptance and the usability of the services. Services were designed to provide support in the areas of environmental control, security, well-being and leisure. These services were installed and evaluated in a Spanish geriatric residence. The participants included elderly persons with disabilities, nursing home care givers and informal carers. The concept of the open platform proved to be satisfactory for the provision of the services in a context aware framework. Furthermore, the usability of the technology was viewed positively and the overall results indicate that this system has the potential to prolong independent living at home for elderly people with disabilities. Deployment was proven successful and awareness of open-platform AAL service delivery was raised in local communities throughout Europe. PMID:23857262

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

    PubMed

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

    2012-12-01

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

  12. Medicaid program; home and community-based services. Health Care Financing Administration (HCFA), HHS. Final rule with comment period.

    PubMed

    2000-10-10

    This final rule with comment period expands State flexibility in providing prevocational, educational, and supported employment services under the Medicaid home and community-based services waiver provisions currently found in section 1915(c) of the Social Security Act (the Act); and incorporates the self-implementing provisions of section 4743 of the Balanced Budget Act of 1997 that amends section 1915(c)(5) of the Act to delete the requirements that an individual have prior institutionalization in a nursing facility or intermediate care facility for the mentally retarded before becoming eligible for the expanded habilitation services. In addition, we are making a number of technical changes to update or correct the regulations.

  13. The Relevance of the Affordable Care Act for Improving Mental Health Care.

    PubMed

    Mechanic, David; Olfson, Mark

    2016-01-01

    Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce.

  14. Provision of out-of-hours interventional radiology services in the London strategic health authority.

    PubMed

    Illing, R O; Clark, C L Ingham; Allum, C

    2010-04-01

    To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA). All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services. An "ad-hoc" service was defined as on-call provision where not all the radiologists could perform intervention: If IR was required out of hours, an interventionalist came in when off-duty or the patient was transferred. Seventeen out of the 29 (59%) hospitals provided ad-hoc out-of-hours services, eight (28%) provided a 24-hour rota, and four (14%) provide no out-of-hours cover. No ad-hoc service had formal transfer arrangements to a centre providing a 24h service. Only two hospitals providing a 24h service had six radiologists on the rota. Strategic planning for out-of-hours IR across London is recommended. This is likely to be welcomed by the hospitals involved, allowing informal arrangements to be formalized, and collaboration to provide comprehensive regional networks, provided appropriate funding is made available. A national audit is recommended; it is unlikely these findings are unique to London.

  15. The recovery model and complex health needs: what health psychology can learn from mental health and substance misuse service provision.

    PubMed

    Webb, Lucy

    2012-07-01

    This article reviews key arguments around evidence-based practice and outlines the methodological demands for effective adoption of recovery model principles. The recovery model is outlined and demonstrated as compatible with current needs in substance misuse service provision. However, the concepts of evidence-based practice and the recovery model are currently incompatible unless the current value system of evidence-based practice changes to accommodate the methodologies demanded by the recovery model. It is suggested that critical health psychology has an important role to play in widening the scope of evidence-based practice to better accommodate complex social health needs.

  16. The provision of ecosystem services in response to global change: Evidences and applications.

    PubMed

    Lafortezza, Raffaele; Chen, Jiquan

    2016-05-01

    As a consequence of the global increase in economic and societal prosperity, ecosystems and natural resources have been substantially exploited, degraded, or even destroyed in the last century. To prevent further deprivation of the quality of ecosystems, the ecosystem services concept has become a central issue in environmental studies. A growing number of environmental agencies and organizations worldwide are now embracing integrated approaches to plan and manage ecosystems, sharing a goal to maintain the long-term provision of ecosystem services for sustainability. A daunting challenge in this process is to move from general pronouncements about the tremendous benefits that ecosystems provide to society to defensible assessments of their services. In other words, we must move beyond the scientific evidences of the ecosystem services concept to its practical applications. In this work, we discuss the theoretical foundations and applications of ecosystem services with a focus on the assessment of ecosystem service trade-offs and synergies at various spatial and temporal scales. Here, we offer examples of the main factors related to land use management that may affect the provision of ecosystem services and provide direction for future research on ecosystem services and related nature-based solutions. We also provide a briefing on the major topics covered in this Special Issue, which focuses on the provision of ecosystem services in the context of global change. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Provision of Palliative Care Services by Family Physicians Is Common.

    PubMed

    Ankuda, Claire K; Jetty, Anuradha; Bazemore, Andrew; Petterson, Stephen

    2017-01-01

    Provision of palliative care services by primary care physicians is increasingly important with an aging population, but it is unknown whether US primary care physicians see themselves as palliative practitioners. This study used cross-sectional analysis of data from the 2013 American Board of Family Medicine Maintenance of Certification Demographic Survey. Of 10,894 family physicians, 33.1% (n = 3609) report providing palliative care. Those providing palliative care are significantly more likely to provide non-clinic-based services such as care in nursing homes, home visits, and hospice. Controlling for other characteristics, physicians reporting palliative care provision are significantly ( P < .05) more likely to be older, white, male, rural, and practicing in a patient-centered medical home. One third of family physicians recertifying in 2013 reported providing palliative care, with physician and practice characteristics driving reporting palliative care provision. © Copyright 2017 by the American Board of Family Medicine.

  18. Efficiency of antenatal care and childbirth services in selected primary health care facilities in rural Tanzania: a cross-sectional study.

    PubMed

    Saronga, Happiness P; Duysburgh, Els; Massawe, Siriel; Dalaba, Maxwell A; Savadogo, Germain; Tonchev, Pencho; Dong, Hengjin; Sauerborn, Rainer; Loukanova, Svetla

    2014-02-28

    Cost studies are paramount for demonstrating how resources have been spent and identifying opportunities for more efficient use of resources. The main objective of this study was to assess the actual dimension and distribution of the costs of providing antenatal care (ANC) and childbirth services in selected rural primary health care facilities in Tanzania. In addition, the study analyzed determining factors of service provision efficiency in order to inform health policy and planning. This was a retrospective quantitative cross-sectional study conducted in 11 health centers and dispensaries in Lindi and Mtwara rural districts. Cost analysis was carried out using step down cost accounting technique. Unit costs reflected efficiency of service provision. Multivariate regression analysis on the drivers of observed relative efficiency in service provision between the study facilities was conducted. Reported personnel workload was also described. The health facilities spent on average 7 USD per capita in 2009. As expected, fewer resources were spent for service provision at dispensaries than at health centers. Personnel costs contributed a high approximate 44% to total costs. ANC and childbirth consumed approximately 11% and 12% of total costs; and 8% and 10% of reported service provision time respectively. On average, unit costs were rather high, 16 USD per ANC visit and 79.4 USD per childbirth. The unit costs showed variation in relative efficiency in providing the services between the health facilities. The results showed that efficiency in ANC depended on the number of staff, structural quality of care, process quality of care and perceived quality of care. Population-staff ratio and structural quality of basic emergency obstetric care services highly influenced childbirth efficiency. Differences in the efficiency of service provision present an opportunity for efficiency improvement. Taking into consideration client heterogeneity, quality improvements are possible and necessary. This will stimulate utilization of ANC and childbirth services in resource-constrained health facilities. Efficiency analyses through simple techniques such as measurement of unit costs should be made standard in health care provision, health managers can then use the performance results to gauge progress and reward efficiency through performance based incentives.

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

    PubMed

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

    2016-09-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-09-01

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

  1. A study on strategic provisioning of cloud computing services.

    PubMed

    Whaiduzzaman, Md; Haque, Mohammad Nazmul; Rejaul Karim Chowdhury, Md; Gani, Abdullah

    2014-01-01

    Cloud computing is currently emerging as an ever-changing, growing paradigm that models "everything-as-a-service." Virtualised physical resources, infrastructure, and applications are supplied by service provisioning in the cloud. The evolution in the adoption of cloud computing is driven by clear and distinct promising features for both cloud users and cloud providers. However, the increasing number of cloud providers and the variety of service offerings have made it difficult for the customers to choose the best services. By employing successful service provisioning, the essential services required by customers, such as agility and availability, pricing, security and trust, and user metrics can be guaranteed by service provisioning. Hence, continuous service provisioning that satisfies the user requirements is a mandatory feature for the cloud user and vitally important in cloud computing service offerings. Therefore, we aim to review the state-of-the-art service provisioning objectives, essential services, topologies, user requirements, necessary metrics, and pricing mechanisms. We synthesize and summarize different provision techniques, approaches, and models through a comprehensive literature review. A thematic taxonomy of cloud service provisioning is presented after the systematic review. Finally, future research directions and open research issues are identified.

  2. A Study on Strategic Provisioning of Cloud Computing Services

    PubMed Central

    Rejaul Karim Chowdhury, Md

    2014-01-01

    Cloud computing is currently emerging as an ever-changing, growing paradigm that models “everything-as-a-service.” Virtualised physical resources, infrastructure, and applications are supplied by service provisioning in the cloud. The evolution in the adoption of cloud computing is driven by clear and distinct promising features for both cloud users and cloud providers. However, the increasing number of cloud providers and the variety of service offerings have made it difficult for the customers to choose the best services. By employing successful service provisioning, the essential services required by customers, such as agility and availability, pricing, security and trust, and user metrics can be guaranteed by service provisioning. Hence, continuous service provisioning that satisfies the user requirements is a mandatory feature for the cloud user and vitally important in cloud computing service offerings. Therefore, we aim to review the state-of-the-art service provisioning objectives, essential services, topologies, user requirements, necessary metrics, and pricing mechanisms. We synthesize and summarize different provision techniques, approaches, and models through a comprehensive literature review. A thematic taxonomy of cloud service provisioning is presented after the systematic review. Finally, future research directions and open research issues are identified. PMID:25032243

  3. Assessment of Information Provision Services of Libraries in the 21st Century in Some Selected Academic Libraries in Delta State

    ERIC Educational Resources Information Center

    Ogbah, Enovwor Laura

    2014-01-01

    This study is an assessment of Information Provision Services of Libraries in the 21st century in some selected academic libraries in Delta State. A descriptive survey was adopted in carrying out the research. The questionnaire was the instrument for data collection of which 62 were retrieved. Based on the findings of the study, it was recommended…

  4. "Six sessions is a drop in the ocean": an exploratory study of neurological physiotherapy in idiopathic and inherited ataxias.

    PubMed

    Daker-White, Gavin; Greenfield, Julie; Ealing, John

    2013-12-01

    An exploratory study to examine specialist neurological physiotherapy service provision and utilisation for people with progressive ataxia. Qualitative study involving thematic analysis of accounts in semi-structured interviews with physiotherapists and patients. People with ataxia and specialist neuro-rehabilitation physiotherapists in Greater Manchester, UK. 38 people with ataxia and 8 neurological-physiotherapists working in academic and hospital and community-based services in NHS and private settings. Recruiting physiotherapists experienced in working with the patient group was a challenge. One hour cross-sectional semi-structured interview at physiotherapists' workplaces or in patients' own homes. Neurological physiotherapy was experienced by 25 (66%) of the 38 people with ataxia. The overarching themes emerging from the analysis were 'making a difference,' engagement and service provision. A majority of both samples felt that services should be organised so as to provide longer term therapy and support that goes beyond short care packages followed by provision of home exercise programme. Engagement with services was linked to patient expectations, adherence and perception of outcomes. The most predominant codes in the data set were encapsulated by the theme 'making a difference,' which further included concerns about how to measure perceived clinical improvement (as experienced by patients) in the context of progressive decline. The findings suggest a model of idealised service provision involving a holistic, open-access service including research efforts to improve the evidence base. Special attention needs to be paid to measuring improvements following therapy. Copyright © 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  5. Regional Correlates of Psychiatric Inpatient Treatment.

    PubMed

    Ala-Nikkola, Taina; Pirkola, Sami; Kaila, Minna; Saarni, Samuli I; Joffe, Grigori; Kontio, Raija; Oranta, Olli; Sadeniemi, Minna; Wahlbeck, Kristian

    2016-12-05

    Current reforms of mental health and substance abuse services (MHS) emphasize community-based care and the downsizing of psychiatric hospitals. Reductions in acute and semi-acute hospital beds are achieved through shortened stays or by avoiding hospitalization. Understanding the factors that drive the current inpatient treatment provision is essential. We investigated how the MHS service structure (diversity of services and balance of personnel resources) and indicators of service need (mental health index, education, single household, and alcohol sales) correlated with acute and semi-acute inpatient treatment provision. The European Service Mapping Schedule-Revised (ESMS-R) tool was used to classify the adult MHS structure in southern Finland (population 1.8 million, 18+ years). The diversity of MHS in terms of range of outpatient and day care services or the overall personnel resourcing in inpatient or outpatient services was not associated with the inpatient treatment provision. In the univariate analyses, sold alcohol was associated with the inpatient treatment provision, while in the multivariate modeling, only a general index for mental health needs was associated with greater hospitalization. In the dehospitalization process, direct resource re-allocation and substituting of inpatient treatment with outpatient care per se is likely insufficient, since inpatient treatment is linked to contextual factors in the population and the health care system. Mental health services reforms require both strategic planning of service system as a whole and detailed understanding of effects of societal components.

  6. Performance evaluation of multi-stratum resources integration based on network function virtualization in software defined elastic data center optical interconnect.

    PubMed

    Yang, Hui; Zhang, Jie; Ji, Yuefeng; Tian, Rui; Han, Jianrui; Lee, Young

    2015-11-30

    Data center interconnect with elastic optical network is a promising scenario to meet the high burstiness and high-bandwidth requirements of data center services. In our previous work, we implemented multi-stratum resilience between IP and elastic optical networks that allows to accommodate data center services. In view of this, this study extends to consider the resource integration by breaking the limit of network device, which can enhance the resource utilization. We propose a novel multi-stratum resources integration (MSRI) architecture based on network function virtualization in software defined elastic data center optical interconnect. A resource integrated mapping (RIM) scheme for MSRI is introduced in the proposed architecture. The MSRI can accommodate the data center services with resources integration when the single function or resource is relatively scarce to provision the services, and enhance globally integrated optimization of optical network and application resources. The overall feasibility and efficiency of the proposed architecture are experimentally verified on the control plane of OpenFlow-based enhanced software defined networking (eSDN) testbed. The performance of RIM scheme under heavy traffic load scenario is also quantitatively evaluated based on MSRI architecture in terms of path blocking probability, provisioning latency and resource utilization, compared with other provisioning schemes.

  7. A Cross-Sectional Cohort Study of a Large, Statewide Medicaid Home and Community-Based Services Autism Waiver Program

    ERIC Educational Resources Information Center

    Eskow, Karen Goldrich; Chasson, Gregory S.; Summers, Jean Ann

    2015-01-01

    State-specific 1915(c) Medicaid Home and Community-Based Services waiver programs have become central in the provision of services specifically tailored to children with autism spectrum disorders (ASD). Using propensity score matching, 130 families receiving waiver services for a child with ASD were matched with and compared to 130 families…

  8. Linking Ecosystem Services and Human Health: The Eco-Health Relationship Browser

    EPA Science Inventory

    Ecosystems provide multiple services associated with the provision of nature-based goods and services. Many of these ecosystem services have been linked to a range of positive health outcomes through buffering of pollutants, mitigation of natural hazards, and promotion of healthy...

  9. 13 CFR 106.402 - What provisions must be set forth in a Non-Fee Based Record?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What provisions must be set forth in a Non-Fee Based Record? 106.402 Section 106.402 Business Credit and Assistance SMALL BUSINESS... endorsement by SBA of the Donor, or the Donor's products or services. ...

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

    PubMed

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

    2012-10-01

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

  11. Typological diversity of tall buildings and complexes in relation to their functional structure

    NASA Astrophysics Data System (ADS)

    Generalov, Viktor P.; Generalova, Elena M.; Kalinkina, Nadezhda A.; Zhdanova, Irina V.

    2018-03-01

    The paper focuses on peculiarities of tall buildings and complexes, their typology and its formation in relation to their functional structure. The research is based on the analysis of tall buildings and complexes and identifies the following main functional elements of their formation: residential, administrative (office), hotel elements. The paper also considers the following services as «disseminated» in the space-planning structure: shops, medicine, entertainment, kids and sports facilities, etc., their location in the structure of the total bulk of the building and their impact on typological diversity. Research results include suggestions to add such concepts as «single-function tall buildings» and «mixed-use tall buildings and complexes» into the classification of tall buildings. In addition, if a single-function building or complex performs serving functions, it is proposed to add such concepts as «a residential tall building (complex) with provision of services», «an administrative (public) tall building (complex) with provision of services» into the classification of tall buildings. For mixed-use buildings and complexes the following terms are suggested: «a mixed-use tall building with provision of services», «a mixed-use tall complex with provision of services».

  12. 42 CFR 441.590 - Increased Federal financial participation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SERVICES Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice... the State will be increased by 6 percentage points, for the provision of Community First Choice services and supports, under an approved State plan amendment. ...

  13. 42 CFR 441.590 - Increased Federal financial participation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SERVICES Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice... the State will be increased by 6 percentage points, for the provision of Community First Choice services and supports, under an approved State plan amendment. ...

  14. Functional Classification of Natural Resources for Valuing Natural Resources in Korea

    NASA Astrophysics Data System (ADS)

    Choi, H.; Lee, W.; Kwak, H.

    2013-12-01

    The ecosystem services concept emphasizes not only regulating services, but also supporting, provisioning, and cultural/social services according to the Millennium Ecosystem Assessment (MA). While the spatial and quantifying of ecosystem services is becoming increasingly recognized for natural resources conservation, however, due to methodological challenges, ecosystem services quantification is rarely considered in Republic of Korea (ROK). This study matches appropriate indicators, data and mapping for describing respective states, quantification and ecosystem valuation. The results were analyzed with statistical and GIS-based techniques. We classified the ecosystem services function based on reference to the literature, interviews and a modified approach compared to the MA, the Economics of Ecosystems and Biodiversity (TEEB). For quantifying values, we subdivided land cover types using ecological features and normalized numerical information of provisioning services, regulating services and cultural services. Resulting hotspots of ecosystem services are related to landscape features and land cover types in ROK. The mapping results show hotspots of ecosystem services where high level of ecosystem services is distributed - around Baekdudaegan protected area (Gangwon, Gyeongbuk Province, Chungbuk, Jeonam Province). n addition, the results of our study show that ecosystem services function - especially, fostering water resources, erosion control, air quality and pollution control in terrestrial ecosystems - can contribute to planning management policy for ecosystem based management at regional scale.

  15. Services for children with developmental co-ordination disorder: an evaluation against best practice principles.

    PubMed

    Pentland, Jacqueline; Maciver, Donald; Owen, Christine; Forsyth, Kirsty; Irvine, Linda; Walsh, Mike; Crowe, Miriam

    2016-01-01

    The National Health Service in Scotland published a best practice framework to support occupational therapists and physiotherapists to deliver effective services for children with developmental co-ordination disorder (DCD); however, adherence is variable. To highlight areas for development, this study compared the care pathway within a paediatric DCD service against the NHS Scotland framework. A partnership of researchers and clinicians based in the United Kingdom conducted a qualitative study with 37 participants (N = 13 interview participants, N = 24 workshop participants). In-depth interviews and/or workshops were used to map the DCD service against the NHS framework. Identified gaps were aligned with four key stages of the care pathway. Qualitative analysis software was used to analyse the data. Core principles to guide future development were identified for each phase of the pathway. These core principles related to the NHS framework and focused on issues such as involving the family, defining clear pathways and enhancing children's participation. Participants identified potential strategies for service improvement such as developing community-based interventions and information provision. Challenges when providing services for children with DCD include confusing service pathways and poor partnership working. It is, therefore, important that clinicians utilise collaborative working strategies that support children's participation. There are numerous challenges related to the implementation of best practice principles into the provision of therapy services for children with developmental coordination disorder (DCD). It is important that AHPs seek ways of engaging parents and educational professionals at all stages of the care pathway in order to ensure optimum service provision for the child. Addressing participation is an important aspect and community-based strategies may be particularly beneficial, both as a preventative activity and as an intervention approach.

  16. Patient perceptions and expectations of an anticoagulation service: a quantitative comparison study of clinic-based testers and patient self-testers.

    PubMed

    Money, Arthur G; Barnett, Julie; Kuljis, Jasna; Duffin, Debbie

    2015-12-01

    Government initiatives see the provision of technology-assisted self-care as one of the key areas in which there is capacity for improving quality of care whilst reducing costs. However, levels of patient engagement in self-testing and management (STM) remain low. Little emphasis has been placed on understanding the patients' perspectives of the reasons for this limited engagement. Typically, patient engagement in STM is achieved via the provision of patient education programmes, which aim to enable patients to make the changes necessary to become competent self-carers. However, placing the onus to change on the individual patient is unrealistic. If levels of patient engagement are to be improved, patient needs and expectations of clinical services must be better understood and service provision must be adapted accordingly. Explore patient perceptions and expectations of clinical service provision and their views of having and making choices about care. Participants [N = 191, 103 patient self-tester managers (PSTMs) and 87 clinic-based testers (CBTs)] completed the SERVQUAL and ChQ instruments to capture perspectives on service quality and choice, respectively. A comparative statistical analysis explored the similarities and differences between PSTMs' and CBTs' responses. Clinic-based testers' perceptions of service quality were significantly more positive than PSTMs', as were their expectations of the 'tangible' aspects of service delivery. PSTMs' expectations of service quality were significantly higher than their perceptions. PSTMs attributed significantly more value to making choices compared with CBTs. To close the gap between PSTMs expectations and perceptions of service quality and better cater for their choice preferences, service providers may benefit from taking into account the following practice considerations: maintain frequent, timely, personalised and direct interactions with PSTMs; prioritise investment in resources to facilitate patient/practitioner interaction over tangible facilities; ensure that PSTMs are given the opportunity to make choices about their care. © 2015 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

  17. 13 CFR 106.302 - What provisions must be set forth in a Fee Based Record?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What provisions must be set forth in a Fee Based Record? 106.302 Section 106.302 Business Credit and Assistance SMALL BUSINESS... does not constitute or imply an endorsement by SBA of the Donor or the Donor's products or services. ...

  18. Selecting cost-effective areas for restoration of ecosystem services.

    PubMed

    Adame, M F; Hermoso, V; Perhans, K; Lovelock, C E; Herrera-Silveira, J A

    2015-04-01

    Selection of areas for restoration should be based on cost-effectiveness analysis to attain the maximum benefit with a limited budget and overcome the traditional ad hoc allocation of funds for restoration projects. Restoration projects need to be planned on the basis of ecological knowledge and economic and social constraints. We devised a novel approach for selecting cost-effective areas for restoration on the basis of biodiversity and potential provision of 3 ecosystem services: carbon storage, water depuration, and coastal protection. We used Marxan, a spatial prioritization tool, to balance the provision of ecosystem services against the cost of restoration. We tested this approach in a mangrove ecosystem in the Caribbean. Our approach efficiently selected restoration areas that at low cost were compatible with biodiversity targets and that maximized the provision of one or more ecosystem services. Choosing areas for restoration of mangroves on the basis carbon storage potential, largely guaranteed the restoration of biodiversity and other ecosystem services. © 2014 Society for Conservation Biology.

  19. Co-scheduling of network resource provisioning and host-to-host bandwidth reservation on high-performance network and storage systems

    DOEpatents

    Yu, Dantong; Katramatos, Dimitrios; Sim, Alexander; Shoshani, Arie

    2014-04-22

    A cross-domain network resource reservation scheduler configured to schedule a path from at least one end-site includes a management plane device configured to monitor and provide information representing at least one of functionality, performance, faults, and fault recovery associated with a network resource; a control plane device configured to at least one of schedule the network resource, provision local area network quality of service, provision local area network bandwidth, and provision wide area network bandwidth; and a service plane device configured to interface with the control plane device to reserve the network resource based on a reservation request and the information from the management plane device. Corresponding methods and computer-readable medium are also disclosed.

  20. The hospital library online--a point of service for consumers and hospital staff: a case study.

    PubMed Central

    Cain, N J; Fuller, H J

    1999-01-01

    The Health Library at Stanford University is described in the context of electronic information services provided to Stanford University Medical Center, the local community, and Internet users in general. The evolution from CD-ROM-based services to Web-based services and in-library services to networked resources are described. Electronic services have expanded the mission of The Health Library to include national and international users and the provision of unique services and collections. PMID:10427424

  1. Building-Based Analysis of the Spatial Provision of Urban Parks in Shenzhen, China.

    PubMed

    Gao, Wenxiu; Lyu, Qiang; Fan, Xiang; Yang, Xiaochun; Liu, Jiangtao; Zhang, Xirui

    2017-12-06

    Urban parks provide important environmental, social, and economic benefits to people and urban areas. The literature demonstrates that proximity to urban parks is one of the key factors influencing people's willingness to use them. Therefore, the provision of urban parks near residential areas and workplaces is one of the key factors influencing quality of life. This study designed a solution based on the spatial association between urban parks and buildings where people live or work to identify whether people in different buildings have nearby urban parks available for their daily lives. A building density map based on building floor area (BFA) was used to illustrate the spatial distribution of urban parks and five indices were designed to measure the scales, service coverage and potential service loads of urban parks and reveal areas lacking urban park services in an acceptable walking distance. With such solution, we investigated the provision of urban parks in ten districts of Shenzhen in China, which has grown from several small villages to a megacity in only 30 years. The results indicate that the spatial provision of urban parks in Shenzhen is not sufficient since people in about 65% of the buildings cannot access urban parks by walking 10-min. The distribution and service coverage of the existing urban parks is not balanced at the district level. In some districts, the existing urban parks have good numbers of potential users and even have large service loads, while in some districts, the building densities surrounding the existing parks are quite low and at the same time there is no urban parks nearby some high-density areas.

  2. Building-Based Analysis of the Spatial Provision of Urban Parks in Shenzhen, China

    PubMed Central

    Gao, Wenxiu; Lyu, Qiang; Fan, Xiang; Liu, Jiangtao; Zhang, Xirui

    2017-01-01

    Urban parks provide important environmental, social, and economic benefits to people and urban areas. The literature demonstrates that proximity to urban parks is one of the key factors influencing people’s willingness to use them. Therefore, the provision of urban parks near residential areas and workplaces is one of the key factors influencing quality of life. This study designed a solution based on the spatial association between urban parks and buildings where people live or work to identify whether people in different buildings have nearby urban parks available for their daily lives. A building density map based on building floor area (BFA) was used to illustrate the spatial distribution of urban parks and five indices were designed to measure the scales, service coverage and potential service loads of urban parks and reveal areas lacking urban park services in an acceptable walking distance. With such solution, we investigated the provision of urban parks in ten districts of Shenzhen in China, which has grown from several small villages to a megacity in only 30 years. The results indicate that the spatial provision of urban parks in Shenzhen is not sufficient since people in about 65% of the buildings cannot access urban parks by walking 10-min. The distribution and service coverage of the existing urban parks is not balanced at the district level. In some districts, the existing urban parks have good numbers of potential users and even have large service loads, while in some districts, the building densities surrounding the existing parks are quite low and at the same time there is no urban parks nearby some high-density areas. PMID:29211046

  3. Community-based post-stroke service provision and challenges: a national survey of managers and inter-disciplinary healthcare staff in Ireland.

    PubMed

    Hickey, Anne; Horgan, Frances; O'Neill, Desmond; McGee, Hannah

    2012-05-06

    The extent of stroke-related disability typically becomes most apparent after patient discharge to the community. As part of the Irish National Audit of Stroke Care (INASC), a national survey of community-based allied health professionals and public health nurses was conducted. The aim was to document the challenges to service availability for patients with stroke in the community and to identify priorities for service improvement. The study was a cross-sectional tailored interview survey with key managerial and service delivery staff. As comprehensive listings of community-based health professionals involved in stroke care were not available, a cascade approach to information gathering was adopted. Representative regional managers for services incorporating stroke care (N = 7) and disciplinary allied health professional and public health nurse managers (N = 25) were interviewed (94% response rate). Results indicated a lack of formal, structured community-based services for stroke, with no designated clinical posts for stroke care across disciplines nationally. There was significant regional variation in availability of allied health professionals. Considerable inequity was identified in patient access to stroke services, with greater access, where available, for older patients (≥ 65 years). The absence of a stroke strategy and stroke prevalence statistics were identified as significant impediments to service planning, alongside organisational barriers limiting the recruitment of additional allied health professional staff, and lack of sharing of discipline-specific information on patients. This study highlighted major gaps in the provision of inter-disciplinary team community-based services for people with stroke in one country. Where services existed, they were generic in nature, rarely inter-disciplinary in function and deficient in input from salient disciplines. Challenges to optimal care included the need for strategic planning; increased funding of healthcare staff; increased team resources and teamwork; and removal of service provision barriers based on age. There were notably many challenges beyond funding. Similar evaluations in other healthcare systems would serve to provide comparative lessons to serve to tackle this underserved aspect of care for patients with stroke and their families.

  4. The Virtual Climate Data Server (vCDS): An iRODS-Based Data Management Software Appliance Supporting Climate Data Services and Virtualization-as-a-Service in the NASA Center for Climate Simulation

    NASA Technical Reports Server (NTRS)

    Schnase, John L.; Tamkin, Glenn S.; Ripley, W. David III; Stong, Savannah; Gill, Roger; Duffy, Daniel Q.

    2012-01-01

    Scientific data services are becoming an important part of the NASA Center for Climate Simulation's mission. Our technological response to this expanding role is built around the concept of a Virtual Climate Data Server (vCDS), repetitive provisioning, image-based deployment and distribution, and virtualization-as-a-service. The vCDS is an iRODS-based data server specialized to the needs of a particular data-centric application. We use RPM scripts to build vCDS images in our local computing environment, our local Virtual Machine Environment, NASA s Nebula Cloud Services, and Amazon's Elastic Compute Cloud. Once provisioned into one or more of these virtualized resource classes, vCDSs can use iRODS s federation capabilities to create an integrated ecosystem of managed collections that is scalable and adaptable to changing resource requirements. This approach enables platform- or software-asa- service deployment of vCDS and allows the NCCS to offer virtualization-as-a-service: a capacity to respond in an agile way to new customer requests for data services.

  5. GEMSS: grid-infrastructure for medical service provision.

    PubMed

    Benkner, S; Berti, G; Engelbrecht, G; Fingberg, J; Kohring, G; Middleton, S E; Schmidt, R

    2005-01-01

    The European GEMSS Project is concerned with the creation of medical Grid service prototypes and their evaluation in a secure service-oriented infrastructure for distributed on demand/supercomputing. Key aspects of the GEMSS Grid middleware include negotiable QoS support for time-critical service provision, flexible support for business models, and security at all levels in order to ensure privacy of patient data as well as compliance to EU law. The GEMSS Grid infrastructure is based on a service-oriented architecture and is being built on top of existing standard Grid and Web technologies. The GEMSS infrastructure offers a generic Grid service provision framework that hides the complexity of transforming existing applications into Grid services. For the development of client-side applications or portals, a pluggable component framework has been developed, providing developers with full control over business processes, service discovery, QoS negotiation, and workflow, while keeping their underlying implementation hidden from view. A first version of the GEMSS Grid infrastructure is operational and has been used for the set-up of a Grid test-bed deploying six medical Grid service prototypes including maxillo-facial surgery simulation, neuro-surgery support, radio-surgery planning, inhaled drug-delivery simulation, cardiovascular simulation and advanced image reconstruction. The GEMSS Grid infrastructure is based on standard Web Services technology with an anticipated future transition path towards the OGSA standard proposed by the Global Grid Forum. GEMSS demonstrates that the Grid can be used to provide medical practitioners and researchers with access to advanced simulation and image processing services for improved preoperative planning and near real-time surgical support.

  6. 7 CFR 1703.145 - Application selection provisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., DEPARTMENT OF AGRICULTURE RURAL DEVELOPMENT Distance Learning and Telemedicine Loan Program § 1703.145 Application selection provisions. (a) Loans will be approved based on availability of funds, the financial feasibility of the project in accordance with § 1703.144(d), the services to be provided which demonstrate...

  7. University Chaplaincy Provisions: Taking the Religion Out?

    ERIC Educational Resources Information Center

    Hunt, Stephen

    2013-01-01

    Albeit fragmented and largely uncoordinated, there is currently considerable debate regarding the nature and rationale of university chaplaincy provisions in England and Wales. Clearly chaplaincies have repositioned themselves from an exclusively Christian ethical and service-based provider to cater for the challenging demands of a multi-faith…

  8. Global Mapping of Provisioning Ecosystem Services

    NASA Astrophysics Data System (ADS)

    Bingham, Lisa; Straatsma, Menno; Karssenberg, Derek

    2016-04-01

    Attributing monetary value to ecosystem services for decision-making has become more relevant as a basis for decision-making. There are a number of problematic aspects of the calculations, including consistency of economy represented (e.g., purchasing price, production price) and determining which ecosystem subservices to include in a valuation. While several authors have proposed methods for calculating ecosystem services and calculations are presented for global and regional studies, the calculations are mostly broken down into biomes and regions without showing spatially explicit results. The key to decision-making for governments is to be able to make spatial-based decisions because a large spatial variation may exist within a biome or region. Our objective was to compute the spatial distribution of global ecosystem services based on 89 subservices. Initially, only the provisioning ecosystem service category is presented. The provisioning ecosystem service category was calculated using 6 ecosystem services (food, water, raw materials, genetic resources, medical resources, and ornaments) divided into 41 subservices. Global data sets were obtained from a variety of governmental and research agencies for the year 2005 because this is the most data complete and recent year available. All data originated either in tabular or grid formats and were disaggregated to 10 km cell length grids. A lookup table with production values by subservice by country were disaggregated over the economic zone (either marine, land, or combination) based on the spatial existence of the subservice (e.g. forest cover, crop land, non-arable land). Values express the production price in international dollars per hectare. The ecosystem services and the ecosystem service category(ies) maps may be used to show spatial variation of a service within and between countries as well as to specifically show the values within specific regions (e.g. countries, continents), biomes (e.g. coastal, forest), or hazardous regions (e.g. landslides, flood plains, war zones). A preliminary example of the provisioning ecosystem service category illustrates the valuation of deltaic regions and a second example illustrates the valuation of the subservice category of food production prices in flood zones. Future work of this research will spatially represent the calculations of the remaining three ecosystem service categories (regulating, habitat, cultural) and investigate the propagation of uncertainty of the input data to ecosystem service maps.

  9. Implementing the optimal provision of ecosystem services

    PubMed Central

    Polasky, Stephen; Lewis, David J.; Plantinga, Andrew J.; Nelson, Erik

    2014-01-01

    Many ecosystem services are public goods whose provision depends on the spatial pattern of land use. The pattern of land use is often determined by the decisions of multiple private landowners. Increasing the provision of ecosystem services, though beneficial for society as a whole, may be costly to private landowners. A regulator interested in providing incentives to landowners for increased provision of ecosystem services often lacks complete information on landowners’ costs. The combination of spatially dependent benefits and asymmetric cost information means that the optimal provision of ecosystem services cannot be achieved using standard regulatory or payment for ecosystem services approaches. Here we show that an auction that sets payments between landowners and the regulator for the increased value of ecosystem services with conservation provides incentives for landowners to truthfully reveal cost information, and allows the regulator to implement the optimal provision of ecosystem services, even in the case with spatially dependent benefits and asymmetric information. PMID:24722635

  10. Implementing the optimal provision of ecosystem services.

    PubMed

    Polasky, Stephen; Lewis, David J; Plantinga, Andrew J; Nelson, Erik

    2014-04-29

    Many ecosystem services are public goods whose provision depends on the spatial pattern of land use. The pattern of land use is often determined by the decisions of multiple private landowners. Increasing the provision of ecosystem services, though beneficial for society as a whole, may be costly to private landowners. A regulator interested in providing incentives to landowners for increased provision of ecosystem services often lacks complete information on landowners' costs. The combination of spatially dependent benefits and asymmetric cost information means that the optimal provision of ecosystem services cannot be achieved using standard regulatory or payment for ecosystem services approaches. Here we show that an auction that sets payments between landowners and the regulator for the increased value of ecosystem services with conservation provides incentives for landowners to truthfully reveal cost information, and allows the regulator to implement the optimal provision of ecosystem services, even in the case with spatially dependent benefits and asymmetric information.

  11. The Role of Mechanized Services in the Provision of Information with Special Reference to the University Environment.

    ERIC Educational Resources Information Center

    Heim, Kathleen M.

    The use, history, and role of machine-readable data base technology is discussed. First the development of data base technology is traced from its beginnings as a special resource for science and technology to its broader use in universities, with descriptions of some specific services. Next the current status of mechanized information services in…

  12. 20 CFR 653.101 - Provision of services to migrant and seasonal farmworkers (MSFWs).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Provision of services to migrant and seasonal..., DEPARTMENT OF LABOR SERVICES OF THE EMPLOYMENT SERVICE SYSTEM Services for Migrant and Seasonal Farmworkers (MSFWs) § 653.101 Provision of services to migrant and seasonal farmworkers (MSFWs). (a) Each State...

  13. Modeling Temporal and Spatial Flows of Ecosystem Services in Chittenden County, VT

    NASA Astrophysics Data System (ADS)

    Voigt, B. G.; Bagstad, K.; Johnson, G.; Villa, F.

    2010-12-01

    This paper documents the integration of ARIES (ARtificial Intelligence for Ecosystem Services) with the land use change model UrbanSim to explore the impacts of current and future land use patterns on flood protection and water provision services in Chittenden County, VT. ARIES, an open source modeling platform, is particularly well-suited for measuring, mapping, and modeling the temporal and spatial flows of ecosystem services across the landscape, linking the areas of provision (sources) with human beneficiaries (users) through a spatially explicit agent-based modeling approach. UrbanSim is an open source agent-based land use model designed to facilitate a wide-range of scenarios based on user-specified behavioral assumptions, zoning regulations, and demographic, economic, and infrastructure (e.g. transportation, water, sewer, etc.) parameters. Ecosystem services travel through time and space and are susceptible to disruption and destruction from both natural and anthropogenic perturbations. The conversion of forested or agricultural land to urbanizing uses is replete with a long history of hydrologic impairment, habitat fragmentation, and the degradation of sensitive landscapes. Development decisions are predicated on the presence of landscape characteristics that meet the needs of developers and satisfy the desires of consumers, with minimal consideration of access to or effect on the provision of ecosystem services. The County houses nearly 25% of the state’s population and several employment centers that draw labor from throughout the region. Additionally, the County is expected to maintain modest residential and employment growth over the next 30 years, and will continue to serve as the state’s population and employment center. Expected future growth is likely to adversely affect the remaining farm and forest land in the County in the absence of policies to support sustainable development. We demonstrate how ARIES can be used to quantify changes in ecosystem service provision based on the outcomes of alternative land use change model scenarios. Stakeholder workshops were hosted to develop scenarios relevant to planning for future growth in the County, including alternative zoning regulations, road network improvements, and a range of future population projections. The results of the land use change simulations were passed to ARIES to model flood protection and water provision services for each of the alternative scenarios. We present Bayesian models of the ecosystem services as individual source, sink, and use components coupled with models of temporal and spatial flows of services across the landscape. Specific beneficiaries include homeowners, farmers, and other business property owners. The location choice decisions of residential and non-residential agents under the alternative scenarios resulted in varying access to ecosystem services depending on development density, habitat fragmentation, and the degree of hydrological impairment, among other factors. Modeled outputs include maps depicting flow paths (linking sources to beneficiaries), changes in land use, hotspot locations that are critical to sustain the flow of services across the landscape, and the demand for and supply of the modeled services.

  14. Place and provision: mapping mental health advocacy services in London.

    PubMed

    Foley, Ronan; Platzer, Hazel

    2007-02-01

    The National Health Service (NHS) Executive for London carried out an investigation in 2002 as part of their wider mental health strategy to establish whether existing mental health advocacy provision in the city was meeting need. The project took a two-part approach, with an emphasis on, (a) mapping the provision of advocacy services and, (b) cartographic mapping of service location and catchments. Data were collected through a detailed questionnaire with service providers in collaboration with the Greater London Mental Health Advocacy Network (GLMHAN) and additional health and government sources. The service mapping identified some key statistics on funding, caseloads and models of service provision with an additional emphasis on coverage, capacity, and funding stability. The questionnaire was augmented by interviews and focus groups with commissioners, service providers and service users and identified differing perspectives and problems, which informed the different perspectives of each of these groups. The cartographic mapping exercise demonstrated a spatially-even provision of mental health advocacy services across the city with each borough being served by at least one local service as well as by London wide specialist schemes. However, at local level, no one borough had the full range of specialist provision to match local demographic need. Ultimately the research assisted the Advisory Group in providing commissioning agencies with clear information on the current status of city-wide mental health advocacy services, and on gaps in existing advocacy provision alongside previously unconsidered geographical and service dimensions of that provision.

  15. A comprehensive Laboratory Services Survey of State Public Health Laboratories.

    PubMed

    Inhorn, Stanley L; Wilcke, Burton W; Downes, Frances Pouch; Adjanor, Oluwatosin Omolade; Cada, Ronald; Ford, James R

    2006-01-01

    In November 2004, the Association of Public Health Laboratories (APHL) conducted a Comprehensive Laboratory Services Survey of State Public Health Laboratories (SPHLs) in order to establish the baseline data necessary for Healthy People 2010 Objective 23-13. This objective aims to measure the increase in the proportion of health agencies that provide or assure access to comprehensive laboratory services to support essential public health services. This assessment addressed only SPHLs and served as a baseline to periodically evaluate the level of improvement in the provision of laboratory services over the decade ending 2010. The 2004 survey used selected questions that were identified as key indicators of provision of comprehensive laboratory services. The survey was developed in consultation with the Centers for Disease Control and Prevention National Center for Health Statistics, based on newly developed data sources. Forty-seven states and one territory responded to the survey. The survey was based on the 11 core functions of SPHLs as previously defined by APHL. The range of performance among individual laboratories for the 11 core functions (subobjectives) reflects the challenging issues that have confronted SPHLs in the first half of this decade. APHL is now working on a coordinated effort with other stakeholders to create seamless state and national systems for the provision of laboratory services in support of public health programs. These services are necessary to help face the threats raised by the specter of terrorism, emerging infections, and natural disasters.

  16. A conceptual framework to assess effectiveness in wheelchair provision.

    PubMed

    Kamaraj, Deepan C; Bray, Nathan; Rispin, Karen; Kankipati, Padmaja; Pearlman, Jonathan; Borg, Johan

    2017-01-01

    Currently, inadequate wheelchair provision has forced many people with disabilities to be trapped in a cycle of poverty and deprivation, limiting their ability to access education, work and social facilities. This issue is in part because of the lack of collaboration among various stakeholders who need to work together to design, manufacture and deliver such assistive mobility devices. This in turn has led to inadequate evidence about intervention effectiveness, disability prevalence and subsequent costeffectiveness that would help facilitate appropriate provision and support for people with disabilities. In this paper, we describe a novel conceptual framework that can be tested across the globe to study and evaluate the effectiveness of wheelchair provision. The Comparative Effectiveness Research Subcommittee (CER-SC), consisting of the authors of this article, housed within the Evidence-Based Practice Working Group (EBP-WG) of the International Society of Wheelchair Professionals (ISWP), conducted a scoping review of scientific literature and standard practices used during wheelchair service provision. The literature review was followed by a series of discussion groups. The three iterations of the conceptual framework are described in this manuscript. We believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe.

  17. Challenges for tree officers to enhance the provision of regulating ecosystem services from urban forests.

    PubMed

    Davies, Helen J; Doick, Kieron J; Hudson, Malcolm D; Schreckenberg, Kate

    2017-07-01

    Urbanisation and a changing climate are leading to more frequent and severe flood, heat and air pollution episodes in Britain's cities. Interest in nature-based solutions to these urban problems is growing, with urban forests potentially able to provide a range of regulating ecosystem services such as stormwater attenuation, heat amelioration and air purification. The extent to which these benefits are realized is largely dependent on urban forest management objectives, the availability of funding, and the understanding of ecosystem service concepts within local governments, the primary delivery agents of urban forests. This study aims to establish the extent to which British local authorities actively manage their urban forests for regulating ecosystem services, and identify which resources local authorities most need in order to enhance provision of ecosystem services by Britain's urban forests. Interviews were carried out with staff responsible for tree management decisions in fifteen major local authorities from across Britain, selected on the basis of their urban nature and high population density. Local authorities have a reactive approach to urban forest management, driven by human health and safety concerns and complaints about tree disservices. There is relatively little focus on ensuring provision of regulating ecosystem services, despite awareness by tree officers of the key role that urban forests can play in alleviating chronic air pollution, flood risk and urban heat anomalies. However, this is expected to become a greater focus in future provided that existing constraints - lack of understanding of ecosystem services amongst key stakeholders, limited political support, funding constraints - can be overcome. Our findings suggest that the adoption of a proactive urban forest strategy, underpinned by quantified and valued urban forest-based ecosystem services provision data, and innovative private sector funding mechanisms, can facilitate a change to a proactive, ecosystem services approach to urban forest management. Copyright © 2017. Published by Elsevier Inc.

  18. RESNA Wheelchair Service Provision Guide

    ERIC Educational Resources Information Center

    Arledge, Stan; Armstrong, William; Babinec, Mike; Dicianno, Brad E.; Digiovine, Carmen; Dyson-Hudson, Trevor; Pederson, Jessica; Piriano, Julie; Plummer, Teresa; Rosen, Lauren; Schmeler, Mark; Shea, Mary; Stogner, Jody

    2011-01-01

    The purpose of the Wheelchair Service Provision Guide is to provide an appropriate framework for identifying the essential steps in the provision of a wheelchair. It is designed for use by all participants in the provision process including consumers, family members, caregivers, social service and health care professionals, suppliers,…

  19. Evaluating Options for Civil Space Situational Awareness (SSA)

    NASA Astrophysics Data System (ADS)

    Lal, B.; Carioscia, S. A.

    In recent years, the number of active satellites and human-made orbital space debris has increased dramatically. An expansion of activities in space, as is currently being proposed by many commercial and international entities, is expected to further exacerbate this challenge. The 18th Space Control Squadron under the Department of Defense (DOD) United States Strategic Command provides space situational awareness (SSA) services to users outside the national security community at no cost. International and commercial users demand better SSA service than is currently feasible, and the demand comes at a time when DOD is under pressure to better prepare for and respond to growing space-based threats to national security. Concerned about the possibility of overextending across conflicting missions in a fiscally constrained environment, some DOD officials have publicly noted a desire to move SSA services not related to national security out of DOD purview. Responding to a request from the Federal Aviation Administration (FAA) Office of Commercial Space Transportation (AST), researchers at the Science and Technology Policy Institute (STPI) identified and evaluated potential approaches for providing SSA services for civil and commercial operations in space. In this paper, we summarize the report [1] and present the pros and cons of four approaches to the provision of civil SSA services in the United States: (1) maintaining status quo through continued provision by DOD; (2) provision by a civil government entity; (3) industry self-provision; and (4) provision by an international organization. Within the second approach, assuming the provision of SSA by a civil agency, STPI further identified and discussed four options: (1) civil agency service capability embedded within DOD; (2) independent civil service capability, using DOD software and systems; (3) independent civil service capability, using commercial software and systems; and (4) the government certifies non-governmental entities (NGEs) to provide service capability. All of these approaches keep military and national security SSA services within DOD. Selecting which approach or option to proceed with depends on the determination of the role of government in the domain as well as consideration of other policy challenges.

  20. Evaluating a primary care psychology service in Ireland: a survey of stakeholders and psychologists.

    PubMed

    Corcoran, Mark; Byrne, Michael

    2017-05-01

    Primary care psychology services (PCPS) represent an important resource in meeting the various health needs of our communities. This study evaluated the PCPS in a two-county area within the Republic of Ireland. The objectives were to (i) examine the viewpoints of the service for both psychologists and stakeholders (healthcare professionals only) and (ii) examine the enactment of the stepped care model of service provision. Separate surveys were sent to primary care psychologists (n = 8), general practitioners (GPs; n = 69) and other stakeholders in the two counties. GPs and stakeholders were required to rate the current PCPS. The GP survey specifically examined referrals to the PCPS and service configuration, while the stakeholder survey also requested suggestions for future service provision. Psychologists were required to provide information regarding their workload, time spent on certain tasks and productivity ideas. Referral numbers, waiting lists and waiting times were also obtained. All 8 psychologists, 23 GPs (33% response rate) and 37 stakeholders (unknown response rate) responded. GPs and stakeholders reported access to the PCPS as a primary concern, with waiting times of up to 80 weeks in some areas. Service provision to children and adults was uneven between counties. A stepped care model of service provision was not observed. Access can be improved by further implementation of a stepped care service, developing a high-throughput service for adults (based on a stepped care model), and employing a single waiting list for each county to ensure equal access. © 2016 John Wiley & Sons Ltd.

  1. Alabama 622 Project Services to Deaf-Blind Children. Final Report.

    ERIC Educational Resources Information Center

    Graham, Terry; Bosarge, Zackie

    This report describes activities and accomplishments of a 3-year federally supported project to improve services to children (ages 0-21) with deaf-blindness in Alabama. The project utilized a service delivery model based on provision of state, regional, local, and individual technical assistance to service providers and families through three…

  2. Enhancing the Metalinguistic Abilities of Pre-Service Teachers via Coursework Targeting Language Structure Knowledge

    ERIC Educational Resources Information Center

    Purvis, Caralyn J.; McNeill, Brigid C.; Everatt, John

    2016-01-01

    Low metalinguistic knowledge of pre-service and in-service teachers is likely to restrict the provision of evidence-based literacy instruction in the classroom. Despite such concerns, relatively few studies have examined the effects of teacher preparation coursework in building pre-service teachers' language structure knowledge. This study…

  3. 77 FR 14385 - Family Violence Prevention and Services/Grants for Domestic Violence Shelters/Grants to Native...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-09

    ... Provision of individual and group counseling, peer support groups, and referral to community-based services... violence, or dating violence, including age- appropriate counseling, supportive services, and services for..., or was, lawfully residing. Indian Tribe: Any Indian Tribe, band, nation, or other organized group or...

  4. 45 CFR 400.147 - Priority in provision of services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 2 2013-10-01 2012-10-01 true Priority in provision of services. 400.147 Section 400.147 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Funding and Service Priorities § 400.147 Priority in provision of services. A...

  5. 45 CFR 400.147 - Priority in provision of services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Priority in provision of services. 400.147 Section 400.147 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Funding and Service Priorities § 400.147 Priority in provision of services. A...

  6. 45 CFR 400.147 - Priority in provision of services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 2 2014-10-01 2012-10-01 true Priority in provision of services. 400.147 Section 400.147 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Funding and Service Priorities § 400.147 Priority in provision of services. A...

  7. 45 CFR 400.147 - Priority in provision of services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 2 2012-10-01 2012-10-01 false Priority in provision of services. 400.147 Section 400.147 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Funding and Service Priorities § 400.147 Priority in provision of services. A...

  8. 45 CFR 400.147 - Priority in provision of services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 2 2011-10-01 2011-10-01 false Priority in provision of services. 400.147 Section 400.147 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Funding and Service Priorities § 400.147 Priority in provision of services. A...

  9. "Selling It as a Holistic Health Provision and Not Just about Condoms..." Sexual Health Services in School Settings: Current Models and Their Relationship with Sex and Relationships Education Policy and Provision

    ERIC Educational Resources Information Center

    Formby, Eleanor; Hirst, Julia; Owen, Jenny; Hayter, Mark; Stapleton, Helen

    2010-01-01

    In this article we discuss the findings from a recent study of UK policy and practice in relation to sexual health services for young people, based in--or closely linked with--schools. This study formed part of a larger project, completed in 2009, which also included a systematic review of international research. The findings discussed in this…

  10. Equitable service provision for inclusive education and effective early intervention.

    PubMed

    Wicks, K M

    1998-01-01

    This paper illustrates one model of providing an integrated paediatric speech and language therapy service which attempts to meet the demands of both inclusive education and effective early intervention. A move has been made from location-oriented therapy provision to offering children and their families equal opportunities to have appropriate intervention according to need. The model incorporates the philosophy of inclusive education and supports the development of current specialist educational establishments into resource bases of expertise for children with special needs in mainstream schools.

  11. Performance evaluation of data center service localization based on virtual resource migration in software defined elastic optical network.

    PubMed

    Yang, Hui; Zhang, Jie; Ji, Yuefeng; Tan, Yuanlong; Lin, Yi; Han, Jianrui; Lee, Young

    2015-09-07

    Data center interconnection with elastic optical network is a promising scenario to meet the high burstiness and high-bandwidth requirements of data center services. In our previous work, we implemented cross stratum optimization of optical network and application stratums resources that allows to accommodate data center services. In view of this, this study extends the data center resources to user side to enhance the end-to-end quality of service. We propose a novel data center service localization (DCSL) architecture based on virtual resource migration in software defined elastic data center optical network. A migration evaluation scheme (MES) is introduced for DCSL based on the proposed architecture. The DCSL can enhance the responsiveness to the dynamic end-to-end data center demands, and effectively reduce the blocking probability to globally optimize optical network and application resources. The overall feasibility and efficiency of the proposed architecture are experimentally verified on the control plane of our OpenFlow-based enhanced SDN testbed. The performance of MES scheme under heavy traffic load scenario is also quantitatively evaluated based on DCSL architecture in terms of path blocking probability, provisioning latency and resource utilization, compared with other provisioning scheme.

  12. Antenatal care and opportunities for quality improvement of service provision in resource limited settings: A mixed methods study

    PubMed Central

    van der Eem, Lisette; Nyanza, Elias C.; van Pelt, Sandra; Ndaki, Pendo; Basinda, Namanya; Sundby, Johanne

    2017-01-01

    Antenatal care is essential to improve maternal and newborn health and wellbeing. The majority of pregnant women in Tanzania attend at least one visit. Since implementation of the focused antenatal care model, quality of care assessments have mostly focused on utilization and coverage of routine interventions for antenatal care. This study aims to assess the quality of antenatal care provision from a holistic perspective in a rural district in Tanzania. Structure, process and outcome components of quality are explored. This paper reports on data collected over several periods from 2012 to 2015 through facility audits of supplies and services, ANC observations and exit interviews with pregnant women. Additional qualitative methods were used such as interviews, focus group observations and participant observations. Findings indicate variable performance of routine ANC services, partly explained by insufficient resources. Poor performance was also observed for appropriate history taking, attention for client’s wellbeing, basic physical examination and adequate counseling and education. Achieving quality improvement for ANC requires increased attention for the process of care provision beyond coverage, including attention for response-based services, which should be assessed based on locally determined criteria. PMID:29236699

  13. 22 CFR 92.92 - Service of legal process under provisions of State law.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Service of legal process under provisions of... AND RELATED SERVICES Quasi-Legal Services § 92.92 Service of legal process under provisions of State law. It may be found that a State statue purporting to regulate the service of process in foreign...

  14. School-Based Speech-Language Pathologists' Perspectives on Dysphagia Management in the Schools

    ERIC Educational Resources Information Center

    Bailey, Rita L.; Stoner, Julia B.; Angell, Maureen E.; Fetzer, Alycia

    2008-01-01

    Purpose: Although provision of dysphagia services is within the scope of practice of speech-language pathologists (SLPs), little is known about the perspectives of school-based SLPs in relation to these services. The purpose of this study was to examine SLPs' perspectives related to school-based management of students with dysphagia. Method: Focus…

  15. Provider Perspectives on School-Based Mental Health for Urban Minority Youth: Access and Services

    ERIC Educational Resources Information Center

    Gamble, Brandon E.; Lambros, Katina M.

    2014-01-01

    This article provides results from a qualitative study on the efforts of school-based mental health providers (SBMHPs) who serve students in urban, suburban, and ethnically diverse settings to help families access quality mental health services. School-based mental health plays a key role in the provision of direct and indirect intervention…

  16. 14 CFR 1214.114 - Provision of services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable Customers § 1214.114 Provision of services. NASA will provide, solely at its discretion, services to the extent...

  17. 14 CFR 1214.114 - Provision of services.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable Customers § 1214.114 Provision of services. NASA will provide, solely at its discretion, services to the extent...

  18. 14 CFR 1214.114 - Provision of services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable Customers § 1214.114 Provision of services. NASA will provide, solely at its discretion, services to the extent...

  19. 14 CFR 1214.114 - Provision of services.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable Customers § 1214.114 Provision of services. NASA will provide, solely at its discretion, services to the extent...

  20. Spatial distribution of emergency obstetric and newborn care services in Ghana: Using the evidence to plan interventions.

    PubMed

    Bosomprah, Samuel; Tatem, Andrew J; Dotse-Gborgbortsi, Winfred; Aboagye, Patrick; Matthews, Zoe

    2016-01-01

    To provide clear policy directions for gaps in the provision of signal function services and sub-regions requiring priority attention using data from the 2010 Ghana Emergency Obstetric and Newborn Care (EmONC) survey. Using 2010 survey data, the fraction of facilities with only one or two signal functions missing was calculated for each facility type and EmONC designation. Thematic maps were used to provide insight into inequities in service provision. Of 1159 maternity facilities, 89 provided all the necessary basic or comprehensive EmONC signal functions 3months prior to the 2010 survey. Only 21% of facility-based births were in fully functioning EmONC facilities, but an additional 30% occurred in facilities missing one or two basic signal functions-most often assisted vaginal delivery and removal of retained products. Tackling these missing signal functions would extend births taking place in fully functioning facilities to over 50%. Subnational analyses based on estimated total pregnancies in each district revealed a pattern of inequity in service provision across the country. Upgrading facilities missing only one or two signal functions will allow Ghana to meet international standards for availability of EmONC services. Reducing maternal deaths will require high national priority given to addressing inequities in the distribution of EmONC services. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  1. 5 CFR 837.702 - Offset from supplemental survivor annuity.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) based on the service of an individual who performed CSRS-Offset service, if the survivor annuitant is... any provision of the Social Security Act, even if reduced to zero, entitlement to that benefit is not...

  2. 29 CFR 779.413 - Methods of compensation of retail store employees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... STANDARDS ACT AS APPLIED TO RETAILERS OF GOODS OR SERVICES Provisions Relating to Certain Employees of... represent commissions “on goods or services,” which would include all types of commissions customarily based...

  3. 10 CFR 35.80 - Provision of mobile medical service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Provision of mobile medical service. 35.80 Section 35.80... § 35.80 Provision of mobile medical service. (a) A licensee providing mobile medical service shall— (1... to ensure compliance with the requirements in Part 20 of this chapter. (b) A mobile medical service...

  4. Nursing Unit Environment Associated with Provision of Language Services in Pediatric Hospices.

    PubMed

    Lindley, Lisa C; Held, Mary L; Henley, Kristen M; Miller, Kathryn A; Pedziwol, Katherine E; Rumley, Laurie E

    2017-04-01

    Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1251 pediatric hospice agencies. Variable selection was guided by structural contingency theory, which posits that organizational effectiveness is dependent upon how well an organization's structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. The majority of hospices provided translation services (74.9 %) and interpreter services (87.1 %). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Findings indicate that nursing unit environment predicts provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staffs who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency and ultimately reduce ethnic disparities in end-of-life care for children and their families.

  5. Nursing unit environment associated with provision of language services in pediatric hospices

    PubMed Central

    Lindley, Lisa C.; Held, Mary L.; Henley, Kristen M.; Miller, Kathryn A.; Pedziwol, Katherine E.; Rumley, Laurie E.

    2016-01-01

    Background Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Methods Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1,251 pediatric hospice agencies. Variable selection was guided by Structural Contingency Theory, which posits that organizational effectiveness is dependent upon how well an organization’s structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. Results The majority of hospices provided translation services (74.9%) and interpreter services (87.1%). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Conclusions Findings indicate that nursing unit environment predict provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staff who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency, and ultimately reduce ethnic disparities in end-of-life care for children and their families. PMID:27059050

  6. 14 CFR § 1214.114 - Provision of services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable Customers § 1214.114 Provision of services. NASA will provide, solely at its discretion, services to the extent...

  7. 26 CFR 1.42-11 - Provision of services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Provision of services. 1.42-11 Section 1.42-11 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Credits Against Tax § 1.42-11 Provision of services. (a) General rule. The furnishing to tenants of services other than housing (whether or not the services...

  8. 26 CFR 1.42-11 - Provision of services.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 1 2014-04-01 2013-04-01 true Provision of services. 1.42-11 Section 1.42-11 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Credits Against Tax § 1.42-11 Provision of services. (a) General rule. The furnishing to tenants of services other than housing (whether or not the services...

  9. 26 CFR 1.42-11 - Provision of services.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 1 2012-04-01 2012-04-01 false Provision of services. 1.42-11 Section 1.42-11 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Credits Against Tax § 1.42-11 Provision of services. (a) General rule. The furnishing to tenants of services other than housing (whether or not the services...

  10. Standards for Libraries Within Regional Library Systems in Saskatchewan.

    ERIC Educational Resources Information Center

    Saskatchewan Library Association, Regina.

    These quantitative standards for the delivery of library services to a dispersed population, which were developed by the Saskatchewan Library Association, are based on the decentralized delivery of library services backed up by the centralized provision of technical services, resource people, and special collections in Saskatchewan. The roles of…

  11. 42 CFR 405.2400 - Basis.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Basis. 405.2400 Section 405.2400 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL... Services § 405.2400 Basis. Subpart X is based on the provisions of the following sections of the Act...

  12. 42 CFR 1003.101 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., such as a prospective payment system; and (b) In the case of a claim based on costs, any entry or...; or (4) Incentives given to individuals to promote the delivery of preventive care services where the delivery of such services is not tied (directly or indirectly) to the provision of other services...

  13. 42 CFR 1003.101 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., such as a prospective payment system; and (b) In the case of a claim based on costs, any entry or...; or (4) Incentives given to individuals to promote the delivery of preventive care services where the delivery of such services is not tied (directly or indirectly) to the provision of other services...

  14. The Role of Federally Qualified Health Centers in Delivering Family Planning Services to Adolescents.

    PubMed

    Mead, Katherine H; Beeson, Tishra; Wood, Susan F; Goldberg, Debora Goetz; Shin, Peter; Rosenbaum, Sara

    2015-07-01

    The purpose of this article was to examine the role of community health centers (CHCs) in providing comprehensive family planning services to adolescents, looking at the range of services offered and factors associated with provision of these services. This study employed a mixed methods approach comprising a national survey of CHCs and six in-depth case studies of health centers to examine the organization and delivery of family planning services. We developed an adolescent family planning index comprising nine family planning services specifically tailored to adolescents. We analyzed the influence of state-level family planning policies, funding for adolescents, and organizational characteristics on the provision of these services in CHCs. The case studies identified barriers to the provision of family planning to adolescent patients. The survey found substantial variation in the provision of family planning services at CHCs, with a mean of 6.33 out of a maximum score of 13 on the family planning adolescent services index. Title X funding and location within a favorable state policy environment were significantly associated with higher scores on the family planning adolescent services index (p value < .001 and .002, respectively). Case studies revealed barriers to adolescent family planning, including lack of funding, lack of knowledge, and limitations on school-based clinical services. CHCs have the opportunity to play a significant role in providing high-quality family planning to low-income, medically underserved adolescents. Additional funding, resources, and a favorable policy climate would further improve CHCs' ability to serve the family planning needs of this special patient population. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  15. Managing change in the care of children with complex needs: healthcare providers' perspectives.

    PubMed

    Law, James; McCann, Dolly; O'May, Fiona

    2011-12-01

     This paper is a report of a descriptive qualitative study of the role and activities of nursing and allied health professionals caring for children with complex needs in a community setting. Health care is changing in terms of service provision and delivery, with an increased focus on person-centred care, prevention and community-based services. The role of nursing and allied health professionals is central to these changes but is not well described in terms of capacity, or the knowledge and skills required to meet increasing demand. Within four Health Boards, semi-structured telephone interviews were conducted in 2007 with three nursing and four allied health managers, followed by four focus groups with 15 nursing and 11 allied health practitioners; in addition, three nurses and one speech therapist were interviewed by telephone. Respondents identified challenges related to communication and information systems, equity of service provision, family-centred care and partnership working. Generic and specialized knowledge and skills are needed, although providing the right skills in the right place can often prove problematic with potential implications for service provision. Findings support the adoption of integrated partnership working, going beyond the identification of key professionals, to developing a set of criteria against which future service provision could be judged. Research priorities were identified; comparative evaluation of services, better understanding of the transition process and a clearer sense of the individual's response to the increasing customization of services. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  16. Evidence based mental healthcare and service innovation: review of concepts and challenges.

    PubMed

    Kouimtsidis, Ch; John-Smith, St; Kemp, P; Ikkos, G

    2013-01-01

    Health provision systems in the developed western nations are currently facing major financial challenges. In order to meet these challenges, a number of new approaches used to assist the provision of health have been introduced, including the practice of health professionals. These approaches utilize specific methods of data capture and summarization such as: evidence based medicine (EBM) and practice guidelines. Evidence is generated from systematic clinical research as well as reported clinical experience and individually case based empirical evidence. All types of research though (quantitative or qualitative) have limitations. Similarly all types of evidence have advantages and disadvantages and can be complimentary to each other. Evidencebased individual decision (EBID) making is the commonest evidence-based medicine as practiced by the individual clinician in making decisions about the care of the individual patient. It involves integrating individual clinical expertise with the best available external clinical evidence from systematic research. However this sort of evidence-based medicine, focuses excessively on the individual (potentially at the expense of others) in a system with limited budgets. Evidence-based guidelines (EBG) also support the practice of evidence-based medicine but at the organizational or institutional level. The main aim is to identify which interventions, over a range of patients, work best and which is cost-effective in order to guide service development and provision at a strategic level. Doing this effectively is a scientific and statistical skill in itself and the quality of guidelines is based primarily on the quality research evidence. It is important to note that lack of systematic evidence to support an intervention does not automatically mean that an intervention must instantly be abandoned. It is also important that guidelines are understood for what they are, i.e. not rules, or complete statements of knowledge. EBM will never have enough suitable evidence for all and every aspects of health provision in every locality. Innovation signifies a substantial positive change compared to gradual or incremental changes. Innovation using inductive reasoning has to play a major role within health care system and it is applicable to all three level of service provision: clinical practice, policy and organisation structure. The aim of this paper is to examine critically the above concepts and their complimentary role in supporting provision of health care systems which are suitable for the requirements of the population, affordable, deliverable, flexible and adaptable to social changes.

  17. The partnership: Space shuttle, space science, and space station

    NASA Technical Reports Server (NTRS)

    Culbertson, Philip E.; Freitag, Robert F.

    1989-01-01

    An overview of the NASA Space Station Program functions, design, and planned implementation is presented. The discussed functions for the permanently manned space facility include: (1) development of new technologies and related commercial products; (2) observations of the Earth and the universe; (3) provision of service facilities for resupply, maintenance, upgrade and repair of payloads and spacecraft; (4) provision of a transportation node for stationing, processing and dispatching payloads and vehicles; (5) provision of manufacturing and assembly facilities; (6) provision of a storage depot for parts and payloads; and (7) provision of a staging base for future space endeavors. The fundamental concept for the Space Station, as given, is that it be designed, operated, and evolved in response to a broad variety of scientific, technological, and commercial user interests. The Space Shuttle's role as the principal transportation system for the construction and maintenance of the Space Station and the servicing and support of the station crew is also discussed.

  18. Quality Services Management: A Consumer-Oriented Model for Systems Audit and Strategic Intervention.

    ERIC Educational Resources Information Center

    Baker, Pamela C.

    The paper describes Quality Service Management (QSM) as applied to the provision of services to disabled and other special needs persons. QSM is defined as a systems approach to consumer relations based on the belief that quality care may be achieved only within the context of overall services management. Differences among "quality…

  19. 38 CFR 17.36 - Enrollment-provision of hospital and outpatient care to veterans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-connected disabilities or unemployability. (2) Veterans with a singular or combined rating of 30 percent or 40 percent based on one or more service-connected disabilities. (3) Veterans who are former prisoners... or 20 percent based on one or more service-connected disabilities; veterans who were discharged or...

  20. Ecosystem services in Mediterranean river basin: climate change impact on water provisioning and erosion control.

    PubMed

    Bangash, Rubab F; Passuello, Ana; Sanchez-Canales, María; Terrado, Marta; López, Alfredo; Elorza, F Javier; Ziv, Guy; Acuña, Vicenç; Schuhmacher, Marta

    2013-08-01

    The Mediterranean basin is considered one of the most vulnerable regions of the world to climate change and such changes impact the capacity of ecosystems to provide goods and services to human society. The predicted future scenarios for this region present an increased frequency of floods and extended droughts, especially at the Iberian Peninsula. This paper evaluates the impacts of climate change on the water provisioning and erosion control services in the densely populated Mediterranean Llobregat river basin of. The assessment of ecosystem services and their mapping at the basin scale identify the current pressures on the river basin including the source area in the Pyrenees Mountains. Drinking water provisioning is expected to decrease between 3 and 49%, while total hydropower production will decrease between 5 and 43%. Erosion control will be reduced by up to 23%, indicating that costs for dredging the reservoirs as well as for treating drinking water will also increase. Based on these data, the concept for an appropriate quantification and related spatial visualization of ecosystem service is elaborated and discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. 45 CFR 400.117 - Provision of care and services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Provision of care and services. 400.117 Section... Child Welfare Services § 400.117 Provision of care and services. (a) A State may provide care and... agency approved or licensed under State law. (b) If a State arranges for the care and services through a...

  2. 42 CFR 476.70 - Statutory bases and applicability.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 476.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions § 476...

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

    NASA Astrophysics Data System (ADS)

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

    2006-05-01

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

  4. The Social Provisions Scale: psychometric properties of the SPS-10 among participants in nature-based services.

    PubMed

    Steigen, Anne Mari; Bergh, Daniel

    2018-02-05

    This article analyses the psychometric properties of the Social Provisions Scale 10-items version. The Social Provisions Scale was analysed by means of the polytomous Rasch model, applied to data on 93 young adults (16-30 years) out of school or work, participating in different nature-based services, due to mental or drug-related problems. The psychometric analysis concludes that the original scale has difficulties related to targeting and construct validity. In order to improve the psychometric properties, the scale was modified to include eight items measuring functional support. The modification was based on theoretical and statistical considerations. After modifications the scale showed not only satisfying psychometric properties, but it also clarified uncertainties regarding construct validity of the measure. However, further analysis on larger samples are required. Implications for Rehabilitation Social support is important for a variety of rehabilitation outcomes and for different patient groups in the rehabilitation context, including people with mental health or drug-related problems. Social Provisions Scale may be used as a screening tool to assess social support of participants in rehabilitation, and the scale may also be an important instrument in rehabilitation research. There might be issues measuring structural support using a 10-items version of the Social Provisions Scale but it seemed to work well as an 8-item scale measuring functional support.

  5. 31 CFR 598.406 - Provision of services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Provision of services. 598.406 Section 598.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.406 Provision of services. (a) The prohibitions contained in § 598.203 apply to services...

  6. 31 CFR 598.406 - Provision of services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Provision of services. 598.406 Section 598.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.406 Provision of services. (a) The prohibitions contained in § 598.203 apply to services...

  7. 31 CFR 598.406 - Provision of services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Provision of services. 598.406 Section 598.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.406 Provision of services. (a) The prohibitions contained in § 598.203 apply to services...

  8. 31 CFR 598.406 - Provision of services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Provision of services. 598.406 Section 598.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.406 Provision of services. (a) The prohibitions contained in § 598.203 apply to services...

  9. Resource Provisioning in SLA-Based Cluster Computing

    NASA Astrophysics Data System (ADS)

    Xiong, Kaiqi; Suh, Sang

    Cluster computing is excellent for parallel computation. It has become increasingly popular. In cluster computing, a service level agreement (SLA) is a set of quality of services (QoS) and a fee agreed between a customer and an application service provider. It plays an important role in an e-business application. An application service provider uses a set of cluster computing resources to support e-business applications subject to an SLA. In this paper, the QoS includes percentile response time and cluster utilization. We present an approach for resource provisioning in such an environment that minimizes the total cost of cluster computing resources used by an application service provider for an e-business application that often requires parallel computation for high service performance, availability, and reliability while satisfying a QoS and a fee negotiated between a customer and the application service provider. Simulation experiments demonstrate the applicability of the approach.

  10. Compositional diversity of rehabilitated tropical lands supports multiple ecosystem services and buffers uncertainties

    PubMed Central

    Knoke, Thomas; Paul, Carola; Hildebrandt, Patrick; Calvas, Baltazar; Castro, Luz Maria; Härtl, Fabian; Döllerer, Martin; Hamer, Ute; Windhorst, David; Wiersma, Yolanda F.; Curatola Fernández, Giulia F.; Obermeier, Wolfgang A.; Adams, Julia; Breuer, Lutz; Mosandl, Reinhard; Beck, Erwin; Weber, Michael; Stimm, Bernd; Haber, Wolfgang; Fürst, Christine; Bendix, Jörg

    2016-01-01

    High landscape diversity is assumed to increase the number and level of ecosystem services. However, the interactions between ecosystem service provision, disturbance and landscape composition are poorly understood. Here we present a novel approach to include uncertainty in the optimization of land allocation for improving the provision of multiple ecosystem services. We refer to the rehabilitation of abandoned agricultural lands in Ecuador including two types of both afforestation and pasture rehabilitation, together with a succession option. Our results show that high compositional landscape diversity supports multiple ecosystem services (multifunction effect). This implicitly provides a buffer against uncertainty. Our work shows that active integration of uncertainty is only important when optimizing single or highly correlated ecosystem services and that the multifunction effect on landscape diversity is stronger than the uncertainty effect. This is an important insight to support a land-use planning based on ecosystem services. PMID:27292766

  11. Compositional diversity of rehabilitated tropical lands supports multiple ecosystem services and buffers uncertainties.

    PubMed

    Knoke, Thomas; Paul, Carola; Hildebrandt, Patrick; Calvas, Baltazar; Castro, Luz Maria; Härtl, Fabian; Döllerer, Martin; Hamer, Ute; Windhorst, David; Wiersma, Yolanda F; Curatola Fernández, Giulia F; Obermeier, Wolfgang A; Adams, Julia; Breuer, Lutz; Mosandl, Reinhard; Beck, Erwin; Weber, Michael; Stimm, Bernd; Haber, Wolfgang; Fürst, Christine; Bendix, Jörg

    2016-06-13

    High landscape diversity is assumed to increase the number and level of ecosystem services. However, the interactions between ecosystem service provision, disturbance and landscape composition are poorly understood. Here we present a novel approach to include uncertainty in the optimization of land allocation for improving the provision of multiple ecosystem services. We refer to the rehabilitation of abandoned agricultural lands in Ecuador including two types of both afforestation and pasture rehabilitation, together with a succession option. Our results show that high compositional landscape diversity supports multiple ecosystem services (multifunction effect). This implicitly provides a buffer against uncertainty. Our work shows that active integration of uncertainty is only important when optimizing single or highly correlated ecosystem services and that the multifunction effect on landscape diversity is stronger than the uncertainty effect. This is an important insight to support a land-use planning based on ecosystem services.

  12. A conceptual framework to assess effectiveness in wheelchair provision

    PubMed Central

    Kankipati, Padmaja

    2017-01-01

    Background Currently, inadequate wheelchair provision has forced many people with disabilities to be trapped in a cycle of poverty and deprivation, limiting their ability to access education, work and social facilities. This issue is in part because of the lack of collaboration among various stakeholders who need to work together to design, manufacture and deliver such assistive mobility devices. This in turn has led to inadequate evidence about intervention effectiveness, disability prevalence and subsequent costeffectiveness that would help facilitate appropriate provision and support for people with disabilities. Objectives In this paper, we describe a novel conceptual framework that can be tested across the globe to study and evaluate the effectiveness of wheelchair provision. Method The Comparative Effectiveness Research Subcommittee (CER-SC), consisting of the authors of this article, housed within the Evidence-Based Practice Working Group (EBP-WG) of the International Society of Wheelchair Professionals (ISWP), conducted a scoping review of scientific literature and standard practices used during wheelchair service provision. The literature review was followed by a series of discussion groups. Results The three iterations of the conceptual framework are described in this manuscript. Conclusion We believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe. PMID:28936421

  13. Geographic information systems (GIS): an emerging method to assess demand and provision for rehabilitation services.

    PubMed

    Passalent, Laura; Borsy, Emily; Landry, Michel D; Cott, Cheryl

    2013-09-01

    To illustrate the application of geographic information systems (GIS) as a tool to assess rehabilitation service delivery by presenting results from research recently conducted to assess demand and provision for community rehabilitation service delivery in Ontario, Canada. Secondary analysis of data obtained from existing sources was used to establish demand and provision profiles for community rehabilitation services. These data were integrated using GIS software. A number of descriptive maps were produced that show the geographical distribution of service provision variables (location of individual rehabilitation health care providers and location of private and publicly funded community rehabilitation clinics) in relation to the distribution of demand variables (location of the general population; location of specific populations (i.e., residents age 65 and older) and distribution of household income). GIS provides a set of tools for describing and understanding the spatial organization of the health of populations and the distribution of health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery. Implications for Rehabilitation It is important to seek out alternative and innovative methods to examine rehabilitation service delivery. GIS is a computer-based program that takes any data linked to a geographically referenced location and processes it through a software system that manages, analyses and displays the data in the form of a map, allowing for an alternative level of analysis. GIS provides a set of tools for describing and understanding the spatial organization of population health and health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery.

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

    PubMed

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

    2014-06-01

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

  15. They're Doing What? A Brief Paper on Service Use and Attitudes in ASD Community-Based Agencies

    ERIC Educational Resources Information Center

    Pickard, Katherine; Meza, Rosemary; Drahota, Amy; Brikho, Brigitte

    2018-01-01

    This brief article examines the community services delivered to youth with autism spectrum disorder (ASD) in a Southern Californian city as a way to better understand ASD service provision and service attitudes. Specific goals of the study were to identify the services being delivered within the area, and how the use, perceived evidence, and value…

  16. A Survey of Mental Health Service Provision in New York State Residential Treatment Centers

    ERIC Educational Resources Information Center

    Baker, Amy J. L.; Fulmore, Darren; Collins, Julie

    2008-01-01

    Thirty-seven of 43 (86%) agencies operating child welfare residential treatment centers in New York State responded to a survey about the provision of mental health services. Questions were asked about provision of services, satisfaction with services, and suggestions for improvement in five domains: therapeutic milieu, individual therapy, group…

  17. Using plant traits to evaluate the resistance and resilience of ecosystem service provision

    NASA Astrophysics Data System (ADS)

    Kohler, Marina; Devaux, Caroline; Fontana, Veronika; Grigulis, Karl; Lavorel, Sandra; Leitinger, Georg; Schirpke, Uta; Tasser, Erich; Tappeiner, Ulrike

    2015-04-01

    Mountain grassland ecosystems are a hotspot of biodiversity and deliver a multiplicity of ecosystem services. Due to a long history of well adapted agricultural use and specific environmental conditions (e.g. slope, altitude, or climate), various types of grassland ecosystems have developed. Each of them shows specific attributes in forms of plant communities and abiotic characteristics, which lead to particular ranges of ecosystem service provision. However, ongoing climate and societal changes thread plant community composition and may lead to changes in plant traits, and therefore, the provision of ecosystem services. Currently it is not clear how vulnerable these ecosystems are to disturbances, or whether they have developed a high resilience over time. Thus, it is essential to know the ranges of resistance and resilience of an ecosystem service. We, therefore, developed a static approach based on community weighted mean plant traits and abiotic parameters to measure the boundaries of resistance and resilience of each ecosystem service separately. By calculating actual minimum and maximum amounts of ecosystem services, we define the range of resistance of an ecosystem service. We then calculate the potential amount of an ecosystem services (via simulated plant communities) by assuming that no species is lost or added to the system. By comparing actual and potential values, we can estimate whether an ecosystem service is in danger to lose its resilience. We selected different ecosystem services related to mountain grassland ecosystems, e.g. carbon storage, forage quality, forage quantity, and soil fertility. We analysed each ecosystem service for different grassland management types, covering meadows and pastures of very low land-use intensity through to grasslands of high land-use intensity. Results indicate that certain ecosystem services have a higher resilience than others (e.g. carbon storage) for all management types. The ecosystem may provide steady amounts of ecosystem services also in future when facing environmental or societal disturbances. In contrary, other services are very depending on actual conditions and are, therefore, less stable (e.g. forage quantity). When comparing ranges of resistance and resilience, the actual amount lies very close to the boundaries of the potential provision. This gives us a hint that the ecosystem service is in danger to lose its resilience and amount of ecosystem service provision when facing disturbances in future.

  18. Micro‐provision of Social Care Support for Marginalized Communities – Filling the Gap or Building Bridges to the Mainstream?

    PubMed Central

    2015-01-01

    Abstract As English social care services reconstruct themselves in response to the personalization agenda, there is increased interest in the contribution of micro‐providers – very small community‐based organizations, which can work directly with individuals. These micro‐providers are assumed to be able to cater for the ‘seldom heard’ groups which have been marginalized within mainstream social care services. This article reviews recent literature from the UK published in peer‐reviewed journals from 2000 to 2013 on support provision for people with protected characteristics under the Equality Act 2010. It considers the marginalising dynamics in mainstream, statutory social care support provision, and how far local community, specialist or small‐scale services are responding to unmet need for support and advice among marginalized groups. The review found that there is a tradition of compensatory self‐organization, use of informal networks and a mobilization of social capital for all these groups in response to marginalization from mainstream, statutory services. This requires recognition and nurturing in ways that do not stifle its unique nature. Specialist and community‐based micro‐providers can contribute to a wider range of choices for people who feel larger, mainstream services are not suitable or accessible. However, the types of compensatory activity identified in the research need recognition and investment, and its existence does not imply that the mainstream should not address marginalization. PMID:27840462

  19. Micro-provision of Social Care Support for Marginalized Communities - Filling the Gap or Building Bridges to the Mainstream?

    PubMed

    Needham, Catherine; Carr, Sarah

    2015-12-01

    As English social care services reconstruct themselves in response to the personalization agenda, there is increased interest in the contribution of micro-providers - very small community-based organizations, which can work directly with individuals. These micro-providers are assumed to be able to cater for the 'seldom heard' groups which have been marginalized within mainstream social care services. This article reviews recent literature from the UK published in peer-reviewed journals from 2000 to 2013 on support provision for people with protected characteristics under the Equality Act 2010. It considers the marginalising dynamics in mainstream, statutory social care support provision, and how far local community, specialist or small-scale services are responding to unmet need for support and advice among marginalized groups. The review found that there is a tradition of compensatory self-organization, use of informal networks and a mobilization of social capital for all these groups in response to marginalization from mainstream, statutory services. This requires recognition and nurturing in ways that do not stifle its unique nature. Specialist and community-based micro-providers can contribute to a wider range of choices for people who feel larger, mainstream services are not suitable or accessible. However, the types of compensatory activity identified in the research need recognition and investment, and its existence does not imply that the mainstream should not address marginalization.

  20. General Practitioners' Attitudes Toward a Web-Based Mental Health Service for Adolescents: Implications for Service Design and Delivery.

    PubMed

    Subotic-Kerry, Mirjana; King, Catherine; O'Moore, Kathleen; Achilles, Melinda; O'Dea, Bridianne

    2018-03-23

    Anxiety disorders and depression are prevalent among youth. General practitioners (GPs) are often the first point of professional contact for treating health problems in young people. A Web-based mental health service delivered in partnership with schools may facilitate increased access to psychological care among adolescents. However, for such a model to be implemented successfully, GPs' views need to be measured. This study aimed to examine the needs and attitudes of GPs toward a Web-based mental health service for adolescents, and to identify the factors that may affect the provision of this type of service and likelihood of integration. Findings will inform the content and overall service design. GPs were interviewed individually about the proposed Web-based service. Qualitative analysis of transcripts was performed using thematic coding. A short follow-up questionnaire was delivered to assess background characteristics, level of acceptability, and likelihood of integration of the Web-based mental health service. A total of 13 GPs participated in the interview and 11 completed a follow-up online questionnaire. Findings suggest strong support for the proposed Web-based mental health service. A wide range of factors were found to influence the likelihood of GPs integrating a Web-based service into their clinical practice. Coordinated collaboration with parents, students, school counselors, and other mental health care professionals were considered important by nearly all GPs. Confidence in Web-based care, noncompliance of adolescents and GPs, accessibility, privacy, and confidentiality were identified as potential barriers to adopting the proposed Web-based service. GPs were open to a proposed Web-based service for the monitoring and management of anxiety and depression in adolescents, provided that a collaborative approach to care is used, the feedback regarding the client is clear, and privacy and security provisions are assured. ©Mirjana Subotic-Kerry, Catherine King, Kathleen O'Moore, Melinda Achilles, Bridianne O'Dea. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 23.03.2018.

  1. Transformation by stealth: the retargeting of home care services in Finland.

    PubMed

    Kröger, Teppo; Leinonen, Anu

    2012-05-01

    This paper analyses the trends and changes that home care services for older people have undergone during the last two decades in Finland. The data used come from national social care statistics, covering the time period from 1990-2010. The results show that, in contrast to many other European nations that have expanded their home care provisions, the coverage levels in Finland have dropped dramatically during this period. Those with the highest needs do receive increased amounts of support, but others have become excluded from publicly funded home care provisions and often need to rely on family members. In most localities, public service provision is focused on personal care, and no longer covers household tasks. This major change of the character of the service is connected to three other recent trends that structure current provisions: the amalgamation of home-based social and healthcare services, the marketisation and emerging privatisation of care and the integration of informal family care into the formal care system. Overall, the changes represent weakening defamilisation, that is, decreasing public responsibility for the needs of many older people and, correspondingly, an increasing reliance on family carers. This full-scale transformation of home care has taken place without any real policy debate or major modification of legislation. No actual decision was ever made to thoroughly alter the character of home care in Finland: the transformation happened by stealth. © 2011 Blackwell Publishing Ltd.

  2. 42 CFR 440.1 - Basis and purpose.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... otherwise require the level of care furnished in a hospital, NF, or ICF/MR. 1915(d) Home and community-based... chapter for related provisions on “swing-bed” services.) 1915(c) Home and community-based services listed... 65 or older who would otherwise require the level of care furnished in a NF. [57 FR 29155, June 30...

  3. Teachers' Reports of Outreach to School-Based Providers of Mental Health Services Following the 2013 Boston Marathon Attack

    ERIC Educational Resources Information Center

    Green, Jennifer Greif; Xuan, Ziming; Kwong, Lana; Holt, Melissa K.; Comer, Jonathan S.

    2016-01-01

    After mass crises, trauma-exposed children report increased psychological distress, yet most receive no mental health (MH) services and supports. This study identifies factors associated with teachers' reports of outreach to school-based MH providers (such as social workers, psychologists, and counselors) as well as provision of informal supports…

  4. 47 CFR 22.711 - Provision of information to applicants.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Provision of information to applicants. 22.711 Section 22.711 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.711 Provision of information to applicants...

  5. 47 CFR 22.711 - Provision of information to applicants.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Provision of information to applicants. 22.711 Section 22.711 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.711 Provision of information to applicants...

  6. 47 CFR 22.711 - Provision of information to applicants.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Provision of information to applicants. 22.711 Section 22.711 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.711 Provision of information to applicants...

  7. 47 CFR 22.711 - Provision of information to applicants.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Provision of information to applicants. 22.711 Section 22.711 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.711 Provision of information to applicants...

  8. Third sector primary care for vulnerable populations.

    PubMed

    Crampton, P; Dowell, A; Woodward, A

    2001-12-01

    This paper aims to describe and explain the development of third sector primary care organisations in New Zealand. The third sector is the non-government, non-profit sector. International literature suggests that this sector fulfils an important role in democratic societies with market-based economies, providing services otherwise neglected by the government and private for-profit sectors. Third sector organisations provided a range of social services throughout New Zealand's colonial history. However, it was not until the 1980s that third sector organisations providing comprehensive primary medical and related services started having a significant presence in New Zealand. In 1994 a range of union health centres, tribally based Mäori health providers, and community-based primary care providers established a formal network -- Health Care Aotearoa. While not representing all third sector primary care providers in New Zealand, Health Care Aotearoa was the best-developed example of a grouping of third sector primary care organisations. Member organisations served populations that were largely non-European and lived in deprived areas, and tended to adopt population approaches to funding and provision of services. The development of Health Care Aotearoa has been consistent with international experience of third sector involvement -- there were perceived "failures" in government policies for funding primary care and private sector responses to these policies, resulting in lack of universal funding and provision of primary care and continuing patient co-payments. The principal policy implication concerns the role of the third sector in providing primary care services for vulnerable populations as a partial alternative to universal funding and provision of primary care. Such an alternative may be convenient for proponents of reduced state involvement in funding and provision of health care, but may not be desirable from the point of view of equity and social cohesion insofar as the role of the welfare state is diminished.

  9. A Semantic Approach with Decision Support for Safety Service in Smart Home Management

    PubMed Central

    Huang, Xiaoci; Yi, Jianjun; Zhu, Xiaomin; Chen, Shaoli

    2016-01-01

    Research on smart homes (SHs) has increased significantly in recent years because of the convenience provided by having an assisted living environment. The functions of SHs as mentioned in previous studies, particularly safety services, are seldom discussed or mentioned. Thus, this study proposes a semantic approach with decision support for safety service in SH management. The focus of this contribution is to explore a context awareness and reasoning approach for risk recognition in SH that enables the proper decision support for flexible safety service provision. The framework of SH based on a wireless sensor network is described from the perspective of neighbourhood management. This approach is based on the integration of semantic knowledge in which a reasoner can make decisions about risk recognition and safety service. We present a management ontology for a SH and relevant monitoring contextual information, which considers its suitability in a pervasive computing environment and is service-oriented. We also propose a rule-based reasoning method to provide decision support through reasoning techniques and context-awareness. A system prototype is developed to evaluate the feasibility, time response and extendibility of the approach. The evaluation of our approach shows that it is more effective in daily risk event recognition. The decisions for service provision are shown to be accurate. PMID:27527170

  10. A Semantic Approach with Decision Support for Safety Service in Smart Home Management.

    PubMed

    Huang, Xiaoci; Yi, Jianjun; Zhu, Xiaomin; Chen, Shaoli

    2016-08-03

    Research on smart homes (SHs) has increased significantly in recent years because of the convenience provided by having an assisted living environment. The functions of SHs as mentioned in previous studies, particularly safety services, are seldom discussed or mentioned. Thus, this study proposes a semantic approach with decision support for safety service in SH management. The focus of this contribution is to explore a context awareness and reasoning approach for risk recognition in SH that enables the proper decision support for flexible safety service provision. The framework of SH based on a wireless sensor network is described from the perspective of neighbourhood management. This approach is based on the integration of semantic knowledge in which a reasoner can make decisions about risk recognition and safety service. We present a management ontology for a SH and relevant monitoring contextual information, which considers its suitability in a pervasive computing environment and is service-oriented. We also propose a rule-based reasoning method to provide decision support through reasoning techniques and context-awareness. A system prototype is developed to evaluate the feasibility, time response and extendibility of the approach. The evaluation of our approach shows that it is more effective in daily risk event recognition. The decisions for service provision are shown to be accurate.

  11. Utilising a collective case study system theory mixed methods approach: a rural health example

    PubMed Central

    2014-01-01

    Background Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. Method A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. Results 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. Conclusions The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services research. PMID:25066241

  12. Utilising a collective case study system theory mixed methods approach: a rural health example.

    PubMed

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

    2014-07-28

    Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services research.

  13. Unmet counselling need amongst women accessing an induced abortion service in KwaZulu-Natal, South Africa.

    PubMed

    Birdsey, Graeme; Crankshaw, Tamaryn L; Mould, Sean; Ramklass, Serela S

    2016-11-01

    Provision of objective, evidence-based counselling in the context of induced abortion services is considered global good practise. However, there is limited understanding over the counselling needs of women accessing abortion services, particularly in sub-Saharan Africa. This study aimed to explore the content and quality of pre-abortion counselling amongst women accessing an abortion service in South Africa as well as client experience of the counselling process. Perceptions of nurse counsellors were also sought. This was a mixed methods study conducted at a Choice of Termination of Pregnancy clinic based at a district level hospital in KwaZulu-Natal, South Africa. Sixty women requesting an abortion were interviewed via a semi-structured questionnaire. In-depth interviews were conducted with four nurses who provided pre-abortion counselling at the clinic. Interviews were coded for emergent themes and categories. Clinic nurses had widely variable counselling training and experience, ranging from less than 2 months to 8 years, but all clients reported that they had been treated with respect at their counselling session. The group-based counselling format and biomedical and health promotion content did not accommodate clients' differential counselling needs, which included requests for support from women experiencing intimate partner violence (IPV). There was limited provider awareness of client's additional counselling needs. Abortion counselling services should be tailored to clients' differential counselling needs. Group-based counselling followed by optional one-on-one counselling sessions is one possible strategy to address unmet client need in South Africa. Provision of abortion provider training in IPV is recommended as well as establishment of referral pathways for women experiencing IPV. Paying attention to the differential counselling needs of women seeking an abortion should be a key component to the provision of abortion services. In this way, abortion services can provide a gateway to additional support for women living in violent relationships and/or other adverse social circumstances. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. From home, to market, to headquarters, to home. Relocating health services planning and purchasing in New Zealand.

    PubMed

    Gauld, Robin

    2002-01-01

    Health sector restructuring has been in vogue, but no country has engaged in as much health sector restructuring as New Zealand where, in a decade, there have been four different public health sector structures. This article discusses New Zealand's four structures with an emphasis on relocating the critical functions of health care planning and purchasing, and on the development of the present district health board system. The four structures include: an area health board system (1989-1991) with planning and purchasing located at "home" in local areas and closely aligned with service provision; a competitive internal market system (1993-1996) which separated planning and purchasing from service provision; a centralised system with a "headquarters" controlling planning and purchasing (1997-1999) while maintaining the distance from provision; and the district health board system currently under development (1999-) which sees purchasing and planning sent home again to regions and linked closely with service provision. The present system entails the devolution of considerable responsibility to the local level, within a framework of strong central government control. Based on New Zealand's experience, the article notes that all but the market structure appear to have provided an adequate environment for effective health care planning and purchasing.

  15. Factors that influence the implementation of dietary guidelines regarding food provision in centre based childcare services: A systematic review.

    PubMed

    Seward, Kirsty; Finch, Meghan; Yoong, Sze Lin; Wyse, Rebecca; Jones, Jannah; Grady, Alice; Wiggers, John; Nathan, Nicole; Conte, Kathleen; Wolfenden, Luke

    2017-12-01

    Children attending centre based childcare services consume as much as two thirds of their daily dietary requirements while in care. However, such services often fail to provide foods that are consistent with guideline recommendations. Developing strategies to improve childcare service adherence to menu dietary guidelines requires a comprehensive understanding of factors that may impede or promote implementation. The primary aim of this systematic review is to describe factors (barriers and facilitators) that may influence the implementation of menu dietary guidelines regarding food provision in centre-based childcare services and to map these factors to a theoretical framework. Over 7000 citations were identified from all sources. Duplicate abstracts were removed and selection criteria applied. Twelve studies (1994-2015) were included in the review. Dual data extraction was conducted and the reported factors were synthesised using the theoretical domains framework (TDF). Barriers and facilitators identified in qualitative studies were classified into 8 and 10 of the 14 TDF domains. Barriers and facilitators reported in quantitative studies covered 6 and 3 TDF domains respectively. The most common domain of which both barriers and facilitators to the implementation of menu dietary guidelines were identified was 'environmental context and resources'. This is the first study that comprehensively assesses literature to identify factors that influence the implementation of menu dietary guidelines in childcare services utilising a theoretical framework. Findings provide guidance to support researchers and policy makers design strategies to improve menu dietary guideline implementation and, as such have the potential to improve food provision in care. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Staff perceptions of the benefits of religion in health and human services nonprofits: evidence from international development.

    PubMed

    Flanigan, Shawn Teresa

    2009-01-01

    Some argue faith-based organizations (FBOs) provide desirable moral or spiritual components to health and human service provision, and that services are more effective due to staffs more supportive approach. However, the majority of research has been conducted in the United States, and has focused on the experiences of Christian FBOs. This article examines the benefits that FBO staff in Bosnia and Herzegovina, Lebanon, and Sri Lanka believe religious identity brings to the work of their organizations, based on interviews with more than 100 staff of Buddhist, Catholic, Druze, Orthodox Christian, Protestant Christian, Shiite Muslim, and Sunni Muslim FBOs, as well as secular NGOs. The interview data indicate that staff members from most of the religious traditions included in the study believe the faith orientation of their organization brings benefits to their service provision. However, these perceived benefits differ based on country context. Some of these benefits are similar to those often mentioned in the literature on FBOs in the United States; however, other benefits are quite different than those discussed in the US literature.

  17. 45 CFR 1306.30 - Provisions of comprehensive child development services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Provisions of comprehensive child development... Start Program Options § 1306.30 Provisions of comprehensive child development services. (a) All Head Start grantees must provide comprehensive child development services, as defined in the Head Start...

  18. 45 CFR 1306.30 - Provisions of comprehensive child development services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Provisions of comprehensive child development... Start Program Options § 1306.30 Provisions of comprehensive child development services. (a) All Head Start grantees must provide comprehensive child development services, as defined in the Head Start...

  19. 45 CFR 1306.30 - Provisions of comprehensive child development services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Provisions of comprehensive child development... Start Program Options § 1306.30 Provisions of comprehensive child development services. (a) All Head Start grantees must provide comprehensive child development services, as defined in the Head Start...

  20. 45 CFR 1306.30 - Provisions of comprehensive child development services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Provisions of comprehensive child development... Start Program Options § 1306.30 Provisions of comprehensive child development services. (a) All Head Start grantees must provide comprehensive child development services, as defined in the Head Start...

  1. 47 CFR 64.401 - Policies and procedures for provisioning and restoring certain telecommunications services in...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...

  2. 47 CFR 64.401 - Policies and procedures for provisioning and restoring certain telecommunications services in...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...

  3. 47 CFR 64.401 - Policies and procedures for provisioning and restoring certain telecommunications services in...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...

  4. 47 CFR 64.401 - Policies and procedures for provisioning and restoring certain telecommunications services in...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...

  5. 47 CFR 64.401 - Policies and procedures for provisioning and restoring certain telecommunications services in...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...

  6. Locating provisioning ecosystem services in urban forests: Forageable woody species in New York City, USA

    Treesearch

    Patrick T. Hurley; Marla R. Emery

    2017-01-01

    Scholarship on the ecosystem services provided by urban forests has focused on regulating and supporting services, with a growing body of research examining provisioning and cultural ecosystem services from farms and gardens in metropolitan areas. Using the case of New York, New York, USA, we propose a method to assess the supply of potential provisioning ecosystem...

  7. Learners' perspectives on the provision of condoms in South African public schools.

    PubMed

    de Bruin, W E; Panday-Soobrayan, S

    2017-12-01

    A stubborn health challenge for learners in South African public schools concerns sexual and reproductive health and rights (SRHR). In 2015, the Department of Basic Education (DBE) proposed the provision of condoms and SRHR-services to learners in schools. This study aimed to contribute to the finalisation and implementation of DBE's policy by exploring learners' perspectives on the provision of condoms and SRHR-services in schools. Sixteen focus group discussions were conducted with learners (n = 116) from 33 public schools, to assess their attitudes, social influences, and needs and desires regarding condom provision and SRHR-services in schools. The majority of learners did not support condom provision in schools as they feared that it may increase sexual activity. Contrarily, they supported the provision of other SRHR-services as clinics fail to offer youth-friendly services. Learners' sexual behaviour and access to SRHR-services are strongly determined by their social environment, including traditional norms and values, and social-pressure from peers and adults. Learners' most pressing needs and desires to access condoms and SRHR-services in school concerned respect, privacy and confidentiality of such service provision. Implementation of DBE's policy must be preceded by an evidence-informed advocacy campaign to debunk myths about the risk of increased sexual activity, to advocate for why such services are needed, to shift societal norms towards open discussion of adolescent SRHR and to grapple with the juxtaposition of being legally empowered but socially inhibited to protect oneself from HIV, STIs and early pregnancy. Provision of condoms and other SRHR-services in schools must be sensitive to learners' privacy and confidentiality to minimise stigma and discrimination.

  8. More people than ever before are receiving behavioral health care in the United States, but gaps and challenges remain.

    PubMed

    Mechanic, David

    2014-08-01

    The high prevalence of mental illness and substance abuse disorders and their significant impact on disability, mortality, and other chronic diseases have encouraged new initiatives in mental health policy including important provisions of the Affordable Care Act and changes in Medicaid. This article examines the development and status of the behavioral health services system, gaps in access to and quality of care, and the challenges to implementing aspirations for improved behavioral and related medical services. Although many more people than ever before are receiving behavioral health services in the United States-predominantly pharmaceutical treatments-care is poorly allocated and rarely meets evidence-based standards, particularly in the primary care sector. Ideologies, finances, and pharmaceutical marketing have shaped the provision of services more than treatment advances or guidance from a growing evidence base. Among the many challenges to overcome are organizational and financial realignments and improved training of primary care physicians and the behavioral health workforce. Project HOPE—The People-to-People Health Foundation, Inc.

  9. Ethical Issues in Providing Services in Schools to Children with Swallowing and Feeding Disorders

    ERIC Educational Resources Information Center

    Huffman, Nancy P.; Owre, DeAnne W.

    2008-01-01

    Purpose: This article is a commentary and discussion of ethical issues in dysphagia services as related to school-based practice in speech-language pathology. Method: A review of the literature on ethical issues in the provision of speech-language pathology services to individuals with dysphagia was conducted, with particular emphasis on students…

  10. 78 FR 16506 - Notice of Hearing: Reconsideration of Disapproval of Florida State Plan Amendments (SPA) 12-015

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-15

    ... limitation is consistent with the provision of a sufficient amount, duration, and scope to reasonably achieve...(c)(2), because it appeared to impose a limitation on outpatient hospital services that was based on... amount, duration, and scope of each service that it provides,'' and ``each service must be sufficient in...

  11. Establishing Key Performance Indicators [KPIs] and Their Importance for the Surgical Management of Inflammatory Bowel Disease-Results From a Pan-European, Delphi Consensus Study.

    PubMed

    Morar, Pritesh S; Hollingshead, James; Bemelman, Willem; Sevdalis, Nick; Pinkney, Thomas; Wilson, Graeme; Dunlop, Malcolm; Davies, R Justin; Guy, Richard; Fearnhead, Nicola; Brown, Steven; Warusavitarne, Janindra; Edwards, Cathryn; Faiz, Omar

    2017-10-27

    Key performance indicators [KPIs] exist across a range of areas in medicine. They help to monitor outcomes, reduce variation, and drive up standards across services. KPIs exist for inflammatory bowel disease [IBD] care, but none specifically cover inflammatory bowel disease [IBD] surgical service provision. This was a consensus-based study using a panel of expert IBD clinicians from across Europe. Items were developed and fed through a Delphi process to achieve consensus. Items were ranked on a Likert scale from 1 [not important] to 5 [very important]. Consensus was defined when the inter quartile range was ≤ 1, and items with a median score > 3 were considered for inclusion. A panel of 21 experts [14 surgeons and 7 gastroenterologists] was recruited. Consensus was achieved on procedure-specific KPIs for ileocaecal and perianal surgery for Crohn's disease, [N = 10] with themes relating to morbidity [N = 7], multidisciplinary input [N = 2], and quality of life [N = 1]; and for subtotal colectomy, proctocolectomy and ileoanal pouch surgery for ulcerative colitis [N = 11], with themes relating to mortality [N = 2], morbidity [N = 8], and service provision [N = 1]. Consensus was also achieved for measures of the quality of IBD surgical service provision and quality assurance in IBD surgery. This study has provided measurable KPIs for the provision of surgical services in IBD. These indicators cover IBD surgery in general, the governance and structures of the surgical services, and separate indicators for specific subareas of surgery. Monitoring of IBD services with these KPIs may reduce variation across services and improve quality. Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

  12. Ecosystem service provision in a changing Europe: adapting to the impacts of combined climate and socio-economic change.

    PubMed

    Dunford, Robert W; Smith, Alison C; Harrison, Paula A; Hanganu, Diana

    Future patterns of European ecosystem services provision are likely to vary significantly as a result of climatic and socio-economic change and the implementation of adaptation strategies. However, there is little research in mapping future ecosystem services and no integrated assessment approach to map the combined impacts of these drivers. Map changing patterns in ecosystem services for different European futures and (a) identify the role of driving forces; (b) explore the potential influence of different adaptation options. The CLIMSAVE integrated assessment platform is used to map spatial patterns in services (food, water and timber provision, atmospheric regulation, biodiversity existence/bequest, landscape experience and land use diversity) for a number of combined climatic and socio-economic scenarios. Eight adaptation strategies are explored within each scenario. Future service provision (particularly water provision) will be significantly impacted by climate change. Socio-economic changes shift patterns of service provision: more dystopian societies focus on food provision at the expense of other services. Adaptation options offer significant opportunities, but may necessitate trade-offs between services, particularly between agriculture- and forestry-related services. Unavoidable trade-offs between regions (particularly South-North) are also identified in some scenarios. Coordinating adaptation across regions and sectors will be essential to ensure that all needs are met: a factor that will become increasingly pressing under dystopian futures where inter-regional cooperation breaks down. Integrated assessment enables exploration of interactions and trade-offs between ecosystem services, highlighting the importance of taking account of complex cross-sectoral interactions under different future scenarios of planning adaptation responses.

  13. 76 FR 61245 - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ...--Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International... of September 28, 2011 Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Memorandum for the Secretary of Transportation By the authority...

  14. 49 CFR 37.191 - Special provision for small mixed-service operators.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Special provision for small mixed-service operators. 37.191 Section 37.191 Transportation Office of the Secretary of Transportation TRANSPORTATION SERVICES FOR INDIVIDUALS WITH DISABILITIES (ADA) Over-the-Road Buses (OTRBs) § 37.191 Special provision for...

  15. Oral health among Liberian refugees in Ghana.

    PubMed

    Mickenautsch, S; Rudolph, M J; Ogunbodede, E O; Chikte, U M

    1999-04-01

    To promote community involvement in the provision of oral health services. The project consisted of a four-week training course in oral health for selected refugees, an oral health survey based on WHO guidelines and conducted by the refugees themselves and the provision of oral health care services to the community by the trained refugees. Liberian refugee camp, Gomoa Buduburam in Ghana. Liberian refugees of all ages. Twelve refugees were given short term training in oral health. In the oral health survey, 196 refugees were clinically examined for dental caries, periodontal disease and malocclusion. DMFT (for dental caries), CPITN (for periodontal disease), and malocclusion scores for selected subjects. Also clinical services rendered. Oral health survey revealed a mean age (+/- SD) of 25.7 (+/- 9.5) years. Only thirty nine (19.9%) of the subjects were caries-free, and total DMFT was 2.5 +/- 2.2. Based on the CPITN, 107 (54.6%) required oral hygiene instructions (OHI), and 41 (20.9%) required prophylactic scaling with OHI. Forty four (22.5%) of the subjects had normal occlusion and 152 (77.5%) mild to severe malocclusion. Periodontal (75.5%), prosthetic (52.5%) interventions and extractions (34.2%) constituted the bulk of the treatment needs required. Clinical treatment was rendered by the trained refugees to 846 patients over a twelve month period. Relief programmes for refugees should emphasise a primary health care approach, focusing on prevention, based on appropriate technology, and promoting involvement by the refugee community in the provision of services.

  16. Smartphone as a personal, pervasive health informatics services platform: literature review.

    PubMed

    Wac, K

    2012-01-01

    The article provides an overview of current trends in personal sensor, signal and imaging informatics, that are based on emerging mobile computing and communications technologies enclosed in a smartphone and enabling the provision of personal, pervasive health informatics services. The article reviews examples of these trends from the PubMed and Google scholar literature search engines, which, by no means claim to be complete, as the field is evolving and some recent advances may not be documented yet. There exist critical technological advances in the surveyed smartphone technologies, employed in provision and improvement of diagnosis, acute and chronic treatment and rehabilitation health services, as well as in education and training of healthcare practitioners. However, the most emerging trend relates to a routine application of these technologies in a prevention/wellness sector, helping its users in self-care to stay healthy. Smartphone-based personal health informatics services exist, but still have a long way to go to become an everyday, personalized healthcare-provisioning tool in the medical field and in a clinical practice. Key main challenge for their widespread adoption involve lack of user acceptance striving from variable credibility and reliability of applications and solutions as they a) lack evidence- based approach; b) have low levels of medical professional involvement in their design and content; c) are provided in an unreliable way, influencing negatively its usability; and, in some cases, d) being industry-driven, hence exposing bias in information provided, for example towards particular types of treatment or intervention procedures.

  17. [About economic aspects of provision of medical services].

    PubMed

    Gerasimov, P A

    2014-01-01

    The contradiction between economic and social components of medical services is present in any state. Initially, the state undertakes the commitment no provide citizen with equal access to medical services. However, this means to provide social equity between all members of society which not always is effective from economic point of view. The article analyzes the problems originated in public system of provision of medical services. These problems are determined by service specificity itself model of provision of medical services and public priorities in social sector.

  18. The structure and organisation of home-based postnatal care in public hospitals in Victoria, Australia: A cross-sectional survey.

    PubMed

    Forster, Della A; McKay, Heather; Powell, Rhonda; Wahlstedt, Emma; Farrell, Tanya; Ford, Rachel; McLachlan, Helen L

    2016-04-01

    There is limited evidence regarding the provision of home-based postnatal care, resulting in a weak evidence-base for policy formulation and the further development of home-based postnatal care services. To explore the structure and organisation of public hospital home-based postnatal care in Victoria, Australia. An online survey including mostly closed-ended questions was sent to representatives of all public maternity providers in July 2011. The response rate of 87% (67/77) included rural (70%; n=47), regional (15%; n=10) and metropolitan (15%; n=10) services. The majority (96%, 64/67) provided home-based postnatal care. The median number of visits for primiparous women was two and for multiparous women, one. The main reason for no visit was the woman declining. Two-thirds of services attempted to provide some continuity of carer for home-based postnatal care. Routine maternal and infant observations were broadly consistent across the services, and various systems were in place to protect the safety of staff members during home visits. Few services had a dedicated home-based postnatal care coordinator. This study demonstrates that the majority of women receive at least one home-based postnatal visit, and that service provision on the whole is similar across the state. Further work should explore the optimum number and timing of visits, what components of care are most valued by women, and what model best ensures the timely detection and prevention of postpartum complications, be they psychological or physiological. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  19. Developing a Home-Based Early Intervention Personnel Training Program in Southeast China

    ERIC Educational Resources Information Center

    Xie, Huichao; Chen, Ching-I; Chen, Chieh-Yu; Squires, Jane; Li, Wenge; Liu, Tian

    2017-01-01

    China is expected to have a rapid growth in specialized early intervention (EI) services for young children ages birth to 6 and their families. A major barrier in the provision of EI services in China is the shortage of well-trained EI personnel. In 2013, a Home-Based Early Intervention Program (HBEIP) was started at South China Normal University…

  20. The second national audit of intermediate care.

    PubMed

    Young, John; Gladman, John R F; Forsyth, Duncan R; Holditch, Claire

    2015-03-01

    Intermediate care services have developed internationally to expedite discharge from hospital and to provide an alternative to an emergency hospital admission. Inconsistencies in the evidence base and under-developed governance structures led to concerns about the care quality, outcomes and provision of intermediate care in the NHS. The National Audit of Intermediate Care was therefore established by an interdisciplinary group. The second national audit reported in 2013 and included crisis response teams, home-based and bed-based services in approximately a half of the NHS. The main findings were evidence of weak local strategic planning, considerable under-provision, delays in accessing the services and lack of mental health involvement in care. There was a very high level of positive patient experience reported across all types of intermediate care, though reported involvement with care decisions was less satisfactory. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Agent-Based Framework for Personalized Service Provisioning in Converged IP Networks

    NASA Astrophysics Data System (ADS)

    Podobnik, Vedran; Matijasevic, Maja; Lovrek, Ignac; Skorin-Kapov, Lea; Desic, Sasa

    In a global multi-service and multi-provider market, the Internet Service Providers will increasingly need to differentiate in the service quality they offer and base their operation on new, consumer-centric business models. In this paper, we propose an agent-based framework for the Business-to-Consumer (B2C) electronic market, comprising the Consumer Agents, Broker Agents and Content Agents, which enable Internet consumers to select a content provider in an automated manner. We also discuss how to dynamically allocate network resources to provide end-to-end Quality of Service (QoS) for a given consumer and content provider.

  2. A family-centered, community-based system of services for children and youth with special health care needs.

    PubMed

    Perrin, James M; Romm, Diane; Bloom, Sheila R; Homer, Charles J; Kuhlthau, Karen A; Cooley, Carl; Duncan, Paula; Roberts, Richard; Sloyer, Phyllis; Wells, Nora; Newacheck, Paul

    2007-10-01

    To present a conceptual definition of a family-centered system of services for children and youth with special health care needs (CYSHCN). Previous work by the Maternal and Child Health Bureau to define CYSHCN has had widespread program effects. This article similarly seeks to provide a definition of a system of services. Comprehensive literature review of systems of services and consensus panel organized to review and refine the definition. Policy research group and advisors at multiple sites. Policy researchers, content experts on CYSHCN, family representatives, and state program directors. Definition of a system of services for CYSHCN. This article defines a system of services for CYSHCN as a family-centered network of community-based services designed to promote the healthy development and well-being of these children and their families. The definition can guide discussion among policy makers, practitioners, state programs, researchers, and families for implementing the "community-based systems of services" contained in Title V of the Social Security Act. Critical characteristics of a system include coordination of child and family services, effective communication among providers and the family, family partnership in care provision, and flexibility. This definition provides a conceptual model that can help measurement development and assessment of how well systems work and achieve their goals. Currently available performance objectives for the provision of care for CYSHCN and national surveys of child health could be modified to assess systems of services in general.

  3. Rehabilitation therapies for older clients of the Ontario home care system: regional variation and client-level predictors of service provision.

    PubMed

    Armstrong, Joshua J; Zhu, Mu; Hirdes, John P; Stolee, Paul

    2015-01-01

    To examine regional variation in service provision and identify the client characteristics associated with occupational therapy (OT) and physiotherapy (PT) services for older adults in the Ontario Home Care System. Secondary analyses of a provincial database containing comprehensive assessments (RAI-HC) linked with service utilization data from every older long-stay home care client in the system between 2005 and 2010 (n = 299 262). Hierarchical logistic regression models were used to model the dependent variables of OT and PT service use within 90 d of the initial assessment. Regional differences accounted for 9% of the variation in PT service provision and 20% of OT service provision. After controlling for the differences across regions, the most powerful predictors of service provision were identified for both OT and PT. The most highly associated client characteristics related to PT service provision were hip fracture, impairments in activities of daily living/instrumental activities of daily living, cerebrovascular accidents, and cognitive impairment. For OT, hazards in the home environment was the most powerful predictor of future service provision. Where a client lived was an important determinant of service provision in Ontario, raising the possibility of inequities in access to rehabilitation services. Health care planners and policy makers should review current practices and make adjustments to meet the increasing and changing needs for rehabilitation therapies of the aging population. Implications for Rehabilitation For older adults in home care, the goal of rehabilitation therapy services is to allow individuals to maintain or improve physical functioning, quality of life and overall independence while living within their community. Previous research has demonstrated that a large proportion of home care clients specifically identified as having rehabilitation potential do not receive it. This article used clinical assessment data to identify the predictors of and barriers to rehabilitation services for older adults in the Ontario Home Care System. Barriers of PT included dementia diagnosis and French as a first language. Barriers to OT included dementia diagnosis. Policies and practices related to service provision for older adults should be reconsidered if we are going to meet the demands of aging populations and increasing rates of functional and cognitive impairments.

  4. Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda

    PubMed Central

    Lu, Chunling; Cook, Benjamin; Desmond, Chris

    2017-01-01

    Background Rural healthcare facilities in low-income countries play a major role in providing primary care to rural populations. We examined the link of foreign aid with government investments and medical service provision in rural health centres in Rwanda. Methods Using the District Health System Strengthening Tool, a web-based database built by the Ministry of Health in Rwanda, we constructed two composite indices representing provision of (1) child and maternal care and (2) HIV, tuberculosis (TB) and malaria services in 330 rural health centres between 2009 and 2011. Financing variables in a healthcare centre included received funds from various sources, including foreign donors and government. We used multilevel random-effects model in regression analyses and examined the robustness of results to a range of alternative specification, including scale of dependent variables, estimation methods and timing of aid effects. Findings Both government and foreign donors increased their direct investments in the 330 rural healthcare centres during the period. Foreign aid was positively associated with government investments (0.13, 95% CI 0.06 to 0.19) in rural health centres. Aid in the previous year was positively associated with service provision for child and maternal health (0.008, 95% CI 0.002 to 0.014) and service provision for HIV, TB and malaria (0.014, 95% CI 0.004 to 0.022) in the current year. The results are robust when using fixed-effects models. Conclusions These findings suggest that foreign aid did not crowd out government investments in the rural healthcare centres. Foreign aid programmes, conducted in addition to government investments, could benefit rural residents in low-income countries through increased service provision in rural healthcare facilities. PMID:29082015

  5. Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda.

    PubMed

    Lu, Chunling; Cook, Benjamin; Desmond, Chris

    2017-01-01

    Rural healthcare facilities in low-income countries play a major role in providing primary care to rural populations. We examined the link of foreign aid with government investments and medical service provision in rural health centres in Rwanda. Using the District Health System Strengthening Tool, a web-based database built by the Ministry of Health in Rwanda, we constructed two composite indices representing provision of (1) child and maternal care and (2) HIV, tuberculosis (TB) and malaria services in 330 rural health centres between 2009 and 2011. Financing variables in a healthcare centre included received funds from various sources, including foreign donors and government. We used multilevel random-effects model in regression analyses and examined the robustness of results to a range of alternative specification, including scale of dependent variables, estimation methods and timing of aid effects. Both government and foreign donors increased their direct investments in the 330 rural healthcare centres during the period. Foreign aid was positively associated with government investments (0.13, 95% CI 0.06 to 0.19) in rural health centres. Aid in the previous year was positively associated with service provision for child and maternal health (0.008, 95% CI 0.002 to 0.014) and service provision for HIV, TB and malaria (0.014, 95% CI 0.004 to 0.022) in the current year. The results are robust when using fixed-effects models. These findings suggest that foreign aid did not crowd out government investments in the rural healthcare centres. Foreign aid programmes, conducted in addition to government investments, could benefit rural residents in low-income countries through increased service provision in rural healthcare facilities.

  6. The provision of assistive technology products and services for people with dementia in the United Kingdom.

    PubMed

    Gibson, Grant; Newton, Lisa; Pritchard, Gary; Finch, Tracy; Brittain, Katie; Robinson, Louise

    2016-07-01

    In this review we explore the provision of assistive technology products and services currently available for people with dementia within the United Kingdom. A scoping review of assistive technology products and services currently available highlighted 171 products or product types and 331 services. In addition, we assimilated data on the amount and quality of information provided by assistive technology services alongside assistive technology costs. We identify a range of products available across three areas: assistive technology used 'by', 'with' and 'on' people with dementia. Assistive technology provision is dominated by 'telecare' provided by local authorities, with services being subject to major variations in pricing and information provision; few currently used available resources for assistive technology in dementia. We argue that greater attention should be paid to information provision about assistive technology services across an increasingly mixed economy of dementia care providers, including primary care, local authorities, private companies and local/national assistive technology resources. © The Author(s) 2014.

  7. 75 FR 10289 - Notice of Opportunity for a Hearing on Compliance of Missouri State Plan Provisions Concerning...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-05

    ... provisions concerning payments for home health services comply with the requirements of the Social Security... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Notice of Opportunity for a Hearing on Compliance of Missouri State Plan Provisions Concerning Payments for Home Health...

  8. 25 CFR 23.49 - Fair and uniform provision of services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Fair and uniform provision of services. 23.49 Section 23.49 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES INDIAN CHILD WELFARE ACT General and Uniform Grant Administration Provisions and Requirements § 23.49 Fair and uniform...

  9. 47 CFR 25.142 - Licensing provisions for the non-voice, non-geostationary mobile-satellite service.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Licensing provisions for the non-voice, non... Stations § 25.142 Licensing provisions for the non-voice, non-geostationary mobile-satellite service. (a... the non-voice, non-geostationary mobile-satellite service shall describe in detail the proposed non...

  10. 47 CFR 25.142 - Licensing provisions for the non-voice, non-geostationary Mobile-Satellite Service.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Licensing provisions for the non-voice, non... Stations § 25.142 Licensing provisions for the non-voice, non-geostationary Mobile-Satellite Service. (a... the non-voice, non-geostationary mobile-satellite service shall describe in detail the proposed non...

  11. 47 CFR 25.142 - Licensing provisions for the non-voice, non-geostationary mobile-satellite service.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Licensing provisions for the non-voice, non... Stations § 25.142 Licensing provisions for the non-voice, non-geostationary mobile-satellite service. (a... the non-voice, non-geostationary mobile-satellite service shall describe in detail the proposed non...

  12. 47 CFR 25.142 - Licensing provisions for the non-voice, non-geostationary mobile-satellite service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Licensing provisions for the non-voice, non... Stations § 25.142 Licensing provisions for the non-voice, non-geostationary mobile-satellite service. (a... the non-voice, non-geostationary mobile-satellite service shall describe in detail the proposed non...

  13. 31 CFR 538.505 - Provision of certain legal services to the Government of Sudan, persons in Sudan, or benefitting...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Licensing Policy § 538.505 Provision of certain legal services to the Government of Sudan, persons in Sudan... for the following legal services by U.S. persons to the Government of Sudan or to a person in Sudan... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Provision of certain legal services to...

  14. 34 CFR 303.345 - Provision of services before evaluation and assessment are completed.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... System of Early Intervention Services Individualized Family Service Plans (ifsps) § 303.345 Provision of services before evaluation and assessment are completed. Early intervention services for an eligible child... Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY...

  15. The just provision of health care: a reply to Elizabeth Telfer.

    PubMed Central

    Steiner, H

    1976-01-01

    Dr Hillel Steiner in this reply to Elizabeth Telfer takes each of her arguments for different arrangements of a health service and examines them--'four positions which can be located on a linear ideological spectrum'--and adds a fifth which could have the effect of 'turning the alleged linear spectrum into a circle'. Underlying both Elizabeth Telfer's article and Dr Steiner's reply, the base is inescapably a 'political' one, but cannot be abandoned in favour of purely philosophical concepts. Whatever the attitude of mind of the reader of these two papers to the provision of a health service, the stimulus to more careful assessments of our own National Health Service and its problems can only be good. PMID:1003436

  16. Crop Farmers' Willingness to Pay for Agricultural Extension Services in Bangladesh: Cases of Selected Villages in Two Important Agro-Ecological Zones

    ERIC Educational Resources Information Center

    Uddin, Ektear MD.; Gao, Qijie; Mamun-Ur-Rashid, MD.

    2016-01-01

    Purpose: Globally, many extension professionals and policy-makers are advocating fee based services, in addressing the fund shortage and sustainable provision of agricultural advisory services. Hence, the article attempts to expose the farmers' willingness to pay (WTP) as agricultural extension in Bangladesh is experiencing chronic fund crisis.…

  17. Ecosystem service bundles for analyzing tradeoffs in diverse landscapes

    PubMed Central

    Raudsepp-Hearne, C.; Peterson, G. D.; Bennett, E. M.

    2010-01-01

    A key challenge of ecosystem management is determining how to manage multiple ecosystem services across landscapes. Enhancing important provisioning ecosystem services, such as food and timber, often leads to tradeoffs between regulating and cultural ecosystem services, such as nutrient cycling, flood protection, and tourism. We developed a framework for analyzing the provision of multiple ecosystem services across landscapes and present an empirical demonstration of ecosystem service bundles, sets of services that appear together repeatedly. Ecosystem service bundles were identified by analyzing the spatial patterns of 12 ecosystem services in a mixed-use landscape consisting of 137 municipalities in Quebec, Canada. We identified six types of ecosystem service bundles and were able to link these bundles to areas on the landscape characterized by distinct social–ecological dynamics. Our results show landscape-scale tradeoffs between provisioning and almost all regulating and cultural ecosystem services, and they show that a greater diversity of ecosystem services is positively correlated with the provision of regulating ecosystem services. Ecosystem service-bundle analysis can identify areas on a landscape where ecosystem management has produced exceptionally desirable or undesirable sets of ecosystem services. PMID:20194739

  18. Family-centred care delivery: comparing models of primary care service delivery in Ontario.

    PubMed

    Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

    2013-11-01

    To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Cross-sectional study. Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. A total of 137 practices, 363 providers, and 5144 patients. Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC.

  19. Decentralizing provision of mental health care in Sri Lanka.

    PubMed

    Fernando, Neil; Suveendran, Thirupathy; de Silva, Chithramalee

    2017-04-01

    In the past, mental health services in Sri Lanka were limited to tertiary-care institutions, resulting in a large treatment gap. Starting in 2000, significant efforts have been made to reconfigure service provision and to integrate mental health services with primary health care. This approach was supported by significant political commitment to establishing island-wide decentralized mental health care in the wake of the 2004 tsunami. Various initiatives were consolidated in The mental health policy of Sri Lanka 2005-2015, which called for implementation of a comprehensive community-based, decentralized service structure. The main objectives of the policy were to provide mental health services of good quality at primary, secondary and tertiary levels; to ensure the active involvement of communities, families and service users; to make mental health services culturally appropriate and evidence based; and to protect the human rights and dignity of all people with mental health disorders. Significant improvements have been made and new cadres of mental health workers have been introduced. Trained medical officers (mental health) now provide outpatient care, domiciliary care, mental health promotion in schools, and community mental health education. Community psychiatric nurses have also been trained and deployed to supervise treatment adherence in the home and provide mental health education to patients, their family members and the wider community. A total of 4367 mental health volunteers are supporting care and raising mental health literacy in the community. Despite these important achievements, more improvements are needed to provide more timely intervention, combat myths and stigma, and further decentralize care provision. These, and other challenges, will be targeted in the new mental health policy for 2017-2026.

  20. 34 CFR 75.52 - Eligibility of faith-based organizations for a grant.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., practice, and expression of its religious beliefs; (iii) Use its facilities to provide services without... prospective beneficiary in the provision of program services on the basis of religion or religious belief. (f... against a private organization on the basis of the organization's religious character or affiliation. (b...

  1. 34 CFR 75.52 - Eligibility of faith-based organizations for a grant.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., practice, and expression of its religious beliefs; (iii) Use its facilities to provide services without... prospective beneficiary in the provision of program services on the basis of religion or religious belief. (f... against a private organization on the basis of the organization's religious character or affiliation. (b...

  2. 34 CFR 75.52 - Eligibility of faith-based organizations for a grant.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., practice, and expression of its religious beliefs; (iii) Use its facilities to provide services without... prospective beneficiary in the provision of program services on the basis of religion or religious belief. (f... against a private organization on the basis of the organization's religious character or affiliation. (b...

  3. 34 CFR 75.52 - Eligibility of faith-based organizations for a grant.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., practice, and expression of its religious beliefs; (iii) Use its facilities to provide services without... prospective beneficiary in the provision of program services on the basis of religion or religious belief. (f... against a private organization on the basis of the organization's religious character or affiliation. (b...

  4. 34 CFR 75.52 - Eligibility of faith-based organizations for a grant.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., practice, and expression of its religious beliefs; (iii) Use its facilities to provide services without... prospective beneficiary in the provision of program services on the basis of religion or religious belief. (f... against a private organization on the basis of the organization's religious character or affiliation. (b...

  5. 76 FR 17139 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-28

    ... programs to support the provision of oral health services for HIV-positive individuals. Institutions... programs use to apply for funding of non-reimbursed costs, incurred in providing oral health care to... their links and collaboration with community-based providers of oral health services. The primary...

  6. Web-Based Academic Support Services: Guidelines for Extensibility

    ERIC Educational Resources Information Center

    McCracken, Holly

    2005-01-01

    Using the experience of the University of Illinois at Springfield's College of Liberal Arts and Sciences at the as a foundation for discussion, this paper addresses the provision of student support services to distant students within the context of development and expansion. Specific issues for consideration include: integrating student support…

  7. 42 CFR 447.202 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Audits. 447.202 Section 447.202 Public Health... ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment Methods: General Provisions § 447.202 Audits. The Medicaid agency must assure appropriate audit of records if payment is based on costs of services or on a fee plus...

  8. Implementation of electronic medical records

    PubMed Central

    Greiver, Michelle; Barnsley, Jan; Glazier, Richard H.; Moineddin, Rahim; Harvey, Bart J.

    2011-01-01

    Abstract Objective To study the effect of electronic medical record (EMR) implementation on preventive services covered by Ontario’s pay-for-performance program. Design Prospective double-cohort study. Participants Twenty-seven community-based family physicians. Setting Toronto, Ont. Intervention Eighteen physicians implemented EMRs, while 9 physicians continued to use paper records. Main outcome measure Provision of 4 preventive services affected by pay-for-performance incentives (Papanicolaou tests, screening mammograms, fecal occult blood testing, and influenza vaccinations) in the first 2 years of EMR implementation. Results After adjustment, combined preventive services for the EMR group increased by 0.7%, a smaller increase than that seen in the non-EMR group (P = .55, 95% confidence interval −2.8 to 3.9). Conclusion When compared with paper records, EMR implementation had no significant effect on the provision of the 4 preventive services studied. PMID:21998246

  9. 42 CFR 24.8 - Applicability of provisions of Title 5, U.S. Code.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Applicability of provisions of Title 5, U.S. Code. 24.8 Section 24.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL SENIOR BIOMEDICAL RESEARCH SERVICE § 24.8 Applicability of provisions of Title 5, U.S. Code. (a...

  10. 42 CFR 24.8 - Applicability of provisions of Title 5, U.S. Code.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Applicability of provisions of Title 5, U.S. Code. 24.8 Section 24.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL SENIOR BIOMEDICAL RESEARCH SERVICE § 24.8 Applicability of provisions of Title 5, U.S. Code. (a...

  11. 42 CFR 24.8 - Applicability of provisions of Title 5, U.S. Code.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Applicability of provisions of Title 5, U.S. Code. 24.8 Section 24.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL SENIOR BIOMEDICAL RESEARCH SERVICE § 24.8 Applicability of provisions of Title 5, U.S. Code. (a...

  12. 42 CFR 24.8 - Applicability of provisions of Title 5, U.S. Code.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Applicability of provisions of Title 5, U.S. Code. 24.8 Section 24.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL SENIOR BIOMEDICAL RESEARCH SERVICE § 24.8 Applicability of provisions of Title 5, U.S. Code. (a...

  13. 42 CFR 24.8 - Applicability of provisions of Title 5, U.S. Code.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Applicability of provisions of Title 5, U.S. Code. 24.8 Section 24.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL SENIOR BIOMEDICAL RESEARCH SERVICE § 24.8 Applicability of provisions of Title 5, U.S. Code. (a...

  14. A Review of Healthcare Service and Education Provision of Autism Spectrum Condition in Mainland China

    ERIC Educational Resources Information Center

    Sun, Xiang; Allison, Carrie; Auyeung, Bonnie; Baron-Cohen, Simon; Brayne, Carol

    2013-01-01

    Little is known about the current situation regarding Autism Spectrum Conditions in mainland China. Electronic databases and bibliographies were searched to identify literature on service provision for ASC in both English and Chinese databases. 14 studies and 6 reports were reviewed. The findings of identified papers on service provision were…

  15. The Provision of Services to Students with Special Needs in Canadian Academic Libraries.

    ERIC Educational Resources Information Center

    Goltz, Eileen

    1991-01-01

    Describes results of a survey of Canadian academic libraries that was conducted to determine the provision of services to the disabled, i.e., students with visual, hearing, or motor deficiencies. External resources are described, the role of library staff is emphasized, and library policy statements concerning the provision of special services are…

  16. 47 CFR 27.1213 - Designated entity provisions for BRS in Commission auctions commencing prior to January 1, 2004.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1213 Designated entity provisions for BRS in...

  17. 47 CFR 27.1213 - Designated entity provisions for BRS in Commission auctions commencing prior to January 1, 2004.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1213 Designated entity provisions for BRS in...

  18. 47 CFR 27.1213 - Designated entity provisions for BRS in Commission auctions commencing prior to January 1, 2004.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1213 Designated entity provisions for BRS in...

  19. 47 CFR 27.1213 - Designated entity provisions for BRS in Commission auctions commencing prior to January 1, 2004.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1213 Designated entity provisions for BRS in...

  20. Public long-term care insurance for the elderly in Korea: design, characteristics, and tasks.

    PubMed

    Seok, Jae Eun

    2010-03-01

    This paper examines the design and issues of the long-term care scheme in Korea: coverage, eligibility, benefit types, financing, delivery system, and role sharing of state, family, and market in long-term care. It also aims to examine the radical change and impacts on service financing, provision, and governance from the introduction of the long-term care insurance for the elderly in Korea. The first noteworthy change is that the long-term care service has transformed from the very selective service applicable only to low-income groups to a universal service for all income groups. The second notable change is that the service provision method has been changed from the provision by nonprofit organizations entrusted by the state under a monopolistic commission arrangement in the past to a new open-service provision arrangement in which free competition among service providers in service market and consumers' choice will be emphasized.

  1. FleXConf: A Flexible Conference Assistant Using Context-Aware Notification Services

    NASA Astrophysics Data System (ADS)

    Armenatzoglou, Nikos; Marketakis, Yannis; Kriara, Lito; Apostolopoulos, Elias; Papavasiliou, Vicky; Kampas, Dimitris; Kapravelos, Alexandros; Kartsonakis, Eythimis; Linardakis, Giorgos; Nikitaki, Sofia; Bikakis, Antonis; Antoniou, Grigoris

    Integrating context-aware notification services to ubiquitous computing systems aims at the provision of the right information to the right users, at the right time, in the right place, and on the right device, and constitutes a significant step towards the realization of the Ambient Intelligence vision. In this paper, we present FlexConf, a semantics-based system that supports location-based, personalized notification services for the assistance of conference attendees. Its special features include an ontology-based representation model, rule-based context-aware reasoning, and a novel positioning system for indoor environments.

  2. Attitudes of Scottish abortion care providers towards provision of abortion after 16 weeks' gestation within Scotland.

    PubMed

    Cochrane, Rosemary A; Cameron, Sharon T

    2013-06-01

    In Scotland, in contrast to the rest of Great Britain, abortion at gestations over 20 weeks is not provided, and provision of procedures above 16 weeks varies considerably between regions. Women at varying gestations above 16 weeks must travel outside Scotland, usually to England, for the procedure. To determine the views of professionals working within Scottish abortion care about a Scottish late abortion service. Delegates at a meeting for abortion providers in Scotland completed a questionnaire about their views on abortion provision over 16 weeks and their perceived barriers to service provision. Of 95 distributed questionnaires, 70 (76%) were analysed. Fifty-six respondents (80%) supported a Scottish late abortion service, ten (14%) would maintain current service arrangements, and five (7%) were undecided. Forty (57%) of the supporters of a Scottish service would prefer a single national service, and 16 (22%) several regional services. Perceived barriers included lack of trained staff (n = 39; 56%), accommodation for the service (n = 34; 48%), and perception of lack of support among senior management (n = 28; 40%). The majority of health professionals surveyed who work in Scottish abortion services support provision of abortion beyond 16 weeks within Scotland, and most favour a single national service. Further work on the feasibility of providing this service is required.

  3. Differences in home-based palliative care service utilisation of people with cancer and non-cancer conditions.

    PubMed

    Kralik, Debbie; Anderson, Barbara

    2008-11-01

    To identify home-based palliative care service utilisation by people with cancer and non-cancer conditions. Palliative care knowledge and skill have been derived from working with people with cancer. People with chronic conditions are now referred for home-based palliative care; however, there has been few studies published that have explored the impact of service utilisation by people with end-stage chronic conditions. The Australia-modified Karnofsky Performance Status (AKPS) scale was calculated for each person upon referral for home-based palliative care services to determine the functional capacity of the individual at the point of referral. Clients were divided into those with cancer diagnosis and those with non-cancer diagnosis. Service utilisation of the individual client was determined until separation from the palliative care service. The study was undertaken in 2007. The majority of people with cancer (63%) and non-cancer (71%) were assessed as having an AKPS score between 50-60. Thirty-one cancer clients (18·7%) and three non-cancer clients (7·1%) had an AKPS score between 70-90. This suggests that people with cancer are referred to palliative care services earlier than people with non-cancer conditions. People with non-cancer conditions were substantially higher users of home-based palliative care services over a longer period of time. Home-based palliative care service utilisation was higher for people with non-cancer conditions. Cost analysis research is recommended to delineate the actual costs of home-based palliative care service provision between people with cancer and non-cancer conditions. There is growing awareness of the need for palliative care services for people with non-cancer conditions. However, these services are provided for longer periods of time for this client group. Implications for practice are that the palliative care needs of people with non-cancer conditions may not be met within current palliative care service provision. There may be funding implications for home-based palliative care services that intend to meet the needs of people at end of life with non-cancer conditions. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd.

  4. Anticipating the potential for positive uptake and adaptation in the implementation of a publicly funded online STBBI testing service: a qualitative analysis.

    PubMed

    Chabot, Cathy; Gilbert, Mark; Haag, Devon; Ogilvie, Gina; Hawe, Penelope; Bungay, Vicky; Shoveller, Jean A

    2018-01-30

    Online health services are a rapidly growing aspect of public health provision, including testing for sexually transmitted and other blood-borne infections (STBBI). Generally, healthcare providers, policymakers, and clients imbue online approaches with great positive potential (e.g., encouraging clients' agency; providing cost-effective services to more clients). However, the promise of online health services may vary across contexts and be perceived in negative or ambiguous ways (e.g., risks to 'gold standard' care provision; loss of provider control over an intervention; uncertainty related to budget implications). This study examines attitudes and perceptions regarding the development of a novel online STBBI testing service in Vancouver, Canada. We examine the perceptions about the intervention's potential by interviewing practitioners and planners who were engaged in the development and initial implementation of this testing service. We conducted in-depth interviews with 37 healthcare providers, administrators, policymakers, and community-based service providers engaged in the design and launch of the new online STBBI testing service. We also conducted observations during planning and implementation meetings for the new service. Thematic analysis techniques were employed to identify codes and broader discursive themes across the interview transcripts and observation notes. Some study participants expressed concern that the potential popularity of the new testing service might increase demand on existing sexual health services or become fiscally unsustainable. However, most participants regarded the new service as having the potential to improve STBBI testing in several ways, including reducing waiting times, enhancing privacy and confidentiality, appealing to more tech-savvy sub-populations, optimizing the redistribution of demands on face-to-face service provision, and providing patient-centred technology to empower clients to seek testing. Participants perceived this online STBBI testing service to have the potential to improve sexual health care provision. But, they also anticipated actions-and-reactions, revealing a need to monitor ongoing implementation dynamics. They also identified the larger, potentially system-transforming dimension of the new technology, which enables new system drivers (consumers) and reduces the amount of control health care providers have over online STBBI testing compared to conventional in-person testing.

  5. 34 CFR 380.5 - What activities may the Secretary fund under community-based supported employment projects?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the Secretary fund under community-based supported employment projects? (a) Authorized activities. The following activities are authorized under community-based projects: (1) Job search assistance. (2) Job... Community-Based Supported Employment projects for the provision of extended supported employment services...

  6. 42 CFR 55a.106 - Provision for waiver by the Secretary.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Provision for waiver by the Secretary. 55a.106 Section 55a.106 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.106 Provision for waiver by the Secretary...

  7. 42 CFR 55a.106 - Provision for waiver by the Secretary.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Provision for waiver by the Secretary. 55a.106 Section 55a.106 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.106 Provision for waiver by the Secretary...

  8. An emergency dental service for students: 4-year findings.

    PubMed

    Sinclair, J; Wilson, N H

    1997-06-01

    To describe the arrangements for the provision of emergency dental services for students at the University of Manchester and to report data collected during the first four and a half years of the student emergency dental services (SEDS) unit based at the University Dental Hospital of Manchester. Data pertaining to every student attending SEDS since its inception were collected by means of questionnaire including provision to record diagnoses, treatment needs and the emergency care provided. The incidence of dental emergencies within the student population served by SEDS has been found to be 39 emergencies per 1000 students per annum, with the service being most heavily used by overseas students. Caries, pulpal pathology and failed restorations account for 46 per cent of the presenting emergencies, with pericoronitis (19 per cent) and other emergencies of periodontal origin (14 per cent) being common place. It is concluded that a student emergency dental service may be found to be an important element of student medical and related welfare services.

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

    PubMed

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

    2010-12-01

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

  10. Factors associated with end-of-life by home-visit nursing-care providers in Japan.

    PubMed

    Nakanishi, Miharu; Niimura, Junko; Nishida, Atsushi

    2017-06-01

    Home-visit nursing-care services in Japan are expected to provide home hospice services for older patients with non-cancer diseases. The aim of the present study was to examine factors that contribute to the provision of end-of-life care by home-visit nursing-care providers in Japan. The present retrospective study was carried out using nationally representative cross-sectional data from the 2007, 2010, and 2013 Survey of Institutions and Establishments for Long-Term Care. A total of 138 008 randomly sampled home-visit nursing-care service users were included in this analysis. End-of-life care (study outcome) was defined as the provision of nursing-care within the last month of life. Of the 138 008 patients at home, 2280 (1.7%) received home-based nursing care within the last month of life, and end-of-life care was offered primarily to cancer patients (n = 1651; 72.4%). After accounting for patient characteristics, patients were more likely to receive end-of-life care when they used home-visit nursing-care providers that had a greater number of nursing staff or were located in a region with fewer hospital beds. Among home-visit nursing-care providers, the nursing staff ratio and the availability of hospital beds were related to the provision of end-of-life care. Home-visit nursing-care providers should establish specialist hospice care teams with enhanced staffing ratios to allow for the adequate provision of home-based end-of-life care. A community-based network between home-visit nursing-care providers and hospitals should also be established to attain an integrated end-of-life care system for elderly populations in regions with more hospital beds. Geriatr Gerontol Int 2017; 17: 991-998. © 2016 Japan Geriatrics Society.

  11. 3 CFR - Provision of Defense Articles and Services to Vetted Members of the Syrian Opposition for Use in...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Provision of Defense Articles and Services to Vetted... and Related Materials, Organizations Implementing U.S. Department of State or U.S. Agency for... Determination No. 2013-15 of September 16, 2013 Provision of Defense Articles and Services to Vetted Members of...

  12. 49 CFR 39.51 - What is the general requirement for PVOs' provision of auxiliary aids and services to passengers?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...' provision of auxiliary aids and services to passengers? 39.51 Section 39.51 Transportation Office of the... for Passengers § 39.51 What is the general requirement for PVOs' provision of auxiliary aids and... auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity...

  13. 49 CFR 39.51 - What is the general requirement for PVOs' provision of auxiliary aids and services to passengers?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...' provision of auxiliary aids and services to passengers? 39.51 Section 39.51 Transportation Office of the... for Passengers § 39.51 What is the general requirement for PVOs' provision of auxiliary aids and... auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity...

  14. 49 CFR 39.51 - What is the general requirement for PVOs' provision of auxiliary aids and services to passengers?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...' provision of auxiliary aids and services to passengers? 39.51 Section 39.51 Transportation Office of the... for Passengers § 39.51 What is the general requirement for PVOs' provision of auxiliary aids and... auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity...

  15. 49 CFR 39.51 - What is the general requirement for PVOs' provision of auxiliary aids and services to passengers?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...' provision of auxiliary aids and services to passengers? 39.51 Section 39.51 Transportation Office of the... for Passengers § 39.51 What is the general requirement for PVOs' provision of auxiliary aids and... auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity...

  16. Cross-Cultural Considerations regarding Inclusion and Service Provision for Children with Disabilities in India

    ERIC Educational Resources Information Center

    Browning, Ellen R.; Caro, Patricia; Shastry, Sunita P.

    2011-01-01

    Providing services for children with disabilities has been a part of the culture of India for generations. However service provision has been within the context of family and community rather than in the public sector and thus has been inclusive by its very nature. This article describes current educational provisions and practices in India for…

  17. 47 CFR 64.402 - Policies and procedures for the provision of priority access service by commercial mobile radio...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... priority access service by commercial mobile radio service providers. 64.402 Section 64.402... RULES RELATING TO COMMON CARRIERS Procedures for Handling Priority Services in Emergencies § 64.402 Policies and procedures for the provision of priority access service by commercial mobile radio service...

  18. Community pharmacists' perspectives on implementation of Medicines Use Review in Slovenia.

    PubMed

    Nabergoj Makovec, Urska; Kos, Mitja; Pisk, Nina

    2018-06-16

    Background In December 2014 Slovene Chamber of Pharmacies defined procedures for Medicines Use Review (MUR) in Slovenia, together with an educational program and certification to ensure pharmacists' competency to perform MUR. The first 15 pharmacists were certified in June 2015 and implemented the service in their practices. Objective This study aimed to understand the implementation of MUR from the perspectives of the first community pharmacists providing the service in practice. Methods A focus group with first MUR providers took place in February 2016, 6 months after the first pharmacists were certified to provide MUR service. Based on regional and institutional criteria ten pharmacists from the first certified group were chosen and invited to participate in guided discussion, where the development and assurance of competencies, the provision of the service in practice and the future of the service were addressed. The discussion was voice recorded with written consent obtained from all participants. Analysis was performed in NVivo 11 software with the use of inductive qualitative content analysis approach. Main outcome measure Views, challenges and opportunities for the Medicines Use Review service in Slovenia. Results Seven pharmacists attended the focus group, 5 from public pharmaceutical institution and 2 from concessionary pharmacies. Three main thematical categories were identified: quality assurance of MUR, different stakeholders' perceptions of MUR and MURs' management. Pharmacists' broad knowledge in pharmacotherapy was emphasized as the basis of quality provision and main advantage in performing MUR in comparison with other healthcare professions. Recognisability of MUR among different stakeholders should be improved with comprehensive approach in marketing of the service. Positive patient feedback was reported, however persuading them to attend MUR presented a challenge. Better management of the service, especially in terms of work organization, would facilitate MUR provision. Conclusion Overall, positive experiences with implementation and provision were reported. To ensure MUR sustainability, the service needs to become more widely known and opportunities must be provided for continuing professional development of providing pharmacists.

  19. 47 CFR 202.0 - Objectives.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL NATIONAL SECURITY AND... services based on national policy/direction. (4) The capability to execute a telecommunications recovery plan based on national policy/guidance. (c) Notwithstanding any provision regarding NS/EP Planning and...

  20. 47 CFR 202.0 - Objectives.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL NATIONAL SECURITY AND... services based on national policy/direction. (4) The capability to execute a telecommunications recovery plan based on national policy/guidance. (c) Notwithstanding any provision regarding NS/EP Planning and...

  1. 47 CFR 202.0 - Objectives.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL NATIONAL SECURITY AND... services based on national policy/direction. (4) The capability to execute a telecommunications recovery plan based on national policy/guidance. (c) Notwithstanding any provision regarding NS/EP Planning and...

  2. 47 CFR 202.0 - Objectives.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL NATIONAL SECURITY AND... services based on national policy/direction. (4) The capability to execute a telecommunications recovery plan based on national policy/guidance. (c) Notwithstanding any provision regarding NS/EP Planning and...

  3. 47 CFR 202.0 - Objectives.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL NATIONAL SECURITY AND... services based on national policy/direction. (4) The capability to execute a telecommunications recovery plan based on national policy/guidance. (c) Notwithstanding any provision regarding NS/EP Planning and...

  4. 20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

  5. 20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

  6. 20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

  7. 20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

  8. 20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

  9. A Bayesian-Based Approach to Marine Spatial Planning: Evaluating Spatial and Temporal Variance in the Provision of Ecosystem Services Before and After the Establishment Oregon's Marine Protected Areas

    NASA Astrophysics Data System (ADS)

    Black, B.; Harte, M.; Goldfinger, C.

    2017-12-01

    Participating in a ten-year monitoring project to assess the ecological, social, and socioeconomic impacts of Oregon's Marine Protected Areas (MPAs), we have worked in partnership with the Oregon Department of Fish and Wildlife (ODFW) to develop a Bayesian geospatial method to evaluate the spatial and temporal variance in the provision of ecosystem services produced by Oregon's MPAs. Probabilistic (Bayesian) approaches to Marine Spatial Planning (MSP) show considerable potential for addressing issues such as uncertainty, cumulative effects, and the need to integrate stakeholder-held information and preferences into decision making processes. To that end, we have created a Bayesian-based geospatial approach to MSP capable of modelling the evolution of the provision of ecosystem services before and after the establishment of Oregon's MPAs. Our approach permits both planners and stakeholders to view expected impacts of differing policies, behaviors, or choices made concerning Oregon's MPAs and surrounding areas in a geospatial (map) format while simultaneously considering multiple parties' beliefs on the policies or uses in question. We quantify the influence of the MPAs as the shift in the spatial distribution of ecosystem services, both inside and outside the protected areas, over time. Once the MPAs' influence on the provision of coastal ecosystem services has been evaluated, it is possible to view these impacts through geovisualization techniques. As a specific example of model use and output, a user could investigate the effects of altering the habitat preferences of a rockfish species over a prescribed period of time (5, 10, 20 years post-harvesting restrictions, etc.) on the relative intensity of spillover from nearby reserves (please see submitted figure). Particular strengths of our Bayesian-based approach include its ability to integrate highly disparate input types (qualitative or quantitative), to accommodate data gaps, address uncertainty, and to investigate temporal and spatial variation. This approach conveys the modeled outcome of proposed policy changes and is also a vehicle through which stakeholders and planners can work together to compare and deliberate on the impacts of policy and management changes, a capacity of considerable utility for planners and stakeholders engaged in MSP.

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

    NASA Technical Reports Server (NTRS)

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

    1995-01-01

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

  11. Crowd Sensing-Enabling Security Service Recommendation for Social Fog Computing Systems

    PubMed Central

    Wu, Jun; Su, Zhou; Li, Jianhua

    2017-01-01

    Fog computing, shifting intelligence and resources from the remote cloud to edge networks, has the potential of providing low-latency for the communication from sensing data sources to users. For the objects from the Internet of Things (IoT) to the cloud, it is a new trend that the objects establish social-like relationships with each other, which efficiently brings the benefits of developed sociality to a complex environment. As fog service become more sophisticated, it will become more convenient for fog users to share their own services, resources, and data via social networks. Meanwhile, the efficient social organization can enable more flexible, secure, and collaborative networking. Aforementioned advantages make the social network a potential architecture for fog computing systems. In this paper, we design an architecture for social fog computing, in which the services of fog are provisioned based on “friend” relationships. To the best of our knowledge, this is the first attempt at an organized fog computing system-based social model. Meanwhile, social networking enhances the complexity and security risks of fog computing services, creating difficulties of security service recommendations in social fog computing. To address this, we propose a novel crowd sensing-enabling security service provisioning method to recommend security services accurately in social fog computing systems. Simulation results show the feasibilities and efficiency of the crowd sensing-enabling security service recommendation method for social fog computing systems. PMID:28758943

  12. Crowd Sensing-Enabling Security Service Recommendation for Social Fog Computing Systems.

    PubMed

    Wu, Jun; Su, Zhou; Wang, Shen; Li, Jianhua

    2017-07-30

    Fog computing, shifting intelligence and resources from the remote cloud to edge networks, has the potential of providing low-latency for the communication from sensing data sources to users. For the objects from the Internet of Things (IoT) to the cloud, it is a new trend that the objects establish social-like relationships with each other, which efficiently brings the benefits of developed sociality to a complex environment. As fog service become more sophisticated, it will become more convenient for fog users to share their own services, resources, and data via social networks. Meanwhile, the efficient social organization can enable more flexible, secure, and collaborative networking. Aforementioned advantages make the social network a potential architecture for fog computing systems. In this paper, we design an architecture for social fog computing, in which the services of fog are provisioned based on "friend" relationships. To the best of our knowledge, this is the first attempt at an organized fog computing system-based social model. Meanwhile, social networking enhances the complexity and security risks of fog computing services, creating difficulties of security service recommendations in social fog computing. To address this, we propose a novel crowd sensing-enabling security service provisioning method to recommend security services accurately in social fog computing systems. Simulation results show the feasibilities and efficiency of the crowd sensing-enabling security service recommendation method for social fog computing systems.

  13. Service Provision for Autism in Mainland China: A Service Providers' Perspective

    ERIC Educational Resources Information Center

    Sun, Xiang; Allison, Carrie; Auyeung, Bonnie; Matthews, Fiona E.; Murray, Stuart; Baron-Cohen, Simon; Brayne, Carol

    2013-01-01

    Qualitative semi-structured interviews were conducted with service providers regarding the current healthcare provision and education services for children with Autism Spectrum Conditions (ASC) and their families in mainland China. 10 service providers described the current policy and identified unmet needs within current practice. Providers…

  14. Filling Service Gaps: Providing Intensive Treatment Services for Offenders

    PubMed Central

    Young, Douglas W.; Farrell, Jill L.; Henderson, Craig E.; Taxman, Faye S.

    2009-01-01

    Consistent with the few studies that have previously examined treatment prevalence and access in the adult and juvenile justice systems, the recent National Criminal Justice Treatment Practices (NCJTP) survey indicated that there is a particular need to expand intensive treatment modalities for offenders in both institutional and community corrections settings. Applying multilevel modeling techniques to NCJTP survey data, this study explores conditions and factors that may underlie the wide variation among states in the provision of intensive treatment for offenders. Results indicate that states' overall rates of substance abuse and dependence, funding resources, and the state governor's political party affiliation were significantly associated with intensive treatment provision. Numerous factors that have been implicated in recent studies of evidence-based practice adoption, including state agency executives' views regarding rehabilitation, agency culture and climate, and other state-level measures (e.g., household income, crime rates, expenditures on treatment for the general population) were not associated with treatment provision. Future research should examine further variations in offenders' service needs, the role of legislators' political affiliations, and how other factors may interact with administrator characteristics in the adoption and expansion of intensive treatment services for offenders. PMID:19261394

  15. Filling service gaps: Providing intensive treatment services for offenders.

    PubMed

    Young, Douglas W; Farrell, Jill L; Henderson, Craig E; Taxman, Faye S

    2009-08-01

    Consistent with the few studies that have previously examined treatment prevalence and access in the adult and juvenile justice systems, the recent National Criminal Justice Treatment Practices (NCJTP) survey indicated that there is a particular need to expand intensive treatment modalities for offenders in both institutional and community corrections settings. Applying multilevel modeling techniques to NCJTP survey data, this study explores conditions and factors that may underlie the wide variation among states in the provision of intensive treatment for offenders. Results indicate that states' overall rates of substance abuse and dependence, funding resources, and the state governor's political party affiliation were significantly associated with intensive treatment provision. Numerous factors that have been implicated in recent studies of evidence-based practice adoption, including state agency executives' views regarding rehabilitation, agency culture and climate, and other state-level measures (e.g., household income, crime rates, expenditures on treatment for the general population) were not associated with treatment provision. Future research should examine further variations in offenders' service needs, the role of legislators' political affiliations, and how other factors may interact with administrator characteristics in the adoption and expansion of intensive treatment services for offenders.

  16. Nonrandom extinction patterns can modulate pest control service decline.

    PubMed

    Karp, Daniel S; Moeller, Holly V; Frishkoff, Luke O

    2013-06-01

    Changes in biodiversity will mediate the consequences of agricultural intensification and expansion for ecosystem services. Regulating services, like pollination and pest control, generally decline with species loss. In nature, however, relationships between service provision and species richness are not always strong, partially because anthropogenic disturbances purge species from communities in nonrandom orders. The same traits that make for effective service providers may also confer resistance or sensitivity to anthropogenic disturbances, which may either temper or accelerate declines in service provision with species loss. We modeled a community of predators interacting with insect pest prey, and identified the contexts in which pest control provision was most sensitive to species loss. We found pest populations increased rapidly when functionally unique and dietary-generalist predators were lost first, with up to 20% lower pest control provision than random loss. In general, pest abundance increased most in the scenarios that freed more pest species from predation. Species loss also decreased the likelihood that the most effective service providers were present. In communities composed of species with identical traits, predators were equally effective service providers and, when competing predators went extinct, remaining community members assumed their functional roles. In more realistic trait-diverse communities, predators differed in pest control efficacy, and remaining predators could not fully compensate for the loss of their competitors, causing steeper declines in pest control provision with predator species loss. These results highlight diet breadth in particular as a key predictor of service provision, as it affects both the way species respond to and alter their environments. More generally, our model provides testable hypotheses for predicting how nonrandom species loss alters relationships between biodiversity and pest control provision.

  17. 44 CFR 353.6 - Schedule of services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... shall be charged the full cost of site-specific services based upon the appropriate professional hourly... will be charged to the licensee by FEMA, at the rate and cost incurred. (a) When a State seeks formal.... This provision does not apply where an operating license has been granted or the application denied or...

  18. An Evaluation of Virtual Home Visits in Early Intervention: Feasibility of "Virtual Intervention"

    ERIC Educational Resources Information Center

    Olsen, Sue; Fiechtl, Barbara; Rule, Sarah

    2012-01-01

    The provision of consistent high quality home- and community-based services to children with disabilities living in rural and frontier areas is a challenge. Distance, weather, geographic terrain (mountains, canyons), and shortages of pediatric early interventionists are among the challenges to ensuring appropriate and equitable services.…

  19. Living waters: Linking cultural knowledge, ecosystem services, and wilderness

    Treesearch

    Linda Moon Stumpff

    2013-01-01

    American Indian tribes value pristine water sources that often originate in wilderness areas to support provisioning and cultural benefits. Based on interviews with four traditional leaders, this article focuses on the concept of living waters in ways that connect ecosystem service benefits to wilderness. Cultural knowledge connects indigenous water stewardship and...

  20. Redesigning Federal Grant Programs. Occasional Paper #24.

    ERIC Educational Resources Information Center

    McLoone, Eugene P.

    When taxation is based on ability to pay and programs are targeted at a minimum service level, every state with any population that requires the service must participate. States and localities receive grants only because groups and individuals are to be treated equally. The role of the recipient government is the provision of the minimum…

  1. Journal Coverage of Issues Related to English Language Learners across Student-Service Professions

    ERIC Educational Resources Information Center

    Albers, Craig A.; Hoffman, Alicia J.; Lundahl, Allison A.

    2009-01-01

    The number of students who are classified as English language learners (ELLs) is increasing within schools across the United States. Thus, it is important that school professionals have access to information regarding research-based assessment, prevention, and intervention practices that reflect the appropriate provision of services to this…

  2. State Plan for Special Education and Services.

    ERIC Educational Resources Information Center

    Hawaii State Dept. of Education, Honolulu. Office of Instructional Services.

    Presented is Hawaii's state plan for the provision of special education and services to all handicapped children under 20 years of age by 1980-81. Explained in Chapter I are the philosophic and legal bases for the plan, including the right to equal educational opportunities for children with the following handicapping conditions: mental…

  3. Shared Agency and Collaboration between the Family and Professionals in Medical Rehabilitation of Children with Severe Disabilities

    ERIC Educational Resources Information Center

    Jarvikoski, Aila; Martin, Marjatta; Autti-Ramo, Ilona; Harkapaa, Kristiina

    2013-01-01

    Implementation of medical rehabilitation for children with severe disabilities, arranged by the Social Insurance Institution of Finland, is based on collaboration of the family with several professionals and organizations providing the necessary services. Therefore, it sets special challenges for service provision. Parents' experiences of shared…

  4. A System for Governmental Virtual Institutions Based on Ontologies and Interaction Protocols

    ERIC Educational Resources Information Center

    de Araujo, Claudia J. Abrao; da Silva, Flavio S. Correa

    2012-01-01

    The authors believe that the adoption of virtual worlds is suitable for electronic government applications as it can increase the capillarity of public services, facilitate the access to government services and provide citizens with a natural and immersive experience. They present a Government Virtual Institution Model (GVI) for the provision of…

  5. 5 CFR 875.203 - Am I eligible if I separated under the FERS MRA+10 provision?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... FERS MRA+10 provision? 875.203 Section 875.203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT....203 Am I eligible if I separated under the FERS MRA+10 provision? If you have separated from service under the FERS Minimum Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C. 8412(g...

  6. 5 CFR 875.203 - Am I eligible if I separated under the FERS MRA+10 provision?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... FERS MRA+10 provision? 875.203 Section 875.203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT....203 Am I eligible if I separated under the FERS MRA+10 provision? If you have separated from service under the FERS Minimum Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C. 8412(g...

  7. 5 CFR 875.203 - Am I eligible if I separated under the FERS MRA+10 provision?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... FERS MRA+10 provision? 875.203 Section 875.203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT....203 Am I eligible if I separated under the FERS MRA+10 provision? If you have separated from service under the FERS Minimum Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C. 8412(g...

  8. 5 CFR 875.203 - Am I eligible if I separated under the FERS MRA+10 provision?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... FERS MRA+10 provision? 875.203 Section 875.203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT....203 Am I eligible if I separated under the FERS MRA+10 provision? If you have separated from service under the FERS Minimum Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C. 8412(g...

  9. 5 CFR 875.203 - Am I eligible if I separated under the FERS MRA+10 provision?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... FERS MRA+10 provision? 875.203 Section 875.203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT....203 Am I eligible if I separated under the FERS MRA+10 provision? If you have separated from service under the FERS Minimum Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C. 8412(g...

  10. 77 FR 42513 - Sunshine Act Meetings Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-19

    ... LEGAL SERVICES CORPORATION Sunshine Act Meetings Notice DATE AND TIME: The Legal Services... Committee 5. Promotion & Provision for the Delivery of Legal Services Committee. 6. Operations & Regulations....C. Sec. 552b(c)(9) and (10), and the corresponding provision of the Legal Services Corporation's...

  11. Hospital services and casemix in Western Australia.

    PubMed

    Hendrie, Delia; Boldy, Duncan

    2002-01-01

    The Health Department of WA currently operates as a single integrated funder and purchaser of health services for the State. Health Service Agreements defining the level of health provision are negotiated with the various health services in WA. During the latter part of the 1990s, the funding of public hospitals for acute inpatient care moved away from a historical basis to output-based funding using a casemix approach based on Diagnosis Related Groups (DRGs). Other hospital services are still mainly purchased using historical funding levels, negotiated block funding or bedday payments, with output-based funding mechanisms under investigation. WA has developed its own approach to classifying admitted patients that recognises differences in complexity of care among episodes grouped to the same DRG. WA also has a unique cost estimation model for calculating DRG cost weights, which is based on a linear estimate of the relationship between nights of stay in hospital and the cost of hospital care for each DRG. Another emerging trend in the provision of public hospital services in WA has been the greater involvement of the private sector through the contracting of private providers to operate public hospitals. While no close examination has been undertaken of the outcomes of these changes in terms of their effect on efficiency or other relevant indicators of hospital performance, current purchasing arrangements are being reviewed following recommendations made in a report by the Health Administrative Review Committee. No decision has yet been made as to future changes to the funding policy of WA public hospitals.

  12. Barriers to providing quality emergency obstetric care in Addis Ababa, Ethiopia: Healthcare providers' perspectives on training, referrals and supervision, a mixed methods study.

    PubMed

    Austin, Anne; Gulema, Hanna; Belizan, Maria; Colaci, Daniela S; Kendall, Tamil; Tebeka, Mahlet; Hailemariam, Mengistu; Bekele, Delayehu; Tadesse, Lia; Berhane, Yemane; Langer, Ana

    2015-03-29

    Increasing women's access to and use of facilities for childbirth is a critical national strategy to improve maternal health outcomes in Ethiopia; however coverage alone is not enough as the quality of emergency obstetric services affects maternal mortality and morbidity. Addis Ababa has a much higher proportion of facility-based births (82%) than the national average (11%), but timely provision of quality emergency obstetric care remains a significant challenge for reducing maternal mortality and improving maternal health. The purpose of this study was to assess barriers to the provision of emergency obstetric care in Addis Ababa from the perspective of healthcare providers by analyzing three factors: implementation of national referral guidelines, staff training, and staff supervision. A mixed methods approach was used to assess barriers to quality emergency obstetric care. Qualitative analyses included twenty-nine, semi-structured, key informant interviews with providers from an urban referral network consisting of a hospital and seven health centers. Quantitative survey data were collected from 111 providers, 80% (111/138) of those providing maternal health services in the same referral network. Respondents identified a lack of transportation and communication infrastructure, overcrowding at the referral hospital, insufficient pre-service and in-service training, and absence of supportive supervision as key barriers to provision of quality emergency obstetric care. Dedicated transportation and communication infrastructure, improvements in pre-service and in-service training, and supportive supervision are needed to maximize the effective use of existing human resources and infrastructure, thus increasing access to and the provision of timely, high quality emergency obstetric care in Addis Ababa, Ethiopia.

  13. 42 CFR 403.756 - Sunset provision.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Sunset provision. 403.756 Section 403.756 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  14. 42 CFR 403.752 - Payment provisions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment provisions. 403.752 Section 403.752 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  15. 42 CFR 403.756 - Sunset provision.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Sunset provision. 403.756 Section 403.756 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  16. 42 CFR 403.756 - Sunset provision.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Sunset provision. 403.756 Section 403.756 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  17. 42 CFR 403.752 - Payment provisions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Payment provisions. 403.752 Section 403.752 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  18. 42 CFR 403.752 - Payment provisions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Payment provisions. 403.752 Section 403.752 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  19. 42 CFR 403.752 - Payment provisions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Payment provisions. 403.752 Section 403.752 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  20. 42 CFR 403.756 - Sunset provision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Sunset provision. 403.756 Section 403.756 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  1. 42 CFR 403.752 - Payment provisions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Payment provisions. 403.752 Section 403.752 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  2. 42 CFR 403.756 - Sunset provision.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Sunset provision. 403.756 Section 403.756 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  3. 40 CFR 63.168 - Standards: Valves in gas/vapor service and in light liquid service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... § 63.168 Standards: Valves in gas/vapor service and in light liquid service. (a) The provisions of this section apply to valves that are either in gas service or in light liquid service. (1) The provisions are... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Standards: Valves in gas/vapor service...

  4. 40 CFR 63.168 - Standards: Valves in gas/vapor service and in light liquid service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... § 63.168 Standards: Valves in gas/vapor service and in light liquid service. (a) The provisions of this section apply to valves that are either in gas service or in light liquid service. (1) The provisions are... 40 Protection of Environment 9 2011-07-01 2011-07-01 false Standards: Valves in gas/vapor service...

  5. 40 CFR 63.168 - Standards: Valves in gas/vapor service and in light liquid service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 63.168 Standards: Valves in gas/vapor service and in light liquid service. (a) The provisions of this section apply to valves that are either in gas service or in light liquid service. (1) The provisions are... 40 Protection of Environment 10 2013-07-01 2013-07-01 false Standards: Valves in gas/vapor service...

  6. 40 CFR 63.168 - Standards: Valves in gas/vapor service and in light liquid service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... § 63.168 Standards: Valves in gas/vapor service and in light liquid service. (a) The provisions of this section apply to valves that are either in gas service or in light liquid service. (1) The provisions are... 40 Protection of Environment 10 2014-07-01 2014-07-01 false Standards: Valves in gas/vapor service...

  7. 40 CFR 63.168 - Standards: Valves in gas/vapor service and in light liquid service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... § 63.168 Standards: Valves in gas/vapor service and in light liquid service. (a) The provisions of this section apply to valves that are either in gas service or in light liquid service. (1) The provisions are... 40 Protection of Environment 10 2012-07-01 2012-07-01 false Standards: Valves in gas/vapor service...

  8. Personalized cloud-based bioinformatics services for research and education: use cases and the elasticHPC package

    PubMed Central

    2012-01-01

    Background Bioinformatics services have been traditionally provided in the form of a web-server that is hosted at institutional infrastructure and serves multiple users. This model, however, is not flexible enough to cope with the increasing number of users, increasing data size, and new requirements in terms of speed and availability of service. The advent of cloud computing suggests a new service model that provides an efficient solution to these problems, based on the concepts of "resources-on-demand" and "pay-as-you-go". However, cloud computing has not yet been introduced within bioinformatics servers due to the lack of usage scenarios and software layers that address the requirements of the bioinformatics domain. Results In this paper, we provide different use case scenarios for providing cloud computing based services, considering both the technical and financial aspects of the cloud computing service model. These scenarios are for individual users seeking computational power as well as bioinformatics service providers aiming at provision of personalized bioinformatics services to their users. We also present elasticHPC, a software package and a library that facilitates the use of high performance cloud computing resources in general and the implementation of the suggested bioinformatics scenarios in particular. Concrete examples that demonstrate the suggested use case scenarios with whole bioinformatics servers and major sequence analysis tools like BLAST are presented. Experimental results with large datasets are also included to show the advantages of the cloud model. Conclusions Our use case scenarios and the elasticHPC package are steps towards the provision of cloud based bioinformatics services, which would help in overcoming the data challenge of recent biological research. All resources related to elasticHPC and its web-interface are available at http://www.elasticHPC.org. PMID:23281941

  9. Personalized cloud-based bioinformatics services for research and education: use cases and the elasticHPC package.

    PubMed

    El-Kalioby, Mohamed; Abouelhoda, Mohamed; Krüger, Jan; Giegerich, Robert; Sczyrba, Alexander; Wall, Dennis P; Tonellato, Peter

    2012-01-01

    Bioinformatics services have been traditionally provided in the form of a web-server that is hosted at institutional infrastructure and serves multiple users. This model, however, is not flexible enough to cope with the increasing number of users, increasing data size, and new requirements in terms of speed and availability of service. The advent of cloud computing suggests a new service model that provides an efficient solution to these problems, based on the concepts of "resources-on-demand" and "pay-as-you-go". However, cloud computing has not yet been introduced within bioinformatics servers due to the lack of usage scenarios and software layers that address the requirements of the bioinformatics domain. In this paper, we provide different use case scenarios for providing cloud computing based services, considering both the technical and financial aspects of the cloud computing service model. These scenarios are for individual users seeking computational power as well as bioinformatics service providers aiming at provision of personalized bioinformatics services to their users. We also present elasticHPC, a software package and a library that facilitates the use of high performance cloud computing resources in general and the implementation of the suggested bioinformatics scenarios in particular. Concrete examples that demonstrate the suggested use case scenarios with whole bioinformatics servers and major sequence analysis tools like BLAST are presented. Experimental results with large datasets are also included to show the advantages of the cloud model. Our use case scenarios and the elasticHPC package are steps towards the provision of cloud based bioinformatics services, which would help in overcoming the data challenge of recent biological research. All resources related to elasticHPC and its web-interface are available at http://www.elasticHPC.org.

  10. Adding Value to the Network: Exploring the Software as a Service and Platform as a Service Models for Mobile Operators

    NASA Astrophysics Data System (ADS)

    Gonçalves, Vânia

    The environments of software development and software provision are shifting to Web-based platforms supported by Platform/Software as a Service (PaaS/SaaS) models. This paper will make the case that there is equally an opportunity for mobile operators to identify additional sources of revenue by exposing network functionalities through Web-based service platforms. By elaborating on the concepts, benefits and risks of SaaS and PaaS, several factors that should be taken into consideration in applying these models to the telecom world are delineated.

  11. Networked remote area dental services: a viable, sustainable approach to oral health care in challenging environments.

    PubMed

    Dyson, Kate; Kruger, Estie; Tennant, Marc

    2012-12-01

    This study examines the cost effectiveness of a model of remote area oral health service. Retrospective financial analysis. Rural and remote primary health services. Clinical activity data and associated cost data relating to the provision of a networked visiting oral health service by the Centre for Rural and Remote Oral Health formed the basis of the study data frameset. The cost-effectiveness of the Centre's model of service provision at five rural and remote sites in Western Australia during the calendar years 2006, 2008 and 2010 was examined in the study. Calculations of the service provision costs and value of care provided were made using data records and the Fee Schedule of Dental Services for Dentists. The ratio of service provision costs to the value of care provided was determined for each site and was benchmarked against the equivalent ratios applicable to large scale government sector models of service provision. The use of networked models have been effective in other disciplines but this study is the first to show a networked hub and spoke approach of five spokes to one hub is cost efficient in remote oral health care. By excluding special cost-saving initiatives introduced by the Centre, the study examines easily translatable direct service provision costs against direct clinical care outcomes in some of Australia's most challenging locations. This study finds that networked hub and spoke models of care can be financially efficient arrangements in remote oral health care. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  12. 76 FR 20050 - Sunshine Act Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-11

    ... LEGAL SERVICES CORPORATION Sunshine Act Meetings Notice DATE AND TIME: The Legal Services.... Promotion & Provision for the Delivery 9 a.m. of Legal Services Committee. 2. Operations & Regulations... provisions of the Legal Services Corporation's implementing regulation, 45 CFR 1622.5(a) and (h), will not be...

  13. 42 CFR 480.103 - Statutory bases for disclosure of information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Statutory bases for disclosure of information. 480.103 Section 480.103 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Organizations (QIOs) General Provisions § 480.103 Statutory bases for disclosure of information. (a) Section...

  14. 42 CFR 480.103 - Statutory bases for disclosure of information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Statutory bases for disclosure of information. 480.103 Section 480.103 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Organizations (QIOs) General Provisions § 480.103 Statutory bases for disclosure of information. (a) Section...

  15. 42 CFR 480.103 - Statutory bases for disclosure of information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Statutory bases for disclosure of information. 480.103 Section 480.103 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Organizations (QIOs) General Provisions § 480.103 Statutory bases for disclosure of information. (a) Section...

  16. 42 CFR 480.103 - Statutory bases for disclosure of information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Statutory bases for disclosure of information. 480.103 Section 480.103 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Organizations (QIOs) General Provisions § 480.103 Statutory bases for disclosure of information. (a) Section...

  17. Health technology assessment of utilization, practice and ethical issues of self-pay services in the German ambulatory health care setting.

    PubMed

    Hunger, Theresa; Schnell-Inderst, Petra; Hintringer, Katharina; Schwarzer, Ruth; Seifert-Klauss, Vanadin; Gothe, Holger; Wasem, Jürgen; Siebert, Uwe

    2014-02-01

    The provision of self-pay medical services is common across health care systems, but understudied. According to the German Medical Association, such services should be medically necessary, recommended or at least justifiable, and requested by the patient. We investigated the empirical evidence regarding frequency and practice of self-pay services as well as related ethical, social, and legal issues (ELSI). A systematic literature search in electronic databases and a structured internet search on stakeholder websites with qualitative and quantitative information synthesis. Of 1,345 references, we included 64 articles. Between 19 and 53 % of insured persons received self-pay service offers from their physician; 16-19 % actively requested such services. Intraocular pressure measurement was the most common service, followed by ultrasound investigations. There is a major discussion about ELSI in the context of individual health services. Self-pay services are common medical procedures in Germany. However, the empirical evidence is limited in quality and extent, even for the most frequently provided services. Transparency of their provision should be increased and independent evidence-based patient information should be supplied.

  18. New directions in health sciences libraries in China.

    PubMed

    Xie, Zhiyun; Zhang, Jianjing

    2018-06-01

    This article briefly describes the services provided by Chinese health science libraries and the factors which influence service provision. Driven by new technologies and national initiatives, the key services delivered by Chinese health libraries in the last 10 years have been research support services (such as research impact assessment, support for data management), evidence-based medicine, systematic reviews, the promotion of health information literacy, and the development of institutional repositories. J.M. © 2018 Health Libraries Group.

  19. Utility, economic rationalism and the circumscription of agency.

    PubMed

    Dirita, P A; Parmenter, T R; Stancliffe, R J

    2008-07-01

    Great strides have been achieved over the past few decades in service provision for people with intellectual disability (ID). However, there has also been a growth in the use of economic rationalism and a related rise in managerialism in forming service provision outcomes. An account of the focus on process and means of provision directed within the managerialist agenda to determine how individual authority has become subsumed within patterns of dependence. An underlying influence of utilitarianism has led to a focus on servicing the average through service provision trajectories which in turn have weakened the pace for social change and perpetuated a vulnerable conception of people with ID. There has been a qualification of the idealised intent of providing individualised support, choice and recognition of the moral worth of people with ID into relative features of equality. There remains an overriding static conception of the person with ID within funding frameworks and service provision which relies on economic and rationalist depictions of the individual.

  20. 42 CFR 409.1 - Statutory basis.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... part is based on the identified provisions of the following sections of the Social Security Act: (a... dialysis, transplantation, and other services furnished to ESRD patients. [60 FR 50441, Sept. 29, 1995, as...

  1. 1 CFR 3.1 - Information services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 1 General Provisions 1 2011-01-01 2011-01-01 false Information services. 3.1 Section 3.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL SERVICES TO THE PUBLIC § 3.1 Information services. Except in cases where the time required would be excessive, information concerning the...

  2. 1 CFR 3.1 - Information services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 1 General Provisions 1 2010-01-01 2010-01-01 false Information services. 3.1 Section 3.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL SERVICES TO THE PUBLIC § 3.1 Information services. Except in cases where the time required would be excessive, information concerning the...

  3. 1 CFR 3.1 - Information services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 1 General Provisions 1 2014-01-01 2012-01-01 true Information services. 3.1 Section 3.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL SERVICES TO THE PUBLIC § 3.1 Information services. Except in cases where the time required would be excessive, information concerning the...

  4. 1 CFR 3.1 - Information services.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 1 General Provisions 1 2012-01-01 2012-01-01 false Information services. 3.1 Section 3.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL SERVICES TO THE PUBLIC § 3.1 Information services. Except in cases where the time required would be excessive, information concerning the...

  5. 1 CFR 3.1 - Information services.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 1 General Provisions 1 2013-01-01 2012-01-01 true Information services. 3.1 Section 3.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL SERVICES TO THE PUBLIC § 3.1 Information services. Except in cases where the time required would be excessive, information concerning the...

  6. Inequalities in healthcare provision for people with severe mental illness.

    PubMed

    Lawrence, David; Kisely, Stephen

    2010-11-01

    There are many factors that contribute to the poor physical health of people with severe mental illness (SMI), including lifestyle factors and medication side effects. However, there is increasing evidence that disparities in healthcare provision contribute to poor physical health outcomes. These inequalities have been attributed to a combination of factors including systemic issues, such as the separation of mental health services from other medical services, healthcare provider issues including the pervasive stigma associated with mental illness, and consequences of mental illness and side effects of its treatment. A number of solutions have been proposed. To tackle systemic barriers to healthcare provision integrated care models could be employed including co-location of physical and mental health services or the use of case managers or other staff to undertake a co-ordination or liaison role between services. The health care sector could be targeted for programmes aimed at reducing the stigma of mental illness. The cognitive deficits and other consequences of SMI could be addressed through the provision of healthcare skills training to people with SMI or by the use of peer supporters. Population health and health promotion approaches could be developed and targeted at this population, by integrating health promotion activities across domains of interest. To date there have only been small-scale trials to evaluate these ideas suggesting that a range of models may have benefit. More work is needed to build the evidence base in this area.

  7. 42 CFR 71.31 - General provisions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false General provisions. 71.31 Section 71.31 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Health Measures at U.S. Ports: Communicable Diseases § 71.31 General provisions. (a...

  8. 42 CFR 71.41 - General provisions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false General provisions. 71.41 Section 71.41 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S. Ports: Sanitary Inspection § 71.41 General provisions...

  9. 42 CFR 71.31 - General provisions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false General provisions. 71.31 Section 71.31 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Health Measures at U.S. Ports: Communicable Diseases § 71.31 General provisions. (a...

  10. 42 CFR 71.31 - General provisions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false General provisions. 71.31 Section 71.31 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Health Measures at U.S. Ports: Communicable Diseases § 71.31 General provisions. (a...

  11. 42 CFR 71.41 - General provisions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false General provisions. 71.41 Section 71.41 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S. Ports: Sanitary Inspection § 71.41 General provisions...

  12. 42 CFR 71.41 - General provisions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false General provisions. 71.41 Section 71.41 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S. Ports: Sanitary Inspection § 71.41 General provisions...

  13. TIDE: an intelligent home-based healthcare information & diagnostic environment.

    PubMed

    Abidi, S S

    1999-01-01

    The 21st century promises to usher in an era of Internet based healthcare services--Tele-Healthcare. Such services augur well with the on-going paradigm shift in healthcare delivery patterns, i.e. patient centred services as opposed to provider centred services and wellness maintenance as opposed to illness management. This paper presents a Tele-Healthcare info-structure TIDE--an 'intelligent' wellness-oriented healthcare delivery environment. TIDE incorporates two WWW-based healthcare systems: (1) AIMS (Automated Health Monitoring System) for wellness maintenance and (2) IDEAS (Illness Diagnostic & Advisory System) for illness management. Our proposal comes from an attempt to rethink the sources of possible leverage in improving healthcare; vis-à-vis the provision of a continuum of personalised home-based healthcare services that emphasise the role of the individual in self health maintenance.

  14. Changes in abortion service provision in Bihar and Jharkhand states, India between 2004 and 2013

    PubMed Central

    Singh, Kaushalendra K.; Li, Qingfeng; Fruhauf, Timothee; Tsui, Amy O.

    2018-01-01

    Background The Medical Termination of Pregnancy (MTP) Act of 1971 liberalized abortion laws in India. This study examines changes in abortion service provision and characteristics of abortion providers in Bihar and Jharkhand states, India between 2004 and 2013. Methods We used state-representative data from cross-sectional surveys of reproductive health service providers we conducted in 2004 (N = 1,323) and 2012/2013 (N = 1,020). We employed chi-squared tests to examine and compare abortion providers’ characteristics, and fitted separate multivariate logistic regression models for provision of surgical, medical, and any abortion services, respectively, adjusting for potential confounders to identify factors associated with abortion service provision at the two survey time points. Results Of providers interviewed in 2004 and 2012/2013, 63.7% and 84.5%, respectively, offered abortion services. Among abortion providers, 21.1% offered surgical and 10.7% offered medical abortions in 2004; 15.8% and 94.1% did so, respectively, in 2012/2013. Private providers were more likely than public providers to offer abortion services at both time points. Compared to female providers, male providers were significantly less likely to provide both surgical and medical abortions in 2004, and significantly less likely to provide surgical abortions in 2012/2013. Pharmacists and community health workers played increasingly important roles in abortion service provision, especially medical abortion, during the period. Conclusion This study documents important changes in abortion provision in the two Indian states during 2004–2013. PMID:29879132

  15. Enhancing the metalinguistic abilities of pre-service teachers via coursework targeting language structure knowledge.

    PubMed

    Purvis, Caralyn J; McNeill, Brigid C; Everatt, John

    2016-04-01

    Low metalinguistic knowledge of pre-service and in-service teachers is likely to restrict the provision of evidence-based literacy instruction in the classroom. Despite such concerns, relatively few studies have examined the effects of teacher preparation coursework in building pre-service teachers' language structure knowledge. This study examined the effects of 7 h of language structure coursework, delivered over 7 weeks, on 121 New Zealand pre-service teachers in their initial year of study. Changes in participants' phonological awareness, morphological awareness, and orthographic knowledge were tracked across the teaching period. The impact of the coursework for participants who presented with strong spelling (n = 24) and poor spelling (n = 24) ability was also compared. The cohort demonstrated significant gains across all measures. Strong spellers responded more favourably to the teaching than poor spellers, even when accounting for initial levels of meta-linguistic knowledge. Implications for the development of teacher preparation programmes that enhance the provision of effective literacy instruction are discussed.

  16. Ghana's National Health Insurance Scheme: a national level investigation of members' perceptions of service provision.

    PubMed

    Dixon, Jenna; Tenkorang, Eric Y; Luginaah, Isaac

    2013-08-23

    Ghana's National Health Insurance Scheme (NHIS), established into law in 2003 and implemented in 2005 as a 'pro-poor' method of health financing, has made great progress in enrolling members of the general population. While many studies have focused on predictors of enrolment this study offers a novel analysis of NHIS members' perceptions of service provision at the national level. Using data from the 2008 Ghana Demographic Health Survey we analyzed the perceptions of service provision as indicated by members enrolled in the NHIS at the time of the survey (n = 3468; m = 1422; f = 2046). Ordinal Logistic Regression was applied to examine the relationship between perceptions of service provision and theoretically relevant socioeconomic and demographic variables. Results demonstrate that wealth, gender and ethnicity all play a role in influencing members' perceptions of NHIS service provision, distinctive from its influence on enrolment. Notably, although wealth predicted enrolment in other studies, our study found that compared to the poorest men and uneducated women, wealthy men and educated women were less likely to perceive their service provision as better/same (more likely to report it was worse). Wealth was not an important factor for women, suggesting that household gender dynamics supersede household wealth status in influencing perceptions. As well, when compared to Akan women, women from all other ethnic groups were about half as likely to perceive the service provision to be better/same. Findings of this study suggest there is an important difference between originally enrolling in the NHIS because one believes it is potentially beneficial, and using the NHIS and perceiving it to be of benefit. We conclude that understanding the nature of this relationship is essential for Ghana's NHIS to ensure its longevity and meet its pro-poor mandate. As national health insurance systems are a relatively new phenomenon in sub-Saharan Africa little is known about their long term viability; understanding user perceptions of service provision is an important piece of that puzzle.

  17. Acceptance of Internet-Based Health Care Services Among Households in Poland: Secondary Analysis of a Population-Based Survey

    PubMed Central

    2012-01-01

    Background Polish society is benefiting from growing access to the Internet, but the use of advanced e-services is still limited. The provision of Internet-based health services depends not only on the penetration of the Internet into society, but also on the acceptance of this technology by potential users. Objective The main objective of this study was focused on the assessment of predictors of acceptance of Internet use for provision of health services (eg, sociodemographic status, the use of information technologies, and consumption of health care services) among households in Poland. Methods The study was based on a secondary analysis of the dataset from the 2011 Social Diagnosis survey (a biannual survey conducted since 2001 about economic and non-economic aspects of household and individual living conditions in Poland). Analysis of the questionnaire results focused on the situations of the households included in the study. The predictors for 2 outcome variables describing the acceptance of households for Internet use for provision of a full health care service, or at least access to information and download of required forms, were assessed using multivariate logistic regression. Results After excluding those households that would not consider the use of health care services or for which predictor variables assumed missing values, the final analyses were conducted on data from 8915 households. Acceptance of the use of the Internet for provision of full health care services in Polish households was significantly higher among households in urban locations with ≥ 200,000 inhabitants than among households in rural areas; it was also higher with salaried employment as the source of income than with self-employment in agriculture (odds ratio [OR] = 0.53, 95% CI 0.40 - 0.70), retirement pension (OR = 0.46, 95% CI 0.39 - 0.54), disability pension (OR = 0.48, 95% CI 0.34 - 0.68), or with several simultaneous income sources (OR = 0.66; 95% CI 0.57 - 0.79). Furthermore, acceptance of Internet-based health care was higher in households with a higher monthly net income per capita (OR = 2.11, 95% CI 1.75 - 2.53 for households from the lowest and the highest income interval), among households with > 1 child aged < 15 years (OR = 1.38, 95% CI 1.20 - 1.59), among households with at least some books (with OR = 3.33, 95% CI 2.39 - 4.64 for household with no books and those with over 500 books). Acceptance was also higher in households with a computer (OR = 1.86, 95% CI 1.35 - 2.56), Internet access (OR = 1.95, 95% CI 1.37 - 2.76), and Internet access for a longer duration (OR = 1.36, 95% CI 1.06 - 1.75 and OR = 1.81, 95% CI 1.40 - 2.33 for households with access < 1 year versus those with access for 1-5 years and > 5 years, respectively). Greater self-declared confidence in using technology was also associated with higher acceptance of the Internet for health care services (OR = 2.94, 95% CI 2.21 - 3.91 for the least confident households versus those with the highest confidence). Furthermore, recent use of health care services increased acceptance of using the Internet for at least some health-related services (OR = 1.49, 95% CI 1.16 - 1.91), but not for full provision of online health care services (OR = 1.20, 95% CI 0.92 - 1.55). Neither the hospitalization of a member of a household nor the opinion about satisfying health care needs of a household affected the degree of acceptance. Conclusions The acceptance of health care services through the Internet is higher in households from larger cities, with stable income from an employee salary, as well as with higher income levels per capita. Furthermore, general computer and Internet use in the household influenced the perception of eHealth. Paradoxically, the use of health care services or the level of satisfaction with the coverage of the household’s health needs has a limited influence on acceptance of Internet-based health care services. PMID:23187116

  18. Providing Alternatives to Nursing Home Care: An Interorganizational Analysis.

    ERIC Educational Resources Information Center

    Austin, Carol D.

    The development of alternatives to institutionally based long-term care requires the creation of greater interdependence among community based agencies and the provision of appropriate interdependence as the foundation for coordinated service delivery. Theoretical models of interorganizational interdependence are examined and assessed for their…

  19. [Health care innovation from a territorial perspective: a call for a new approach].

    PubMed

    Costa, Laís Silveira; Gadelha, Carlos Augusto Grabois; Maldonado, José

    2012-12-01

    Innovation plays an increasingly important role in health care, partly because it is responsible for a significant share of national investment in research and development, and partly because of its industrial and service provision base, which provides a conduit to future technology. The relationship between health care and development is also strengthened as a result of the leading role of health care in generating innovation. Nevertheless, Brazil's health care production base is persistently weak, hindering both universal provision of health care services and international competitiveness. This article, based on the theoretical framework of Political Economy and innovation systems, has sought to identify variables in subnational contexts that influence the dynamic of innovation generation in health care. To this end, the theoretical approach used lies on the assumption that innovation is a contextualized social process and that the production base in healthcare will remain weak if new variables involved in the dynamic of innovation are not taken into account.

  20. 42 CFR 67.101 - Purpose and scope.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... services and procedures; projects to improve methods and data bases for outcomes and effectiveness research... regulations of this subpart also contain provisions respecting confidentiality of research data, control of data, and availability of information. ...

  1. 42 CFR 67.101 - Purpose and scope.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... services and procedures; projects to improve methods and data bases for outcomes and effectiveness research... regulations of this subpart also contain provisions respecting confidentiality of research data, control of data, and availability of information. ...

  2. 42 CFR 67.101 - Purpose and scope.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... services and procedures; projects to improve methods and data bases for outcomes and effectiveness research... regulations of this subpart also contain provisions respecting confidentiality of research data, control of data, and availability of information. ...

  3. 42 CFR 67.101 - Purpose and scope.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... services and procedures; projects to improve methods and data bases for outcomes and effectiveness research... regulations of this subpart also contain provisions respecting confidentiality of research data, control of data, and availability of information. ...

  4. 49 CFR 37.191 - Special provision for small mixed-service operators.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false Special provision for small mixed-service operators. 37.191 Section 37.191 Transportation Office of the Secretary of Transportation TRANSPORTATION... small mixed-service operators. (a) For purposes of this section, a small mixed-service operator is a...

  5. 49 CFR 37.191 - Special provision for small mixed-service operators.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false Special provision for small mixed-service operators. 37.191 Section 37.191 Transportation Office of the Secretary of Transportation TRANSPORTATION... small mixed-service operators. (a) For purposes of this section, a small mixed-service operator is a...

  6. 49 CFR 37.191 - Special provision for small mixed-service operators.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Special provision for small mixed-service operators. 37.191 Section 37.191 Transportation Office of the Secretary of Transportation TRANSPORTATION... small mixed-service operators. (a) For purposes of this section, a small mixed-service operator is a...

  7. 49 CFR 37.191 - Special provision for small mixed-service operators.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false Special provision for small mixed-service operators. 37.191 Section 37.191 Transportation Office of the Secretary of Transportation TRANSPORTATION... small mixed-service operators. (a) For purposes of this section, a small mixed-service operator is a...

  8. 75 FR 35989 - Facilitating the Provision of Fixed and Mobile Broadband Access, Educational and Other Advanced...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-24

    ...] Facilitating the Provision of Fixed and Mobile Broadband Access, Educational and Other Advanced Services in the...), clarifying the requirements necessary for Broadband Radio Service (BRS) and Educational Broadband Service (EBS) licensees to demonstrate substantial service and ensure that BRS licensees of new initial...

  9. Acquisition Reform in House and Senate Passed Versions of the FY2016 National Defense Authorization Act (H.R. 1735)

    DTIC Science & Technology

    2015-07-02

    defense acquisitions may depend less on the extent to which provisions of the bill make substantive changes to acquisitions...1 Because the House Armed Services Committee’s focus on small business predates the current reform effort, and because small... business provisions also affect only a specific segment of the industrial base, not the overall acquisition system, such sections were excluded from

  10. Community pharmacists and mental illness: a survey of service provision, stigma, attitudes and beliefs.

    PubMed

    Giannetti, Vincent; Caley, Charles F; Kamal, Khalid M; Covvey, Jordan R; McKee, Jerry; Wells, Barbara G; Najarian, Dean M; Dunn, Tyler J; Vadagam, Pratyusha

    2018-06-04

    Background Half of Americans experience mental illness during their lifetime. Significant opportunity exists for community pharmacists to deliver services to these patients; however, personal and practice-related barriers may prevent full engagement. Objective To assess the demographics, practice characteristics, service provision, stigma, attitudes and beliefs of a national sample of community pharmacists towards individuals with mental illness. Setting National random sample of 3008 community pharmacists in the USA. Method 101-item cross-sectional mailed survey questionnaire on: (1) demographics, (2) knowledge and practice characteristics, (3) provision of clinical pharmacy services, and (4) comparative opinions. Main outcome measure Scaled measures of service provision (comfort, confidence, willingness and interest) and comparative opinions (stigma, attitudes and beliefs) of mental illness, four linear regression models to predict service provision. Results A total of 239 responses were received (response rate 7.95%). Across pharmacy services, ratings for willingness/interest were higher than those for comfort/confidence. Pharmacists who reported providing medication therapy management (MTM) services for patients reported higher comfort (18.36 vs. 17.46, p < 0.05), confidence (17.73 vs. 16.01, p < 0.05), willingness (20.0 vs. 18.62, p < 0.05) and interest (19.13 vs. 17.66, p < 0.05). Pharmacists with personal experience with mental illness also resulted in higher scores across all four domains of service provision, lower levels of stigma (18.28 vs. 20.76, p < 0.05) and more positive attitudes (52.24 vs. 50.53, p < 0.01). Regression analyses demonstrated increased frequency of MTM service delivery and more positive attitudes as significantly predictive across all four models for comfort, confidence, willingness and interest. Increased delivery of pharmacy services was significantly associated with both willingness and interest to provide mental illness-specific services. Conclusion Despite willingness/interest to provide services to patients with mental illness, decreased levels of comfort/confidence remain service-related barriers for community pharmacists.

  11. 3 CFR - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Presidential Documents Other Presidential Documents Memorandum of December 27, 2013 Provision of Aviation Insurance Coverage for Commercial...

  12. 3 CFR - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Presidential Documents Other Presidential Documents Memorandum of September 29, 2010 Provision of Aviation Insurance Coverage for Commercial...

  13. 3 CFR - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Presidential Documents Other Presidential Documents Memorandum of September 28, 2011 Provision of Aviation Insurance Coverage for Commercial...

  14. 3 CFR - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Presidential Documents Other Presidential Documents Memorandum of September 27, 2012 Provision of Aviation Insurance Coverage for Commercial...

  15. 3 CFR - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Presidential Documents Other Presidential Documents Memorandum of August 21, 2009 Provision of Aviation Insurance Coverage for Commercial...

  16. 78 FR 19797 - Designation & Determination Pursuant to the Foreign Missions Act; Concerning the Provision of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ... DEPARTMENT OF STATE [Public Notice 8266] Designation & Determination Pursuant to the Foreign Missions Act; Concerning the Provision of Application Services for Visas, Passports and Similar Documents... designate the provision of application services with respect to visas, passports and similar documents by...

  17. 29 CFR 552.108 - Child labor provisions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Child labor provisions. 552.108 Section 552.108 Labor... OF THE FAIR LABOR STANDARDS ACT TO DOMESTIC SERVICE Interpretations § 552.108 Child labor provisions. Congress made no change in section 12 as regards domestic service employees. Accordingly, the child labor...

  18. 29 CFR 552.108 - Child labor provisions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Child labor provisions. 552.108 Section 552.108 Labor... OF THE FAIR LABOR STANDARDS ACT TO DOMESTIC SERVICE Interpretations § 552.108 Child labor provisions. Congress made no change in section 12 as regards domestic service employees. Accordingly, the child labor...

  19. 29 CFR 552.108 - Child labor provisions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Child labor provisions. 552.108 Section 552.108 Labor... OF THE FAIR LABOR STANDARDS ACT TO DOMESTIC SERVICE Interpretations § 552.108 Child labor provisions. Congress made no change in section 12 as regards domestic service employees. Accordingly, the child labor...

  20. 29 CFR 552.108 - Child labor provisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Child labor provisions. 552.108 Section 552.108 Labor... OF THE FAIR LABOR STANDARDS ACT TO DOMESTIC SERVICE Interpretations § 552.108 Child labor provisions. Congress made no change in section 12 as regards domestic service employees. Accordingly, the child labor...

  1. 29 CFR 552.108 - Child labor provisions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Child labor provisions. 552.108 Section 552.108 Labor... OF THE FAIR LABOR STANDARDS ACT TO DOMESTIC SERVICE Interpretations § 552.108 Child labor provisions. Congress made no change in section 12 as regards domestic service employees. Accordingly, the child labor...

  2. 76 FR 19792 - Notice of Intent To Award-Grant Awards for the Provision of Civil Legal Services to Eligible...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-08

    ... LEGAL SERVICES CORPORATION Notice of Intent To Award--Grant Awards for the Provision of Civil Legal Services to Eligible Clients in Louisiana (Service Area LA- 1) Beginning June 2011 AGENCY: Legal...: The Legal Services Corporation (LSC) hereby announces its intention to award grants and contracts to...

  3. 75 FR 62429 - Notice of Intent to Award-Grant Awards for the Provision of Civil Legal Services to Eligible Low...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-08

    ... LEGAL SERVICES CORPORATION Notice of Intent to Award--Grant Awards for the Provision of Civil Legal Services to Eligible Low-Income Clients Beginning January 1, 2011 AGENCY: Legal Services... economical and effective delivery of high quality civil legal services to eligible low-income clients...

  4. Best Practices in Supporting Persistence of Distant Education Students through Integrated Web-Based Systems

    ERIC Educational Resources Information Center

    McCracken, Holly

    2009-01-01

    The importance of the interconnectedness of academic, student, and technical support processes intrinsic to the provision of on-line instruction has been frequently depicted as a "service Web," with students at the center of the infrastructure. However, as programming to support distance learning continues to develop, such service Webs have grown…

  5. A U.S. Human Well-being Index (HWBI) for Multiple Scales: Linking Services Provisioning to Human Well-being Endpoints (2000-2010)

    EPA Science Inventory

    objective of this report is to characterize well-being at multiple scales in order to evaluate the relationship of service flows in terms of sustainable well-being. The HWBI results presented represent snapshot assessments for the 2000-2010 time period. Based on the spatial and t...

  6. School Psychologists as Mental Health Providers: The Impact of Staffing Ratios and Medicaid on Service Provisions

    ERIC Educational Resources Information Center

    Eklund, Katie; Meyer, Lauren; Way, Samara; Mclean, Deija

    2017-01-01

    As one out of five children in the United States demonstrate some type of mental or behavioral health concern warranting additional intervention, federal policies have emphasized the need for school-based mental health (SBMH) services and an expansion of Medicaid reimbursement for eligible children and families. Most youth access mental health…

  7. Dynamics of ecosystem services provided by subtropical forests in Southeast China during succession as measured by donor and receiver value

    EPA Science Inventory

    The trends in the provision of ecosystem services during restoration and succession of subtropical forests and plantations were quantified, in terms of both receiver and donor values, based on a case study of a 3-step secondary succession series that included a 400-year-old subtr...

  8. Denmark's National Family Guidance Program: A Preventive Mental Health Program for Children and Families.

    ERIC Educational Resources Information Center

    Wagner, Marsden

    This document describes Denmark's 10-year (1965-75) program of cost-effective provision of social services to crisis families with children under the Danish 1964 Child and Youth Welfare Act. The program, voluntary and open to all families, provided preventive psychosocial services for children based on a family support system. The background to…

  9. The General Agreement on Trade in Services (GATS): Why You Need To Be Concerned.

    ERIC Educational Resources Information Center

    Schacter, Noel

    2002-01-01

    The General Agreement on Trade in Services gives priority to international commercial interests, and unless this trend is countered, public policy authority for education will shift to the World Trade Organization. While the Canadian government has stated that public education systems are not negotiable, the exclusion provisions it bases that…

  10. Financial Operations of Distance Education and Campus-Based Education: A Zambian Case

    ERIC Educational Resources Information Center

    Chakupalesa, Anna Bucheba; Panda, Santosh

    2012-01-01

    Distance education is often hailed as the answer to the worlds problems of educational provision particularly in the developing countries of which African governments are no exception. Distance education has been used for both pre-service and in-service education, and at most levels of education. However, other than the structural differences…

  11. Public economics of hitchhiking species and tourism-based risk to ecosystem services

    Treesearch

    Travis W. Warziniack; David Finnoff; Jason F. Shogren

    2013-01-01

    This paper is the first to examine the public economics of exportbased externalities arising within the provisioning of ecosystem services, with direct application to policies to prevent the spread of hitchhiking invasive species. We find when risk enters through exports, policy makers face a tradeoff between welfare improvements and reducing risk of invasion....

  12. Service Oriented Architecture Security Risks and their Mitigation

    DTIC Science & Technology

    2012-10-01

    this section can be mitigated by making use of suitable authentication , confidentiality, integrity, and authorisation standards such as Security...for authorisation . Machines/non-human users should be clearly identified and authenticated by the identity provision and authentication services... authentication , any security related attributes for the subject, and the authorisation decisions given based on the security and privilege attributes

  13. 77 FR 28876 - Information Collections Being Submitted for Review and Approval to the Office of Management and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-16

    ... description of the applicant's organizational structure, and the names of its executives, officers, members of.... Title: Structure and Practices of the Video Relay Service Program, Second Report and Order and Order, CG... prevent fraud and abuse, and ensure quality service, in the provision of Internet-based forms of...

  14. How Far Is Leadership Distributed in Extended Services Provision?

    ERIC Educational Resources Information Center

    Fuller, Kay; Parsons, Sarah; MacNab, Natasha; Thomas, Hywel

    2013-01-01

    This study focuses on the leadership engagement of children, young people (CYP) and their families in six school-based extended services (ES) clusters in a single, large, urban local authority in England. Empirical research was carried out in two strands of activity that focused on outcomes and experiences for CYP and leaders and leadership.…

  15. Treating first episode psychosis--the service users' perspective: a focus group evaluation.

    PubMed

    O'Toole, M S; Ohlsen, R I; Taylor, T M; Purvis, R; Walters, J; Pilowsky, L S

    2004-06-01

    UK national guidance has prioritized developing specialist services for first episode psychosis. Such services are in the early stages of development and a definitive treatment model has yet to be established. The aim of this study was to explore service users' experiences of a first episode intervention designed along evidence-based 'best practice' guidelines and to establish specific elements seen as effective to help inform future service planning and provision. Twelve users of a specialist first episode service participated in focus groups. These were then analyzed using Interpretative Phenomenological Analysis, a specialized form of content analysis. Key elements identified by the service users included the 'human' approach as a key to the recovery process, being involved in treatment decisions, flexibility of appointments, high nurse to patient ratio, reduction in psychotic symptoms, increased confidence and independence and the provision of daily structure. To our knowledge, this is the first systematic qualitative evaluation of users' experience of a specialist first episode treatment intervention. Our findings indicate that adherence to best practice guidelines was appreciated. Regular focus groups provide a continuous audit cycle incorporating service improvements in line with government recommendations, centrally informed by the service users' and caregivers' perspective.

  16. Provision of QoS for Multimedia Services in IEEE 802.11 Wireless Network

    DTIC Science & Technology

    2006-10-01

    Provision of QoS for Multimedia Services in IEEE 802.11 Wireless Network. In Dynamic Communications Management (pp. 10-1 – 10-16). Meeting Proceedings...mechanisms have been used for managing a limited bandwidth link within the IPv6 military narrowband network. The detailed description of these...confirms that implemented video rate adaptation mechanism enables improvement of qaulity of video transfer. Provision of QoS for Multimedia Services in

  17. Commissioning of specialist palliative care services in England.

    PubMed

    Lancaster, Harriet; Finlay, Ilora; Downman, Maxwell; Dumas, James

    2018-03-01

    Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise. We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services. 29 CCGs provided information about the number of patients with some form of palliative care needs in their population. For specialist palliative care services, CCGs allocated budgets ranging from £51.83 to £2329.19 per patient per annum. 163 CCGs (77.90%) currently commission 7-day admission to their specialist palliative care beds. 82.84% of CCGs commission 7-day specialist palliative care services in patients' own homes and out-of-hours services rely heavily on hospice provision. 64 CCGs (31.37%) commission pain control teams, the majority of whom only operate in regular working hours. 68.14% of CCGs reported commissioning palliative care education of any sort for healthcare professionals and 44.85% of CCGs had no plans to update or review their palliative care services. The most important finding from this exercise is that the information CCGs hold about their population and services is not standardised. However, information based on data that are more objective, for example, population and total budget for palliative care, demonstrate wide variations in commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Use of fees to fund local public health services in Western Massachusetts.

    PubMed

    Shila Waritu, A; Bulzacchelli, Maria T; Begay, Michael E

    2015-01-01

    Recent budget cuts have forced many local health departments (LHDs) to cut staff and services. Setting fees that cover the cost of service provision is one option for continuing to fund certain activities. To describe the use of fees by LHDs in Western Massachusetts and determine whether fees charged cover the cost of providing selected services. A cross-sectional descriptive analysis was used to identify the types of services for which fees are charged and the fee amounts charged. A comparative cost analysis was conducted to compare fees charged with estimated costs of service provision. Fifty-nine LHDs in Western Massachusetts. Number of towns charging fees for selected types of services; minimum, maximum, and mean fee amounts; estimated cost of service provision; number of towns experiencing a surplus or deficit for each service; and average size of deficits experienced. Enormous variation exists both in the types of services for which fees are charged and fee amounts charged. Fees set by most health departments did not cover the cost of service provision. Some fees were set as much as $600 below estimated costs. These results suggest that considerations other than costs of service provision factor into the setting of fees by LHDs in Western Massachusetts. Given their limited and often uncertain funding, LHDs could benefit from examining their fee schedules to ensure that the fee amounts charged cover the costs of providing the services. Cost estimates should include at least the health agent's wage and time spent performing inspections and completing paperwork, travel expenses, and cost of necessary materials.

  19. Recovery-oriented service provision and clinical outcomes in assertive community treatment.

    PubMed

    Kidd, Sean A; George, Lindsey; O'Connell, Maria; Sylvestre, John; Kirkpatrick, Helen; Browne, Gina; Odueyungbo, Adefowope O; Davidson, Larry

    2011-01-01

    While the term "recovery" is routinely referenced in clinical services and health policy, few studies have examined the relationship between recovery-oriented service provision and client outcomes. The present study was designed to examine the relationship between recovery-orientation of service provision for persons with severe mental illnesses and outcomes in Assertive Community Treatment (ACT). Client, family, staff, and manager ratings of service recovery-orientation and outcomes across a range of service utilization and community functioning indicators were examined among 67 ACT teams in Ontario, Canada. Significant associations were found between ratings of recovery-oriented service provision and better outcomes in the domains of legal involvement, hospitalization days, education involvement, and employment. Results were not uniformly positive or consistent, however, across stakeholder Recovery Self-Assessment (RSA) ratings or outcomes. These findings provide some preliminary support for an association between recovery-oriented service delivery for persons with severe mental illnesses and better outcomes. In line with the current practice commentary, this association would suggest the importance of evaluating and cultivating recovery-oriented values and practices in ACT contexts. This is a particularly salient point given that ACT standards minimally address key domains of recovery-oriented service provision. Further study is required, however, to determine if these findings apply to the implementation of ACT in other jurisdictions or generalize to other community support programs.

  20. Information Assurance in Wireless Networks

    NASA Astrophysics Data System (ADS)

    Kabara, Joseph; Krishnamurthy, Prashant; Tipper, David

    2001-09-01

    Emerging wireless networks will contain a hybrid infrastructure based on fixed, mobile and ad hoc topologies and technologies. In such a dynamic architecture, we define information assurance as the provisions for both information security and information availability. The implications of this definition are that the wireless network architecture must (a) provide sufficient security measures, (b) be survivable under node or link attack or failure and (c) be designed such that sufficient capacity remains for all critical services (and preferably most other services) in the event of attack or component failure. We have begun a research project to investigate the provision of information assurance for wireless networks viz. survivability, security and availability and here discuss the issues and challenges therein.

  1. Service provision and quality outcomes in home health for rural Medicare beneficiaries at high risk for unplanned care.

    PubMed

    Mroz, Tracy M; Andrilla, C Holly A; Garberson, Lisa A; Skillman, Susan M; Patterson, Davis G; Larson, Eric H

    2018-06-11

    Multiple barriers exist to providing home health care in rural areas. This study examined relationships between service provision and quality outcomes among rural, fee-for-service Medicare beneficiaries who received home health care between 2011 and 2013 for conditions associated with high-risk for unplanned care. More skilled nursing visits, visits by more types of providers, more timely care, and shorter lengths of stay were associated with significantly higher odds of hospital readmission and emergency department use and significantly lower odds of community discharge. Results may indicate unmeasured clinical severity and care needs among this population. Additional research regarding the accuracy of current severity measures and adequacy of case-mix adjustment for quality metrics is warranted, especially given the continued focus on value-based payment policies.

  2. Spatial dynamics of ecosystem service flows: a comprehensive approach to quantifying actual services

    USGS Publications Warehouse

    Bagstad, Kenneth J.; Johnson, Gary W.; Voigt, Brian; Villa, Ferdinando

    2013-01-01

    Recent ecosystem services research has highlighted the importance of spatial connectivity between ecosystems and their beneficiaries. Despite this need, a systematic approach to ecosystem service flow quantification has not yet emerged. In this article, we present such an approach, which we formalize as a class of agent-based models termed “Service Path Attribution Networks” (SPANs). These models, developed as part of the Artificial Intelligence for Ecosystem Services (ARIES) project, expand on ecosystem services classification terminology introduced by other authors. Conceptual elements needed to support flow modeling include a service's rivalness, its flow routing type (e.g., through hydrologic or transportation networks, lines of sight, or other approaches), and whether the benefit is supplied by an ecosystem's provision of a beneficial flow to people or by absorption of a detrimental flow before it reaches them. We describe our implementation of the SPAN framework for five ecosystem services and discuss how to generalize the approach to additional services. SPAN model outputs include maps of ecosystem service provision, use, depletion, and flows under theoretical, possible, actual, inaccessible, and blocked conditions. We highlight how these different ecosystem service flow maps could be used to support various types of decision making for conservation and resource management planning.

  3. Expansion in the private sector provision of institutional delivery services and horizontal equity: evidence from Nepal and Bangladesh

    PubMed Central

    Hotchkiss, David R; Godha, Deepali; Do, Mai

    2014-01-01

    Wealth-related inequity in the use of maternal healthcare services continues to be a substantial problem in most low- and middle-income countries. One strategic approach to increase the use of appropriate maternal healthcare services is to encourage the expansion of the role of the private sector. However, critics of such an approach argue that increasing the role of the private sector will lead to increased inequity in the use of maternal healthcare services. This article explores this issue in two South Asian countries that have traditionally had high rates of maternal mortality—Nepal and Bangladesh. The study is based on multiple rounds of nationally representative household survey data collected in Nepal and Bangladesh from 1996 to 2011. The methodology involves estimating a concentration index for each survey to assess changes in wealth-related inequity in the use of institutional delivery assistance over time. The results of the study suggest that the expansion of private sector supply of institutional-based delivery services in Nepal and Bangladesh has not led to increased horizontal inequity. In fact, in both countries, inequity was shown to have decreased over the study period. The study findings also suggest that the provision of government delivery services to the poor protects against increased wealth-related inequity in service use. PMID:25012794

  4. Availability of family planning services and quality of counseling by faith-based organizations: a three country comparative analysis.

    PubMed

    Barden-O'Fallon, Janine

    2017-05-08

    Faith-based organizations (FBOs) have a long history of providing health services in developing countries and are important contributors to healthcare systems. Support for the wellbeing of women, children, and families is evidenced through active participation in the field of family planning (FP). However, there is little quantitative evidence on the availability or quality of FP services by FBOs. The descriptive analysis uses facility-level data collected through recent Service Provision Assessments in Malawi (2013-14), Kenya (2010), and Haiti (2012) to examine 11 indicators of FP service and method availability and nine indicators of comprehensive and quality counseling. The indicators include measures of FP service provision, method mix, method stock, the provision of accurate information, and the discussion of reproductive intentions, client's questions/concerns, prevention of sexually transmitted infections, and return visits, among others. Pearson's Chi-square test is used to assess the selected indicators by managing authority (FBO, public, and other private sector) to determine statistical equivalence. Results show that FBOs are less likely to offer FP services than other managing authorities (p < 0.05). For example, 69% of FBOs in Kenya offer FP services compared to 97% of public facilities and 83% of other private facilities. Offering long-acting or permanent methods in faith-based facilities is especially low (43% in Malawi, 29% in Kenya and 39% in Haiti). There were few statistically significant differences between the managing authorities in comprehensive and quality counseling indicators. Interestingly, Haitian FBOs often perform as well or better than public sector health facilities on counseling indicators, such as discussion of a return visit (79% of FBO providers vs. 68% of public sector providers) and discussion of client concerns/questions (52% vs. 49%, respectively). Results from this analysis indicate that there is room for improvement in the availability of FP services by FBOs in these countries. Quality of counseling should be improved by all managing authorities in the three countries, as indicated by low overall coverage for practices such as ensuring confidentiality (22% in Malawi, 47% in Kenya and 12% in Haiti), discussion of sexually transmitted infections (18%, 25%, 17%, respectively), and providing services to youth (53%, 27%, 32%, respectively).

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

    PubMed

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

    2005-12-01

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

  6. Palliative care needs of terminally ill people living alone: a service provider perspective.

    PubMed

    Aoun, Samar M; Wall, David; Kristjanson, Linda J; Shahid, Shaouli

    2013-01-01

    Community-based palliative care services face challenges in meeting the needs of terminally ill clients who live alone without a primary caregiver. Yet, there is a dearth of literature on the perceptions of health service providers (HSPs) regarding the care needs and possible management options to assist this growing group to remain at home. This paper investigated the support needs of people living alone with a terminal illness from a service provider perspective. In depth semi-structured interviews were conducted with nine HSPs from community based services in three Australian states. Four main themes emerged: care challenges, differences in care provision, appropriate approaches to care and essentials for an effective service such as 24 h care, cost-free provision of personal alarm systems, supported and coordinated housekeeping services, funded respite care and financial care packages. HSPs expressed a respect for the autonomy and independence of the clients, yet felt pressured to ensure that safe and attentive care was possible. HSPs recognised the central importance of maintaining the independence and autonomy of palliative care clients living alone. This study is the first in-depth account of what HSPs perceive they need to effectively look after home alone dying clients. The study provided directions to inform service planning for this growing and challenging population group regarding adequate and timely services that will lead to more complying with the clients' wishes, more care being delivered at home, a reduction in hospitalisations, a better quality of life and a capacity to die at home.

  7. Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?

    PubMed

    Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna

    2016-02-06

    Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.

  8. From theoretical to actual ecosystem services: mapping beneficiaries and spatial flows in ecosystem service assessments

    USGS Publications Warehouse

    Bagstad, Kenneth J.; Villa, Ferdinando; Batker, David; Harrison-Cox, Jennifer; Voigt, Brian; Johnson, Gary W.

    2014-01-01

    Ecosystem services mapping and modeling has focused more on supply than demand, until recently. Whereas the potential provision of economic benefits from ecosystems to people is often quantified through ecological production functions, the use of and demand for ecosystem services has received less attention, as have the spatial flows of services from ecosystems to people. However, new modeling approaches that map and quantify service-specific sources (ecosystem capacity to provide a service), sinks (biophysical or anthropogenic features that deplete or alter service flows), users (user locations and level of demand), and spatial flows can provide a more complete understanding of ecosystem services. Through a case study in Puget Sound, Washington State, USA, we quantify and differentiate between the theoretical or in situ provision of services, i.e., ecosystems’ capacity to supply services, and their actual provision when accounting for the location of beneficiaries and the spatial connections that mediate service flows between people and ecosystems. Our analysis includes five ecosystem services: carbon sequestration and storage, riverine flood regulation, sediment regulation for reservoirs, open space proximity, and scenic viewsheds. Each ecosystem service is characterized by different beneficiary groups and means of service flow. Using the ARtificial Intelligence for Ecosystem Services (ARIES) methodology we map service supply, demand, and flow, extending on simpler approaches used by past studies to map service provision and use. With the exception of the carbon sequestration service, regions that actually provided services to people, i.e., connected to beneficiaries via flow paths, amounted to 16-66% of those theoretically capable of supplying services, i.e., all ecosystems across the landscape. These results offer a more complete understanding of the spatial dynamics of ecosystem services and their effects, and may provide a sounder basis for economic valuation and policy applications than studies that consider only theoretical service provision and/or use.

  9. Trace saver: A tool for network service improvement and personalised analysis of user centric statistics

    NASA Astrophysics Data System (ADS)

    Bilal, Muhammad; Asfand-e-Yar, Mockford, Steve; Khan, Wasiq; Awan, Irfan

    2012-11-01

    Mobile technology is among the fastest growing technologies in today's world with low cost and highly effective benefits. Most important and entertaining areas in mobile technology development and usage are location based services, user friendly networked applications and gaming applications. However, concern towards network operator service provision and improvement has been very low. The portable applications available for a range of mobile operating systems which help improve the network operator services are desirable by the mobile operators. This paper proposes a state of the art mobile application Tracesaver, which provides a great achievement over the barriers in gathering device and network related information, for network operators to improve their network service provision. Tracesaver is available for a broad range of mobile devices with different mobile operating systems and computational capabilities. The availability of Tracesaver in market has proliferated over the last year since it was published. The survey and results show that Tracesaver is being used by millions of mobile users and provides novel ways of network service improvement with its highly user friendly interface.

  10. 42 CFR 483.118 - Residents and applicants determined not to require NF level of services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... provision of specialized services for the mental illness or mental retardation. (2) Short term residents... provision of, specialized services for the mental illness or mental retardation. (3) For the purpose of...) Applicants who do not require NF services. If the State mental health or mental retardation authority...

  11. Service Provision to Students: Where the Gown Best Fits

    ERIC Educational Resources Information Center

    Schulz, Lucy; Szekeres, Judy

    2008-01-01

    One of the challenges facing those responsible for service provision in universities is ensuring that service is provided at the right point in the organisation. Service delivery points can exist at the school/department level, faculty/division level or central unit/university wide level. This does not always follow organisational logic, common…

  12. 20 CFR 670.760 - How will Job Corps coordinate with other agencies?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... students; (2) Participant assessment; (3) Pre-employment and work maturity skills training; (4) Work-based learning; (5) Job search, occupational, and basic skills training; and (6) Provision of continued services...

  13. 20 CFR 670.760 - How will Job Corps coordinate with other agencies?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... students; (2) Participant assessment; (3) Pre-employment and work maturity skills training; (4) Work-based learning; (5) Job search, occupational, and basic skills training; and (6) Provision of continued services...

  14. 20 CFR 670.760 - How will Job Corps coordinate with other agencies?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... students; (2) Participant assessment; (3) Pre-employment and work maturity skills training; (4) Work-based learning; (5) Job search, occupational, and basic skills training; and (6) Provision of continued services...

  15. 47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

  16. 47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

  17. 47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

  18. 47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

  19. 31 CFR 560.416 - Brokering services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... provision of goods, services or technology, from whatever source, to or from Iran or the Government of Iran... the Government of Iran; (3) Act as broker for the provision of financing, a financial guarantee or an extension of credit by any person to Iran or the Government of Iran; (4) Act as a broker for the provision...

  20. 31 CFR 560.416 - Brokering services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... provision of goods, services or technology, from whatever source, to or from Iran or the Government of Iran... the Government of Iran; (3) Act as broker for the provision of financing, a financial guarantee or an extension of credit by any person to Iran or the Government of Iran; (4) Act as a broker for the provision...

  1. 31 CFR 560.416 - Brokering services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... provision of goods, services or technology, from whatever source, to or from Iran or the Government of Iran... the Government of Iran; (3) Act as broker for the provision of financing, a financial guarantee or an extension of credit by any person to Iran or the Government of Iran; (4) Act as a broker for the provision...

  2. 76 FR 36400 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ...-000 and AD10-13-000] Third-Party Provision of Ancillary Services; Accounting and Financial Reporting... current accounting and reporting requirements as applied to electric storage. As such, the Commission... the technologies used for such provision; and the adequacy of current accounting and reporting...

  3. Exploring views on long term rehabilitation for people with stroke in a developing country: findings from focus group discussions

    PubMed Central

    2014-01-01

    Background The importance of long term rehabilitation for people with stroke is increasingly evident, yet it is not known whether such services can be materialised in countries with limited community resources. In this study, we explored the perception of rehabilitation professionals and people with stroke towards long term stroke rehabilitation services and potential approaches to enable provision of these services. Views from providers and users are important in ensuring whatever strategies developed for long term stroke rehabilitations are feasible and acceptable. Methods Focus group discussions were conducted involving 15 rehabilitation professionals and eight long term stroke survivors. All recorded conversations were transcribed verbatim and analysed using the principles of qualitative research. Results Both groups agreed that people with stroke may benefit from more rehabilitation compared to the amount of rehabilitation services presently provided. Views regarding the unavailability of long term rehabilitation services due to multi-factorial barriers were recognised. The groups also highlighted the urgent need for the establishment of community-based stroke rehabilitation centres. Family-assisted home therapy was viewed as a potential approach to continued rehabilitation for long term stroke survivors, given careful planning to overcome several family-related issues. Conclusions Barriers to the provision of long term stroke rehabilitation services are multi-factorial. Establishment of community-based stroke rehabilitation centres and training family members to conduct home-based therapy are two potential strategies to enable the continuation of rehabilitation for long term stroke survivors. PMID:24606911

  4. Family-centred care delivery

    PubMed Central

    Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

    2013-01-01

    Abstract Objective To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Design Cross-sectional study. Setting Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. Participants A total of 137 practices, 363 providers, and 5144 patients. Main outcome measures Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Results Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Conclusion Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC. PMID:24235195

  5. 47 CFR 90.363 - Grandfathering provisions for existing AVM licensees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Grandfathering provisions for existing AVM licensees. 90.363 Section 90.363 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES Intelligent Transportation Systems Radio Service...

  6. Provision of ambulatory health services in Poland: a case study from Krakow.

    PubMed

    Chawla, Mukesh; Berman, Peter; Windak, Adam; Kulis, Marzena

    2004-01-01

    This study provides a comprehensive picture of the organization and delivery of ambulatory health care services in Poland. A main finding of the study is that, following the introduction of health insurance in 1999, the newly introduced Sickness Funds have become the main players in the medical services market, introducing new bidding procedures and contracts for provision of medical services. Contracts, and negotiations which precede them, have introduced elements of market competition, which has affected the number and types of services provided by health care centers operating under a contract. The health financing reforms have led to an even playing field for public and non-public providers, marked by a proliferation of structurally smaller health units. The introduction of a market environment has changed the way in which providers are compensated, with a discernible shift away from salary-based systems to capitation and fee-for-service compensation. The analysis of the provider market for outpatient care underscores the importance of understanding the organization and supply of health services, particularly insofar as it relates to the design of appropriate financial and other incentives for providers of health services and of policy interventions necessary for achieving systemic changes.

  7. How does outcome-based funding affect service delivery? An analysis of consequences within employment services for people living with serious mental illness.

    PubMed

    Gewurtz, Rebecca E; Cott, Cheryl; Rush, Brian; Kirsh, Bonnie

    2015-01-01

    This paper explores the impact of outcome-based funding on service delivery within employment services for people with serious mental illness. It draws on a case study of a policy change in the provincial disability support program in Ontario, Canada where funding for employment programs and services was changed from a fee-for-service to an outcome-based model. The findings highlight that the financial imperative for programs to meet employment targets in order to secure their funding has shifted the focus away from the provision of pre-employment supports to job development and job placements. However, there remains little attention to job matching and career development, and there is concern about access to services among those with complex barriers to employment. There is a need to reconcile tensions between the goals of outcome-based funding and on-the-ground service delivery to promote ongoing innovation in employment services for people with serious mental illness.

  8. SOAP based web services and their future role in VO projects

    NASA Astrophysics Data System (ADS)

    Topf, F.; Jacquey, C.; Génot, V.; Cecconi, B.; André, N.; Zhang, T. L.; Kallio, E.; Lammer, H.; Facsko, G.; Stöckler, R.; Khodachenko, M.

    2011-10-01

    Modern state-of-the-art web services are from crucial importance for the interoperability of different VO tools existing in the planetary community. SOAP based web services assure the interconnectability between different data sources and tools by providing a common protocol for communication. This paper will point out a best practice approach with the Automated Multi-Dataset Analysis Tool (AMDA) developed by CDPP, Toulouse and the provision of VEX/MAG data from a remote database located at IWF, Graz. Furthermore a new FP7 project IMPEx will be introduced with a potential usage example of AMDA web services in conjunction with simulation models.

  9. Performance-based financing to increase utilization of maternal health services: Evidence from Burkina Faso.

    PubMed

    Steenland, Maria; Robyn, Paul Jacob; Compaore, Philippe; Kabore, Moussa; Tapsoba, Boukary; Zongo, Aloys; Haidara, Ousmane Diadie; Fink, Günther

    2017-12-01

    Performance-based financing (PBF) programs are increasingly implemented in low and middle-income countries to improve health service quality and utilization. In April 2011, a PBF pilot program was launched in Boulsa, Leo and Titao districts in Burkina Faso with the objective of increasing the provision and quality of maternal health services. We evaluate the impact of this program using facility-level administrative data from the national health management information system (HMIS). Primary outcomes were the number of antenatal care visits, the proportion of antenatal care visits that occurred during the first trimester of pregnancy, the number of institutional deliveries and the number of postnatal care visits. To assess program impact we use a difference-in-differences approach, comparing changes in health service provision post-introduction with changes in matched comparison areas. All models were estimated using ordinary least squares (OLS) regression models with standard errors clustered at the facility level. On average, PBF facilities had 2.3 more antenatal care visits (95% CI [0.446-4.225]), 2.1 more deliveries (95% CI [0.034-4.069]) and 9.5 more postnatal care visits (95% CI [6.099, 12.903]) each month after the introduction of PBF. Compared to the service provision levels prior to the interventions, this implies a relative increase of 27.7 percent for ANC, of 9.2 percent for deliveries, and of 118.7 percent for postnatal care. Given the positive results observed during the pre-pilot period and the limited resources available in the health sector, the PBF program in Burkina Faso may be a low-cost, high impact intervention to improve maternal and child health.

  10. If psychosis were cancer: a speculative comparison

    PubMed Central

    Boden, Zoë; Newton, Elizabeth

    2017-01-01

    Recently, health policy in the UK has begun to engage with the concept of ‘parity of esteem’ between physical and mental healthcare. This has led one recent initiative to improve service provision for first episode psychosis, which aims to bring it into line with some of the principles underpinning good practice in cancer care. In this paper, we consider some of the metaphorical consequences of likening psychosis to cancer. While we find the comparison unhelpful for clinical purposes, we argue that it can be a helpful lens through which to examine service provision for psychosis in young people. Through this lens, specialist community-based services would appear to compare reasonably well. Inpatient care for young people with psychosis, on the other hand, suffers very badly by comparison with inpatient facilities for teenage cancer care. We note some of the many positive features of inpatient cancer care for young adults, and—drawing upon previous research on inpatient psychiatric care—observe that many of these are usually absent from mental health facilities. We conclude that this metaphor may be a helpful rhetorical device for communicating the lack of ‘parity of esteem’ between mental and physical healthcare. This inequity must be made visible in health policy, in commissioning, and in service provision. PMID:28559369

  11. Developments in oral health policy in the Nordic countries since 1990.

    PubMed

    Widström, Eeva; Ekman, Agneta; Aandahl, Liljan S; Pedersen, Maria Malling; Agustsdottir, Helga; Eaton, Kenneth A

    2005-01-01

    There is a number of systems for the provision of oral health care, one of which is the Nordic model of centrally planned oral health care provision. This model has historically been firmly based on the concept of a welfare state in which there is universal entitlement to services and mutual responsibility and agreement to financing them. This study reports and analyses oral health care provision systems and developments in oral health policy in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) since 1990. Descriptions of and data on the oral health care provision systems in the Nordic countries were obtained from the Chief Dental Officers of the five countries, and contemporary scientific literature was appraised using cross-case analyses to identify generalisable features. It was found that in many respects the system in Iceland did not follow the 'Nordic' pattern. In the other four countries, tax-financed public dental services employing salaried dentists were complemented by publicly subsidised private services. Additional, totally private services were also available to a variable extent. Recently, the availabilty of publicly subsidised oral health care has been extended to cover wider groups of the total population in Finland and Sweden and, to a smaller extent, in Denmark. Concepts from market-driven care models have been introduced. In all five countries, relative to the national populations and other parts of the world, there were high numbers of dentists, dental hygienists and technicians. Access to oral health care services was good and utilisation rates generally high. In spite of anticipated problems with increasing health care costs, more public funds have recently been invested in oral health care in three of the five countries. The essential principles of the Nordic model for the delivery of community services, including oral health care, i.e. universal availability, high quality, finance through taxation and public provision, were still adhered to in spite of attempts at privatisation during the 1990 s. It appeared that, in general, the populations of the Nordic countries still believed that there was a need for health and oral health care to be paid for from public funds.

  12. Toward eliminating blindness due to uncorrected refractive errors: assessment of refractive services in the northern and central regions of Ghana.

    PubMed

    Ntodie, Michael; Danquah, Lisa; Kandel, Himal; Abokyi, Samuel

    2014-11-01

    This study sought to document current refractive services in the northern and central regions of Ghana as a first step toward evidence-based planning of refractive services. A descriptive cross-sectional survey was carried out in health facilities in the northern and central regions of Ghana, which provided eye-care services. A semi-structured questionnaire was administered to gather information on each facility type, human resources providing refractive services, assessment of refraction and spectacle dispensing output and provider barriers to the services. Current outputs of refraction in the northern and central regions were 0.5 and 1.2 per cent of the estimated refractive needs, respectively. Spectacle dispensing services were below the outputs of refraction. Lack of equipment (36.8 per cent) and cost of providing spectacles frames (31.6 per cent), were identified as the main barriers to providing refractive services. The provision of refractive services in the study regions was inadequate. Lack of infrastructure and inadequate human resource were the major reasons for the limited service provision. This should be considered for planning refractive services in the study regions and Ghana as a whole. © 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometrists Association Australia.

  13. Autism spectrum disorder in adults: diagnosis, management, and health services development

    PubMed Central

    Murphy, Clodagh M; Wilson, C Ellie; Robertson, Dene M; Ecker, Christine; Daly, Eileen M; Hammond, Neil; Galanopoulos, Anastasios; Dud, Iulia; Murphy, Declan G; McAlonan, Grainne M

    2016-01-01

    Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological), development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude that health services research for adults with ASD is urgently warranted. In particular, research is required to better understand the needs of adults with ASD, including health, aging, service development, transition, treatment options across the lifespan, sex, and the views of people with ASD. Additionally, the outcomes of recent international legislative efforts to raise awareness of ASD and service provision for adults with ASD are to be determined. Future research is required to identify high-quality, evidence-based, and cost-effective models of care. Furthermore, future health services research is also required at the beginning and end of adulthood, including improved transition from youth to adult health care and increased understanding of aging and health in older adults with ASD. PMID:27462160

  14. The evaluation of NIMROD, a community-based service for people with mental handicap: revenue costs.

    PubMed

    Davies, L; Felce, D; Lowe, K; de Paiva, S

    1991-11-01

    The cost implications of moving from a system of services for people with mental handicaps centred on large institutions to a network of community-based services are not precisely known. The provision of the NIMROD service in a part of Cardiff, with its aim not only to meet the residential needs of adults comprehensively by providing a number of houses in the community but also to develop a support service to people living in their family home, gave an opportunity to investigate and report the revenue costs of a number of service elements with respect to a defined total population. The residential costs of intensively staffed houses in 1986-87, varying in size from two to six places, were found to range between pounds 16,473 and pounds 23,319 per person per year. With the addition of community support costs, such as the provision of day services, the total costs of care per resident averaged pounds 21,708; range, pounds 18,883-pounds 26,009. These compared to the total costs in a minimally staffed house of pounds 9,678 per resident. The costs of community support services for people living in their family homes averaged pounds 5,614 inclusive of DSS benefits, of which pounds 1,743 was accounted for by the NIMROD domiciliary support service, office base and administrative overheads. The residential costs reported were compared to other cost data in the literature. The study supports previous conclusions that there is little evidence of diseconomy attached to small scale per se but that the way staffing levels and therefore staff costs are determined is critical. No evidence was found in this study to link greater cost to better quality.

  15. Concept of a spatial data infrastructure for web-mapping, processing and service provision for geo-hazards

    NASA Astrophysics Data System (ADS)

    Weinke, Elisabeth; Hölbling, Daniel; Albrecht, Florian; Friedl, Barbara

    2017-04-01

    Geo-hazards and their effects are distributed geographically over wide regions. The effective mapping and monitoring is essential for hazard assessment and mitigation. It is often best achieved using satellite imagery and new object-based image analysis approaches to identify and delineate geo-hazard objects (landslides, floods, forest fires, storm damages, etc.). At the moment, several local/national databases and platforms provide and publish data of different types of geo-hazards as well as web-based risk maps and decision support systems. Also, the European commission implemented the Copernicus Emergency Management Service (EMS) in 2015 that publishes information about natural and man-made disasters and risks. Currently, no platform for landslides or geo-hazards as such exists that enables the integration of the user in the mapping and monitoring process. In this study we introduce the concept of a spatial data infrastructure for object delineation, web-processing and service provision of landslide information with the focus on user interaction in all processes. A first prototype for the processing and mapping of landslides in Austria and Italy has been developed within the project Land@Slide, funded by the Austrian Research Promotion Agency FFG in the Austrian Space Applications Program ASAP. The spatial data infrastructure and its services for the mapping, processing and analysis of landslides can be extended to other regions and to all types of geo-hazards for analysis and delineation based on Earth Observation (EO) data. The architecture of the first prototypical spatial data infrastructure includes four main areas of technical components. The data tier consists of a file storage system and the spatial data catalogue for the management of EO-data, other geospatial data on geo-hazards, as well as descriptions and protocols for the data processing and analysis. An interface to extend the data integration from external sources (e.g. Sentinel-2 data) is planned for the possibility of rapid mapping. The server tier consists of java based web and GIS server. Sub and main services are part of the service tier. Sub services are for example map services, feature editing services, geometry services, geoprocessing services and metadata services. For (meta)data provision and to support data interoperability, web standards of the OGC and the rest-interface is used. Four central main services are designed and developed: (1) a mapping service (including image segmentation and classification approaches), (2) a monitoring service to monitor changes over time, (3) a validation service to analyze landslide delineations from different sources and (4) an infrastructure service to identify affected landslides. The main services use and combine parts of the sub services. Furthermore, a series of client applications based on new technology standards making use of the data and services offered by the spatial data infrastructure. Next steps include the design to extend the current spatial data infrastructure to other areas and geo-hazard types to develop a spatial data infrastructure that can assist targeted mapping and monitoring of geo-hazards on a global context.

  16. 31 CFR 588.405 - Provision of services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 588.405 Section 588.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE..., accounting, financial, brokering, freight forwarding, transportation, public relations, or other services to...

  17. Service mix in the hospital outpatient department: implications for Medicare payment reform.

    PubMed Central

    Miller, M E; Sulvetta, M B; Englert, E

    1995-01-01

    OBJECTIVE. To determine if implementation of a PPS for Medicare hospital outpatient department (HOPD) services will have distributional consequences across hospital types and regions, this analysis assesses variation in service mix and the provision of high-technology services in the HOPD. DATA. HCFA's 1990 claims file for a 5 percent random sample of Medicare beneficiaries using the HOPD was merged, by hospital provider number, with various HCFA hospital characteristic files. STUDY DESIGN. Hospital characteristics examined are urban/rural location, teaching status, disproportionate-share status, and bed size. Two analyses of HOPD services are presented: mix of services provided and the provision of high-technology services. The mix of services is measured by the percentage of services in each of 14 type-of-service categories (e.g., medical visits, advanced imaging services, diagnostic testing services). Technology provision is measured by the percentage of hospitals providing selected high-technology services. FINDINGS/CONCLUSIONS. The findings suggest that the role hospital types play in providing HOPD services warrants consideration in establishing a PPS. HOPDs in major teaching hospitals and hospitals serving a disproportionate share of the poor play an important role in providing routine visits. HOPDs in both major and minor teaching hospitals are important providers of high-technology services. Other findings have implications for the structure of an HOPD PPS as well. First, over half of the services provided in the HOPD are laboratory tests and HOPDs may have limited control over these services since they are often for patients referred from local physician offices. Second, service mix and technology provision vary markedly among regions, suggesting the need for a transition to prospective payment. Third, the organization of service supply in a region may affect service provision in the HOPD suggesting that an HOPD PPS needs to be coordinated with payment policies in competing sites of care (e.g., ambulatory surgical centers). PMID:7721585

  18. 39 CFR 3010.6 - Type 3 adjustment-in general.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... extraordinary circumstances. (b) An exigency-based rate adjustment is not subject to the inflation-based....6 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL REGULATION OF RATES FOR MARKET DOMINANT PRODUCTS General Provisions § 3010.6 Type 3 adjustment—in general. (a) A Type 3 rate adjustment is a...

  19. 7 CFR 4288.131 - Payment provisions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program General Provisions Payment Provisions § 4288.131 Payment provisions. Payments to advanced biofuel producers for eligible advanced biofuel production will be determined in accordance with the provisions of...

  20. Innovations in primary mental healthcare.

    PubMed

    Reifels, Lennart; Bassilios, Bridget; King, Kylie E; Fletcher, Justine R; Blashki, Grant; Pirkis, Jane E

    2013-06-01

    We review the evidence on innovations in Tier 2 of the Access to Allied Psychological Services (ATAPS) program, which is designed to facilitate the provision of primary mental healthcare to hard-to-reach and at-risk population groups (including women with perinatal depression, people at risk of self-harm or suicide, people experiencing or at risk of homelessness, people affected by the 2009 Victorian bushfires, people in remote locations, Aboriginal and Torres Strait Islanders and children with mental disorders) and the trialling of new modalities of service delivery (e.g. telephone-based or web-based CBT). The primary focus is on the uptake, outcomes and issues associated with the provision of ATAPS Tier 2. Drawing on data from an ongoing national ATAPS evaluation, including a national minimum dataset, key informant interviews and surveys, the impact of ATAPS innovations is analysed and illustrated through program examples. ATAPS Tier 2 facilitates access to, uptake of and positive clinical outcomes from primary mental healthcare for population groups with particular needs, although it requires periods of time to implement locally. Relatively simple innovations in mental health program design can have important practical ramifications for service provision, extending program reach and improving mental health outcomes for target populations. What is known about the topic? It is recognised that innovative approaches are required to tailor mental health programs for hard-to-reach and at-risk population groups. Divisions of General Practice have implemented innovations in the Access to Allied Psychological Services (ATAPS) program for several years. What does this paper add? Drawing on data from an ongoing national ATAPS evaluation, this paper presents a systematic analysis of the uptake, outcomes and issues associated with provision of the innovative ATAPS program. What are the implications for practitioners? The findings highlight the benefits of introducing innovations in primary mental healthcare in terms of increased access to care and positive consumer outcomes. They also identify challenges to and facilitators of the implementation process, which can inform innovation efforts in other primary care contexts.

  1. A Digest and Comparative Analysis of Major Federal Programs Affecting Infants and Toddlers with Handicaps and Their Families.

    ERIC Educational Resources Information Center

    O'Reilly, Fran E.; And Others

    This study analyzes major federal programs designed to provide services to children, from birth through age 2, who have developmental delays or a high probability of developmental delays, and their families. Programs were selected based on their provision of education or health-related services to infants and toddlers with handicaps and their…

  2. Defense Energy Resilience: Lessons from Ecology

    DTIC Science & Technology

    2010-08-01

    ecosystem -based manage- ment of natural resources and sustainability science have yielded theory that is markedly different from theory arising from more...research regarding natural resource management and the provision of ecosystem services reveals how hu- man and “natural” systems are interlinked.18...Ecosys- tems provide the myriad services upon which society depends for survival. Society influences ecosystems through conversion of land cover

  3. Women in the Military. More Military Jobs Can Be Opened under Current Statutes. Report to Congressional Requesters.

    ERIC Educational Resources Information Center

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

    A study determined how service policies implementing the combat exclusion provisions affect the number and assignment of military women and whether service procedures unrelated to the combat exclusion limit job opportunities for women. Based on the combat exclusion and related program needs, about 1.1 million of 2.2 million military jobs were…

  4. Working with Urban, African American Fathers: The Importance of Service Provision, Joining, Accountability, the Father-Child Relationship, and Couples Work

    ERIC Educational Resources Information Center

    Greif, Geoffrey L.; Jones, Joseph T., Jr.; Worthy, James; White, Eddie; Davis, Will; Pitchford, Edward

    2011-01-01

    Urban, African American fathers have been a difficult population for social workers and other helping professionals to effectively serve. This article, based on interviews with front-line African American service professionals at a father-focused program, who also participated in writing this article, provides information about and suggestions for…

  5. Bridging the Skills Gap. Working Paper Part II: High Technology and Related Occupations.

    ERIC Educational Resources Information Center

    Kaplan, Christine E.

    This part of a 2-part working paper identifies and describes major occupational groups that are characteristic of high technology manufacturing and service industries as well as employment sectors that use high technology products in their provision of goods and services. The paper is based on a review of a wide range of employment projections…

  6. Costing and competition.

    PubMed

    Bates, K; Brignall, S

    1994-01-01

    Working for patients established a new system of contracts between providers and purchasers of healthcare, with prices based on full costs, avoiding cross-subsidization. The new regime necessitates greatly improved costing systems, to improve the efficiency of service provision by creating price competition between providers. Ken Bates and Stan Brignall argue that non-price competition also occurs, with providers 'differentiating' on quality of service/product, flexibility or innovation.

  7. An organizational cybernetics framework for achieving balance in evidence-based practice and practice-based evidence.

    PubMed

    Fitch, Dale

    2014-01-01

    This article applies the systems science of organizational cybernetics to the implementation of evidence-based practice (EBP) in the provision of social work services in a residential treatment center setting. It does so by systemically balancing EBP with practice-based evidence (PBE) with a focus on the organizational and information system infrastructures necessary to ensure successful implementation. This application is illustrated by discussing a residential treatment program that implemented evidence-based programming and evaluated the results; however, the systemic principles articulated can be applied to any human services organizational setting.

  8. 25 CFR 900.196 - Do covered services include the conduct of clinical studies and investigations and the provision...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Do covered services include the conduct of clinical studies and investigations and the provision of emergency services, including the operation of emergency... Claims § 900.196 Do covered services include the conduct of clinical studies and investigations and the...

  9. 78 FR 64249 - Notice of Intent To Award-Grant Awards for the Provision of Civil Legal Services to Eligible Low...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... LEGAL SERVICES CORPORATION Notice of Intent To Award--Grant Awards for the Provision of Civil Legal Services to Eligible Low-Income Clients Beginning January 1, 2014 AGENCY: Legal Services Corporation. ACTION: Announcement of intention to make FY 2014 Competitive Grant Awards. SUMMARY: The Legal...

  10. 77 FR 64551 - Notice of Intent to Award-Grant Awards for the Provision of Civil Legal Services to Eligible Low...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ... LEGAL SERVICES CORPORATION Notice of Intent to Award--Grant Awards for the Provision of Civil Legal Services to Eligible Low-Income Clients Beginning January 1, 2013 AGENCY: Legal Services Corporation. ACTION: Announcement of intention to make FY 2013 Competitive Grant Awards. SUMMARY: The Legal...

  11. 76 FR 68221 - Notice of Intent To Award-Grant Awards for the Provision of Civil Legal Services to Eligible Low...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-03

    ... LEGAL SERVICES CORPORATION Notice of Intent To Award--Grant Awards for the Provision of Civil Legal Services to Eligible Low-Income Clients Beginning January 1, 2012 AGENCY: Legal Services Corporation. ACTION: Announcement of intention to make FY 2012 Competitive Grant Awards. SUMMARY: The Legal...

  12. Business Model Evaluation for an Advanced Multimedia Service Portfolio

    NASA Astrophysics Data System (ADS)

    Pisciella, Paolo; Zoric, Josip; Gaivoronski, Alexei A.

    In this paper we analyze quantitatively a business model for the collaborative provision of an advanced mobile data service portfolio composed of three multimedia services: Video on Demand, Internet Protocol Television and User Generated Content. We provide a description of the provision system considering the relation occurring between tecnical aspects and business aspects for each agent providing the basic multimedia service. Such a techno-business analysis is then projected into a mathematical model dealing with the problem of the definition of incentives between the different agents involved in a collaborative service provision. Through the implementation of this model we aim at shaping the behaviour of each of the contributing agents modifying the level of profitability that the Service Portfolio yields to each of them.

  13. Ecosystem services capacity across heterogeneous forest types: understanding the interactions and suggesting pathways for sustaining multiple ecosystem services.

    PubMed

    Alamgir, Mohammed; Turton, Stephen M; Macgregor, Colin J; Pert, Petina L

    2016-10-01

    As ecosystem services supply from tropical forests is declining due to deforestation and forest degradation, much effort is essential to sustain ecosystem services supply from tropical forested landscapes, because tropical forests provide the largest flow of multiple ecosystem services among the terrestrial ecosystems. In order to sustain multiple ecosystem services, understanding ecosystem services capacity across heterogeneous forest types and identifying certain ecosystem services that could be managed to leverage positive effects across the wider bundle of ecosystem services are required. We sampled three forest types, tropical rainforests, sclerophyll forests, and rehabilitated plantation forests, over an area of 32,000m(2) from Wet Tropics bioregion, Australia, aiming to compare supply and evaluate interactions and patterns of eight ecosystem services (global climate regulation, air quality regulation, erosion regulation, nutrient regulation, cyclone protection, habitat provision, energy provision, and timber provision). On average, multiple ecosystem services were highest in the rainforests, lowest in sclerophyll forests, and intermediate in rehabilitated plantation forests. However, a wide variation was apparent among the plots across the three forest types. Global climate regulation service had a synergistic impact on the supply of multiple ecosystem services, while nutrient regulation service was found to have a trade-off impact. Considering multiple ecosystem services, most of the rehabilitated plantation forest plots shared the same ordination space with rainforest plots in the ordination analysis, indicating that rehabilitated plantation forests may supply certain ecosystem services nearly equivalent to rainforests. Two synergy groups and one trade-off group were identified. Apart from conserving rainforests and sclerophyll forests, our findings suggest two additional integrated pathways to sustain the supply of multiple ecosystem services from a heterogeneous tropical forest landscape: (i) rehabilitation of degraded forests aiming to provide global climate regulation and habitat provision ecosystem services and (ii) management intervention to sustain global climate regulation and habitat provision ecosystem services. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Organizational-level correlates of the provision of detoxification services and medication-based treatments for substance abuse in correctional institutions.

    PubMed

    Oser, Carrie B; Knudsen, Hannah K; Staton-Tindall, Michele; Taxman, Faye; Leukefeld, Carl

    2009-08-01

    In recent years, there has been an increased examination of organizational-level innovation adoption in substance abuse treatment organizations. However, the majority of these studies have focused on community-based treatment centers. One understudied area of the substance abuse treatment system is correctional institutions. This study uses the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) cooperative's National Criminal Justice Treatment Practices (NCJTP) survey to examine the adoption of detoxification services and pharmacotherapies for the treatment of substance abuse across a nationally representative sample of correctional institutions (n=198). There were significant differences between jails and prisons in the percentage of organizations offering detoxification services and medications. Specifically, detoxification services were offered by 5% of prisons and 34% of jails; and, medications were offered by 6% of prisons and 32% of jails. Binary logistic regression models were used to examine the associations between these services and organizational characteristics, including context, resources, previously introduced practices, culture, and systems integration. Variables measuring organizational context and previously introduced practices were significant correlates of the provision of both detoxification services and medications. Multivariate results indicated that the differences between jails and prisons remained significant after controlling for other organizational factors. Although the adoption of detoxification services and pharmacotherapies may be a controversial topic for correctional institutions, these services have the potential to improve offender well-being and reduce public health risks associated with substance abuse.

  15. Organizational-Level Correlates of the Provision of Detoxification Services and Medication-Based Treatments for Substance Abuse in Correctional Institutions

    PubMed Central

    Knudsen, Hannah K.; Staton-Tindall, Michele; Taxman, Faye; Leukefeld, Carl

    2009-01-01

    In recent years, there has been an increased examination of organizational-level innovation adoption in substance abuse treatment organizations. However, the majority of these studies have focused on community-based treatment centers. One understudied area of the substance abuse treatment system is correctional institutions. This study uses the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) cooperative’s National Criminal Justice Treatment Practices survey (NCJTP) to examine the adoption of detoxification services and pharmacotherapies for the treatment of substance abuse across a nationally representative sample of correctional institutions (n=198). There were significant differences between jails and prisons in the percentage of organizations offering detoxification services and medications. Specifically, detoxification services were offered by 5% of prisons and 34% of jails; and, medications were offered by 6% of prisons and 32% of jails. Binary logistic regression models were used to examine the associations between these services and organizational characteristics, including context, resources, previously introduced practices, culture, and systems integration. Variables measuring organizational context and previously introduced practices were significant correlates of the provision of both detoxification services and medications. Multivariate results indicated that the differences between jails and prisons remained significant after controlling for other organizational factors. Although the adoption of detoxification services and pharmacotherapies may be a controversial topic for correctional institutions, these services have the potential to improve offender well-being and reduce public health risks associated with substance abuse. PMID:19108957

  16. 34 CFR 300.43 - Transition services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., including postsecondary education, vocational education, integrated employment (including supported...; (2) Is based on the individual child's needs, taking into account the child's strengths, preferences..., acquisition of daily living skills and provision of a functional vocational evaluation. (b) Transition...

  17. Not Nearly Enough Geography! University Provision for England's Pre-Service Primary Teachers

    ERIC Educational Resources Information Center

    Catling, Simon

    2017-01-01

    Research into geography provision in primary initial teacher education [ITE] courses in the United Kingdom and worldwide is very limited. England educates pre-service primary teachers of 5-11 year olds to be "generalists" who teach the full range of curriculum subjects, including geography. This article identifies that the provision of…

  18. Inequalities in the Provision of Paediatric Speech and Language Therapy Services across London Boroughs

    ERIC Educational Resources Information Center

    Pring, Tim

    2016-01-01

    Background: The inverse-care law suggests that fewer healthcare resources are available in deprived areas where health needs are greatest. Aims: To examine the provision of paediatric speech and language services across London boroughs and to relate provision to the level of deprivation of the boroughs. Methods & Procedures: Information on the…

  19. Effects of user fee exemptions on the provision and use of maternal health services: a review of literature.

    PubMed

    Hatt, Laurel E; Makinen, Marty; Madhavan, Supriya; Conlon, Claudia M

    2013-12-01

    User fee removal has been put forward as an approach to increasing priority health service utilization, reducing impoverishment, and ultimately reducing maternal and neonatal mortality. However, user fees are a source of facility revenue in many low-income countries, often used for purchasing drugs and supplies and paying incentives to health workers. This paper reviews evidence on the effects of user fee exemptions on maternal health service utilization, service provision, and outcomes, including both supply-side and demand-side effects. We reviewed 19 peer-reviewed research articles addressing user fee exemptions and maternal health services or outcomes published since 1990. Studies were identified through a USAID-commissioned call for evidence, key word search, and screening process. Teams of reviewers assigned criteria-based quality scores to each paper and prepared structured narrative reviews. The grade of the evidence was found to be relatively weak, mainly from short-term, non-controlled studies. The introduction of user fee exemptions appears to have resulted in increased rates of facility-based deliveries and caesarean sections in some contexts. Impacts on maternal and neonatal mortality have not been conclusively demonstrated; exemptions for delivery care may contribute to modest reductions in institutional maternal mortality but the evidence is very weak. User fee exemptions were found to have negative, neutral, or inconclusive effects on availability of inputs, provider motivation, and quality of services. The extent to which user fee revenue lost by facilities is replaced can directly affect service provision and may have unintended consequences for provider motivation. Few studies have looked at the equity effects of fee removal, despite clear evidence that fees disproportionately burden the poor. This review highlights potential and documented benefits (increased use of maternity services) as well as risks (decreased provider motivation and quality) of user fee exemption policies for maternal health services. Governments should link user fee exemption policies with the replacement of lost revenue for facilities as well as broader health system improvements, including facility upgrades, ensured supply of needed inputs, and improved human resources for health. Removing user fees may increase uptake but will not reduce mortality proportionally if the quality of facility-based care is poor. More rigorous evaluations of both demand- and supply-side effects of mature fee exemption programmes are needed.

  20. Important features of home-based support services for older Australians and their informal carers.

    PubMed

    McCaffrey, Nikki; Gill, Liz; Kaambwa, Billingsley; Cameron, Ian D; Patterson, Jan; Crotty, Maria; Ratcliffe, Julie

    2015-11-01

    In Australia, newly initiated, publicly subsidised 'Home-Care Packages' designed to assist older people (≥ 65 years of age) living in their own home must now be offered on a 'consumer-directed care' (CDC) basis by service providers. However, CDC models have largely developed in the absence of evidence on users' views and preferences. The aim of this study was to determine what features (attributes) of consumer-directed, home-based support services are important to older people and their informal carers to inform the design of a discrete choice experiment (DCE). Semi-structured, face-to-face interviews were conducted in December 2012-November 2013 with 17 older people receiving home-based support services and 10 informal carers from 5 providers located in South Australia and New South Wales. Salient service characteristics important to participants were determined using thematic and constant comparative analysis and formulated into attributes and attribute levels for presentation within a DCE. Initially, eight broad themes were identified: information and knowledge, choice and control, self-managed continuum, effective co-ordination, effective communication, responsiveness and flexibility, continuity and planning. Attributes were formulated for the DCE by combining overlapping themes such as effective communication and co-ordination, and the self-managed continuum and planning into single attributes. Six salient service features that characterise consumer preferences for the provision of home-based support service models were identified: choice of provider, choice of support worker, flexibility in care activities provided, contact with the service co-ordinator, managing the budget and saving unspent funds. Best practice indicates that qualitative research with individuals who represent the population of interest should guide attribute selection for a DCE and this is the first study to employ such methods in aged care service provision. Further development of services could incorporate methods of consumer engagement such as DCEs which facilitate the identification and quantification of users' views and preferences on alternative models of delivery. © 2015 John Wiley & Sons Ltd.

  1. 45 CFR 400.314 - Priority in provision of services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Priority in provision of services. 400.314 Section 400.314 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM...

  2. 45 CFR 303.7 - Provision of services in interstate IV-D cases.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ENFORCEMENT (CHILD SUPPORT ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES STANDARDS FOR PROGRAM OPERATIONS § 303.7 Provision of services in interstate IV... central registry responsible for receiving, distributing and responding to inquiries on all incoming...

  3. 47 CFR 1.9047 - Special provisions relating to leases of educational broadband service spectrum.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... educational broadband service spectrum. 1.9047 Section 1.9047 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Spectrum Leasing General Policies and Procedures § 1.9047 Special provisions relating to leases of educational broadband service spectrum...

  4. 47 CFR 1.9047 - Special provisions relating to leases of educational broadband service spectrum.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... educational broadband service spectrum. 1.9047 Section 1.9047 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Spectrum Leasing General Policies and Procedures § 1.9047 Special provisions relating to leases of educational broadband service spectrum. Licensees in the Educational...

  5. 47 CFR 1.9047 - Special provisions relating to leases of educational broadband service spectrum.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... educational broadband service spectrum. 1.9047 Section 1.9047 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Spectrum Leasing General Policies and Procedures § 1.9047 Special provisions relating to leases of educational broadband service spectrum. Licensees in the Educational...

  6. 47 CFR 1.9047 - Special provisions relating to leases of educational broadband service spectrum.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... educational broadband service spectrum. 1.9047 Section 1.9047 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Spectrum Leasing General Policies and Procedures § 1.9047 Special provisions relating to leases of educational broadband service spectrum...

  7. 47 CFR 1.9047 - Special provisions relating to leases of educational broadband service spectrum.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... educational broadband service spectrum. 1.9047 Section 1.9047 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Spectrum Leasing General Policies and Procedures § 1.9047 Special provisions relating to leases of educational broadband service spectrum...

  8. 5 CFR 731.601 - Savings provision.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Savings provision. 731.601 Section 731.601 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SUITABILITY Savings Provision § 731.601 Savings provision. No provision of the regulations in...

  9. 5 CFR 731.601 - Savings provision.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Savings provision. 731.601 Section 731.601 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SUITABILITY Savings Provision § 731.601 Savings provision. No provision of the regulations in...

  10. Strengthening rehabilitation services in Indonesia: A brief situation analysis.

    PubMed

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

    2018-04-18

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

  11. Ghana’s National Health Insurance Scheme: a national level investigation of members’ perceptions of service provision

    PubMed Central

    2013-01-01

    Background Ghana’s National Health Insurance Scheme (NHIS), established into law in 2003 and implemented in 2005 as a ‘pro-poor’ method of health financing, has made great progress in enrolling members of the general population. While many studies have focused on predictors of enrolment this study offers a novel analysis of NHIS members’ perceptions of service provision at the national level. Methods Using data from the 2008 Ghana Demographic Health Survey we analyzed the perceptions of service provision as indicated by members enrolled in the NHIS at the time of the survey (n = 3468; m = 1422; f = 2046). Ordinal Logistic Regression was applied to examine the relationship between perceptions of service provision and theoretically relevant socioeconomic and demographic variables. Results Results demonstrate that wealth, gender and ethnicity all play a role in influencing members’ perceptions of NHIS service provision, distinctive from its influence on enrolment. Notably, although wealth predicted enrolment in other studies, our study found that compared to the poorest men and uneducated women, wealthy men and educated women were less likely to perceive their service provision as better/same (more likely to report it was worse). Wealth was not an important factor for women, suggesting that household gender dynamics supersede household wealth status in influencing perceptions. As well, when compared to Akan women, women from all other ethnic groups were about half as likely to perceive the service provision to be better/same. Conclusions Findings of this study suggest there is an important difference between originally enrolling in the NHIS because one believes it is potentially beneficial, and using the NHIS and perceiving it to be of benefit. We conclude that understanding the nature of this relationship is essential for Ghana’s NHIS to ensure its longevity and meet its pro-poor mandate. As national health insurance systems are a relatively new phenomenon in sub-Saharan Africa little is known about their long term viability; understanding user perceptions of service provision is an important piece of that puzzle. PMID:23968385

  12. Addressing governance challenges in the provision of animal health services: A review of the literature and empirical application transaction cost theory.

    PubMed

    Ilukor, John; Birner, Regina; Nielsen, Thea

    2015-11-01

    Providing adequate animal health services to smallholder farmers in developing countries has remained a challenge, in spite of various reform efforts during the past decades. The focuses of the past reforms were on market failures to decide what the public sector, the private sector, and the "third sector" (the community-based sector) should do with regard to providing animal health services. However, such frameworks have paid limited attention to the governance challenges inherent in the provision of animal health services. This paper presents a framework for analyzing institutional arrangements for providing animal health services that focus not only on market failures, but also on governance challenges, such as elite capture, and absenteeism of staff. As an analytical basis, Williamson's discriminating alignment hypothesis is applied to assess the cost-effectiveness of different institutional arrangements for animal health services in view of both market failures and governance challenges. This framework is used to generate testable hypotheses on the appropriateness of different institutional arrangements for providing animal health services, depending on context-specific circumstances. Data from Uganda and Kenya on clinical veterinary services is used to provide an empirical test of these hypotheses and to demonstrate application of Williamson's transaction cost theory to veterinary service delivery. The paper concludes that strong public sector involvement, especially in building and strengthening a synergistic relation-based referral arrangement between paraprofessionals and veterinarians is imperative in improving animal health service delivery in developing countries. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Cultural diversity and the mistreatment of older people in black and minority ethnic communities: some implications for service provision.

    PubMed

    Bowes, Alison; Avan, Ghizala; Macintosh, Sherry Bien

    2012-07-01

    Previous research on mistreatment of older people in black and minority ethnic communities has identified limited service responses and the need to consider mistreatment as an issue not only for individuals but also for families, communities, and institutions. The impact of cultural factors on understandings, experiences, and remedies for mistreatment has been debated. Drawing on empirical research in the United Kingdom involving service providers and ethnically-diverse community members, the article explores implications of cultural variation for service provision. Clear gaps exist between service provision and people experiencing mistreatment due to structural and contextual factors; cultural factors have a relatively minor impact.

  14. Enhancement of biodiversity and ecosystem services by ecological restoration: a meta-analysis.

    PubMed

    Rey Benayas, José M; Newton, Adrian C; Diaz, Anita; Bullock, James M

    2009-08-28

    Ecological restoration is widely used to reverse the environmental degradation caused by human activities. However, the effectiveness of restoration actions in increasing provision of both biodiversity and ecosystem services has not been evaluated systematically. A meta-analysis of 89 restoration assessments in a wide range of ecosystem types across the globe indicates that ecological restoration increased provision of biodiversity and ecosystem services by 44 and 25%, respectively. However, values of both remained lower in restored versus intact reference ecosystems. Increases in biodiversity and ecosystem service measures after restoration were positively correlated. Results indicate that restoration actions focused on enhancing biodiversity should support increased provision of ecosystem services, particularly in tropical terrestrial biomes.

  15. The rise and fall of complementary medicine in National Health Service hospitals in England.

    PubMed

    Cant, Sarah; Watts, Peter; Ruston, Annmarie

    2012-08-01

    Whilst Complementary and Alternative Medicine (CAM) has never been systematically integrated into National Health Service (NHS) provision, there has been some limited evidence of a developing presence of CAM in NHS hospital based nursing and midwifery. This paper reports on a qualitative study that sought to document the nature and extent of such integrative practice in England, and the interpersonal and organisational factors that facilitated or impeded it. The data revealed a history in which attempts to integrate CAM had some initial success underpinned by the enthusiasm of individual practitioners and a relatively permissive organisational context. However, this was followed by a decline in service provision. The fact that the services were established by individuals left them vulnerable when more restrictive funding and governance regimes emerged. Whilst the data revealed a consistent story about CAM within the NHS, it must be recognised that the use of a snowball sample limits the generalizability of the findings. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Deficit Reduction Act of 1984: provisions related to the OASDI and SSI programs.

    PubMed

    1984-11-01

    This article summarizes the provisions of the Deficit Reduction Act of 1984 (Public Law 98-369) that relate to the Old-Age, Survivors, and Disability Insurance (OASDI) and Supplemental Security Income (SSI) programs. With regard to the OASDI program, the new law includes provisions relating to Social Security coverage of employees of the executive and legislative branches of the Government, and a provision allowing churches and church-related organizations to be exempt from Social Security employer taxes. Other OASDI provisions clarify or modify the Social Security Amendments of 1983 (Public Law 98-21). SSI program changes include provisions to increase the countable assets limit, to limit the rate of recovery for overpayments in nonfraud situations, and to waive certain overpayments that result from countable resources exceeding the applicable limits by +50 or less. The new law also contains amendments based on recommendations by the Grace Commission that will affect the administration of various programs of the Department of Health and Human Services.

  17. A national study of transitional hospital services in mental health.

    PubMed Central

    Dorwart, R A; Hoover, C W

    1994-01-01

    OBJECTIVES. Shifts in care for the seriously mentally ill from inpatient to community-based treatment have highlighted the importance of transitional care. Our objectives were to document the kinds and quantity of transitional services provided by psychiatric hospitals nationally and to assess the impact of hospital type (psychiatric vs general), ownership (public vs private), case mix, and revenue source on provision of these services. METHODS. A national sample of nonfederal inpatient mental health facilities (n = 915) was surveyed in 1988, and data were analyzed by using multiple regression. RESULTS. Half (46%) of the facilities surveyed provided patient follow-up of 1 week or less, and almost all (93%) conducted team review of discharge plans, but 74% provided no case management services. Hospital type was the most consistent predictor of transitional care, with psychiatric hospitals providing more of these services than general hospitals. Severity of illness, level of nonfederal funding, urbanicity, and teaching hospital affiliation were positively associated with provision of case management. CONCLUSIONS. Transitional care services for mentally ill patients leaving the hospital were found to be uneven and often inadequate. Reasons for broad variation in services are discussed. PMID:8059877

  18. The relationship between general population suicide rates and mental health funding, service provision and national policy: a cross-national study.

    PubMed

    Shah, Ajit; Bhandarkar, Ritesh; Bhatia, Gurleen

    2010-07-01

    The main aims were to examine the relationship between general population suicide rates and the presence of national policies on mental health, funding for mental health, and measures of mental health service provision. Data on general population suicide rates for both genders were obtained from the World Health Organization (WHO) databank available on the WHO website. Data on the presence of national policies on mental health, funding for mental health and measures of mental health service provision were obtained from the Mental Health Atlas 2005, also available on the WHO website. The main findings were: (i) there was no relationship between suicide rates in both genders and different measures of mental health policy, except they were increased in countries with mental health legislation; (ii) there was a significant positive correlation between suicide rates in both genders and the percentage of the total health budget spent on mental health; and (iii) suicide rates in both genders were higher in countries with greater provision of mental health services, including the number of psychiatric beds, psychiatrists and psychiatric nurses, and the availability of training in mental health for primary care professionals. Cross-national ecological studies using national-level aggregate data are not helpful in establishing a causal relationship (and the direction of this relationship) between suicide rates and mental health funding, service provision and national policies. The impact of introducing national policies on mental health, increasing funding for mental health services and increasing mental health service provision on suicide rates requires further examination in longitudinal within-country studies.

  19. The value of Web-based library services at Cedars-Sinai Health System.

    PubMed

    Halub, L P

    1999-07-01

    Cedars-Sinai Medical Library/Information Center has maintained Web-based services since 1995 on the Cedars-Sinai Health System network. In that time, the librarians have found the provision of Web-based services to be a very worthwhile endeavor. Library users value the services that they access from their desktops because the services save time. They also appreciate being able to access services at their convenience, without restriction by the library's hours of operation. The library values its Web site because it brings increased visibility within the health system, and it enables library staff to expand services when budget restrictions have forced reduced hours of operation. In creating and maintaining the information center Web site, the librarians have learned the following lessons: consider the design carefully; offer what services you can, but weigh the advantages of providing the services against the time required to maintain them; make the content as accessible as possible; promote your Web site; and make friends in other departments, especially information services.

  20. The value of Web-based library services at Cedars-Sinai Health System.

    PubMed Central

    Halub, L P

    1999-01-01

    Cedars-Sinai Medical Library/Information Center has maintained Web-based services since 1995 on the Cedars-Sinai Health System network. In that time, the librarians have found the provision of Web-based services to be a very worthwhile endeavor. Library users value the services that they access from their desktops because the services save time. They also appreciate being able to access services at their convenience, without restriction by the library's hours of operation. The library values its Web site because it brings increased visibility within the health system, and it enables library staff to expand services when budget restrictions have forced reduced hours of operation. In creating and maintaining the information center Web site, the librarians have learned the following lessons: consider the design carefully; offer what services you can, but weigh the advantages of providing the services against the time required to maintain them; make the content as accessible as possible; promote your Web site; and make friends in other departments, especially information services. PMID:10427423

  1. The development of NEdSERV: quantitative instrumentation to measure service quality in nurse education.

    PubMed

    Roberts, P

    1999-07-01

    The political climate of health care provision and education for health care in the latter years of the 20th century is evolving from the uncertainty of newly created markets to a more clearly focused culture of collaboration, dissemination of good practice, with an increased emphasis on quality provision and its measurement. The need for provider units to prove and improve efficiency and effectiveness through evidence-based quality strategies in order to stay firmly in the market place has never been more necessary. The measurement of customer expectations and perceptions of delivered service quality is widely utilized as a basis for customer retention and business growth in both commercial and non-profit organizations. This paper describes the methodological development of NEdSERV--quantitative instrumentation designed to measure and respond to ongoing stakeholder expectations and perceptions of delivered service quality within nurse education.

  2. 47 CFR 64.1502 - Limitations on the provision of pay-per-call services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Limitations on the provision of pay-per-call services. 64.1502 Section 64.1502 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Interstate Pay-Per-Call and...

  3. 47 CFR 64.705 - Restrictions on charges related to the provision of operator services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... provision of operator services. 64.705 Section 64.705 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... operator services shall: (1) Not bill for unanswered telephone calls in areas where equal access is available; (2) Not knowingly bill for unanswered telephone calls where equal access is not available; (3...

  4. Service Provision for Preschool Children Who Are Deaf: Parents' Perspectives.

    ERIC Educational Resources Information Center

    Robinshaw, Helen; Evans, Roy

    2001-01-01

    Reports on data from national review of preschool service provision for deaf children and their families in the United Kingdom. Presents families' responses to early identification; information available after identification; perceptions of partnerships with professionals; and value of family-centered services for themselves, for their children,…

  5. 12 CFR 611.1125 - Treatment of associations not approving districtwide mergers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... in a districtwide merger or consolidation: (1) Discriminate in the provision of any financial service... provision of any related services that are offered by the district bank to associations and their member... to, charging different rates of interest or different prices for services, or declining to provide...

  6. 45 CFR 303.7 - Provision of services in intergovernmental IV-D cases.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ENFORCEMENT (CHILD SUPPORT ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES STANDARDS FOR PROGRAM OPERATIONS § 303.7 Provision of services in intergovernmental IV-D cases. (a) General responsibilities. A State IV-D agency must: (1) Establish and use...

  7. 47 CFR 64.402 - Policies and procedures for the provision of priority access service by commercial mobile radio...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Policies and procedures for the provision of... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS... National Security and Emergency Preparedness personnel shall provide priority access service in accordance...

  8. 42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... technologies: General provisions. 412.87 Section 412.87 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... SERVICES Payments for Outlier Cases, Special Treatment Payment for New Technology, and Payment Adjustment for Certain Replaced Devices Additional Special Payment for Certain New Technology § 412.87 Additional...

  9. 42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... technologies: General provisions. 412.87 Section 412.87 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... SERVICES Payments for Outlier Cases, Special Treatment Payment for New Technology, and Payment Adjustment for Certain Replaced Devices Additional Special Payment for Certain New Technology § 412.87 Additional...

  10. 42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... technologies: General provisions. 412.87 Section 412.87 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... SERVICES Payments for Outlier Cases, Special Treatment Payment for New Technology, and Payment Adjustment for Certain Replaced Devices Additional Special Payment for Certain New Technology § 412.87 Additional...

  11. 42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... technologies: General provisions. 412.87 Section 412.87 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... SERVICES Payments for Outlier Cases, Special Treatment Payment for New Technology, and Payment Adjustment for Certain Replaced Devices Additional Special Payment for Certain New Technology § 412.87 Additional...

  12. Assessment of water, sanitation, and hygiene practice and associated factors among people living with HIV/AIDS home based care services in Gondar city, Ethiopia

    PubMed Central

    2012-01-01

    Background People living with HIV/AIDS have substantially greater need for water, sanitation, and hygiene. Encouraging hygiene education for People Living with HIV/AIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended. Methods A cross-sectional study was carried during 2009 to assess water, sanitation status and hygiene practices and associated factors among People Living with HIV/AIDS in home based care services in Gondar city of Ethiopia. A systematic random sampling was used to select study subjects from 900 Home Based Care clients of People Living HIV/AIDS in Gondar city. Data was collected from 296 People Living with HIV/AIDS from two NGO’s in the city. For in-depth interview, four different categories were participated. Logistic regression and thematic framework analysis were performed for quantitative and qualitative part respectively. Results Two hundred ninety four subjects (72.8% (214) females and 27.2% (80) males) were studied. The mean age was 35.8 ± 8.7 years. In the study, 42.9% (126) of the households have unimproved water status, 67% (197) of the households have unimproved sanitation status, and 51.7% (152) of the households have poor hygienic practice. Diarrhoea with water status; educational status and latrine availability with sanitation status; and hand washing device availability and economical reasons for the affordability of soap with hygienic practice were significantly associated. Economical reasons and hygiene education were factors that affect water, sanitation, and hygienic practice. Stigma and discrimination were minimized as a factor in the study area. Conclusions There is high burden of water, sanitation and hygiene in people living HIV/AIDS in home based care services. Encouraging hygiene education for people living HIVAIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended. PMID:23216835

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

    NASA Technical Reports Server (NTRS)

    Arcidiancono, Antonio

    1990-01-01

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

  14. A methodology for quantifying and mapping ecosystem services provided by watersheds

    USGS Publications Warehouse

    Villamagna, Amy M.; Angermeier, Paul L.

    2015-01-01

    Watershed processes – physical, chemical, and biological – are the foundation for many benefits that ecosystems provide for human societies. A crucial step toward accurately representing those benefits, so they can ultimately inform decisions about land and water management, is the development of a coherent methodology that can translate available data into the ecosystem services (ES) produced by watersheds. Ecosystem services (ES) provide an instinctive way to understand the tradeoffs associated with natural resource management. We provide a synthesis of common terminology and explain a rationale and framework for distinguishing among the components of ecosystem service delivery, including: an ecosystem’s capacity to produce a service; societal demand for the service; ecological pressures on this service; and flow of the service to people. We discuss how interpretation and measurement of these components can differ among provisioning, regulating, and cultural services and describe selected methods for quantifying ES components as well as constraints on data availability. We also present several case studies to illustrate our methods, including mapping capacity of several water purification services and demand for two forms of wildlife-based recreation, and discuss future directions for ecosystem service assessments. Our flexible framework treats service capacity, demand, ecological pressure, and flow as separate but interactive entities to better evaluate the sustainability of service provision across space and time and to help guide management decisions.

  15. Management to Insulate Ecosystem Services from the Effects of Catchment Development

    NASA Astrophysics Data System (ADS)

    Gell, Peter

    2018-02-01

    Natural ecosystems provide amenity to human populations in the form of ecosystem services. These services are grouped into four broad categories: provisioning - food and water production; regulating - control of climate and disease; supporting - crop pollination; and cultural - spiritual and recreational benefits. Aquatic systems provide considerable service through the provision of potable water, fisheries and aquaculture production, nutrient mitigation and the psychological benefits that accrue from the aesthetic amenity provided from lakes, rivers and other wetlands. Further, littoral and riparian ecosystems, and aquifers, protect human communities from sea level encroachment, and tidal and river flooding. Catchment and water development provides critical resources for human consumption. Where these provisioning services are prioritized over others, the level and quality of production may be impacted. Further, the benefits from these provisioning services comes with the opportunity cost of diminishing regulating, supporting and cultural services. This imbalance flags concerns for humanity as it exceeds recognised safe operating spaces. These concepts are explored by reference to long term records of change in some of the world's largest river catchments and lessons are drawn that may enable other communities to consider the balance of ecosystems services in natural resource management.

  16. Development and evaluation of a wheelchair service provision training of trainers programme

    PubMed Central

    2017-01-01

    Background In many countries, availability of basic training and continued professional development programmes in wheelchair services is limited. Therefore, many health professionals lack access to formal training opportunities and new approaches to improve wheelchair service provision. To address this need, the World Health Organization (WHO) developed the WHO Wheelchair Service Training of Trainers Programme (WSTPt), aiming to increase the number of trainers who are well prepared to deliver the WHO Wheelchair Service Training Packages. Despite these efforts, there was no recognised method to prepare trainers to facilitate these training programmes in a standardised manner. Objectives To understand if the WSTPt is an effective mechanism to train aspiring wheelchair service provision trainers. Method An action research study was conducted using a mixed-methods approach to data collection and analysis to integrate feedback from questionnaires and focus groups from three WHO WSTPt pilots. Results Trainees were satisfied with the WHO WSTPt and the iterative process appears to have helped to improve each subsequent pilot and the final training package. Conclusion The WHO WSTPt is an effective mechanism to train wheelchair service provision trainers. This programme has potential to increase the number of trainees and may increase the number of qualified service providers. PMID:28936423

  17. Assessment of economic viability of solid waste service provision in small settlements in developing countries: case study Rosetta, Egypt.

    PubMed

    Abdrabo, Mohamed Abdel-Karim

    2008-12-01

    Problems associated with solid waste management (SWM) service provision in developing countries are reaching an ever increasing magnitude, leading to considerable adverse impacts on the environment and quality of life of the inhabitants. Such problems are usually associated with limited managerial, technical and financial capabilities of municipal authorities. Municipal authorities in Egypt that are responsible for SWM services have always been accused of providing a less than satisfactory service, leading to huge quantities of solid waste being uncollected. This study assesses the potential for the provision of an effective and sustainable service, by estimating willingness of the residents to pay for such a service and the cost involved in its provision. The study covered the Rosetta urban centre and its adjacent areas, which are located in the northwestern part of the Nile Delta. It was found that, from an economic perspective, a viable SWM service could be provided in the study area using local funds. In order to increase the likelihood of success of such a service, it may be provided by a local firm or a cooperative to be established for that purpose.

  18. Valuation of pollinator forage services provided by Eucalyptus cladocalyx.

    PubMed

    de Lange, Willem J; Veldtman, Ruan; Allsopp, Mike H

    2013-08-15

    We assess the monetary value of forage provisioning services for honeybees as provided by an alien tree species in the Western Cape province of South Africa. Although Eucalyptus cladocalyx is not an officially declared invader, it is cleared on a regular basis along with other invasive Eucalyptus species such as Eucalyptus camaldulensis, and Eucalyptus conferruminata (which have been prioritised for eradication in South Africa). We present some of the trade-offs associated with the clearing of E. cladocalyx by means of a practical example that illustrates a situation where the benefits of the species to certain stakeholders could support the containment of the species in demarcated areas, while allowing clearing outside such areas. Given the absence of market prices for such forage provisioning services, the replacement cost is used to present the value of the loss in forage as provided by E. cladocalyx if the alien tree species is cleared along with invasive alien tree species. Two replacement scenarios formed the basis for our calculations. The first scenario was an artificial diet as replacement for the forage provisioning service, which yielded a direct cost estimate of US$7.5 m per year. The second was based on a Fynbos cultivation/restoration initiative aimed at substituting the forage provisioning service of E. cladocalyx, which yielded a direct cost of US$20.2 m per year. These figures provide estimates of the potential additional cost burden on the beekeeping industry if E. cladocalyx is completely eradicated from the Western Cape. The cost estimates should be balanced against the negative impacts of E. cladocalyx on ecosystem services in order to make an informed decision with regard to appropriate management strategies for this species. The findings therefore serve as useful inputs to balance trade-offs for alien species that are considered as beneficial to some, but harmful to other. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Towards Internet QoS provisioning based on generic distributed QoS adaptive routing engine.

    PubMed

    Haikal, Amira Y; Badawy, M; Ali, Hesham A

    2014-01-01

    Increasing efficiency and quality demands of modern Internet technologies drive today's network engineers to seek to provide quality of service (QoS). Internet QoS provisioning gives rise to several challenging issues. This paper introduces a generic distributed QoS adaptive routing engine (DQARE) architecture based on OSPFxQoS. The innovation of the proposed work in this paper is its undependability on the used QoS architectures and, moreover, splitting of the control strategy from data forwarding mechanisms, so we guarantee a set of absolute stable mechanisms on top of which Internet QoS can be built. DQARE architecture is furnished with three relevant traffic control schemes, namely, service differentiation, QoS routing, and traffic engineering. The main objective of this paper is to (i) provide a general configuration guideline for service differentiation, (ii) formalize the theoretical properties of different QoS routing algorithms and then introduce a QoS routing algorithm (QOPRA) based on dynamic programming technique, and (iii) propose QoS multipath forwarding (QMPF) model for paths diversity exploitation. NS2-based simulations proved the DQARE superiority in terms of delay, packet delivery ratio, throughput, and control overhead. Moreover, extensive simulations are used to compare the proposed QOPRA algorithm and QMPF model with their counterparts in the literature.

  20. Towards Internet QoS Provisioning Based on Generic Distributed QoS Adaptive Routing Engine

    PubMed Central

    Haikal, Amira Y.; Badawy, M.; Ali, Hesham A.

    2014-01-01

    Increasing efficiency and quality demands of modern Internet technologies drive today's network engineers to seek to provide quality of service (QoS). Internet QoS provisioning gives rise to several challenging issues. This paper introduces a generic distributed QoS adaptive routing engine (DQARE) architecture based on OSPFxQoS. The innovation of the proposed work in this paper is its undependability on the used QoS architectures and, moreover, splitting of the control strategy from data forwarding mechanisms, so we guarantee a set of absolute stable mechanisms on top of which Internet QoS can be built. DQARE architecture is furnished with three relevant traffic control schemes, namely, service differentiation, QoS routing, and traffic engineering. The main objective of this paper is to (i) provide a general configuration guideline for service differentiation, (ii) formalize the theoretical properties of different QoS routing algorithms and then introduce a QoS routing algorithm (QOPRA) based on dynamic programming technique, and (iii) propose QoS multipath forwarding (QMPF) model for paths diversity exploitation. NS2-based simulations proved the DQARE superiority in terms of delay, packet delivery ratio, throughput, and control overhead. Moreover, extensive simulations are used to compare the proposed QOPRA algorithm and QMPF model with their counterparts in the literature. PMID:25309955

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