Relationships, Expertise, Incentives, and Governance: Supporting Care Home Residents' Access to Health Care. An Interview Study From England

PubMed Central

Goodman, Claire; Davies, Sue L.; Gordon, Adam L.; Meyer, Julienne; Dening, Tom; Gladman, John R.F.; Iliffe, Steve; Zubair, Maria; Bowman, Clive; Victor, Christina; Martin, Finbarr C.

2015-01-01

Objectives To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. Methods Qualitative, semistructured interviews with a purposive sample of people with direct experience of commissioning, providing, and regulating health care provision in care homes and care home residents. Data from interviews were augmented by a secondary analysis of previous interviews with care home residents on their personal experience of and priorities for access to health care. Analysis was framed by the assumptions of realist evaluation and drew on the constant comparative method to identify key themes about what is required to achieve quality health care provision to care homes and resident health. Results Participants identified 3 overlapping approaches to the provision of NHS that they believed supported access to health care for older people in care homes: (1) Investment in relational working that fostered continuity and shared learning between visiting NHS staff and care home staff, (2) the provision of age-appropriate clinical services, and (3) governance arrangements that used contractual and financial incentives to specify a minimum service that care homes should receive. Conclusion The 3 approaches, and how they were typified as working, provide a rich picture of the stakeholder perspectives and the underlying assumptions about how service delivery models should work with care homes. The findings inform how evidence on effective working in care homes will be interrogated to identify how different approaches, or specifically key elements of those approaches, achieve different health-related outcomes in different situations for residents and associated health and social care organizations. PMID:25687930

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…

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.

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.

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.

48 CFR 1213.7101 - Solicitation provision and contract clause.

Code of Federal Regulations, 2011 CFR

2011-10-01

... contract clause. 1213.7101 Section 1213.7101 Federal Acquisition Regulations System DEPARTMENT OF TRANSPORTATION CONTRACTING METHODS AND CONTRACT TYPES SIMPLIFIED ACQUISITION PROCEDURES Department of Transportation Procedures for Acquiring Training Services 1213.7101 Solicitation provision and contract clause...

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.

Pharmacists' views on the development of asthma pharmaceutical care model in Indonesia: A needs analysis study.

PubMed

Widayati, Aris; Virginia, Dita Maria; Setiawan, Christianus Heru; Fenty, Fenty; Donowati, Maria Wisnu; Christasani, Putu Dyana; Hartayu, Titien Siwi; Suhadi, Rita; Saini, Bandana; Armour, Carol

2018-01-30

Over recent years the pharmacy profession in Indonesia has adopted a stance of pharmaceutical care to expand their scope of practice. Asthma management presents a key opportunity for pharmacists to test expanded roles in health service provision. There is however no exploratory work on the willingness, experience or future practice needs of Indonesian pharmacists in the realm of specialised asthma service provision. The objectives of this study were to explore Indonesian pharmacists' experiences, perspectives, and needs regarding the provision of pharmaceutical care for asthma patients in Indonesia. The study utilised conventional qualitative content analyses with two stages, i.e.: deductive analyses and inductive concept development. Data were collected using Focus Group Discussion (FGD) Method. FGDs were conducted using a topic guide and by facilitators trained in FGD conduct. FGDs were audio-recorded and transcribed verbatim prior to analysis. A maximum variation sampling methods targeted pharmacist across various settings of practice within Yogyakarta Indonesia. Nine focus groups with 103 pharmacist participants were conducted, with an average of 11 participants in each group. Inductively derived concepts that emerged included: willingness to adopt asthma service provision roles, pragmatism in recognising essential barriers/facilitators in adopting such roles, reflections regarding practice gaps and barriers to interprofessional collaboration mainly in relation to doctors. Inductive data analysis indicated clear differences in responses between hospital and non-hospital pharmacists. Key barriers to service provision included lack of training, lack of supportive professional frameworks, time and lack of reimbursement channels for services. Participants urged for a visionary leadership to facilitate pharmacists' role expansion into health services provision in Indonesia. Indonesian pharmacists were willing to adopt change and reported universally recognised barriers and facilitators to changing roles, especially in the provision of asthma care. Given this universality of pharmacists expressions, it may be suggested that the experience of researchers and academics who have expended time and effort in developing and implementing asthma care models in other countries should be, to some extent, transplanted to regions where pharmacy organisations are now considering adopting roles additional to medicines supply. Copyright © 2018 Elsevier Inc. All rights reserved.

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.

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.

The Commissioning and Provision of Advocacy for Problem Drug Users in English DATS: A Cross-Sectional Survey

ERIC Educational Resources Information Center

Cargill, Tamsin; Weaver, Tim D.; Patterson, Sue

2012-01-01

Aims: This study investigated the commissioning and delivery of advocacy for problem drug users. We aimed to quantify provision, describe the commissioning of advocacy services in Drug Action Teams (DATs) and to identify factors influencing advocacy provision. Methods: A cross-sectional survey of a randomly selected sample of 50 English DATs. The…

7 CFR 800.83 - Sampling provisions by kind of movement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Section 800.83 Agriculture Regulations of the Department of Agriculture (Continued) GRAIN INSPECTION, PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Inspection Methods and Procedures § 800.83 Sampling provisions by kind of movement. (a) Export...

7 CFR 800.83 - Sampling provisions by kind of movement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Section 800.83 Agriculture Regulations of the Department of Agriculture (Continued) GRAIN INSPECTION, PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Inspection Methods and Procedures § 800.83 Sampling provisions by kind of movement. (a) Export...

7 CFR 800.83 - Sampling provisions by kind of movement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Section 800.83 Agriculture Regulations of the Department of Agriculture (Continued) GRAIN INSPECTION, PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Inspection Methods and Procedures § 800.83 Sampling provisions by kind of movement. (a) Export...

7 CFR 800.83 - Sampling provisions by kind of movement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 800.83 Agriculture Regulations of the Department of Agriculture (Continued) GRAIN INSPECTION, PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Inspection Methods and Procedures § 800.83 Sampling provisions by kind of movement. (a) Export...

7 CFR 800.83 - Sampling provisions by kind of movement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Section 800.83 Agriculture Regulations of the Department of Agriculture (Continued) GRAIN INSPECTION, PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Inspection Methods and Procedures § 800.83 Sampling provisions by kind of movement. (a) Export...

What is the current NHS service provision for patients severely affected by chronic fatigue syndrome/myalgic encephalomyelitis? A national scoping exercise

PubMed Central

McDermott, Clare; Al Haddabi, Atheer; Akagi, Hiroko; Selby, Michelle; Cox, Diane; Lewith, George

2014-01-01

Background Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), in its most severe clinical presentation, can result in patients becoming housebound and bedbound so unable to access most available specialist services. This presents particular clinical risks and treatment needs for which the National Institute for Health and Care Excellence (NICE) advises specialist medical care and monitoring. The extent of National Health Service (NHS) specialist provision in England for severe CFS/ME is currently unknown. Objectives To establish the current NHS provision for patients with severe CFS/ME in England. Setting and participants All 49 English NHS specialist CFS/ME adult services in England, in 2013. Method Cross-sectional survey by email questionnaire. Primary outcome measures Adherence to NICE guidelines for severe CFS/ME. Results All 49 services replied (100%). 33% (16/49) of specialist CFS/ME services provided no service for housebound patients. 55% (27/49) services did treat patients with severe CFS/ME and their interventions followed the NICE guidelines. The remaining services (12%, 6/49) offered occasional or minimal support where funding allowed. There was one NHS unit providing specialist inpatient CFS/ME provision in England. Conclusions Study findings highlight substantial variation in access to specialist care for patients with severe presentation of CFS/ME. Where treatment was provided, this appeared to comply with NICE recommendations for this patient group. PMID:24984956

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

Rural women's perspectives of maternity services in the Midland Region of New Zealand.

PubMed

Gibbons, Veronique; Lancaster, Gytha; Gosman, Kim; Lawrenson, Ross

2016-09-01

INTRODUCTION Rural women face many challenges with regards to maternity services. Many rural primary birthing facilities in New Zealand have closed. The Lead Maternity Carer (LMC) model of maternity care, introduced in 1990, has moved provision of rural maternity care from doctors to independent midwifery services. Shortages of rural midwives in the Midland region led to rural maternity care being seen as a vulnerable service. AIM To understand the views and experiences of rural women concerning maternity care, to inform the future design and provision of rural maternity services. METHODS Participants were drawn from areas purposively selected to represent the five District Health Boards comprising the Midland health region. A demographic questionnaire, focus groups and individual interviews explored rural women's perspectives of antenatal care provision. These were analysed thematically. RESULTS Sixty-two women were recruited. Key themes emerging from focus groups and interviews included: access to services, the importance of safety and quality of care, the need for appropriate information at different stages, and the role of partners, family and friends in the birthing journey. While most women were happy with access to services, quality of care, provision of information, and the role of family in their care, for some women, this experience could be enhanced. CONCLUSION Midwives are the frontline service for women seeking antenatal services. Support for rural midwives and for local birthing units is needed to ensure rural women receive services equal to that of their urban counterparts.

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.

42 CFR 441.20 - Family planning services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Family planning services. 441.20 Section 441.20... General Provisions § 441.20 Family planning services. For recipients eligible under the plan for family... free to choose the method of family planning to be used. ...

42 CFR 441.20 - Family planning services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Family planning services. 441.20 Section 441.20... General Provisions § 441.20 Family planning services. For recipients eligible under the plan for family... free to choose the method of family planning to be used. ...

Towards improving service delivery in screening and intervention services in community pharmacies: a case study of an alcohol IBA service.

PubMed

Mackridge, A J; Krska, J; Stokes, E C; Heim, D

2016-03-01

Previous studies have demonstrated positive outcomes from a range of pharmacy public health services, but barriers to delivery remain. This paper explores the processes of delivering an alcohol screening and intervention service, with a view to improving service delivery. A mixed-methods, multi-perspective approach was used, comprising in-pharmacy observations and recording of service provision, follow-up interviews with service users and interactive feedback sessions with service providers. Observations and recordings indicate that staff missed opportunities to offer the service and that both availability and delivery of the service were inconsistent, partly owing to unavailability of trained staff and service restrictions. Most service users gave positive accounts of the service and considered pharmacies to be appropriate places for this service. Respondents also described positive impacts, ranging from thinking more about alcohol consumption generally to substantial reductions in consumption. Key facilitators to service provision included building staff confidence and service champions. Barriers included commissioning issues and staff perception of alcohol as a sensitive topic. Findings support expansion of pharmacies' role in delivering public health services and highlight benefits of providing feedback to pharmacy staff on their service provision as a possible avenue for service improvement. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Perceptions of retired professional soccer players about the provision of support services before and after retirement

PubMed Central

Drawer, S; Fuller, C.; Waddington, I

2002-01-01

Objective: To determine the views of retired players about the provision of support services in English professional soccer before and after retirement and to assess the impact of career ending injury on these views. Method: An anonymous self administered questionnaire was distributed to 500 former players registered with the English Professional Footballers' Association. The questions asked about personal details, current medical status, reasons for retirement, perceptions of the provision and quality of support services, and use of prophylactic treatments while injured. Results: Of the 500 questionnaires distributed, 185 (37%) were returned. The Professional Footballers' Association provided significantly (p<0.001) more help and advice to retired players on medical, financial, career, and educational matters than any other organisation. Although respondents showed some satisfaction with the provision of medical support, they were significantly (p<0.001) less satisfied with the provision of sports science (23%) and education/welfare (19%) support. Respondents who had retired through injury, however, were more dissatisfied with the provision of all services. Significantly (p<0.001) more respondents agreed with the view that injuries would reduce income earning potential, contribute to medical problems, and restrict the duration of their playing career. Respondents who had been medically diagnosed with osteoarthritis were significantly more likely, at some time, to have regularly received steroid injections while injured. Conclusion: The results presented are consistent with other evidence that the provision of injury prevention and socioeconomic services at professional soccer clubs is inadequate. The soccer industry should therefore develop a long term strategy for managing the needs of players who are forced to retire through injury. PMID:11867490

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.

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

Freshwater Ecosystem Service Flow Model To Evaluate Regional Water Security: A Case Study In Beijing-Tianjin-Hebei Region, China

NASA Astrophysics Data System (ADS)

Li, D.; Li, S.

2016-12-01

Freshwater service, as the most important support ecosystem service, is essential to human survival and development. Many studies have evidenced the spatial differences in the supply and demand of ecosystem services and raised the concept of ecosystem service flow. However, rather few studies quantitatively characterize the freshwater service flow. This paper aims to quantify the effect of freshwater ecosystem service flow on downstream areas in Beijing-Tianjin-Hebei (BTH) region, China over 2000, 2005 and 2010. We computed the freshwater ecosystem service provision with InVEST model. We calculated freshwater ecosystem service consumption with water quota method. We simulated the freshwater ecosystem service flow using our simplified flow model and assessed the regional water security with the improved freshwater security index. The freshwater provision service mainly depends on climatic factors that cannot be influenced by management, while the freshwater consumption service is constrained by human activities. Furthermore, the decrease of water quota for agricultural, domestic and industrial water counteracts the impact of increasing freshwater demand. The analysis of freshwater ecosystem service flow reveals that the majority area of the BTH (69.2%) is affected by upstream freshwater. If freshwater ecosystem service flow is considered, the water safety areas of the whole BTH account for 66.9%, 66.1%, 71.3%, which increase 6.4%, 6.8% and 5.7% in 2000, 2005 and 2010, respectively. These results highlight the need to understand the teleconnections between distant freshwater ecosystem service provision and local freshwater ecosystem service use. This approach therefore helps managers choose specific management and investment strategies for critical upstream freshwater provisions across different regions.

40 CFR 65.120 - Reporting provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) CONSOLIDATED FEDERAL AIR RULE Equipment Leaks § 65.120 Reporting provisions. (a) Initial Compliance Status... equipment in vacuum service; and (iii) Method of compliance with the standard (for example, “monthly leak... in a summary format by equipment type the number of components for which leaks were detected, and for...

Service Provision for Young People with Intellectual Disabilities and Additional Mental Health Needs: Service-Providers' Perspectives

ERIC Educational Resources Information Center

Scior, Katrina; Grierson, Kate

2004-01-01

Background: Very little is known about young people with intellectual disabilities who experience additional mental health problems. The perspective of service providers has been highlighted as one unresearched area. Method: Semi-structured interviews were completed with senior service providers. Aims: (1) to explore experiences of working with…

Day Service Provision for People with Intellectual Disabilities: A Case Study Mapping 15-Year Trends in Ireland

ERIC Educational Resources Information Center

Fleming, Padraic; McGilloway, Sinead; Barry, Sarah

2017-01-01

Background: Day services for people with intellectual disabilities are experiencing a global paradigm shift towards innovative person-centred models of care. This study maps changing trends in day service utilization to highlight how policy, emergent patterns and demographic trends influence service delivery. Methods: National intellectual…

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

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...

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.

Quality of service provision assessment in the healthcare information and telecommunications infrastructures.

PubMed

Babulak, Eduard

2006-01-01

The continuous increase in the complexity and the heterogeneity of corporate and healthcare telecommunications infrastructures will require new assessment methods of quality of service (QoS) provision that are capable of addressing all engineering and social issues with much faster speeds. Speed and accessibility to any information at any time from anywhere will create global communications infrastructures with great performance bottlenecks that may put in danger human lives, power supplies, national economy and security. Regardless of the technology supporting the information flows, the final verdict on the QoS is made by the end user. The users' perception of telecommunications' network infrastructure QoS provision is critical to the successful business management operation of any organization. As a result, it is essential to assess the QoS Provision in the light of user's perception. This article presents a cost effective methodology to assess the user's perception of quality of service provision utilizing the existing Staffordshire University Network (SUN) by adding a component of measurement to the existing model presented by Walker. This paper presents the real examples of CISCO Networking Solutions for Health Care givers and offers a cost effective approach to assess the QoS provision within the campus network, which could be easily adapted to any health care organization or campus network in the world.

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

PubMed Central

Margaria, Tiziana; Kubczak, Christian; Steffen, Bernhard

2008-01-01

Background With Bio-jETI, we introduce a service platform for interdisciplinary work on biological application domains and illustrate its use in a concrete application concerning statistical data processing in R and xcms for an LC/MS analysis of FAAH gene knockout. Methods Bio-jETI uses the jABC environment for service-oriented modeling and design as a graphical process modeling tool and the jETI service integration technology for remote tool execution. Conclusions As a service definition and provisioning platform, Bio-jETI has the potential to become a core technology in interdisciplinary service orchestration and technology transfer. Domain experts, like biologists not trained in computer science, directly define complex service orchestrations as process models and use efficient and complex bioinformatics tools in a simple and intuitive way. PMID:18460173

Policy implementation in wheelchair service delivery in a rural South African setting.

PubMed

Visagie, Surona; Scheffler, Elsje; Schneider, Marguerite

2013-01-01

Wheelchairs allow users to realise basic human rights and improved quality of life. South African and international documents guide rehabilitation service delivery and thus the provision of wheelchairs. Evidence indicates that rehabilitation policy implementation gaps exist in rural South Africa. The aim of this article was to explore the extent to which wheelchair service delivery in a rural, remote area of South Africa was aligned with the South African National Guidelines on Provision of Assistive Devices, The United Nations Convention on the Rights of Persons with Disabilities and The World Health Organization Guidelines on Provision of Wheelchairs in Less-Resourced Settings. Qualitative methods were used. Data were collected through semi-structured interviews with 22 participants who were identified through purposive sampling. Content analysis of data was preformed around the construct of wheelchair service delivery. Study findings identified gaps between the guiding documents and wheelchair service delivery. Areas where gaps were identified included service aspects such as referral, assessment, prescription, user and provider training, follow up, maintenance and repair as well as management aspects such as staff support, budget and monitoring. Positive findings related to individual assessments, enthusiastic and caring staff and the provision of wheelchairs at no cost. The gaps in policy implementation can have a negative impact on users and the service provider. Inappropriate or no wheelchairs limit user function, participation and quality of life. In addition, an inappropriate wheelchair will have a shorter lifespan, requiring frequent repairs and replacements with cost implications for the service provider.

Who, What, Where: an analysis of private sector family planning provision in 57 low- and middle-income countries.

PubMed

Campbell, Oona M R; Benova, Lenka; Macleod, David; Goodman, Catherine; Footman, Katharine; Pereira, Audrey L; Lynch, Caroline A

2015-12-01

Family planning service delivery has been neglected; rigorous analyses of the patterns of contraceptive provision are needed to inform strategies to address this neglect. We used 57 nationally representative Demographic and Health Surveys in low- and middle-income countries (2000-2013) in four geographic regions to estimate need for contraceptive services, and examined the sector of provision, by women's socio-economic position. We also assessed method mix and whether women were informed of side effects. Modern contraceptive use among women in need was lowest in sub-Saharan Africa (39%), with other regions ranging from 64% to 72%. The private sector share of the family planning market was 37-39% of users across the regions and 37% overall (median across countries: 41%). Private sector users accessed medical providers (range across regions: 30-60%, overall mean: 54% and median across countries 23%), specialised drug sellers (range across regions: 31-52%, overall mean: 36% and median across countries: 43%) and retailers (range across regions: 3-14%, overall mean: 6% and median across countries: 6%). Private retailers played a more important role in sub-Saharan Africa (14%) than in other regions (3-5%). NGOs and FBOs served a small percentage. Privileged women (richest wealth quintile, urban residents or secondary-/tertiary-level education) used private sector services more than the less privileged. Contraceptive method types with higher requirements (medical skills) for provision were less likely to be acquired from the private sector, while short-acting methods/injectables were more likely. The percentages of women informed of side effects varied by method and provider subtype, but within subtypes were higher among public than private medical providers for four of five methods assessed. Given the importance of private sector providers, we need to understand why women choose their services, what quality services the private sector provides, and how it can be improved. However, when prioritising one of the two sectors (public vs. private), it is critical to consider the potential impact on contraceptive prevalence and equity of met need. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

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

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.

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

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

A statistical analysis of the relationship between land values and freestanding bus facilities.

DOT National Transportation Integrated Search

2010-02-01

Public transit professionals continue to seek methods that offer greater service opportunities, while : not materially increasing the costs of service provision. One strategy is to construct bus transit : centers which operate much like the airline h...

System considerations, projected requirements and applications for aeronautical mobile satellite communications for air traffic services

NASA Technical Reports Server (NTRS)

Mcdonald, K. D.; Miller, C. M.; Scales, W. C.; Dement, D. K.

1990-01-01

The projected application and requirements in the near term (to 1995) and far term (to 2010) for aeronautical mobile services supporting air traffic control operations are addressed. The implications of these requirements on spectrum needs, and the resulting effects on the satellite design and operation are discussed. The U.S. is working with international standards and regulatory organizations to develop the necessary aviation standards, signalling protocols, and implementation methods. In the provision of aeronautical safety services, a number of critical issues were identified, including system reliability and availability, access time, channel restoration time, interoperability, pre-emption techniques, and the system network interfaces. Means for accomplishing these critical services in the aeronautical mobile satellite service (AMSS), and the various activities relating to the future provision of aeronautical safety services are addressed.

System considerations, projected requirements and applications for aeronautical mobile satellite communications for air traffic services

NASA Astrophysics Data System (ADS)

McDonald, K. D.; Miller, C. M.; Scales, W. C.; Dement, D. K.

The projected application and requirements in the near term (to 1995) and far term (to 2010) for aeronautical mobile services supporting air traffic control operations are addressed. The implications of these requirements on spectrum needs, and the resulting effects on the satellite design and operation are discussed. The U.S. is working with international standards and regulatory organizations to develop the necessary aviation standards, signalling protocols, and implementation methods. In the provision of aeronautical safety services, a number of critical issues were identified, including system reliability and availability, access time, channel restoration time, interoperability, pre-emption techniques, and the system network interfaces. Means for accomplishing these critical services in the aeronautical mobile satellite service (AMSS), and the various activities relating to the future provision of aeronautical safety services are addressed.

Improving health worker performance of abortion services: an assessment of post-training support to providers in India, Nepal and Nigeria.

PubMed

Benson, Janie; Healy, Joan; Dijkerman, Sally; Andersen, Kathryn

2017-11-21

Health worker performance has been the focus of numerous interventions and evaluation studies in low- and middle-income countries. Few have examined changes in individual provider performance with an intervention encompassing post-training support contacts to improve their clinical practice and resolve programmatic problems. This paper reports the results of an intervention with 3471 abortion providers in India, Nepal and Nigeria. Following abortion care training, providers received in-person visits and virtual contacts by a clinical and programmatic support team for a 12-month period, designed to address their individual practice issues. The intervention also included technical assistance to and upgrades in facilities where the providers worked. Quantitative measures to assess provider performance were established, including: 1) Increase in service provision; 2) Consistent service provision; 3) Provision of high quality of care through use of World Health Organization-recommended uterine evacuation technologies, management of pain and provision of post-abortion contraception; and 4) Post-abortion contraception method mix. Descriptive univariate analysis was conducted, followed by examination of the bivariate relationships between all independent variables and the four dependent performance outcome variables by calculating unadjusted odds ratios, by country and overall. Finally, multivariate logistic regression was performed for each outcome. Providers received an average of 5.7 contacts. Sixty-two percent and 46% of providers met measures for consistent service provision and quality of care, respectively. Fewer providers achieved an increased number of services (24%). Forty-six percent provided an appropriate postabortion contraceptive mix to clients. Most providers met the quality components for use of WHO-recommended abortion methods and provision of pain management. Factors significantly associated with achievement of all measures were providers working in sites offering community outreach and those trained in intervention year two. The number of in-person contacts was significantly associated with achievement of three of four measures. Post-training support holds promise for strengthening health worker performance. Further research is needed to compare this intervention with other approaches and assess how post-training contacts could be incorporated into current health system supervision.

Community and health systems barriers and enablers to family planning and contraceptive services provision and use in Kabwe District, Zambia.

PubMed

Silumbwe, Adam; Nkole, Theresa; Munakampe, Margarate Nzala; Milford, Cecilia; Cordero, Joanna Paula; Kriel, Yolandie; Zulu, Joseph Mumba; Steyn, Petrus S

2018-05-31

Unmet need for contraception results in several health challenges such as unintended pregnancies, unwanted births and unsafe abortions. Most interventions have been unable to successfully address this unmet need due to various community and health system level factors. Identifying these inhibiting and enabling factors prior to implementation of interventions forms the basis for planning efforts to increase met needs. This qualitative study was part of the formative phase of a larger research project that aimed to develop an intervention to increase met needs for contraception through community and health system participation. The specific study component reported here explores barriers and enablers to family planning and contraceptive services provision and utilisation at community and health systems levels. Twelve focus group discussions were conducted with community members (n = 114) and two with healthcare providers (n = 19). Ten in-depth interviews were held with key stakeholders. The study was conducted in Kabwe district, Zambia. Interviews/discussions were translated and transcribed verbatim. Data were coded and organised using NVivo 10 (QSR international), and were analysed using thematic analysis. Health systems barriers include long distances to healthcare facilities, stock-outs of preferred methods, lack of policies facilitating contraceptive provision in schools, and undesirable provider attitudes. Community level barriers comprise women's experience with contraceptive side effects, myths, rumours and misconceptions, societal stigma, and negative traditional and religious beliefs. On the other hand, health systems enablers consist of political will from government to expand contraceptive services access, integration of contraceptive services, provision of couples counselling, and availability of personnel to offer basic methods mix. Functional community health system structures, community desire to delay pregnancy, and knowledge of contraceptive services are enablers at a community level. These study findings highlight key community and health systems factors that should be considered by policy, program planners and implementers in the design and implementation of family planning and contraceptive services programmes, to ensure sustained uptake and increased met needs for contraceptive methods and services.

Uncertainty of Monetary Valued Ecosystem Services – Value Transfer Functions for Global Mapping

PubMed Central

Schmidt, Stefan; Manceur, Ameur M.; Seppelt, Ralf

2016-01-01

Growing demand of resources increases pressure on ecosystem services (ES) and biodiversity. Monetary valuation of ES is frequently seen as a decision-support tool by providing explicit values for unconsidered, non-market goods and services. Here we present global value transfer functions by using a meta-analytic framework for the synthesis of 194 case studies capturing 839 monetary values of ES. For 12 ES the variance of monetary values could be explained with a subset of 93 study- and site-specific variables by utilizing boosted regression trees. This provides the first global quantification of uncertainties and transferability of monetary valuations. Models explain from 18% (water provision) to 44% (food provision) of variance and provide statistically reliable extrapolations for 70% (water provision) to 91% (food provision) of the terrestrial earth surface. Although the application of different valuation methods is a source of uncertainty, we found evidence that assuming homogeneity of ecosystems is a major error in value transfer function models. Food provision is positively correlated with better life domains and variables indicating positive conditions for human well-being. Water provision and recreation service show that weak ownerships affect valuation of other common goods negatively (e.g. non-privately owned forests). Furthermore, we found support for the shifting baseline hypothesis in valuing climate regulation. Ecological conditions and societal vulnerability determine valuation of extreme event prevention. Valuation of habitat services is negatively correlated with indicators characterizing less favorable areas. Our analysis represents a stepping stone to establish a standardized integration of and reporting on uncertainties for reliable and valid benefit transfer as an important component for decision support. PMID:26938447

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.

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.

The State of Sexual Health Services at U.S. Colleges and Universities

ERIC Educational Resources Information Center

Habel, Melissa A.; Coor, Alexandra; Beltran, Oscar; Becasen, Jeffrey; Pearson, William S.; Dittus, Patricia

2018-01-01

Objective: To describe the array of sexual health care services provided at US colleges and universities. Participants: During 2014-2015, 885 colleges were surveyed about their provision of sexual health services. Methods: 55% of colleges responded. Data were weighted and stratified by minority-serving institutions (MSIs), 2-year and 4-year…

Mental Health Services for Children and Adolescents with Learning Disabilities: A Review of Research on Experiences of Service Users and Providers

ERIC Educational Resources Information Center

Jacobs, Myrthe; Downie, Helen; Kidd, Gill; Fitzsimmons, Lorna; Gibbs, Susie; Melville, Craig

2016-01-01

Background: Children and young people with learning disabilities experience high rates of mental health problems. Methods: The present study reviewed the literature on mental health services for children with learning disabilities, to identify known models of service provision and what has been experienced as effective or challenging in providing…

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

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.

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.

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...

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.

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,…

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...

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...

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...

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...

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...

Projecting global land-use change and its effect on ecosystem service provision and biodiversity with simple models.

PubMed

Nelson, Erik; Sander, Heather; Hawthorne, Peter; Conte, Marc; Ennaanay, Driss; Wolny, Stacie; Manson, Steven; Polasky, Stephen

2010-12-15

As the global human population grows and its consumption patterns change, additional land will be needed for living space and agricultural production. A critical question facing global society is how to meet growing human demands for living space, food, fuel, and other materials while sustaining ecosystem services and biodiversity [1]. We spatially allocate two scenarios of 2000 to 2015 global areal change in urban land and cropland at the grid cell-level and measure the impact of this change on the provision of ecosystem services and biodiversity. The models and techniques used to spatially allocate land-use/land-cover (LULC) change and evaluate its impact on ecosystems are relatively simple and transparent [2]. The difference in the magnitude and pattern of cropland expansion across the two scenarios engenders different tradeoffs among crop production, provision of species habitat, and other important ecosystem services such as biomass carbon storage. For example, in one scenario, 5.2 grams of carbon stored in biomass is released for every additional calorie of crop produced across the globe; under the other scenario this tradeoff rate is 13.7. By comparing scenarios and their impacts we can begin to identify the global pattern of cropland and irrigation development that is significant enough to meet future food needs but has less of an impact on ecosystem service and habitat provision. Urban area and croplands will expand in the future to meet human needs for living space, livelihoods, and food. In order to jointly provide desired levels of urban land, food production, and ecosystem service and species habitat provision the global society will have to become much more strategic in its allocation of intensively managed land uses. Here we illustrate a method for quickly and transparently evaluating the performance of potential global futures.

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...

Response of ecosystem services to land use change in Xiamen Island

NASA Astrophysics Data System (ADS)

Gao, L.

2009-12-01

: Land use change was a major factor affecting ecosystem services. Taken Xiamen Island as an example, by integrating remote sensing data to examine land use patterns from 1950 to 2007, the regional ecosystem services of Xiamen Island were evaluated based on two revised methods aiming to identify the stress effects and mechanisms of land use change on ecosystem services. The results showed that during 1950~2007, in general, Xiamen Island’s land use intensity had been annually rising. The trends of Xiamen Island’s ecosystem services value acquired by two methods were both consistent with decreasing along with the growth of land use intensity. Before 1987, the ecosystem service value of Xiamen Island had increased by 1.07 million yuan, due to the expanding of 12.87 km2 water and wetland. After the establishment of Xiamen special economic zone in 1984, the rapid urbanization has resulted a sharp decline in ecosystem service value, the average annual loss reached by 619,773 yuan after 1987. As the utilization of land reaching saturation and the launching of ecological projects, such as the Xiamen Eastern Sea Comprehensive Improvement Project, it could be predicted that the decreasing trend of ecosystem services value was going to be slowed down in the near future. The first revised method referencing four eco-system services solved the problem of overestimated value caused by the second revised method based on provisioning service alone. By applying the ESV total correction method, the problem of over counting service value by correction made from a single aspect could be solved.Equivalent value per unit area of ecosystem services in China 2007 and revised value by second method Note: The modified coefficient of crop, orchard & forest, wetland and inland water provisioning ESV revised by the second method is 2.858, 2.405, 1.523, 1.843 respectively; for regulating, ultural and supporting ESV, the coefficient is 2.339, 15.339, 2.339 respectively.

Implementation Evaluation in a Private Nonprofit Setting: A Mixed-Methods Approach

ERIC Educational Resources Information Center

Walker, Jacquelyn Ann

2013-01-01

Demand for quality service provision in the human services industry requires that private nonprofit organizations have the administrative and management capacities to ensure successful implementation and sustain staff development programs. Unfamiliarity with implementation challenges, and limited awareness of implementation strategies, can trigger…

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...

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...

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...

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...

The Current Status and Factors Associated With Implanon Service Provision by the Health Extension Workers at the Health Post Level, Wolaita Zone, Southern Ethiopia: A Cross-Sectional Study

PubMed Central

Desalegn, Ketsela; Loha, Eskindir; Meskele, Mengistu

2017-01-01

Objective: Family Planning is often taken as one of the “Magic Bullet” interventions owing to its high impact and wide reaching nature in achieving multiple goals. This study aimed to assess the current status and the factors associated with health post level Implanon service provision through trained health extension workers in Wolaita zone, southern Ethiopia. Materials and methods: A cross sectional study was conducted among trained health extension workers in Wolaita zone in February 2013. A simple random sampling technique was used to identify a total of 285 trained HEWs. First bivariate, then multivariate logistic regression model along with 95% confidence interval was used to see the independent effect of factors associated with current Implanon service provision by the health extension workers. Results: Currently, the number of Implaon providing trained health extension workers in Wolaita was 264(45.8%). Distance of health post from district health offices and health center, turnover of trained health extension workers in the health post, interest of trained health extension workers in providing Implanon and their job satisfaction to serve as a health extension workers and availability of service delivery guidelines and teaching aids were associated with the current provision of Implanon by health extension workers. Conclusion: Implanon provision among trained health extension workers was affected by different factors. Hence, improving the working conditions of trained health extension workers, regular and periodic facilitative supervision, availing service delivery guidelines and improvement of health management information system are recommended. PMID:29114263

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…

Is Telephone Review Feasible and Potentially Effective in Low Vision Services?

ERIC Educational Resources Information Center

Parkes, Claire; Lennon, Julie; Harper, Robert

2013-01-01

Purpose: Demographic transformations within the UK population combine to contribute to a substantial increase in demand for low vision (LV) services, creating a pressing need to reconsider the appropriate methods for service provision. In this study, we evaluate the feasibility of using telephone triage to assess the need for, and timing of, LV…

Evidence for Overuse of Medical Services Around the World

PubMed Central

Brownlee, Shannon; Chalkidou, Kalipso; Doust, Jenny; Elshaug, Adam G.; Glasziou, Paul; Heath, Iona; Nagpal, Somil; Saini, Vikas; Srivastava, Divya; Chalmers, Kelsey; Korenstein, Deborah

2017-01-01

Summary Overuse, which is defined as the provision of medical services that are more likely to cause harm than good, is a global problem that afflicts rich and poor countries alike. This article reviews the definition of overuse, methods for measuring overuse, harms from overuse, and the evidence for worldwide overuse of many types of services. PMID:28077234

Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists

PubMed Central

2014-01-01

Background Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. Methods A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Results Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on ‘as needed’ basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS’ perceived 4 important ‘needs’ in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support. Conclusions Post discharge stroke care guidelines and access to rehabilitation services at primary care is needed for post stroke patients residing at home in the community. PMID:24580779

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...

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.

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...

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.

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...

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...

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...

‘Mind the gap’ - mapping services for young people with ADHD transitioning from child to adult mental health services

PubMed Central

2013-01-01

Background Once considered to be a disorder restricted to childhood, Attention Deficit/Hyperactivity Disorder (ADHD) is now recognised to persist into adult life. However, service provision for adults with ADHD is limited. Additionally, there is little guidance or research on how best to transition young people with ADHD from child to adult services. Method We report the findings of a survey of 96 healthcare professionals working in children’s (Child and Adolescent Mental Health Services and Community Paediatrics) and adult services across five NHS Trusts within the East Midlands region of England to gain a better understanding of the current provision of services for young people with ADHD transitioning into adult mental health services. Results Our findings indicate a lack of structured guidelines on transitioning and little communication between child and adult services. Child and adult services had differing opinions on what they felt adult services should provide for ADHD cases. Adult services reported feeling ill-prepared to deal with ADHD patients, with clinicians in these services citing a lack of specific knowledge of ADHD and a paucity of resources to deal with such cases. Conclusions We discuss suggestions for further research, including the need to map the national provision of services for adults with ADHD, and provide recommendations for commissioned adult ADHD services. We specifically advocate an increase in ADHD-specific training for clinicians in adult services, the development of specialist adult ADHD clinics and greater involvement of Primary Care to support the work of generic adult mental health services in adult ADHD management. PMID:23842080

Combining qualitative and quantitative operational research methods to inform quality improvement in pathways that span multiple settings

PubMed Central

Crowe, Sonya; Brown, Katherine; Tregay, Jenifer; Wray, Jo; Knowles, Rachel; Ridout, Deborah A; Bull, Catherine; Utley, Martin

2017-01-01

Background Improving integration and continuity of care across sectors within resource constraints is a priority in many health systems. Qualitative operational research methods of problem structuring have been used to address quality improvement in services involving multiple sectors but not in combination with quantitative operational research methods that enable targeting of interventions according to patient risk. We aimed to combine these methods to augment and inform an improvement initiative concerning infants with congenital heart disease (CHD) whose complex care pathway spans multiple sectors. Methods Soft systems methodology was used to consider systematically changes to services from the perspectives of community, primary, secondary and tertiary care professionals and a patient group, incorporating relevant evidence. Classification and regression tree (CART) analysis of national audit datasets was conducted along with data visualisation designed to inform service improvement within the context of limited resources. Results A ‘Rich Picture’ was developed capturing the main features of services for infants with CHD pertinent to service improvement. This was used, along with a graphical summary of the CART analysis, to guide discussions about targeting interventions at specific patient risk groups. Agreement was reached across representatives of relevant health professions and patients on a coherent set of targeted recommendations for quality improvement. These fed into national decisions about service provision and commissioning. Conclusions When tackling complex problems in service provision across multiple settings, it is important to acknowledge and work with multiple perspectives systematically and to consider targeting service improvements in response to confined resources. Our research demonstrates that applying a combination of qualitative and quantitative operational research methods is one approach to doing so that warrants further consideration. PMID:28062603

12 CFR 618.8000 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Definitions. 618.8000 Section 618.8000 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Related Services § 618... means the method or procedures used to deliver a related service. This distinguishes the particulars of...

21 CFR 2.19 - Methods of analysis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Methods of analysis. 2.19 Section 2.19 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GENERAL ADMINISTRATIVE RULINGS AND DECISIONS General Provisions § 2.19 Methods of analysis. Where the method of analysis...

21 CFR 2.19 - Methods of analysis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Methods of analysis. 2.19 Section 2.19 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GENERAL ADMINISTRATIVE RULINGS AND DECISIONS General Provisions § 2.19 Methods of analysis. Where the method of analysis...

21 CFR 2.19 - Methods of analysis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Methods of analysis. 2.19 Section 2.19 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GENERAL ADMINISTRATIVE RULINGS AND DECISIONS General Provisions § 2.19 Methods of analysis. Where the method of analysis...

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...

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.

Information technologies in optimization process of monitoring of software and hardware status

NASA Astrophysics Data System (ADS)

Nikitin, P. V.; Savinov, A. N.; Bazhenov, R. I.; Ryabov, I. V.

2018-05-01

The article describes a model of a hardware and software monitoring system for a large company that provides customers with software as a service (SaaS solution) using information technology. The main functions of the monitoring system are: provision of up-todate data for analyzing the state of the IT infrastructure, rapid detection of the fault and its effective elimination. The main risks associated with the provision of these services are described; the comparative characteristics of the software are given; author's methods of monitoring the status of software and hardware are proposed.

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...

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...

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...

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...

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.

Towards understanding the availability of physiotherapy services in rural Australia.

PubMed

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

2016-01-01

A recent exploration of factors affecting rural physiotherapy service provision revealed considerable variation in services available between communities of the study. Multiple factors combined to influence local service provision, including macro level policy and funding decisions, service priorities and fiscal constraints of regional health services and capacity and capabilities at the physiotherapy service level. The aim of this article is to describe the variation in local service provision, the factors influencing service provision and the impact on availability of physiotherapy services. A priority-sequence mixed methods design structured the collection and integration of qualitative and quantitative data. The investigation area, a large part of one Australian state, was selected for the number of physiotherapy services and feasibility of conducting site visits. Stratified purposive sampling permitted exploration of rural physiotherapy with subgroups of interest, including physiotherapists, their colleagues, managers, and other key decision makers. Participant recruitment commenced with public sector physiotherapists and progressed to include private practitioners, team colleagues and managers. Surveys were mailed to key physiotherapy contacts in each public sector service in the area for distribution to physiotherapists, their colleagues and managers within their facility. Private physiotherapist principals working in the same communities were invited by the researcher to complete the physiotherapy survey. The survey collected demographic data, rural experience, work setting and number of colleagues, services provided, perspectives on factors influencing service provision and decisions about service provision. Semi-structured interviews were conducted with consenting physiotherapists and other key decision makers identified by local physiotherapists. Quantitative survey data were recorded in spreadsheets and analysed using descriptive statistics. Interviews were recorded and transcribed verbatim, with transcripts provided to participants for review. Open-ended survey questions and interview transcripts were analysed thematically. Surveys were received from 11/25 (44%) of facilities in the investigation area, with a response rate of 29.4% (16/54) from public sector physiotherapists. A further 18 surveys were received: five from principals of private physiotherapy practices and 13 from colleagues and managers. Nineteen interviews were conducted: with 14 physiotherapists (nine public, five private), four other decision makers and one colleague. Three decision makers declined an interview. The variation in physiotherapy service availability between the 11 communities of this study prompted the researchers to consider how such variation could be reflected. The influential factors that emerged from participant comments included rurality and population, size and funding model of public hospitals, the number of public sector physiotherapists and private practices, and the availability of specialised paediatric and rehabilitation services. The factors described by participants were used to develop a conceptual framework or index of rural physiotherapy availability. It is important to make explicit the link between workforce maldistribution, the resultant rural workforce shortages and the implications for local service availability. This study sought to do so by investigating physiotherapy service provision within the rural communities of the investigation area. In doing so, varying levels of availability emerged within local communities. A conceptual framework combining key influencing factors is offered as a way to reflect the availability of physiotherapy services.

Planning for Deinstitutionalization: A Review of Principles, Methods, and Applications. Human Services Monograph Series Number 28.

ERIC Educational Resources Information Center

Rutman, Irvin D., Ed.

This monograph advances ideas to aid planners and administrators responsible for the development of deinstitutionalization services for the disabled to develop a more rigorous, systematic approach to the provision of these services. The seven chapters of the publication, each written by a recognized leader in the field, focus on the following: (1)…

Books to Rural Users: Public Library Provision for Remote Communities.

ERIC Educational Resources Information Center

Haggis, Sarah; Goulding, Anne

2003-01-01

Discusses alternative methods of providing public library service to one-house stop clients of mobile libraries in the United Kingdom. Investigated books by mail, village shop libraries, extending housebound service, and transporting clients to the library; calculated costs to compare with mobile library cost; and surveyed staff and client…

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...

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

48 CFR 1335.006 - Contracting methods and contract type.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SPECIAL CATEGORIES OF CONTRACTING RESEARCH AND DEVELOPMENT CONTRACTING 1335.006 Contracting methods and... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contracting methods and... research services under the contract might involve the use of human subjects. The provision is mandatory...

Reengineering the retail/ambulatory pharmacy for provision of biotechnology pharmaceutical services.

PubMed

Schneider, P J

1998-07-01

Biotechnology products offer both problems and opportunities for pharmacists. On one hand, they are expensive to purchase and keep on inventory. Typical compensation for outpatient prescriptions does not offset the cost of maintaining the inventory, or providing the education and training that patients often need to use biotechnology products properly. On the other hand, there are issues related to proper storage, preparation, and administration for which pharmacists are well prepared to address. Pharmacists are also convenient, trusted, and provide service at relatively low cost. Examples of special services that pharmacists can provide to improve the use of biotechnology products include patient education, injection clinics, provision of medical supplies, and predrawing syringes for patients. Patients are often sent to many providers for these services, resulting in inconvenience and fragmentation of care. If new compensation methods can be established to support more comprehensive pharmacy services, the use of biotechnology products by patients will improve.

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.

An evaluation of a family planning mobile job aid for community health workers in Tanzania.

PubMed

Braun, Rebecca; Lasway, Christine; Agarwal, Smisha; L'Engle, Kelly; Layer, Erica; Silas, Lucy; Mwakibete, Anna; Kudrati, Mustafa

2016-07-01

The global rapid growth in mobile technology provides unique opportunities to support community health workers (CHWs) in providing family planning (FP) services. FHI 360, Pathfinder International and D-tree International developed an evidence-based mobile job aid to support CHW counseling, screening, service provision and referrals, with mobile forms for client and service data, and text-message reporting and reminders. The purpose of this study is to evaluate the acceptability and potential benefits to service quality from the perspective of CHWs and their clients. The mobile job aid was piloted in Dar es Salaam, Tanzania. Data collection tools included a demographic survey of all 25 CHWs trained to use the mobile job aid, in-depth interviews with 20 of the CHWs after 3 months and a survey of 176 clients who received FP services from a CHW using the mobile job aid after 6 months. Both CHWs and their clients reported that the mobile job aid was a highly acceptable FP support tool. CHWs perceived benefits to service quality, including timelier and more convenient care; better quality of information; increased method choice; and improved privacy, confidentiality and trust with clients. Most clients discussed multiple FP methods with CHWs; only 1 in 10 clients reported discussion of all 9 methods. This research suggests that mobile phones can be effective tools to support CHWs with FP counseling, screening and referrals, data collection and reporting, and communication. Challenges remain to support informed contraceptive choice. Future research should focus on implementation, including scale-up and sustainability. Mobile job aids can uniquely enhance FP service provision at the community level through adherence to standard protocols, real-time feedback and technical assistance, and provision of confidential care. This study can inform future efforts to support and expand the role of CHWs in increasing FP access and informed contraceptive choice. Copyright © 2016 Elsevier Inc. All rights reserved.

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…

The Climate Services Partnership (CSP): Working Together to Improve Climate Services Worldwide

NASA Astrophysics Data System (ADS)

Zebiak, S.; Brasseur, G.; Members of the CSP Coordinating Group

2012-04-01

Throughout the world, climate services are required to address urgent needs for climate-informed decision-making, policy and planning. These needs were explored in detail at the first International Conference on Climate Services (ICCS), held in New York in October 2011. After lengthy discussions of needs and capabilities, the conference culminated in the creation of the Climate Services Partnership (CSP). The CSP is an informal interdisciplinary network of climate information users, providers, donors and researchers interested in improving the provision and development of climate services worldwide. Members of the Climate Services Partnership work together to share knowledge, accelerate learning, develop new capacities, and establish good practices. These collaborative efforts will inform and support the evolution and implementation of the Global Framework for Climate Services. The Climate Services Partnership focuses its efforts on three levels. These include: 1. encouraging and sustaining connections between climate information providers, users, donors, and researchers 2. gathering, synthesizing and disseminating current knowledge on climate services by way of an online knowledge management platform 3. generating new knowledge on critical topics in climate service development and provision, through the creation of focused working groups on specific topics To date, the Climate Services Partnership has made progress on all three fronts. Connections have been fostered through outreach at major international conferences and professional societies. The CSP also maintains a website and a monthly newsletter, which serves as a resource for those interested in climate services. The second International Conference on Climate Services (ICCS2) will be held in Berlin in September. The CSP has also created a knowledge capture system that gathers and disseminates a wide range of information related to the development and provision of climate services. This includes an online-searchable database that allows users to see what climate services activities are underway in what locations, to gather and analyze information. As part of the knowledge capture system, more than 10 CSP members are currently developing case studies to describe specific climate services activities; in a few cases, this involves in-depth evaluations of the service in question. Finally, the Economics Working Group of the Climate Services Partnership is analyzing previous methods to economically value climate services in hopes of generating knew knowledge regarding the methods are best suited to assessing the benefits associated with various climate services. Other groups are working to develop guidance materials for the development and use of climate information to support decision and policy-making. The Climate Services Partnership is an open, informal network that builds on activities that are already underway and works to create synergies to improve the provision and development for climate services. Its members currently number more than 50 organizations; it seeks new participants and new initiatives.

The role of veterinary research laboratories in the provision of veterinary services.

PubMed

Verwoerd, D W

1998-08-01

Veterinary research laboratories play an essential role in the provision of veterinary services in most countries. These laboratories are the source of new knowledge, innovative ideas and improved technology for the surveillance, prevention and control of animal diseases. In addition, many laboratories provide diagnostic and other services. To ensure the optimal integration of various veterinary activities, administrators must understand the functions and constraints of research laboratories. Therefore, a brief discussion is presented of the following: organisational structures methods for developing research programmes outputs of research scientists and how these are measured the management of quality assurance funding of research. Optimal collaboration can only be attained by understanding the environment in which a research scientist functions and the motivational issues at stake.

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.

Relationships, expertise, incentives, and governance: supporting care home residents' access to health care. An interview study from England.

PubMed

Goodman, Claire; Davies, Sue L; Gordon, Adam L; Meyer, Julienne; Dening, Tom; Gladman, John R F; Iliffe, Steve; Zubair, Maria; Bowman, Clive; Victor, Christina; Martin, Finbarr C

2015-05-01

To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. Qualitative, semistructured interviews with a purposive sample of people with direct experience of commissioning, providing, and regulating health care provision in care homes and care home residents. Data from interviews were augmented by a secondary analysis of previous interviews with care home residents on their personal experience of and priorities for access to health care. Analysis was framed by the assumptions of realist evaluation and drew on the constant comparative method to identify key themes about what is required to achieve quality health care provision to care homes and resident health. Participants identified 3 overlapping approaches to the provision of NHS that they believed supported access to health care for older people in care homes: (1) Investment in relational working that fostered continuity and shared learning between visiting NHS staff and care home staff, (2) the provision of age-appropriate clinical services, and (3) governance arrangements that used contractual and financial incentives to specify a minimum service that care homes should receive. The 3 approaches, and how they were typified as working, provide a rich picture of the stakeholder perspectives and the underlying assumptions about how service delivery models should work with care homes. The findings inform how evidence on effective working in care homes will be interrogated to identify how different approaches, or specifically key elements of those approaches, achieve different health-related outcomes in different situations for residents and associated health and social care organizations. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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...

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...

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...

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...

Using design science research to develop online enhanced pharmaceutical care services.

PubMed

Lapão, Luís Velez; Gregório, João; Mello, Diogo; Cavaco, Afonso; Mira Da Silva, Miguel; Lovis, Christian

2014-01-01

The ePharmaCare project aims at assessing the potential of eHealth services for the provision of pharmaceutical services interacting actively with patients. The results presented here focus on the first three steps of Design Science Research Methodology. A mixed methods approach was used with an online survey to collect data on use of information technologies in community pharmacy, followed by an exploratory observational time and business processes study, which use the shadowing method to identify and assess the opportunity to lunch online services. Combining this with the Service Experiment Blueprint and the Dáder method an enhanced pharmaceutical service was designed. Next, an artifact is developed and a prototype is implemented to demonstrate the value of online pharmaceutical services' delivery. This new service could represent a new perspective for pharmaceutical services integration within the health system.

Association of British Clinical Diabetologists (ABCD) survey of secondary care services for diabetes in the UK, 2000. 1. Methods and major findings.

PubMed

Winocour, P H; Ainsworth, A; Williams, R

2002-04-01

To examine the provision, and variations in, secondary care diabetes services in the UK. A postal survey of all 238 identified secondary care providers of diabetes services in 2000. Following two reminders, a 77% response rate was achieved. Major deficiencies in core staffing levels were recorded, with 36% of services provided by only one consultant physician with an interest in diabetes. The provision of diabetes specialist nurses was less than recommended in 87% of responses, whereas podiatry and dietetic support was unavailable in 3% and 27% of responses, respectively. Diabetes registers were not present in 28%, and a co-ordinated retinopathy screening programme unavailable in 26% of responses. Key biochemical measurements were unavailable in 9% (microalbuminuria) to 18% (HDL-cholesterol) of responses. A 'Well-Resourced Service' score was devised taking account of levels of personnel, facilities and specialized clinical services. There was a significant geographical variation in this score (P < 0.001), with the lowest score (least well-resourced services) in the Eastern NHS Region of England, and the highest score in the North-west NHS Region of England. The 'Well-Resourced Service' score was also significantly lower (P < 0.05) where there were less than two whole-time consultant physicians providing diabetes services. In contrast to other aspects of service provision, availability of dieticians and a combined diabetes-ophthalmology service had declined since 1990. Of 245 recorded bids for resources and service improvements for diabetes care, the success rate overall was 44%, and lowest where bids were made for dietetic and podiatry support. There is presently a major shortfall in provision of secondary care diabetes services throughout the UK, with evidence that there is significant regional variation and less facilities and resources where there are less than two consultants providing specialized diabetes services. On average bids for service improvements were only successful in < 50% of cases, most usually where the service was relatively better provided for. Considerable development and investment are required nationally to ensure equitable access to specialized diabetes services, a vital component in reducing adverse diabetes outcomes.

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).

21 CFR 133.5 - Methods of analysis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Methods of analysis. 133.5 Section 133.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CHEESES AND RELATED CHEESE PRODUCTS General Provisions § 133.5 Methods of analysis. Moisture...

21 CFR 133.5 - Methods of analysis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Methods of analysis. 133.5 Section 133.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CHEESES AND RELATED CHEESE PRODUCTS General Provisions § 133.5 Methods of analysis. Moisture...

21 CFR 133.5 - Methods of analysis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Methods of analysis. 133.5 Section 133.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CHEESES AND RELATED CHEESE PRODUCTS General Provisions § 133.5 Methods of analysis. Moisture...

21 CFR 610.9 - Equivalent methods and processes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Equivalent methods and processes. 610.9 Section 610.9 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS GENERAL BIOLOGICAL PRODUCTS STANDARDS General Provisions § 610.9 Equivalent methods and processes...

21 CFR 610.9 - Equivalent methods and processes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Equivalent methods and processes. 610.9 Section 610.9 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS GENERAL BIOLOGICAL PRODUCTS STANDARDS General Provisions § 610.9 Equivalent methods and processes...

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International

PubMed Central

Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

2014-01-01

Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels—mobile outreach, social franchising, and clinics—to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and choice in sub-Saharan Africa, especially as the global health community works to achieve its Family Planning 2020 (FP2020) commitments to expand family planning access to 120 million new users. PMID:25276564

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International.

PubMed

Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

2014-02-01

Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels-mobile outreach, social franchising, and clinics-to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and choice in sub-Saharan Africa, especially as the global health community works to achieve its Family Planning 2020 (FP2020) commitments to expand family planning access to 120 million new users.

A mixed-method evaluation of a New Zealand based midwifery education development unit.

PubMed

McAra-Couper, Judith; Gilkison, Andrea; Fielder, Anna; Donald, Heather

2017-07-01

The Midwifery Development Education Service was established in the Birthing Unit at Middlemore Hospital in South Auckland New Zealand in 2007. The service is unique in the New Zealand midwifery context for the way it operates as a collaboration between the education and health provider to optimise the clinical learning experience of student midwives. This paper reports on the evaluation of the Midwifery Development Education Service that was undertaken in 2015. The evaluation captured the views and experience of students and midwives who had been involved with, or had worked alongside, the service. A mixed-method approach was adopted for the evaluation study, comprising of an anonymous on-line survey, qualitative interviews and focus group discussion. Considerable satisfaction with the service was identified. This article draws attention to participants' perceptions of the service as supporting student midwives; the significance of quality time in the provision of the clinical midwifery education; the situating of the service at a unique vantage point (overseeing the needs of the university and the hospital) and its impact upon the learning culture of education within the unit. A potential tension is also identified between the provision of a supportive learning environment and the assessment of student performance. Copyright © 2017. Published by Elsevier Ltd.

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.

Land use/land cover change and implications for ecosystems services in the Likangala River Catchment, Malawi

NASA Astrophysics Data System (ADS)

Pullanikkatil, Deepa; Palamuleni, Lobina G.; Ruhiiga, Tabukeli M.

2016-06-01

Likangala River catchment in Zomba District of Southern Malawi is important for water resources, agriculture and provides many ecosystem services. Provisioning ecosystem services accrued by the populations within the catchment include water, fish, medicinal plants and timber among others. In spite of its importance, the River catchment is under threat from anthropogenic activities and land use change. This paper studies land uses and land cover change in the catchment and how the changes have impacted on the ecosystem services. Landsat 5 and 8 images (1984, 1994, 2005 and 2013) were used to map land cover change and subsequent inventorying of provisioning ecosystem services. Participatory Geographic Information Systems and Focus group discussions were conducted to identify provisioning ecosystems services that communities benefit from the catchment and indicate these on the map. Post classification comparisons indicate that since 1984, there has been a decline in woodlands from 135.3 km2 in 1984 to 15.5 km2 in 2013 while urban areas increased from 9.8 km2 to 23.8 km2 in 2013. Communities indicated that provisioning ecosystems services such as forest products, wild animals and fruits and medicinal plants have been declining over the years. In addition, evidence of catchment degradation through waste disposal, illegal sand mining, deforestation and farming on marginal lands were observed. Population growth, urbanization and demand for agricultural lands have contributed to this land use and land cover change. The study suggests addressing catchment degradation through integrated method where an ecosystems approach is used. Thus, both the proximate and underlying driving factors of land-use and land cover change need to be addressed in order to sustainably reduce ecosystem degradation.

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.

Resource Input, Service Process and Resident Activity Indicators in a Welsh National Random Sample of Staffed Housing Services for People with Intellectual Disabilities

ERIC Educational Resources Information Center

Felce, David; Perry, Jonathan

2004-01-01

Background: The aims were to: (i) explore the association between age and size of setting and staffing per resident; and (ii) report resident and setting characteristics, and indicators of service process and resident activity for a national random sample of staffed housing provision. Methods: Sixty settings were selected randomly from those…

Funding models in palliative care: Lessons from international experience.

PubMed

Groeneveld, E Iris; Cassel, J Brian; Bausewein, Claudia; Csikós, Ágnes; Krajnik, Malgorzata; Ryan, Karen; Haugen, Dagny Faksvåg; Eychmueller, Steffen; Gudat Keller, Heike; Allan, Simon; Hasselaar, Jeroen; García-Baquero Merino, Teresa; Swetenham, Kate; Piper, Kym; Fürst, Carl Johan; Murtagh, Fliss Em

2017-04-01

Funding models influence provision and development of palliative care services. As palliative care integrates into mainstream health care provision, opportunities to develop funding mechanisms arise. However, little has been reported on what funding models exist or how we can learn from them. To assess national models and methods for financing and reimbursing palliative care. Initial literature scoping yielded limited evidence on the subject as national policy documents are difficult to identify, access and interpret. We undertook expert consultations to appraise national models of palliative care financing in England, Germany, Hungary, Republic of Ireland, New Zealand, The Netherlands, Norway, Poland, Spain, Sweden, Switzerland, the United States and Wales. These represent different levels of service development and a variety of funding mechanisms. Funding mechanisms reflect country-specific context and local variations in care provision. Patterns emerging include the following: Provider payment is rarely linked to population need and often perpetuates existing inequitable patterns in service provision. Funding is frequently characterised as a mixed system of charitable, public and private payers. The basis on which providers are paid for services rarely reflects individual care input or patient needs. Funding mechanisms need to be well understood and used with caution to ensure best practice and minimise perverse incentives. Before we can conduct cross-national comparisons of costs and impact of palliative care, we need to understand the funding and policy context for palliative care in each country of interest.

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

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.

Patients’ online access to their electronic health records and linked online services: a systematic review in primary care

PubMed Central

Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

2015-01-01

Background Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. Aim To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. Design and setting A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Method Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King’s Fund, Nuffield Health, PsycINFO, OpenGrey (1999–2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. Results A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. Conclusion While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups. Professional concerns about privacy were unrealised and those about workload were only partly so. PMID:25733435

Nursing home reimbursement and the allocation of rehabilitation therapy resources.

PubMed

Murtaugh, C M; Cooney, L M; DerSimonian, R R; Smits, H L; Fetter, R B

1988-10-01

Most public funding methods for long-term care do not adequately match payment rates with patient need for services. Case-mix payment systems are designed to encourage a more efficient and equitable allocation of limited health care resources. Even nursing home case-mix payment systems, however, do not currently provide the proper incentives to match rehabilitation therapy resources to a patient's needs. We were able to determine by a review of over 8,500 patients in 65 nursing homes that certain diagnoses, partial dependence in activities of daily living (ADLs), clear mental status, and improving medical status are associated with the provision of rehabilitation services to nursing home residents. These patient characteristics are clinically reasonable predictors of the need for therapy and should be considered for use in nursing home case-mix reimbursement systems. Primary payment source also was associated with the provision of rehabilitation services even after taking into account significant patient characteristics. It is unclear how much of the variation in service use across payers is due to differences in patient need as opposed to differences in the financial incentives associated with current payment methods.

User involvement: children's participation in a parent-baby group.

PubMed

Maconochie, Heloise; McNeill, Fiona

2010-08-01

According to the National Service Framework, children have a right to participate in the development of healthcare services and yet research suggests that young children are at risk of exclusion from user involvement initiatives. This paper outlines the findings of a participatory action research project conducted with families attending a health visitors' parent-baby group. A combination of participatory research methods were used to ascertain the infants' perspectives of the service and this led to a number of changes in terms of professional attitudes, service provision and working practices. Changes in professional attitudes included acknowledging the importance of social interaction to the children, recognising young children's views as embodied and produced within social interactions, and respecting children as active contributors and not simply as passive recipients of healthcare services. Changes in service provision resulted in redistributing resources, structures and spaces to take account of children's perspectives. Finally, reciprocity and responsiveness were seen as key components in enhancing young children's participation.

Evaluation of a primary care adult mental health service: Year 2

PubMed Central

2013-01-01

Aims This study aimed to examine the effectiveness of a primary care adult mental health service operating within a stepped care model of service delivery. Methods Supervised by a principal psychologist manager, psychology graduate practitioners provided one-to-one brief cognitive behavioural therapy (CBT) to service users. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) was used to assess service user treatment outcomes. Satisfaction questionnaires were administered to service users and referring general practitioners (GPs). Results A total of 43 individuals attended for an initial appointment, of whom 19 (44.2%) completed brief CBT treatment. Of the 13 service users who were in the clinical range pre-treatment, 11 (84.6%) achieved clinical and reliably significant improvement. Of the six service users who were in the non-clinical range pre-treatment, three (50%) achieved reliably significant improvement. Both service users and GPs indicated high levels of satisfaction with the service, although service accessibility was highlighted as needing improvement. Conclusion The service was effective in treating mild to moderate mental health problems in primary care. Stricter adherence to a stepped care model through the provision of low-intensity, high-throughput interventions would be desirable for future service provision. PMID:24381655

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...

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...

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...

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...

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...

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...

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...

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...

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...

Resource Provisioning in Large-Scale Self-Organizing Distributed Systems

DTIC Science & Technology

2012-06-01

using the Provisioning Norm (α=0.99999) and the modified Kullback - Leibler . Figure 15 is the plot of how many services and nodes each method included in...Problem,” European Journal of Operational Research, vol. 174, issue 1, pp. 54-68, 2006. [64] S. Kullback , R.A. Leibler , “On Information and Sufficiency...Description Language KB Kilobytes KL Kullback - Leibler xvii KLD Kullback - Leibler Distance LRU Least Recently Used Mb

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.

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.

Balancing the balanced scorecard for a New Zealand mental health service.

PubMed

Coop, Colleen F

2006-05-01

Given the high prevalence of mental disorders, there is a need to evaluate mental health services to ensure they are efficient, effective, responsive and accessible. One method that is being used is the "balanced scorecard" which uses performance indicators in four quadrants to assess various dimensions of service provision. This case study describes the steps taken by a New Zealand mental health service to improve service management through greater use of key performance indicators in relation to preset targets using this approach.

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.

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.

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...

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...

[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.

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.

[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.

The “empty void” is a crowded space: health service provision at the margins of fragile and conflict affected states

PubMed Central

2014-01-01

Background Definitions of fragile states focus on state willingness and capacity to ensure security and provide essential services, including health. Conventional analyses and subsequent policies that focus on state-delivered essential services miss many developments in severely disrupted healthcare arenas. The research seeks to gain insights about the large sections of the health field left to evolve spontaneously by the absent or diminished state. Methods The study examined six diverse case studies: Afghanistan, Central African Republic, Democratic Republic of the Congo, Haïti, Palestine, and Somalia. A comprehensive documentary analysis was complemented by site visits in 2011–2012 and interviews with key informants. Results Despite differing histories, countries shared chronic disruption of health services, with limited state service provision, and low community expectations of quality of care. The space left by compromised or absent state-provided services is filled by multiple diverse actors. Health is commoditized, health services are heterogeneous and irregular, with public goods such as immunization and preventive services lagging behind curative ones. Health workers with disparate skills, and atypical health facilities proliferate. Health care absorbs large private expenditures, sustained by households, remittances, charitable and solidarity funding, and constitutes a substantial portion of the country economy. Pharmaceutical markets thrive. Trans-border healthcare provision is prominent in most studied settings, conferring regional and sometimes true globalized characteristics to these arenas. Conclusions We identify three distortions in the way the global development community has considered health service provision. The first distortion is the assumption that beyond the reach of state- and donor-sponsored services is a “void”, waiting to be filled. Our analysis suggests that the opposite is the case. The second distortion relates to the inadequacy of the usual binary categories structuring conventional health system analyses, when applied to these contexts. The third distortion reflects the failure of the global development community to recognise—or engage—the emergent networks of health providers. To effectively harness the service provision currently available in this crowded space, development actors need to adapt their current approaches, engage non-state providers, and support local capacity and governance, particularly grassroots social institutions with a public-good orientation. PMID:25349625

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.

Relationship Between the Provision of Injection Services in Ambulatory Physician Offices and Prescribing Injectable Medicines.

PubMed

Yousefi, Naeimeh; Rashidian, Arash; Soleymani, Fatemeh; Kebriaeezade, Abbas

2017-01-01

Overuse of injections is a common problem in many low-income and middle income countries. While cultural factors and attitudes of both physicians and patients are important factors, physicians› financial intensives may play an important role in overprescribing of injections. This study was designed to assess the effects of providing injection- services in physicians› ambulatory offices on prescribing injectable medicines. This cross-sectional study was conducted in Tehran in 2012 -2013and included a random sample of general physicians, pediatricians and infectious disease specialists. We collected data on the provision of injection services in or in proximity of physician offices, and obtained data from physicians› prescriptions in the previous three-month period. We analyzed the data using ANOVA, Student›s t-test and linear regression methods. We obtained complete data from 465 of 600 sampled physicians. Overall 41.9% of prescriptions contained injectable medicines. 75% of physicians offered injection services in their offices. Male physicians and general physicians were more likely to offer the services, and more likely to prescribe injectables. We observed a clear linear relationship between the injection service working hours and the proportion of prescriptions containing injectables (p-value<0.001). Providing injection service in the office was directly linked with the proportion of prescriptions containing injectables. While provision of injection services may provide a direct financial benefit to physicians, it is unlikely to be able to substantially reduce injectable medicines› prescription without addressing the issue.

Attitudes and Intentions Regarding Abortion Provision Among Medical School Students in South Africa

PubMed Central

Wheeler, Stephanie B.; Zullig, Leah L.; Reeve, Bryce B.; Buga, Geoffrey A.; Morroni, Chelsea

2018-01-01

CONTEXT Although South Africa liberalized its abortion law in 1996, significant barriers still impede service provision, including the lack of trained and willing providers. A better understanding is needed of medical students’ attitudes, beliefs and intentions regarding abortion provision. METHODS Surveys about abortion attitudes, beliefs and practice intentions were conducted in 2005 and 2007 among 1,308 medical school students attending the University of Cape Town and Walter Sisulu University in South Africa. Bivariate and multivariate analyses identified associations between students’ characteristics and their general and conditional support for abortion provision, as well as their intention to act according to personal attitudes and beliefs. RESULTS Seventy percent of medical students believed that women should have the right to decide whether to have an abortion, and large majorities thought that abortion should be legal in a variety of medical circumstances. Nearly one-quarter of students intended to perform abortions once they were qualified, and 72% said that conscientiously objecting clinicians should be required to refer women for such services. However, one-fifth of students believed that abortion should not be allowed for any reason. Advanced medical students were more likely than others to support abortion provision. In multivariate analyses, year in medical school, race or ethnicity, religious affiliation, relationship status and sexual experience were associated with attitudes, beliefs and intentions regarding provision. CONCLUSIONS Academic medical institutions must ensure that students understand their responsibilities with respect to abortion care—regardless of their personal views—and must provide appropriate abortion training to those who are willing to offer these services in the future. PMID:23018137

Anaesthesia or sedation for paediatric MRI: advantages and disadvantages.

PubMed

Arthurs, Owen J; Sury, Michael

2013-08-01

The purpose of the present review is to place the current literature into historical context of what is understood about the conceptual as well as practical differences between sedation and anaesthesia, and what the potential benefits and risks may be, where paediatric imaging is concerned. This review is timely, as there is an increasing demand for the expensive resource of anaesthesia service provision, above and beyond sedation provision. Adequate and appropriate training is the major issue in well tolerated drug administration: the practitioner must have appropriate skills to monitor and rescue the patient from general anaesthesia. There is an increasing understanding on what can be achieved with subanaesthetic doses of traditional anaesthetic drugs, as well as what can be achieved without access to anaesthetic drugs at all. The risk-benefit analysis must ultimately be taken on a patient-by-patient basis, and to this end should determine service provision and training requirements. One single method cannot be applied to all children. Many can be sedated, but others will need anaesthesia with careful airway management, and the accompanying skilled personnel. Service models should be developed and tested to ensure maximum efficiency of service delivery.

26 CFR 31.6302(b)-1 - Method of collection.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 15 2012-04-01 2012-04-01 false Method of collection. 31.6302(b)-1 Section 31.6302(b)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) EMPLOYMENT... Revenue Code of 1954) § 31.6302(b)-1 Method of collection. For provisions relating to collection by means...

21 CFR 163.5 - Methods of analysis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Methods of analysis. 163.5 Section 163.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CACAO PRODUCTS General Provisions § 163.5 Methods of analysis. Shell and cacao fat content in...

21 CFR 163.5 - Methods of analysis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Methods of analysis. 163.5 Section 163.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CACAO PRODUCTS General Provisions § 163.5 Methods of analysis. Shell and cacao fat content in...

21 CFR 163.5 - Methods of analysis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Methods of analysis. 163.5 Section 163.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CACAO PRODUCTS General Provisions § 163.5 Methods of analysis. Shell and cacao fat content in...

21 CFR 163.5 - Methods of analysis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Methods of analysis. 163.5 Section 163.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CACAO PRODUCTS General Provisions § 163.5 Methods of analysis. Shell and cacao fat content in...

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.

Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists.

PubMed

Abdul Aziz, Aznida F; Mohd Nordin, Nor Azlin; Abd Aziz, Noor; Abdullah, Suhazeli; Sulong, Saperi; Aljunid, Syed M

2014-03-02

Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on 'as needed' basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS' perceived 4 important 'needs' in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support. Post discharge stroke care guidelines and access to rehabilitation services at primary care is needed for post stroke patients residing at home in the community.

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.

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.

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. ...

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. ...

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. ...

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. ...

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.

Doctors and Witches, Conscience and Violence: Abortion Provision on American Television.

PubMed

Sisson, Gretchen; Kimport, Katrina

2016-12-01

Popular entertainment may reflect and produce-as well as potentially contest-stigma regarding abortion provision. Knowledge of how providers are portrayed on-screen is needed to improve understanding of how depictions may contribute to the stigmatization of real providers. All abortion provision plotlines on American television from 2005 to 2014 were identified through Internet searches. Plotlines were assessed in their entirety and coded for genre, abortion provision space, provider characteristics, method and efficacy of provision, and occurrence of violence. Inductive content analysis was used to identify themes in how these features were depicted. Fifty-two plotlines involving abortion provision were identified on 40 television shows; a large majority of plotlines appeared in dramas, particularly in the subgenre of medical dramas. Medical spaces were depicted as normal and safe for abortion provision, and nonmedical spaces were often portrayed as remote and unsafe. Legal abortion care using medical methods was depicted as effective and safe, and legal providers were presented as compassionate, while providers operating outside of medical and legal authority were depicted as ineffective, dangerous and uncaring. Fictional providers were largely motivated by the belief that abortion provision is a necessary and moral service. Plotlines linked abortion provision to violence. The differing ways in which legal and illegal abortion are portrayed reveal potential consequences regarding real-world abortion provision, and suggest that representations situated in medical contexts may work to legitimate and destigmatize such provision. Copyright © 2016 by the Guttmacher Institute.

42 CFR 447.205 - Public notice of changes in Statewide methods and standards for setting payment rates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Public notice of changes in Statewide methods and... SERVICES Payment Methods: General Provisions § 447.205 Public notice of changes in Statewide methods and... this section, the agency must provide public notice of any significant proposed change in its methods...

42 CFR 447.205 - Public notice of changes in Statewide methods and standards for setting payment rates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Public notice of changes in Statewide methods and... SERVICES Payment Methods: General Provisions § 447.205 Public notice of changes in Statewide methods and... this section, the agency must provide public notice of any significant proposed change in its methods...

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...

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...

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...

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...

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...

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...

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…

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...

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...

Perceived and insurance-related barriers to the provision of contraceptive services in U.S. abortion care settings.

PubMed

Kavanaugh, Megan L; Jones, Rachel K; Finer, Lawrence B

2011-01-01

Abortion facilities represent a potentially convenient setting for providing contraception to women experiencing unintended pregnancies. This analysis examines a range of factors that may act as barriers to integrating contraceptive and abortion services and documents abortion providers' perspectives on their role in their patients' contraceptive care. Administrators from 173 large, nonhospital facilities that provide abortions in the United States responded to a structured survey between May and September 2009. We used chi-square tests to assess differences in categorical outcomes. Although the majority of U.S. abortion facilities offer a range of contraceptive methods on site, facility staff identified multiple barriers to full integration of the two services, in particular, insurance, patient, and cost barriers. Few of these perceived barriers, however, were associated with differences in the actual provision of most contraceptive methods. Specialized abortion clinics that do not accept health insurance were less likely to have highly effective methods, such as intrauterine devices and implants, on site. Facilities located in Medicaid states were more likely to accept both public and private health insurance for contraceptive services. Increased access to contraceptive services during abortion care is one strategy for reducing repeat unintended pregnancy, and stakeholders at all levels--including abortion providers, insurance companies, and policy makers--have a role to play in achieving this goal. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Medical abortion: understanding perspectives of rural and marginalized women from rural South India.

PubMed

Sri, B Subha; Ravindran, T K Sundari

2012-09-01

To understand how rural and other groups of marginalized women define safe abortion; their perspectives and concerns regarding medical abortion (MA); and what factors affect their access to safe abortion. Focus group discussions were held with various groups of rural and marginalized women in Tamil Nadu to understand their perspectives and concerns on abortion, especially MA. Nearly a decade after mifepristone was approved for abortion in India, most study participants had never heard of MA. When they learned of the method, most preferred it over other methods of abortion. The women also had questions and concerns about the method and recommendations on how services should be provided. Their definition of a "safe abortion" included criteria beyond medical safety. They placed a high priority on "social safety," including confidentiality and privacy. In their view, factors affecting access to safe abortion and choice of provider included cost, assurance of secrecy, promptness of service provision, and absence of provider gatekeeping and provider-imposed conditions for receiving services. Women's preference for MA shows the potential of this technology to address the problem of unsafe abortion in India. Women need better access to information and services to realize this potential, however. Women's preferences regarding information dissemination and service provision need to be taken into account if policies and programs are to be truly responsive to the needs of marginalized women. Copyright © 2012. Published by Elsevier Ireland Ltd.

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

Vulnerability to climate-induced changes in ecosystem services of boreal forests

NASA Astrophysics Data System (ADS)

Holmberg, Maria; Rankinen, Katri; Aalto, Tuula; Akujärvi, Anu; Nadir Arslan, Ali; Liski, Jari; Markkanen, Tiina; Mäkelä, Annikki; Peltoniemi, Mikko

2016-04-01

Boreal forests provide an array of ecosystem services. They regulate climate, and carbon, water and nutrient fluxes, and provide renewable raw material, food, and recreational possibilities. Rapid climate warming is projected for the boreal zone, and has already been observed in Finland, which sets these services at risk. MONIMET (LIFE12 ENV/FI/000409, 2.9.2013 - 1.9.2017) is a project funded by EU Life programme about Climate Change Indicators and Vulnerability of Boreal Zone Applying Innovative Observation and Modeling Techniques. The coordinating beneficiary of the project is the Finnish Meteorological Institute. Associated beneficiaries are the Natural Resources Institute Finland, the Finnish Environment Institute and the University of Helsinki. In the MONIMET project, we use state-of-the-art models and new monitoring methods to investigate the impacts of a warming climate on the provision of ecosystem services of boreal forests. This poster presents results on carbon storage in soil and assessment of drought indices, as a preparation for assessing the vulnerability of society to climate-induced changes in ecosystem services. The risk of decreasing provision of ecosystem services depends on the sensitivity of the ecosystem as well as its exposure to climate stress. The vulnerability of society, in turn, depends on the risk of decreasing provision of a certain service in combination with society's demand for that service. In the next phase, we will look for solutions to challenges relating to the quantification of the demand for ecosystem services and differences in spatial extent and resolution of the information on future supply and demand.

Combining qualitative and quantitative operational research methods to inform quality improvement in pathways that span multiple settings.

PubMed

Crowe, Sonya; Brown, Katherine; Tregay, Jenifer; Wray, Jo; Knowles, Rachel; Ridout, Deborah A; Bull, Catherine; Utley, Martin

2017-08-01

Improving integration and continuity of care across sectors within resource constraints is a priority in many health systems. Qualitative operational research methods of problem structuring have been used to address quality improvement in services involving multiple sectors but not in combination with quantitative operational research methods that enable targeting of interventions according to patient risk. We aimed to combine these methods to augment and inform an improvement initiative concerning infants with congenital heart disease (CHD) whose complex care pathway spans multiple sectors. Soft systems methodology was used to consider systematically changes to services from the perspectives of community, primary, secondary and tertiary care professionals and a patient group, incorporating relevant evidence. Classification and regression tree (CART) analysis of national audit datasets was conducted along with data visualisation designed to inform service improvement within the context of limited resources. A 'Rich Picture' was developed capturing the main features of services for infants with CHD pertinent to service improvement. This was used, along with a graphical summary of the CART analysis, to guide discussions about targeting interventions at specific patient risk groups. Agreement was reached across representatives of relevant health professions and patients on a coherent set of targeted recommendations for quality improvement. These fed into national decisions about service provision and commissioning. When tackling complex problems in service provision across multiple settings, it is important to acknowledge and work with multiple perspectives systematically and to consider targeting service improvements in response to confined resources. Our research demonstrates that applying a combination of qualitative and quantitative operational research methods is one approach to doing so that warrants further consideration. 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/.

The impact of direct provision accommodation for asylum seekers on organisation and delivery of local primary care and social care services: A case study

PubMed Central

2011-01-01

Background Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. Methods In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. Results There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Conclusions Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations. PMID:21575159

21 CFR 530.24 - Procedure for announcing analytical methods for drug residue quantification.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS EXTRALABEL DRUG USE IN ANIMALS Specific Provisions Relating to Extralabel Use of Animal and Human Drugs in Food-Producing Animals § 530.24 Procedure for announcing analytical methods for drug residue quantification. (a...

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...

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...

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...

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...

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...

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…

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…

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...

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...

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...

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...

Funding models in palliative care: Lessons from international experience

PubMed Central

Groeneveld, E Iris; Cassel, J Brian; Bausewein, Claudia; Csikós, Ágnes; Krajnik, Malgorzata; Ryan, Karen; Haugen, Dagny Faksvåg; Eychmueller, Steffen; Gudat Keller, Heike; Allan, Simon; Hasselaar, Jeroen; García-Baquero Merino, Teresa; Swetenham, Kate; Piper, Kym; Fürst, Carl Johan; Murtagh, Fliss EM

2017-01-01

Background: Funding models influence provision and development of palliative care services. As palliative care integrates into mainstream health care provision, opportunities to develop funding mechanisms arise. However, little has been reported on what funding models exist or how we can learn from them. Aim: To assess national models and methods for financing and reimbursing palliative care. Design: Initial literature scoping yielded limited evidence on the subject as national policy documents are difficult to identify, access and interpret. We undertook expert consultations to appraise national models of palliative care financing in England, Germany, Hungary, Republic of Ireland, New Zealand, The Netherlands, Norway, Poland, Spain, Sweden, Switzerland, the United States and Wales. These represent different levels of service development and a variety of funding mechanisms. Results: Funding mechanisms reflect country-specific context and local variations in care provision. Patterns emerging include the following: Provider payment is rarely linked to population need and often perpetuates existing inequitable patterns in service provision. Funding is frequently characterised as a mixed system of charitable, public and private payers. The basis on which providers are paid for services rarely reflects individual care input or patient needs. Conclusion: Funding mechanisms need to be well understood and used with caution to ensure best practice and minimise perverse incentives. Before we can conduct cross-national comparisons of costs and impact of palliative care, we need to understand the funding and policy context for palliative care in each country of interest. PMID:28156188

Service provider perspectives on post-abortion contraception in Nepal.

PubMed

Wang, Lin-Fan; Puri, Mahesh; Rocca, Corinne H; Blum, Maya; Henderson, Jillian T

2016-01-01

The government of Nepal has articulated a commitment to the provision of post-abortion contraception since the implementation of a legal safe abortion policy in 2004. Despite this, gaps in services remain. This study examined the perspectives of abortion service providers and administrators regarding strengths and shortcomings of post-abortion contraceptive service provision. In-depth interviews were conducted with 24 abortion providers and administrators at four major health facilities that provide legal abortion in Nepal. Facility factors perceived to impact post-abortion contraceptive services included on-site availability of contraceptive supplies, dedicated and well-trained staff and adequate infrastructure. Cultural norms emerged as influencing contraceptive demand by patients, including method use being unacceptable for women whose husbands migrate and limited decision-making power among women. Service providers described their personal views on appropriate childbearing and the use of specific contraceptive methods that influenced counselling. Findings suggest that improvements to a facility's infrastructure and training to address provider biases and misinformation may improve post-abortion family planning uptake. Adapting services to be sensitive to cultural expectations and norms may help address some barriers to contraceptive use. More research is needed to determine how to best meet the contraceptive needs of women who have infrequent sexual activity or who may face stigma for using family planning, including adolescents, unmarried women and women whose husbands migrate.

Effects of harvesting forest biomass on water and climate regulation services: A synthesis of long-term ecosystem experiments in eastern North America

USGS Publications Warehouse

Caputo, Jesse; Beier, Colin D; Groffman, Peter M; Burns, Douglas A.; Beall, Frederick D; Hazlett, Paul W.; Yorks, Thad E

2016-01-01

Demand for woody biomass fuels is increasing amidst concerns about global energy security and climate change, but there may be negative implications of increased harvesting for forest ecosystem functions and their benefits to society (ecosystem services). Using new methods for assessing ecosystem services based on long-term experimental research, post-harvest changes in ten potential benefits were assessed for ten first-order northern hardwood forest watersheds at three long-term experimental research sites in northeastern North America. As expected, we observed near-term tradeoffs between biomass provision and greenhouse gas regulation, as well as tradeoffs between intensive harvest and the capacity of the forest to remediate nutrient pollution. In both cases, service provision began to recover along with the regeneration of forest vegetation; in the case of pollution remediation, the service recovered to pre-harvest levels within 10 years. By contrast to these two services, biomass harvesting had relatively nominal and transient impacts on other ecosystem services. Our results are sensitive to empirical definitions of societal demand, including methods for scaling societal demand to ecosystem units, which are often poorly resolved. Reducing uncertainty around these parameters can improve confidence in our results and increase their relevance for decision-making. Our synthesis of long-term experimental studies provides insights on the social-ecological resilience of managed forest ecosystems to multiple drivers of change.

Australian integrative oncology services: a mixed-method study exploring the views of cancer survivors.

PubMed

Hunter, Jennifer; Ussher, Jane; Parton, Chloe; Kellett, Andrew; Smith, Caroline; Delaney, Geoff; Oyston, Eleanor

2018-05-09

The significant use of traditional and complementary medicine (T&CM) by cancer survivors is well documented. The aim of this study was to explore cancer survivors' views on integrating T&CM services with conventional cancer care. A mixed-method study design with an emphasis on qualitative methodology was used to conduct and analyse four focus group interviews and an on-line survey. Purposive sampling recruited 33 cancer survivors and caregivers from Arabic, Vietnamese, Chinese and Anglo-European Australian backgrounds who participated in one of four focus group interviews, and 121 cancer survivors who responded to an on-line survey. The inductive thematic analysis was augmented with a descriptive statistical analysis. Most participants had used T&CM therapies or consulted T&CM practitioners as an adjuvant during and/or after their initial cancer treatment. Two themes emerged: 'positive perceptions and experiences' and 'barriers and unmet needs'. Participants emphasised that T&CM was not a 'luxury item', rather it was considered important for managing side effects and comorbidities, rehabilitation and quality of life. A wide range of complex, interrelated barriers and solutions to IO service provision and access were identified. Structural barriers included inadequate service provision, medical practitioner attitudes, logistical constraints and funding. Personal barriers were influenced by the severity of impairment and disability; attitudes, beliefs and knowledge about T&CM; and available resources (e.g. finances, time, transport). Unmet need and inequitable access was exacerbated by geographical location, ethnicity and ability to pay. There was a mismatch between where participants were accessing T&CM services and their preference for IO service delivery. Participants perceived hospital-based IO services availability to have several benefits, including the T&CM practitioners having more expert knowledge about cancer care, the convenience of co-locating oncology services, and potentially lower out-of-pocket costs. Patients' use, preferences and needs for T&CM services in the oncology setting are important for informing service provision. Inequitable, unmet need reflected the increasing demand and expectation from patients for their oncology teams to be well informed about the benefits, risks and indications for T&CM use, and for the public and private health sectors to formally integrate and fund IO services.

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.

Alternative management structures for municipal waste collection services: The influence of economic and political factors

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

Plata-Díaz, Ana María, E-mail: amplata@ugr.es; Zafra-Gómez, José Luis, E-mail: jlzafra@ugr.es; Pérez-López, Gemma, E-mail: gemmapl@ugr.es

2014-11-15

Highlights: • We analyzed the factors that influence on the restructuring of MSW services. • We evaluated five different alternatives for public and private service. • Our analysis covers a broad time horizon, 2002–2010. • We used a conditional fixed-effects logistic regression as the evaluation method. • Municipalities tend to contract out the MSW service in the presence of high costs and fiscal stress. - Abstract: Identifying and characterising the factors that determine why a local authority opts for a particular way of managing its waste collection service is an important issue, warranting research interest in the field of municipalmore » solid waste (MSW) management. This paper presents empirical evidence spanning a broad time horizon (2002–2010) showing that economic and political factors impact in different ways on the provision of waste management services. We examine five alternatives in this area, including public and private service delivery formulas and, within each field, individual and joint options. Our findings highlight the importance of the service cost and that of the various indicators of fiscal stress as determinant factors of management decisions regarding the provision of MSW management services.« less

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...

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...

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

PubMed Central

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

2014-01-01

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

Lessons learnt from the introduction of the contraceptive implant in South Africa

PubMed

Pleaner, M; Morroni, C; Smit, J; Lince-Deroche, N; Chersich, M; Mullick, S; Pillay, D; Makua, M; Rees, H

2017-10-01

In 2014, South Africa (SA) introduced the subdermal contraceptive implant with the aim of expanding the contraceptive method mix and availability of long-acting reversible methods in the public sector. Three years on, concerns have been raised about the decline in uptake, early implant removals and challenges in service delivery. This article explores the lessons learnt from the introduction of contraceptive technologies elsewhere and applies these to the SA context. Drawing on the World Health Organization’s conceptual framework for the introduction of new contraceptive methods, and subsequent literature on the topic, lessons are classified into six cross-cutting themes. Recommendations highlight the need for SA to review and explore strategies to strengthen current implant services, including the provision of improved provider training aimed at sensitive, client-centred approaches; increased community engagement; and improved systems for programmatic monitoring and evaluation. With implementation of these recommendations, worrying trends in the provision of implants could be reversed. Creative Commons Attribution - NonCommercial Works License (CC BY-NC 4.0)

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...

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...

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...

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...

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...

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…

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

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

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...

Attributes and perspectives of public providers related to provision of medical abortion at public health facilities in Vietnam: a cross-sectional study in three provinces

PubMed Central

Ngo, Thoai D; Free, Caroline; Le, Hoan T; Edwards, Phil; Pham, Kiet HT; Nguyen, Yen BT; Nguyen, Thang H

2014-01-01

Background The purpose of this study was to investigate attributes of public service providers associated with the provision of medical abortion in Vietnam. Methods We conducted a cross-sectional study via interviewer-administered questionnaire among abortion providers from public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City in Vietnam between August 2011 and January 2012. We recruited abortion providers at all levels of Vietnam’s public health service delivery system. Participants were questioned about their medical abortion provision practices and perspectives regarding abortion methods. Results A total of 905 providers from 62 health facilities were included, comprising 525 (58.0%) from Hanoi, 122 (13.5%) from Khanh Hoa, and 258 (28.5%) from Ho Chi Minh City. The majority of providers were female (96.7%), aged ≥25 years (94%), married (84.4%), and had at least one child (89%); 68.9% of providers offered only manual vacuum aspiration and 31.1% performed both medical abortion and manual vacuum aspiration. Those performing both methods included physicians (74.5%), midwives (21.7%), and nurses (3.9%). Unadjusted analyses showed that female providers (odds ratio 0.1; 95% confidence interval 0.01–0.30) and providers in rural settings (odds ratio 0.3; 95% confidence interval 0.08–0.79) were less likely to provide medical abortion than their counterparts. Obstetricians and gynecologists were more likely to provide medical abortion than providers with nursing/midwifery training (odds ratio 22.2; 95% confidence interval 3.81–129.41). The most frequently cited advantages of medical abortion for providers were that no surgical skills are required (61.7%) and client satisfaction is better (61.0%). Conclusion Provision of medical abortion in Vietnam is lower than provision of manual vacuum aspiration. While the majority of abortion providers are female midwives in Vietnam, medical abortion provision is concentrated in urban settings among physicians. Individuals providing medical abortion found that the method yields high client satisfaction. PMID:25152635

Scholars' Satisfaction with Digital Library Collection and Gaps in the Provision of Effective Information Resources and Services: A Pakistani Perspective

ERIC Educational Resources Information Center

Khan, Amjid; Ahmed, Shamshad; Masrek, Mohamad Noorman

2014-01-01

The study aims to explore the researchers' satisfaction with digital library resources and services and how they improved the research culture in Pakistani universities. A descriptive survey method was employed to achieve objectives of this study. Using stratified random sampling, for this survey we selected 14 public sector universities of Khyber…

The Impact of Local Environmental Health Capacity on Foodborne Illness Morbidity in Maryland

PubMed Central

Resnick, Beth A.; Fox, Mary A.; McGready, John; Yager, James P.; Burke, Thomas A.

2011-01-01

Objectives. We evaluated the relationship between local food protection capacity and service provision in Maryland's 24 local food protection programs (FPPs) and incidence of foodborne illness at the county level. Methods. We conducted regression analyses to determine the relationship between foodborne illness and local FPP characteristics. We used the Centers for Disease Control and Prevention's FoodNet and Maryland Department of Health and Mental Hygiene outbreak data set, along with data on Maryland's local FPP capacity (workforce size and experience levels, budget) and service provision (food service facility inspections, public notification programs). Results. Counties with higher capacity, such as larger workforce, higher budget, and greater employee experience, had fewer foodborne illnesses. Counties with better performance and county-level regulations, such as high food service facility inspection rates and requiring certified food manager programs, respectively, had lower rates of illness. Conclusions. Counties with strong local food protection capacity and services can protect the public from foodborne illness. Research on public health services can enhance our understanding of the food protection infrastructure, and the effectiveness of food protection programs in preventing foodborne illness. PMID:21750282

Hepatitis C education and support in Australian prisons: preliminary findings of a nationwide survey.

PubMed

Dyer, Jade; Tolliday, Lyn

2009-04-01

Rates of hepatitis C infection are up to 60 times higher in correctional facilities than in the general population, yet prisoners have limited access to many methods of blood-borne virus prevention. The aim of this study was therefore to explore the efficiency of hepatitis C education and support services available in custodial settings, from the perspective of health educators and policy makers. Semi-structured interviews were conducted with 23 health professionals, from all states and territories of Australia, who were involved in the management or provision of hepatitis C education or support to prisoners. Results were interpreted using thematic analysis. Participant reports regarding the provision of hepatitis C education and support services varied considerably between prisons and across states. Interviewees identified successful services and barriers to improvement, including limited time, insufficient funding and frequent personnel changes. Many prisons were believed to have unique needs and educators from external agencies were not always aware of the medical procedures or methods of harm reduction available in particular facilities. Interviewee perceptions indicated that the delivery of hepatitis C education and support services in Australian custodial settings is marred by inconsistency. However, both education programs and psychological support services could be developed by external agencies wishing to reduce the impact of hepatitis C within the prison system.

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…

A Survey of Psychological Support Provision for People with Inflammatory Arthritis in Secondary Care in England

PubMed Central

Dures, Emma; Almeida, Celia; Caesley, Judy; Peterson, Alice; Ambler, Nicholas; Morris, Marianne; Pollock, Jon; Hewlett, Sarah

2014-01-01

Objectives The consequences of inflammatory arthritis can include depression, anxiety and low mood, reducing patients’ quality of life and increasing pressure on the healthcare system. Treatment guidelines recommend psychological support, but data are lacking on the provision available. Methods A postal survey concerning psychological support provision was sent to rheumatology units in 143 acute trusts across England. Nurses from 73 rheumatology units (51%) responded. Results Overall, 73% rated their unit's psychological support provision as ‘inadequate’ and only 4% rated it as ‘good’. Few units believed that psychological support did not fall within their remit (12%), yet only 8% had a psychologist in the team. Most units (68%) did not routinely screen patients to identify psychological difficulties. Referral to other service providers was reported in 42% of units, with 3% very satisfied with this provision. Within units, services containing elements of psychological support ranged from occupational therapy (81%) to psychology/counselling (14%). Psychological approaches used by team members ranged from shared decision making (77%) to cognitive–behavioural approaches (26%). The current barriers to providing psychological support were lack of clinical time and available training (86% and 74%, respectively), and delivery costs (74%). Future facilitators included management support (74%) and availability of skills training (74%). Conclusions Rheumatology units viewed psychological support provision as part of their remit but rated their overall provision as inadequate, despite some team members using psychological skills. To improve provision, clinicians’ training needs must be addressed and organizational support generated, and further research needs to define adequate psychological support provision from the patient perspective. © 2014 The Authors. Musculoskeletal Care published by John Wiley & Sons Ltd. PMID:24753071

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.

Decomposing Cost Efficiency in Regional Long-term Care Provision in Japan.

PubMed

Yamauchi, Yasuhiro

2015-07-12

Many developed countries face a growing need for long-term care provision because of population ageing. Japan is one such example, given its population's longevity and low birth rate. In this study, we examine the efficiency of Japan's regional long-term care system in FY2010 by performing a data envelopment analysis, a non-parametric frontier approach, on prefectural data and separating cost efficiency into technical, allocative, and price efficiencies under different average unit costs across regions. In doing so, we elucidate the structure of cost inefficiency by incorporating a method for restricting weight flexibility to avoid unrealistic concerns arising from zero optimal weight. The results indicate that technical inefficiency accounts for the highest share of losses, followed by price inefficiency and allocation inefficiency. Moreover, the majority of technical inefficiency losses stem from labor costs, particularly those for professional caregivers providing institutional services. We show that the largest share of allocative inefficiency losses can also be traced to labor costs for professional caregivers providing institutional services, while the labor provision of in-home care services shows an efficiency gain. However, although none of the prefectures gains efficiency by increasing the number of professional caregivers for institutional services, quite a few prefectures would gain allocative efficiency by increasing capital inputs for institutional services. These results indicate that preferred policies for promoting efficiency might vary from region to region, and thus, policy implications should be drawn with care.

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

Improving the public health sector in South Africa: eliciting public preferences using a discrete choice experiment.

PubMed

Honda, Ayako; Ryan, Mandy; van Niekerk, Robert; McIntyre, Diane

2015-06-01

The introduction of national health insurance (NHI), aimed at achieving universal coverage, is the most important issue currently on the South African health policy agenda. Improvement in public sector health-care provision is crucial for the successful implementation of NHI as, regardless of whether health-care services become more affordable and available, if the quality of the services provided is not acceptable, people will not use the services. Although there has been criticism of the quality of public sector health services, limited research is available to identify what communities regard as the greatest problems with the services. A discrete choice experiment (DCE) was undertaken to elicit public preferences on key dimensions of quality of care when selecting public health facilities in South Africa. Qualitative methods were applied to establish attributes and levels for the DCE. To elicit preferences, interviews with community members were held in two South African provinces: 491 in Western Cape and 499 in Eastern Cape. The availability of necessary medicine at health facilities has the greatest impact on the probability of attending public health facilities. Other clinical quality attributes (i.e. provision of expert advice and provision of a thorough examination) are more valued than non-clinical quality of care attributes (i.e. staff attitude, treatment by doctors or nurses, and waiting time). Treatment by a doctor was less valued than all other attributes. Communities are prepared to tolerate public sector health service characteristics such as a long waiting time, poor staff attitudes and lack of direct access to doctors if they receive the medicine they need, a thorough examination and a clear explanation of the diagnosis and prescribed treatment from health professionals. These findings prioritize issues that the South African government must address in order to meet their commitment to improve public sector health-care service provision. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

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...

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...

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...

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...

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...

Information and professional support: key factors in the provision of family-centred early childhood intervention services.

PubMed

Fordham, L; Gibson, F; Bowes, J

2012-09-01

Much has been written on the principles of family-centred practice and on the service delivery methods and skills required of its practitioners. Far less has been written from the perspective of families whose children have a disability. The aims of this study were twofold: firstly to understand families' experiences of family-centred early childhood intervention services and secondly to explore other factors that might impact on these experiences. One hundred and thirty families attending two established early childhood intervention services in New South Wales, Australia completed a survey incorporating the Measure of Processes of Care-56, the Family Empowerment Scale, the Family Support Scale and the Parenting Daily Hassles Scale. Consistent with previous research using the Measure of Processes of Care-56, 'respectful and supportive care' was the domain of care families rated to occur most and 'provision of general information' was the domain they rated to occur least. Significant positive relationships existed between families' ratings of family-centred care and feelings of empowerment. Being provided with general information was strongly correlated with family empowerment. Families' social support networks played an important role but support from professionals was most strongly correlated with families' experiences of family-centred care. Finally, families whose children's early intervention services were co-ordinated by a professional experienced significantly better care. The provision of general information and professional support are key components of family-centred early childhood intervention services. © 2011 Blackwell Publishing Ltd.

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.

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.

Adolescents Confusion in Receiving Health Services: A Qualitative Study

PubMed Central

Azh, Nezal; Ozgoli, Giti; Ardalan, Gelayol

2017-01-01

Introduction Providing health services for adolescents requires exploration of hidden factors from the perspective of adolescents, providers, and key individuals. Understanding the process of providing health services from adolescents point of view will help receiving and continuation of services. Although many studies have been conducted in Iran on adolescents health needs, few studies have dealt with provision of these services to adolescents. Aim The present study aimed to explain the adolescents and key informants’ perception of healthcare provision. Materials and Methods The present qualitative study was conducted according to grounded theory. Data were collected using deep semi-structured individual interviews and group discussion. Participants were selected through purposive sampling followed by theoretical sampling. Participants in present study were 65 adolescents, nine youths (19-24-year-old), and 19 parents and key people involved in providing health services. Adolescents and their parents were selected from different parts of Tehran. Data collection continued until data saturation, and was analysed using Corbin-Strauss (2008) method. Results Issues relating to adolescents perception of the process of providing services included health concerns, society’s inappropriate behaviours, and weakness of the health services system in responding to adolescents needs, which as underlying factors contributed to adolescents confusion in receiving services and their proper coping with puberty. Conclusion Due to lack of education on how to manage puberty by parents, schools, society, and the health system, participating adolescents from Tehran were confused about receiving information and unable to manage puberty problems. Solving this problem requires continuity of services and interaction of family, school and community. PMID:28658809

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...

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.

Assessing the context of health care utilization in Ecuador: A spatial and multilevel analysis

PubMed Central

2010-01-01

Background There are few studies that have analyzed the context of health care utilization, particularly in Latin America. This study examines the context of utilization of health services in Ecuador; focusing on the relationship between provision of services and use of both preventive and curative services. Methods This study is cross-sectional and analyzes data from the 2004 National Demographic and Maternal & Child Health dataset. Provider variables come from the Ecuadorian System of Social Indicators (SIISE). Global Moran's I statistic is used to assess spatial autocorrelation of the provider variables. Multilevel modeling is used for the simultaneous analysis of provision of services at the province-level with use of services at the individual level. Results Spatial analysis indicates no significant differences in the density of health care providers among Ecuadorian provinces. After adjusting for various predisposing, enabling, need factors and interaction terms, density of public practice health personnel was positively associated with use of preventive care, particularly among rural households. On the other hand, density of private practice physicians was positively associated with use of curative care, particularly among urban households. Conclusions There are significant public/private, urban/rural gaps in provision of services in Ecuador; which in turn affect people's use of services. It is necessary to strengthen the public health care delivery system (which includes addressing distribution of health workers) and national health information systems. These efforts could improve access to health care, and inform the civil society and policymakers on the advances of health care reform. PMID:20222988

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...

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...

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...

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...

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...

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.

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...

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...

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...

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...

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...

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...

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.

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.

Personality Disorders in Offenders with Intellectual Disability: A Comparison of Clinical, Forensic and Outcome Variables and Implications for Service Provision

ERIC Educational Resources Information Center

Alexander, R. T.; Green, F. N.; O'Mahony, B.; Gunaratna, I. J.; Gangadharan, S. K.; Hoare, S.

2010-01-01

Aim: To establish any differences between patients with and without a diagnosis of personality disorders, being treated in a secure inpatient service for offenders with intellectual disability (ID) in the UK. Method: A cohort study involving a selected population of people with ID and offending behaviours. Results: The study included a total of…

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

PubMed

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

2014-05-01

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

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

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.

New UK graduates' knowledge of training and service provision within restorative dentistry - a survey.

PubMed

Kalsi, A S; Kochhar, S; Lewis, N J; Hemmings, K W

2017-06-09

Objective To assess new UK graduates' knowledge of training and service provision within restorative dentistry.Design A national descriptive cross-sectional survey.Subjects and methods An online survey assessing clinicians' knowledge of restorative dentistry, who had graduated within the last four years in the UK, was distributed across the UK via postgraduate dental deaneries. One-hundred responses were accepted as a sample of a potential population of 4,000.Main outcome measure How well respondents understood the service provision and training aspects of the specialty of restorative dentistry.Results The responses were received from graduates from a variety of dental schools across the UK. Of those respondents, 41 reported receiving career guidance within restorative dentistry. 45 new graduates were confident in their understanding of the specialty, while 53 were confident in the differences between restorative dentistry and monospecialty training. The respondents appeared unaware regarding treatment priorities within restorative dentistry departments. Most respondents felt that receiving teaching on restorative dentistry as a specialty and career pathway would be beneficial.Conclusion The results suggest that new graduates may benefit from clarification regarding the specialty of restorative dentistry, however, caution must be taken due to the limitations of the study.

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...

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...

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...

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...

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...

Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China

PubMed Central

Richards, Esther; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel

2017-01-01

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers’ perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces—Zhejiang, Hubei and Yunnan—were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources. PMID:29045434

Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China.

PubMed

Jiang, Hong; Xu, Jieshuang; Richards, Esther; Qian, Xu; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel

2017-01-01

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources.

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

Issues in evaluation: evaluating assessments of elderly people using a combination of methods.

PubMed

McEwan, R T

1989-02-01

In evaluating a health service, individuals will give differing accounts of its performance, according to their experiences of the service, and the evaluative perspective they adopt. The value of a service may also change through time, and according to the particular part of the service studied. Traditional health care evaluations have generally not accounted for this variability because of the approaches used. Studies evaluating screening or assessment programmes for the elderly have focused on programme effectiveness and efficiency, using relatively inflexible quantitative methods. Evaluative approaches must reflect the complexity of health service provision, and methods must vary to suit the particular research objective. Under these circumstances, this paper presents the case for the use of multiple triangulation in evaluative research, where differing methods and perspectives are combined in one study. Emphasis is placed on the applications and benefits of subjectivist approaches in evaluation. An example of combined methods is provided in the form of an evaluation of the Newcastle Care Plan for the Elderly.

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

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.

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.

21 CFR 130.12 - General methods for water capacity and fill of containers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false General methods for water capacity and fill of containers. 130.12 Section 130.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD STANDARDS: GENERAL General Provisions § 130.12 General...

Feasibility of sustainable provision of intradermal post exposure prophylaxis against rabies at primary care level –evidence from rural Haryana

PubMed Central

2014-01-01

Background Rabies is the most severe and neglected public health problem in India. Management of animal bite with post exposure prophylaxis is the only existent strategy to prevent rabies related deaths. Cost-effective and sustainable programme for provision of post exposure prophylaxis (PEP) is needed in India. Methods In this study, we have documented the experience of implementation of intra-dermal anti rabies vaccination in Animal Bite Management (ABM) clinic at Primary Health Centre (PHC). This study facility belonged to Comprehensive Rural Health Services Project, Ballabgarh in Faridabad district of Haryana. Hospital service record of ABM clinic was analyzed and various feasibility issues such as costing of services, vaccine wastage and other operational issues in providing PEP services at PHC level were documented. Results A total of 619 patients were treated in the ABM clinic. Service utilization of ABM clinic was increased by 38% in the second year of implementation. Mean age of the patients was 23.9 years (SD: 18.8) and majority (70.4%) were males. Majority (86%) of the patients received the first dose of anti-rabies vaccine within the recommended 48 hours. A total 446 vaccine vials (1 ml) were consumed of which 20.8% was contributed in vaccine wastage. User-fee (350 Indian Rupees) collected from the patients. User-fee was re-used to purchase vaccines, intradermal (ID) syringes and other consumables required to ensure regular availability of ARV services at the PHC. Conclusions This study demonstrated the cost-effective and sustainable model of provision of PEP against rabies at primary care level. ID PEP provision at primary care level not only address the unmet need of animal bite management in the community also reduces the out of pocket expenditure of the patients. PMID:24965875

[Ecological regulation services of Hainan Island ecosystem and their valuation].

PubMed

Ouyang, Zhiyun; Zhao, Tongqian; Zhao, Jingzhu; Xiao, Han; Wang, Xiaoke

2004-08-01

Ecosystem services imply the natural environmental conditions on which human life relies for existence, and their effectiveness formed and sustained by ecosystem and its ecological processes. In newly research reports, they were divided into four groups, i. e., provisioning services, regulation services, cultural services, and supporting services. To assess and valuate ecosystem services is the foundation of regional environmental reserve and development. Taking Hainan Island as an example and based on the structure and processes of natural ecosystem, this paper discussed the proper methods for regulation services assessment. The ecosystems were classified into 13 types including valley rain forest, mountainous rain forest, tropical monsoon forest, mountainous coppice forest, mountainous evergreen forest, tropical coniferous forest, shrubs, plantation, timber forest, windbreak forest, mangrove, savanna, and cropland, and then, the regulation services and their economic values of Hainan Island ecosystem were assessed and evaluated by terms of water-holding, soil conservancy, nutrient cycle, C fixation, and windbreak function. The economic value of the regulation services of Hainan Island ecosystem was estimated as 2035.88 x 10(8)-2153.39 x 10(8) RMB yuan, 8 times higher to its provisioning services (wood and agricultural products) which were estimated as only 254.06 x 10(8) RMB yuan. The result implied that ecosystem regulation services played an even more important role in the sustainable development of society and economy in Hainan Island.

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.

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.

Being Single as a Social Barrier to Access Reproductive Healthcare Services by Iranian Girls

PubMed Central

Kohan, Shahnaz; Mohammadi, Fatemeh; Mostafavi, Firoozeh; Gholami, Ali

2017-01-01

Background: Iranian single women are deprived of reproductive healthcare services, though the provision of such services to the public has increased. This study aimed to explore the experiences of Iranian single women on their access to reproductive health services. Methods: A qualitative design using a conventional content analysis method was used. Semi-structured interviews were held with 17 single women and nine health providers chosen using the purposive sampling method. Results: Data analysis resulted in the development of three categories: ‘family’s attitudes and performance about single women’s reproductive healthcare,’ ‘socio-cultural factors influencing reproductive healthcare,’ and ‘cultural factors influencing being a single woman.’ Conclusion: Cultural and contextual factors affect being a single woman in every society. Therefore, healthcare providers need to identify such factors during the designing of strategies for improving the facilitation of access to reproductive healthcare services. PMID:28812794

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...

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.…

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…

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...

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...

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...

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...

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...

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...

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...

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...

The Impact of Medical Tourism on Thai Private Hospital Management: Informing Hospital Policy

PubMed Central

James, Paul TJ

2012-01-01

Background: The purpose of this paper is to help consolidate and understand management perceptions and experiences of a targeted group (n=7) of Vice-Presidents of international Private Thai hospitals in Bangkok regarding medical tourism impacts. Methods: The method adopted uses a small-scale qualitative inquiry. Examines the on-going development and service management factors which contribute to the establishment and strengthening of relationships between international patients and hospital medical services provision. Develops a qualitative model that attempts to conceptualise the findings from a diverse range of management views into a framework of main (8) - Hospital Management; Hospital Processes; Hospital Technology; Quality Related; Communications; Personnel; Financial; and Patients; and consequent sub-themes (22). Results: Outcomes from small-scale qualitative inquiries cannot by design be taken outside of its topical arena. This inevitably indicates that more research of this kind needs to be carried out to understand this field more effectively. The evidence suggests that Private Thai hospital management have established views about what constitutes the impact of medical tourism on hospital policies and practices when hospital staff interact with international patients. Conclusions: As the private health service sector in Thailand continues to grow, future research is needed to help hospitals provide appropriate service patterns and appropriate medical products/services that meet international patient needs and aspirations. Highlights the increasing importance of the international consumer in Thailand’s health industry. This study provides insights of private health service providers in Bangkok by helping to understand more effectively health service quality environments, subsequent service provision, and the integrated development and impacts of new medical technology. PMID:22980119

Provision of a Medicines Information Service to Consumers on Facebook: An Australian Case Study

PubMed Central

Chen, Timothy F; Spagnardi, Sarah; Beer, Troy; Aslani, Parisa

2015-01-01

Background Social networking sites (SNSs) have changed the way people communicate. They may also change the way people seek health advice. Objective This study describes the provision of a medicines information service on Facebook to individual consumers. It aimed to discuss the pros and cons, and inform health and pharmacy stakeholders and researchers about the opportunities and challenges of providing such a service. Methods We adopted an exploratory approach using a case study method. Results NPS MedicineWise, an independent, not-for-profit Australian organization, runs a public question-and-answer service on Facebook, dubbed Pharmacist Hour. Consumers following the organization’s Facebook page are invited to post medication-related questions often with a suggested health topic. A wide range of questions and comments are posted related to medication usage. The pharmacist answers the queries, providing evidence-based medicines information and using consumer-friendly language, during the specific 1-hour period. The most popular questions in the past 12 months were related to adverse effects, treatment options for conditions, and drug interactions. The service had a mean number of engagements (defined as a like or share of the Pharmacy Hour post) of 38 (SD 19) people and a mean 5 (SD 3) questions per session. Conclusions The Pharmacist Hour Facebook service addresses the medicines information needs of consumers and indirectly promotes other appropriate and relevant NPS MedicineWise products and services to further assist consumers. The service offers a new medium for a quality use of medicines organization committed to promoting awareness about the correct and safe use of medicines in Australia. PMID:26596328

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.

How do we incorporate patient views into the design of healthcare services for older people: a discussion paper.

PubMed

Brocklehurst, Paul R; McKenna, Gerald; Schimmel, Martin; Kossioni, Anastassia; Jerković-Ćosić, Katarina; Hayes, Martina; da Mata, Cristiane; Müller, Frauke

2018-04-06

Across the European Union costs for the treatment of oral disease is expected to rise to €93 Billion by 2020 and be higher than those for stroke and dementia combined. A significant proportion of these costs will relate to the provision of care for older people. Dental caries severity and experience is now a major public health issue in older people and periodontal disease disproportionately affects older adults. Poor oral health impacts on older people's quality of life, their self-esteem, general health and diet. Oral health care service provision for older people is often unavailable or poor, as is the standard of knowledge amongst formal and informal carers. The aim of this discussion paper is to explore some of the approaches that could be taken to improve the level of co-production in the design of healthcare services for older people. People's emotional and practical response to challenges in health and well-being and the responsiveness of systems to their needs is crucial to improve the quality of service provision. This is a particularly important aspect of care for older people as felt, expressed and normative needs may be fundamentally different and vary as they become increasingly dependent. Co-production shifts the design process away from the traditional 'top-down' medical model, where needs assessments are undertaken by someone external to a community and strategies are devised that encourage these communities to become passive recipients of services. Instead, an inductive paradigm of partnership working and shared leadership is actively encouraged to set priorities and ultimately helps improve the translational gap between research, health policy and health-service provision. The four methodological approaches discussed in this paper (Priority Setting Partnerships, Discrete Choice Experiments, Core Outcome Sets and Experience Based Co-Design) represent an approach that seeks to better engage with older people and ensure an inductive, co-produced process to the research and design of healthcare services of the future. These methods facilitate partnerships between researchers, healthcare professionals and patients to produce more responsive and appropriate public services for older people.

Improving Birth Control Service Utilization By Offering Services Prerelease Vs Postincarceration

PubMed Central

Clarke, Jennifer G.; Rosengard, Cynthia; Rose, Jennifer S.; Hebert, Megan R.; Peipert, Jeffrey; Stein, Michael D.

2006-01-01

Objectives. We examined whether incarcerated women would substantially increase birth control initiation if contraceptive services were available within the prison compared with after their release back into the community. Methods. During phase 1 of the study, a nurse educator met with women at the Rhode Island Adult Correctional Institute and offered them referrals for contraceptive services at a community health clinic after their release. During phase 2, contraceptive services were offered to women during their incarceration. Results. The majority of the participants (77.5%) reported a desire to initiate use of birth control methods. Within 4 weeks of their release, 4.4% of phase 1 participants initiated use of a contraceptive method, compared with 39.1% of phase 2 participants (odds ratio [OR]=14.6; 95% confidence interval [CI]=5.5, 38.8). Conclusions. Provision of contraceptive services to women during their incarceration is feasible and greatly increases birth control initiation compared to providing services only in the community. PMID:16571698

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...

Decomposing Cost Efficiency in Regional Long-term Care Provision in Japan

PubMed Central

Yamauchi, Yasuhiro

2016-01-01

Many developed countries face a growing need for long-term care provision because of population ageing. Japan is one such example, given its population's longevity and low birth rate. In this study, we examine the efficiency of Japan's regional long-term care system in FY2010 by performing a data envelopment analysis, a non-parametric frontier approach, on prefectural data and separating cost efficiency into technical, allocative, and price efficiencies under different average unit costs across regions. In doing so, we elucidate the structure of cost inefficiency by incorporating a method for restricting weight flexibility to avoid unrealistic concerns arising from zero optimal weight. The results indicate that technical inefficiency accounts for the highest share of losses, followed by price inefficiency and allocation inefficiency. Moreover, the majority of technical inefficiency losses stem from labor costs, particularly those for professional caregivers providing institutional services. We show that the largest share of allocative inefficiency losses can also be traced to labor costs for professional caregivers providing institutional services, while the labor provision of in-home care services shows an efficiency gain. However, although none of the prefectures gains efficiency by increasing the number of professional caregivers for institutional services, quite a few prefectures would gain allocative efficiency by increasing capital inputs for institutional services. These results indicate that preferred policies for promoting efficiency might vary from region to region, and thus, policy implications should be drawn with care. PMID:26493427

Seasonality of service provision in hip and knee surgery: A possible contributor to waiting times? A time series analysis

PubMed Central

Upshur, Ross EG; Moineddin, Rahim; Crighton, Eric J; Mamdani, Muhammad

2006-01-01

Background The question of how best to reduce waiting times for health care, particularly surgical procedures such as hip and knee replacements is among the most pressing concern of the Canadian health care system. The objective of this study was to test the hypothesis that significant seasonal variation exists in the performance of hip and knee replacement surgery in the province of Ontario. Methods We performed a retrospective, cross-sectional time series analysis examining all hip and knee replacement surgeries in people over the age of 65 in the province of Ontario, Canada between 1992 and 2002. The main outcome measure was monthly hospitalization rates per 100 000 population for all hip and knee replacements. Results There was a marked increase in the rate of hip and knee replacement surgery over the 10-year period as well as an increasing seasonal variation in surgeries. Highly significant (Fisher Kappa = 16.05, p < 0.01; Bartlett-Kolmogorov-Smirnov Test = 0.31, p < 0.01) and strong (R2Autoreg = 0.85) seasonality was identified in the data. Conclusion Holidays and utilization caps appear to exert a significant influence on the rate of service provision. It is expected that waiting times for hip and knee replacement could be reduced by reducing seasonal fluctuations in service provision and benchmarking services to peak delivery. The results highlight the importance of system behaviour in seasonal fluctuation of service delivery. PMID:16509992

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.

Five years of poisons information on the internet: the UK experience of TOXBASE

PubMed Central

Bateman, D N; Good, A M

2006-01-01

Introduction In 1999, the UK adopted a policy of using TOXBASE, an internet service available free to registered National Health Service (NHS) departments and professionals, as the first point of information on poisoning. This was the first use worldwide of the internet for provision of clinical advice at a national level. We report the impact on database usage and NPIS telephone call loads. Methods Trends in the pattern of TOXBASE usage from 2000–2004 are reported by user category. Information on the monographs accessed most frequently was also extracted from the webserver and sorted by user category. The numbers of telephone calls to the National Poisons Information Service (NPIS) were extracted from NPIS annual reports. Results Numbers of database logons increased 3.5 fold from 102 352 in 2000 to 368 079 in 2004, with a total of 789 295 accesses to product monographs in 2004. Registered users increased almost tenfold, with approximately half accessing the database at least once a year. Telephone calls to the NPIS dropped by over half. Total contacts with NPIS (web and telephone) increased 50%. Major users in 2004 were hospital emergency departments (60.5% of logons) and NHS public access helplines (NHS Direct and NHS24) (29.4%). Different user groups access different parts of the database. Emergency departments access printable fact sheets for about 10% of monographs they access. Conclusion Provision of poisons information by the internet has been successful in reducing NPIS call loads. Provision of basic poisons information by this method appears to be acceptable to different professional groups, and to be effective in reducing telephone call loads and increasing service cost effectiveness. PMID:16858093

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.

Nursing service innovation: A case study examining emergency nurse practitioner service sustainability.

PubMed

Fox, Amanda; Gardner, Glenn; Osborne, Sonya

2018-02-01

This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service. Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision. This research used case study methodology (Yin, ). Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions. In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse. This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability. © 2017 John Wiley & Sons Ltd.

How does specialist nursing contribute to HIV service delivery across England?

PubMed

Piercy, Hilary; Bell, Gill; Hughes, Charlie; Naylor, Simone; Bowman, Christine A

2017-07-01

This study aimed to examine what specialist nursing contributes to HIV service delivery across England and how it could be optimised. A three part multi-method qualitative study was undertaken, involving (1) interviews with 19 stakeholders representing professional or service user groups; (2) interviews with nurse/physician pairs from 21 HIV services; and (3) case studies involving site visits to five services. A framework analysis approach was used to manage and analyse the data. There was substantial variability in specialist nursing roles and the extent of role development. Most hospital-based HIV nurses (13/19) were running nurse-led clinics, primarily for stable patients with almost half (6/13) also managing more complex patients. Role development was supported by non-medical prescribing, a robust governance framework and appropriate workload allocation. The availability and organisation of community HIV nursing provision determined how services supported vulnerable patients to keep them engaged in care. Four service models were identified. The study showed that there is scope for providing a greater proportion of routine care through nurse-led clinics. HIV community nursing can influence health outcomes for vulnerable patients, but provision is variable. With limited financial resources, services may need to decide how to deploy their specialist nurses for best effect.

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.

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...

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

A Quantitative review of relationships between Ecosystem services

NASA Astrophysics Data System (ADS)

Lee, H.; Lautenbach, S.

2014-12-01

Each decision in natural resources management can generate trade-offs with respect to the provisioning of ecosystem services (ES). If the increase of one ES happens directly or indirectly at the cost of another ES, an attempt to maximize the provision of a single ES will lead to suboptimal results. However, decisions in natural resources management are often made without considering such trade-offs, despite their crucial role toward supporting better decision-making. The research on trade-offs between ES has gained some attention in the scientific community. However, a synthesis on existing knowledge and knowledge gaps is missing so far. We aim at closing that gap by a quantitative review of recent literature on trade-offs of ES. We looked at the pairs of ES that have been studied in ~100 case studies that report on trade-offs between ES. If a case study analyzed more than one ES pair, we looked at all pairwise combinations. We categorized relationships between these pairs of ES into the categories "trade-off", "synergy" or "no-effect". Most pairs of ES had a clear association with one category: the majority of case studies that studied a specific pair of ES identified the same category of relationship between the two ES. Pairs of regulating services were typically synergetic in relationship, whereas provisioning services and regulating services typically showed a trade-off. However, for several pairs of ES we were not able to identify a dominate category of relationship. Our hypothesis is that this relates to either the scale of the analysis, the land system where the analysis took place or the method used to quantify the relationship. The number of case studies for each pair of ES was spread unevenly. This hinders the support for a conclusive statement drawn for the pairs. Our results showed further that the method used to identify the relationship between services had a strong effect on the direction of the effect. This suggests that researchers should consider their method carefully. We believe that our results are of use for the scientific community as well as for practitioners since they provide helpful information about which services to include in ES assessments. Furthermore, they allow a first check if critical trade-offs have been considered in an analysis.

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...

Meeting the contraceptive needs of teens and young adults: youth-friendly and long-acting reversible contraceptive services in U.S. family planning facilities.

PubMed

Kavanaugh, Megan L; Jerman, Jenna; Ethier, Kathleen; Moskosky, Susan

2013-03-01

Increased use of contraceptive services, including long-acting reversible contraceptives (LARCs), among sexually active teens and young adults could significantly reduce unintended pregnancy. Objectives were to describe youth-friendly contraceptive services (including LARC) available to teens and young adults at U.S. publicly funded family planning facilities. Between April and September 2011, center directors at a nationally representative sample of 1,196 U.S. publicly funded family planning facilities were surveyed to assess accessibility and provision of contraceptive services for teens and young adults; 584 (52%) responded. Facilities were accessible to young clients in several ways, including not requiring scheduled appointments for method refills (67%) and having flexible hours (64%). Most facilities provided outreach and/or education to young people (70%), and 27% used social network media to do this. Most facilities took steps to ensure confidentiality for young clients. These youth-friendly practices were more common at Planned Parenthood, Title X, and reproductive health focused facilities than at other facilities. Long-acting reversible contraceptive methods were regularly discussed with younger clients at less than half the facilities. Youth-friendly sites had increased rates of LARC provision among younger clients. The most common challenges to providing contraceptive and LARC services to younger clients were the costs of LARC methods (60%), inconvenient clinic hours (51%), staff concerns about intrauterine device (IUD) use among teens (47%), and limited training on implant insertion (47%). Improving the ability of family planning facilities to provide youth-friendly contraceptive and LARC-specific methods to younger clients may increase the use of highly effective contraception in this population. Copyright © 2013 Society for Adolescent Health and Medicine. All rights reserved.

Consumer panel study on elderly people's wishes concerning services.

PubMed

Valkila, Noora; Litja, Heli; Aalto, Leena; Saari, Arto

2010-01-01

This study informs on the wishes and needs of elderly people themselves regarding services for the elderly. The data for the study were gathered using a consumer panel method. Elderly people desire assistance in heavy cleaning chores, in outdoor activities and in carrying out their personal business. Elderly people felt that there should be more recreational services available. Elderly people link aging with feelings of insecurity and loneliness. Becoming a service user for the first time is felt to be a very difficult step to take, and so this decision is postponed as long as possible. The elderly people desire a service for assessing their individual service needs in an organized, expert and objective fashion. The study indicates that elderly people value the human contact gained through service provision. The consumer panel method for collecting data was successful. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Implementation of a panel of service users for the evaluation of mental health outpatient services.

PubMed

Perreault, Michel; Renaud, Jeff; Bourassa, Francine; Beauchesne, Louise; Mpiana, André; Bernier, Sylvain; Milton, Diana

2010-12-01

The purpose of this study is to describe the experience of a standing panel of psychiatric outpatients over a period of five years. The procedure is used as a complementary method to assess client satisfaction regarding services provided by a Montreal psychiatric institute. During this period, 13 meetings were held, involving a total of 22 patients as active members of the panel. These sessions allowed 11 decision makers of the institute to consult the panel regarding various topics such as service organization, quality of services, and client information. In a context of internal evaluation, by giving direct and rapid access to service users' perspectives on key issues regarding service provision, the panel appeared to be a practical procedure for use in complement with other satisfaction assessment methods. Unplanned effects included the recruitment of participants as patient representatives on different hospital committees and associations, and as presenters in conferences and congresses.

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...

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...

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...

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...

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.

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.

Assessing the Value of Volunteer Activity.

ERIC Educational Resources Information Center

Brown, Eleanor

1999-01-01

Looks at methods of converting estimates of volunteer time into dollar value of volunteered time. Suggests an alternative strategy that acknowledges the importance of taxes, the provision of volunteer-assisted services at less-than-market prices, and the value of experiences gained by the volunteer. (JOW)

7 CFR 27.100 - Administration.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Administration. 27.100 Section 27.100 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Administration. The details of the method of carrying out the provisions of this subpart in each bona fide spot...

7 CFR 205.105 - Allowed and prohibited substances, methods, and ingredients in organic production and handling.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ingredients in organic production and handling. 205.105 Section 205.105 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC...

7 CFR 27.100 - Administration.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Administration. 27.100 Section 27.100 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Administration. The details of the method of carrying out the provisions of this subpart in each bona fide spot...

7 CFR 27.100 - Administration.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Administration. 27.100 Section 27.100 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Administration. The details of the method of carrying out the provisions of this subpart in each bona fide spot...

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…

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...

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...

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...

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...

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...

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...

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...

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...

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...

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.

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.

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.

“They just scraped off the calluses”: a mixed methods exploration of foot care access and provision for people with rheumatoid arthritis in south-western Sydney, Australia

PubMed Central

2013-01-01

Background There is little indication that foot health services in Australia are meeting modern day recommendations for Rheumatoid Arthritis (RA) patients. The overall objective of this study was to explore the current state of foot health services for patients with RA with an emphasis on identifying barriers to the receipt of appropriate foot care in South-West Sydney, New South Wales, Australia. Methods A mixed (quantitative and qualitative) approach was adopted. Indications for appropriate access to foot care were determined by comparing the foot health, disease and socio-demographic characteristics of patients with unmet foot care demands, foot care users and patients with no demands for foot care. Perceptions of provision of, and access to, foot care were explored by conducting telephone-based interviews using an interpretative phenomenology approach with thematic analysis. Results Twenty-nine participants took part in the cross-sectional quantitative research study design, and 12 participants took part in the interpretative phenomenological approach (qualitative study). Foot care access appeared to be driven predominantly by the presence of rearfoot deformity, which was significantly worse amongst participants in the foot care user group (p = 0.02). Five main themes emerged from the qualitative data: 1) impact of disease-related foot symptoms, 2) footwear difficulties, 3) medical/rheumatology encounters, 4) foot and podiatry care access and experiences, and 5) financial hardship. Conclusions Foot care provision does not appear to be driven by appropriate foot health characteristics such as foot pain or foot-related disability. There may be significant shortfalls in footwear and foot care access and provision in Greater Western Sydney. Several barriers to adequate foot care access and provision were identified and further efforts are required to improve access to and the quality of foot care for people who have RA. Integration of podiatry services within rheumatology centres could resolve unmet needs of people with RA by permitting rapid access to expert-led multidisciplinary foot care for people with RA. PMID:23938103

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.

De-optical-line-terminal hybrid access-aggregation optical network for time-sensitive services based on software-defined networking orchestration

NASA Astrophysics Data System (ADS)

Bai, Wei; Yang, Hui; Xiao, Hongyun; Yu, Ao; He, Linkuan; Zhang, Jie; Li, Zhen; Du, Yi

2017-11-01

With the increase in varieties of services in network, time-sensitive services (TSSs) appear and bring forward an impending need for delay performance. Ultralow-latency communication has become one of the important development goals for many scenarios in the coming 5G era (e.g., robotics and driverless cars). However, the conventional methods, which decrease delay by promoting the available resources and the network transmission speed, have limited effect; a new breakthrough for ultralow-latency communication is necessary. We propose a de-optical-line-terminal (De-OLT) hybrid access-aggregation optical network (DAON) for TSS based on software-defined networking (SDN) orchestration. In this network, low-latency all-optical communication based on optical burst switching can be achieved by removing OLT. For supporting this network and guaranteeing the quality of service for TSSs, we design SDN-driven control method and service provision method. Numerical results demonstrate the proposed DAON promotes network service efficiency and avoids traffic congestion.

Provider imposed restrictions to clients’ access to family planning in urban Uttar Pradesh, India: a mixed methods study

PubMed Central

2013-01-01

Background Medical barriers refer to unnecessary policies or procedures imposed by health care providers that are not necessarily medically advised; these restrictions impede clients’ access to family planning (FP). This mixed methods study investigates provider imposed barriers to provision of FP using recent quantitative and qualitative data from urban Uttar Pradesh, India. Methods Baseline quantitative data were collected in six cities in Uttar Pradesh, India from service delivery points (SDP), using facility audits, exit interviews, and provider surveys; for this study, the focus is on the provider surveys. More than 250 providers were surveyed in each city. Providers were asked about the FP methods they provide, and if they restrict clients’ access to each method based on age, parity, partner consent, or marital status. For the qualitative research, we conducted one-on-one interviews with 21 service providers in four of the six cities in Uttar Pradesh. Each interview lasted approximately 45 minutes. Results The quantitative findings show that providers restrict clients’ access to spacing and long-acting and permanent methods of FP based on age, parity, partner consent and marital status. Qualitative findings reinforce that providers, at times, make judgments about their clients’ education, FP needs and ability to understand FP options thereby imposing unnecessary barriers to FP methods. Conclusions Provider restrictions on FP methods are common in these urban Uttar Pradesh sites. This means that women who are young, unmarried, have few or no children, do not have the support of their partner, or are less educated may not be able to access or use FP or their preferred method. These findings highlight the need for in-service training for staff, with a focus on reviewing current guidelines and eligibility criteria for provision of methods. PMID:24365015

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...

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...

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,…

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...

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...

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...

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...

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...

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...

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...

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

Breast cancer services in Vietnam: a scoping review

PubMed Central

Jenkins, Chris; Minh, Luu Ngoc; Anh, Tran Tuan; Ngan, Tran Thu; Tuan, Ngo Tri; Giang, Kim Bao; Hoat, Luu Ngoc; Lohfeld, Lynne; Donnelly, Michael; Van Minh, Hoang; Murray, Liam

2018-01-01

ABSTRACT Background: Breast cancer incidence has been increasing consistently in Vietnam. Thus far, there have been no analytical reviews of research produced within this area. Objectives: We sought to analyse the nature andextent of empirical studies about breast cancer in Vietnam, identifying areas for future research and systemsstrengthening. Methods: We undertook a scoping study using a five-stage framework to review published and grey literature in English and Vietnamese on breast cancer detection, diagnosis and treatment. We focused specifically on research discussing the health system and service provision. Results: Our results show that breast cancer screening is limited, with no permanent or integrated national screening activities. There is a lack of information on screening processes and on the integration of screening services with other areas of the health system. Treatment is largely centralised, and across all services there is a lack of evaluation and data collection that would be informative for recommendations seeking to improve accessibility and quality of breast cancer services. Conclusions: This paper is the first scoping review of breast cancer services in Vietnam. It outlines areas for future focus for policy makers and researchers with the objective of strengthening service provision to women with breast cancer across the country while also providing a methodological example for how to conduct a collaborative scoping review. PMID:29473488

The Effects of Introducing Mixed Payment Systems for Physicians: Experimental Evidence.

PubMed

Brosig-Koch, Jeannette; Hennig-Schmidt, Heike; Kairies-Schwarz, Nadja; Wiesen, Daniel

2017-02-01

Mixed payment systems have become a prominent alternative to paying physicians through fee-for-service and capitation. While theory shows mixed payment systems to be superior, causal effects on physicians' behavior when introducing mixed systems are not well understood empirically. We systematically analyze the influence of fee-for-service, capitation, and mixed payment systems on physicians' service provision. In a controlled laboratory setting, we implement an exogenous variation of the payment method. Medical and non-medical students in the role of physicians in the lab (N = 213) choose quantities of medical services affecting patients' health outside the lab. Behavioral data reveal significant overprovision of medical services under fee-for-service and significant underprovision under capitation, although less than predicted when assuming profit maximization. Introducing mixed payment systems significantly reduces deviations from patient-optimal treatment. Although medical students tend to be more patient regarding, our results hold for both medical and non-medical students. Responses to incentive systems can be explained by a behavioral model capturing individual altruism. In particular, we find support that altruism plays a role in service provision and can partially mitigate agency problems, but altruism is heterogeneous in the population. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

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.

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.

Provision of Ecosystem Services Through Market-Based Approaches: Department of Defense Applications

DTIC Science & Technology

2008-03-17

lands. When undeveloped or rural land is converted to urban uses, valuable ecosystem services are lost. Accounting methods are needed to track the...used for training and testing missions has been ‘held back’ from transformations to commercial forestry, cropland, or urban uses and be- cause it...meet built infrastructure needs. Converting land from natural, to rural, to urban causes the loss of important ‘natural infrastructure.’ As the

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…

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.

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.

29 CFR 4.151 - Employees covered by provisions of section 2(a).

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 4.151 Labor Office of the Secretary of Labor LABOR STANDARDS FOR FEDERAL SERVICE CONTRACTS Application of the McNamara-O'Hara Service Contract Act Employees Covered by the Act § 4.151 Employees covered by provisions of section 2(a). The provisions of sections 2(a) and 4(c) of the Act prescribe labor...

12 CFR 303.46 - Financial education programs that include the provision of bank products and services.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Financial education programs that include the provision of bank products and services. 303.46 Section 303.46 Banks and Banking FEDERAL DEPOSIT INSURANCE... Branches and Offices § 303.46 Financial education programs that include the provision of bank products and...

12 CFR 303.46 - Financial education programs that include the provision of bank products and services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Financial education programs that include the provision of bank products and services. 303.46 Section 303.46 Banks and Banking FEDERAL DEPOSIT INSURANCE... Branches and Offices § 303.46 Financial education programs that include the provision of bank products and...

48 CFR 2016.307-70 - Contract provisions and clauses.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., Level of Effort, in solicitations for negotiated procurements containing labor costs other than maintenance services to be awarded on a cost reimbursement, cost sharing, cost-plus-award fee, cost-plus-fixed... COMMISSION CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Cost Reimbursement Contracts 2016.307-70...

Crop diversity effects on productivity and economic returns under dryland agriculture

USDA-ARS?s Scientific Manuscript database

Increasing crop diversity has been identified as a method to improve agronomic performance of cropping systems and increase provision of ecosystem services. However, there is a need to understand the economic performance of more diverse cropping systems. Crop productivity and economic net returns we...

32 CFR 199.14 - Provider reimbursement methods.

Code of Federal Regulations, 2014 CFR

2014-07-01

... for neonatal services which has standardized costs that exceed a threshold of the greater of two times... CHAMPUS discharges in fiscal year 1988. (iv) Hold harmless provision. At such time as the weights... direct medical education costs. (x) Total full-time equivalents for: (A) Residents. (B) Interns. (xi...

32 CFR 199.14 - Provider reimbursement methods.

Code of Federal Regulations, 2013 CFR

2013-07-01

... for neonatal services which has standardized costs that exceed a threshold of the greater of two times... CHAMPUS discharges in fiscal year 1988. (iv) Hold harmless provision. At such time as the weights... direct medical education costs. (x) Total full-time equivalents for: (A) Residents. (B) Interns. (xi...

24 CFR 969.101 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... This part provides a basis for maintaining the low-income nature of a public housing project after the completion of debt service on the project, specifying methods for extending the effective period of those provisions of the Annual Contributions Contract (ACC) which relate to project operation. Such an extension...

Do family-planning workers in China support provision of sexual and reproductive health services to unmarried young people?

PubMed

Tu, Xiaowen; Cui, Nian; Lou, Chaohua; Gao, Ersheng

2004-04-01

To ascertain the perspectives of family-planning service providers in eight sites in China on the provision of sexual and reproductive health services to unmarried young people. Data were drawn from a survey of 1927 family-planning workers and 16 focus group discussions conducted in eight sites in China in 1998-99. Family-planning workers recognized the need to protect the sexual health of unmarried young people and were unambiguous about the need for government agencies to provide information and education on sexual and reproductive health to unmarried young people; however, perceptions about the appropriate age for and content of such education remained conservative. While about 70% of family-planning workers were willing to provide contraceptives to unmarried young people, and about 60% approved government provision of contraceptive services to unmarried young people, only one quarter agreed that the services could be extended to senior high schools. Family-planning workers in China are ambivalent about the provision of sexual and reproductive health services to unmarried young people, which potentially poses a significant obstacle to the adoption of safe sex behaviours by young people, as well as to the provision of sexual and reproductive health information and services to young unmarried people in China. Training programmes for family-planning workers are urgently needed to address this issue.

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

Inequities in Mental Health Care After Health Care System Reform in Chile

PubMed Central

Araya, Ricardo; Rojas, Graciela; Fritsch, Rosemarie; Frank, Richard; Lewis, Glyn

2006-01-01

Objectives. We compared differences in mental health needs and provision of mental health services among residents of Santiago, Chile, with private and public health insurance coverage. Methods. We conducted a cross-sectional survey of a random sample of adults. Presence of mental disorders and use of health care services were assessed via structured interviews. Individuals were classified as having public, private, or no health insurance coverage. Results. Among individuals with mental disorders, only 20% (95% confidence interval [CI]=16%, 24%) had consulted a professional about these problems. A clear mismatch was found between need and provision of services. Participants with public insurance coverage exhibited the highest prevalence of mental disorders but the lowest rates of consultation; participants with private coverage exhibited exactly the opposite pattern. After adjustment for age, income, and severity of symptoms, private insurance coverage (odds ratio [OR]=2.72; 95% CI=1.6, 4.6) and higher disability level (OR=1.27, 95% CI=1.1, 1.5) were the only factors associated with increased frequency of mental health consultation. Conclusions. The health reforms that have encouraged the growth of the private health sector in Chile also have increased risk segmentation within the health system, accentuating inequalities in health care provision. PMID:16317207

Parental views on informed consent for expanded newborn screening.

PubMed

Moody, Louise; Choudhry, Kubra

2013-09-01

An increasing array of rare inherited conditions can be detected as part of the universal newborn screening programme. The introduction and evaluation of these service developments require consideration of the ethical issues involved and appropriate mechanisms for informing parents and gaining consent if required. Exploration of parental views is needed to inform the debate and specifically consider whether more flexible protocols are needed to fit with the public perception of new developments in this context. This study has been undertaken to explore perceptions and attitudes of parents and future parents to an expanded newborn screening programme in the United Kingdom and the necessary information provision and consent processes. A mixed methods study involving focus groups (n = 29) and a web-survey (n = 142) undertaken with parents and future parents. Parents want guaranteed information provision with clear decision-making powers and an awareness of the choices available to them. The difference between existing screening provision and expanded screening was not considered to be significant enough by participants to warrant formal written, informed consent for expanded screening. It is argued that the ethical review processes need to be more flexible towards the provision of information and consent processes for service developments in newborn screening. © 2011 John Wiley & Sons Ltd.

18 CFR 358.4 - Non-discrimination requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... provisions relating to the sale or purchase of open access transmission service, if the tariff provisions do... relating to the sale or purchase of open access transmission service in a fair and impartial manner that...

Adolescent Sexual and Reproductive Health Services and Implications for the Provision of Voluntary Medical Male Circumcision: Results of a Systematic Literature Review

PubMed Central

Van Lith, Lynn M.; Mallalieu, Elizabeth C.; Waxman, Aliza; Hatzhold, Karin; Marcell, Arik V.; Kasedde, Susan; Lija, Gissenge; Hasen, Nina; Ncube, Gertrude; Samuelson, Julia L.; Bonnecwe, Collen; Seifert-Ahanda, Kim; Njeuhmeli, Emmanuel; Tobian, Aaron A. R.

2016-01-01

Background Voluntary medical male circumcision (VMMC) is a critical HIV prevention tool. Since 2007, sub-Saharan African countries with the highest prevalence of HIV have been mobilizing resources to make VMMC available. While implementers initially targeted adult men, demand has been highest for boys under age 18. It is important to understand how male adolescents can best be served by quality VMMC services. Methods and Findings A systematic literature review was performed to synthesize the evidence on best practices in adolescent health service delivery specific to males in sub-Saharan Africa. PubMed, Scopus, and JSTOR databases were searched for literature published between January 1990 and March 2014. The review revealed a general absence of health services addressing the specific needs of male adolescents, resulting in knowledge gaps that could diminish the benefits of VMMC programming for this population. Articles focused specifically on VMMC contained little information on the adolescent subgroup. The review revealed barriers to and gaps in sexual and reproductive health and VMMC service provision to adolescents, including structural factors, imposed feelings of shame, endorsement of traditional gender roles, negative interactions with providers, violations of privacy, fear of pain associated with the VMMC procedure, and a desire for elements of traditional non-medical circumcision methods to be integrated into medical procedures. Factors linked to effective adolescent-focused services included the engagement of parents and the community, an adolescent-friendly service environment, and VMMC counseling messages sufficiently understood by young males. Conclusions VMMC presents an opportune time for early involvement of male adolescents in HIV prevention and sexual and reproductive health programming. However, more research is needed to determine how to align VMMC services with the unique needs of this population. PMID:26938639

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.

Medicare and Medicaid programs; rural hospitals: provision of long-term care services (swing-bed provision); flexibility in application of standards--Health Care Financing Administration. Interim final rule with comment period.

PubMed

1982-07-20

These regulations implement sections 904 and 949 of Pub. L. 96-499, the Omnibus Reconciliation Act of 1980. Under section 904 (the swing-bed provision), certain small, rural hospitals may use their inpatient facilities to furnish skilled nursing facility (SNF) services to Medicare and Medicaid beneficiaries, and intermediate care facility (ICF) services to Medicaid beneficiaries. These hospitals will be reimbursed at rates appropriate for those services, which are generally lower than hospital rates. This statutory provision is intended to encourage the most efficient and effective use of inpatient hospital beds for delivery of either hospital or SNF and ICF services. Under section 949, rural hospitals of 50 or fewer beds may be exempted from certain personnel standards in the conditions of participation for hospitals. This exemption applies only to the extent that it does not jeopardize or adversely affect the health and safety of patients.

[The roles and functions of volunteer counselors to the elderly].

PubMed

Chen, Chun-Yu

2004-06-01

In Taiwan's current counseling centers for the elderly, large numbers of volunteers are supervised by only a few social workers or nurses, so the roles and functions of these volunteers are very important. A neat summary of the services provided by the volunteers would include: (1) Direct services: telephone counseling, telephone interviewing, case handling, mail counseling, resource provision. (2) Indirect services: fundraising, supervision. (3) Administration: administrative assistance, management of institutional web sites. (4) Strategic consultancy: consultancy, provision of expertise. (5) Advocacy: service as educators and spokespersons; public relations and marketing. (6) MANAGEMENT: team leadership, plan implementation. To sum up, their functions are, by means of telephone and face-to-face contact, to provide information to the elderly about finances, medical services, housing, citizenship, the dignity of life and death, and related issues, as well as to serve as advocates for the provision of resources--such as educational courses--and to facilitate such provision. Indeed, the roles and functions of volunteer counselors become more diverse and more comprehensive by the day.

Employment relationships in Victorian public hospitals: the Kennett years.

PubMed

Stanton, P

2000-01-01

From 1992 to 1999, the Kennett government in Victoria moved to competitive market models of service delivery and the measurement of service provision through casemix funding. Public hospital managers were given greater accountability for the costs and provision of service delivery and a new range of service providers, many from the private sector, entered the public health market. The decentralisation of the industrial relations system led to new developments in bargaining that brought both opportunities and problems. In the Victorian public health system there was an increasing emphasis on decentralisation in both service provision and employment relations. In this paper I suggest that there were contradictions in these developments for government, and new challenges and difficulties for employers, employees and trade unions.

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.

75 FR 27322 - Capacity Building Program for Traditionally Underserved Populations-Technical Assistance for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... improve the provision of vocational rehabilitation (VR) services to, and the employment outcomes of... foundation of the VR process and service provision; (2) the application of Federal rules, regulations, and... AIVRS grantees are among the many State VR agency partners eligible to receive services from the TACE...

34 CFR 361.50 - Written policies governing the provision of services for individuals with disabilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false Written policies governing the provision of services for individuals with disabilities. 361.50 Section 361.50 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF...

34 CFR 361.50 - Written policies governing the provision of services for individuals with disabilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Written policies governing the provision of services for individuals with disabilities. 361.50 Section 361.50 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

34 CFR 361.50 - Written policies governing the provision of services for individuals with disabilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true Written policies governing the provision of services for individuals with disabilities. 361.50 Section 361.50 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

34 CFR 361.50 - Written policies governing the provision of services for individuals with disabilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false Written policies governing the provision of services for individuals with disabilities. 361.50 Section 361.50 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF...

34 CFR 364.43 - What requirements apply to the provision of State IL services?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true What requirements apply to the provision of State IL services? 364.43 Section 364.43 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

34 CFR 364.43 - What requirements apply to the provision of State IL services?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false What requirements apply to the provision of State IL services? 364.43 Section 364.43 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

42 CFR 5a.1 - Statutory basis and purpose.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Statutory basis and purpose. 5a.1 Section 5a.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS RURAL... the Public Health Service Act. These provisions define “underserved rural community” for purposes of...

42 CFR 5a.1 - Statutory basis and purpose.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Statutory basis and purpose. 5a.1 Section 5a.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS RURAL... the Public Health Service Act. These provisions define “underserved rural community” for purposes of...

42 CFR 5a.1 - Statutory basis and purpose.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Statutory basis and purpose. 5a.1 Section 5a.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS RURAL... the Public Health Service Act. These provisions define “underserved rural community” for purposes of...

Provision of Mental Health Services in South African Substance Abuse Treatment Facilities

ERIC Educational Resources Information Center

Myers, Bronwyn; Fakier, Nuraan

2009-01-01

To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…

18 CFR 367.1110 - Account 111, Accumulated provision for amortization of service company property.

Code of Federal Regulations, 2010 CFR

2010-04-01

... THE PUBLIC UTILITY HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED SERVICE COMPANIES SUBJECT TO THE PROVISIONS OF THE PUBLIC UTILITY HOLDING... (§ 367.4040), for the current amortization of limited-term service company property investments. (2...

36 CFR 1501.1 - Cross reference to National Park Service regulations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Cross reference to National... NATIONAL MEMORIAL TRUST GENERAL PROVISIONS § 1501.1 Cross reference to National Park Service regulations... (the Trust) adopts by cross reference the provisions of the National Park Service in 36 CFR chapter I...

36 CFR 1501.1 - Cross reference to National Park Service regulations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Cross reference to National... NATIONAL MEMORIAL TRUST GENERAL PROVISIONS § 1501.1 Cross reference to National Park Service regulations... (the Trust) adopts by cross reference the provisions of the National Park Service in 36 CFR chapter I...

31 CFR 515.572 - Authorization of transactions incident to the provision of travel services, carrier services, and...

Code of Federal Regulations, 2011 CFR

2011-07-01

... who use their services information showing compliance with the relevant remittance provisions of this.... Note to paragraph (a)(3): A suggested form for the collection of information showing compliance with... state of applicant's organization, if a juridical entity, the address of its principal place of business...

14 CFR 93.30 - Assignment provisions for domestic and U.S./Canada transborder service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Assignment provisions for domestic and U.S./Canada transborder service. 93.30 Section 93.30 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... domestic and U.S./Canada transborder service. (a) Whenever the FAA has determined that sufficient Arrival...

20 CFR 203.1 - Statutory provisions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... property used in the employer's operations, other personal services the rendition of which is integrated... THE ACT § 203.1 Statutory provisions. The term “employee” means (1) any individual in the service of... local lodge or division defined as an employer in sub-section (a) only if he was in the service of or in...

20 CFR 203.1 - Statutory provisions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... property used in the employer's operations, other personal services the rendition of which is integrated... THE ACT § 203.1 Statutory provisions. The term “employee” means (1) any individual in the service of... local lodge or division defined as an employer in sub-section (a) only if he was in the service of or in...

15 CFR 270.204 - Provision of additional resources and services needed by a Team.

Code of Federal Regulations, 2013 CFR

2013-01-01

... services needed by a Team. 270.204 Section 270.204 Commerce and Foreign Trade Regulations Relating to... CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Investigations § 270.204 Provision of additional resources and services needed by a Team. The Director will determine the appropriate resources that a Team...

15 CFR 270.204 - Provision of additional resources and services needed by a Team.

Code of Federal Regulations, 2014 CFR

2014-01-01

... services needed by a Team. 270.204 Section 270.204 Commerce and Foreign Trade Regulations Relating to... CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Investigations § 270.204 Provision of additional resources and services needed by a Team. The Director will determine the appropriate resources that a Team...

15 CFR 270.204 - Provision of additional resources and services needed by a Team.

Code of Federal Regulations, 2012 CFR

2012-01-01

... services needed by a Team. 270.204 Section 270.204 Commerce and Foreign Trade Regulations Relating to... CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Investigations § 270.204 Provision of additional resources and services needed by a Team. The Director will determine the appropriate resources that a Team...

15 CFR 270.204 - Provision of additional resources and services needed by a Team.

Code of Federal Regulations, 2010 CFR

2010-01-01

... services needed by a Team. 270.204 Section 270.204 Commerce and Foreign Trade Regulations Relating to... CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Investigations § 270.204 Provision of additional resources and services needed by a Team. The Director will determine the appropriate resources that a Team...

15 CFR 270.204 - Provision of additional resources and services needed by a Team.

Code of Federal Regulations, 2011 CFR

2011-01-01

... services needed by a Team. 270.204 Section 270.204 Commerce and Foreign Trade Regulations Relating to... CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Investigations § 270.204 Provision of additional resources and services needed by a Team. The Director will determine the appropriate resources that a Team...

42 CFR 5a.1 - Statutory basis and purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Statutory basis and purpose. 5a.1 Section 5a.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS RURAL... the Public Health Service Act. These provisions define “underserved rural community” for purposes of...

42 CFR 5a.1 - Statutory basis and purpose.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Statutory basis and purpose. 5a.1 Section 5a.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS RURAL... the Public Health Service Act. These provisions define “underserved rural community” for purposes of...

Provision of Early Intervention and Special Education Services to Eligible DoD Dependents. Final rule.

PubMed

2015-06-25

This rule reissues the current regulations and: Establishes policy, assigns responsibilities, and implements the non-funding and non-reporting provisions in DoD for: Provision of early intervention services (EIS) to infants and toddlers with disabilities and their families, as well as special education and related services to children with disabilities entitled under this part to receive education services from the DoD; implementation of a comprehensive, multidisciplinary program of EIS for infants and toddlers with disabilities and their families who, but for age, are eligible to be enrolled in DoD schools; provision of a free appropriate public education (FAPE), including special education and related services, for children with disabilities, as specified in their individualized education programs (IEP), who are eligible to enroll in DoD schools; and monitoring of DoD programs providing EIS, and special education and related services for compliance with this part. This rule also establishes a DoD Coordinating Committee to recommend policies and provide compliance oversight for early intervention and special education.

42 CFR 137.167 - What cost principles must a Self-Governance Tribe follow when participating in self-governance...

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Operational Provisions Audits and Cost Principles § 137.167 What... modified by: (a) Section 106 (k) of the Act [25 U.S.C. 450j-1], (b) Other provisions of law, or (c) Any...

Which Preschool Children with Specific Language Impairment Receive Language Intervention?

ERIC Educational Resources Information Center

Wittke, Kacie; Spaulding, Tammie J.

2018-01-01

Purpose: Potential biases in service provision for preschool children with specific language impairment (SLI) were explored. Method: In Study 1, children with SLI receiving treatment (SLI-T) and those with SLI not receiving treatment (SLI-NT) were compared on demographic characteristics and developmental abilities. Study 2 recruited children with…

7 CFR 205.105 - Allowed and prohibited substances, methods, and ingredients in organic production and handling.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC... (specified ingredients or food group(s)),” the product must be produced and handled without the use of: (a...

32 CFR 199.14 - Provider reimbursement methods.

Code of Federal Regulations, 2010 CFR

2010-07-01

... services which has standardized costs that exceed a threshold of the greater of two times the DRG-based... fiscal year 1988. (iv) Hold harmless provision. At such time as the weights initially assigned to... direct medical education costs. (x) Total full-time equivalents for: (A) Residents. (B) Interns. (xi...

32 CFR 199.14 - Provider reimbursement methods.

Code of Federal Regulations, 2012 CFR

2012-07-01

... services which has standardized costs that exceed a threshold of the greater of two times the DRG-based... fiscal year 1988. (iv) Hold harmless provision. At such time as the weights initially assigned to... direct medical education costs. (x) Total full-time equivalents for: (A) Residents. (B) Interns. (xi...

32 CFR 199.14 - Provider reimbursement methods.

Code of Federal Regulations, 2011 CFR

2011-07-01

... services which has standardized costs that exceed a threshold of the greater of two times the DRG-based... fiscal year 1988. (iv) Hold harmless provision. At such time as the weights initially assigned to... direct medical education costs. (x) Total full-time equivalents for: (A) Residents. (B) Interns. (xi...

29 CFR 4000.3 - What methods of filing may I use?

Code of Federal Regulations, 2010 CFR

2010-07-01

... submission with us by hand, mail, or commercial delivery service. (b) Electronic filings. (1) You must file... the PBGC's Web site subject to the following provisions: (i) This electronic filing requirement... after 2006. (ii) This electronic filing requirement does not apply to premium information to the extent...

LIBRARY FACILITIES FOR ELEMENTARY AND SECONDARY SCHOOLS.

ERIC Educational Resources Information Center

Office of Education (DHEW), Washington, DC.

MODERN METHODS OF TEACHING REQUIRE INCREASED RESEARCH, INDEPENDENT STUDY, READING, LISTENING, AND VIEWING. NEW DESIGNS FOR LIBRARY FACILITIES ARE NECESSARY. SOME OF THE INNOVATIONS IN LIBRARY SERVICE AND DESIGN INCLUDE--THE USE OF CARRELS FOR INDIVIDUAL STUDY, PROVISION OF A LIBRARY CLASSROOM FOR USE IN TEACHING LIBRARY RESEARCH TECHNIQUES, A…

Indicators and Methods for Evaluating Economic, Ecosystem and Social Services Provisioning: A Human Well-being Index (HWBI) Research Product

EPA Science Inventory

The U.S. Human Well-being Index (HWBI) is a composite measure that incorporates economic, environmental, and societal well-being elements through the eight domains of connection to nature, cultural fulfillment, education, health, leisure time, living standards, safety and securit...

Readability of Self-Report Measures of Depression and Anxiety

ERIC Educational Resources Information Center

McHugh, R. Kathryn; Behar, Evelyn

2009-01-01

As the demand for accountability in service provision settings increases, the need for valid methods for assessing clinical outcomes is of particular importance. Self-report measures of functioning are particularly useful in the assessment of psychological functioning, but a vital factor in their validity and transportability is the reading level…

Offer versus Serve or Serve Only: Does Service Method Affect Elementary Children's Fruit and Vegetable Consumption?

ERIC Educational Resources Information Center

Goggans, Margaret Harbison; Lambert, Laurel; Chang, Yunhee

2011-01-01

Purpose/Objectives: The purpose of this study was to determine if the use of the Offer versus Serve (OVS) provision in the National School Lunch Program would result in a significant difference in fruit and vegetable consumption by fourth and fifth grade elementary students, and in plate waste cost. Methods: Weighed and visual plate waste data…

Plural provision of primary medical care in England, 2002-2012.

PubMed

Sheaff, Rod

2013-10-01

Health care reforms often include provider diversification, including privatization, to increase competition and thereby health care quality and efficiency. Donabedian's organizational theory implies that the consequences will vary according to the providers' ownership. The aim was to examine how far that theory applies to changes in English NHS primary medical care (general practice) since 1998, and the consequences for patterns of service provision. Framework analysis whose categories and structure reflected Donabedian's theory and its implications, populated with data from a systematic review, administrative sources and press rapportage. Two patterns of provider diversification occurred: 'native' diversification among existing providers and plural provision as providers with different types of ownership were introduced. Native diversification occurred through: extensive recruitment of salaried GPs; extending the range of services provided by general practices; introducing limited liability partnerships; establishing GPs with special clinical interests; and introducing a wider range of services for GPs to refer to. All of these had little apparent effect on competition between general practices. Plural provision involved: increased primary care provision by corporations; introducing GP-owned firms; establishing social enterprises (initially mostly out-of-hours cooperatives); and Primary Care Trusts taking over general practices. Plural provision was on a smaller scale than native diversification and appeared to go into reverse in 2011. Although the available data confirm the implications of Donabedian's theory, there are exceptions. Native diversification and plural provision policies differ in their implications for service development.

A scoping literature review of the provision of orthoses and prostheses in resource-limited environments 2000-2010. Part one: considerations for success.

PubMed

Ikeda, Andrea J; Grabowski, Alena M; Lindsley, Alida; Sadeghi-Demneh, Ebrahim; Reisinger, Kim D

2014-08-01

Literature Review We estimate that over 29 million people worldwide in resource-limited environments (RLEs) are in need of orthotic and prosthetic (O&P) devices and services. Our goal was to ascertain the current state of O&P provision in RLEs and identify factors that may lead to more successful O&P provision. We conducted a comprehensive scoping literature review of all information related to O&P provision in RLEs published from 2000 to 2010. We targeted Vietnam, Cambodia, Tanzania, Malawi, Colombia, and the Navajo Nation, but also included information about developing countries in general. We searched academic databases and grey literature. We extracted information from each article in the areas of design, manufacturing, distribution, service provision, and technology transfer. We identified commonly reported considerations and strategies for O&P provision from 431 articles. Analysis of expert consensus documents revealed recurring themes for improving O&P provision. We found that some suggestions from the consensus documents are being followed, but many are overlooked or have not yet been implemented. Areas for improvement include conducting field testing during the design process, providing services to rural environments, offering follow-up services, considering government collaboration, and encouraging an active role of the orthosis/prosthesis user. Outcomes and research studies will be further discussed in Part Two. © The International Society for Prosthetics and Orthotics 2013.

Perceptions of retired professional soccer players about the provision of support services before and after retirement.

PubMed

Drawer, S; Fuller, C W

2002-02-01

To determine the views of retired players about the provision of support services in English professional soccer before and after retirement and to assess the impact of career ending injury on these views. An anonymous self administered questionnaire was distributed to 500 former players registered with the English Professional Footballers' Association. The questions asked about personal details, current medical status, reasons for retirement, perceptions of the provision and quality of support services, and use of prophylactic treatments while injured. Of the 500 questionnaires distributed, 185 (37%) were returned. The Professional Footballers' Association provided significantly (p<0.001) more help and advice to retired players on medical, financial, career, and educational matters than any other organisation. Although respondents showed some satisfaction with the provision of medical support, they were significantly (p<0.001) less satisfied with the provision of sports science (23%) and education/welfare (19%) support. Respondents who had retired through injury, however, were more dissatisfied with the provision of all services. Significantly (p<0.001) more respondents agreed with the view that injuries would reduce income earning potential, contribute to medical problems, and restrict the duration of their playing career. Respondents who had been medically diagnosed with osteoarthritis were significantly more likely, at some time, to have regularly received steroid injections while injured. The results presented are consistent with other evidence that the provision of injury prevention and socioeconomic services at professional soccer clubs is inadequate. The soccer industry should therefore develop a long term strategy for managing the needs of players who are forced to retire through injury.

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.

76 FR 78009 - Information Collection; Implementation of Information Technology Security Provision

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-15

...] Information Collection; Implementation of Information Technology Security Provision AGENCY: General Services... collection requirement regarding Implementation of Information Technology Security Provision. Public comments... Information Collection 3090- 0294, Implementation of Information Technology Security Provision, by any of the...

High Availability in Optical Networks

NASA Astrophysics Data System (ADS)

Grover, Wayne D.; Wosinska, Lena; Fumagalli, Andrea

2005-09-01

Call for Papers: High Availability in Optical Networks Submission Deadline: 1 January 2006 The Journal of Optical Networking (JON) is soliciting papers for a feature Issue pertaining to all aspects of reliable components and systems for optical networks and concepts, techniques, and experience leading to high availability of services provided by optical networks. Most nations now recognize that telecommunications in all its forms -- including voice, Internet, video, and so on -- are "critical infrastructure" for the society, commerce, government, and education. Yet all these services and applications are almost completely dependent on optical networks for their realization. "Always on" or apparently unbreakable communications connectivity is the expectation from most users and for some services is the actual requirement as well. Achieving the desired level of availability of services, and doing so with some elegance and efficiency, is a meritorious goal for current researchers. This requires development and use of high-reliability components and subsystems, but also concepts for active reconfiguration and capacity planning leading to high availability of service through unseen fast-acting survivability mechanisms. The feature issue is also intended to reflect some of the most important current directions and objectives in optical networking research, which include the aspects of integrated design and operation of multilevel survivability and realization of multiple Quality-of-Protection service classes. Dynamic survivable service provisioning, or batch re-provisioning is an important current theme, as well as methods that achieve high availability at far less investment in spare capacity than required by brute force service path duplication or 100% redundant rings, which is still the surprisingly prevalent practice. Papers of several types are envisioned in the feature issue, including outlook and forecasting types of treatments, optimization and analysis, new concepts for survivability, or papers on availability analysis methods or results. Customer, vendor, and researcher viewpoints and priorities will all be given consideration. Especially valuable to the community would be papers that include or provide measured data on actual reliability and availability performance of optical networking components or systems. The scope of the papers includes, but is not limited to, the following topics: Reliability and availability measurement techniques specific to optical network devices or services. Data on SRLG statistics and frequency of different actual failure causes. Real-life accounts or data on failure and repair rates or projected values for use in availability analysis. Availability analysis methods, especially for survivable networks with reconfigurable or adaptive failure-specific responses. Availability analysis and comparisons of basic schemes for survivability. Differentiated availability schemes. Design for Multiple Quality of Protection. Different schemes for on-demand survivable service provisioning. Basic comparisons or proposals of new survivability mechanisms and architectures. Concepts yielding higher than 1+1 protection switching availability at less than 100% redundancy. Survivable service provisioning in domains of optical transparency: dealing with signal impairments. To submit to this special issue, follow the normal procedure for submission to JON, indicating "Feature Issue: Optical Network Availability" in the "Comments" field of the online submission form. For all other questions relating to this feature issue, please send an e-mail to jon@osa.org, subject line "Feature Issue: Optical Network Availability." Additional information can be found on the JON website: http://www.osa-jon.org/submission/

Practice activity trends among oral and maxillofacial surgeons in Australia

PubMed Central

Brennan, David S; Spencer, A John; Singh, Kiran A; Teusner, Dana N; Goss, Alastair N

2004-01-01

Background The aim of this study was to describe practice activity trends among oral and maxillofacial surgeons in Australia over time. Methods All registered oral and maxillofacial surgeons in Australia were surveyed in 1990 and 2000 using mailed self-complete questionnaires. Results Data were available from 79 surgeons from 1990 (response rate = 73.8%) and 116 surgeons from 2000 (response rate = 65.1%). The rate of provision of services per visit changed over time with increased rates observed overall (from 1.43 ± 0.05 services per visit in 1990 to 1.66 ± 0.06 services per visit in 2000), reflecting increases in pathology and reconstructive surgery. No change over time was observed in the provision of services per year (4,521 ± 286 services per year in 1990 and 4,503 ± 367 services per year in 2000). Time devoted to work showed no significant change over time (1,682 ± 75 hours per year in 1990 and 1,681 ± 94 hours per year in 2000), while the number of visits per week declined (70 ± 4 visits per week in 1990 to 58 ± 4 visits per week in 2000). Conclusions The apparent stability in the volume of services provided per year reflected a counterbalancing of increased services provided per visit and a decrease in the number of visits supplied. PMID:15613233

HIV/AIDS Services in Private Substance Abuse Treatment Programs

PubMed Central

Abraham, Amanda J.; O’Brien, Lauren A.; Bride, Brian E.; Roman, Paul M.

2010-01-01

Background HIV infection among substance abusers is a growing concern in the United States. Little research, however, has examined the provision of HIV/AIDS services in substance abuse treatment programs. Methods This study examines the provision of onsite HIV/AIDS services in a nationally representative sample of 345 privately funded substance abuse treatment programs. Data were collected via face-to-face interviews with administrators and clinical directors of treatment programs in 2007–2008. Results Results show that larger programs and programs with a higher percentage of both African American and injection drug using (IDU) patients were more likely to offer onsite HIV/AIDS support groups and a dedicated HIV/AIDS treatment track. Multinomial logistic regression reveals that the odds of offering onsite HIV testing services were higher for hospital based programs, programs providing medical services onsite, and programs with higher percentages of African American patients, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. The odds of providing onsite testing were lower for outpatient-only treatment programs, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. Conclusions Our findings highlight critical barriers to the adoption of onsite HIV/AIDS services and suggest treatment programs are missing the opportunity to significantly impact HIV-related health outcomes. PMID:21145179

A decade of experience with a clinical pharmacokinetics service.

PubMed

Ambrose, P J; Smith, W E; Palarea, E R

1988-09-01

The development, operation, and functions of the pharmacokinetics service at Memorial Medical Center of Long Beach (MMCLB) are described, and the data used to determine the quality and cost-effectiveness of the service are presented. Current functions of the pharmacokinetics service at MMCLB include making brief written comments about the interpretations of serum drug concentrations (SDCs) and oral recommendations to physicians on dosage adjustment; provision of written consultations with dosage recommendations; provision of drug information, education, and research; and development of drug dosing guidelines for the pharmacy and medical staff. During the 10-year existence of this service, costs have been justified on the basis of not only revenue generated by the service (in the form of "drug concentration scheduling" and "drug concentration evaluation" fees charged to patients) but also by cost savings resulting from the prevention of inappropriate, misleading, and potentially dangerous SDCs. An audit conducted in 1986 showed that the policy of having pharmacists schedule the sampling times for SDCs saves about $500,000 annually. Quality assurance has been documented by auditing compliance with and therapeutic effectiveness of dosing guidelines and by working with laboratory personnel to identify and prevent spurious SDC results and assay errors. The methods used by the pharmacokinetics service at MMCLB to document the benefits of the service have been vital in proving both its cost-effectiveness and its positive effect on patient care.

What is consumerism and has it had an impact on health visiting provision? A literature review.

PubMed

Almond, P

2001-09-01

This paper analyses the concept of consumerism drawing on methods of concept analysis. It attempts to identify who the actual consumers of health visiting are before examining whether consumerism and the consumer's voice has had an impact on health visiting provision. Patients and clients are increasingly being referred to as consumers, but the term seems to be used simply as substitute for patient, client or service user. Consumerism is a complex concept and the extent of its usage in the context of health visiting has not been fully explored. An integrative review of a range of literature relating to consumerism is presented. A focused analysis of consumer views of child health clinics is used to illustrate the concept of consumerism. Elements of concept analysis methods such as formulating a model case and a definition are used to illustrate the concept further. The review suggests that consumerism is an outdated concept and has been replaced by other less emotive terms such as partnership and participation. The apparent lack of impact of consumerism research in health visiting is argued by examining empirical evidence relating to child health clinics. Consumerism has had relatively little impact on improving child health clinics although high levels of consumer satisfaction with the overall service exist. More methodologically sound studies are needed to explore users' views of health visiting services and to implement findings to maintain or improve services.

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

Tax subsidization of personal assistance services.

PubMed

Mendelsohn, Steven; Myhill, William N; Morris, Michael

2012-04-01

Personal assistance services (PAS) is the term used to describe the range of assistance, services, and supports many people with disabilities and older Americans need to remain in their homes and communities. The Americans with Disabilities Act requires that people with disabilities receive essential services in the communities of their choice rather than in institutional settings. PAS availability often determines whether persons with disabilities become institutionalized or remain in their communities. PAS, however, are not inexpensive or broadly available. Strategies are needed to improve their availability to people with disabilities and the elderly. We sought to analyze 8 provisions of the Internal Revenue Code for their utility to make PAS more affordable and available. The authors conducted a legal analysis of 8 statutory provisions, as interpreted by regulations, court decisions, and other authoritative sources. Each of the tax provisions analyzed covers some PAS expenses incurred by an individual or family. Favorable tax treatment is impacted by the nature and amount of expenses and by the location and conditions of services. The current limitations and complexities of legal interpretations and the fact that many individuals with disabilities are uninformed about these tax provisions present challenges and opportunities. As the need for PAS grows, reform of tax policy is an important complement to health care and long-term services and supports for people with disabilities. To increase utilization of current beneficial tax provisions that subsidize the cost of PAS, individuals with disabilities and tax preparers must become better informed about using these provisions. Copyright © 2012 Elsevier Inc. All rights reserved.

Are family-oriented interventions in Portuguese genetics services a remote possibility? Professionals' views on a multifamily intervention for cancer susceptibility families.

PubMed

Mendes, Alvaro; Paneque, Milena; Sousa, Liliana

2012-10-01

This article examines genetics healthcare professionals' opinions about a multifamily psychoeducational programme for hereditary cancer susceptibility families, implemented at a Portuguese genetics service. Their views on how a family-oriented approach is envisioned to be incorporated in Portuguese genetic counselling services are also reported. Six focus groups and three individual interviews were undertaken comprising 30 professionals working in the provision of genetic counselling and genetic counsellor trainees. Participants were given a page-summary describing the intervention and asked to comment the strengths and limitations of the multifamily intervention. All interviews were fully transcribed and analysed using the constant comparison method. The qualitative analysis generated data comprising four thematic categories in relation to the professionals' views: (a) usefulness of the programme; (b) programme's methodological and practical obstacles; (c) genetics services constraints; and (d) suggestions for improving the programme and further family-oriented interventions. We reflect on the reported views examining the intervention, and on how current constraints of genetic services limit the provision of psychosocial support for cancer susceptibility families. The implications of these findings regarding the purpose of genetic counselling are discussed. Results may sensitise stakeholders and policy makers for the need to deliver family-based services in cancer genetic counselling, with adequate planning and collaborative involvement of different professionals.

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.

Dentistry's intrinsic link to provision of services for persons with disabilities.

PubMed

Surabian, Stanley R

2013-09-01

This article provides the dentist with a background on disabilities, education, practice and provision of services related to statutory and regulatory requirements, particularly the Americans with Disabilities Act anrid the California Fair Employment and Housing Act.

Service implications from a comparison of the evidence on the effectiveness and a survey of provision in England and Wales of COPD specialist nurse services in the community.

PubMed

Candy, Bridget; Taylor, Stephanie J C; Ramsay, Jean; Esmond, Glenda; Griffiths, Chris J; Bryar, Rosamund M

2007-05-01

Chronic obstructive pulmonary disease (COPD) is the fifth leading cause of mortality worldwide and is a burden on healthcare resources. Therefore, implementing the right care model(s) for patients with COPD is a priority. Nurses, particularly those with specialist roles, are often the principal health professionals involved in new service models. for patients in the community with COPD are increasing in many countries. Two main types of initiatives have been evaluated; those designed to transfer acute care out of hospital and into the community, and those offering chronic disease management. The extent and nature of such specialist services in the UK and internationally are unknown. To present the results of the first survey of specialist nurse service provision for patients in the community with COPD in England and Wales. To combine the survey findings with systematic review evidence to explore to what extent provision is supported by evidence of effectiveness. A postal survey of respiratory healthcare professionals undertaken concurrently with a review of the evidence of the effectiveness of nurse COPD services (review findings are reported fully elsewhere). Two hundred and thirty four specialist nurse services were identified; 71% involved chronic disease management, of which 47% also provided acute care. Seventeen per cent of services involved acute care only. The review identified evidence to support the provision of acute services but data on chronic disease management services are sparse and there is currently little evidence to support these services. Those interventions that have been evaluated to date differed from many of the services provided. This study identifies a considerable mismatch between existing evidence around effectiveness and services provision for patients with COPD. It clearly highlights the need for greater interaction between what happens in practice and research. This is an issue that has relevance across all healthcare practice, both nationally and internationally.

Childhood bereavement services: a survey of UK provision.

PubMed

Rolls, L; Payne, S

2003-07-01

The purpose of the study was to identify the location, range and type of childhood bereavement service provision in the UK. A questionnaire was mailed to 127 services who were either solely dedicated to childhood bereavement or who offered a service within the range of work of a host organization and for which there was a supporting organizational structure. Responses were received from 108 services (a response rate of 85%). The findings identified that 85% of childhood bereavement services are located in the voluntary sector; 14% are dedicated childhood bereavement services, while 86% are offered as part of a host organization. Forty-four per cent of host organizations are hospices. The majority of services (73%) relied on both paid and unpaid staff, with 11% relying entirely on paid staff and 14% of services relying entirely on unpaid staff. The interventions offered ranged from individual family work (86%), individual child work (62%), groupwork with families (53%) and groupwork with children (45%). In addition, services offered prebereavement support (64%), a 'drop-in' service (17%), information and advice (95%), training (32%) and the provision of resources (88%). As well as offering a service to children and their families, 74% of childhood bereavement services provided a service to 'secondary users', such as schools (66%), the emergency services (28%) and other professionals (63%). In terms of funding, 12% of services relied solely on external sources of funding, including donations, legacies, revenue from the host organization or grants, while 12% of services relied solely on internal sources of funding, including fundraising and training. The majority of services (73%), however, gained income from a range of sources. The study identifies the diversity of provision that has implications for the evaluation of childhood bereavement services.

Identifying spatial priorities for protecting ecosystem services

PubMed Central

Luck, Gary W

2012-01-01

Priorities for protecting ecosystem services must be identified to ensure future human well-being. Approaches to broad-scale spatial prioritization of ecosystem services are becoming increasingly popular and are a vital precursor to identifying locations where further detailed analyses of the management of ecosystem services is required (e.g., examining trade-offs among management actions). Prioritization approaches often examine the spatial congruence between priorities for protecting ecosystem services and priorities for protecting biodiversity; therefore, the spatial prioritization method used is crucial because it will influence the alignment of service protection and conservation goals. While spatial prioritization of ecosystem services and prioritization for conservation share similarities, such as the need to document threats and costs, the former differs substantially from the latter owing to the requirement to measure the following components: supply of services; availability of human-derived alternatives to service provision; capacity to meet beneficiary demand; and site dependency in and scale of service delivery. We review studies that identify broad-scale spatial priorities for managing ecosystem services and demonstrate that researchers have used different approaches and included various measures for identifying priorities, and most studies do not consider all of the components listed above. We describe a conceptual framework for integrating each of these components into spatial prioritization of ecosystem services and illustrate our approach using a worked example for water provision. A fuller characterization of the biophysical and social context for ecosystem services that we call for should improve future prioritization and the identification of locations where ecosystem-service management is especially important or cost effective. PMID:24555017

The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations.

PubMed

Tsetis, Dimitrios; Uberoi, Raman; Fanelli, Fabrizio; Roberston, Iain; Krokidis, Miltiadis; van Delden, Otto; Radeleff, Boris; Müller-Hülsbeck, Stefan; Szerbo-Trojanowska, Malgorzata; Lee, Michael; Morgan, Robert; Brountzos, Elias; Belli, Anna Maria

2016-04-01

Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.

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.

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.

An Integrated Approach to Forest Ecosystem Services

Treesearch

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

2005-01-01

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

31 CFR 560.525 - Provision of certain legal services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... services. (a) The provision of the following legal services to or on behalf of the Government of Iran, an... pursuant to § 560.211, or to or on behalf of a person in Iran, or in circumstances in which the benefit is otherwise received in Iran is authorized, provided that receipt of payment of professional fees and...

31 CFR 560.525 - Provision of certain legal services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... services. (a) The provision of the following legal services to or on behalf of the Government of Iran, an... pursuant to § 560.211, or to or on behalf of a person in Iran, or in circumstances in which the benefit is otherwise received in Iran is authorized, provided that receipt of payment of professional fees and...

Provision of Services to Students with Attention Deficit Hyperactivity Disorder. A Vision for Education.

ERIC Educational Resources Information Center

Virginia State Dept. of Education, Richmond.

Presented is the report of a Virginia study committee analyzing various policy options on the provision of services to students with Attention Deficit Hyperactivity Disorder (ADHD). The study found that approximately 49,000 Virginia students have an attention deficit disorder, with 24,500 in need of special education services and an additional…

"One-Stop Shopping": Meeting Diverse Family Needs in the Inner City?

ERIC Educational Resources Information Center

Wigfall, Valerie G.; Moss, Peter

This paper considers the concept of the "one-stop shop" in relation to the provision of family services, whereby the family can access a range of support services made available in one location. The paper examines how the concept fits within the context of mainstream service provision in Great Britain today, specifically how the Coram…

31 CFR 515.512 - Provision of certain legal services authorized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... authorized. (a) The provision of the following legal services to or on behalf of Cuba or a Cuban national is... services to Cuba or a Cuban national, not otherwise authorized in this part, requires the issuance of a... other judicial process purporting to transfer or otherwise alter or affect property in which Cuba or a...

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

Code of Federal Regulations, 2010 CFR

2010-10-01

... Secretary of Transportation TRANSPORTATION FOR INDIVIDUALS WITH DISABILITIES: PASSENGER VESSELS Information... type of auxiliary aid or service is necessary, you must give primary consideration to the requests of... disabilities. (c) If a provision of a particular auxiliary aid or service would result in a fundamental...

36 CFR § 1501.1 - Cross reference to National Park Service regulations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Cross reference to National... NATIONAL MEMORIAL TRUST GENERAL PROVISIONS § 1501.1 Cross reference to National Park Service regulations... (the Trust) adopts by cross reference the provisions of the National Park Service in 36 CFR chapter I...

20 CFR 632.87 - Equitable provision of services to the eligible population and significant segments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... eligible population and significant segments. 632.87 Section 632.87 Employees' Benefits EMPLOYMENT AND... Program Design and Management § 632.87 Equitable provision of services to the eligible population and... system is in place to afford all members of the eligible population within the service area for which the...

20 CFR 632.87 - Equitable provision of services to the eligible population and significant segments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... eligible population and significant segments. 632.87 Section 632.87 Employees' Benefits EMPLOYMENT AND... Program Design and Management § 632.87 Equitable provision of services to the eligible population and... system is in place to afford all members of the eligible population within the service area for which the...

20 CFR 632.87 - Equitable provision of services to the eligible population and significant segments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... eligible population and significant segments. 632.87 Section 632.87 Employees' Benefits EMPLOYMENT AND... Program Design and Management § 632.87 Equitable provision of services to the eligible population and... system is in place to afford all members of the eligible population within the service area for which the...

47 CFR 25.145 - Licensing provisions for the Fixed-Satellite Service in the 20/30 GHz bands.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Licensing provisions for the Fixed-Satellite Service in the 20/30 GHz bands. 25.145 Section 25.145 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... indicating the number of earth stations actually brought into service under its blanket licensing authority...

78 FR 76096 - Request for Comment on Petition Filed by AT&T Services, Inc., Regarding the Provision of Muting...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

...] Request for Comment on Petition Filed by AT&T Services, Inc., Regarding the Provision of Muting for Speech-to-Speech Telephone Services AGENCY: Federal Communications Commission. ACTION: Petition of... requirement contained in the Commission's 2013 STS Order for providers to offer speech-to-speech (STS) users...

7 CFR 4288.131 - Payment provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program General Provisions § 4288.131 Payment provisions. Payments to advanced biofuel producers for eligible advanced biofuel production will be determined in accordance with the provisions of this section. (a) Types...