48 CFR 546.312 - Construction contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Construction contracts. 546.312 Section 546.312 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION CONTRACT MANAGEMENT QUALITY ASSURANCE Contract Clauses 546.312 Construction contracts. Insert the clause at...

Implementing Quality Service-Learning Programs in Community Colleges

ERIC Educational Resources Information Center

Vaknin, Lauren Weiner; Bresciani, Marilee J.

2013-01-01

This cross-case comparative study at Western Community College and the University of the Coast explored through a constructive lens the characteristics that lead to sustainable, high quality service-learning programs and how they are implemented at institutions of higher education. The researchers determined that both Western Community College and…

The behavioral consequences of service quality: an empirical study in the Chinese retail pharmacy industry.

PubMed

Chen, Yuwen; Fu, Frank Q

2015-01-01

This study focuses on the impacts of service quality and examines the mediating effects of customer satisfaction and customer loyalty on willingness to pay more. The authors collected survey data from 479 actual retail pharmacy customers in China and used the structural equation modeling approach to test the hypotheses. The results reveal six dimensions of service quality and the differential impact of these dimensions on customer satisfaction and behavioral intentions. This study contributes to the existing literature by exploring the dimensionality of the service quality construct and mediating effects of customer satisfaction and customer loyalty in a non-Western setting.

Occupational Competencies Report. The Electronics, Health Service and Construction Industries as Surveyed by the Trade Associations.

ERIC Educational Resources Information Center

National Council on Vocational Education, Washington, DC.

This report presents comments from working groups in the electronics, health services, and construction industries regarding what occupational competencies are and will be needed by current and future employees. It is intended for use by state and local advisers and administrators to evaluate the relevance and quality of vocational-technical…

Constructing a consumption model of fine dining from the perspective of behavioral economics

PubMed Central

Tsai, Sang-Bing

2018-01-01

Numerous factors affect how people choose a fine dining restaurant, including food quality, service quality, food safety, and hedonic value. A conceptual framework for evaluating restaurant selection behavior has not yet been developed. This study surveyed 150 individuals with fine dining experience and proposed the use of mental accounting and axiomatic design to construct a consumer economic behavior model. Linear and logistic regressions were employed to determine model correlations and the probability of each factor affecting behavior. The most crucial factor was food quality, followed by service and dining motivation, particularly regarding family dining. Safe ingredients, high cooking standards, and menu innovation all increased the likelihood of consumers choosing fine dining restaurants. PMID:29641554

Constructing a consumption model of fine dining from the perspective of behavioral economics.

PubMed

Hsu, Sheng-Hsun; Hsiao, Cheng-Fu; Tsai, Sang-Bing

2018-01-01

Numerous factors affect how people choose a fine dining restaurant, including food quality, service quality, food safety, and hedonic value. A conceptual framework for evaluating restaurant selection behavior has not yet been developed. This study surveyed 150 individuals with fine dining experience and proposed the use of mental accounting and axiomatic design to construct a consumer economic behavior model. Linear and logistic regressions were employed to determine model correlations and the probability of each factor affecting behavior. The most crucial factor was food quality, followed by service and dining motivation, particularly regarding family dining. Safe ingredients, high cooking standards, and menu innovation all increased the likelihood of consumers choosing fine dining restaurants.

Family Quality of Life Empowered by Family-Oriented Support

ERIC Educational Resources Information Center

Schippers, Alice; van Boheemen, Marleen

2009-01-01

Professional services for persons with intellectual disabilities (ID) have begun to attach more importance to their environment. The concept of (family-related) quality of life proved to link very well with this idea and lent itself to constructing and evaluating services. One outcome was the emergence of equal partnerships between families,…

Validation of Medical Tourism Service Quality Questionnaire (MTSQQ) for Iranian Hospitals.

PubMed

Qolipour, Mohammad; Torabipour, Amin; Khiavi, Farzad Faraji; Malehi, Amal Saki

2017-03-01

Assessing service quality is one of the basic requirements to develop the medical tourism industry. There is no valid and reliable tool to measure service quality of medical tourism. This study aimed to determine the reliability and validity of a Persian version of medical tourism service quality questionnaire for Iranian hospitals. To validate the medical tourism service quality questionnaire (MTSQQ), a cross-sectional study was conducted on 250 Iraqi patients referred to hospitals in Ahvaz (Iran) from 2015. To design a questionnaire and determine its content validity, the Delphi Technique (3 rounds) with the participation of 20 medical tourism experts was used. Construct validity of the questionnaire was assessed through exploratory and confirmatory factor analysis. Reliability was assessed using Cronbach's alpha coefficient. Data were analyzed by Excel 2007, SPSS version18, and Lisrel l8.0 software. The content validity of the questionnaire with CVI=0.775 was confirmed. According to exploratory factor analysis, the MTSQQ included 31 items and 8 dimensions (tangibility, reliability, responsiveness, assurance, empathy, exchange and travel facilities, technical and infrastructure facilities and safety and security). Construct validity of the questionnaire was confirmed, based on the goodness of fit quantities of model (RMSEA=0.032, CFI= 0.98, GFI=0.88). Cronbach's alpha coefficient was 0.837 and 0.919 for expectation and perception questionnaire. The results of the study showed that the medical tourism SERVQUAL questionnaire with 31 items and 8 dimensions was a valid and reliable tool to measure service quality of medical tourism in Iranian hospitals.

The trust-commitment challenge in service quality-loyalty relationships.

PubMed

Moreira, Antonio Carrizo; Silva, Pedro Miguel

2015-01-01

The purpose of this paper is to develop and empirically test a model to examine service quality, satisfaction, trust and commitment as loyalty antecedents in a private healthcare service. The approach was tested using structural equation modelling, involving 175 patients from a private Portuguese healthcare unit, using a revised Service Quality Assessment Scale (SQAS) scale for service quality evaluation. The scale used to evaluate service quality is valid and meaningful. Service quality proved to be a multidimensional construct and relevant to build satisfaction. The path satisfaction→trust→loyalty was validated, whereas the path satisfaction→commitment→loyalty was not statistically supported. The revised SQAS scale showed good internal consistency in healthcare context. Further trust-commitment antecedents must be examined in a private healthcare landscape to generalise the findings. Healthcare quality managers must explore the service quality dimensions to generate satisfaction among their patients. Developing trust generates positive patient attitudes and loyalty. This study explores using the SQAS scale in a private healthcare context. The authors provide further evidence that service quality is an antecedent and different from satisfaction. All the measures used proved to be valid and reliable. Trust and commitment play different roles in their relationship with loyalty.

Health-Related Quality of Life: Expanding a Conceptual Framework to Include Older Adults Who Receive Long-Term Services and Supports

ERIC Educational Resources Information Center

Zubritsky, Cynthia; Abbott, Katherine M.; Hirschman, Karen B.; Bowles, Kathryn H.; Foust, Janice B.; Naylor, Mary D.

2013-01-01

For older adults receiving long-term services and supports (LTSS), health-related quality of life (HRQoL) has emerged as a critical construct to examine because of its focus on components of well-being, which are affected by progressive changes in health status, health care, and social support. HRQoL is a health-focused quality of life (QOL)…

Service quality, satisfaction, and behavioral intention in home delivered meals program

PubMed Central

Joung, Hyun-Woo; Yuan, Jingxue Jessica; Huffman, Lynn

2011-01-01

This study was conducted to evaluate recipients' perception of service quality, satisfaction, and behavioral intention in home delivered meals program in the US. Out of 398 questionnaires, 265 (66.6%) were collected, and 209 questionnaires (52.5%) were used for the statistical analysis. A Confirmatory Factor Analysis (CFA) with a maximum likelihood was first conducted to estimate the measurement model by verifying the underlying structure of constructs. The level of internal consistency in each construct was acceptable, with Cronbach's alpha estimates ranging from 0.7 to 0.94. All of the composite reliabilities of the constructs were over the cutoff value of 0.50, ensuring adequate internal consistency of multiple items for each construct. As a second step, a Meals-On-Wheels (MOW) recipient perception model was estimated. The model's fit as indicated by these indexes was satisfactory and path coefficients were analyzed. Two paths between (1) volunteer issues and behavioral intention and (2) responsiveness and behavioral intention were not significant. The path for predicting a positive relationship between food quality and satisfaction was supported. The results show that having high food quality may create recipient satisfaction. The findings suggest that food quality and responsiveness are significant predictors of positive satisfaction. Moreover, satisfied recipients have positive behavioral intention toward MOW programs. PMID:21556231

Service quality, satisfaction, and behavioral intention in home delivered meals program.

PubMed

Joung, Hyun-Woo; Kim, Hak-Seon; Yuan, Jingxue Jessica; Huffman, Lynn

2011-04-01

This study was conducted to evaluate recipients' perception of service quality, satisfaction, and behavioral intention in home delivered meals program in the US. Out of 398 questionnaires, 265 (66.6%) were collected, and 209 questionnaires (52.5%) were used for the statistical analysis. A Confirmatory Factor Analysis (CFA) with a maximum likelihood was first conducted to estimate the measurement model by verifying the underlying structure of constructs. The level of internal consistency in each construct was acceptable, with Cronbach's alpha estimates ranging from 0.7 to 0.94. All of the composite reliabilities of the constructs were over the cutoff value of 0.50, ensuring adequate internal consistency of multiple items for each construct. As a second step, a Meals-On-Wheels (MOW) recipient perception model was estimated. The model's fit as indicated by these indexes was satisfactory and path coefficients were analyzed. Two paths between (1) volunteer issues and behavioral intention and (2) responsiveness and behavioral intention were not significant. The path for predicting a positive relationship between food quality and satisfaction was supported. The results show that having high food quality may create recipient satisfaction. The findings suggest that food quality and responsiveness are significant predictors of positive satisfaction. Moreover, satisfied recipients have positive behavioral intention toward MOW programs.

Dahuk Rehabilitation Center. Dahuk, Iraq

DTIC Science & Technology

2007-01-08

this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services , Directorate for Information...construction services . As a result, it was very likely that the project would be successfully completed without major issues related to inadequate design...visit. Specifically, Quality Control and Quality Assurance personnel were well informed about the history and progression of the project and its

Nurse education in competitive markets: the case for relationship marketing.

PubMed

Roberts, P M

1998-10-01

Since the National Health Service reforms of the late 1980s, nurse education has been increasingly subject to market forces. This new competitive environment presents not only threat, but also challenge and opportunity. Providers of nurse education who recognize the need for market orientation and develop responsive marketing strategies will maximize their potential for market retention and growth. Traditional marketing strategies have considerable limitations for public sector services. The new and growing field of relationship marketing offers nurse education an opportunity to retain and develop profitable relationships with both internal and external markets. This paper reviews the marketing arena in nurse education and proposes context-based qualitative research to ascertain definitive constructs of service quality. Such constructs might then be rooted in a theoretical framework of service quality measurement, and be measured within the disconfirmation paradigm of relationship marketing.

Does quality influence utilization of primary health care? Evidence from Haiti.

PubMed

Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E

2018-06-20

Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.

Validation of Medical Tourism Service Quality Questionnaire (MTSQQ) for Iranian Hospitals

PubMed Central

Qolipour, Mohammad; Torabipour, Amin; Khiavi, Farzad Faraji; Malehi, Amal Saki

2017-01-01

Introduction Assessing service quality is one of the basic requirements to develop the medical tourism industry. There is no valid and reliable tool to measure service quality of medical tourism. This study aimed to determine the reliability and validity of a Persian version of medical tourism service quality questionnaire for Iranian hospitals. Methods To validate the medical tourism service quality questionnaire (MTSQQ), a cross-sectional study was conducted on 250 Iraqi patients referred to hospitals in Ahvaz (Iran) from 2015. To design a questionnaire and determine its content validity, the Delphi Technique (3 rounds) with the participation of 20 medical tourism experts was used. Construct validity of the questionnaire was assessed through exploratory and confirmatory factor analysis. Reliability was assessed using Cronbach’s alpha coefficient. Data were analyzed by Excel 2007, SPSS version18, and Lisrel l8.0 software. Results The content validity of the questionnaire with CVI=0.775 was confirmed. According to exploratory factor analysis, the MTSQQ included 31 items and 8 dimensions (tangibility, reliability, responsiveness, assurance, empathy, exchange and travel facilities, technical and infrastructure facilities and safety and security). Construct validity of the questionnaire was confirmed, based on the goodness of fit quantities of model (RMSEA=0.032, CFI= 0.98, GFI=0.88). Cronbach’s alpha coefficient was 0.837 and 0.919 for expectation and perception questionnaire. Conclusion The results of the study showed that the medical tourism SERVQUAL questionnaire with 31 items and 8 dimensions was a valid and reliable tool to measure service quality of medical tourism in Iranian hospitals. PMID:28461863

Studies in Ambulatory Care Quality Assessment in the Indian Health Service. Volume II: Appraisal of System Performance.

ERIC Educational Resources Information Center

Nutting, Paul A.; And Others

Six Indian Health Service (IHS) units, chosen in a non-random manner, were evaluated via a quality assessment methodology currently under development by the IHS Office of Research and Development. A set of seven health problems (tracers) was selected to represent major health problems, and clinical algorithms (process maps) were constructed for…

Assessing Learner Satisfaction by Simultaneously Measuring Learner Attitude, Motivation, Loyalty and Service Quality in English Academies

ERIC Educational Resources Information Center

Huong, Vu Thi; Casadesus, Marti; Marimon, Frederic

2017-01-01

The aims of this study are threefold in their approach to English academy teaching: (i) to assess learner satisfaction, (ii) to assess the impact of satisfaction on loyalty and (iii) to assess the three constructs that we considered to be the antecedents of learner satisfaction: learner motivation, learner attitude and service quality. To collect…

Review: A Systematic Review of Quality of Life Measures for People with Intellectual Disabilities and Challenging Behaviours

ERIC Educational Resources Information Center

Townsend-White, C.; Pham, A. N. T.; Vassos, M. V.

2012-01-01

Background: The quality of life (QOL) construct is proposed as a method to assess service outcomes for people utilising disability services. With this in mind, the aim of this study was to conduct a systematic review of available QOL measures for people with intellectual disability (ID) to pinpoint psychometrically sound measures that can be…

Assessing the multidimensional and hierarchical structure of SERVQUAL.

PubMed

Ma, Jun; Harvey, Milton E; Hu, Michael Y

2007-10-01

Parasuraman, Zeithaml, and Berry introduced SERVQUAL in 1998 as a scale to measure service quality. Since then, researchers have proposed several variations. This study examines the development of the tool. Marketing researchers have first challenged the conceptualization of a perceptions-expectations gap and have concluded that the performance-based measures are adequate to capture consumers' perception of service quality. Some researchers have argued that the five dimensions of the SERVQUAL scale only focus on the process of service delivery and have extended the SERVQUAL scale into six dimensions by including the service outcome dimension. Others have proposed that service quality is a multilevel construct and should be measured accordingly. From a sample of 467 undergraduate students data on service quality toward up-scale restaurants were collected. Using the structural equation approach, two measurement models of service quality were compared, the extended SERVQUAL model and the restructured multilevel SERVQUAL model. Analysis suggested that the latter model fits the data better than the extended one.

41 CFR 102-76.10 - What basic design and construction policy governs Federal agencies?

Code of Federal Regulations, 2012 CFR

2012-01-01

... basic design and construction policies: (a) Provide the highest quality services for designing and... requirements. (See 40 U.S.C. 3310 and 3312.) (d) Design Federal buildings to have a long life expectancy and...

41 CFR 102-76.10 - What basic design and construction policy governs Federal agencies?

Code of Federal Regulations, 2013 CFR

2013-07-01

... basic design and construction policies: (a) Provide the highest quality services for designing and... requirements. (See 40 U.S.C. 3310 and 3312.) (d) Design Federal buildings to have a long life expectancy and...

Alabama Public Library Service, 1987 Annual Report.

ERIC Educational Resources Information Center

Alabama Public Library Service, Montgomery.

Designed to provide an overview of the range and quality of services provided by the Alabama Public Library Service (APLS), this annual report focuses on the 1987 activities of APLS. A report on the activities of the Library Development Division shows the allocation of state aid and Library Services and Construction Act (LCSA) Titles I and III…

QoS measurement of workflow-based web service compositions using Colored Petri net.

PubMed

Nematzadeh, Hossein; Motameni, Homayun; Mohamad, Radziah; Nematzadeh, Zahra

2014-01-01

Workflow-based web service compositions (WB-WSCs) is one of the main composition categories in service oriented architecture (SOA). Eflow, polymorphic process model (PPM), and business process execution language (BPEL) are the main techniques of the category of WB-WSCs. Due to maturity of web services, measuring the quality of composite web services being developed by different techniques becomes one of the most important challenges in today's web environments. Business should try to provide good quality regarding the customers' requirements to a composed web service. Thus, quality of service (QoS) which refers to nonfunctional parameters is important to be measured since the quality degree of a certain web service composition could be achieved. This paper tried to find a deterministic analytical method for dependability and performance measurement using Colored Petri net (CPN) with explicit routing constructs and application of theory of probability. A computer tool called WSET was also developed for modeling and supporting QoS measurement through simulation.

The design, construction and implementation of a computerised trauma registry in a developing South African metropolitan trauma service.

PubMed

Laing, G L; Bruce, J L; Aldous, C; Clarke, D L

2014-01-01

The Pietermaritzburg Metropolitan Trauma Service formerly lacked a robust computerised trauma registry. This made surgical audit difficult for the purpose of quality of care improvement and development. We aimed to design, construct and implement a computerised trauma registry within our service. Twelve months following its implementation, we sought to examine and report on the quality of the registry. Formal ethical approval to maintain a computerised trauma registry was obtained prior to undertaking any design and development. Appropriate commercial software was sourced to develop this project. The registry was designed as a flat file. A flat file is a plain text or mixed text and binary file which usually contains one record per line or physical record. Thereafter the registry file was launched onto a secure server. This provided the benefits of access security and automated backups. Registry training was provided to clients by the developer. The exercise of data capture was then integrated into the process of service delivery, taking place at the endpoint of patient care (discharge, transfer or death). Twelve months following its implementation, the compliance rates of data entry were measured. The developer of this project managed to design, construct and implement an electronic trauma registry into the service. Twelve months following its implementation the data were extracted and audited to assess the quality. A total of 2640 patient entries were captured onto the registry. Compliance rates were in the order of eighty percent and client satisfaction rates were high. A number of deficits were identified. These included the omission of weekend discharges and underreporting of deaths. The construction and implementation of the computerised trauma registry was the beginning of an endeavour to continue improvements in the quality of care within our service. The registry provided a reliable audit at twelve months post implementation. Deficits and limitations were identified and new strategies have been planned to overcome these problems and integrate the trauma registry into the process of clinical care. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Validating an instrument for measuring the perceived quality of services received by people using hospitals in Colombia].

PubMed

Cabrera-Arana, Gustavo A; Londoño-Pimienta, Jaime L; Bello-Parías, León D

2008-01-01

Validating an instrument for measuring the perceived quality of services received by people using hospitals forming part of the Colombian Ministry of Social Protection's restructuring, redesigning and modernisation programme for health-service providing networks. Sánchez and Echeverri's guidelines for validating health quality measurement scales were followed due to the lack of a valid instrument for doing this in Colombia. Conceptual synthesis led to identifying a structure of constituent indicators, domains and sub-domains regarding the perception of health service quality. A list of reactions (having a scale for categorising the replies) was analysed according to the validity of appearance, construct, criteria and utility as criteria for sensitivity and usefulness. Successive revisions and three rounds of field-trials led to producing PECASUSS, an acronym given to the instrument for measuring users' perception of health service quality (Percepción de Calidad Según Usuarios de Servicios de Salud). The guidelines effectively orientated the validation of the instrument required for measuring the perceived quality of health services received by people using hospitals forming part of the programme.

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

PubMed

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

1995-01-01

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

Process service quality evaluation based on Dempster-Shafer theory and support vector machine.

PubMed

Pei, Feng-Que; Li, Dong-Bo; Tong, Yi-Fei; He, Fei

2017-01-01

Human involvement influences traditional service quality evaluations, which triggers an evaluation's low accuracy, poor reliability and less impressive predictability. This paper proposes a method by employing a support vector machine (SVM) and Dempster-Shafer evidence theory to evaluate the service quality of a production process by handling a high number of input features with a low sampling data set, which is called SVMs-DS. Features that can affect production quality are extracted by a large number of sensors. Preprocessing steps such as feature simplification and normalization are reduced. Based on three individual SVM models, the basic probability assignments (BPAs) are constructed, which can help the evaluation in a qualitative and quantitative way. The process service quality evaluation results are validated by the Dempster rules; the decision threshold to resolve conflicting results is generated from three SVM models. A case study is presented to demonstrate the effectiveness of the SVMs-DS method.

Is patient satisfaction and perceived service quality with musculoskeletal rehabilitation determined by patient experiences?

PubMed

Medina-Mirapeix, Francesc; Jimeno-Serrano, Francisco J; Escolar-Reina, Pilar; Del Baño-Aledo, M Elena

2013-06-01

To assess the relationships between patient experiences and two overall evaluations - satisfaction and service quality - in outpatient rehabilitation settings. A cross-sectional, self-reported survey carried out in the year 2009. Three outpatient rehabilitation units belonging to Spanish hospitals located in Barcelona, Madrid and Seville. Four hundred and sixty-five outpatients (response rate 90%) mean age 39.4 (SD = 11.9) years. Self-reported experiences on aspects of care, participants' perception of service quality, satisfaction with care, socio-demographic and health characteristics. Satisfaction and service quality were highly correlated (rho = 0.72, P< 0.001). Two multivariate logistic regression models using satisfaction and service quality (with adjusted R(2) 31.5% and 37.1%, respectively) indicated that patients' experiences and global rating of health improvement have more effect on those evaluations than socio-demographic characteristics. Mean satisfaction was 8.9 (SD = 1.2), and 88% of respondents described high service quality. However, nearly 25% of the respondents who reported high-quality evaluations also indicated a problem score of more than 50% in almost all aspects of care studied. Satisfaction and service quality provide a poor indicator of patients' experiences. Both are two proxies but distinct constructs in rehabilitation care. Besides, not all problems encountered by patients are equally important to them.

An Empirical Study of the Impact of Service Quality on Patient Satisfaction in Private Hospitals, Iran

PubMed Central

Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

2015-01-01

Objective: Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. Method: This cross-sectional study was conducted in the year 2010. The study’s sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. Result: this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Conclusions: Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers. PMID:25560338

An empirical study of the impact of service quality on patient satisfaction in private hospitals, Iran.

PubMed

Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

2014-07-29

Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. This cross-sectional study was conducted in the year 2010. The study's sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers.

The Silencing of the Knowledge-Base in Early Childhood Education and Care Professionalism

ERIC Educational Resources Information Center

Campbell-Barr, Verity

2018-01-01

It is widely accepted that the early childhood education and care (ECEC) workforce is central to the quality of services. Modernist constructs of quality signal the importance of qualifications for quality, but the preoccupation with qualification levels silences questions about the knowledge required of ECEC professionals. Postmodern perspectives…

Reexamining competitive priorities: Empirical study in service sector

NASA Astrophysics Data System (ADS)

Idris, Fazli; Mohammad, Jihad

2015-02-01

The general objective of this study is to validate the multi-level concept of competitive priorities using reflective-formative model at a higher order for service industries. An empirical study of 228 firms from 9 different service industries is conducted to answer the objective of this study. Partial least square analysis with SmartPLS 2.0 was used to perform the analysis. Finding revealed six priorities: cost, flexibility, delivery, quality talent management, quality tangibility, and innovativeness. It emerges that quality are expanded into two types; one is related to managing talent for process improvement and the second one is the physical appearance and tangibility of the service quality. This study has confirmed competitive priorities as formative second-order hierarchical latent construct by using rigorous empirical evidence. Implications, limitation and suggestion for future research are accordingly discussed in this paper.

Real time laser scanning of aggregate materials in highway construction : a transportation pooled fund study.

DOT National Transportation Integrated Search

2016-12-01

The quality and service life of the roadways that make up the highway transportation infrastructure are dependent upon : the selection and use of high quality aggregate materials. Five state transportation agencies participated in this Transportation...

[Development of an evaluation instrument for service quality in nursing homes].

PubMed

Lee, Jia; Ji, Eun Sun

2011-08-01

The purposes of this study were to identify the factors influencing service quality in nursing homes, and to develop an evaluation instrument for service quality. A three-phase process was employed for the study. 1) The important factors to evaluate the service quality in nursing homes were identified through a literature review, panel discussion and focus group interview, 2) the evaluation instrument was developed, and 3) validity and reliability of the study instrument were tested by factor analysis, Pearson correlation coefficient, Cronbach's α and Cohen's Kappa. Factor analysis showed that the factors influencing service quality in nursing homes were healthcare, diet/assistance, therapy, environment and staff. To improve objectivity of the instrument, quantitative as well as qualitative evaluation approaches were adopted. The study instrument was developed with 30 items and showed acceptable construct validity. The criterion-related validity was a Pearson correlation coefficient of .85 in 151 care facilities. The internal consistency was Cronbach's α=.95. The instrument has acceptable validity and a high degree of reliability. Staff in nursing homes can continuously improve and manage their services using the results of the evaluation instrument.

Automated geospatial Web Services composition based on geodata quality requirements

NASA Astrophysics Data System (ADS)

Cruz, Sérgio A. B.; Monteiro, Antonio M. V.; Santos, Rafael

2012-10-01

Service-Oriented Architecture and Web Services technologies improve the performance of activities involved in geospatial analysis with a distributed computing architecture. However, the design of the geospatial analysis process on this platform, by combining component Web Services, presents some open issues. The automated construction of these compositions represents an important research topic. Some approaches to solving this problem are based on AI planning methods coupled with semantic service descriptions. This work presents a new approach using AI planning methods to improve the robustness of the produced geospatial Web Services composition. For this purpose, we use semantic descriptions of geospatial data quality requirements in a rule-based form. These rules allow the semantic annotation of geospatial data and, coupled with the conditional planning method, this approach represents more precisely the situations of nonconformities with geodata quality that may occur during the execution of the Web Service composition. The service compositions produced by this method are more robust, thus improving process reliability when working with a composition of chained geospatial Web Services.

Portfolios as Evidence of Reflective Practice: What Remains "Untold"

ERIC Educational Resources Information Center

Orland-Barak, Lily

2005-01-01

Addressing recent calls for investigating the specific quality of reflection associated with the uses of portfolios in teacher education, this paper describes and interprets the "practice of portfolio construction" as revealed in the construction and presentation of two kinds of portfolio in two in-service courses for mentors of teachers…

Role to Be Played by Independent Geotechnical Supervision in the Foundation for Bridge Construction

NASA Astrophysics Data System (ADS)

Sobala, Dariusz; Rybak, Jarosław

2017-10-01

Some remarks concerning the necessity of employing an independent and over all ethical geotechnical survey were presented in the paper. Starting from the design phase, through the whole construction process, the importance of geotechnical engineer is stated in legal acts. Numerous testing technologies serve for the calibration of geotechnical technologies and allow for confirming the quality and capacity of piles. Special emphasis was payed to the involvement of scientifical and research institutions which can not only serve services but also can postprocess and methodize collected data. Such databases enable for new codes, methods and recommendations. Selection of deep foundations for bridge-type structures is most often dependent on complex geotechnical conditions, concentrated loads and constraints for pier displacements. Besides the last ones, prior to more common introduction of the design-construct system, could be a convenient justification for design engineer, who imposed deep foundation because he did not want or was not able to estimate the effect of pier settlement on civil engineering structure. The paper provides some notes about the need to engage a geotechnical supervising service of high competency and ethical quality during engineering and construction stages of foundations for bridge-type structures where legal requirements are of special consideration. Successive stages of projects are reviewed and research methods used for current calibration of geotechnical technologies and verification of geotechnical work quality are analysed. Special attention is given to potential involvement of independent R&D institutions which, apart from rendering specific services, also collect and systemize the research results thus enabling, in the long term, to revise engineering standards, instructions and guidelines.

Family Quality of Life: Adaptation to Spanish Population of Several Family Support Questionnaires

ERIC Educational Resources Information Center

Balcells-Balcells, A.; Gine, C.; Guardia-Olmos, J.; Summers, J. A.

2011-01-01

Background: The concept of family quality of life has emerged as a decisive construct in the last decades to improve the capabilities of families and to assess the outcomes of the services and supports they get. The goal of this research is to adapt three instruments to the Spanish population: the "Beach Center Family Quality of Life…

A system framework of inter-enterprise machining quality control based on fractal theory

NASA Astrophysics Data System (ADS)

Zhao, Liping; Qin, Yongtao; Yao, Yiyong; Yan, Peng

2014-03-01

In order to meet the quality control requirement of dynamic and complicated product machining processes among enterprises, a system framework of inter-enterprise machining quality control based on fractal was proposed. In this system framework, the fractal-specific characteristic of inter-enterprise machining quality control function was analysed, and the model of inter-enterprise machining quality control was constructed by the nature of fractal structures. Furthermore, the goal-driven strategy of inter-enterprise quality control and the dynamic organisation strategy of inter-enterprise quality improvement were constructed by the characteristic analysis on this model. In addition, the architecture of inter-enterprise machining quality control based on fractal was established by means of Web service. Finally, a case study for application was presented. The result showed that the proposed method was available, and could provide guidance for quality control and support for product reliability in inter-enterprise machining processes.

Innovation and construction management in Brazil: Challenges of companies in times of quality and productivity

NASA Astrophysics Data System (ADS)

Barbosa, A. A. R.; Vilnītis, M.

2017-10-01

Considering the efforts to optimize productivity and quality in the construction through the potential existing in the respective companies, this study presents an approach for identification, management and priorities of improvements actions at construction sites focusing status on productivity, added value and innovation in the socioeconomic context and scenario of construction industry in Brazil. Technological advances in recent years have made the Brazilian construction industry gradually incorporate technologies and forms of management, despite its traditionally conservative character. In current days, the innovations are pursued with the quest for greater quality, productivity, safety and customer satisfaction, which have been increasingly competitive and global. Construction in Brazil occupies an important role in the economy, directly contributing to GDP and acting on an extensive productive chain of suppliers, commercialization services and maintenance. The Brazilian construction sector has undergone major changes in recent years, facilitated by factors such as the resumption of public investments, the creation of laws that facilitate real estate, investments and funding of external resources, and the efforts of the Brazilian Quality and Productivity Program - PBQP H. However, the sector faces problems of a lack of skilled labour to meet the growth needs of the sector. There are still problems and challenges of quality and productivity that prevent full sector development. The aspects of nonconformity, low quality, high tax burden, outsourcing and informality of the workforce have not been adequately addressed and resolved. Through the use of indicators of productivity and growth, the challenges of the Brazilian construction industry are discussed and the possible paths for the sector that allow its full development and to reduce the distance between the Brazilian construction industry and that of the developed countries.

A modify ant colony optimization for the grid jobs scheduling problem with QoS requirements

NASA Astrophysics Data System (ADS)

Pu, Xun; Lu, XianLiang

2011-10-01

Job scheduling with customers' quality of service (QoS) requirement is challenging in grid environment. In this paper, we present a modify Ant colony optimization (MACO) for the Job scheduling problem in grid. Instead of using the conventional construction approach to construct feasible schedules, the proposed algorithm employs a decomposition method to satisfy the customer's deadline and cost requirements. Besides, a new mechanism of service instances state updating is embedded to improve the convergence of MACO. Experiments demonstrate the effectiveness of the proposed algorithm.

Ensuring Quality Service-Learning Experiences for At-Risk Adolescents

ERIC Educational Resources Information Center

Nelson, Judith A.; Sneller, Susan

2011-01-01

Service-learning is one way of reconstructing educators' thinking about adolescents who demonstrate at-risk behaviors. It allows educators and others to involve youth considered to be "at risk" in talking about their concerns and interests, solving problems, and making decisions as they construct their own identities with the help and…

Assessment of the potential quality of preservative-treated pilings removed from service : [abstract

Treesearch

Xiping Wang; John W. Forsman; John R. Erickson; Robert J. Ross; Douglas J. Gardner; Gary D. McGinnis; Rodney C. DeGroot

1999-01-01

Preservative-treated wood products are important construction materials. Preservative-treated wood pilings, after removal from service, constitute a major disposal problem for managers of waterfront facilities. For example, approximately 7,000 to 8,000 tons of mechanically or biologically deteriorated wood pilings are currently removed from U.S. naval facilities...

A Five Year Plan; Pennsylvania Library Development, 1971-1976.

ERIC Educational Resources Information Center

Pennsylvania State Library, Harrisburg.

The objective of Pennsylvania's State Plan for use of Library Services and Construction Act (LSCA) funds is continued development of a statewide system of libraries so that good quality, free, convenient, public library service will be available to every resident of the state. The system consists of: (1) local libraries or bookmobile stops so…

Enhancing the Validity of a Quality of Life Measure for Autistic People

ERIC Educational Resources Information Center

McConachie, Helen; Mason, David; Parr, Jeremy R.; Garland, Deborah; Wilson, Colin; Rodgers, Jacqui

2018-01-01

Accurate measurement of quality of life (QoL) is important for evaluation of autism services and trials of interventions. We undertook psychometric validation of the World Health Organisation measure--WHOQoL-BREF, examined construct validity of the WHO Disabilities module and developed nine additional autism-specific items (ASQoL) from extensive…

Study on the construction of Intelligent Courier Station Model

NASA Astrophysics Data System (ADS)

zhao, Ce; lu, Jia xin; li, Zhuang zhuang; shao, Zi rong; pi, Kun yi

2018-06-01

Campus Express is an important window to observe the city consumption logistics service "last kilometer".The research on Campus Express service is not only conducive to campus environment improvement and service quality promotion, but also provides all types of community, agglomeration areas such as urban terminal "last kilometer" logistics with reference.This article first proposed the main problems of campus express service,analyzed the mode of smart express station and finally built a smart express station.

Enhancing Dairy Manufacturing through customer feedback: A statistical approach

NASA Astrophysics Data System (ADS)

Vineesh, D.; Anbuudayasankar, S. P.; Narassima, M. S.

2018-02-01

Dairy products have become inevitable of habitual diet. This study aims to investigate the consumers’ satisfaction towards dairy products so as to provide useful information for the manufacturers which would serve as useful inputs for enriching the quality of products delivered. The study involved consumers of dairy products from various demographical backgrounds across South India. The questionnaire focussed on quality aspects of dairy products and also the service provided. A customer satisfaction model was developed based on various factors identified, with robust hypotheses that govern the use of the product. The developed model proved to be statistically significant as it passed the required statistical tests for reliability, construct validity and interdependency between the constructs. Some major concerns detected were regarding the fat content, taste and odour of packaged milk. A minor proportion of people (15.64%) were unsatisfied with the quality of service provided, which is another issue to be addressed to eliminate the sense of dissatisfaction in the minds of consumers.

Development and Psychometric Testing of a Novel Food Service Satisfaction Questionnaire for Food Service Staff of Aged Care Homes.

PubMed

Miller, M; Hamilton, J; Scupham, R; Matwiejczyk, L; Prichard, I; Farrer, O; Yaxley, A

2018-01-01

Food service staff are integral to delivery of quality food in aged care homes yet measurement of their satisfaction is unable to be performed due to an absence of a valid and reliable questionnaire. The aim of this study was to develop and perform psychometric testing for a new Food Service Satisfaction Questionnaire developed in Australia specifically for use by food service staff working in residential aged care homes (Flinders FSSQFSAC). A mixed methods design utilizing both a qualitative (in-depth interviews, focus groups) and a quantitative approach (cross sectional survey) was used. Content validity was determined from focus groups and interviews with food service staff currently working in aged care homes, related questionnaires from the literature and consultation with an expert panel. The questionnaire was tested for construct validity and internal consistency using data from food service staff currently working in aged care homes that responded to an electronic invitation circulated to Australian aged care homes using a national database of email addresses. Construct validity was tested via principle components analysis and internal consistency through Cronbach's alpha. Temporal stability of the questionnaire was determined from food service staff undertaking the Flinders FSSQFSAC on two occasions, two weeks apart, and analysed using Pearson's correlations. Content validity for the Flinders FSSQFSAC was established from a panel of experts and stakeholders. Principle components analysis revealed food service staff satisfaction was represented by 61-items divided into eight domains: job satisfaction (α=0.832), food quality (α=0.871), staff training (α=0.922), consultation (α=0.840), eating environment (α=0.777), reliability (α=0.695), family expectations (α=0.781) and resident relationships (α=0.429), establishing construct validity in all domains, and internal consistency in all (α>0.5) except for "resident relationships" (α=0.429). Test-retest reliability coefficients ranged from 0.276 to 0.826 dependent on domain, with test-retest reliability established in seven domains at r>0.4; an exception was "reliability" at r=0.276. The newly developed Flinders FSSQFSAC has acceptable validity and reliability and thereby the potential to measure satisfaction of food service staff working in residential aged care homes, identify areas for strategic change, measure improvements and in turn, improve the satisfaction and quality of life of both food service staff and residents of aged care homes.

Examining visitors' behavioral intentions and behaviors in a Taiwan National Park

Treesearch

Chieh-Lu Li; Garry E. Chick

2011-01-01

In 2007-2008, some visitors to Taroko National Park in Taiwan were surveyed to allow testing of a behavioral prediction model in the context of national park recreation. This model includes three constructs: values (a cultural anthropology factor), perceptions of service quality (service marketing factors), and perceptions of crowding (a national park recreation factor...

36 CFR 51.87 - Does the concessioner have an unconditional right to receive the Director's approval of an...

Code of Federal Regulations, 2010 CFR

2010-07-01

... affect adversely the quality of facilities and services provided by the concessioner, or result in a need for increased rates and charges to the public to maintain the quality of concession facilities and... construction of capital improvements under the applicable concession contract in the applicable park area or to...

Care Models of eHealth Services: A Case Study on the Design of a Business Model for an Online Precare Service.

PubMed

van Meeuwen, Dorine Pd; van Walt Meijer, Quirine J; Simonse, Lianne Wl

2015-03-24

With a growing population of health care clients in the future, the organization of high-quality and cost-effective service providing becomes an increasing challenge. New online eHealth services are proposed as innovative options for the future. Yet, a major barrier to these services appears to be the lack of new business model designs. Although design efforts generally result in visual models, no such artifacts have been found in the literature on business model design. This paper investigates business model design in eHealth service practices from a design perspective. It adopts a research by design approach and seeks to unravel what characteristics of business models determine an online service and what are important value exchanges between health professionals and clients. The objective of the study was to analyze the construction of care models in-depth, framing the essential elements of a business model, and design a new care model that structures these elements for the particular context of an online pre-care service in practice. This research employs a qualitative method of an in-depth case study in which different perspectives on constructing a care model are investigated. Data are collected by using the visual business modeling toolkit, designed to cocreate and visualize the business model. The cocreated models are transcribed and analyzed per actor perspective, transactions, and value attributes. We revealed eight new actors in the business model for providing the service. Essential actors are: the intermediary network coordinator connecting companies, the service dedicated information technology specialists, and the service dedicated health specialist. In the transactions for every service providing we found a certain type of contract, such as a license contract and service contracts for precare services and software products. In addition to the efficiency, quality, and convenience, important value attributes appeared to be: timelines, privacy and credibility, availability, pleasantness, and social interaction. Based on the in-depth insights from the actor perspectives, the business model for online precare services is modeled with a visual design. A new care model of the online precare service is designed and compiled of building blocks for the business model. For the construction of a care model, actors, transactions, and value attributes are essential elements. The design of a care model structures these elements in a visual way. Guided by the business modeling toolkit, the care model design artifact is visualized in the context of an online precare service. Important building blocks include: provision of an online flow of information with regular interactions to the client stimulates self-management of personal health and service-dedicated health expert ensure an increase of the perceived quality of the eHealth service.

Care Models of eHealth Services: A Case Study on the Design of a Business Model for an Online Precare Service

PubMed Central

2015-01-01

Background With a growing population of health care clients in the future, the organization of high-quality and cost-effective service providing becomes an increasing challenge. New online eHealth services are proposed as innovative options for the future. Yet, a major barrier to these services appears to be the lack of new business model designs. Although design efforts generally result in visual models, no such artifacts have been found in the literature on business model design. This paper investigates business model design in eHealth service practices from a design perspective. It adopts a research by design approach and seeks to unravel what characteristics of business models determine an online service and what are important value exchanges between health professionals and clients. Objective The objective of the study was to analyze the construction of care models in-depth, framing the essential elements of a business model, and design a new care model that structures these elements for the particular context of an online pre-care service in practice. Methods This research employs a qualitative method of an in-depth case study in which different perspectives on constructing a care model are investigated. Data are collected by using the visual business modeling toolkit, designed to cocreate and visualize the business model. The cocreated models are transcribed and analyzed per actor perspective, transactions, and value attributes. Results We revealed eight new actors in the business model for providing the service. Essential actors are: the intermediary network coordinator connecting companies, the service dedicated information technology specialists, and the service dedicated health specialist. In the transactions for every service providing we found a certain type of contract, such as a license contract and service contracts for precare services and software products. In addition to the efficiency, quality, and convenience, important value attributes appeared to be: timelines, privacy and credibility, availability, pleasantness, and social interaction. Based on the in-depth insights from the actor perspectives, the business model for online precare services is modeled with a visual design. A new care model of the online precare service is designed and compiled of building blocks for the business model. Conclusions For the construction of a care model, actors, transactions, and value attributes are essential elements. The design of a care model structures these elements in a visual way. Guided by the business modeling toolkit, the care model design artifact is visualized in the context of an online precare service. Important building blocks include: provision of an online flow of information with regular interactions to the client stimulates self-management of personal health and service-dedicated health expert ensure an increase of the perceived quality of the eHealth service. PMID:25831094

[Patients and quality of primary health care services. Survey of practitioners at the Bahía de Cádiz and La Janda health centers].

PubMed

Hernán García, M; Gutiérrez Cuadra, J L; Lineros González, C; Ruiz Barbosa, C; Rabadán Asensio, A

2002-10-31

To report the opinions of practitioners at health centers on dimensions of quality that affect user satisfaction. Cross-sectional study of focus groups (FG). Bahía de Cádiz and La Janda health centers in southwestern Spain. We studied 4 FG whose participants were staff members of the two health centers: FG1, physicians; FG2, user satisfaction service staff; FG3, social workers; FG4, nurses. The groups were based on the different functions of staff at the two centers. The analysis was based on variables in the SERCAL model (an adaptation of the SERVQUAL model for the Spanish health care system) of opinions regarding service quality: access, comfort (tangibles), personalized service (courtesy), competence, and loyalty. The data were analyzed with version N-Vivo of the NUDIST program. All dimensions of the theoretical model were identified by practitioners as constructs of users' perceptions of service quality. Users' and practitioners' views contrasted with and complemented each other to generate a model that could be validated. Access, personalized service and problem-solving (responsiveness) were key variables. Practitioners' opinions provided information of use in improving the quality model. Differences in opinion between users and practitioners merit further study based on an understanding of these groups' values and interests, and on the care provision context. Practitioners identified access, personalized service and problem-solving as features that influenced users' opinions of the quality of the health center.

An Engineering Report in Civil Engineering and Management.

DTIC Science & Technology

1987-12-01

programs as the Apollo program and the Canaveral program. Progress in the late 70s and the 80s has seen advancements in the application of sophisticated...other forces in military operations; subsequent combat service support ashore and defense against overt or clandestine enemy attacks directed toward...construction execution plans; assigns construction projects to NCF units; monitors progress and assures adherence to quality standards: directs

Quality differentials and reproductive health service utilisation determinants in India.

PubMed

Anand, Sandip; Sinha, R K

2010-01-01

This paper seeks to establish relationships between women's reproductive health service use, assessed longitudinally and by facility type, with service quality perceptions related to public or private health facilities. The study was mainly secondary and quantitative in nature. It included analysing data collected by the International Institute for Population Sciences (IIPS) and The Johns Hopkins University (JHU) as a follow-up study to the 1998-1999 National Family Health Survey (NFHS-2). The follow-up survey was carried out in Tamil Nadu, Maharashtra, Bihar and Jharkhand. In 2002-2003, these four states were selected to capture socio-economic and demographic variations. Analysis includes composite indices and logistic regression analysis. A scale was constructed to measure utilisation levels. Dimensions include: service proximity, doctor availability, waiting time, medicines, facility cleanliness, dignified treatment, privacy, service affordability and treatment effectiveness. Findings indicate that doctor availability, waiting time, cleanliness, privacy and affordability at private health facilities enhance the probability that a health facility will be used for any reproductive health purpose. At the combined states level, medicine availability and treatment effectiveness at public health facilities enhances service use. The major limitation is that the study includes only selected Indian states. The findings may enhance Indian service-quality policy. The paper's main contribution is that seemingly for the first time in India, healthcare service use has been measured longitudinally and then explained through service quality variables by comparing public and private health facilities.

Understanding patients' behavioral intentions: evidence from Iran's private hospitals industry.

PubMed

Zarei, Ehsan; Arab, Mohammad; Tabatabaei, Seyed Mahmoud Ghazi; Rashidian, Arash; Forushani, Abbas Rahimi; Khabiri, Roghayeh

2014-01-01

In the ever-increasing competitive market of private hospital industry, creating a strong relationship with the customers that shapes patients' loyalty has been considered a key factor in obtaining market share. The purpose of this paper is to test a model of customer loyalty among patients of private hospitals in Iran. This cross-sectional study was carried out in Tehran, the capital of the Islamic Republic of Iran in 2010. The study samples composed of 969 patients who were consecutively selected from eight private hospitals. The survey instrument was designed based on a review of the related literature and included 36 items. Data analysis was performed using structural equation modeling. For the service quality construct, three dimensions extracted: Process, interaction, and environment. Both process and interaction quality had significant effects on perceived value. Perceived value along with the process and interaction quality were the most important antecedents of patient overall satisfaction. The direct effect of the process and interaction quality on behavioral intentions was insignificant. Perceived value and patient overall satisfaction were the direct antecedents of patient behavioral intentions and the mediators between service quality and behavioral intentions. Environment quality of service delivery had no significant effect on perceived value, overall satisfaction, and behavioral intentions. Contrary to previous similar studies, the role of service quality was investigated not in a general sense, but in the form of three types of qualities including quality of environment, quality of process, and quality of interaction.

Environmental Assessment: Maintenance of the Bear Lake Storm Water Retention Pond Whiteman Air Force Base, Missouri

DTIC Science & Technology

2010-10-01

Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be...and fugitive dust The noise environment due to construction vehicle operations Biological resources and wetlands due to land and water disturbance...construction vehicle operations ; Biological resources and wetlands due to land and water disturbance; Water quality due to land and water disturbance

The Road to Success: Importance of Construction on Reconstruction in Conflict-Affected States

DTIC Science & Technology

2011-12-01

provision of infrastructure services , formation of the market, management of the state‟s assets, international relations, and rule of law (p. 5). Both... international capability to speed project completion and raise quality of critical infrastructure development such as the electrical grid. Using...burden, to Washington headquarters Services , Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA

Quality improvement: the nurse's role.

PubMed

Moran, M J; Johnson, J E

1992-06-01

Continuous quality improvement is a concept which includes: Quality assurance--the provision of services that meet an appropriate standard. Problem resolution--including all departments involved in the issue at hand. Quality improvement--a continuous process involving all levels of the organization working together across departmental lines to produce better services for health care clients. Deming (1982b) and others have espoused total system reform to achieve quality improvement--not merely altering the current system, but radically changing it. It must be assumed that those who provide services at the staff level are acting in good faith and are not willfully failing to do what is correct (Berwick, 1991). Those who perform direct services are in an excellent position to identify the need for change in service delivery processes. Based on this premise, the staff nurse--who is at the heart of the system--is the best person to assess the status of health care services and to work toward improving the processes by which these services are provided to clients in the health care setting. The nurse manager must structure the work setting to facilitate the staff nurse's ability to undertake constructive action for improving care. The use of quality circles, quality councils, or quality improvement forums to facilitate the coordination of quality improvement efforts is an effective way to achieve success. The QA coordinator assists departments in documenting that the quality improvement efforts are effective across all departments of the organization, and aggregates data to demonstrate that they meet the requirements of external regulatory agencies, insurers, and professional standards. The nurse executive provides the vision and secures the necessary resources to ensure that the organization's quality improvement efforts are successful. By inspiring and empowering the staff in their efforts to improve the process by which health care is provided, nurse managers participate in reshaping the health care environment. The professional nurse plays a vital role in the quality improvement of health care services. However, nurses cannot make these improvements in a vacuum; they must include other professionals and ancillary personnel in their efforts. Total quality commitment must include all levels of an organization's structure. Quality patient care services will be achieved as the result of positive interactions among departments working together to build a dynamic mechanism that continuously improves the processes and outcomes of health care services.

Research on construction technology for orthotropic steel deck pavement of Haihe River Chunyi Bridge

NASA Astrophysics Data System (ADS)

Xue, Y. C.; Qian, Z. D.; Zhang, M.

2017-01-01

In order to ensure the good service quality of orthotropic steel deck pavement of Haihe River Chunyi Bridge in Tianjin, and to reduce the occurrence of pavement diseases like lateral and longitudinal cracks, the key working procedures such as steel deck cleaning, anticorrosive coating, bonding layer spraying, seam cutting, epoxy asphalt concrete’s mixing, transportation, paving and compaction were studied. The study was based on the main features of epoxy asphalt concrete which is the pavement materials of Haihe River Chunyi Bridge, and combined with the basic characteristics and construction conditions of Haihe River Chunyi Bridge. Furthermore, some processing measures like controlling time and temperature, continuous paving with two pavers, lateral feeding, and improving the compaction method were proposed. The project example shows that the processing measures can effectively solve the technical difficulties in the construction of orthotropic steel deck pavement of Haihe River Chunyi Bridge, can greatly improve the construction speed and quality, and can provide reference for the same kinds of orthotropic steel deck pavement construction.

The Quest for Quality 1964. A Report on School Planning Laboratory Efforts to Encourage Better Planning for Better Schools in 1964.

ERIC Educational Resources Information Center

MacConnell, James D.

The Fourth Annual Report from the School Planning Laboratory discusses the quest for quality and explains how better schools have been planned at the Center through--(1) systems construction, (2) an airborne institute, (3) school planning education, (4) service to visitors, (5) community college planning, (6) direct assistance, and (7) continued…

Identifying Continuous Quality Improvement Priorities in Maternal, Infant, and Early Childhood Home Visiting.

PubMed

Preskitt, Julie; Fifolt, Matthew; Ginter, Peter M; Rucks, Andrew; Wingate, Martha S

2016-01-01

The purpose of this article was to describe a methodology to identify continuous quality improvement (CQI) priorities for one state's Maternal, Infant, and Early Childhood Home Visiting program from among the 40 required constructs associated with 6 program benchmarks. The authors discuss how the methodology provided consensus on system CQI quality measure priorities and describe variation among the 3 service delivery models used within the state. Q-sort methodology was used by home visiting (HV) service delivery providers (home visitors) to prioritize HV quality measures for the overall state HV system as well as their service delivery model. There was general consensus overall and among the service delivery models on CQI quality measure priorities, although some variation was observed. Measures associated with Maternal, Infant, and Early Childhood Home Visiting benchmark 1, Improved Maternal and Newborn Health, and benchmark 3, Improvement in School Readiness and Achievement, were the highest ranked. The Q-sort exercise allowed home visitors an opportunity to examine priorities within their service delivery model as well as for the overall First Teacher HV system. Participants engaged in meaningful discussions regarding how and why they selected specific quality measures and developed a greater awareness and understanding of a systems approach to HV within the state. The Q-sort methodology presented in this article can easily be replicated by other states to identify CQI priorities at the local and state levels and can be used effectively in states that use a single HV service delivery model or those that implement multiple evidence-based models for HV service delivery.

Modular Laboratories—Cost-Effective and Sustainable Infrastructure for Resource-Limited Settings

PubMed Central

Bridges, Daniel J.; Colborn, James; Chan, Adeline S. T.; Winters, Anna M.; Dengala, Dereje; Fornadel, Christen M.; Kosloff, Barry

2014-01-01

High-quality laboratory space to support basic science, clinical research projects, or health services is often severely lacking in the developing world. Moreover, the construction of suitable facilities using traditional methods is time-consuming, expensive, and challenging to implement. Three real world examples showing how shipping containers can be converted into modern laboratories are highlighted. These include use as an insectary, a molecular laboratory, and a BSL-3 containment laboratory. These modular conversions have a number of advantages over brick and mortar construction and provide a cost-effective and timely solution to offer high-quality, user-friendly laboratory space applicable within the developing world. PMID:25223943

a Web Api and Web Application Development for Dissemination of Air Quality Information

NASA Astrophysics Data System (ADS)

Şahin, K.; Işıkdağ, U.

2017-11-01

Various studies have been carried out since 2005 under the leadership of Ministry of Environment and Urbanism of Turkey, in order to observe the quality of air in Turkey, to develop new policies and to develop a sustainable air quality management strategy. For this reason, a national air quality monitoring network has been developed providing air quality indices. By this network, the quality of the air has been continuously monitored and an important information system has been constructed in order to take precautions for preventing a dangerous situation. The biggest handicap in the network is the data access problem for instant and time series data acquisition and processing because of its proprietary structure. Currently, there is no service offered by the current air quality monitoring system for exchanging information with third party applications. Within the context of this work, a web service has been developed to enable location based querying of the current/past air quality data in Turkey. This web service is equipped with up-todate and widely preferred technologies. In other words, an architecture is chosen in which applications can easily integrate. In the second phase of the study, a web-based application was developed to test the developed web service and this testing application can perform location based acquisition of air-quality data. This makes it possible to easily carry out operations such as screening and examination of the area in the given time-frame which cannot be done with the national monitoring network.

The determinations of remote sensing satellite data delivery service quality: A positivistic case study in Chinese context

NASA Astrophysics Data System (ADS)

Jin, Jiahua; Yan, Xiangbin; Tan, Qiaoqiao; Li, Yijun

2014-03-01

With the development of remote sensing technology, remote-sensing satellite has been widely used in many aspects of national construction. Big data with different standards and massive users with different needs, make the satellite data delivery service to be a complex giant system. How to deliver remote-sensing satellite data efficiently and effectively is a big challenge. Based on customer service theory, this paper proposes a hierarchy conceptual model for examining the determinations of remote-sensing satellite data delivery service quality in the Chinese context. Three main dimensions: service expectation, service perception and service environment, and 8 sub-dimensions are included in the model. Large amount of first-hand data on the remote-sensing satellite data delivery service have been obtained through field research, semi-structured questionnaire and focused interview. A positivist case study is conducted to validate and develop the proposed model, as well as to investigate the service status and related influence mechanisms. Findings from the analysis demonstrate the explanatory validity of the model, and provide potentially helpful insights for future practice.

Evaluation of Rural Primary Health Care in Western China: A Cross-Sectional Study

PubMed Central

Wang, Manli; Fang, Haiqing; Bishwajit, Ghose; Xiang, Yuanxi; Fu, Hang; Feng, Zhanchun

2015-01-01

Purpose: China’s Ministry of Health has enacted Rural Primary Health Care Program (2001–2010) (HCP) guidelines to improve the quality of people’s health. However, the program’s success in Western China remains unevaluated. Thus, this study aims to begin to fill that gap by analyzing the provision and utilization of Rural Primary Health Care (RPHC) in Western China. Methods: A cross-sectional study was conducted to collect secondary data on the socio-economic characteristics, system construction, services use and implementation of RPHC, and the residents’ health status of the sampled areas. Four hundred counties from 31 provinces in China were selected via stratified random sampling, including 171 counties from 12 Western provinces. Twenty-seven analysis indicators, covering system construction, services use and implementation of RPHC were chosen to assess Western China’s primary health quality. Analysis of Variance (ANOVA) and Least Significant Difference (LSD) methods were used to measure the RPHC disparities between Western and Eastern and Central China. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to rank Western, Eastern and Central internal provinces regarding quality of their RPHC. Results: Of the 27 indicators, 13 (48.15%) were below the standard in Western China. These focused on rural health service system construction, Chinese medicine services, and public health. In the comparison between Western, Central and Eastern China, 12 indicators had statistical significance (p < 0.05), and using LSD to compare between Western and Eastern China, all indicators were statistically significant (p < 0.05), demonstrating regional disparities. Xinjiang Province’s RPHC ranked highest overall, and Yunnan Province ranked the lowest, indicating the internal differences within the 12 Western provinces; and Western provinces’ Ci value was lower than that of Eastern and Central China overall. Conclusion: Western China’s RPHC has proceeded well, but remains weaker than that of Eastern and Central China. Differences within Western internal provinces threaten the successful implementation of RPHC.  PMID:26528993

Evaluation of Rural Primary Health Care in Western China: A Cross-Sectional Study.

PubMed

Wang, Manli; Fang, Haiqing; Bishwajit, Ghose; Xiang, Yuanxi; Fu, Hang; Feng, Zhanchun

2015-10-29

China's Ministry of Health has enacted Rural Primary Health Care Program (2001-2010) (HCP) guidelines to improve the quality of people's health. However, the program's success in Western China remains unevaluated. Thus, this study aims to begin to fill that gap by analyzing the provision and utilization of Rural Primary Health Care (RPHC) in Western China. A cross-sectional study was conducted to collect secondary data on the socio-economic characteristics, system construction, services use and implementation of RPHC, and the residents' health status of the sampled areas. Four hundred counties from 31 provinces in China were selected via stratified random sampling, including 171 counties from 12 Western provinces. Twenty-seven analysis indicators, covering system construction, services use and implementation of RPHC were chosen to assess Western China's primary health quality. Analysis of Variance (ANOVA) and Least Significant Difference (LSD) methods were used to measure the RPHC disparities between Western and Eastern and Central China. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to rank Western, Eastern and Central internal provinces regarding quality of their RPHC. Of the 27 indicators, 13 (48.15%) were below the standard in Western China. These focused on rural health service system construction, Chinese medicine services, and public health. In the comparison between Western, Central and Eastern China, 12 indicators had statistical significance (p < 0.05), and using LSD to compare between Western and Eastern China, all indicators were statistically significant (p < 0.05), demonstrating regional disparities. Xinjiang Province's RPHC ranked highest overall, and Yunnan Province ranked the lowest, indicating the internal differences within the 12 Western provinces; and Western provinces' Ci value was lower than that of Eastern and Central China overall. Western China's RPHC has proceeded well, but remains weaker than that of Eastern and Central China. Differences within Western internal provinces threaten the successful implementation of RPHC.

Serviceability-related issues for bridge live load deflection and construction closure pours.

DOT National Transportation Integrated Search

2015-06-01

This study investigated the design criteria and practices in an effort to improve the quality of bridge designs in the : State of Maryland and beyond. This first criterion investigated was the live load deflection for steel bridges. The : second desi...

Quality of life, health status, and health service utilization related to a new measure of health literacy: FLIGHT/VIDAS.

PubMed

Ownby, Raymond L; Acevedo, Amarilis; Jacobs, Robin J; Caballero, Joshua; Waldrop-Valverde, Drenna

2014-09-01

Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Context-aware workflow management of mobile health applications.

PubMed

Salden, Alfons; Poortinga, Remco

2006-01-01

We propose a medical application management architecture that allows medical (IT) experts readily designing, developing and deploying context-aware mobile health (m-health) applications or services. In particular, we elaborate on how our application workflow management architecture enables chaining, coordinating, composing, and adapting context-sensitive medical application components such that critical Quality of Service (QoS) and Quality of Context (QoC) requirements typical for m-health applications or services can be met. This functional architectural support requires learning modules for distilling application-critical selection of attention and anticipation models. These models will help medical experts constructing and adjusting on-the-fly m-health application workflows and workflow strategies. We illustrate our context-aware workflow management paradigm for a m-health data delivery problem, in which optimal communication network configurations have to be determined.

Modular laboratories--cost-effective and sustainable infrastructure for resource-limited settings.

PubMed

Bridges, Daniel J; Colborn, James; Chan, Adeline S T; Winters, Anna M; Dengala, Dereje; Fornadel, Christen M; Kosloff, Barry

2014-12-01

High-quality laboratory space to support basic science, clinical research projects, or health services is often severely lacking in the developing world. Moreover, the construction of suitable facilities using traditional methods is time-consuming, expensive, and challenging to implement. Three real world examples showing how shipping containers can be converted into modern laboratories are highlighted. These include use as an insectary, a molecular laboratory, and a BSL-3 containment laboratory. These modular conversions have a number of advantages over brick and mortar construction and provide a cost-effective and timely solution to offer high-quality, user-friendly laboratory space applicable within the developing world. © The American Society of Tropical Medicine and Hygiene.

Discussion on a Public Hospital's Practice in Culture Shaping and Innovative Development.

PubMed

Zhang, Peiying

2015-05-01

Culture shaping is an important part of a hospital's quality management to enhance its medical service, improve doctor-patient relations, and cement its brand image (Jianping and Hong in Chinese Hospital Management 29(1):36-37, 2009). First built in 1953, Xuzhou Central Hospital is a tertiary general hospital in the Huaihai Economic Zone and has won a series of honorary titles for its reforms, innovations, and the level of medical services provided. In recent years, the hospital has increased its efforts in culture shaping through the construction of special departments, medical services, hospital culture, and professional ethics. This has resulted in substantial progress in the hospital's medical capabilities and service quality, and laid a solid foundation to achieve its ambitious goal of becoming a nationally prestigious hospital, among the best in Jiangsu and a regional healthcare center in the Huaihai Economic Zone.

Traffic information computing platform for big data

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

Duan, Zongtao, E-mail: ztduan@chd.edu.cn; Li, Ying, E-mail: ztduan@chd.edu.cn; Zheng, Xibin, E-mail: ztduan@chd.edu.cn

Big data environment create data conditions for improving the quality of traffic information service. The target of this article is to construct a traffic information computing platform for big data environment. Through in-depth analysis the connotation and technology characteristics of big data and traffic information service, a distributed traffic atomic information computing platform architecture is proposed. Under the big data environment, this type of traffic atomic information computing architecture helps to guarantee the traffic safety and efficient operation, more intelligent and personalized traffic information service can be used for the traffic information users.

The Transforming Maternity Care Project: Goals, Methods, and Outcomes of a National Maternity Care Policy Initiative, With Construction of a Theoretical Model to Explain the Process

DTIC Science & Technology

2011-03-21

to and receive comprehensive high-quality, high-value reproductive health and maternity care. • Comprehensive health care reform strategies...and its implementation, ensure that access to comprehensive, high-quality reproductive health and maternity care services are essential benefits for... Reproductive Health, Centers for Disease Control and Prevention Stakeholder Workgroup Consumers and their Advocates Chair: Judy Norsigian

Identifying role of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context.

PubMed

Karim, Rizwanul M; Abdullah, Mamun S; Rahman, Anisur M; Alam, Ashraful M

2016-06-24

Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic services. This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 community clinics. Since most of the outcome indicators focus mainly on women and children, women having children less than 2 years of age were randomly assigned and interviewed for the study purpose. Data were collected through FGD, Key informants interview and a pretested semi- structured questionnaire. About 95 % of the respondents were Muslims and 5 % were Hindus. The average age of the respondents was 23.38 (SD 4.15) and almost all of them are home makers. The average monthly expenditure of their family was 95US $ (SD 32US$). At the beginning of the study, two psychometric research instruments; 24 items perceived quality of primary care services PQPCS scale (chronbach's α = .89) and 22 items community clinic service satisfaction CCSS scale (chronbach's α = .97), were constructed and validated. This study showed less educated, poor, landless mothers utilized the community clinic services more than their educated and wealthier counterpart. Women who lived in their own residence used the community clinic services more frequently than those who lived in a rental house. Perceptions concerning skill and competence of the health care provider and satisfaction indicating interpersonal communication and attitude of the care provider were important predictors for community clinic service utilization. Perception related to the quality of management, administration, physical environment of the service point and satisfaction addressing health promotion and women health issues played significant role on community clinic's services utilization. Besides parental education and income, client's perception and satisfaction played significant role in community clinic service utilization. Provider's perception of service quality should be studied. The study findings will enable policy-makers to improve quality of primary health care services, realizing providers' and patients' ideas of community clinic service quality.

Does integrated care lead to both improved service quality and lower care cost

PubMed Central

Waldeyer, Regina; Siegel, Achim; Daul, Gisela; Gaiser, Karin; Hildebrandt, Helmut; Köster, Ingrid; Schubert, Ingrid; Stunder, Brigitte; Stützle, Yvonne

2010-01-01

Purpose and context ‘Gesundes Kinzigtal’ is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The management company and its contracting partners (the physicians’ network in the region and two statutory health insurers) strive to reach a higher quality of care at a lower overall cost as compared with the German standard. During its first two years of operation (2006–2007), the Kinzigtal project achieved surprisingly positive financial results compared with its reference value. To gain independent evidence on the quality aspects of the system, the management company and its partners provided a remarkable budget for its evaluation by independent scientific institutions. Case description and data sources We will present interim results of a population-based controlled cohort study. In this study, quality of care is checked by relying on health and service quality indicators that have been constructed from health insurers’ administrative data (claims data). Interim results are presented for the intervention region (Kinzigtal area) and the control region (the rest of Baden-Württemberg, i.e., Southwest Germany). Preliminary conclusions and discussion The evaluation of ‘Gesundes Kinzigtal’ is in full progress. Until now, there is no evidence that the surprisingly positive financial results of the Kinzigtal system have been achieved at the expense of care quality. Rather, Gesundes Kinzigtal Integrated Care seems to be about to increasingly realize comparative advantages regarding health service quality (in comparison to the control region).

Nursing identity and patient-centredness in scholarly health services research: a computational text analysis of PubMed abstracts 1986-2013.

PubMed

Bell, Erica; Campbell, Steve; Goldberg, Lynette R

2015-01-22

The most important and contested element of nursing identity may be the patient-centredness of nursing, though this concept is not well-treated in the nursing identity literature. More conceptually-based mapping of nursing identity constructs are needed to help nurses shape their identity. The field of computational text analytics offers new opportunities to scrutinise how growing disciplines such as health services research construct nursing identity. This paper maps the conceptual content of scholarly health services research in PubMed as it relates to the patient-centeredness of nursing. Computational text analytics software was used to analyse all health services abstracts in the database PubMed since 1986. Abstracts were treated as indicative of the content of health services research. The database PubMed was searched for all research papers using the term "service" or "services" in the abstract or keywords for the period 01/01/1986 to 30/06/2013. A total of 234,926 abstracts were obtained. Leximancer software was used in 1) mapping of 4,144,458 instances of 107 concepts; 2) analysis of 106 paired concept co-occurrences for the nursing concept; and 3) sentiment analysis of the nursing concept versus patient, family and community concepts, and clinical concepts. Nursing is constructed within quality assurance or service implementation or workforce development concepts. It is relatively disconnected from patient, family or community care concepts. For those who agree that patient-centredness should be a part of nursing identity in practice, this study suggests that there is a need for development of health services research into both the nature of the caring construct in nursing identity and its expression in practice. More fundamentally, the study raises questions about whether health services research cultures even value the politically popular idea of nurses as patient-centred caregivers and whether they should.

Small and big quality in health care.

PubMed

Lillrank, Paul Martin

2015-01-01

The purpose of this paper is to clarify healthcare quality's ontological and epistemological foundations; and examine how these lead to different measurements and technologies. Conceptual analysis. Small quality denotes conformance to ex ante requirements. Big quality includes product and service design, based on customer requirements and expectations. Healthcare quality can be divided into three areas: clinical decision making; patient safety; and patient experience, each with distinct measurement and improvement technologies. The conceptual model is expected to bring clarity to constructing specific definitions, measures, objectives and technologies for improving healthcare. This paper claims that before healthcare quality can be defined, measured and integrated into systems, it needs to be clearly separated into ontologically and epistemologically different parts.

Relationships between structure, process and outcome to assess quality of integrated chronic disease management in a rural South African setting: applying a structural equation model.

PubMed

Ameh, Soter; Gómez-Olivé, Francesc Xavier; Kahn, Kathleen; Tollman, Stephen M; Klipstein-Grobusch, Kerstin

2017-03-23

South Africa faces a complex dual burden of chronic communicable and non-communicable diseases (NCDs). In response, the Integrated Chronic Disease Management (ICDM) model was initiated in primary health care (PHC) facilities in 2011 to leverage the HIV/ART programme to scale-up services for NCDs, achieve optimal patient health outcomes and improve the quality of medical care. However, little is known about the quality of care in the ICDM model. The objectives of this study were to: i) assess patients' and operational managers' satisfaction with the dimensions of ICDM services; and ii) evaluate the quality of care in the ICDM model using Avedis Donabedian's theory of relationships between structure (resources), process (clinical activities) and outcome (desired result of healthcare) constructs as a measure of quality of care. A cross-sectional study was conducted in 2013 in seven PHC facilities in the Bushbuckridge municipality of Mpumalanga Province, north-east South Africa - an area underpinned by a robust Health and Demographic Surveillance System (HDSS). The patient satisfaction questionnaire (PSQ-18), with measures reflecting structure/process/outcome (SPO) constructs, was adapted and administered to 435 chronic disease patients and the operational managers of all seven PHC facilities. The adapted questionnaire contained 17 dimensions of care, including eight dimensions identified as priority areas in the ICDM model - critical drugs, equipment, referral, defaulter tracing, prepacking of medicines, clinic appointments, waiting time, and coherence. A structural equation model was fit to operationalise Donabedian's theory, using unidirectional, mediation, and reciprocal pathways. The mediation pathway showed that the relationships between structure, process and outcome represented quality systems in the ICDM model. Structure correlated with process (0.40) and outcome (0.75). Given structure, process correlated with outcome (0.88). Of the 17 dimensions of care in the ICDM model, three structure (equipment, critical drugs, accessibility), three process (professionalism, friendliness and attendance to patients) and three outcome (competence, confidence and coherence) dimensions reflected their intended constructs. Of the priority dimensions, referrals, defaulter tracing, prepacking of medicines, appointments, and patient waiting time did not reflect their intended constructs. Donabedian's theoretical framework can be used to provide evidence of quality systems in the ICDM model.

Importance of relationship quality and communication on foodservice for the elderly.

PubMed

Seo, Sunhee; Back, Ki Joon; Shanklin, Carol W

2011-02-01

In order to promote foodservice for the elderly, foodservice managers in Continuing Care Retirement Communities (CCRCs) must identify the main factors to enhance the satisfaction and behavioral intentions with food service. The purpose of this study was to investigate the relationships between relationship quality (consisting of trust, commitment, and satisfaction) and communication in the formation of elderly's behavioral intentions with food services at CCRCs. A survey was administered to residents in two CCRCs and a total of 327 residents participated. A tested structural equation model exhibited good model fit and explanatory power of the study construct. Satisfaction directly influenced word-of-mouth and service quality has an influence on commitment. Commitment was a significant determinant of behavioral intentions to eat more often in the dining room. Also, communication showed positive association with trust. The results provided strong evidence for the importance of satisfaction and communication as a consequence of relationship marketing efforts. Suggestions for future research to better understand the elderly' behavioral intention judgments were given.

Importance of relationship quality and communication on foodservice for the elderly

PubMed Central

Back, Ki Joon; Shanklin, Carol W.

2011-01-01

In order to promote foodservice for the elderly, foodservice managers in Continuing Care Retirement Communities (CCRCs) must identify the main factors to enhance the satisfaction and behavioral intentions with food service. The purpose of this study was to investigate the relationships between relationship quality (consisting of trust, commitment, and satisfaction) and communication in the formation of elderly's behavioral intentions with food services at CCRCs. A survey was administered to residents in two CCRCs and a total of 327 residents participated. A tested structural equation model exhibited good model fit and explanatory power of the study construct. Satisfaction directly influenced word-of-mouth and service quality has an influence on commitment. Commitment was a significant determinant of behavioral intentions to eat more often in the dining room. Also, communication showed positive association with trust. The results provided strong evidence for the importance of satisfaction and communication as a consequence of relationship marketing efforts. Suggestions for future research to better understand the elderly' behavioral intention judgments were given. PMID:21487500

International Perspectives on Early Childhood Curricula

ERIC Educational Resources Information Center

Oberhuemer, Pamela

2005-01-01

The early years of childhood are receiving increased public policy attention in many countries around the world. Debates on providing quality services and ensuring a good foundation for lifelong learning are generating a new interest in curriculum issues. What understandings do we have of young children? How do they access and construct knowledge…

Racial Variation in Vocational Rehabilitation Outcomes: A Structural Equation Modeling Approach

ERIC Educational Resources Information Center

Martin, Frank H.

2010-01-01

Numerous studies have indicated racial and ethnic disparities in the vocational rehabilitation (VR) system, including differences in acceptance, services provided, closure types, and employment outcomes. Few of these studies, however, have used advanced multivariate techniques or latent constructs to measure quality of employment outcomes (QEO) or…

Portuguese Adaptation and Input for the Validation of the Views on Inpatient Care (VOICE) Outcome Measure to Assess Service Users'Perceptions of Inpatient Psychiatric Care.

PubMed

Palha, João; Palha, Filipa; Dias, Pedro; Gonçalves-Pereira, Manuel

2017-11-29

Patient satisfaction is an important measure of health care quality. Patients' views have seldom been considered in the construction of measures addressing satisfaction with inpatient facilities in psychiatry. The Views on Inpatient Care - VOICE - is a first service-user generated outcome measure relying solely on their perceptions of acute care, representing a valuable indicator of service users' perceived quality of care. The present study aimed to contribute to the validation of the Portuguese version of VOICE. The questionnaire was translated into Portuguese and applied to a sample of eighty-five female inpatients of a psychiatric institution. Data analysis focused on assessing reliability and exploring the impact of demographic and clinical variables on participants' satisfaction. Internal consistency of the questionnaire was high (α = 0.87). Participants' age and marital status were associated with differences in scores, with older patients and patients who were married or involved in a close relationship presenting higher satisfaction levels. The questionnaire demonstrated good internal consistency and acceptability, as well as construct validity. Further studies should expand the analysis of the psychometric properties of this measure e.g., test-retest reliability. The Portuguese version of VOICE is a promising tool to assess service users' perceptions of inpatient psychiatric care in Portugal.

A Knowledge Navigation Method for the Domain of Customers' Services of Mobile Communication Corporations in China

NASA Astrophysics Data System (ADS)

Wu, Jiangning; Wang, Xiaohuan

Rapidly increasing amount of mobile phone users and types of services leads to a great accumulation of complaining information. How to use this information to enhance the quality of customers' services is a big issue at present. To handle this kind of problem, the paper presents an approach to construct a domain knowledge map for navigating the explicit and tacit knowledge in two ways: building the Topic Map-based explicit knowledge navigation model, which includes domain TM construction, a semantic topic expansion algorithm and VSM-based similarity calculation; building Social Network Analysis-based tacit knowledge navigation model, which includes a multi-relational expert navigation algorithm and the criterions to evaluate the performance of expert networks. In doing so, both the customer managers and operators in call centers can find the appropriate knowledge and experts quickly and exactly. The experimental results show that the above method is very powerful for knowledge navigation.

Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

PubMed Central

2011-01-01

Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries. PMID:21864335

Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

PubMed

Hutchinson, Paul L; Do, Mai; Agha, Sohail

2011-08-24

Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries.

Primary health care quality and hospitalizations for ambulatory care sensitive conditions in the public health system in Porto Alegre, Brazil.

PubMed

Gonçalves, Marcelo Rodrigues; Hauser, Lisiane; Prestes, Isaías Valente; Schmidt, Maria Inês; Duncan, Bruce Bartholow; Harzheim, Erno

2016-06-01

To investigate the relation of hospitalization for ambulatory care sensitive conditions (ACSC) with the quality of public primary care health services in Porto Alegre, Brazil. Cohort study constructed by probabilistic record linkage performed from August 2006 to December 2011 in a population ≥18 years of age that attended public primary care health services. The Primary Care Assessment Tool (PCATool-Brazil) was used for evaluation of primary care services. Of 1200 subjects followed, 84 were hospitalized for primary care sensitive conditions. The main causes of ACSC hospital admissions were cardiovascular (40.5%) and respiratory (16.2%) diseases. The PCATool average score was 5.3, a level considerably below that considered to represent quality care. After adjustment through Cox proportional hazard modelling for covariates, >60 years of age [hazard ratio (HR): 1.13; P = 0.001), lesser education (HR: 0.66; P = 0.02), ethnicity other than white (HR: 1.77; P = 0.01) and physical inactivity (HR: 1.65; P = 0.04) predicted hospitalization, but higher quality of primary health care did not. Better quality of health care services, in a setting of overwhelmingly low quality services not adapted to the care of chronic conditions, did not influence the rate of avoidable hospitalizations, while social and demographic characteristics, especially non-white ethnicity and lesser schooling, indicate that social inequities play a predominant role in health outcomes. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Development and evaluation of an instrument to measure parental satisfaction with quality of care in neonatal follow-up.

PubMed

Butt, Michelle L; Pinelli, Janet; Boyle, Michael H; Thomas, Helen; Hunsberger, Mabel; Saigal, Saroj; Lee, David S; Fanning, Jamie K; Austin, Patricia

2009-02-01

The goal of this study was to develop and subsequently evaluate the psychometric properties of a new discriminative instrument to measure parental satisfaction with the quality of care provided in neonatal follow-up (NFU) programs. The methodological framework for developing and evaluating measurement scales described by Streiner and Norman (Health Measurement Scales: A Practical Guide to Their Development and Use. 3rd ed. New York: Oxford University Press; 2003) was used for the study. Informing the phases of the research was a sample of 24 health care professionals and 381 parents who use NFU services. A comprehensive list of items representing the construct, parental satisfaction with quality of care, was generated from published reliable and valid instruments, research studies, focus groups with health care experts, and focus groups with parents. Using a clinimetric approach, the 62 items generated were reduced to 39 items based on parents' ratings of importance and refinement of the items by the research team. After content validation and pretesting, the instrument was tested with parents and underwent item-analysis. The resulting 16-item instrument was composed of 2 subscales, Process and Outcomes. Evaluation of the instrument's psychometric properties indicated adequate test-retest reliability (intraclass correlation coefficient = 0.72) and internal consistency (Process subscale, alpha = 0.77; Outcomes subscale, alpha = 0.90; overall instrument, alpha = 0.90), as well as good content and construct validity. A confirmatory factor analysis supported the multidimensionality of the construct. This new instrument provides clinicians and policy-makers with a tool to assess parental satisfaction with the quality of care in NFU, so areas of dissatisfaction can be identified and changes implemented to optimize service provision.

The organizational context of children's mental health services.

PubMed

Glisson, Charles

2002-12-01

This paper reviews what is known about the organizational context of children's mental health services and describes organizational constructs, conceptual models, research methods, and intervention strategies that can be used to link organizational context to service quality and outcomes. Using evidence from studies of business and industrial organizations as well as studies of children's service organizations, the paper presents a model of organizational effectiveness that depends on several contextual characteristics that include organizational culture, structure, climate, and work attitudes. These characteristics are believed to affect the adoption of efficacious treatments (EBPs [evidence-based practices]), adherence to treatment protocols, therapeutic alliance, and the availability, responsiveness, and continuity of services. Finally, 10 components of the ARC(Availability Responsiveness and Continuity) organizational intervention are described as examples of strategies that can be used to develop organizational contexts with the prescribed characteristics. Mental health researchers are encouraged to consider including these constructs, conceptual models, research methods, and intervention strategies in dissemination, effectiveness, and implementation studies that address the gap between research-based knowledge about mental health treatment and what is actually offered in the community.

Design and construction of an experimental pervious paved parking area to harvest reusable rainwater.

PubMed

Gomez-Ullate, E; Novo, A V; Bayon, J R; Hernandez, Jorge R; Castro-Fresno, Daniel

2011-01-01

Pervious pavements are sustainable urban drainage systems already known as rainwater infiltration techniques which reduce runoff formation and diffuse pollution in cities. The present research is focused on the design and construction of an experimental parking area, composed of 45 pervious pavement parking bays. Every pervious pavement was experimentally designed to store rainwater and measure the levels of the stored water and its quality over time. Six different pervious surfaces are combined with four different geotextiles in order to test which materials respond better to the good quality of rainwater storage over time and under the specific weather conditions of the north of Spain. The aim of this research was to obtain a good performance of pervious pavements that offered simultaneously a positive urban service and helped to harvest rainwater with a good quality to be used for non potable demands.

Quality of life in adults with an intellectual disability: the Evaluation of Quality of Life Instrument.

PubMed

Nota, L; Soresi, S; Perry, J

2006-05-01

The construct of quality of life (QoL) has been the focus of a great deal of recent research and has been operationalized in the assessment of the effectiveness of biomedical and rehabilitative interventions. Consequently, the effective measurement of QoL has become a relevant issue. QoL assessment should take account of both objective life conditions and reported satisfaction with those conditions, and should recognize that QoL has multiple domains. There is also evidence to suggest that it is useful to supplement such assessments with the evaluations of significant others within a multidimensional assessment perspective. The current study describes a further stage of testing and refinement of the Evaluation of Quality of Life Instrument (EQLI), which was designed to elicit from staff of health and social care services assessments of the level of satisfaction experienced by adults with an intellectual disability. Specifically, the EQLI's internal consistency, and construct, convergent and discriminant validity were analysed. The EQLI appears to be a psychometrically valid measure for collecting data on the levels of satisfaction which, according to health and social services staff, might be experienced by individuals with an intellectual disability who attend residential institutions and community-based day centres. The factor analyses supported a three-factor structure for the EQLI and reliability estimates of scores on the three factors were in the moderate to high range. The data collected supported convergent and discriminant validity. The results indicate that the EQLI is an effective measure for gaining staff perceptions of individuals who may be at risk of dissatisfaction with various QoL domains. The EQLI is as an instrument which, within a multidimensional assessment, could contribute to the identification of areas of user dissatisfaction with services.

Effects of a performance and quality improvement intervention on the work environment in HIV-related care: a quasi-experimental evaluation in Zambia.

PubMed

Bazant, Eva; Sarkar, Supriya; Banda, Joseph; Kanjipite, Webby; Reinhardt, Stephanie; Shasulwe, Hildah; Mulilo, Joyce Monica Chongo; Kim, Young Mi

2014-12-20

Human resource shortages and reforms in HIV-related care make it challenging for frontline health care providers in southern Africa to deliver high-quality services. At health facilities of the Zambian Defence Forces, a performance and quality improvement approach was implemented to improve HIV-related care and was evaluated in 2010/2011. Changes in providers' work environment and perceived quality of HIV-related care were assessed to complement data of provider performance. The intervention involved on-site training, supportive supervision, and action planning focusing on detailed service delivery standards. The quasi-experimental evaluation collected pre- and post-intervention data from eight intervention and comparison facilities matched on defence force branch and baseline client volume. Overall, 101 providers responded to a 24-item questionnaire on the work environment, covering topics of drugs, supplies, and equipment; training, feedback, and supervision; compensation; staffing; safety; fulfilment; and HIV services quality. In bivariate analysis and multivariate analyses, we assessed changes within each study group and between the two groups. In the bivariate analysis, the intervention group providers reported improvements in the work environment on adequacy of equipment, feeling safe from harm, confidence in clinical skills, and reduced isolation, while the comparison group reported worsening of the work environment on supplies, training, safety, and departmental morale.In the multivariate analysis, the intervention group's improvement and the comparison group's decline were significant on perceived adequacy of drugs, supplies, and equipment; constructive feedback received from supervisor and co-workers; and feeling safe from physical harm (all P <0.01, except P <0.04 for equipment). Further, the item "provider lacks confidence in some clinical skills" declined in the intervention group but increased in the comparison group (P = -0.005). In multivariate analysis, changes in perceived quality of HIV care did not differ between study groups. Provider perceptions were congruent with observations of preparing drugs, supplies, equipment, and in service delivery of prevention of mother-to-child transmission of HIV and antiretroviral therapy follow-up care. The performance and quality improvement intervention implemented at Zambian Defence Forces' health facilities was associated with improvements in providers' perceptions of work environment consistent with the intervention's focus on commodities, skills acquisition, and receipt of constructive feedback.

Finding of No Significant Impact: Construction and Operation of an Emergency Services Center United States Air Force Academy, Colorado

DTIC Science & Technology

2012-02-08

alternatives and resource issues. Agencies and Persons Consulted Jay Burgoon, Environmental Manager, USAFA Jeanie Duncan , Air Quality and Solid Waste Manager...Academy and their conservation. Colorado Natural Heritage Program, Colorado State University, Fort Collins, CO. Fitzgerald , J.P. and R.R

Library Services in Institutions for Mentally and Developmentally Disabled Adults.

ERIC Educational Resources Information Center

Ensor, Pat

To improve the quality of life of institutionalized individuals, libraries can serve as a constructive escape mechanism for dealing with stress, a representation of external reality, and a therapeutic agent, in addition to offering bibliotherapy. Ideally, the library should be an integral part of the institution and provide a user-appropriate…

A qualitative comparative analysis of well-managed school sanitation in Bangladesh

PubMed Central

2014-01-01

Background Continued management of sanitation and hygiene services, post-intervention, is a global challenge, particularly in the school-setting. This situation threatens anticipated impacts of school sanitation and hygiene investments. To improve programming and policies, and increase the effectiveness of limited development resources, we seek to understand how and why some schools have well-managed sanitation post-intervention, while others do not. Methods Based on in-depth qualitative data from 16 case schools in Meherpur, Bangladesh, we employ fuzzy-set qualitative comparative analysis to identify the necessary and sufficient conditions, or combinations of conditions (referred to as pathways), that lead to either well-managed or poorly managed school sanitation. We include posited sustainability determinants from the literature and factors that emerged from the cases themselves in the analysis. Results We identified three distinct pathways sufficient to support well-managed services, providing multiple options for how well-managed school sanitation could be encouraged. Two of these are applicable to both government and non-government schools: (1) quality construction, financial community support and a champion; and (2) quality construction, financial government support, a maintenance plan and school management committee involvement. On-going financial support for operations and maintenance was identified as a necessary condition for continued service management, which was absent from many schools with poorly managed services. However, financial support was insufficient alone and other conditions are needed in conjunction, including quality construction and incentivizing conditions, such as school management committee involvement in sanitation specifically, a sanitation champion, and/or one teacher clearly responsible for toilet maintenance. Surprisingly, the number of students per toilet (ranging from 18–95 students) and toilet age (ranging from 8–32 months) had no significant effect on sanitation conditions. Conclusions Findings corroborate those from a similar study in Belize, and comparison suggests the need for financial community support and the possibly tenuous reliance on local champions in the absence of adequate government support for operations and maintenance. Sub-determinants to the necessary conditions are also discussed which have implications for school sanitation in Bangladesh and may have broader relevance for other low-income countries though further research is needed. PMID:24397540

A qualitative comparative analysis of well-managed school sanitation in Bangladesh.

PubMed

Chatterley, Christie; Javernick-Will, Amy; Linden, Karl G; Alam, Kawser; Bottinelli, Laure; Venkatesh, Mohini

2014-01-08

Continued management of sanitation and hygiene services, post-intervention, is a global challenge, particularly in the school-setting. This situation threatens anticipated impacts of school sanitation and hygiene investments. To improve programming and policies, and increase the effectiveness of limited development resources, we seek to understand how and why some schools have well-managed sanitation post-intervention, while others do not. Based on in-depth qualitative data from 16 case schools in Meherpur, Bangladesh, we employ fuzzy-set qualitative comparative analysis to identify the necessary and sufficient conditions, or combinations of conditions (referred to as pathways), that lead to either well-managed or poorly managed school sanitation. We include posited sustainability determinants from the literature and factors that emerged from the cases themselves in the analysis. We identified three distinct pathways sufficient to support well-managed services, providing multiple options for how well-managed school sanitation could be encouraged. Two of these are applicable to both government and non-government schools: (1) quality construction, financial community support and a champion; and (2) quality construction, financial government support, a maintenance plan and school management committee involvement. On-going financial support for operations and maintenance was identified as a necessary condition for continued service management, which was absent from many schools with poorly managed services. However, financial support was insufficient alone and other conditions are needed in conjunction, including quality construction and incentivizing conditions, such as school management committee involvement in sanitation specifically, a sanitation champion, and/or one teacher clearly responsible for toilet maintenance. Surprisingly, the number of students per toilet (ranging from 18-95 students) and toilet age (ranging from 8-32 months) had no significant effect on sanitation conditions. Findings corroborate those from a similar study in Belize, and comparison suggests the need for financial community support and the possibly tenuous reliance on local champions in the absence of adequate government support for operations and maintenance. Sub-determinants to the necessary conditions are also discussed which have implications for school sanitation in Bangladesh and may have broader relevance for other low-income countries though further research is needed.

Organizational issues related to satisfaction with food and food service in the nursing home from the resident's perspective.

PubMed

Shultz, Jill Armstrong; Crogan, Neva L; Evans, Bronwynne C

2005-01-01

This paper reviews organizational factors that potentially affect food quality and food service in the nursing home. A model is proposed for assessing the influence of organizational technology on resident satisfaction with food and food service from the resident's perspective. Findings from an exploratory phenomenological case study applying the model are presented. Staff knowledge of how to prepare and serve food properly, and staff availability to serve food on time, were key constructs. Resident-staff interactions appeared to moderate resident control over food and food service. Recommendations are suggested for improved communication between residents and staff to address certain limitations and enhance empowerment of residents.

Development and Validation of a Gender Ideology Scale for Family Planning Services in Rural China

PubMed Central

Yang, Xueyan; Li, Shuzhuo; Feldman, Marcus W.

2013-01-01

The objectives of this study are to develop a scale of gender role ideology appropriate for assessing Quality of Care in family planning services for rural China. Literature review, focus-group discussions and in-depth interviews with service providers and clients from two counties in eastern and western China, as well as experts’ assessments, were used to develop a scale for family planning services. Psychometric methodologies were applied to samples of 601 service clients and 541 service providers from a survey in a district in central China to validate its internal consistency, reliability, and construct validity with realistic and strategic dimensions. This scale is found to be reliable and valid, and has prospects for application both academically and practically in the field. PMID:23573222

Measuring nursing home resident satisfaction with food and food service: initial testing of the FoodEx-LTC.

PubMed

Crogan, Neva L; Evans, Bronwynne; Velasquez, Donna

2004-04-01

Malnutrition impacts the quality of life and general health of many older persons living in our nation's 20,000 nursing homes (1). Despite the urgency of this issue, no instrument that measures resident satisfaction with food and food service was found in an extensive literature search. The purpose of this article is to describe the development and initial testing of a resident satisfaction with food and food service questionnaire (FoodEx-LTC) in the context of the Quality Nutrition Outcomes-Long-Term Care Model. This pilot study was conducted in two phases. During phase one the instrument was developed, peer-reviewed, and pretested. Phase two further tested the instrument using a correlational design, measuring both intermediate and long-term outcomes found on the Quality Nutrition Outcomes-Long-Term Care Model. Hypothesis testing was used to measure construct validity. 4 of 5 FoodEx-LTC domains were significantly correlated with depression, 2 of 5 with serum albumin. The FoodEx-LTC demonstrates acceptable reliability for a new instrument. The coefficient alpha scores ranged from.69-.87 and test-retest correlations ranged from.55-.89, dependent upon domain. FoodEx-LTC appears to be a valid and reliable measure of resident food and food service satisfaction in nursing homes. This line of inquiry is of great importance because perceived quality of food and food service are strongly related to quality of life for residents in nursing homes, and adequate food intake is integral to maintaining weight and preventing protein-calorie malnutrition among elderly residents.

The quality of health care and patient satisfaction: an exploratory investigation of the 5Qs model at some Egyptian and Jordanian medical clinics.

PubMed

Zineldin, Mosad

2006-01-01

To examine the major factors affecting patients' perception of cumulative satisfaction and to address the question whether patients in Egypt and Jordan evaluate quality of health care similarly or differently. A conceptual model including behavioural dimensions of patient-physician relationships and patient satisfaction has been developed. As the empirical research setting, this study concerns three hospitals in Egypt and Jordan. The survey instrument in a questionnaire form was designed to achieve the research objectives. A total of 48 items (attributes) of the newly developed five quality dimensions were identified to be the most relevant. A total of 224 complete and usable questionnaires were received from the in-patients. Hospital C has above-average total and dimensional qualities and patients are the most satisfied in accordance with all dimensions of services. Hospitals A and B have under-average total qualities as the majority of patients are not satisfied with services. Comparing hospitals A and B, in the majority of dimensions (with the exception of Q5), the quality in hospital B is higher than in hospital A. Patients' satisfaction with different service quality dimensions is correlated with their willingness to recommend the hospital to others. A cure to improve the quality for health-care services can be an application of total relationship management and the 5Qs model together with customer orientation strategy. The result can be used by the hospitals to reengineer and redesign creatively their quality management processes and the future direction of their more effective health-care quality strategies. In this research a study is described involving a new instrument and a new method which assure a reasonable level of relevance, validity and reliability, while being explicitly change-oriented. This study argues that a patient's satisfaction is a cumulative construct, summing satisfaction with five different qualities (5Qs) of the hospital: quality of object, processes, infrastructure, interaction, and atmosphere.

MUSTANG: A Community-Facing Web Service to Improve Seismic Data Quality Awareness Through Metrics

NASA Astrophysics Data System (ADS)

Templeton, M. E.; Ahern, T. K.; Casey, R. E.; Sharer, G.; Weertman, B.; Ashmore, S.

2014-12-01

IRIS DMC is engaged in a new effort to provide broad and deep visibility into the quality of data and metadata found in its terabyte-scale geophysical data archive. Taking advantage of large and fast disk capacity, modern advances in open database technologies, and nimble provisioning of virtual machine resources, we are creating an openly accessible treasure trove of data measurements for scientists and the general public to utilize in providing new insights into the quality of this data. We have branded this statistical gathering system MUSTANG, and have constructed it as a component of the web services suite that IRIS DMC offers. MUSTANG measures over forty data metrics addressing issues with archive status, data statistics and continuity, signal anomalies, noise analysis, metadata checks, and station state of health. These metrics could potentially be used both by network operators to diagnose station problems and by data users to sort suitable data from unreliable or unusable data. Our poster details what MUSTANG is, how users can access it, what measurements they can find, and how MUSTANG fits into the IRIS DMC's data access ecosystem. Progress in data processing, approaches to data visualization, and case studies of MUSTANG's use for quality assurance will be presented. We want to illustrate what is possible with data quality assurance, the need for data quality assurance, and how the seismic community will benefit from this freely available analytics service.

Participation in mental healthcare: a qualitative meta-synthesis.

PubMed

Stomski, Norman J; Morrison, Paul

2017-01-01

Facilitation of service user participation in the co-production of mental healthcare planning and service delivery is an integral component of contemporary mental health policy and clinical guidelines. However, many service users continue to experience exclusion from the planning of their care. This review synthesizes qualitative research about participation in mental healthcare and articulates essential processes that enable service user participation in mental health care. Electronic databases were systematically searched. Studies were included if they were peer reviewed qualitative studies, published between 2000 and 2015, examining participation in mental health care. The Critical Appraisal Skills Program checklist was used to assess the quality of each included study. Constant comparison was used to identify similar constructs across several studies, which were then abstracted into thematic constructs. The synthesis resulted in the identification of six principal themes, which articulate key processes that facilitate service user participation in mental healthcare. These themes included: exercising influence; tokenism; sharing knowledge; lacking capacity; respect; and empathy. This meta-synthesis demonstrates that service user participation in mental healthcare remains a policy aspiration, which generally has not been translated into clinical practice. The continued lack of impact on policy on the delivery of mental healthcare suggests that change may have to be community driven. Systemic service user advocacy groups could contribute critically to promoting authentic service user participation in the co-production of mental health services.

Contrast research of CDMA and GSM network optimization

NASA Astrophysics Data System (ADS)

Wu, Yanwen; Liu, Zehong; Zhou, Guangyue

2004-03-01

With the development of mobile telecommunication network, users of CDMA advanced their request of network service quality. While the operators also change their network management object from signal coverage to performance improvement. In that case, reasonably layout & optimization of mobile telecommunication network, reasonably configuration of network resource, improvement of the service quality, and increase the enterprise's core competition ability, all those have been concerned by the operator companies. This paper firstly looked into the flow of CDMA network optimization. Then it dissertated to some keystones in the CDMA network optimization, like PN code assignment, calculation of soft handover, etc. As GSM is also the similar cellular mobile telecommunication system like CDMA, so this paper also made a contrast research of CDMA and GSM network optimization in details, including the similarity and the different. In conclusion, network optimization is a long time job; it will run through the whole process of network construct. By the adjustment of network hardware (like BTS equipments, RF systems, etc.) and network software (like parameter optimized, configuration optimized, capacity optimized, etc.), network optimization work can improve the performance and service quality of the network.

76 FR 21108 - Advisory Committee on Structural Safety of Department of Veterans Affairs Facilities; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-14

... Quality Service, Office of Construction and Facilities Management (00CFM1A), Department of Veterans... Affairs Facilities; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public... Safety of Department of Veterans Affairs Facilities will be held on May 12-13, 2011, in Room 442, at the...

A Four-Part Framework to Meet the Responsibilities of Higher Education to Gerontology

ERIC Educational Resources Information Center

Ehrlich, Ira F.; Ehrlich, Phyllis D.

1976-01-01

This article delineates a four-part educational framework including specific ways in which higher-learning institutions have a responsibility to the aged consumer, related educational systems, and service practitioners. It suggests that constructive use of the model could enhance the quality of life for the aging, and for the rest of society.…

25 CFR 900.118 - Do these “construction contract” regulations apply to construction management services?

Code of Federal Regulations, 2014 CFR

2014-04-01

... construction management services? 900.118 Section 900.118 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE...” regulations apply to construction management services? No. Construction management services may be contracted separately under section 108 of the Act. Construction management services consultants and/or Indian tribe or...

Construction of Multimodal Transport Information Platform

NASA Astrophysics Data System (ADS)

Wang, Ya; Cheng, Yu; Zhao, Zhi

2018-06-01

With the rapid development of economy, the volume of transportation in China is increasing, the opening process of the market is accelerating, the scale of enterprises is expanding, the service quality is being improved, and the container multimodal transport is developing continuously.The hardware infrastructure of container multimodal transport is improved obviously, but the network platform construction of multimodal transport is still insufficient.Taking Shandong region of China as an example, the present situation of container multimodal transport in Shandong area can no longer meet the requirement of rapid development of container, and the construction of network platform needs to be solved urgently. Therefore, this paper will briefly describe the conception of construction of multimodal transport network platform in Shandong area.In order to achieve the rapid development of multimodal transport.

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

PubMed Central

Damschroder, Laura J; Aron, David C; Keith, Rosalind E; Kirsh, Susan R; Alexander, Jeffery A; Lowery, Julie C

2009-01-01

Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings. PMID:19664226

Grizzly Substation Fiber Optics : Environmental Assessment.

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

United States. Bonneville Power Administration.

1998-02-01

This notice announces BPA`s decision to construct, operate, and maintain the Grizzly Substation Fiber Optic Project (Project). This Project is part of a continuing effort by BPA to complete a regionwide upgrade of its existing telecommunications system. The US Forest Service and BPA jointly prepared the Grizzly Substation Fiber Optic Project Environmental Assessment (EA) (DOE/EA-1241) evaluating the potential environmental impacts of the Proposed Action, the Underground Installation Alternative, and the No Action Alternative. Based on the analysis in the EA, the US Forest Service and BPA have determined that the Proposed Action is not a major Federal action significantly affectingmore » the quality of the human environment, within the meaning of the National Environmental Policy Act (NEPA) of 1969. Therefore, the preparation of an Environmental Impact Statement (EIS) is not required and BPA is issuing this FONSI. The US Forest Service has separately issued a FONSI and Decision Notice authorizing BPA to construct, operate, and maintain the Project within the Crooked River National Grassland (Grassland).« less

Quality of life constructs of Chinese people living with HIV/AIDS.

PubMed

Ho, Choi-Fung; Twinn, Sheila; Cheng, Karis K F

2010-03-01

A range of quality of life (QOL) measurements specific for people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) are available. They were, however, developed before or at about the time of introducing highly active antiretroviral therapy (HAART) and there has been very little measurement developed from a Chinese perspective. A study was therefore undertaken and we report our findings of the first phase, in which Chinese people living with HIV/AIDS in Hong Kong were asked to explain their perceptions of QOL so as to identify their construct of QOL using a qualitative approach. Thirty-six participants, thirty males and six females, of mixed demographic and disease-related characteristics were recruited through purposive sampling. Following thematic analysis, nine QOL constructs emerged which included perceptions of adaptation and coping, physical health, stigmatization and discrimination, HIV care services, antiretroviral therapy, sexual relationships, relationships with family and friends, work and money, and pleasure and contentment. When comparing these constructs with those of Western populations, they contain more components on focusing psychosocial and spiritual aspects but less on functional status and HIV-related symptoms. The differences may not be attributed by cultural variations alone but also by the dynamic nature of QOL. Since there has been a rapid evolution of HIV medicine, instrument developers may need to regularly review and update measures of QOL. The subjective perceptions and experiences of targeted population should be addressed. Our findings also suggest the need of maintaining tailor-made psychosocial support services for HIV-infected people despite general reduction of morbidity and mortality from HAART.

Initial validation of the Chinese Quality of Life Questionnaire-Intellectual Disabilities (CQOL-ID): a cultural perspective.

PubMed

Wong, P K S; Wong, D F K; Schalock, R L; Chou, Y-C

2011-06-01

In the field of intellectual disabilities (ID), the quality of life concept has been developing rapidly in Chinese societies including Hong Kong, mainland China and Taiwan. However, there is a lack of locally validated instruments to measure the quality of life of people with ID. The study reported in this paper attempted to validate the Chinese Quality of Life Questionnaire - Intellectual Disabilities adapted from the Quality of Life Questionnaire developed by Schalock & Keith. People with mild/moderate ID aged 15 years or above were recruited from special schools, skills centres, community service units and residential units in different regions of Hong Kong. A number of procedures were followed including reliability tests, factor analysis, content validity and construct validity. A total of 359 participants were recruited for the study. Factor analysis was conducted according to the rotated component matrix method, in which 23 items were extracted from the original 40-item version of the Quality of Life Questionnaire and three domains (renamed satisfaction, competence and daily choice making/interpersonal relations) were observed. The items in each domain were shown to have factor loadings ranging from 0.42 to 0.90. Construct validity tests indicated the positive nature of the relationship between earnings, and that self-determination and social interaction increase with more independent living environments and less segregated work environments achieving higher scores (P<0.000, P<0.01 and P<0.05 respectively). The scale also achieved a good degree of reliability (Cronbach's α=0.79). Initial validity tests indicated that the Chinese Quality of Life Questionnaire - Intellectual Disabilities may be a useful instrument for measuring the quality of life of Chinese people with ID. Cultural issues are discussed and recommendations for future research and service development are made. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

Development, implementation, and evaluation of a hybrid electronic medical record system specifically designed for a developing world surgical service.

PubMed

Laing, G L; Bruce, J L; Skinner, D L; Allorto, N L; Clarke, D L; Aldous, C

2014-06-01

The Pietermaritzburg Metropolitan Trauma Service previously successfully constructed and implemented an electronic surgical registry (ESR). This study reports on our attempts to expand and develop this concept into a multi-functional hybrid electronic medical record (HEMR) system for use in a tertiary level surgical service. This HEMR system was designed to incorporate the function and benefits of an ESR, an electronic medical record (EMR) system, and a clinical decision support system (CDSS). Formal ethical approval to maintain the HEMR system was obtained. Appropriate software was sourced to develop the project. The data model was designed as a relational database. Following the design and construction process, the HEMR file was launched on a secure server. This provided the benefits of access security and automated backups. A systematic training program was implemented for client training. The exercise of data capture was integrated into the process of clinical workflow, taking place at multiple points in time. Data were captured at the times of admission, operative intervention, endoscopic intervention, adverse events (morbidity), and the end of patient care (discharge, transfer, or death). A quarterly audit was performed 3 months after implementation of the HEMR system. The data were extracted and audited to assess their quality. A total of 1,114 patient entries were captured in the system. Compliance rates were in the order of 87-100 %, and client satisfaction rates were high. It is possible to construct and implement a unique, simple, cost-effective HEMR system in a developing world surgical service. This information system is unique in that it combines the discrete functions of an EMR system with an ESR and a CDSS. We identified a number of potential limitations and developed interventions to ameliorate them. This HEMR system provides the necessary platform for ongoing quality improvement programs and clinical research.

Modeling antecedents of electronic medical record system implementation success in low-resource setting hospitals.

PubMed

Tilahun, Binyam; Fritz, Fleur

2015-08-01

With the increasing implementation of Electronic Medical Record Systems (EMR) in developing countries, there is a growing need to identify antecedents of EMR success to measure and predict the level of adoption before costly implementation. However, less evidence is available about EMR success in the context of low-resource setting implementations. Therefore, this study aims to fill this gap by examining the constructs and relationships of the widely used DeLone and MacLean (D&M) information system success model to determine whether it can be applied to measure EMR success in those settings. A quantitative cross sectional study design using self-administered questionnaires was used to collect data from 384 health professionals working in five governmental hospitals in Ethiopia. The hospitals use a comprehensive EMR system since three years. Descriptive and structural equation modeling methods were applied to describe and validate the extent of relationship of constructs and mediating effects. The findings of the structural equation modeling shows that system quality has significant influence on EMR use (β = 0.32, P < 0.05) and user satisfaction (β = 0.53, P < 0.01); information quality has significant influence on EMR use (β = 0.44, P < 0.05) and user satisfaction (β = 0.48, P < 0.01) and service quality has strong significant influence on EMR use (β = 0.36, P < 0.05) and user satisfaction (β = 0.56, P < 0.01). User satisfaction has significant influence on EMR use (β = 0.41, P < 0.05) but the effect of EMR use on user satisfaction was not significant. Both EMR use and user satisfaction have significant influence on perceived net-benefit (β = 0.31, P < 0.01; β = 0.60, P < 0.01), respectively. Additionally, computer literacy was found to be a mediating factor in the relationship between service quality and EMR use (P < 0.05) as well as user satisfaction (P < 0.01). Among all the constructs, user satisfaction showed the strongest effect on perceived net-benefit of health professionals. EMR implementers and managers in developing countries are in urgent need of implementation models to design proper implementation strategies. In this study, the constructs and relationships depicted in the updated D&M model were found to be applicable to assess the success of EMR in low resource settings. Additionally, computer literacy was found to be a mediating factor in EMR use and user satisfaction of health professionals. Hence, EMR implementers and managers in those settings should give priority in improving service quality of the hospitals like technical support and infrastructure; providing continuous basic computer trainings to health professionals; and give attention to the system and information quality of the systems they want to implement.

Construction quality assurance report

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

Roscha, V.

1994-09-08

This report provides a summary of the construction quality assurance (CQA) observation and test results, including: The results of the geosynthetic and soil materials conformance testing. The observation and testing results associates with the installation of the soil liners. The observation and testing results associated with the installation of the HDPE geomembrane liner systems. The observation and testing results associated with the installation of the leachate collection and removal systems. The observation and testing results associated with the installation of the working surfaces. The observation and testing results associated with in-plant manufacturing process. Summary of submittal reviews by Golder Constructionmore » Services, Inc. The submittal and certification of the piping material specifications. The observation and verification associated of the Acceptance Test Procedure results of the operational equipment functions. Summary of the ECNs which are incorporated into the project.« less

Toward Risk Reduction for Mobile Service Composition.

PubMed

Deng, Shuiguang; Huang, Longtao; Li, Ying; Zhou, Honggeng; Wu, Zhaohui; Cao, Xiongfei; Kataev, Mikhail Yu; Li, Ling

2016-08-01

The advances in mobile technologies enable us to consume or even provide services through powerful mobile devices anytime and anywhere. Services running on mobile devices within limited range can be composed to coordinate together through wireless communication technologies and perform complex tasks. However, the mobility of users and devices in mobile environment imposes high risk on the execution of the tasks. This paper targets reducing this risk by constructing a dependable service composition after considering the mobility of both service requesters and providers. It first proposes a risk model and clarifies the risk of mobile service composition; and then proposes a service composition approach by modifying the simulated annealing algorithm. Our objective is to form a service composition by selecting mobile services under the mobility model and to ensure the service composition have the best quality of service and the lowest risk. The experimental results demonstrate that our approach can yield near-optimal solutions and has a nearly linear complexity with respect to a problem size.

Stroke survivors' and informal caregivers' experiences of primary care and community healthcare services - A systematic review and meta-ethnography.

PubMed

Pindus, Dominika M; Mullis, Ricky; Lim, Lisa; Wellwood, Ian; Rundell, A Viona; Abd Aziz, Noor Azah; Mant, Jonathan

2018-01-01

To describe and explain stroke survivors and informal caregivers' experiences of primary care and community healthcare services. To offer potential solutions for how negative experiences could be addressed by healthcare services. Systematic review and meta-ethnography. Medline, CINAHL, Embase and PsycINFO databases (literature searched until May 2015, published studies ranged from 1996 to 2015). Primary qualitative studies focused on adult community-dwelling stroke survivors' and/or informal caregivers' experiences of primary care and/or community healthcare services. A set of common second order constructs (original authors' interpretations of participants' experiences) were identified across the studies and used to develop a novel integrative account of the data (third order constructs). Study quality was assessed using the Critical Appraisal Skills Programme checklist. Relevance was assessed using Dixon-Woods' criteria. 51 studies (including 168 stroke survivors and 328 caregivers) were synthesised. We developed three inter-dependent third order constructs: (1) marginalisation of stroke survivors and caregivers by healthcare services, (2) passivity versus proactivity in the relationship between health services and the patient/caregiver dyad, and (3) fluidity of stroke related needs for both patient and caregiver. Issues of continuity of care, limitations in access to services and inadequate information provision drove perceptions of marginalisation and passivity of services for both patients and caregivers. Fluidity was apparent through changing information needs and psychological adaptation to living with long-term consequences of stroke. Potential limitations of qualitative research such as limited generalisability and inability to provide firm answers are offset by the consistency of the findings across a range of countries and healthcare systems. Stroke survivors and caregivers feel abandoned because they have become marginalised by services and they do not have the knowledge or skills to re-engage. This can be addressed by: (1) increasing stroke specific health literacy by targeted and timely information provision, and (2) improving continuity of care between specialist and generalist services. PROSPERO 2015:CRD42015026602.

Chandler Public Library, Final Performance Report for Library Services and Construction Act (LSCA) Title VI, Library Literacy Program.

ERIC Educational Resources Information Center

Drake, Karen; Rodriguez, Leonard

This final performance report for the Chandler Public Library literacy project for fiscal year 1992 begins with a section that provides quantitative data. The next section compares actual accomplishments to the project goal--to improve the quality of life for illiterate, semiliterate, and non-English-speaking citizens by providing a comprehensive…

[Validity and reliability of the Culture of Quality Health Services questionnaire in Mexico].

PubMed

Herrera-Kiengelher, L; Zepeda-Zaragoza, J; Austria-Corrales, F; Vázquez-Zarate, V M

2013-01-01

Patient Safety is a major public health problem worldwide and is responsibility of all those involved in health care. Establishing a Safety Culture has proved to be a factor that favors the integration of work teams, communication and construction of clear procedures in various organizations. Promote a culture of safety depends on several factors, such as organization, work unit and staff. Objective assessment of these factors will help to identify areas for improvement and establish strategic lines of action. [corrected] To adapt, validate and calibrate the questionnaire Culture of Quality in Health Services (CQHS) in Mexican population. A cross with a stratified representative sample of 522 health workers. The questionnaire was translated and adapted from Singer's. Content was validated by experts, internal consistency, confirmatory factorial validity and item calibration with Samejima's Graded Response Model. Convergent and divergent construct validity was confirmed from the CQHS, item calibration showed that the questionnaire is able to discriminate between patients and represent different levels of the hypothesized dimensions with greater accuracy and lower standard error. The CQHS is a valid and reliable instrument to assess patient safety culture in hospitals in Mexico. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Value Assessment Study for Air quality in Regulation Services of Ecosystems Services target on NO2 using Remote sensing data

NASA Astrophysics Data System (ADS)

Jeon, S. W.; Ryu, J.; Choi, Y.; Jung, H. I.; Jang, R.; Lee, J.

2017-12-01

The purpose of this study is to evaluate the value of green space that regulates the air quality in the regulatory service classification of ecosystem services. In this study, statistical data and satellite images (GOME) were used to construct data and evaluate the control functions of the whole country. In order to evaluate the value, national economic activities are evaluated and typified based on national GDP. This is because the amount of No2 emissions and the damage caused by them are different depending on the speed and characteristics of national development. After that, regression models were made using land cover, change in urban green area ratio, NDVI (Normalised Difference Vegetation Index), increase or decrease in population, increase in urban area, altitude and slope, cardiovascular due to NO2 and respiratory population. After that, the value of green space was evaluated by applying the scenario of NO2 increase or decrease for each type. The value of green space was converted into economic value by increasing or decreasing the number of affected people and the damage amount when NO2 increased. The results of this study are expected to provide a basis for conservation of forests by assessing the value of greenery to control air quality globally.

Baseline data for evaluating development trajectory and provision of ecosystem services of created fringing oyster reefs in Vermilion Bay, Louisiana

USGS Publications Warehouse

La Peyre, Megan K.; Schwarting, Lindsay; Miller, Shea

2013-01-01

Understanding the time frame in which ecosystem services (that is, water quality maintenance, shoreline protection, habitat provision) are expected to be provided is important when restoration projects are being designed and implemented. Restoration of three-dimensional shell habitats in coastal Louisiana and elsewhere presents a valuable and potentially self-sustaining approach to providing shoreline protection, enhancing nekton habitat, and providing water quality maintenance. As with most restoration projects, the development of expected different ecosystem services often occurs over varying time frames, with some services provided immediately and others taking longer to develop. This project was designed initially to compare the provision and development of ecosystem services by created fringing shoreline reefs in subtidal and intertidal environments in Vermilion Bay, Louisiana. Specifically, the goal was to test the null hypothesis that over time, the oyster recruitment and development of a sustainable oyster reef community would be similar at both intertidal and subtidal reef bases, and these sustainable reefs would in time provide similar shoreline stabilization, nekton habitat, and water quality services over similar time frames. Because the ecosystem services hypothesized to be provided by oyster reefs reflect long-term processes, fully testing the above-stated null hypothesis requires a longer-time frame than this project allowed. As such, this project was designed to provide the initial data on reef development and provision of ecosystem services, to identify services that may develop immediately, and to provide baseline data to allow for longer-term follow up studies tracking reef development over time. Unfortunately, these initially created reef bases (subtidal, intertidal) were not constructed as planned because of the Deepwater Horizon oil spill in April 2010, which resulted in reef duplicates being created 6 months apart. Further confounding the project were additional construction and restoration projects along the same shorelines which occurred between 2011 and June 2012. Because of constant activity near and around the reefs and continuing construction, development trajectories could not be compared among reef types at this time. This report presents the data collected at the sites over 3 years (2010–2012), describing only conditions and trends. In addition, these data provide an extensive and detailed dataset documenting initial conditions and initial ecosystem changes which will prove valuable in future data collection and analyses of reef development at this site. Data collection characterized the local water quality conditions (salinity, temperature, total suspended sediments, dissolved oxygen, chlorophyll a), adjacent marsh vegetation, soils, and shoreline position along the project shoreline at Vermilion Bay. During the study, marsh vegetation and soil characteristics were similar across the study area and did not change over time. Shoreline movement indicated shoreline loss at all sites, which varied by reefs. Water quality conditions followed expected seasonal patterns for this region, and no significant nonseasonal changes were measured throughout the study period. Despite oyster recruitment in fall 2010 and 2011, few if any oysters survived from the 2010 year class to 2012. At the last sampling of this project, some oysters recruited in fall 2011 survived through 2012, resulting in an on-reef density of 18.3 ± 2.1 individuals per square meter (mean size: 85.6 ± 2.2 millimeters). Because project goals were to compare reef development and provision of ecosystem services over time, as well as many of the processes identified for monitoring reflect long-term processes, results and data are presented only qualitatively, and trends or observations should be interpreted cautiously at this point. Measurable system responses to reef establishment require more time than was available for this study. These data provide a valuable baseline that can be ultimately used to help inform site selections for future restoration projects as well to further investigate the development trajectories of ecosystem provision of created reefs in this region.

Cost effectiveness of a community-based crisis intervention program for people bereaved by suicide.

PubMed

Comans, Tracy; Visser, Victoria; Scuffham, Paul

2013-01-01

Postvention services aim to ameliorate distress and reduce future incidences of suicide. The StandBy Response Service is one such service operating in Australia for those bereaved through suicide. Few previous studies have reported estimates or evaluations of the economic impact and outcomes associated with the implementation of bereavement/grief interventions. To estimate the cost-effectiveness of a postvention service from a societal perspective. A Markov model was constructed to estimate the health outcomes, quality-adjusted life years, and associated costs such as medical costs and time off work. Data were obtained from a prospective cross-sectional study comparing previous clients of the StandBy service with a control group of people bereaved by suicide who had not had contact with StandBy. Costs and outcomes were measured at 1 year after suicide bereavement and an incremental cost-effectiveness ratio was calculated. The base case found that the StandBy service dominated usual care with a cost saving from providing the StandBy service of AUS $803 and an increase in quality-adjusted life years of 0.02. Probabilistic sensitivity analysis indicates there is an 81% chance the service would be cost-effective given a range of possible scenarios. Postvention services are a cost-effective strategy and may even be cost-saving if all costs to society from suicide are taken into account.

Creation of a synthetic indicator of quality of care as a clinical management standard in primary care.

PubMed

Coma, Ermengol; Ferran, Manel; Méndez, Leonardo; Iglesias, Begoña; Fina, Francesc; Medina, Manuel

2013-12-01

The development of electronic medical records has allowed the creation of new quality indicators in healthcare. Among them, synthetic indicators facilitate global interpretation of results and comparisons between professionals. A healthcare quality standard (EQA, the Catalan acronym for Estàndard de Qualitat Assistencial) was constructed to serve as a synthetic indicator to measure the quality of care provided by primary care professionals in Catalonia (Spain). The project phases were to establish the reference population; select health problems to be included; define, select and deliberate about subindicators; and construct and publish the EQA. Construction of the EQA involved 107 healthcare professionals, and 91 health problems were included. In addition, 133 experts were consulted, who proposed a total of 339 indicators. After systematic paired comparison, 61 indicators were selected to create the synthetic indicator. The EQA is now calculated on a monthly basis for more than 8000 healthcare professionals using an automated process that extracts data from electronic medical records; results are published on a follow-up website. Along with the use of the online EQA results tool, there has been an ongoing improvement in most of the quality of care indicators. Creation of the EQA has proven to be useful for the measurement of the quality of care of primary care services. Also an improvement trend over 5 years is shown across most of the measured indicators. The online version of this article (doi:10.1186/2193-1801-2-51) contains supplementary material, which is available to authorized users.

Solidarity-conflict and ambivalence: testing two conceptual frameworks and their impact on quality of life for older family members.

PubMed

Lowenstein, Ariela

2007-03-01

The purpose of this study was to test empirically two major conceptualizations of parent-child relations in later adulthood-intergenerational solidarity-conflict and ambivalence paradigms-and their predictive validity on elders' quality of life using comparative cross-national data. Data were from a sample of 2,064 elders (aged 75 and older) from the five-country OASIS study (Old Age and Autonomy: The Role of Service Systems and Intergenerational Family Solidarity; Norway, England, Germany, Spain, and Israel). Multivariate and block-recursive regression models estimated the predictivity of the two conceptualizations of family dynamics on quality of life controlling for country, personal characteristics, and activity of daily living functioning. Descriptive analyses indicated that family solidarity, especially the affective/cognitive component (called Solidarity A), was high in all five countries, whereas conflict and ambivalence were low. When I entered all three constructs into the regression Solidarity A, reciprocal intergenerational support and ambivalence predicted quality of life. Controlling for activity of daily living functioning, socioeconomics status, and country, intergenerational relations had only a weak explanatory power, and personal resources explained most of the variance. The data suggest that the three constructs exist simultaneously but in varying combinations, confirming that in cross-cultural contexts family cohesion predominates, albeit with low degrees of conflict and ambivalence. The solidarity construct evidenced relatively robust measurement. More work is required to enhance the ambivalence measurement.

Perceived service quality, perceived value, overall satisfaction and happiness of outlook for long-term care institution residents.

PubMed

Lin, Jesun; Hsiao, Chih-Tung; Glen, Robert; Pai, Jar-Yuan; Zeng, Sin-Huei

2014-06-01

To investigate the psychometric properties and relationships of perceived service quality, perceived value and overall satisfaction for residents with respect to their long-term care institutions. The five-point Likert scale questionnaire administered through facetoface interviews. Fourteen long-term care institutions located in central and southern Taiwan stratified according to services and accommodation population. One hundred and eighty long-term institutional care residents. Perceived service quality (the SERVPERF model), perceived value and overall satisfaction (models based on the literature on perceived value and satisfaction). Student's t-test on institutional location shows a significant difference between overall satisfaction for central and southern institution long-term care recipients. The correlation test revealed that the higher a resident's level of education, the higher the scores for perceived value. The factor loading results of confirmation factor analysis show acceptable levels of reliability and index-of-model fits for perceived service, perceived value and overall satisfaction. In addition, the results suggest that an additional construct, a positive attitude (happiness of outlook) towards long-term care institutions, is also an important factor in residents' overall satisfaction. The primary goal of long-term institutional care policy in Taiwan, as in other countries, is to provide residents with practical, cost-effective but high-quality care. On the basis of the results of in-depth interviews with long-term institutional care residents, this study suggests long-term care institutions arrange more family visit days to increase the accessibility and interaction of family and residents and thereby increase the happiness of outlook of the residents. © 2012 John Wiley & Sons Ltd.

Analysis on the security of cloud computing

NASA Astrophysics Data System (ADS)

He, Zhonglin; He, Yuhua

2011-02-01

Cloud computing is a new technology, which is the fusion of computer technology and Internet development. It will lead the revolution of IT and information field. However, in cloud computing data and application software is stored at large data centers, and the management of data and service is not completely trustable, resulting in safety problems, which is the difficult point to improve the quality of cloud service. This paper briefly introduces the concept of cloud computing. Considering the characteristics of cloud computing, it constructs the security architecture of cloud computing. At the same time, with an eye toward the security threats cloud computing faces, several corresponding strategies are provided from the aspect of cloud computing users and service providers.

Relevance of spirituality for people with mental illness attending consumer-centered services.

PubMed

Bellamy, Chyrell D; Jarrett, Nicole C; Mowbray, Orion; MacFarlane, Peter; Mowbray, Carol T; Holter, Mark C

2007-01-01

Spirituality has been cited in the literature as having a positive effect on mental health outcomes. This paper explores the relationship of spirituality to demographic, psychiatric illness history and psychological constructs for people with mental illness (N=1835) involved in consumer-centered services (CCS-Clubhouses and Consumer run drop-in centers). Descriptive statistics indicate that spirituality is important for at least two thirds of the members in the study. Members primarily indicated participation in public spiritual activities (i.e., church, bible study groups), followed by private activities (prayer, reading the bible, and meditation) (both of which were centered on belief in the transcendent). A logistic regression analysis was done to explore variables related to spirituality (i.e., demographics, psychiatric illness history, and psychological constructs). Results suggest that age, gender, having psychotic symptoms, having depressive symptoms, and having a higher global quality of life, hope and sense of community were all significant correlates of spirituality.

Constructing a strategic, national resource: European policies and the up-scaling of water services in the Algarve, Portugal.

PubMed

Thiel, Andreas

2010-07-01

Water management has been significantly reshaped throughout recent decades in Europe and worldwide. Vivid examples of this restructuring include Southern European coastal zones which have been transformed into the European "pleasure periphery" over the last 40 years, requiring significant changes in water service provision. Taking it as an illustrative case of the Southern European coastal freshwater crisis and the way different European Member States have dealt with it, the article provides an account of the Algarve, indicative of typical Portuguese dynamics, and compares it with developments in other European countries. Expanding demands on water services in this region led to a crisis situation throughout the nineties, which was resolved by shifting physical infrastructures and competencies to the supra-local level. The re-scaling of water management was instrumental to expanding national control over the sector at the expense of local authorities and privatization. The national level used European funds and regulations to re-configure the institutional and infrastructure set-up in order to provide for tourism and agricultural expansion. Quality tourism was constructed as a decentral, hegemonic state spatial project, with the Algarvian's entire water resource base being put at its disposal. The solution found illustrates a modified version of the supply side and surface water oriented "hydraulic paradigm" in Portugal: geared towards tourism and urban areas and the maintenance of irrigation agriculture. Delays in infrastructures, ideological preferences, maintaining national control over strategic water services and territoriality contributed towards the construction of water services as part of this hegemonic state spatial strategy for tourism expansion.

Constructing a Strategic, National Resource: European Policies and the Up-Scaling of Water Services in the Algarve, Portugal

NASA Astrophysics Data System (ADS)

Thiel, Andreas

2010-07-01

Water management has been significantly reshaped throughout recent decades in Europe and worldwide. Vivid examples of this restructuring include Southern European coastal zones which have been transformed into the European “pleasure periphery” over the last 40 years, requiring significant changes in water service provision. Taking it as an illustrative case of the Southern European coastal freshwater crisis and the way different European Member States have dealt with it, the article provides an account of the Algarve, indicative of typical Portuguese dynamics, and compares it with developments in other European countries. Expanding demands on water services in this region led to a crisis situation throughout the nineties, which was resolved by shifting physical infrastructures and competencies to the supra-local level. The re-scaling of water management was instrumental to expanding national control over the sector at the expense of local authorities and privatization. The national level used European funds and regulations to re-configure the institutional and infrastructure set-up in order to provide for tourism and agricultural expansion. Quality tourism was constructed as a decentral, hegemonic state spatial project, with the Algarvian’s entire water resource base being put at its disposal. The solution found illustrates a modified version of the supply side and surface water oriented “hydraulic paradigm” in Portugal: geared towards tourism and urban areas and the maintenance of irrigation agriculture. Delays in infrastructures, ideological preferences, maintaining national control over strategic water services and territoriality contributed towards the construction of water services as part of this hegemonic state spatial strategy for tourism expansion.

Construction of Traceability System for Quality Safety of Cereal and Oil Products

NASA Astrophysics Data System (ADS)

Zheng, Huoguo; Liu, Shihong; Meng, Hong; Hu, Haiyan

After several significant food safety incident, global food industry and governments in many countries are putting increasing emphasis on establishment of food traceability systems. Food traceability has become an effective way in food quality and safety management. The traceability system for quality safety of cereal and oil products was designed and implemented with HACCP and FMECA method, encoding, information processing, and hardware R&D technology etc, according to the whole supply chain of cereal and oil products. Results indicated that the system provide not only the management in origin, processing, circulating and consuming for enterprise, but also tracing service for customers and supervisor by means of telephone, internet, SMS, touch machine and mobile terminal.

The impact of complaint management and service quality on organizational image: A case study at the Malaysian public university library

NASA Astrophysics Data System (ADS)

Tan, Pei Kian; Mohd Suradi, Nur Riza; Saludin, Mohamad Nasir

2013-04-01

Service failure frequently occurs. This affects customer expectations which lead to complaint. However, not all dissatisfied customers actually complain. Without customer feedback, it would be impossible for a company to know whether they needed a change for improvement. Thus, complaint management brings a learning experience to organization in order to provide better service. Therefore, it is important to identify customer dissatisfaction through a systematic complaint handling or management. The study proposes a model of systematic complaint management which applied to academic library as a tool of service recovery. As such, the main purpose of this study is to investigate the critical success factors of complaint management towards service quality, customer satisfaction, customer loyalty and the impact to organizational image at academic library. Three academic libraries have been identified and selected for this project, the Library of Tun Sri Lanang, UKM, UTeM and UNIMAS. Using the justice theory, this study investigates the perception of customers on complaint management in terms of outcomes they receive, procedures used by organization and interpersonal treatment. In this study, there are five factors of complaint management identified, which includes speed of recovery, management system, empowerment, culture and psychology and tangible compensation. A questionnaire was designed and used as the data gathering instrument. A total of 600 respondents participated in this study. Ten hypotheses were used to test the relationships between complaint management, service quality, customer satisfaction, customer loyalty and organizational image. To measure the construct relationships, Structural Equation Model (SEM) approach was used. The results show that management system (b = 0.210; p < 0.05) exerts the highest positive impact on service quality. It followed by psychology and culture (b = 0.188; p < 0.05), empowerment (b = 0.179; p < 0.05) and tangible compensation (b = 0.175; p < 0.05). However, the empirical results suggest that speed of recovery (b = -0.009; p > 0.05) do not influence service quality. The second part of this study uses confirmatory factor analysis (CFA) to analyze and confirm the conceptual model proposed in this research. The result shows that all the values obtained in this study fits the data reasonably well.

Quality of water and time of travel in part of Tillatoba Creek basin, Mississippi, October 1974 to September 1980

USGS Publications Warehouse

Bednar, Gene A.

1981-01-01

A 6-year quality-of-water and time-of-travel study was conducted during the construction phase of a flood-water protection and flood prevention project in a 118 square mile area of Tillatoba Creek basin in northwest Mississippi. Weekly suspended sediment, daily discharge, time of travel, nutrient, biochemical oxygen demand, bacteria and field data were collected. The study was conducted by the U.S. Geological Survey in cooperation with the U.S. Soil Conservation Service. The results of the study are presented in graphs and tables without interpretation. (USGS)

Study of Collaborative Management for Transportation Construction Project Based on BIM Technology

NASA Astrophysics Data System (ADS)

Jianhua, Liu; Genchuan, Luo; Daiquan, Liu; Wenlei, Li; Bowen, Feng

2018-03-01

Abstract. Building Information Modeling(BIM) is a building modeling technology based on the relevant information data of the construction project. It is an advanced technology and management concept, which is widely used in the whole life cycle process of planning, design, construction and operation. Based on BIM technology, transportation construction project collaborative management can have better communication through authenticity simulation and architectural visualization and can obtain the basic and real-time information such as project schedule, engineering quality, cost and environmental impact etc. The main services of highway construction management are integrated on the unified BIM platform for collaborative management to realize information intercommunication and exchange, to change the isolated situation of information in the past, and improve the level of information management. The final BIM model is integrated not only for the information management of project and the integration of preliminary documents and design drawings, but also for the automatic generation of completion data and final accounts, which covers the whole life cycle of traffic construction projects and lays a good foundation for smart highway construction.

Environment construction and bottleneck breakthrough in the improvement of wisdom exhibition

NASA Astrophysics Data System (ADS)

Zhang, Jiankang

2017-08-01

Wisdom exhibition is an inexorable trend in convention and exhibition industry in China. Information technology must be utilized by exhibition industry to achieve intelligent application and wisdom management, breaking the limitation of time as well as space, which raise the quality of exhibition service and level of operation to a totally new standard. Accordingly, exhibition industry should optimize mobile internet, a fundamental technology platform, during the advancing process of wisdom exhibition and consummate the combination among three plates including wisdom connection of information, wisdom exhibition environment and wisdom application of technology. Besides, the industry should realize the wisdom of external environment including wisdom of exhibition city, exhibition place, exhibition resource deal etc and break through bottle-neck in construction of wisdom exhibition industry, which includes construction of big data center, development of Mobile Internet application platform, promotion of information construction, innovative design of application scenarios.

Case study of restaurant successfully designed, constructed, and operated for excellent dining acoustics

NASA Astrophysics Data System (ADS)

Bollard, Paul; Des Jardins, Stephen

2005-09-01

Prior to the construction of La Provence Restaurant in Roseville, California in 2004, the owner, Stephen Des Jardins, traveled with his cook, architect, and engineer to the Provence Region of France to study the cuisine, architecture, and acoustics of the local restaurants. This information was incorporated into the design, construction, and operation of his restaurant, with acoustical design assistance provided by the author, Paul Bollard. The result of the owner's painstaking attention to detail is a restaurant which has received very positive reviews for its architecture, quality of food, service, and acoustic ambience. This paper documents the measures included in the construction of the restaurant to ensure that the building acoustics enhance the dining experience, rather than detract from it. Photographs of acoustic treatments are included, as are reverberation time (RT60) test results and ambient noise level measurement results.

[Status of traditional Chinese medicine materials seed and seedling breeding bases].

PubMed

Li, Ying; Huang, Lu-Qi; Zhang, Xiao-Bo; Wang, Hui; Cheng, Meng; Zhang, Tian; Yang, Guang

2017-11-01

Seeds and seedlings are the material basis of traditional Chinese medicine materials production, and the construction of traditional Chinese medicine materials seed and seedling breeding bases is beneficial to the production of high-quality traditional Chinese medicine materials. The construction of traditional Chinese medicine materials seed and seedling breeding bases is one of the major topics of Chinese medica resources census pilot. Targets, tasks of traditional Chinese medicine materials seed and seedling breeding bases based on Chinese medica resources census pilot were expounded.Construction progress including hardware construction, germplasm conservation and breeding, procedures and standardsestablishment, social servicesare presented. Development counter measures were proposed for the next step: perfect the standard and system, maintain and strengthen the breeding function, strengthen the cultivation of multi-level talents, explore market development model, joint efforts to deepen services and development. Copyright© by the Chinese Pharmaceutical Association.

Evaluating knowledge transfer practices among construction organization in Malaysia

NASA Astrophysics Data System (ADS)

Zaidi, Mohd Azian; Baharuddin, Mohd Nurfaisal; Bahardin, Nur Fadhilah; Yasin, Mohd Fadzil Mat; Nawi, Mohd Nasrun Mohd; Deraman, Rafikullah

2016-08-01

The aims of this paper is to identify a key dimension of knowledge transfer component to improve construction organization performance. It investigates the effectiveness of present knowledge transfer practices currently adopted by the Malaysian construction organizations and examines the relationship between knowledge transfer factors and organizational factors. A survey among 151 respondents including a different contractor registration grade was employed for the study. The survey shows that a seven-teen (17) factors known as creating shared awareness for information sharing, communication, personal skills,individual attitude,training, organizational culture, information technology,motivation, monitoring and supervision, service quality,information accessibility, information supply, socialization process,knowledge tools, coaching and monitoring, staff briefing and information sharing were identify as a key dimension for knowledge transfer success. This finding suggest that through improvement of each factor, the recognition of the whole strategic knowledge transfer process can be increase thus helping to strengthen the Malaysian construction organization for competitive advantages.

Using concept mapping to design an indicator framework for addiction treatment centres.

PubMed

Nabitz, Udo; van Den Brink, Wim; Jansen, Paul

2005-06-01

The objective of this study is to determine an indicator framework for addiction treatment centres based on the demands of stakeholders and in alignment with the European Foundation for Quality Management (EFQM) Excellence Model. The setting is the Jellinek Centre based in Amsterdam, the Netherlands, which serves as a prototype for an addiction treatment centre. Concept mapping was used in the construction of the indicator framework. During the 1-day workshop, 16 stakeholders generated, prioritized and sorted 73 items concerning quality and performance. Multidimensional scaling and cluster analysis was applied in constructing a framework consisting of two dimensions and eight clusters. The horizontal axis of the indicator framework is named 'Organization' and has two poles, namely, 'Processes' and 'Results'. The vertical axis is named ' Task' and the poles are named 'Efficient treatment' and 'Prevention programs'. The eight clusters in the two-dimensional framework are arranged in the following, prioritized sequence: 'Efficient treatment network', 'Effective service', ' Target group', 'Quality of life', 'Efficient service', 'Knowledge transfer', 'Reducing addiction related problems', and 'Prevention programs'. The most important items in the framework are: 'patients are satisfied with their treatment', 'early interventions', and 'efficient treatment chain'. The indicator framework aligns with three clusters of the results criteria of the EFQM Excellence Model. It is based on the stakeholders' perspectives and is believed to be specific for addiction treatment centres. The study demonstrates that concept mapping is a suitable strategy for generating indicator frameworks.

An Item Bank to Measure Systems, Services, and Policies: Environmental Factors Affecting People With Disabilities.

PubMed

Lai, Jin-Shei; Hammel, Joy; Jerousek, Sara; Goldsmith, Arielle; Miskovic, Ana; Baum, Carolyn; Wong, Alex W; Dashner, Jessica; Heinemann, Allen W

2016-12-01

To develop a measure of perceived systems, services, and policies facilitators (see Chapter 5 of the International Classification of Functioning, Disability and Health) for people with neurologic disabilities and to evaluate the effect of perceived systems, services, and policies facilitators on health-related quality of life. Qualitative approaches to develop and refine items. Confirmatory factor analysis including 1-factor confirmatory factor analysis and bifactor analysis to evaluate unidimensionality of items. Rasch analysis to identify misfitting items. Correlational and analysis of variance methods to evaluate construct validity. Community-dwelling individuals participated in telephone interviews or traveled to the academic medical centers where this research took place. Participants (N=571) had a diagnosis of spinal cord injury, stroke, or traumatic brain injury. They were 18 years or older and English speaking. Not applicable. An item bank to evaluate environmental access and support levels of services, systems, and policies for people with disabilities. We identified a general factor defined as "access and support levels of the services, systems, and policies at the level of community living" and 3 local factors defined as "health services," "community living," and "community resources." The systems, services, and policies measure correlated moderately with participation measures: Community Participation Indicators (CPI) - Involvement, CPI - Control over Participation, Quality of Life in Neurological Disorders - Ability to Participate, Quality of Life in Neurological Disorders - Satisfaction with Role Participation, Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate, PROMIS Satisfaction with Role Participation, and PROMIS Isolation. The measure of systems, services, and policies facilitators contains items pertaining to health services, community living, and community resources. Investigators and clinicians can measure perceptions of systems, services, and policies resources reliably with the items described here. Moderate relations between systems, services, and policies facilitators and PROMIS and CPI variables provide support for the measurement and theory of environmental effects on social functioning related to participation. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Modeling work of the dispatching service of high-rise building as queuing system

NASA Astrophysics Data System (ADS)

Dement'eva, Marina; Dement'eva, Anastasiya

2018-03-01

The article presents the results of calculating the performance indicators of the dispatcher service of a high-rise building as a queuing system with an unlimited queue. The calculation was carried out for three models: with a single control room and brigade of service, with a single control room and a specialized service, with several dispatch centers and specialized services. The aim of the work was to investigate the influence of the structural scheme of the organization of the dispatcher service of a high-rise building on the amount of operating costs and the time of processing and fulfilling applications. The problems of high-rise construction and their impact on the complication of exploitation are analyzed. The composition of exploitation activities of high-rise buildings is analyzed. The relevance of the study is justified by the need to review the role of dispatch services in the structure of management of the quality of buildings. Dispatching service from the lower level of management of individual engineering systems becomes the main link in the centralized automated management of the exploitation of high-rise buildings. With the transition to market relations, the criterion of profitability at the organization of the dispatching service becomes one of the main parameters of the effectiveness of its work. A mathematical model for assessing the efficiency of the dispatching service on a set of quality of service indicators is proposed. The structure of operating costs is presented. The algorithm of decision-making is given when choosing the optimal structural scheme of the dispatching service of a high-rise building.

PERFORMANCE-BASED CONTRACTING IN CONSTRUCTION PHASE AND MAINTENANCE PHASE OF PAVEMENT

NASA Astrophysics Data System (ADS)

Yoshida, Takeshi

Performance-based contracting for pavement in Japan started as performance warranties in construction phase, in 1999. Recently, road agencies have recognized the applicability of this type of contracting in outsourcing of maintenance activities. The objectives of this study are to clarify the issues of performance specifying in construction phase and maintenance phase of pavement, and to propose measures to be taken. This paper, with the recognition that the life of each pavement depends on performance standards for various attributes, reviews domestic and foreign examples of performance-based contracting. A performance standard based on the average of current practices can enhance product quality and service life with a warranty contract. Repair thresholds and response time for each deficiency should be considered as performance standards in maintenance phase.

Lives of quality in the face of challenge in Israel.

PubMed

Neikrug, S; Roth, D; Judes, J

2011-12-01

The purpose of this study is to describe and analyse the quality of life of Israeli families raising a child with a disability while challenged with all the usual demands of family life. Respondents were main caregivers of 103 children with disability receiving services at Beit Issie Shapiro, a service agency in Israel. The respondents completed the Family Quality of Life Survey-2006 which operationalises family quality of life (FQOL) as a construct in nine domains of family life. The findings show an underlying pattern within the domains that define FQOL. In general, the findings indicate that the families are strongly challenged to meet the needs of a special child and raise a family meeting the needs of all its members. The respondents report that, within the limits of available opportunities, they had achieved well and they are satisfied with their attainment. In general, our findings seem to reflect in our respondents a sense of resilience and an ability to manage family challenges to achieve a reasonably high FQOL. Domains described as internal to the family were rated highly in terms of FQOL as compared to domains external to the family. The Family Quality of Life Survey-2006 was found to be a valuable tool for identifying and evaluating factors that enhance FQOL. Further research is needed to develop application models for integrating this instrument into the agency's service and evaluation repertoire. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

Perceived service quality, perceived value, overall satisfaction and happiness of outlook for long‐term care institution residents

PubMed Central

Lin, Jesun; Hsiao, Chih‐Tung; Glen, Robert; Pai, Jar‐Yuan; Zeng, Sin‐Huei

2012-01-01

Abstract Objective  To investigate the psychometric properties and relationships of perceived service quality, perceived value and overall satisfaction for residents with respect to their long‐term care institutions. Design  The five‐point Likert scale questionnaire administered through facetoface interviews. Setting  Fourteen long‐term care institutions located in central and southern Taiwan stratified according to services and accommodation population. Participants  One hundred and eighty long‐term institutional care residents. Main outcome measures  Perceived service quality (the SERVPERF model), perceived value and overall satisfaction (models based on the literature on perceived value and satisfaction). Results  Student’s t‐test on institutional location shows a significant difference between overall satisfaction for central and southern institution long‐term care recipients. The correlation test revealed that the higher a resident’s level of education, the higher the scores for perceived value. The factor loading results of confirmation factor analysis show acceptable levels of reliability and index‐of‐model fits for perceived service, perceived value and overall satisfaction. In addition, the results suggest that an additional construct, a positive attitude (happiness of outlook) towards long‐term care institutions, is also an important factor in residents’ overall satisfaction. Conclusion  The primary goal of long‐term institutional care policy in Taiwan, as in other countries, is to provide residents with practical, cost‐effective but high‐quality care. On the basis of the results of in‐depth interviews with long‐term institutional care residents, this study suggests long‐term care institutions arrange more family visit days to increase the accessibility and interaction of family and residents and thereby increase the happiness of outlook of the residents. PMID:22429448

A three-model comparison of the relationship between quality, satisfaction and loyalty: an empirical study of the Chinese healthcare system.

PubMed

Lei, Ping; Jolibert, Alain

2012-11-30

Previous research has addressed the relationship between customer satisfaction, perceived quality and customer loyalty intentions in consumer markets. In this study, we test and compare three theoretical models of the quality-satisfaction-loyalty relationship in the Chinese healthcare system. This research focuses on hospital patients as participants in the process of healthcare procurement. Empirical data were obtained from six Chinese public hospitals in Shanghai. A total of 630 questionnaires were collected in two studies. Study 1 tested the research instruments, and Study 2 tested the three models. Confirmatory factor analysis was used to assess the scales' construct validity by testing convergent and discriminant validity. A structural equation model (SEM) specified the distinctions between each construct. A comparison of the three theoretical models was conducted via AMOS analysis. The results of the SEM demonstrate that quality and satisfaction are distinct concepts and that the first model (satisfaction mediates quality and loyalty) is the most appropriate one in the context of the Chinese healthcare environment. In this study, we test and compare three theoretical models of the quality-satisfaction-loyalty relationship in the Chinese healthcare system. Findings show that perceived quality improvement does not lead directly to customer loyalty. The strategy of using quality improvement to maintain patient loyalty depends on the level of patient satisfaction. This implies that the measurement of patient experiences should include topics of importance for patients' satisfaction with health care services.

Building Specifications

NASA Technical Reports Server (NTRS)

1978-01-01

The building in the top photo is the new home of the National Permanent Savings Bank in Washington, D.C., designed by Hartman-Cox Architects. Its construction was based on a money-saving method of preparing building specifications which derived from NASA technology developed to obtain quality construction while holding down cost of launch facilities, test centers and other structures. Written technical specifications spell out materials and components to be used on construction projects and identify the quality tests each item must pass. Specifications can have major impact on construction costs. Poorly formulated specifications can lead to unacceptable construction which must be replaced, unnecessarily high materials costs, safety hazards, disputes and often additional costs due to delays and litigation. NASA's Langley Research Center developed a novel approach to providing accurate, uniform, cost-effective specifications which can be readily updated to incorporate new building technologies. Called SPECSINTACT, it is a computerized - system accessible to all NASA centers involved in construction programs. The system contains a comprehensive catalog of master specifications applicable to many types of construction. It enables designers of any structure to call out relevant sections from computer storage and modify them to fit the needs of the project at hand. Architects and engineers can save time by concentrating their efforts on needed modifications rather than developing all specifications from scratch. Successful use of SPECSINTACT has led to a number of spinoff systems. One of the first was MASTERSPEC, developed from NASA's experience by Production Systems for Architects and Engineers, Inc., an organization established by the American Institute of Architects. MASTERSPEC, used in construction of the bank building pictured, follows the same basic format as SPECSINTACT and can be used in either automated or manual modes. The striking appearance of the bank building shows that, while MASTERSPEC saves time and money, its use involves no sacrfice in architectural design freedom. The Naval Engineering Facilities Command employs an automated specifications system based on SPECSINTACT. The Public Buildings Service of the General Services Administration used SPECSINTACT as a starting point in a plan to make its guideline specifications available to architects and engineers on a nationwide computer network. Public Technology, Inc., a NASA Technology Application Team, is working with Production Systems for Architects and Engineers, Inc., to promote widespread use of the system by state and local governments for cost benefits to taxpayers.

25 CFR 900.118 - Do these “construction contract” regulations apply to construction management services?

Code of Federal Regulations, 2013 CFR

2013-04-01

... management services, these services shall be limited to: (1) Coordination and exchange of information between... construction management services? 900.118 Section 900.118 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN...

25 CFR 900.118 - Do these “construction contract” regulations apply to construction management services?

Code of Federal Regulations, 2010 CFR

2010-04-01

... management services, these services shall be limited to: (1) Coordination and exchange of information between... construction management services? 900.118 Section 900.118 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN...

25 CFR 900.118 - Do these “construction contract” regulations apply to construction management services?

Code of Federal Regulations, 2012 CFR

2012-04-01

... management services, these services shall be limited to: (1) Coordination and exchange of information between... construction management services? 900.118 Section 900.118 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN...

25 CFR 900.118 - Do these “construction contract” regulations apply to construction management services?

Code of Federal Regulations, 2011 CFR

2011-04-01

... management services, these services shall be limited to: (1) Coordination and exchange of information between... construction management services? 900.118 Section 900.118 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN...

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.

Guidelines for establishing and maintaining construction quality databases : tech brief.

DOT National Transportation Integrated Search

2006-12-01

Construction quality databases contain a variety of construction-related data that characterize the quality of materials and workmanship. The primary purpose of construction quality databases is to help State highway agencies (SHAs) assess the qualit...

47 CFR 22.511 - Construction period for the Paging and Radiotelephone Service.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Construction period for the Paging and Radiotelephone Service. 22.511 Section 22.511 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Paging and Radiotelephone Service § 22.511 Construction...

47 CFR 22.511 - Construction period for the Paging and Radiotelephone Service.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Construction period for the Paging and Radiotelephone Service. 22.511 Section 22.511 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Paging and Radiotelephone Service § 22.511 Construction...

47 CFR 22.511 - Construction period for the Paging and Radiotelephone Service.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Construction period for the Paging and Radiotelephone Service. 22.511 Section 22.511 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Paging and Radiotelephone Service § 22.511 Construction...

47 CFR 22.511 - Construction period for the Paging and Radiotelephone Service.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Construction period for the Paging and Radiotelephone Service. 22.511 Section 22.511 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Paging and Radiotelephone Service § 22.511 Construction...

Developing a measure of mental health service satisfaction for use in low income countries: a mixed methods study.

PubMed

Mayston, Rosie; Habtamu, Kassahun; Medhin, Girmay; Alem, Atalay; Fekadu, Abebaw; Habtamu, Alehegn; Prince, Martin; Hanlon, Charlotte

2017-03-09

Service satisfaction is integral to quality of care and measures are therefore considered important indicators of quality. Patient's responses to their experiences of using services are under-researched in the context of mental healthcare in low income countries. Our aim was to use mixed methods to develop a new measure of satisfaction for use among consumers of the new models of mental healthcare which are currently being scaled-up. We used qualitative methods to explore the concept of service satisfaction. On the basis of these findings, we developed a new 'Mental health service satisfaction scale' (MHSSS v0.0) by adapting existing measures of service satisfaction. We evaluated psychometric properties of the new measure, among a sample of service users with severe mental disorder (SMD) (n = 200) and caregivers (n = 200). Following expert review, a modified version of the measure was developed (MHSSS v1.0) and psychometric properties were examined with data from a second independent sample (n = 150 service users with SMD and n = 150 caregivers). Factors identified in analysis of the first quantitative sample coincide with core concepts of service satisfaction as reported in the literature and were reflected in the key themes which emerged from our qualitative study: interpersonal factors, efficacy, communication, technical competency and adequacy of facilities. There was generally consensus among caregivers and service users regarding dimensions of satisfaction. However there was evidence of some differences in prioritization. Revisions made to version 0.0 of the Mental Health Service Satisfaction Scale (MHSSS) led to an improved instrument, with excellent internal consistency, convergent validity and factor loadings indicative of a uni-dimensional construct. Our findings suggest that conceptions of service satisfaction among people accessing a service for SMD are broadly similar with those established in the literature. Our findings indicate that the MHSSS might be a useful candidate for inclusion in the new toolkit of measures needed to facilitate monitoring of service satisfaction which will be crucial to quality improvement.

22 CFR 228.17 - Special procurement rules for construction and engineering services.

Code of Federal Regulations, 2012 CFR

2012-04-01

... engineering services. 228.17 Section 228.17 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES FOR... construction and engineering services. Advanced developing countries, as defined in § 228.01, which USAID has... engineering services are not eligible to furnish USAID-financed construction and engineering services unless...

22 CFR 228.17 - Special procurement rules for construction and engineering services.

Code of Federal Regulations, 2013 CFR

2013-04-01

... engineering services. 228.17 Section 228.17 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES FOR... construction and engineering services. Advanced developing countries, as defined in § 228.01, which USAID has... engineering services are not eligible to furnish USAID-financed construction and engineering services unless...

22 CFR 228.17 - Special procurement rules for construction and engineering services.

Code of Federal Regulations, 2014 CFR

2014-04-01

... engineering services. 228.17 Section 228.17 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES FOR... construction and engineering services. Advanced developing countries, as defined in § 228.01, which USAID has... engineering services are not eligible to furnish USAID-financed construction and engineering services unless...

47 CFR 22.1035 - Construction period.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Construction period. 22.1035 Section 22.1035 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Offshore Radiotelephone Service § 22.1035 Construction period. The construction period (see § 22.142) for...

47 CFR 22.1035 - Construction period.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Construction period. 22.1035 Section 22.1035 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Offshore Radiotelephone Service § 22.1035 Construction period. The construction period (see § 22.142) for...

47 CFR 22.1035 - Construction period.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Construction period. 22.1035 Section 22.1035 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Offshore Radiotelephone Service § 22.1035 Construction period. The construction period (see § 22.142) for...

47 CFR 22.1035 - Construction period.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Construction period. 22.1035 Section 22.1035 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Offshore Radiotelephone Service § 22.1035 Construction period. The construction period (see § 22.142) for...

47 CFR 22.1035 - Construction period.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Construction period. 22.1035 Section 22.1035 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Offshore Radiotelephone Service § 22.1035 Construction period. The construction period (see § 22.142) for...

Factors and values of willingness to pay for improved construction waste management--a perspective of Malaysian contractors.

PubMed

Begum, Rawshan Ara; Siwar, Chamhuri; Pereira, Joy Jacqueline; Jaafar, Abdul Hamid

2007-01-01

Malaysia is facing an increase in the generation of waste and of accompanying problems with the disposal of this waste. In the last two decades, extensive building and infrastructure development projects have led to an increase in the generation of construction waste material. The construction industry has a substantial impact on the environment, and its environmental effects are in direct relation to the quality and quantity of the waste it generates. This paper discusses general characteristics of the construction contractors, the contractors' willingness to pay (WTP) for improved construction waste management, determining factors which affect the amount of their willingness to pay, and suggestions and policy implications in the perspective of construction waste management in Malaysia. The data in this study is based on contractors registered with the construction industry development board (CIDB) of Malaysia. Employing the open ended contingent valuation method, the study assessed the contractors' average maximum WTP for improved construction waste management to be RM69.88 (1US$=3.6 RM) per tonne of waste. The result shows that the average maximum WTP is higher for large contractors than for medium and small contractors. The highest average maximum WTP value is RM88.00 for Group A (large contractors) RM78.25 for Group B (medium-size contractors) and RM55.80 for Group C (small contractors). One of the contributions of this study is to highlight the difference of CIDB registration grade in the WTP for improved construction waste management. It is found that contractors' WTP for improved waste collection and disposal services increases with the increase in contractors' current paid up capital. The identified factors and determinants of the WTP will assist the formulation of appropriate policies in addressing the construction waste problem in Malaysia and indirectly improve the quality of construction in the country.

Next-generation services for e-traceability to ionizing radiation national standards

NASA Astrophysics Data System (ADS)

Desrosiers, Marc F.; Klemick, Mark; Puhl, James M.; Uchida, David; Mallis, Steven

2004-09-01

An Internet-based system for fast, remote certification of high-dose radiation sources against the US national standard is being constructed at the National Institute of Standards and Technology (NIST). The new service will establish traceability (through transfer dosimetry) in real time at a lower cost by using automated routines and the Internet. A prototype of this service was successfully demonstrated in 2000 at the American Society for Testing and Materials (ASTM) Dosimetry Workshop in San Diego. Despite this impressive accomplishment, new developments demanded that several aspects of the service be modified. The new service has been completely redesigned to address these new demands and ensure greater accessibility. A description of the hardware and software configurations of this service as well as the communication and information management aspects will be presented. The Internet-based transfer certification program will provide industry with 24-h, 7-day-per-week, on-demand certifications, immediate turnaround times, and lower cost, ultimately improving the quality of the manufacturing process.

The Mental Health Recovery Measure Can Be Used to Assess Aspects of Both Customer-Based and Service-Based Recovery in the Context of Severe Mental Illness.

PubMed

Oliveira-Maia, Albino J; Mendonça, Carina; Pessoa, Maria J; Camacho, Marta; Gago, Joaquim

2016-01-01

Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective well-being in patients suffering from SMI.

The Mental Health Recovery Measure Can Be Used to Assess Aspects of Both Customer-Based and Service-Based Recovery in the Context of Severe Mental Illness

PubMed Central

Oliveira-Maia, Albino J.; Mendonça, Carina; Pessoa, Maria J.; Camacho, Marta; Gago, Joaquim

2016-01-01

Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective well-being in patients suffering from SMI. PMID:27857698

The right place? Users and professionals' constructions of the place's influence on personal recovery in community mental health services.

PubMed

Femdal, Ingrid

2018-01-01

Current mental health policy emphasizes the importance of community-based service delivery for people with mental health problems to encompass personal recovery. The aim of this study is to explore how users and professionals construct the place's influence on personal recovery in community mental health services. This is a qualitative, interpretive study based on ten individual, semi-structured interviews with users and professionals, respectively. A discourse analysis inspired by the work of Foucault was used to analyze the interviews. The findings show how place can be constructed as a potential for and as a barrier against recovery. Constructions of the aim of the services matter when choosing a place for the services. Further, constructions of user-professional relationships and flexibility are important in the constructions of an appropriate place for the services. The aim of the service, the user-professional relationship, and flexibility in choosing place were essential in the participants' constructions. To find "the right place" for mental health services was constructed as context-sensitive and complex processes of assessment and co-determination. Trial registration The study is approved by the Regional Committee for Medical Research Ethics, Norway (REK-Midt 2011/2057).

Staff Turnover in Assertive Community Treatment (Act) Teams: The Role of Team Climate.

PubMed

Zhu, Xi; Wholey, Douglas R; Cain, Cindy; Natafgi, Nabil

2017-03-01

Staff turnover in Assertive Community Treatment (ACT) teams can result in interrupted services and diminished support for clients. This paper examines the effect of team climate, defined as team members' shared perceptions of their work environment, on turnover and individual outcomes that mediate the climate-turnover relationship. We focus on two climate dimensions: safety and quality climate and constructive conflict climate. Using survey data collected from 26 ACT teams, our analyses highlight the importance of safety and quality climate in reducing turnover, and job satisfaction as the main mediator linking team climate to turnover. The findings offer practical implications for team management.

Solar Air Heating Metal Roofing for Reroofing, New Construction, and Retrofit

DTIC Science & Technology

2013-05-20

roof is installed starting the cycle over again. In contrast, metal roofing has a nominal service life of 40 years, can be recycled when removed and...energy, recycled content, innovation, air quality and other elements. American Solar intends to target trade publications, websites, and speaking...insulation with cloth jacket covered the bottom of the metal deck. The schematic Figure A-2, 3, shows the system as proposed at the

Construction and Operation of the West Coast OTH-B Radar System

DTIC Science & Technology

1983-11-07

that the RFR energy is absorbed by the organism as widely distributed heat that increases the whole-body temperature, or as inter- nally localized heat...Air pollutant emissions would be increased by substantLl percentages, but significant degradation of air quality is not likely. Noise may be a...would be offset somewhat by increased civilian employment opportunities. The facilities and services in the cities and towns where 0TH-B employees are

Challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries: a systematic review and thematic synthesis of qualitative research

PubMed Central

Robertshaw, Luke; Dhesi, Surindar

2017-01-01

Objectives To thematically synthesise primary qualitative studies that explore challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries. Design Systematic review and qualitative thematic synthesis. Methods Searches of MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science. Search terms were combined for qualitative research, primary healthcare professionals, refugees and asylum seekers, and were supplemented by searches of reference lists and citations. Study selection was conducted by two researchers using prespecified selection criteria. Data extraction and quality assessment using the Critical Appraisal Skills Programme tool was conducted by the first author. A thematic synthesis was undertaken to develop descriptive themes and analytical constructs. Results Twenty-six articles reporting on 21 studies and involving 357 participants were included. Eleven descriptive themes were interpreted, embedded within three analytical constructs: healthcare encounter (trusting relationship, communication, cultural understanding, health and social conditions, time); healthcare system (training and guidance, professional support, connecting with other services, organisation, resources and capacity); asylum and resettlement. Challenges and facilitators were described within these themes. Conclusions A range of challenges and facilitators have been identified for health professionals providing primary healthcare for refugees and asylum seekers that are experienced in the dimensions of the healthcare encounter, the healthcare system and wider asylum and resettlement situation. Comprehensive understanding of these challenges and facilitators is important to shape policy, improve the quality of services and provide more equitable health services for this vulnerable group. PMID:28780549

CF60 Concrete Composition Design and Application on Fudiankou Xijiang Super Large Bridge

NASA Astrophysics Data System (ADS)

Qiu, Yi Mei; Wen, Sen Yuan; Chen, Jun Xiang

2018-06-01

Guangxi Wuzhou City Ring Road Fudiankou Xijiang super large bridge CF60 concrete is a new multi-phase composite high-performance concrete, this paper for the Fudiankou Xijiang bridge structure and characteristics of the project, in accordance with the principle of local materials and technical specification requirements, combined with the site conditions of CF60 engineering high performance concrete component materials, proportion and the technical performance, quantify the main physical and mechanical performance index. Analysis main influencing factors of the technical indicators, reasonable adjustment of concrete mix design parameters, and the use of technical means of admixture and multi-function composite admixture of concrete, obtain the optimal proportion of good work, process, mechanical properties stability and durability of engineering properties, recommend and verification of concrete mix; to explore the CF60 high performance concrete Soil in the Fudiankou Xijiang bridge application technology, detection and tracking the quality of concrete construction, concrete structure during the construction of the key technology and control points is proposed, evaluation of CF60 high performance concrete in the actual engineering application effect and benefit to ensure engineering quality of bridge structure and service life, and super long span bridge engineering construction to provide basis and reference.

Validity of a questionnaire measuring the world health organization concept of health system responsiveness with respect to perinatal services in the Dutch obstetric care system.

PubMed

van der Kooy, Jacoba; Valentine, Nicole B; Birnie, Erwin; Vujkovic, Marijana; de Graaf, Johanna P; Denktaş, Semiha; Steegers, Eric A P; Bonsel, Gouke J

2014-12-03

The concept of responsiveness, introduced by the World Health Organization (WHO), addresses non-clinical aspects of health service quality that are relevant regardless of provider, country, health system or health condition. Responsiveness refers to "aspects related to the way individuals are treated and the environment in which they are treated" during health system interactions. This paper assesses the psychometric properties of a newly developed responsiveness questionnaire dedicated to evaluating maternal experiences of perinatal care services, called the Responsiveness in Perinatal and Obstetric Health Care Questionnaire (ReproQ), using the eight-domain WHO concept. The ReproQ was developed between October 2009 and February 2010 by adapting the WHO Responsiveness Questionnaire items to the perinatal care context. The psychometric properties of feasibility, construct validity, and discriminative validity were empirically assessed in a sample of Dutch women two weeks post partum. A total of 171 women consented to participation. Feasibility: the interviews lasted between 20 and 40 minutes and the overall missing rate was 8%. Construct validity: mean Cronbach's alphas for the antenatal, birth and postpartum phase were: 0.73 (range 0.57-0.82), 0.84 (range 0.66-0.92), and 0.87 (range 0.62-0.95) respectively. The item-own scale correlations within all phases were considerably higher than most of the item-other scale correlations. Within the antenatal care, birth care and post partum phases, the eight factors explained 69%, 69%, and 76% of variance respectively. Discriminative validity: overall responsiveness mean sum scores were higher for women whose children were not admitted. This confirmed the hypothesis that dissatisfaction with health outcomes is transferred to their judgement on responsiveness of the perinatal services. The ReproQ interview-based questionnaire demonstrated satisfactory psychometric properties to describe the quality of perinatal care in the Netherlands, with the potential to discriminate between different levels of quality of care. In view of the relatively small sample, further testing and research is recommended.

47 CFR 22.815 - Construction period for general aviation ground stations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Construction period for general aviation ground... CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service General Aviation Air-Ground Stations § 22.815 Construction period for general aviation ground stations. The construction period (see...

47 CFR 22.815 - Construction period for general aviation ground stations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Construction period for general aviation ground... CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service General Aviation Air-Ground Stations § 22.815 Construction period for general aviation ground stations. The construction period (see...

47 CFR 22.815 - Construction period for general aviation ground stations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Construction period for general aviation ground... CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service General Aviation Air-Ground Stations § 22.815 Construction period for general aviation ground stations. The construction period (see...

47 CFR 22.815 - Construction period for general aviation ground stations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Construction period for general aviation ground... CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service General Aviation Air-Ground Stations § 22.815 Construction period for general aviation ground stations. The construction period (see...

47 CFR 22.815 - Construction period for general aviation ground stations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Construction period for general aviation ground... CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service General Aviation Air-Ground Stations § 22.815 Construction period for general aviation ground stations. The construction period (see...

47 CFR 95.833 - Construction requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Construction requirements. 95.833 Section 95... PERSONAL RADIO SERVICES 218-219 MHz Service System Requirements § 95.833 Construction requirements. (a... record of expansion, including a timetable of new construction to meet changes in demand for service; (3...

47 CFR 95.833 - Construction requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Construction requirements. 95.833 Section 95... PERSONAL RADIO SERVICES 218-219 MHz Service System Requirements § 95.833 Construction requirements. (a... record of expansion, including a timetable of new construction to meet changes in demand for service; (3...

An innovative time-cost-quality tradeoff modeling of building construction project based on resource allocation.

PubMed

Hu, Wenfa; He, Xinhua

2014-01-01

The time, quality, and cost are three important but contradictive objectives in a building construction project. It is a tough challenge for project managers to optimize them since they are different parameters. This paper presents a time-cost-quality optimization model that enables managers to optimize multiobjectives. The model is from the project breakdown structure method where task resources in a construction project are divided into a series of activities and further into construction labors, materials, equipment, and administration. The resources utilized in a construction activity would eventually determine its construction time, cost, and quality, and a complex time-cost-quality trade-off model is finally generated based on correlations between construction activities. A genetic algorithm tool is applied in the model to solve the comprehensive nonlinear time-cost-quality problems. Building of a three-storey house is an example to illustrate the implementation of the model, demonstrate its advantages in optimizing trade-off of construction time, cost, and quality, and help make a winning decision in construction practices. The computational time-cost-quality curves in visual graphics from the case study prove traditional cost-time assumptions reasonable and also prove this time-cost-quality trade-off model sophisticated.

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

PubMed

Coelho, Carla Faustino; O'Farrell, Catherine Commander

2011-01-01

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

13 CFR 305.6 - Allowable methods of procurement for construction services.

Code of Federal Regulations, 2013 CFR

2013-01-01

... design/build, construction management at risk and force account. If an alternate method is used, the... for construction services. 305.6 Section 305.6 Business Credit and Assistance ECONOMIC DEVELOPMENT... Approved Projects § 305.6 Allowable methods of procurement for construction services. (a) Recipients may...

13 CFR 305.6 - Allowable methods of procurement for construction services.

Code of Federal Regulations, 2012 CFR

2012-01-01

... design/build, construction management at risk and force account. If an alternate method is used, the... for construction services. 305.6 Section 305.6 Business Credit and Assistance ECONOMIC DEVELOPMENT... Approved Projects § 305.6 Allowable methods of procurement for construction services. (a) Recipients may...

13 CFR 305.6 - Allowable methods of procurement for construction services.

Code of Federal Regulations, 2014 CFR

2014-01-01

... design/build, construction management at risk and force account. If an alternate method is used, the... for construction services. 305.6 Section 305.6 Business Credit and Assistance ECONOMIC DEVELOPMENT... Approved Projects § 305.6 Allowable methods of procurement for construction services. (a) Recipients may...

48 CFR 532.905-70 - Final payment-construction and building service contracts.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Final payment-construction...-70 Final payment—construction and building service contracts. The following procedures apply to construction and building service contracts: (a) The Government shall pay the final amount due the Contractor...

48 CFR 532.905-70 - Final payment-construction and building service contracts.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Final payment-construction...-70 Final payment—construction and building service contracts. The following procedures apply to construction and building service contracts: (a) The Government shall pay the final amount due the Contractor...

48 CFR 532.905-70 - Final payment-construction and building service contracts.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Final payment-construction...-70 Final payment—construction and building service contracts. The following procedures apply to construction and building service contracts: (a) The Government shall pay the final amount due the Contractor...

77 FR 6985 - General Services Administration Acquisition Regulation; Reinstatement of Coverage Pertaining to...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-10

... Claims, for releases of claims under construction and building service contracts, was inadvertently... the release of claims under construction and building service contracts. At this time, consideration... for releases of claims under construction and building service contracts, was inadvertently deleted as...

Factors affecting pharmacy engagement and pharmacy customer devotion in community pharmacy: A structural equation modeling approach.

PubMed

Nitadpakorn, Sujin; Farris, Karen B; Kittisopee, Tanattha

2017-01-01

The concept of customer engagement and devotion has been applied in various service businesses to keep the customers with business However, a limited number of studies were performed to examine the context of customer engagement and devotion in pharmacy business which focus on the impact of customer perceptions about pharmacists, perceived quality of pharmacy structure, medication price strategy on pharmacy engagement and pharmacy customer devotion in a pharmacy providing pharmaceutical care to the customers. This study aimed to assess a conceptual model depicting the relationships among customer perceptions about pharmacists, pharmacy quality structure, medication price, customer engagement, and customer devotion. And also aimed to assess and measure if there is a direct or indirect relationship between these factors. A quantitative study was conducted by using self-administered questionnaires. Two hundred and fifty three customers who regularly visited the pharmacy were randomly recruited from a purposively selected 30 community pharmacies in Bangkok. The survey was completed during February to April 2016. A structural equation model (SEM) was used to assess the direct and indirect relationships between constructs. A total of 253/300 questionnaires were returned for analysis, and the response rate was 84%. Only perceptions about pharmacist in customers receiving professional pharmacy services was statically significant regarding relationship with pharmacy engagement (beta=0.45). Concurrently, the model from empirical data fit with the hypothetical model (p-value = 0.06, adjusted chi-square (CMIN/DF)=1.16, Goodness of Fit Index (GFI)=0.93, Comparatively Fit Index (CFI)=0.99, and Root Mean Square Error Approximation (RMSEA)=0.03). The study confirmed the indirect positive influence of customer perceptions about pharmacist on pharmacy customer devotion in providing pharmacy services via pharmacy engagement It was customer perceptions about pharmacist that influenced customer retention, positive word of mouth and constructive advice to pharmacies, not quality of pharmacy structure and medication price. To create a long term impact on community pharmacy business, pharmacist is the key success factor.

A review of the present state and future policy alternatives for home visit nursing services in Korea.

PubMed

Lim, Ji Young; Noh, Wonjung; Kim, Eunjoo; Choi, Kyung Won

2014-01-01

The aim of this study was to describe the current state of home visit nursing services in the Korean context and to suggest future policy directions. First, the three home visit nursing services that have developed in Korea are compared using the analytic framework provided by Gilbert and Terrell in 2012. The framework is based on four dimensions of social welfare: users, services, source of funds, and service delivery process. Second, we perform a strength, weakness, opportunity, and threat analysis to suggest comprehensive and constructive home visit nursing service policies for the future. Specifically, we advocate the creation of an organization that steers the central government to operate an integrated management organization to distribute services and reduce redundancy for preventing the waste of both medical and state financial resources. This study also recommends the development of educational programs to improve the quality of services and service evaluation criteria for the objective assessment of those services. These policy guidelines may prove useful both for Korea and for other countries that intend to prepare or revise their home visit nursing service systems. © 2014 Wiley Periodicals, Inc.

Knowledge, attitudes, and practices of private sector immunization service providers in Gujarat, India.

PubMed

Hagan, José E; Gaonkar, Narayan; Doshi, Vikas; Patni, Anas; Vyas, Shailee; Mazumdar, Vihang; Kosambiya, J K; Gupta, Satish; Watkins, Margaret

2018-01-02

India is responsible for 30% of the annual global cohort of unvaccinated children worldwide. Private practitioners provide an estimated 21% of vaccinations in urban centers of India, and are important partners in achieving high vaccination coverage. We used an in-person questionnaire and on-site observation to assess knowledge, attitudes, and practices of private immunization service providers regarding delivery of immunization services in the urban settings of Surat and Baroda, in Gujarat, India. We constructed a comprehensive sampling frame of all private physician providers of immunization services in Surat and Baroda cities, by consulting vaccine distributors, local branches of physician associations, and published lists of private medical practitioners. All providers were contacted and asked to participate in the study if they provided immunization services. Data were collected using an in-person structured questionnaire and directly observing practices; one provider in each practice setting was interviewed. The response rate was 82% (121/147) in Surat, and 91% (137/151) in Baroda. Of 258 participants 195 (76%) were pediatricians, and 63 (24%) were general practitioners. Practices that were potential missed opportunities for vaccination (MOV) included not strictly following vaccination schedules if there were concerns about ability to pay (45% of practitioners), and not administering more than two injections in the same visit (60%). Only 22% of respondents used a vaccination register to record vaccine doses, and 31% reported vaccine doses administered to the government. Of 237 randomly selected vaccine vials, 18% had expired vaccine vial monitors. Quality of immunization services in Gujarat can be strengthened by providing training and support to private immunization service providers to reduce MOVs and improve quality and safety; other more context specific strategies that should be evaluated may involve giving feedback to providers on quality of services delivered and working through professional societies to adopt standards of practice. Published by Elsevier Ltd.

A three-model comparison of the relationship between quality, satisfaction and loyalty: an empirical study of the Chinese healthcare system

PubMed Central

2012-01-01

Background Previous research has addressed the relationship between customer satisfaction, perceived quality and customer loyalty intentions in consumer markets. In this study, we test and compare three theoretical models of the quality–satisfaction–loyalty relationship in the Chinese healthcare system. Methods This research focuses on hospital patients as participants in the process of healthcare procurement. Empirical data were obtained from six Chinese public hospitals in Shanghai. A total of 630 questionnaires were collected in two studies. Study 1 tested the research instruments, and Study 2 tested the three models. Confirmatory factor analysis was used to assess the scales’ construct validity by testing convergent and discriminant validity. A structural equation model (SEM) specified the distinctions between each construct. A comparison of the three theoretical models was conducted via AMOS analysis. Results The results of the SEM demonstrate that quality and satisfaction are distinct concepts and that the first model (satisfaction mediates quality and loyalty) is the most appropriate one in the context of the Chinese healthcare environment. Conclusions In this study, we test and compare three theoretical models of the quality–satisfaction–loyalty relationship in the Chinese healthcare system. Findings show that perceived quality improvement does not lead directly to customer loyalty. The strategy of using quality improvement to maintain patient loyalty depends on the level of patient satisfaction. This implies that the measurement of patient experiences should include topics of importance for patients’ satisfaction with health care services. PMID:23198824

SITE COMPREHENSIVE LISTING (CERCLIS) (Superfund)

EPA Pesticide Factsheets

The Comprehensive Environmental Response, Compensation and Liability Information System (CERCLIS) (Superfund) Public Access Database contains a selected set of non-enforcement confidential information and is updated by the regions every 90 days. The data describes what has happened at Superfund sites prior to this quarter (updated quarterly). This database includes lists of involved parties (other Federal Agencies, states, and tribes), Human Exposure and Ground Water Migration, and Site Wide Ready for Reuse, Construction Completion, and Final Assessment Decision (GPRA-like measures) for fund lead sites. Other information that is included has been included only as a service to allow public evaluations utilizing this data. EPA does not have specific Data Quality Objectives for use of the data. Independent Quality Assessments may be made of this data by reviewing the Quality Assurance Action Plan (QAPP).

Association between infrastructure and observed quality of care in 4 healthcare services: A cross-sectional study of 4,300 facilities in 8 countries

PubMed Central

Sun, Zeye

2017-01-01

Background It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs)—the structural inputs to care—predicts the clinical quality of care provided to patients. Methods and findings Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development. These surveys assess health system capacity in LMICs. We drew data from assessments conducted in 8 countries between 2007 and 2015: Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania, and Uganda. The surveys included an audit of facility infrastructure and direct observation of family planning, antenatal care (ANC), sick-child care, and (in 2 countries) labor and delivery. To measure structural inputs, we constructed indices that measured World Health Organization-recommended amenities, equipment, and medications in each service. For clinical quality, we used data from direct observations of care to calculate providers’ adherence to evidence-based care guidelines. We assessed the correlation between these metrics and used spline models to test for the presence of a minimum input threshold associated with good clinical quality. Inclusion criteria were met by 32,531 observations of care in 4,354 facilities. Facilities demonstrated moderate levels of infrastructure, ranging from 0.63 of 1 in sick-child care to 0.75 of 1 for family planning on average. Adherence to evidence-based guidelines was low, with an average of 37% adherence in sick-child care, 46% in family planning, 60% in labor and delivery, and 61% in ANC. Correlation between infrastructure and evidence-based care was low (median 0.20, range from −0.03 for family planning in Senegal to 0.40 for ANC in Tanzania). Facilities with similar infrastructure scores delivered care of widely varying quality in each service. We did not detect a minimum level of infrastructure that was reliably associated with higher quality of care delivered in any service. These findings rely on cross-sectional data, preventing assessment of relationships between structural inputs and clinical quality over time; measurement error may attenuate the estimated associations. Conclusion Inputs to care are poorly correlated with provision of evidence-based care in these 4 clinical services. Healthcare workers in well-equipped facilities often provided poor care and vice versa. While it is important to have strong infrastructure, it should not be used as a measure of quality. Insight into health system quality requires measurement of processes and outcomes of care. PMID:29232377

Association between infrastructure and observed quality of care in 4 healthcare services: A cross-sectional study of 4,300 facilities in 8 countries.

PubMed

Leslie, Hannah H; Sun, Zeye; Kruk, Margaret E

2017-12-01

It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs)-the structural inputs to care-predicts the clinical quality of care provided to patients. Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development. These surveys assess health system capacity in LMICs. We drew data from assessments conducted in 8 countries between 2007 and 2015: Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania, and Uganda. The surveys included an audit of facility infrastructure and direct observation of family planning, antenatal care (ANC), sick-child care, and (in 2 countries) labor and delivery. To measure structural inputs, we constructed indices that measured World Health Organization-recommended amenities, equipment, and medications in each service. For clinical quality, we used data from direct observations of care to calculate providers' adherence to evidence-based care guidelines. We assessed the correlation between these metrics and used spline models to test for the presence of a minimum input threshold associated with good clinical quality. Inclusion criteria were met by 32,531 observations of care in 4,354 facilities. Facilities demonstrated moderate levels of infrastructure, ranging from 0.63 of 1 in sick-child care to 0.75 of 1 for family planning on average. Adherence to evidence-based guidelines was low, with an average of 37% adherence in sick-child care, 46% in family planning, 60% in labor and delivery, and 61% in ANC. Correlation between infrastructure and evidence-based care was low (median 0.20, range from -0.03 for family planning in Senegal to 0.40 for ANC in Tanzania). Facilities with similar infrastructure scores delivered care of widely varying quality in each service. We did not detect a minimum level of infrastructure that was reliably associated with higher quality of care delivered in any service. These findings rely on cross-sectional data, preventing assessment of relationships between structural inputs and clinical quality over time; measurement error may attenuate the estimated associations. Inputs to care are poorly correlated with provision of evidence-based care in these 4 clinical services. Healthcare workers in well-equipped facilities often provided poor care and vice versa. While it is important to have strong infrastructure, it should not be used as a measure of quality. Insight into health system quality requires measurement of processes and outcomes of care.

Household's willingness to pay for heterogeneous attributes of drinking water quality and services improvement: an application of choice experiment

NASA Astrophysics Data System (ADS)

Dauda, Suleiman Alhaji; Yacob, Mohd Rusli; Radam, Alias

2015-09-01

The service of providing good quality of drinking water can greatly improve the lives of the community and maintain a normal health standard. For a large number of population in the world, specifically in the developing countries, the availability of safe water for daily sustenance is none. Damaturu is the capital of Yobe State, Nigeria. It hosts a population of more than two hundred thousand, yet only 45 % of the households are connected to the network of Yobe State Water Corporation's pipe borne water services; this has led people to source for water from any available source and thus, exposed them to the danger of contracting waterborne diseases. In order to address the problem, Yobe State Government has embarked on the construction of a water treatment plant with a capacity and facility to improve the water quality and connect the town with water services network. The objectives of this study are to assess the households' demand preferences of the heterogeneous water attributes in Damaturu, and to estimate their marginal willingness to pay, using mixed logit model in comparison with conditional logit model. A survey of 300 households randomly sampled indicated that higher education greatly influenced the households' WTP decisions. The most significant variable from both of the models is TWQ, which is MRS that rates the water quality from the level of satisfactory to very good. 219 % in simple model is CLM, while 126 % is for the interaction model. As for MLM, 685 % is for the simple model and 572 % is for the interaction model. Estimate of MLM has more explanatory powers than CLM. Essentially, this finding can help the government in designing cost-effective management and efficient tariff structure.

Discussion on mass concrete construction of wind turbine generator foundation

NASA Astrophysics Data System (ADS)

Shang, Liang; Wu, Chaoxiang; Yin, Xiaoyong

2018-04-01

Wind power is one of the main power sources currently. China has rich wind power resources, wind power plants are developed faster and faster. However, China wind power construction started late, which is lack of relevant experience technology. It is easy to produce quality problems. The key to the construction quality of wind power plant is the construction quality of mass concrete construction. Therefore, construction technology and quality control of wind turbine generator foundation mass concrete are discussed and analyzed in the paper.

76 FR 13329 - Reinstatement of Coverage Pertaining to Final Payment Under Construction and Building Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

..., Release of Claims, for releases of claims under construction and building service contracts, was... prescribed the use of GSA Form 1142 for releases of claims under construction and building service contracts...] RIN 3090-AJ13 Reinstatement of Coverage Pertaining to Final Payment Under Construction and Building...

Research on construction quality and improvement of assembly construction

NASA Astrophysics Data System (ADS)

Cheng, Fei

2017-11-01

Based on the acceleration of the urbanization process and the improvement of the quality of life of our residents, the demand for building construction has been increasing. In this context, the construction industry in order to promote the construction efficiency, quality improvement, to meet the needs of the development of the times to strengthen the new technology, the use of new technologies. At present, China’s engineering construction units in the process of carrying out the project to strengthen the use of assembly-type construction technology, which thus achieved for the traditional construction work low-level, high time-consuming issues, and promote the steady improvement of production efficiency. Based on this, this paper focuses on the analysis of the connotation of the assembly structure and analyzes the quality problems in the construction process of the construction projects and puts forward the improvement measures to promote the improvement of the building quality and the construction of the building Construction speed. Based on this, this paper analyzes the structural system and design of prefabricated building.

Impact of service attributes on customer satisfaction and loyalty in a healthcare context.

PubMed

Lonial, Subash; Raju, P S

2015-01-01

The purpose of this paper is to examine the role of perceived service attributes in the development of overall customer satisfaction (OCS) and customer loyalty (CL) in a health-care setting. This paper also sheds light on the role of hospitalist physicians (HPs) and offers suggestions to improve patient satisfaction and loyalty. A telephone survey was used to collect data from recently hospitalized patients with respect to their HP. Structural equations modeling (SEM) was used to confirm the overall relationships between perceived service quality (PSQ), OCS and CL. The sample was then divided into customer relationship groups (CRGs) based on satisfaction and loyalty measures. Discriminant analysis was used to determine which attributes differentiated most between high and low satisfaction and loyalty groups. Overall relationships among PSQ, OCS and CL were in conformity with the conceptual model. Findings also revealed that service attributes played an important role in distinguishing between high and low satisfaction and loyalty groups, although some attributes were more important than others and different attributes emerged as being key influencers for satisfaction and loyalty. The conceptual model used is a fairly straight forward model, and we have not considered the impact of individual factors such as expectations and value perceptions or involvement levels and demographic characteristics on service quality and overall satisfaction. The data for this study were provided by a major health maintenance organization (HMO), and there is room for improvement in the manner in which certain constructs were measured. For example, OCS, recommendation and retention all used single item measures, and it might have been preferable to use multiple item measures for these constructs. The study shows that organizations can benefit by identifying and focusing on critical attributes as part of their customer relationship management program. The SEM results provide strong support for the overall model linking service quality, OCS and CL in a health-care setting. As one would expect, PSQ has a strong impact on OCS, which, in turn, has a fairly strong impact on CL. However, there is also a significant direct linkage between PSQ and CL. This linkage shows that at least a certain portion of CL could evolve independent of the satisfaction level with the HP. This shows that, in addition to trying to improve satisfaction, organizations should also explore influencing loyalty directly, perhaps by the strategic use of service attribute perceptions. The study shows that customer perceptions at the service attribute level can often be the key to the generation and management of customer satisfaction and loyalty. It also has significance for how satisfaction and loyalty with HPs can be improved in a hospital setting.

An Innovative Time-Cost-Quality Tradeoff Modeling of Building Construction Project Based on Resource Allocation

PubMed Central

2014-01-01

The time, quality, and cost are three important but contradictive objectives in a building construction project. It is a tough challenge for project managers to optimize them since they are different parameters. This paper presents a time-cost-quality optimization model that enables managers to optimize multiobjectives. The model is from the project breakdown structure method where task resources in a construction project are divided into a series of activities and further into construction labors, materials, equipment, and administration. The resources utilized in a construction activity would eventually determine its construction time, cost, and quality, and a complex time-cost-quality trade-off model is finally generated based on correlations between construction activities. A genetic algorithm tool is applied in the model to solve the comprehensive nonlinear time-cost-quality problems. Building of a three-storey house is an example to illustrate the implementation of the model, demonstrate its advantages in optimizing trade-off of construction time, cost, and quality, and help make a winning decision in construction practices. The computational time-cost-quality curves in visual graphics from the case study prove traditional cost-time assumptions reasonable and also prove this time-cost-quality trade-off model sophisticated. PMID:24672351

Developing patient-centred care: an ethnographic study of patient perceptions and influence on quality improvement.

PubMed

Renedo, Alicia; Marston, Cicely

2015-04-23

Understanding quality improvement from a patient perspective is important for delivering patient-centred care. Yet the ways patients define quality improvement remains unexplored with patients often excluded from improvement work. We examine how patients construct ideas of 'quality improvement' when collaborating with healthcare professionals in improvement work, and how they use these understandings when attempting to improve the quality of their local services. We used in-depth interviews with 23 'patient participants' (patients involved in quality improvement work) and observations in several sites in London as part of a four-year ethnographic study of patient and public involvement (PPI) activities run by Collaborations for Leadership in Applied Health Research and Care for Northwest London. We took an iterative, thematic and discursive analytical approach. When patient participants tried to influence quality improvement or discussed different dimensions of quality improvement their accounts and actions frequently started with talk about improvement as dependent on collective action (e.g. multidisciplinary healthcare professionals and the public), but usually quickly shifted away from that towards a neoliberal discourse emphasising the role of individual patients. Neoliberal ideals about individual responsibility were taken up in their accounts moving them away from the idea of state and healthcare providers being held accountable for upholding patients' rights to quality care, and towards the idea of citizens needing to work on self-improvement. Participants portrayed themselves as governed by self-discipline and personal effort in their PPI work, and in doing so provided examples of how neoliberal appeals for self-regulation and self-determination also permeated their own identity positions. When including patient voices in measuring and defining 'quality', governments and public health practitioners should be aware of how neoliberal rationalities at the heart of policy and services may discourage consumers from claiming rights to quality care by contributing to public unwillingness to challenge the status quo in service provision. If the democratic potential of patient and public involvement initiatives is to be realised, it will be crucial to help citizens to engage critically with how neoliberal rationalities can undermine their abilities to demand quality care.

Conceptualizing and Categorizing Race and Ethnicity in Health Services Research

PubMed Central

Ford, Marvella E; Kelly, P Adam

2005-01-01

Objectives Veterans Affairs (VA) patient populations are becoming increasingly diverse in race and ethnicity. The purpose of this paper is to (1) document the importance of using consistent standards of conceptualizing and categorizing race and ethnicity in health services research, (2) provide an overview of different methods currently used to assess race and ethnicity in health services research, and (3) suggest assessment methods that could be incorporated into health services research to ensure accurate assessment of disease prevalence and incidence, as well as accounts of appropriate health services use, in patients with different racial and ethnic backgrounds. Design A critical review of published literature was used. Principal Findings Race is a complex, multidimensional construct. For some individuals, institutionalized racism and internalized racism are intertwined in the effects of race on health outcomes and health services use. Ethnicity is most commonly used as a social–political construct and includes shared origin, shared language, and shared cultural traditions. Acculturation appears to affect the strength of the relationships among ethnicity, health outcomes, and health services use. Conclusions Improved and consistent methods of data collection need to be developed for use by VA researchers across the country. VA research sites with patients representing specific population groups could use a core set of demographic items in addition to expanded modules designed to assess the ethnic diversity within these population groups. Improved and consistent methods of data collection could result in the collection of higher-quality data, which could lead to the identification of race- and ethnic-specific health services needs. These investigations could in turn lead to the development of interventions designed to reduce or eliminate these disparities. PMID:16179001

A family-specific use of the Measure of Processes of Care for Service Providers (MPOC-SP).

PubMed

Siebes, R C; Nijhuis, B J G; Boonstra, A M; Ketelaar, M; Wijnroks, L; Reinders-Messelink, H A; Postema, K; Vermeer, A

2008-03-01

To examine the validity and utility of the Dutch Measure of Processes of Care for Service Providers (MPOC-SP) as a family-specific measure. A validation study. Five paediatric rehabilitation settings in the Netherlands. The MPOC-SP was utilized in a general (reflecting on services provided for all clients and clients' families) and family-specific way (filled out in reference to a particular child and his or her family). Professionals providing rehabilitation and educational services to children with cerebral palsy. For construct validity, Pearson's product-moment correlation coefficients (r ) between the scales were calculated. The ability of service providers to discriminate between general and family-specific ratings was examined by exploration of absolute difference scores. One hundred and sixteen service professionals filled out 240 family-specific MPOC-SPs. In addition, a subgroup of 81 professionals filled out a general MPOC-SP. For each professional, family-specific and general scores were paired, resulting in 151 general-family-specific MPOC-SP pairs. The construct validity analyses confirmed the scale structure: 21 items (77.8%) loaded highest in the original MPOC-SP factors, and all items correlated best and significantly with their own scale score (r 0.565 to 0.897; P<0.001). Intercorrelations between the scales ranged from r = 0.159 to r = 0.522. In total, 94.4% of the mean absolute difference scores between general and family-specific scale scores were larger than the expected difference. Service providers were able to discriminate between general and family-specific MPOC-SP item ratings. The family-specific MPOC-SP is a valid measure that can be used for individual evaluation of family-centred services and can be the impetus for family-related quality improvement.

Indicators for the automated analysis of drug prescribing quality.

PubMed

Coste, J; Séné, B; Milstein, C; Bouée, S; Venot, A

1998-01-01

Irrational and inconsistent drug prescription has considerable impact on morbidity, mortality, health service utilization, and community burden. However, few studies have addressed the methodology of processing the information contained in these drug orders used to study the quality of drug prescriptions and prescriber behavior. We present a comprehensive set of quantitative indicators for the quality of drug prescriptions which can be derived from a drug order. These indicators were constructed using explicit a priori criteria which were previously validated on the basis of scientific data. Automatic computation is straightforward, using a relational database system, such that large sets of prescriptions can be processed with minimal human effort. We illustrate the feasibility and value of this approach by using a large set of 23,000 prescriptions for several diseases, selected from a nationally representative prescriptions database. Our study may result in direct and wide applications in the epidemiology of medical practice and in quality control procedures.

An Overview of Total Quality Management (TQM) practice in Construction Sector

NASA Astrophysics Data System (ADS)

Likita, A. J.; Zainun, N. Y.; Rahman, I. Abdul; Awal, A. S. M. Abdul; Alias, A. R.; Rahman, M. Q. Abdul; Ghazali, F. E. Mohamed

2018-04-01

In construction sector TQM can be termed as a philosophy which guides construction professionals on the proper execution of construction projects in terms of quality. The aim of this paper is to discuss on quality management practice in construction sector. This paper evaluated five previous researches and the findings were discussed to find a conclusion of TQM practise in construction sector. The study found that TQM had been successfully practice in construction sector at Saudi Arabia, India, US and South Africa. Application of Artificial Neural Network (ANN) help to improve the implementation of TQM in construction sector. In conclusion, quality management practices will give better control of processes in construction sector.

Assessing Community Quality of Health Care.

PubMed

Herrin, Jeph; Kenward, Kevin; Joshi, Maulik S; Audet, Anne-Marie J; Hines, Stephen J

2016-02-01

To determine the agreement of measures of care in different settings-hospitals, nursing homes (NHs), and home health agencies (HHAs)-and identify communities with high-quality care in all settings. Publicly available quality measures for hospitals, NHs, and HHAs, linked to hospital service areas (HSAs). We constructed composite quality measures for hospitals, HHAs, and nursing homes. We used these measures to identify HSAs with exceptionally high- or low-quality of care across all settings, or only high hospital quality, and compared these with respect to sociodemographic and health system factors. We identified three dimensions of hospital quality, four HHA dimensions, and two NH dimensions; these were poorly correlated across the three care settings. HSAs that ranked high on all dimensions had more general practitioners per capita, and fewer specialists per capita, than HSAs that ranked highly on only the hospital measures. Higher quality hospital, HHA, and NH care are not correlated at the regional level; regions where all dimensions of care are high differ systematically from regions which score well on only hospital measures and from those which score well on none. © Health Research and Educational Trust.

17 CFR 250.85 - Service, sales, and construction by registered holding companies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Service, sales, and... ACT OF 1935 Service, Sales and Construction Contracts § 250.85 Service, sales, and construction by...; or (c) Such transaction consists of performance of a contract made before August 26, 1935, for the...

17 CFR 250.85 - Service, sales, and construction by registered holding companies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Service, sales, and... ACT OF 1935 Service, Sales and Construction Contracts § 250.85 Service, sales, and construction by...; or (c) Such transaction consists of performance of a contract made before August 26, 1935, for the...

Argumentation Practices in Classroom: Pre-service teachers' conceptual understanding of chemical equilibrium

NASA Astrophysics Data System (ADS)

Kaya, Ebru

2013-05-01

This study examines the impact of argumentation practices on pre-service teachers' understanding of chemical equilibrium. The sample consisted of 100 pre-service teachers in two classes of a public university. One of these classes was assigned as experimental and the other as control group, randomly. In the experimental group, the subject of chemical equilibrium was taught by using argumentative practices and the participants were encouraged to participate in the lessons actively. However, the instructor taught the same subject by using the lecturing method without engaging argumentative activities in the control group. The Chemical Equilibrium Concept Test and Written Argumentation Survey were administered to all participants to assess their conceptual understanding and the quality of their arguments, respectively. The analysis of covariance results indicate that argumentation practices significantly improved conceptual understanding of the experimental group when compared to the control group. Furthermore, the results show that the pre-service teachers exposed to argumentative practices constructed more quality arguments than those in the control group after the instruction. Based on these results, it can be concluded that the instruction based on argumentative practices is effective in concept teaching in science education. Therefore, argumentation should be explicitly taught in teacher education besides elementary and secondary education.

Identifying influence of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context.

PubMed

Karim, R M; Abdullah, M S; Rahman, A M; Alam, A M

2015-04-01

Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic (CC) services. This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 Community Clinics (CCs). Since most of the outcome indicators focus mainly on women and children, women having children less than two years of age were randomly assigned and interviewed for the study purpose. Data for the development of perceived service quality and satisfaction tools were collected through Focus Group Discussion (FGD), key informants interview and data for measuring the utilization status were collected by an interviewer administered pretested semi-structured questionnaire. About 95% of the respondents were Muslims and 5% were Hindus. The average age of the respondents was 23.38 (SD ± 4.15) years and almost all of them are home makers. The average monthly expenditure of their family was 7462.92 (SD ± 2545) BDT equivalent to 95 (SD ± 32) US$. To measure lay peoples' perception and satisfaction regarding primary health care service quality two scales e.g. Slim Haddad's 20-item scale for measuring perceived quality of primary health care services (PQPCS) validated in Guinea and Burkina Fuso and primary care satisfaction survey for women (PCSSW) developed by Scholle and colleagues 2004; is a 24-item survey tool validated in Turkey were chosen as a reference tools. Based on those, two psychometric research instruments; 24 items PQPCS scale (chronbach's α =0.89) and 22-items Community Clinic Service Satisfaction (CCSS) scale (chronbach's α = 0.97), were constructed and validated for measuring perceived service quality and satisfaction in Bangladesh context. This study showed mothers with preprimary education [(χ2 = 4.20, p = 0.04), AOR with 95% CI = 1.89 (1.03, 3.53)] utilized the limited curative care services more than educated mothers. On the contrary, higher income families [for income group 5000-10,000 BDT χ2 = 8.83, p = 0.003 and AOR with 95% CI = 0.37(0.19, 0.71)] and [for income group above 10,000 BDT χ2 = 5.02, p = 0.025 and AOR with 95% CI = 0.40 (0.18, 0.89)] and families having cultivable lands [for 5-10 decimal group χ2 = 5.51, p = 0.19, and AOR with 95% CI = 0.56 (0.35, 0.91)] and [for > 10 decimal group χ2 = 6.70, p = 0.010, and AOR with 95% CI = 0.50 (0.29, 0.84)] utilized the limited curative care services less than their poorer and landless counterpart. The same relationship was observed in case of health education and Antenatal Care (ANC) and Postnatal Care (PNC) services. Women who lived in their own residence used health education services more frequently than those who lived in a rental house [χ2 = 24.00, p = 0.000 and AOR with 95% CI = 1.21, (1.12, 1.30)] and they also increasingly used maternal and child health services χ2 = 27.49, p = 0.000 and AOR with 95% CI 1.61, (1.35, 1.93)]. Perceptions concerning skill and competence of the health care provider [χ2 = 16.90, p = 0.000 and AOR with 95% CI = 1.14, (1.07, 1.22)] and satisfaction indicating interpersonal communication and attitude of the care provider [χ2 = 7.07, p = 0.008 AOR with 95% CI = 1.08, (1.02, 1.15)] were found significant predictors for limited curative care service utilization of CC. Perception related to the quality of management, administration, physical environment of the service point and satisfaction addressing health promotion and women health issues also played significant role on CC's services utilization. Besides parental education and income, client's perception and satisfaction played significant role in CC service utilization. Provider's perception of service quality should be studied. The study findings will enable policy-makers .to improve quality of primary health care services, realizing providers' and patients' ideas of CC service quality.

Dynamic quality of service differentiation using fixed code weight in optical CDMA networks

NASA Astrophysics Data System (ADS)

Kakaee, Majid H.; Essa, Shawnim I.; Abd, Thanaa H.; Seyedzadeh, Saleh

2015-11-01

The emergence of network-driven applications, such as internet, video conferencing, and online gaming, brings in the need for a network the environments with capability of providing diverse Quality of Services (QoS). In this paper, a new code family of novel spreading sequences, called a Multi-Service (MS) code, has been constructed to support multiple services in Optical- Code Division Multiple Access (CDMA) system. The proposed method uses fixed weight for all services, however reducing the interfering codewords for the users requiring higher QoS. The performance of the proposed code is demonstrated using mathematical analysis. It shown that the total number of served users with satisfactory BER of 10-9 using NB=2 is 82, while they are only 36 and 10 when NB=3 and 4 respectively. The developed MS code is compared with variable-weight codes such as Variable Weight-Khazani Syed (VW-KS) and Multi-Weight-Random Diagonal (MW-RD). Different numbers of basic users (NB) are used to support triple-play services (audio, data and video) with different QoS requirements. Furthermore, reference to the BER of 10-12, 10-9, and 10-3 for video, data and audio, respectively, the system can support up to 45 total users. Hence, results show that the technique can clearly provide a relative QoS differentiation with lower value of basic users can support larger number of subscribers as well as better performance in terms of acceptable BER of 10-9 at fixed code weight.

Rooftop farming on urban wastes: a first assessment of ecosystem services provided by constructed technosols

NASA Astrophysics Data System (ADS)

Grard, Baptiste; Chenu, Claire; Frascaria-Lacoste, Nathalie; Aubry, Christine

2017-04-01

Urban farming, especially on rooftops, is a popular and a growing topic in media as well as in the scientific literature. It is a great opportunity to meet some of the challenges linked to urban areas development worldwide. However, little attention has been paid so far to the growing media of green roofs, i.e. technosols. A better understanding of the influence of technosol choice and component links with ecosystem services is required in order to maximize environmental benefits from rooftop urban farming. Between March 2013 and 2015, a pilot project called T4P (Parisian Productive rooftoP, Pilot Experiment) took place on the rooftop of the technical University AgroParisTech. Two different units based on the use of two contrasted urban organic wastes were compared to a commercial potting soil through yield measurements, substrates characterization and leaching quantification. We performed a first assessment of several ecosystem services expected from these technosols, i.e. provisioning of food (food production), regulation of water runoff (quantity and quality of runoff), recycling of organic wastes. We identified indicators of the ecosystem services (e.g. yield, annual mass loss of mineral nitrogen) and compared their measured values to reference situations (asphalt roof, green roof or cropland). Our analysis shows the multifunctional character of technosols made from organic wastes located on urban rooftops and the ecosystem services approach appears as a fertile one to evaluate and devise constructed technosols as a component of green infrastructures.

Improving client-centred care and services: the role of front/back-office configurations.

PubMed

Broekhuis, Manda; de Blok, Carolien; Meijboom, Bert

2009-05-01

This paper is a report of a study conducted to explore the application of designing front- and back-office work resulting in efficient client-centred care in healthcare organizations that supply home care, welfare and domestic services. Front/back-office configurations reflect a neglected domain of design decisions in the development of more client-centred processes and structures without incurring major cost increases. Based on a literature search, a framework of four front/back-office configurations was constructed. To illustrate the usefulness of this framework, a single, longitudinal case study was performed in a large organization, which provides home care, welfare and domestic services for a sustained period (2005-2006). The case study illustrates how front/back-office design decisions are related to the complexity of the clients' demands and the strategic objectives of an organization. The constructed framework guides the practical development of front/back-office designs, and shows how each design contributes differently to such performance objectives as quality, speed and efficiency. The front/back-office configurations presented comprise an important first step in elaborating client-centred care and service provision to the operational level. It helps healthcare organizations to become more responsive and to provide efficient client-centred care and services when approaching demand in a well-tuned manner. In addition to its applicability in home care, we believe that a deliberate front/back-office configuration also has potential in other fields of health care.

7 CFR 1924.11 - District Director's review of incomplete development.

Code of Federal Regulations, 2010 CFR

2010-01-01

... HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS CONSTRUCTION AND REPAIR Planning and Performing Construction...

Variable weight spectral amplitude coding for multiservice OCDMA networks

NASA Astrophysics Data System (ADS)

Seyedzadeh, Saleh; Rahimian, Farzad Pour; Glesk, Ivan; Kakaee, Majid H.

2017-09-01

The emergence of heterogeneous data traffic such as voice over IP, video streaming and online gaming have demanded networks with capability of supporting quality of service (QoS) at the physical layer with traffic prioritisation. This paper proposes a new variable-weight code based on spectral amplitude coding for optical code-division multiple-access (OCDMA) networks to support QoS differentiation. The proposed variable-weight multi-service (VW-MS) code relies on basic matrix construction. A mathematical model is developed for performance evaluation of VW-MS OCDMA networks. It is shown that the proposed code provides an optimal code length with minimum cross-correlation value when compared to other codes. Numerical results for a VW-MS OCDMA network designed for triple-play services operating at 0.622 Gb/s, 1.25 Gb/s and 2.5 Gb/s are considered.

Study on the Quality Management of Building Electricity Engineering Construction in the Whole Process

NASA Astrophysics Data System (ADS)

Qin, Minwu

2018-05-01

With the progress of science and technology, people use more and more types of electrical equipment and the functions are more and more complicated, which put forward higher requirements on the construction quality of electrical construction. If you ignore some of the necessary quality requirements and violate the specification of operation in the process of building electrical construction, that will bring great security risks and resulting in huge economic losses, even endanger personal safety. Manage and control construction quality of building electrical construction must be carried out throughout the whole process of construction. According to the construction characteristics of building electrical construction, this article analyze the construction details that are easy to be ignored but very important in the construction, based on management theory and put forward the methods of quality management in the whole process of building electrical construction. This template explains and demonstrates how to prepare your camera-ready paper for Trans Tech Publications. The best is to read these instructions and follow the outline of this text.

Developing and integrating a practice model for health finance reform into wound healing programs: an examination of the triple aim approach.

PubMed

Flattau, Anna; Thompson, Maureen; Meara, Anne

2013-10-01

Throughout the United States, government and private payers are exploring new payment models such as accountable care organizations and shared savings agreements. These models are widely based on the construct of the Triple Aim, a set of three principles for health services reform: improving population-based outcomes, improving patient care experiences, and reducing costs through better delivery systems. Wound programs may adapt to the new health financing environment by incorporating initiatives known to promote the Triple Aim, such as diabetes amputation reduction and pressure ulcer prevention programs, and by rethinking how health services can best be delivered to meet these new criteria. The existing literature supports that programmatic approaches can improve care, quality, and cost, especially in the field of diabetic foot ulcers. Wound healing programs have opportunities to develop new business plan models that provide quality, cost-efficient care to their patient population and to be leaders in the development of new types of partnerships with payers and health delivery organizations.

47 CFR 22.713 - Construction period for rural radiotelephone stations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Construction period for rural radiotelephone stations. 22.713 Section 22.713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.713 Construction period for...

47 CFR 22.713 - Construction period for rural radiotelephone stations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Construction period for rural radiotelephone stations. 22.713 Section 22.713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.713 Construction period for...

47 CFR 22.713 - Construction period for rural radiotelephone stations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Construction period for rural radiotelephone stations. 22.713 Section 22.713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.713 Construction period for...

47 CFR 22.713 - Construction period for rural radiotelephone stations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Construction period for rural radiotelephone stations. 22.713 Section 22.713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.713 Construction period for...

Assessing the quality of healthcare provided to children.

PubMed

Mangione-Smith, R; McGlynn, E A

1998-10-01

To present a conceptual framework for evaluating quality of care for children and adolescents, summarize the key issues related to developing measures to assess pediatric quality of care, examine some existing measures, and present evidence about their current level of performance. Assessing the quality of care for children poses many challenges not encountered when making these measurements in the adult population. Children and adolescents (from this point forward referred to collectively as children unless differentiation is necessary) differ from adults in two clinically important ways (Jameson and Wehr 1993): (1) their normal developmental trajectory is characterized by change, and (2) they have differential morbidity. These factors contribute to the limitations encountered when developing measures to assess the quality of care for children. The movement of a child through the various stages of development makes it difficult to establish what constitutes a "normal" outcome and by extension what constitutes a poor outcome. Additionally, salient developmental outcomes that result from poor quality of care may not be observed for several years. This implies that poor outcomes may be observed when the child is receiving care from a delivery system other than the one that provided the low-quality care. Attributing the suboptimal outcome to the new delivery system would be inappropriate. Differential morbidity refers to the fact that the type, prevalence, and severity of illness experienced by children is measurably different from that observed in adults. Most children experience numerous self-limited illness of mild severity. A minority of children suffer from markedly more severe diseases. Thus, condition-specific measures in children are problematic to implement for routine assessments because of the extremely low incidence and prevalence of most severe pediatric diseases (Halfon 1996). However, children with these conditions are potentially the segment of the pediatric population that can be most affected by variations in the quality of care. Improving the care provided to these children is likely to have the largest impact on quality of life and longevity. The low prevalence of most severe pediatric diseases also makes it difficult to evaluate the effectiveness of new treatment modalities; multi-center trials or long enrollment periods are usually required to obtain a large enough patient sample to conduct the necessary randomized controlled trials or cohort studies. Another challenge encountered when measuring quality of care for children is that, in most cases, they depend on adults to both obtain care and to report on the outcomes of that care. Parents and their children may have different perceptions of what defines health or have different levels of satisfaction with the care they receive. Children, particularly those with special needs, also depend on a broad range of services including the medical system, community intervention programs, social programs, and school-based services. Dependency on these various services adds to the difficulty of measuring and appropriately attributing health outcomes observed in children to a particular service delivery entity. Adolescents also depend on adults for access to some of their care; however, they have special needs related to confidentiality and parent-child information sharing. Adolescents commonly seek care at facilities, such as school-based clinics, that allow them to obtain confidential care. These facilities usually provide out-of-health plan care for these children, which raises special issues related to information availability for quality assessments and for assessing utilization patterns in this population. If the source of poor health outcomes is not known, quality improvement is not possible. The many challenges faced when constructing pediatric (this term will be used to refer to both children and adolescents) quality of care measures have resulted in few of these instruments being developed specifically for children. Most of the measures developed to date have either a very limited pediatric component or still require the process or outcome validation step. Although several practice guidelines and indicators of quality have been constructed, a conceptual framework to guide the development of such tools for quality assessment in the pediatric population is lacking. Pediatric health services researchers and the organizations that fund this work need to focus on developing a set of quality assessment tools that will address several challenging issues. Working within the context of the conceptual framework presented, we draw several conclusions related to issues that should be considered in developing quality of care measures for children.

Defining High-Quality Palliative Care in Oncology Practice: An American Society of Clinical Oncology/American Academy of Hospice and Palliative Medicine Guidance Statement.

PubMed

Bickel, Kathleen E; McNiff, Kristen; Buss, Mary K; Kamal, Arif; Lupu, Dale; Abernethy, Amy P; Broder, Michael S; Shapiro, Charles L; Acheson, Anupama Kurup; Malin, Jennifer; Evans, Tracey; Krzyzanowska, Monika K

2016-09-01

Integrated into routine oncology care, palliative care can improve symptom burden, quality of life, and patient and caregiver satisfaction. However, not all oncology practices have access to specialist palliative medicine. This project endeavored to define what constitutes high-quality primary palliative care as delivered by medical oncology practices. An expert steering committee outlined 966 palliative care service items, in nine domains, each describing a candidate element of primary palliative care delivery for patients with advanced cancer or high symptom burden. Using modified Delphi methodology, 31 multidisciplinary panelists rated each service item on three constructs: importance, feasibility, and scope within medical oncology practice. Panelists endorsed the highest proportion of palliative care service items in the domains of End-of-Life Care (81%); Communication and Shared Decision Making (79%); and Advance Care Planning (78%). The lowest proportions were in Spiritual and Cultural Assessment and Management (35%) and Psychosocial Assessment and Management (39%). In the largest domain, Symptom Assessment and Management, there was consensus that all symptoms should be assessed and managed at a basic level, with more comprehensive management for common symptoms such as nausea, vomiting, diarrhea, dyspnea, and pain. Within the Appropriate Palliative Care and Hospice Referral domain, there was consensus that oncology practices should be able to describe the difference between palliative care and hospice to patients and refer patients appropriately. This statement describes the elements comprising high-quality primary palliative care for patients with advanced cancer or high symptom burden, as delivered by oncology practices. Oncology providers wishing to enhance palliative care delivery may find this information useful to inform operational changes and quality improvement efforts. Copyright © 2016 by American Society of Clinical Oncology.

Family quality of life of Chinese families of children with intellectual disabilities.

PubMed

Hu, X; Wang, M; Fei, X

2012-01-01

The concepts of quality of life and family quality of life (FQOL) are increasingly being studied in the field of intellectual disabilities (ID) in China as important frameworks for: (1) assessing families' need for supports and services; (2) guiding organisational and service delivery system changes; and (3) evaluating quality family outcomes. The present study focused on exploring the perceptions of Chinese families who have a child with an ID regarding FQOL as well as examining the factor structure of FQOL concept from Chinese families. The Chinese version of the Family Quality of Life Scale was used to survey Chinese families living in the urban and suburban areas of Beijing who have a child with ID. A total of 442 families participated in this study. Confirmatory factor analysis was used to test the factor structure of FQOL. Multivariate analysis was also used to examine group differences among families in terms of family demographic variables. A five-factor structure of the FQOL construct was found in the Chinese sample, suggesting a similar factor structure found from US families in the literature. Different living conditions (e.g. housing and transportation) tended to affect significantly families' satisfaction ratings of their FQOL. It is also found that family income and severity of disability of the child are predictors of families' satisfaction ratings of FQOL. The preliminary findings of this study suggest a cross-cultural factor structure comparability of FQOL between samples in the USA and China. Results call for further examination of the family-centred service and support as a mediator on the interactive relationship between family characteristics, family needs and FQOL outcomes. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

Application of Non-pressure Reinforced Concrete Pipes in Modern Construction and Reconstruction of Highways

NASA Astrophysics Data System (ADS)

Rakitin, B. A.; Pogorelov, S. N.; Kolmogorova, A. O.

2017-11-01

Modern highway construction technologies provide for the quality water discharge systems to increase facilities’ service life. Pipeline operating conditions require the use of durable and reliable materials and structures. The experience in using reinforced concrete pipes for these purposes shows their utilization efficiency. The present paper considers the experience in the use of non-pressure reinforced concrete pipes manufactured by the German company SCHLOSSER-PFEIFFER under the Ural region geological and climatic conditions. The authors analyzed the actual operation of underground pipelines and effective loads upon them. A detailed study of the mechanical properties of reinforced concrete pipes is necessary to improve their production technology and to enhance their serviceability. The use of software-based methods helped to develop a mathematical model and to estimate the strength and crack resistance of reinforced concrete pipes at different laying depths. The authors carried out their complex research of the strain-stress behaviour of reinforced concrete pipes and identified the most hazardous sections in the structure. The calculations performed were confirmed by the results of laboratory tests completed in the construction materials, goods, and structures test center. Based on the completed research, the authors formulated their recommendations to improve the design and technology of non-pressure reinforced concrete pipes.

17 CFR 250.91 - Determination of cost.

Code of Federal Regulations, 2010 CFR

2010-04-01

... RULES AND REGULATIONS, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 Service, Sales and Construction... amount of capital reasonably necessary for the performance of services or construction for, or the... service, sales, or construction contract. (c) Any expense (including the price paid for goods) incurred in...

39 CFR 776.6 - Design requirements for construction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Design requirements for construction. 776.6 Section 776.6 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Floodplain Management § 776.6 Design requirements for construction. If structures impact, are...

17 CFR 250.95 - Reports required from affiliate service companies and companies principally engaged in performing...

Code of Federal Regulations, 2010 CFR

2010-04-01

... performance of any service or construction for, or any sale of goods to, any company of which it is an affiliate and no company whose principal business is the performance of service or construction for, or sale... REGULATIONS, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 Service, Sales and Construction Contracts § 250.95...

17 CFR 250.95 - Reports required from affiliate service companies and companies principally engaged in performing...

Code of Federal Regulations, 2011 CFR

2011-04-01

... performance of any service or construction for, or any sale of goods to, any company of which it is an affiliate and no company whose principal business is the performance of service or construction for, or sale... REGULATIONS, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 Service, Sales and Construction Contracts § 250.95...

42 CFR 137.352 - What is contained in a construction project progress report?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false What is contained in a construction project progress report? 137.352 Section 137.352 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Roles of Self-Governance Tribe in...

42 CFR 137.353 - What is contained in a construction project financial report?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false What is contained in a construction project financial report? 137.353 Section 137.353 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Roles of Self-Governance Tribe in...

42 CFR 137.352 - What is contained in a construction project progress report?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false What is contained in a construction project progress report? 137.352 Section 137.352 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Roles of Self-Governance Tribe in...

42 CFR 137.353 - What is contained in a construction project financial report?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false What is contained in a construction project financial report? 137.353 Section 137.353 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Roles of Self-Governance Tribe in...

42 CFR 137.353 - What is contained in a construction project financial report?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false What is contained in a construction project financial report? 137.353 Section 137.353 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Roles of Self-Governance Tribe in...

Research on the Problem and Countermeasures of Group-Buying

NASA Astrophysics Data System (ADS)

Dong, Yahui; Li, Wei; Cheng, Limin

The threshold of group-buying is low, so the group-buying develops very fast. But at the same time, there are many goods which have low price and high quality service which is false to get the network users' trust. Therefore, consumers should keep a clear head and avoiding straying into the trap of business, the website of group-buying should strengthen self-construction to safeguard the consumers' interest. In addition, government needs to play its due role to protect the legitimate right of the consumers.

Demonstration and Validation of a Regenerated Cellulose Dialysis Membrane Diffusion Sampler for Monitoring Ground-Water Quality and Remediation Progress at DoD Site: Perchlorate and Ordnance Compounds

DTIC Science & Technology

2011-10-01

Regulatory Council LDPE low-density polyethylene MDL minimum detection limit NAVFAC ESC Naval Facilities Engineering Command Engineering Service...membrane sampler design consists of a tubular-shaped bag made of flexible low-density polyethylene ( LDPE ) (Vroblesky, 2001a, 2001b). The LDPE tube is...requirements, and can be constructed from small-diameter LDPE tubing that fits into small- 4 diameter wells. These polyethylene diffusion bag

Final Environmental Impact Statement. F-15E Beddown at Seymour Johnson AFB, North Carolina

DTIC Science & Technology

1988-11-18

beetle; and the following threatened species: artic peregrine falcon, piping plover, dismal swamp southeastern shrew , green sea turtle, and the log...Fish and Wildlife Service’s Raleigh Field Office. There would be no construction activity in the habitats of the shrew and tiger beetle and the Iong...sAadd .. 4 P~loqh/ DIN Z7-~2S ’UL 16 󈨡 9:31 703 614 7572 PAGE.002 DISGLAIMUJ NOTIGI THIS DOCUMENT IS BEST QUALITY AVAILABLE. THE COPY FURNISHED TO

What You Should Know about Construction Disputes.

ERIC Educational Resources Information Center

Hohns, H. Murray

1979-01-01

A number of rules that will aid in the decision making of the individual confronted with the need to purchase construction services, administer a construction contract, or be responsible for the performance of those construction services. (Author)

25 CFR 900.110 - What does this subpart cover?

Code of Federal Regulations, 2013 CFR

2013-04-01

... contracts under this subpart are: design and architectural/engineering services, construction project management, and the actual construction of the building or facility in accordance with the construction... construction management services as defined in § 900.113 may be included in a construction contract under this...

25 CFR 900.110 - What does this subpart cover?

Code of Federal Regulations, 2014 CFR

2014-04-01

... contracts under this subpart are: design and architectural/engineering services, construction project management, and the actual construction of the building or facility in accordance with the construction... construction management services as defined in § 900.113 may be included in a construction contract under this...

25 CFR 900.110 - What does this subpart cover?

Code of Federal Regulations, 2011 CFR

2011-04-01

... contracts under this subpart are: design and architectural/engineering services, construction project management, and the actual construction of the building or facility in accordance with the construction... construction management services as defined in § 900.113 may be included in a construction contract under this...

25 CFR 900.110 - What does this subpart cover?

Code of Federal Regulations, 2012 CFR

2012-04-01

... contracts under this subpart are: design and architectural/engineering services, construction project management, and the actual construction of the building or facility in accordance with the construction... construction management services as defined in § 900.113 may be included in a construction contract under this...

77 FR 3070 - Electric Engineering, Architectural Services, Design Policies and Construction Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-23

... Engineering, Architectural Services, Design Policies and Construction Standards AGENCY: Rural Utilities..., engineering services and architectural services for transactions above the established threshold dollar levels... Code of Federal Regulations as follows: PART 1724--ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND...

Assessment of derelict soil quality: Abiotic, biotic and functional approaches.

PubMed

Vincent, Quentin; Auclerc, Apolline; Beguiristain, Thierry; Leyval, Corinne

2018-02-01

The intensification and subsequent closing down of industrial activities during the last century has left behind large surfaces of derelict lands. Derelict soils have low fertility, can be contaminated, and many of them remain unused. However, with the increasing demand of soil surfaces, they might be considered as a resource, for example for non-food biomass production. The study of their physico-chemical properties and of their biodiversity and biological activity may provide indications for their potential re-use. The objective of our study was to investigate the quality of six derelict soils, considering abiotic, biotic, and functional parameters. We studied (i) the soil bacteria, fungi, meso- and macro-fauna and plant communities of six different derelict soils (two from coking plants, one from a settling pond, two constructed ones made from different substrates and remediated soil, and an inert waste storage one), and (ii) their decomposition function based on the decomposer trophic network, enzyme activities, mineralization activity, and organic pollutant degradation. Biodiversity levels in these soils were high, but all biotic parameters, except the mycorrhizal colonization level, discriminated them. Multivariate analysis showed that biotic parameters co-varied more with fertility proxies than with soil contamination parameters. Similarly, functional parameters significantly co-varied with abiotic parameters. Among functional parameters, macro-decomposer proportion, enzyme activity, average mineralization capacity, and microbial polycyclic aromatic hydrocarbon degraders were useful to discriminate the soils. We assessed their quality by combining abiotic, biotic, and functional parameters: the compost-amended constructed soil displayed the highest quality, while the settling pond soil and the contaminated constructed soil displayed the lowest. Although differences among the soils were highlighted, this study shows that derelict soils may provide a biodiversity ecosystem service and are functional for decomposition. Copyright © 2017 Elsevier B.V. All rights reserved.

Use of qualitative methods to explore the quality-of-life construct from a consumer perspective.

PubMed

Corring, Deborah J; Cook, Joanne V

2007-02-01

This study explored the construct of quality of life from the perspective of adults diagnosed as having severe and persistent mental illness, such as schizophrenia. Qualitative research strategies, specifically in-depth interviews (N=18) and focus groups (N=35), were used to collect data. Interviews and focus groups took place in hospitals, community clinics, community agencies, and clients' homes. A convenience, snowball sampling strategy was utilized. Analysis using the constant comparative method resulted in the identification of two dominant themes. These themes permeated the results, crossed all domains, influenced the linkages between domains, and clearly influenced how individuals frame their expectations regarding quality of life. The first theme was the presence of stigma and its effects on everyday life and future planning, and the second was the pervasive fear of the return of major positive symptoms of psychosis, such as hallucinations, delusions, and general loss of contact with reality. In addition, four quality-of-life domains were identified-the experience of illness, relationships, occupation, and sense of self. Many persons with mental illness simply wish for the basics in life-mental and physical health, supportive relationships, meaningful occupations, and a positive sense of self-believing that acquisition of these basics will lead to a more satisfactory quality of life. Ensuring that they are able to obtain the basics requires action on their part, by those who support them, by service providers that interact with them, and by a more accepting society.

Contract management techniques for improving construction quality

DOT National Transportation Integrated Search

1997-07-01

Efforts to improve quality in highway construction embrace many aspects of the construction process. Quality goals include enhanced efficiency and productivity, optimal cost and delivery time, improved performance, and changes in attitude-promoting a...

Impacts: NIST Building and Fire Research Laboratory (technical and societal)

NASA Astrophysics Data System (ADS)

Raufaste, N. J.

1993-08-01

The Building and Fire Research Laboratory (BFRL) of the National Institute of Standards and Technology (NIST) is dedicated to the life cycle quality of constructed facilities. The report describes major effects of BFRL's program on building and fire research. Contents of the document include: structural reliability; nondestructive testing of concrete; structural failure investigations; seismic design and construction standards; rehabilitation codes and standards; alternative refrigerants research; HVAC simulation models; thermal insulation; residential equipment energy efficiency; residential plumbing standards; computer image evaluation of building materials; corrosion-protection for reinforcing steel; prediction of the service lives of building materials; quality of construction materials laboratory testing; roofing standards; simulating fires with computers; fire safety evaluation system; fire investigations; soot formation and evolution; cone calorimeter development; smoke detector standards; standard for the flammability of children's sleepwear; smoldering insulation fires; wood heating safety research; in-place testing of concrete; communication protocols for building automation and control systems; computer simulation of the properties of concrete and other porous materials; cigarette-induced furniture fires; carbon monoxide formation in enclosure fires; halon alternative fire extinguishing agents; turbulent mixing research; materials fire research; furniture flammability testing; standard for the cigarette ignition resistance of mattresses; support of navy firefighter trainer program; and using fire to clean up oil spills.

The complexity of earth observation valuation: Modeling the patterns and processes of agricultural production and groundwater quality to construct a production possibilities frontier

NASA Astrophysics Data System (ADS)

Forney, W.; Raunikar, R. P.; Bernknopf, R.; Mishra, S.

2012-12-01

A production possibilities frontier (PPF) is a graph comparing the production interdependencies for two commodities. In this case, the commodities are defined as the ecosystem services of agricultural production and groundwater quality. This presentation focuses on the refinement of techniques used in an application to estimate the value of remote sensing information. Value of information focuses on the use of uncertain and varying qualities of information within a specific decision-making context for a certain application, which in this case included land use, biogeochemical, hydrogeologic, economic and geospatial data and models. The refined techniques include deriving alternate patterns and processes of ecosystem functions, new estimates of ecosystem service values to construct a PPF, and the extension of this work into decision support systems. We have coupled earth observations of agricultural production with groundwater quality measurements to estimate the value of remote sensing information in northeastern Iowa to be 857M ± 198M (at the 2010 price level) per year. We will present an improved method for modeling crop rotation patterns to include multiple years of rotation, reduction in the assumptions associated with optimal land use allocations, and prioritized improvement of the resolution of input data (for example, soil resources and topography). The prioritization focuses on watersheds that were identified at a coarse-scale of analysis to have higher intensities of agricultural production and lower probabilities of groundwater survivability (in other words, remaining below a regulatory threshold for nitrate pollution) over time, and thus require finer-scaled modeling and analysis. These improved techniques and the simulation of certain scale-dependent policy and management actions, which trade-off the objectives of optimizing crop value versus maintaining potable groundwater, and provide new estimates for the empirical values of the PPF. The calculation of a PPF in this way provides a decision maker with a tool to consider the ramifications of different policies, management practices and regional objectives.

The index of tobacco treatment quality: development of a tool to assess evidence-based treatment in a national sample of drug treatment facilities.

PubMed

Cupertino, A Paula; Hunt, Jamie J; Gajewski, Byron J; Jiang, Yu; Marquis, Janet; Friedmann, Peter D; Engelman, Kimberly K; Richter, Kimber P

2013-03-15

Quitting smoking improves health and drug use outcomes among people in treatment for substance abuse. The twofold purpose of this study is to describe tobacco treatment provision across a representative sample of U.S. facilities and to use these data to develop the brief Index of Tobacco Treatment Quality (ITTQ). We constructed survey items based on current tobacco treatment guidelines, existing surveys, expert input, and qualitative research. We administered the survey to a stratified sample of 405 facility administrators selected from all 3,800 U.S. adult outpatient facilities listed in the SAMHSA Inventory of Substance Abuse Treatment Services. We constructed the ITTQ with a subset of 7 items that have the strongest clinical evidence for smoking cessation. Most facilities (87.7%) reported that a majority of their clients were asked if they smoke cigarettes. Nearly half of facilities (48.6%) reported that a majority of their smoking clients were advised to quit. Fewer (23.3%) reported that a majority of their smoking clients received tobacco treatment counseling and even fewer facilities (18.3%) reported a majority of their smoking clients were advised to use quit smoking medications. The median facility ITTQ score was 2.57 (on a scale of 1-5) and the ITTQ displayed good internal consistency (Cronbach's alpha = .844). Moreover, the ITTQ had substantial test-retest reliability (.856), and ordinal confirmatory factor analysis found that our one-factor model for ITTQ fit the data very well with a CFI of 0.997 and an RMSEA of 0.042. The ITTQ is a brief and reliable tool for measuring tobacco treatment quality in substance abuse treatment facilities. Given the clear-cut room for improvement in tobacco treatment, the ITTQ could be an important tool for quality improvement by identifying service levels, facilitating goal setting, and measuring change.

The index of tobacco treatment quality: development of a tool to assess evidence-based treatment in a national sample of drug treatment facilities

PubMed Central

2013-01-01

Background Quitting smoking improves health and drug use outcomes among people in treatment for substance abuse. The twofold purpose of this study is to describe tobacco treatment provision across a representative sample of U.S. facilities and to use these data to develop the brief Index of Tobacco Treatment Quality (ITTQ). Methods We constructed survey items based on current tobacco treatment guidelines, existing surveys, expert input, and qualitative research. We administered the survey to a stratified sample of 405 facility administrators selected from all 3,800 U.S. adult outpatient facilities listed in the SAMHSA Inventory of Substance Abuse Treatment Services. We constructed the ITTQ with a subset of 7 items that have the strongest clinical evidence for smoking cessation. Results Most facilities (87.7%) reported that a majority of their clients were asked if they smoke cigarettes. Nearly half of facilities (48.6%) reported that a majority of their smoking clients were advised to quit. Fewer (23.3%) reported that a majority of their smoking clients received tobacco treatment counseling and even fewer facilities (18.3%) reported a majority of their smoking clients were advised to use quit smoking medications. The median facility ITTQ score was 2.57 (on a scale of 1–5) and the ITTQ displayed good internal consistency (Cronbach’s alpha = .844). Moreover, the ITTQ had substantial test-retest reliability (.856), and ordinal confirmatory factor analysis found that our one-factor model for ITTQ fit the data very well with a CFI of 0.997 and an RMSEA of 0.042. Conclusions The ITTQ is a brief and reliable tool for measuring tobacco treatment quality in substance abuse treatment facilities. Given the clear-cut room for improvement in tobacco treatment, the ITTQ could be an important tool for quality improvement by identifying service levels, facilitating goal setting, and measuring change. PMID:23497366

Experimental Design-Based Functional Mining and Characterization of High-Throughput Sequencing Data in the Sequence Read Archive

PubMed Central

Nakazato, Takeru; Ohta, Tazro; Bono, Hidemasa

2013-01-01

High-throughput sequencing technology, also called next-generation sequencing (NGS), has the potential to revolutionize the whole process of genome sequencing, transcriptomics, and epigenetics. Sequencing data is captured in a public primary data archive, the Sequence Read Archive (SRA). As of January 2013, data from more than 14,000 projects have been submitted to SRA, which is double that of the previous year. Researchers can download raw sequence data from SRA website to perform further analyses and to compare with their own data. However, it is extremely difficult to search entries and download raw sequences of interests with SRA because the data structure is complicated, and experimental conditions along with raw sequences are partly described in natural language. Additionally, some sequences are of inconsistent quality because anyone can submit sequencing data to SRA with no quality check. Therefore, as a criterion of data quality, we focused on SRA entries that were cited in journal articles. We extracted SRA IDs and PubMed IDs (PMIDs) from SRA and full-text versions of journal articles and retrieved 2748 SRA ID-PMID pairs. We constructed a publication list referring to SRA entries. Since, one of the main themes of -omics analyses is clarification of disease mechanisms, we also characterized SRA entries by disease keywords, according to the Medical Subject Headings (MeSH) extracted from articles assigned to each SRA entry. We obtained 989 SRA ID-MeSH disease term pairs, and constructed a disease list referring to SRA data. We previously developed feature profiles of diseases in a system called “Gendoo”. We generated hyperlinks between diseases extracted from SRA and the feature profiles of it. The developed project, publication and disease lists resulting from this study are available at our web service, called “DBCLS SRA” (http://sra.dbcls.jp/). This service will improve accessibility to high-quality data from SRA. PMID:24167589

Beyond the material grave: Life Cycle Impact Assessment of leaching from secondary materials in road and earth constructions.

PubMed

Schwab, Oliver; Bayer, Peter; Juraske, Ronnie; Verones, Francesca; Hellweg, Stefanie

2014-10-01

In industrialized countries, large amounts of mineral wastes are produced. They are re-used in various ways, particularly in road and earth constructions, substituting primary resources such as gravel. However, they may also contain pollutants, such as heavy metals, which may be leached to the groundwater. The toxic impacts of these emissions are so far often neglected within Life Cycle Assessments (LCA) of products or waste treatment services and thus, potentially large environmental impacts are currently missed. This study aims at closing this gap by assessing the ecotoxic impacts of heavy metal leaching from industrial mineral wastes in road and earth constructions. The flows of metals such as Sb, As, Pb, Cd, Cr, Cu, Mo, Ni, V and Zn originating from three typical constructions to the environment are quantified, their fate in the environment is assessed and potential ecotoxic effects evaluated. For our reference country, Germany, the industrial wastes that are applied as Granular Secondary Construction Material (GSCM) carry more than 45,000 t of diverse heavy metals per year. Depending on the material quality and construction type applied, up to 150 t of heavy metals may leach to the environment within the first 100 years after construction. Heavy metal retardation in subsoil can potentially reduce the fate to groundwater by up to 100%. One major challenge of integrating leaching from constructions into macro-scale LCA frameworks is the high variability in micro-scale technical and geographical factors, such as material qualities, construction types and soil types. In our work, we consider a broad range of parameter values in the modeling of leaching and fate. This allows distinguishing between the impacts of various road constructions, as well as sites with different soil properties. The findings of this study promote the quantitative consideration of environmental impacts of long-term leaching in Life Cycle Assessment, complementing site-specific risk assessment, for the design of waste management strategies, particularly in the construction sector. Copyright © 2014 Elsevier Ltd. All rights reserved.

42 CFR 137.351 - Is a Self-Governance Tribe required to submit construction project progress and financial reports...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Is a Self-Governance Tribe required to submit construction project progress and financial reports for construction project agreements? 137.351 Section 137.351 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

42 CFR 137.351 - Is a Self-Governance Tribe required to submit construction project progress and financial reports...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Is a Self-Governance Tribe required to submit construction project progress and financial reports for construction project agreements? 137.351 Section 137.351 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

42 CFR 137.351 - Is a Self-Governance Tribe required to submit construction project progress and financial reports...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Is a Self-Governance Tribe required to submit construction project progress and financial reports for construction project agreements? 137.351 Section 137.351 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

Service quality in health care setting.

PubMed

Rashid, Wan Edura Wan; Jusoff, Hj Kamaruzaman

2009-01-01

This paper attempts to explore the concept of service quality in a health care setting. This paper probes the definition of service quality from technical and functional aspects for a better understanding on how consumers evaluate the quality of health care. It adopts the conceptual model of service quality frequently used by the most researchers in the health care sector. The paper also discusses several service quality dimensions and service quality problems in order to provide a more holistic conception of hospital service quality. The paper finds that service quality in health care is very complex as compared to other services because this sector highly involves risk. The paper adds a new perspective towards understanding how the concept of service quality is adopted in a health care setting.

17 CFR 250.83 - Exemption in the case of transactions with foreign associates.

Code of Federal Regulations, 2010 CFR

2010-04-01

... become engaged in the performance of any service, sales, or construction contract for any associate... thereunder, relating to the performance of any service, sales, or construction contract for such associate... Service, Sales and Construction Contracts § 250.83 Exemption in the case of transactions with foreign...

18 CFR 367.24 - Construction and service contracts for other companies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... service company undertakes projects to construct physical property for associate or non-associate... COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED... POWER ACT AND NATURAL GAS ACT General Instructions § 367.24 Construction and service contracts for other...

GP Practices as a One-Stop Shop: How Do Patients Perceive the Quality of Care? A Cross-Sectional Study in Thirty-Four Countries.

PubMed

Schäfer, Willemijn L A; Boerma, Wienke G W; Schellevis, François G; Groenewegen, Peter P

2017-12-29

To contribute to the current knowledge on how a broad range of services offered by general practitioners (GPs) may contribute to the patient perceived quality and, hence, the potential benefits of primary care. Between 2011 and 2013, primary care data were collected among GPs and their patients in 31 European countries, plus Australia, Canada, and New Zealand. In these countries, GPs are the main providers of primary care, mostly specialized in family medicine and working in the ambulatory setting. In this cross-sectional study, questionnaires were completed by 7,183 GPs and 61,931 visiting patients. Moreover, 7,270 patients answered questions about what they find important (their values). In the analyses of patient experiences, we adjusted for patients' values in each country to measure patient perceived quality. Perceived quality was measured regarding five areas: accessibility and continuity of care, doctor-patient communication, patient involvement in decision making, and comprehensiveness of care. The range of GP services was measured in relation to four areas: (1) to what extent they are the first contact to the health care system for patients in need of care, (2) their involvement in treatment and follow-up of acute and chronic conditions, in other words treatment of diseases, (3) their involvement in minor technical procedures, and (4) their involvement in preventive treatments. Data of the patients were linked to the data of the GPs. Multilevel modeling was used to construct scale scores for the experiences of patients in the five areas of quality and the range of services of GPs. In these four-level models, items were nested within patients, nested in GP practices, nested in countries. The relationship between the range of services and the experiences of patients was analyzed in three-level multilevel models, also taking into account the values of patients. In countries where GPs offer a broader range of services patients perceive better accessibility, continuity, and comprehensiveness of care, and more involvement in decision making. No associations were found between the range of services and the patient perceived communication with their GP. The range of GP services mostly explained the variation between countries in the areas of patient perceived accessibility and continuity of care. This study showed that in countries where GP practices serve as a "one-stop shop," patients perceive better quality of care, especially in the areas of accessibility and continuity of care. Therefore, primary care in a country is expected to benefit from investments in a broader range of services of GPs or other primary care physicians. © Health Research and Educational Trust.

7 CFR 1924.3 - Authorities and responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS CONSTRUCTION AND REPAIR Planning and Performing Construction and Other Development...

Study on the quality of FRP fishing vessel based on improved Fishbone Chart

NASA Astrophysics Data System (ADS)

Sui, J. H.; Yu, Y. F.; Du, Q. F.; Jiang, D. W.

2018-01-01

The construction quality of FRP fishing vessels influences their production, use and industry development. In order to explore the factors that affect the construction quality of FRP fishing vessels, key factors affecting the construction quality of FRP fishing vessels are determined based on the quality problems of FRP fishing vessels constructed. The improved Fishbone Chart is used to analyze the eight factors of “human, machine, material, process, environment, inspection, design and information”. Taking the factors that affect the construction quality of FRP fishing vessels as the central target, the eight influencing factors were condensed into five aspects and a composite Fishbone Chart is drawn. The Fishbone Chart is used as the basic model, the influencing factors are sorted, screened and discriminated, and the system model convenient for construction site management and control is established. Finally, the causes of poor construction of FRP fishing vessels are analyzed and discussed, and relevant suggestions are put forward.

Service quality and clinical outcomes: an example from mental health rehabilitation services in England.

PubMed

Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael

2013-01-01

Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.

Examining the feasibility of an economic analysis of dyadic developmental psychotherapy for children with maltreatment associated psychiatric problems in the United Kingdom.

PubMed

Boyer, Nicole R S; Boyd, Kathleen A; Turner-Halliday, Fiona; Watson, Nicholas; Minnis, Helen

2014-12-10

Children with maltreatment associated psychiatric problems are at increased risk of developing behavioural or mental health disorders. Dyadic Developmental Psychotherapy (DDP) was proposed as treatment for children with maltreatment histories in the USA, however, being new to the UK little is known of its effectiveness or cost-effectiveness. As part of an exploratory study, this paper explores the feasibility of undertaking economic analysis of DDP in the UK. Feasibility for economic analysis was determined by ensuring such analysis could meet key criteria for economic evaluation. Phone interviews were conducted with professionals (therapists trained and accredited or in the process of becoming accredited DDP practitioners). Three models were developed to represent alternative methods of DDP service delivery. Once appropriate comparators were determined, economic scenarios were constructed. Cost analyses were undertaken from a societal perspective. Finally, appropriate outcome measurement was explored through clinical opinion, literature and further discussions with clinical experts. Three DDP models were constructed: DDP Full-Basic, DDP Home-Based and DDP Long-Term. Two potential comparator interventions were identified and defined as Consultation with Carers and Individual Psychotherapy. Costs of intervention completion per case were estimated to be: £6,700 (DDP Full-Basic), £7,100 (Consultations with Carers), £7,200 (DDP Home-Based), £11,400 (Individual Psychotherapy) and £14,500 (DDP Long-Term). None of the models of service delivery were found to currently measure effectiveness consistently. The Strengths and Difficulties Questionnaire (SDQ) was deemed an appropriate primary outcome measure, however, it does not cover all disorders DDP intends to treat and the SDQ is not a direct measure of health gain. Inclusion of quality of life measurement is required for comprehensive economic analysis. Economic analysis of DDP in the UK is feasible if vital next steps are taken to measure intervention outcomes consistently, ideally with a quality of life measurement. An economic analysis using the models constructed could determine the potential cost-effectiveness of DDP in the UK and identify the most efficient mode of service delivery.

Developing students' worksheets applying soft skill-based scientific approach for improving building engineering students' competencies in vocational high schools

NASA Astrophysics Data System (ADS)

Suparno, Sudomo, Rahardjo, Boedi

2017-09-01

Experts and practitioners agree that the quality of vocational high schools needs to be greatly improved. Many construction services have voiced their dissatisfaction with today's low-quality vocational high school graduates. The low quality of graduates is closely related to the quality of the teaching and learning process, particularly teaching materials. In their efforts to improve the quality of vocational high school education, the government have implemented Curriculum 2013 (K13) and supplied teaching materials. However, the results of monitoring and evaluation done by the Directorate of Vocational High School, Directorate General of Secondary Education (2014), the provision of tasks for students in the teaching materials was totally inadequate. Therefore, to enhance the quality and the result of the instructional process, there should be provided students' worksheets that can stimulate and improve students' problem-solving skills and soft skills. In order to develop worksheets that can meet the academic requirements, the development needs to be in accordance with an innovative learning approach, which is the soft skill-based scientific approach.

75 FR 13299 - Lower Colorado River Authority Transmission Services Corporation; Construction, Operation...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

...] Lower Colorado River Authority Transmission Services Corporation; Construction, Operation, Maintenance... activities associated with LCRA TSC's construction, maintenance, operation, and repair of four Competitive..., substation upgrades, and access roads) required to be constructed by the Public Utility Commission of Texas...

22 CFR 228.39 - Special source rules for construction and engineering services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... engineering services. 228.39 Section 228.39 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES ON... engineering services. Advanced developing countries, eligible under Geographic Code 941, which have attained a competitive capability in international markets for construction services or engineering services are not...

7 CFR 1717.606 - Standard forms of construction contracts, and engineering and architectural services contracts.

Code of Federal Regulations, 2013 CFR

2013-01-01

... engineering and architectural services contracts. 1717.606 Section 1717.606 Agriculture Regulations of the... Standard forms of construction contracts, and engineering and architectural services contracts. All..., materials, equipment, engineering services, and architectural services, regardless of the source of funding...

7 CFR 1717.606 - Standard forms of construction contracts, and engineering and architectural services contracts.

Code of Federal Regulations, 2012 CFR

2012-01-01

... engineering and architectural services contracts. 1717.606 Section 1717.606 Agriculture Regulations of the... Standard forms of construction contracts, and engineering and architectural services contracts. All..., materials, equipment, engineering services, and architectural services, regardless of the source of funding...

7 CFR 1717.606 - Standard forms of construction contracts, and engineering and architectural services contracts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... engineering and architectural services contracts. 1717.606 Section 1717.606 Agriculture Regulations of the... Standard forms of construction contracts, and engineering and architectural services contracts. All..., materials, equipment, engineering services, and architectural services, regardless of the source of funding...

7 CFR 1717.606 - Standard forms of construction contracts, and engineering and architectural services contracts.

Code of Federal Regulations, 2014 CFR

2014-01-01

... engineering and architectural services contracts. 1717.606 Section 1717.606 Agriculture Regulations of the... Standard forms of construction contracts, and engineering and architectural services contracts. All..., materials, equipment, engineering services, and architectural services, regardless of the source of funding...

7 CFR 1717.606 - Standard forms of construction contracts, and engineering and architectural services contracts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... engineering and architectural services contracts. 1717.606 Section 1717.606 Agriculture Regulations of the... Standard forms of construction contracts, and engineering and architectural services contracts. All..., materials, equipment, engineering services, and architectural services, regardless of the source of funding...

22 CFR 228.39 - Special source rules for construction and engineering services.

Code of Federal Regulations, 2011 CFR

2011-04-01

... engineering services. 228.39 Section 228.39 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES ON... engineering services. Advanced developing countries, eligible under Geographic Code 941, which have attained a competitive capability in international markets for construction services or engineering services are not...

Constructing RBAC Based Security Model in u-Healthcare Service Platform

PubMed Central

Shin, Moon Sun; Jeon, Heung Seok; Ju, Yong Wan; Lee, Bum Ju; Jeong, Seon-Phil

2015-01-01

In today's era of aging society, people want to handle personal health care by themselves in everyday life. In particular, the evolution of medical and IT convergence technology and mobile smart devices has made it possible for people to gather information on their health status anytime and anywhere easily using biometric information acquisition devices. Healthcare information systems can contribute to the improvement of the nation's healthcare quality and the reduction of related cost. However, there are no perfect security models or mechanisms for healthcare service applications, and privacy information can therefore be leaked. In this paper, we examine security requirements related to privacy protection in u-healthcare service and propose an extended RBAC based security model. We propose and design u-healthcare service integration platform (u-HCSIP) applying RBAC security model. The proposed u-HCSIP performs four main functions: storing and exchanging personal health records (PHR), recommending meals and exercise, buying/selling private health information or experience, and managing personal health data using smart devices. PMID:25695104

Constructing RBAC based security model in u-healthcare service platform.

PubMed

Shin, Moon Sun; Jeon, Heung Seok; Ju, Yong Wan; Lee, Bum Ju; Jeong, Seon-Phil

2015-01-01

In today's era of aging society, people want to handle personal health care by themselves in everyday life. In particular, the evolution of medical and IT convergence technology and mobile smart devices has made it possible for people to gather information on their health status anytime and anywhere easily using biometric information acquisition devices. Healthcare information systems can contribute to the improvement of the nation's healthcare quality and the reduction of related cost. However, there are no perfect security models or mechanisms for healthcare service applications, and privacy information can therefore be leaked. In this paper, we examine security requirements related to privacy protection in u-healthcare service and propose an extended RBAC based security model. We propose and design u-healthcare service integration platform (u-HCSIP) applying RBAC security model. The proposed u-HCSIP performs four main functions: storing and exchanging personal health records (PHR), recommending meals and exercise, buying/selling private health information or experience, and managing personal health data using smart devices.

39 CFR 776.6 - Design requirements for construction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Design requirements for construction. 776.6 Section 776.6 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Floodplain Management § 776.6 Design requirements for construction. If structures impact, are located in, or support development in a...

48 CFR 52.223-2 - Affirmative Procurement of Biobased Products Under Service and Construction Contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Biobased Products Under Service and Construction Contracts. 52.223-2 Section 52.223-2 Federal Acquisition... CONTRACT CLAUSES Text of Provisions and Clauses 52.223-2 Affirmative Procurement of Biobased Products Under Service and Construction Contracts. As prescribed in 23.406(b), insert the following clause: Affirmative...

Analysing the Socio-Psychological Construction of Identity among Pre-Service Teachers

ERIC Educational Resources Information Center

Sanya Pelini, Eunice

2017-01-01

A teacher's representation of self is crucial in how they construct their identity. In this article, it is argued that pre-service teachers' identities are intricately linked to their perceptions of the teaching profession. This paper explores the social construction of identity among pre-service teachers and the implications for professional…

48 CFR 1827.304-3 - Contracts for construction work or architect-engineer services. (NASA supplements paragraph (a))

Code of Federal Regulations, 2010 CFR

2010-10-01

... work or architect-engineer services. (NASA supplements paragraph (a)) 1827.304-3 Section 1827.304-3... REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Patent Rights Under Government Contracts 1827.304-3 Contracts for construction work or architect-engineer services. (NASA supplements paragraph (a)) (a) For construction or...

Quality effort decision in service supply chain with quality preference based on quantum game

NASA Astrophysics Data System (ADS)

Zhang, Cuihua; Xing, Peng; Wang, Jianwei

2015-04-01

Service quality preference behaviors of both members are considered in service supply chain (SSC) including a service integrator and a service provider with stochastic demand. Through analysis of service quality cost and revenue, the utility functions are established on service quality effort degree and service quality preference level in integrated and decentralized SSC. Nash equilibrium and quantum game are used to optimize the models. By comparing the different solutions, the optimal strategies are obtained in SSC with quality preference. Then some numerical examples are studied and the changing trend of service quality effort is further analyzed by the influence of the entanglement operator and quality preferences.

47 CFR 1.946 - Construction and coverage requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Random Selection Wireless Radio Services Applications and Proceedings Application Requirements and... requirements. For each of the Wireless Radio Services, requirements for construction and commencement of... service requirements. In certain Wireless Radio Services, licensees must comply with geographic coverage...

47 CFR 1.946 - Construction and coverage requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Random Selection Wireless Radio Services Applications and Proceedings Application Requirements and... requirements. For each of the Wireless Radio Services, requirements for construction and commencement of... service requirements. In certain Wireless Radio Services, licensees must comply with geographic coverage...

47 CFR 1.946 - Construction and coverage requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Random Selection Wireless Radio Services Applications and Proceedings Application Requirements and... requirements. For each of the Wireless Radio Services, requirements for construction and commencement of... service requirements. In certain Wireless Radio Services, licensees must comply with geographic coverage...

Decision Support Tool for Nighttime Construction and Air Quality - User’s Guide

DOT National Transportation Integrated Search

2017-11-01

The Texas Department of Transportation (TxDOT) Research Project 0-6864 Investigate the Air Quality Benefits of Nighttime Construction in Non-attainment Counties investigated the potential air quality benefits of shifting construction/maintenance acti...

E-Services quality assessment framework for collaborative networks

NASA Astrophysics Data System (ADS)

Stegaru, Georgiana; Danila, Cristian; Sacala, Ioan Stefan; Moisescu, Mihnea; Mihai Stanescu, Aurelian

2015-08-01

In a globalised networked economy, collaborative networks (CNs) are formed to take advantage of new business opportunities. Collaboration involves shared resources and capabilities, such as e-Services that can be dynamically composed to automate CN participants' business processes. Quality is essential for the success of business process automation. Current approaches mostly focus on quality of service (QoS)-based service selection and ranking algorithms, overlooking the process of service composition which requires interoperable, adaptable and secure e-Services to ensure seamless collaboration, data confidentiality and integrity. Lack of assessment of these quality attributes can result in e-Service composition failure. The quality of e-Service composition relies on the quality of each e-Service and on the quality of the composition process. Therefore, there is the need for a framework that addresses quality from both views: product and process. We propose a quality of e-Service composition (QoESC) framework for quality assessment of e-Service composition for CNs which comprises of a quality model for e-Service evaluation and guidelines for quality of e-Service composition process. We implemented a prototype considering a simplified telemedicine use case which involves a CN in e-Healthcare domain. To validate the proposed quality-driven framework, we analysed service composition reliability with and without using the proposed framework.

42 CFR 137.274 - Does this subpart cover construction programs?

Code of Federal Regulations, 2014 CFR

2014-10-01

... INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction....275, this subpart does not cover construction programs such as the: (a) Maintenance and Improvement...

42 CFR 137.274 - Does this subpart cover construction programs?

Code of Federal Regulations, 2013 CFR

2013-10-01

... INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction....275, this subpart does not cover construction programs such as the: (a) Maintenance and Improvement...

42 CFR 137.274 - Does this subpart cover construction programs?

Code of Federal Regulations, 2012 CFR

2012-10-01

... INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction....275, this subpart does not cover construction programs such as the: (a) Maintenance and Improvement...

42 CFR 137.274 - Does this subpart cover construction programs?

Code of Federal Regulations, 2010 CFR

2010-10-01

... INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction....275, this subpart does not cover construction programs such as the: (a) Maintenance and Improvement...

42 CFR 137.274 - Does this subpart cover construction programs?

Code of Federal Regulations, 2011 CFR

2011-10-01

... INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction....275, this subpart does not cover construction programs such as the: (a) Maintenance and Improvement...

The trade-off between hospital cost and quality of care. An exploratory empirical analysis.

PubMed

Morey, R C; Fine, D J; Loree, S W; Retzlaff-Roberts, D L; Tsubakitani, S

1992-08-01

The debate concerning quality of care in hospitals, its "value" and affordability, is increasingly of concern to providers, consumers, and purchasers in the United States and elsewhere. We undertook an exploratory study to estimate the impact on hospital-wide costs if quality-of-care levels were varied. To do so, we obtained costs and service output data regarding 300 U.S. hospitals, representing approximately a 5% cross section of all hospitals operating in 1983; both inpatient and outpatient services were included. The quality-of-care measure used for the exploratory analysis was the ratio of actual deaths in the hospital for the year in question to the forecasted number of deaths for the hospital; the hospital mortality forecaster had earlier (and elsewhere) been built from analyses of 6 million discharge abstracts, and took into account each hospital's actual individual admissions, including key patient descriptors for each admission. Such adjusted death rates have increasingly been used as potential indicators of quality, with recent research lending support for the viability of that linkage. The authors then utilized the economic construct of allocative efficiency relying on "best practices" concepts and peer groupings, built using the "envelopment" philosophy of Data Envelopment Analysis and Pareto efficiency. These analytical techniques estimated the efficiently delivered costs required to meet prespecified levels of quality of care. The marginal additional cost per each death deferred in 1983 was estimated to be approximately $29,000 (in 1990 dollars) for the average efficient hospital. Also, over a feasible range, a 1% increase in the level of quality of care delivered was estimated to increase hospital cost by an average of 1.34%. This estimated elasticity of quality on cost also increased with the number of beds in the hospital.

Infrared survey of 50 buildings constructed during 100 years: thermal performances and damage conditions

NASA Astrophysics Data System (ADS)

Ljungberg, Sven-Ake

1995-03-01

Different building constructions and craftsmanship give rise to different thermal performance and damage conditions. The building stock of most industrial countries consists of buildings of various age, and constructions, from old historic buildings with heavy stone or wooden construction, to new buildings with heavy or light concrete construction, or modern steel or wooden construction. In this paper the result from a detailed infrared survey of 50 buildings from six Swedish military camps is presented. The presentation is limited to a comparison of thermal performance and damage conditions of buildings of various ages, functions, and constructions, of a building period of more than 100 years. The result is expected to be relevant even to civilian buildings. Infrared surveys were performed during 1992-1993, with airborne, and mobile short- and longwave infrared systems, out- and indoor thermography. Interpretation and analysis of infrared data was performed with interactive image and analyzing systems. Field inspections were carried out with fiber optics system, and by ocular inspections. Air-exchange rate was measured in order to quantify air leakages through the building envelope, indicated in thermograms. The objects studied were single-family houses, barracks, office-, service-, school- and exercise buildings, military hotels and restaurants, aircraft hangars, and ship factory buildings. The main conclusions from this study are that most buildings from 1880 - 1940 have a solid construction with a high quality of craftsmanship, relatively good thermal performance, due to extremely thick walls, and adding insulation at the attic floor. From about 1940 - 1960 the quality of construction, thermal performance and craftsmanship seem to vary a lot. Buildings constructed during the period of 1960 - 1990 have in general the best thermal performance due to a better insulation capacity, however, also one finds here the greatest variety of problems. The result from this study is to be incorporated in planning of short- and long term maintenance programs of the Swedish Defence. In general the military buildings are expected to have better status than civilian buildings, due to the more rigorous control during the building process, performed by military building authorities.

'Forensic' labelling: an empirical assessment of its effects on self-stigma for people with severe mental illness.

PubMed

Livingston, James D; Rossiter, Katherine R; Verdun-Jones, Simon N

2011-06-30

Increasingly, specialized 'forensic' mental health services are being developed to address the criminogenic and clinical needs of people with mental illness who are involved in the criminal justice system. Theoretically, the construction of such specialized services can produce simultaneous positive benefits and negative consequences. This mixed methods study examined and compared the level of self-stigma that was experienced by people who receive compulsory community-based treatment services in the forensic (n=52) and civil (n=39) mental health systems of British Columbia, Canada. The quantitative findings indicate that 'forensic' labelling was not associated with elevated levels of self-stigma. Quantitative level of self-stigma was significantly associated with psychiatric symptom severity, history of incarceration, and history of homelessness. The qualitative findings suggest that access to high-quality, well-resourced forensic mental health services may, for some service users, come at the risk of increased exposure to social and structural stigma. Together, these findings reveal some of the strengths and weaknesses that are associated with organizing forensic mental health services using a specialized service delivery model. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Validity and test-retest reliability of the self-completion adult social care outcomes toolkit (ASCOT-SCT4) with adults with long-term physical, sensory and mental health conditions in England.

PubMed

Rand, Stacey; Malley, Juliette; Towers, Ann-Marie; Netten, Ann; Forder, Julien

2017-08-18

The Adult Social Care Outcomes Toolkit (ASCOT-SCT4) is a multi-attribute utility index designed for the evaluation of long-term social care services. The measure comprises eight attributes that capture aspects of social care-related quality of life. The instrument has previously been validated with a sample of older adults who used home care services in England. This paper aims to demonstrate the instrument's test-retest reliability and provide evidence for its validity in a diverse sample of adults who use publicly-funded, community-based social care in England. A survey of 770 social care service users was conducted in England. A subsample of 100 services users participated in a follow-up interview between 7 and 21 days after baseline. Spearman rank correlation coefficients between the ASCOT-SCT4 index score and the EQ-5D-3 L, the ICECAP-A or ICECAP-O and overall quality of life were used to assess convergent validity. Data on variables hypothesised to be related to the ASCOT-SCT4 index score, as well as rating of individual attributes, were also collected. Hypothesised relationships were tested using one-way ANOVA or Fisher's exact test. Test-retest reliability was assessed using the intra-class correlation coefficient for the ASCOT-SCT4 index score at baseline and follow-up. There were moderate to strong correlations between the ASCOT-SCT4 index and EQ-5D-3 L, the ICECAP-A or ICECAP-O, and overall quality of life (all correlations ≥ 0.3). The construct validity was further supported by statistically significant hypothesised relationships between the ASCOT-SCT4 index and individual characteristics in univariate and multivariate analysis. There was also further evidence for the construct validity for the revised Food and drink and Dignity items. The test-retest reliability was considered to be good (ICC = 0.783; 95% CI: 0.678-0.857). The ASCOT-SCT4 index has good test-retest reliability for adults with physical or sensory disabilities who use social care services. The index score and the attributes appear to be valid for adults receiving social care for support reasons connected to underlying mental health problems, and physical or sensory disabilities. Further reliability testing with a wider sample of social care users is warranted, as is further exploration of the relationship between the ASCOT-SCT4, ICECAP-A/O and EQ-5D-3 L indices.

Hospitalist workload influences faculty evaluations by internal medicine clerkship students.

PubMed

Robinson, Robert L

2015-01-01

The last decade has brought significant changes to internal medicine clerkships through resident work-hour restrictions and the widespread adoption of hospitalists as medical educators. These key medical educators face competing demands for quality teaching and clinical service intensity. The study reported here was conducted to explore the relationship between clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students. A retrospective correlation analysis of clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students during the 2009 to 2013 academic years at Southern Illinois University School of Medicine was conducted. Internal medicine hospitalists who supervise the third-year inpatient experience for medical students during the 2009 to 2013 academic years participated in the study. Clinical service intensity data in terms of work relative value units (RVUs), patient encounters, and days of inpatient duty were collected for all members of the hospitalist service. Medical students rated hospitalists in the areas of patient rapport, enthusiasm about the profession, clinical skills, sharing knowledge and skills, encouraging the students, probing student knowledge, stimulating independent learning, providing timely feedback, providing constructive criticism, and observing patient encounters with students. Significant negative correlations between higher work RVU production, total patient encounters, duty days, and learner evaluation scores for enthusiasm about the profession, clinical skills, probing the student for knowledge and judgment, and observing a patient encounter with the student were identified. Higher duty days had a significant negative correlation with sharing knowledge/skills and encouraging student initiative. Higher work RVUs and total patient encounters were negatively correlated with timely feedback and constructive criticism. The results suggest that internal medicine clerkship student evaluations of hospitalist faculty are negatively influenced by high clinical service intensity measured in terms of annual work RVUs, patient encounters, and duty days.

What is the difference between comprehensive and selective primary health care? Evidence from a five-year longitudinal realist case study in South Australia.

PubMed

Baum, Fran; Freeman, Toby; Lawless, Angela; Labonte, Ronald; Sanders, David

2017-04-28

Since the WHO's Alma Ata Declaration on Primary Health Care (PHC) there has been debate about the advisability of adopting comprehensive or selective PHC. Proponents of the latter argue that a more selective approach will enable interim gains while proponents of a comprehensive approach argue that it is needed to address the underlying causes of ill health and improve health outcomes sustainably. This research is based on four case studies of government-funded and run PHC services in Adelaide, South Australia. Program logic models were constructed from interviews and workshops. The initial model represented relatively comprehensive service provision in 2010. Subsequent interviews in 2013 permitted the construction of a selective PHC program logic model following a series of restructuring service changes. Comparison of the PHC service program logic models before and after restructuring illustrates the changes to the operating context, underlying mechanisms, service qualities, activities, activity outcomes and anticipated community health outcomes. The PHC services moved from focusing on a range of community, group and individual clinical activities to a focus on the management of people with chronic disease. Under the more comprehensive model, activities were along a continuum of promotive, preventive, rehabilitative and curative. Under the selective model, the focus moved to rehabilitative and curative with very little other activities. The study demonstrates the difference between selective and comprehensive approaches to PHC in a rich country setting and is useful in informing debates on PHC especially in the context of the Sustainable Development Goals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effects of highway construction on stream water quality and macroinvertebrate condition in a mid-atlantic highlands watershed, USA.

PubMed

Chen, Yushun; Viadero, Roger C; Wei, Xinchao; Fortney, Ronald; Hedrick, Lara B; Welsh, Stuart A; Anderson, James T; Lin, Lian-Shin

2009-01-01

Refining best management practices (BMPs) for future highway construction depends on a comprehensive understanding of environmental impacts from current construction methods. Based on a before-after-control impact (BACI) experimental design, long-term stream monitoring (1997-2006) was conducted at upstream (as control, n = 3) and downstream (as impact, n = 6) sites in the Lost River watershed of the Mid-Atlantic Highlands region, West Virginia. Monitoring data were analyzed to assess impacts of during and after highway construction on 15 water quality parameters and macroinvertebrate condition using the West Virginia stream condition index (WVSCI). Principal components analysis (PCA) identified regional primary water quality variances, and paired t tests and time series analysis detected seven highway construction-impacted water quality parameters which were mainly associated with the second principal component. In particular, impacts on turbidity, total suspended solids, and total iron during construction, impacts on chloride and sulfate during and after construction, and impacts on acidity and nitrate after construction were observed at the downstream sites. The construction had statistically significant impacts on macroinvertebrate index scores (i.e., WVSCI) after construction, but did not change the overall good biological condition. Implementing BMPs that address those construction-impacted water quality parameters can be an effective mitigation strategy for future highway construction in this highlands region.

Factor selection for service quality evaluation: a hospital case study.

PubMed

Ameryoun, Ahmad; Najafi, Seyedvahid; Nejati-Zarnaqi, Bayram; Khalilifar, Seyed Omid; Ajam, Mahdi; Ansarimoghadam, Ahmad

2017-02-13

Purpose The purpose of this paper is to develop a systematic approach to predict service quality dimension's influence on service quality using a novel analysis based on data envelopment and SERVQUAL. Design/methodology/approach To assess hospital service quality in Tehran, expectation and perception of those who received the services were evaluated using SERVQUAL. The hospital service quality dimensions were found by exploratory factor analysis (EFA). To compare customer expectation and perception, perceived service quality index (PSQI) was measured using a new method based on common weights. A novel sensitivity approach was used to test the service quality factor's impact on the PSQI. Findings A new service quality dimension named "trust in services" was found using EFA, which is not an original SERVQUAL factor. The approach was applied to assess the hospital's service quality. Since the PSQI value was 0.76 it showed that improvements are needed to meet customer expectations. The results showed the factor order that affect PSQI. "Trust in services" has the strongest influence on PSQI followed by "tangibles," "assurance," "empathy," and "responsiveness," respectively. Practical implications This work gives managers insight into service quality by following a systematic method; i.e., measuring perceived service quality from the customer viewpoint and service factors' impact on customer perception. Originality/value The procedure helps managers to select the required service quality dimensions which need improvement and predict their effects on customer perception.

Quality of services and quality of life from service providers' perspectives: analysis with focus groups.

PubMed

Jenaro, C; Vega, V; Flores, N; Cruz, M

2013-06-01

Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this population. The current study aims to identify service providers' perceptions regarding the quality of life of their clients and the quality of services they provide. It also aims to identify similarities and differences of appraisals among professionals, and to identify associations between supports, quality of life and quality of services. Data were collected from 22 service providers who attended three focus groups (professionals, direct support staff, and managers) from whom 424 comments were analysed. Service providers were asked about the required support for users, the meaning of quality of life for those users, and about features that should characterise quality services. Thematic analysis was employed and transcripts of the sessions were coded according to the dimensions of models on supports, quality of life and quality of services. Chi-squared tests were utilised to test for potential differences among groups. Each professional group has its own priorities concerning required supports. Among the organisation different and potentially conflicting perceptions regarding the meaning of experiencing quality of life coexist. Concerning quality of services, only managers mentioned personal outcomes. Finally, institutionalisation has a negative impact on supports, quality of life and quality of services. It is necessary to move beyond a shared awareness of the negative impact of institutionalisation towards the transformation of services in search of personal quality outcomes. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

Continuous Turbidity Monitoring in the Indian Creek Watershed, Tazewell County, Virginia, 2006-08

USGS Publications Warehouse

Moyer, Douglas; Hyer, Kenneth

2009-01-01

Thousands of miles of natural gas pipelines are installed annually in the United States. These pipelines commonly cross streams, rivers, and other water bodies during pipeline construction. A major concern associated with pipelines crossing water bodies is increased sediment loading and the subsequent impact to the ecology of the aquatic system. Several studies have investigated the techniques used to install pipelines across surface-water bodies and their effect on downstream suspended-sediment concentrations. These studies frequently employ the evaluation of suspended-sediment or turbidity data that were collected using discrete sample-collection methods. No studies, however, have evaluated the utility of continuous turbidity monitoring for identifying real-time sediment input and providing a robust dataset for the evaluation of long-term changes in suspended-sediment concentration as it relates to a pipeline crossing. In 2006, the U.S. Geological Survey, in cooperation with East Tennessee Natural Gas and the U.S. Fish and Wildlife Service, began a study to monitor the effects of construction of the Jewell Ridge Lateral natural gas pipeline on turbidity conditions below pipeline crossings of Indian Creek and an unnamed tributary to Indian Creek, in Tazewell County, Virginia. The potential for increased sediment loading to Indian Creek is of major concern for watershed managers because Indian Creek is listed as one of Virginia's Threatened and Endangered Species Waters and contains critical habitat for two freshwater mussel species, purple bean (Villosa perpurpurea) and rough rabbitsfoot (Quadrula cylindrical strigillata). Additionally, Indian Creek contains the last known reproducing population of the tan riffleshell (Epioblasma florentina walkeri). Therefore, the objectives of the U.S. Geological Survey monitoring effort were to (1) develop a continuous turbidity monitoring network that attempted to measure real-time changes in suspended sediment (using turbidity as a surrogate) downstream from the pipeline crossings, and (2) provide continuous turbidity data that enable the development of a real-time turbidity-input warning system and assessment of long-term changes in turbidity conditions. Water-quality conditions were assessed using continuous water-quality monitors deployed upstream and downstream from the pipeline crossings in Indian Creek and the unnamed tributary. These paired upstream and downstream monitors were outfitted with turbidity, pH (for Indian Creek only), specific-conductance, and water-temperature sensors. Water-quality data were collected continuously (every 15 minutes) during three phases of the pipeline construction: pre-construction, during construction, and post-construction. Continuous turbidity data were evaluated at various time steps to determine whether the construction of the pipeline crossings had an effect on downstream suspended-sediment conditions in Indian Creek and the unnamed tributary. These continuous turbidity data were analyzed in real time with the aid of a turbidity-input warning system. A warning occurred when turbidity values downstream from the pipeline were 6 Formazin Nephelometric Units or 15 percent (depending on the observed range) greater than turbidity upstream from the pipeline crossing. Statistical analyses also were performed on monthly and phase-of-construction turbidity data to determine if the pipeline crossing served as a long-term source of sediment. Results of this intensive water-quality monitoring effort indicate that values of turbidity in Indian Creek increased significantly between the upstream and downstream water-quality monitors during the construction of the Jewell Ridge pipeline. The magnitude of the significant turbidity increase, however, was small (less than 2 Formazin Nephelometric Units). Patterns in the continuous turbidity data indicate that the actual pipeline crossing of Indian Creek had little influence of downstream water quality; co

Service employees give as they get: internal service as a moderator of the service climate-service outcomes link.

PubMed

Ehrhart, Karen Holcombe; Witt, L A; Schneider, Benjamin; Perry, Sara Jansen

2011-03-01

We lend theoretical insight to the service climate literature by exploring the joint effects of branch service climate and the internal service provided to the branch (the service received from corporate units to support external service delivery) on customer-rated service quality. We hypothesized that service climate is related to service quality most strongly when the internal service quality received is high, providing front-line employees with the capability to deliver what the service climate motivates them to do. We studied 619 employees and 1,973 customers in 36 retail branches of a bank. We aggregated employee perceptions of the internal service quality received from corporate units and the local service climate and external customer perceptions of service quality to the branch level of analysis. Findings were consistent with the hypothesis that high-quality internal service is necessary for branch service climate to yield superior external customer service quality. PsycINFO Database Record (c) 2011 APA, all rights reserved.

Analysis of quality raw data of second generation sequencers with Quality Assessment Software.

PubMed

Ramos, Rommel Tj; Carneiro, Adriana R; Baumbach, Jan; Azevedo, Vasco; Schneider, Maria Pc; Silva, Artur

2011-04-18

Second generation technologies have advantages over Sanger; however, they have resulted in new challenges for the genome construction process, especially because of the small size of the reads, despite the high degree of coverage. Independent of the program chosen for the construction process, DNA sequences are superimposed, based on identity, to extend the reads, generating contigs; mismatches indicate a lack of homology and are not included. This process improves our confidence in the sequences that are generated. We developed Quality Assessment Software, with which one can review graphs showing the distribution of quality values from the sequencing reads. This software allow us to adopt more stringent quality standards for sequence data, based on quality-graph analysis and estimated coverage after applying the quality filter, providing acceptable sequence coverage for genome construction from short reads. Quality filtering is a fundamental step in the process of constructing genomes, as it reduces the frequency of incorrect alignments that are caused by measuring errors, which can occur during the construction process due to the size of the reads, provoking misassemblies. Application of quality filters to sequence data, using the software Quality Assessment, along with graphing analyses, provided greater precision in the definition of cutoff parameters, which increased the accuracy of genome construction.

An Examination of Pre-Service Mathematics Teachers' Approaches to Construct and Solve Mathematical Modelling Problems

ERIC Educational Resources Information Center

Bukova-Guzel, Esra

2011-01-01

This study examines the approaches displayed by pre-service mathematics teachers in their experiences of constructing mathematical modelling problems and the extent to which they perform the modelling process when solving the problems they construct. This case study was carried out with 35 pre-service teachers taking the Mathematical Modelling…

[Constructing ecological security patterns in mountain areas based on geological disaster sensitivity: A case study in Yuxi City, Yunnan Province, China.

PubMed

Peng, Jian; Guo, Xiao Nan; Hu, Yi Na; Liu, Yan Xu

2017-02-01

As one of the key topics in the research of landscape ecology, regional ecological security patterns can effectively promote regional sustainable development and terrestrial ecological barriers construction. It is extremely important for middle Yunnan, with frequent disasters and fragile ecolo-gical environment, to construct ecological security patterns so as to effectively avoid the geological disasters, maintain ecosystem health, and promote the coordinated development of regional ecological system and social economic system. Taking Yuxi City as a case study area, this study firstly estimated the ecosystem services importance of water conservation, carbon fixation and oxygen release, soil conservation, and biodiversity according to the basal characteristics of regional ecological environment, and then identified ecological sources in consideration of the quality of integrated ecosystem services and single types. Secondly, the resistance surface based on land use types was modified by the sensitivity of regional geological disasters. Lastly, the ecological corridors were identified using minimum cumulative resistance model, and as a result, the ecological security pattern of Yuxi City was constructed. The results showed that there were 81 patches for ecological sources in Yuxi City, accounting for 38.4% of the total area, and overlaying 75.2% of nature protection areas. The ecological sources were mainly distributed in the western mountainous areas as well as eastern water areas of the city. The length of ecological corridors was 1642.04 km, presenting a spatial pattern of one vertical and three horizontals, and extending along river valleys and fault basins with high vegetation coverage. This paper constructed ecological security patterns in mountainous areas aiming at the characteristics of geological disasters, providing spatial guidance for development and conservation decision-making in mountain areas.

The effects of elevated highway construction on water quality in Louisiana wetlands : final report.

DOT National Transportation Integrated Search

1981-02-02

This study is to determined by physical, chemical, and biological means, the effects of bridged highway construction techniques on water quality in wetlands. Water quality was monitored before, during, and after construction. The data shows the incre...

Process Reengineering for Quality Improvement in ICU Based on Taylor's Management Theory.

PubMed

Tao, Ziqi

2015-06-01

Using methods including questionnaire-based surveys and control analysis, we analyzed the improvements in the efficiency of ICU rescue, service quality, and patients' satisfaction, in Xuzhou Central Hospital after the implementation of fine management, with an attempt to further introduce the concept of fine management and implement the brand construction. Originating in Taylor's "Theory of Scientific Management" (1982), fine management uses programmed, standardized, digitalized, and informational approaches to ensure each unit of an organization is running with great accuracy, high efficiency, strong coordination, and at sustained duration (Wang et al., Fine Management, 2007). The nature of fine management is a process that breaks up the strategy and goal, and executes it. Strategic planning takes place at every part of the process. Fine management demonstrates that everybody has a role to play in the management process, every area must be examined through the management process, and everything has to be managed (Zhang et al., The Experience of Hospital Nursing Precise Management, 2006). In other words, this kind of management theory demands all people to be involved in the entire process (Liu and Chen, Med Inf, 2007). As public hospital reform is becoming more widespread, it becomes imperative to "build a unified and efficient public hospital management system" and "improve the quality of medical services" (Guidelines on the Pilot Reform of Public Hospitals, 2010). The execution of fine management is of importance in optimizing the medical process, improving medical services and building a prestigious hospital brand.

Shared decision making in Swedish community mental health services - an evaluation of three self-reporting instruments.

PubMed

Rosenberg, David; Schön, Ulla-Karin; Nyholm, Maria; Grim, Katarina; Svedberg, Petra

2017-04-01

Despite the potential impact of shared decision making on users satisfaction with care and quality in health care decisions, there is a lack of knowledge and skills regarding how to work with shared decision making among health care providers. The aim of this study was to evaluate the psychometric properties of three instruments that measure varied dimensions of shared decision making, based on self-reports by clients, in a Swedish community mental health context. The study sample consisted of 121 clients with experience of community mental health care, and involved in a wide range of decisions regarding both social support and treatment. The questionnaires were examined for face and content validity, internal consistency, test-retest reliability and construct validity. The instruments displayed good face and content validity, satisfactory internal consistency and a moderate to good level of stability in test-retest reliability with fair to moderate construct correlations, in a sample of clients with serious mental illness and experience of community mental health services in Sweden. The questionnaires are considered to be relevant to the decision making process, user-friendly and appropriate in a Swedish community mental health care context. They functioned well in settings where non-medical decisions, regarding social and support services, are the primary focus. The use of instruments that measure various dimensions of the self-reported experience of clients, can be a key factor in developing knowledge of how best to implement shared decision making in mental health services.

Factors affecting pharmacy engagement and pharmacy customer devotion in community pharmacy: A structural equation modeling approach

PubMed Central

Nitadpakorn, Sujin; Kittisopee, Tanattha

2017-01-01

Background: The concept of customer engagement and devotion has been applied in various service businesses to keep the customers with business However, a limited number of studies were performed to examine the context of customer engagement and devotion in pharmacy business which focus on the impact of customer perceptions about pharmacists, perceived quality of pharmacy structure, medication price strategy on pharmacy engagement and pharmacy customer devotion in a pharmacy providing pharmaceutical care to the customers. Objective: This study aimed to assess a conceptual model depicting the relationships among customer perceptions about pharmacists, pharmacy quality structure, medication price, customer engagement, and customer devotion. And also aimed to assess and measure if there is a direct or indirect relationship between these factors. Methods: A quantitative study was conducted by using self-administered questionnaires. Two hundred and fifty three customers who regularly visited the pharmacy were randomly recruited from a purposively selected 30 community pharmacies in Bangkok. The survey was completed during February to April 2016. A structural equation model (SEM) was used to assess the direct and indirect relationships between constructs. Results: A total of 253/300 questionnaires were returned for analysis, and the response rate was 84%. Only perceptions about pharmacist in customers receiving professional pharmacy services was statically significant regarding relationship with pharmacy engagement (beta=0.45). Concurrently, the model from empirical data fit with the hypothetical model (p-value = 0.06, adjusted chi-square (CMIN/DF)=1.16, Goodness of Fit Index (GFI)=0.93, Comparatively Fit Index (CFI)=0.99, and Root Mean Square Error Approximation (RMSEA)=0.03). Conclusion: The study confirmed the indirect positive influence of customer perceptions about pharmacist on pharmacy customer devotion in providing pharmacy services via pharmacy engagement It was customer perceptions about pharmacist that influenced customer retention, positive word of mouth and constructive advice to pharmacies, not quality of pharmacy structure and medication price. To create a long term impact on community pharmacy business, pharmacist is the key success factor. PMID:28943984

Construction Services at Northern Arizona University.

ERIC Educational Resources Information Center

Van Dyke, Gary

Construction Services is an innovative response to a chronic construction-remodeling problem at Northern Arizona State University. It is an in-house facilities maintenance department designed to address a variety of needs: prevention of construction or remodeling done by individual staff or faculty members without regard for applicable codes;…

Maintenance & construction operations user service : an addendum to the ITS program plan

DOT National Transportation Integrated Search

2001-01-26

The Maintenance and Construction Operations User Service describes the need for integrating key activities. Generally, key Maintenance and Construction Operations (MCO) activities include monitoring, operating, maintaining, improving, and managing th...

The effects of elevated highway construction on water quality in Louisiana wetlands : interim report No. 1.

DOT National Transportation Integrated Search

1979-07-01

This study is to determined by physical, chemical, and biological means, the effects of bridged highway construction techniques on water quality in wetlands. Water quality was monitored before, during, and after construction. The data shows the incre...

TECHNICAL GUIDANCE DOCUMENT: CONSTRUCTION QUALITY MANAGEMENT FOR REMEDIAL ACTION AND REMEDIAL DESIGN WASTE CONTAINMENT SYSTEMS

EPA Science Inventory

This Technical Guidance Document is intended to augment the numerous construction quality control and construction quality assurance (CQC and CQA) documents that are available far materials associated with waste containment systems developed for Superfund site remediation. In ge...

Development of a validation process for parameters utilized in optimizing construction quality management of pavements.

DOT National Transportation Integrated Search

2006-01-01

The implementation of an effective performance-based construction quality management requires a tool for determining impacts of construction quality on the life-cycle performance of pavements. This report presents an update on the efforts in the deve...

Evaluation of ecosystem service based on scenario simulation of land use in Yunnan Province

NASA Astrophysics Data System (ADS)

Zhang, Hong; Liao, Xiaoli; Zhai, Tianlin

2018-04-01

Climate change and rapid urbanization are important factors restricting future land use. Situational analysis, as an important foundation for the optimization of land use, needs to focus on the impact of climate factors and socio-economic factors. In this paper, the Markov model and the DLS (Simulation of Land System Dynamics) model are combined for the first time, and the land use pattern in 2020 is simulated based on the data of land use in 2000 and 2010 as well as the climate, soil, topography and socio-economic factors of Yunnan Province. In his paper, we took Yunnan Province as the case study area, and selected 12 driving factors by logistic regression method, then the land use demands and layout of Yunnan Province in 2020 has been forecasted and simulated under business as usual (BAU) scenario and farmland protection (FP) scenario and the changes in ecosystem service value has been calculated. The result shows that: (1) after the regression analysis and ROC (Relative Operating Characteristics) test, the 12 factors selected in this paper have a strong ability to explain the land use change in Yunnan Province. (2) Under the two scenarios, the significant reduction of arable land area is a common feature of land use change in Yunnan Province in the future, and its main land use type will be construction land. However, under FP scenario, the current situation where construction land encroach on arable land will be improved. Compared with the change from 2000 to 2010, the trend of arable land, forest land, water area, construction land and unused land will be the same under the two scenarios, whereas the change trend of grassland was opposite. (3) From 2000 to 2020, the value of ecosystem services in Yunnan Province is on the rise, but the ecosystem service value under FP scenario is higher than that of the ecosystem services under BAU scenario. In general, land use in 2020 in Yunnan Province continues the pattern of 2010, but there are also significant spatial differences. Under the BAU scenario, the construction land is mainly in the south of Lijiang City and the northeastern part of Kunming. Under the FP scenario, the new construction land is concentrated near the Lashi dam in northern Yunnan Province, and the high-quality arable land in the valley will be better protected. The research results can provide reference for the optimization of land use pattern in Yunnan Province, and provide scientific basis for land use management and planning. Based on the value of ecosystem services, we should implement the policy of strict protection of arable land, both to ensure food supply and promote the healthy development of ecological environment.

Space station mobile transporter

NASA Technical Reports Server (NTRS)

Renshall, James; Marks, Geoff W.; Young, Grant L.

1988-01-01

The first quarter of the next century will see an operational space station that will provide a permanently manned base for satellite servicing, multiple strategic scientific and commercial payload deployment, and Orbital Maneuvering Vehicle/Orbital Transfer Vehicle (OMV/OTV) retrieval replenishment and deployment. The space station, as conceived, is constructed in orbit and will be maintained in orbit. The construction, servicing, maintenance and deployment tasks, when coupled with the size of the station, dictate that some form of transportation and manipulation device be conceived. The Transporter described will work in conjunction with the Orbiter and an Assembly Work Platform (AWP) to construct the Work Station. The Transporter will also work in conjunction with the Mobile Remote Servicer to service and install payloads, retrieve, service and deploy satellites, and service and maintain the station itself. The Transporter involved in station construction when mounted on the AWP and later supporting a maintenance or inspection task with the Mobile Remote Servicer and the Flight Telerobotic Servicer is shown.

The Turkish adaptation of scale to measure patient perceptions of the quality of nursing care and related hospital services: A validity and reliability study

PubMed Central

Oren, Besey; Zengin, Neriman; Yildiz, Nebahat

2016-01-01

OBJECTIVE: This study aimed to test the validity and reliability of a version of the tool developed in Sri Lanka in 2011 to assess patient perceptions of the quality of nursing care and related hospital services created for use with Turkish patients. METHODS: This methodological study was conducted between November 2013 and November 2014 after obtaining ethical approval and organizational permission. Data was collected during discharge from 180 adult patients who were hospitalized for at least 3 days at a medical school hospital located in Istanbul. After language validation, validity and reliability analyses of the scale were conducted. Content validity, content validity index (CVI), construct validity, and exploratory factor analysis were assessed and examined, and reliability was tested using the Cronbach’s alpha coefficient and item-total correlations. RESULTS: Mean CVI was found to be 0.95, which is above expected value. Exploratory factor analysis revealed 4 factors with eigenvalues above 1, which explained 82.4% of total variance in the Turkish version of the tool to measure patient perceptions of nursing care and other hospital services. Factor loading for each item was ≥.40. Cronbach’s alpha coefficient of sub-dimensions and total scale were found to be 0.84-0.98 and 0.98, respectively. Item-total correlations ranged from 0.56 to 0.83 for the entire group, which was above expected values. CONCLUSION: The Turkish version of the scale to assess patient perceptions of the quality of nursing care and related hospital services, which comprised 4 sub-dimensions and 36 items, was found to be valid and reliable for use with the Turkish population. PMID:28275750

Review on Malaysian Rail Transit Operation and Management System: Issues and Solution in Integration

NASA Astrophysics Data System (ADS)

Masirin, Mohd Idrus Mohd; Salin, Aminah Mohd; Zainorabidin, Adnan; Martin, David; Samsuddin, Norshakina

2017-08-01

In any context, operation and management of transportation systems are key issues which may affect both life quality and economic development. In large urban agglomerations, an efficient public transportation system may help abate the negative externalities of private car use such as congestion, air and noise pollution, accident and fuel consumption, without excessively penalizing user travel times or zone accessibility. Thus, this study is conducted to appraise the Malaysian rural rail transit operation and management system, which are considered important as there are many issues and solution in integration of the services that need to be tackled more conscientiously. The purpose of this paper is to describe some of the most important issues on integration of services and rail transit system in Malaysian and how to solve or reduce these problems and conflicts. In this paper, it consists of the historical development of rail transit construction in Malaysia. This paper also attempts to identify the important issues related to rail transit services and integration in Malaysian rural rail operation and management system. Comparison is also conducted with other countries such as UK, France, and Japan. Finally, a critical analysis is presented in this paper by looking at the possible application for future Malaysian rail transit operation system and management, especially focusing on enhancing the quality of Malaysian rural rail transit. In conclusion, this paper is expected to successfully review and appraise the existing Malaysian rural rail transit operation and management system pertaining to issues & solution in integration. It is also hoped that reformation or transformation of present service delivery quality of the rail transit operation and management will enable Malaysia to succeed in transforming Malaysian transportation system to greater heights.

The Turkish adaptation of scale to measure patient perceptions of the quality of nursing care and related hospital services: A validity and reliability study.

PubMed

Oren, Besey; Zengin, Neriman; Yildiz, Nebahat

2016-01-01

This study aimed to test the validity and reliability of a version of the tool developed in Sri Lanka in 2011 to assess patient perceptions of the quality of nursing care and related hospital services created for use with Turkish patients. This methodological study was conducted between November 2013 and November 2014 after obtaining ethical approval and organizational permission. Data was collected during discharge from 180 adult patients who were hospitalized for at least 3 days at a medical school hospital located in Istanbul. After language validation, validity and reliability analyses of the scale were conducted. Content validity, content validity index (CVI), construct validity, and exploratory factor analysis were assessed and examined, and reliability was tested using the Cronbach's alpha coefficient and item-total correlations. Mean CVI was found to be 0.95, which is above expected value. Exploratory factor analysis revealed 4 factors with eigenvalues above 1, which explained 82.4% of total variance in the Turkish version of the tool to measure patient perceptions of nursing care and other hospital services. Factor loading for each item was ≥.40. Cronbach's alpha coefficient of sub-dimensions and total scale were found to be 0.84-0.98 and 0.98, respectively. Item-total correlations ranged from 0.56 to 0.83 for the entire group, which was above expected values. The Turkish version of the scale to assess patient perceptions of the quality of nursing care and related hospital services, which comprised 4 sub-dimensions and 36 items, was found to be valid and reliable for use with the Turkish population.

Evaluation of Safety, Quality and Productivity in Construction

NASA Astrophysics Data System (ADS)

Usmen, M. A.; Vilnitis, M.

2015-11-01

This paper examines the success indicators of construction projects, safety, quality and productivity, in terms of their implications and impacts during and after construction. First safety is considered during construction with a focus on hazard identification and the prevention of occupational accidents and injuries on worksites. The legislation mandating safety programs, training and compliance with safety standards is presented and discussed. Consideration of safety at the design stage is emphasized. Building safety and the roles of building codes in prevention of structural failures are also covered in the paper together with factors affecting building failures and methods for their prevention. Quality is introduced in the paper from the perspective of modern total quality management. Concepts of quality management, quality control, quality assurance and Six Sigma and how they relate to building quality and structural integrity are discussed with examples. Finally, productivity concepts are presented with emphasis on effective project management to minimize loss of productivity, complimented by lean construction and lean Six Sigma principles. The paper concludes by synthesizing the relationships between safety, quality and productivity.

The Impact of International Service-Learning on Nursing Students' Cultural Competency.

PubMed

Kohlbry, Pamela Wolfe

2016-05-01

This article reports research findings on the effect of an international immersion service-learning project on the level and components of cultural competence of baccalaureate (BSN) nursing students. A triangulated methodology was used to determine changes in components and level of cultural competence pre- and postexperience. The theoretical model The Process of Cultural Competence in the Delivery of Healthcare Services was used. It identifies five central constructs in the process of becoming culturally competent: cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire. The sample of 121 BSN nursing students was gathered from three southern California universities. Data were collected from 2009 to 2013. Using the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version© and Cultural Self-Efficacy Scale, constructs of cultural competency were measured in pre- and posttest participants who participated in international service-learning immersion experiences. A demographic survey and open-ended qualitative questions were completed at the posttrip meeting. Mean, frequencies, and correlations with demographic data and survey data were calculated. Pre- and posttrip means were analyzed. Qualitative analysis from six open-ended questions completed at the posttest were coded and themes emerged. The research findings demonstrated the impact of the international service-learning project on building cultural competency in nursing students. Quantitative findings revealed statistically significant differences between pre- and posttest surveys for two of the five constructs of cultural competence. Qualitative analysis supported the quantitative findings in cultural competency constructs found in the model. The research findings support nursing education program use of international service-learning immersion experiences to foster cultural competence in nursing students. Findings from student participants demonstrated and articulated that these program experiences strengthen the process of becoming culturally competent. The research findings support the inclusion of international service-learning experiences with debriefing and reflective learning as effective teaching strategies. Researchers have demonstrated that poor healthcare outcomes are a result of health disparities, which are then compounded by healthcare workers not being prepared to care for clients from differing cultures. The American Association of Colleges of Nursing identified innovative ways for nursing students to develop skills in cultural competency, which included international experiences. In nursing education, this study demonstrated that international service-learning immersion experiences are of value as they impact and improve cultural competency. Nurses graduating with enhanced cultural understanding will contribute to decreased health disparities and improved patient care quality and safety. Further research that examines nurses' cultural competency in the patient care setting who have had previous education in international nursing could further inform nursing education and contribute to the understanding of patient satisfaction. © 2016 Sigma Theta Tau International.

76 FR 8778 - Construction Standards on Posting Emergency Telephone Numbers and Floor Load Limits; Extension of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-15

...). Two construction standards, ``Medical Services and First Aid'' (Sec. 1926.50), and ``General... the two construction standards, ``Medical Services and First Aid'' paragraph (f) of Sec. 1926.50, and...

Effects of highway construction on stream water quality and macroinvertebrate condition in a mid-Atlantic highlands watershed, USA

USGS Publications Warehouse

Welsh, Stuart A.; Chen, Yushun; Viadero, Stuart C.; Wei, Xinchao; Hedrick, Lara B.; Anderson, James T.; Lin, Lian-Shin

2009-01-01

Refining best management practices (BMPs) for future highway construction depends on a comprehensive understanding of environmental impacts from current construction methods. Based on a before-after-control impact (BACI) experimental design, long-term stream monitoring (1997–2006) was conducted at upstream (as control, n = 3) and downstream (as impact, n = 6) sites in the Lost River watershed of the Mid-Atlantic Highlands region, West Virginia. Monitoring data were analyzed to assess impacts of during and after highway construction on 15 water quality parameters and macroinvertebrate condition using the West Virginia stream condition index (WVSCI). Principal components analysis (PCA) identified regional primary water quality variances, and paired t tests and time series analysis detected seven highway construction-impacted water quality parameters which were mainly associated with the second principal component. In particular, impacts on turbidity, total suspended solids, and total iron during construction, impacts on chloride and sulfate during and after construction, and impacts on acidity and nitrate after construction were observed at the downstream sites. The construction had statistically significant impacts on macroinvertebrate index scores (i.e., WVSCI) after construction, but did not change the overall good biological condition. Implementing BMPs that address those construction-impacted water quality parameters can be an effective mitigation strategy for future highway construction in this highlands region.

The patient experience in community mental health services for older people: a concept mapping approach to support the development of a new quality measure.

PubMed

Wilberforce, Mark; Batten, Eric; Challis, David; Davies, Linda; Kelly, Michael P; Roberts, Chris

2018-06-18

The patient experience is a crucial part of the measurement of service quality. However, instruments to evaluate experiential quality in the community mental health care of older adults are lacking. Before designing a new instrument, clarity is needed about what is to be measured, and how care experiences are articulated by patients. The study aimed to construct a framework to describe older patients' experience of community mental health and social care. Concept mapping blends structured qualitative data collection with quantitative analysis in a mixed method approach. Five activities were undertaken. Patients first identified sentences describing the care experience; a card-sort exercise then grouped these thematically; multidimensional analysis portrayed these data in a map of clusters; interpretation was by patient advisers; finally a new questionnaire was designed. The research involved 22 older people with mental health problems and 29 mental health practitioners, from one region of England. Sixty-seven statements were identified that described the care experience. Analysis of card sort data revealed seven clusters, which were interpreted by patient advisers to the study as: personal qualities and relationships; communication problems; feeling powerless; in-and-out care; bureaucracy; focus on life, not just mental health; and continuity of care. These themes and the component statements were used as a foundation for later work, developing a new measure of the care experience in mental health services for older people. Concept mapping has many strengths as an empirical and participant-driven means for underpinning new measurement instruments. A group of older people identified 67 candidate statements that could act as questionnaire items grouped within seven themes. Future research will establish the psychometric properties of the new measure.

Proposed DoD (Department of Defense) Internet Protocol Standard.

DTIC Science & Technology

1982-07-06

parameters fall into two categories: service quality parameters and service options. Service quality parameters influence the transmission service provided...Corporation 6 July 1982 -7- TM-7172/481/OO o Service Quality Parameters - Precedence : attempts preferential treatment for high importance datagrams...select the transmission quality. IP passes the type of service (TOS) command set for service quality to the SNP where it is mapped into subnetwork

NAVAJO ELECTRIFICATION DEMONSTRATION PROJECT

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

Terry W. Battiest

2008-06-11

The Navajo Electrification Demonstration Project (NEDP) is a multi-year project which addresses the electricity needs of the unserved and underserved Navajo Nation, the largest American Indian tribe in the United States. The program serves to cumulatively provide off-grid electricty for families living away from the electricty infrastructure, line extensions for unserved families living nearby (less than 1/2 mile away from) the electricity, and, under the current project called NEDP-4, the construction of a substation to increase the capacity and improve the quality of service into the central core region of the Navajo Nation.

Industrial wind turbine post-construction bird and bat monitoring: A policy framework for Canada.

PubMed

Parisé, Jason; Walker, Tony R

2017-10-01

Electricity generation from wind energy has proliferated throughout North America and will continue to grow. Given Canada's expected increase in wind energy capacity, consideration of the potential adverse impacts to bird and bat populations is prudent given their sensitivity to these projects. The province of Ontario, Canada is currently the leading jurisdiction for wind energy development, and for provincial guidance on pre- and post-construction monitoring. With uniform monitoring guidance in Ontario, wind energy proponents, and third-party consultants, have developed post-construction monitoring protocols that meet provincial guidance, while also providing standardized reporting. In Atlantic Canada, post-construction guidelines vary between provinces, depending mostly on guidance from the Environment Canada Canadian Wildlife Service and relevant provincial agencies. To ensure quality post-construction monitoring results in Atlantic Canada and other provinces, it is imperative that all Canadian provinces adopt similar approaches to those employed in Ontario. This paper reviews major causes of bird and bat mortalities; reviews Canadian federal and Ontario provincial bird and bat monitoring guidelines to elucidate gaps between environmental assessment (EA) theory and application; summarizes post-construction monitoring protocols from eight bird and bat post-construction monitoring programs used in Ontario; and, proposes recommendations to support future wind development opportunities across Canada and specifically in Atlantic Canada. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Effect of Service Quality on Patient loyalty: a Study of Private Hospitals in Tehran, Iran.

PubMed

Arab, M; Tabatabaei, Sm Ghazi; Rashidian, A; Forushani, A Rahimi; Zarei, E

2012-01-01

Service quality is perceived as an important factor for developing patient's loyalty. The aim of this study was to determine the hospital service quality from the patients' viewpoints and the relative importance of quality dimensions in predicting the patient's loyalty. A cross-sectional study was conducted in 2010. The study sample was composed of 943 patients selected from eight private general hospitals in Tehran. The survey instrument was a questionnaire included 24 items about the service quality and 3 items about the patient's loyalty. Exploratory factor analysis was employed to extracting the dimensions of service quality. Also, regression analysis was performed to determining the relative importance of the service quality dimensions in predicting the patient's loyalty. The mean score of service quality and patient's loyalty was 3.99 and 4.16 out of 5, respectively. About 29% of the loyalty variance was explained by the service quality dimensions. Four quality dimensions (Costing, Process Quality, Interaction Quality and Environment Quality) were found to be key determinants of the patient's loyalty in the private hospitals of Tehran. The patients' experience in relation to the private hospitals' services has strong impact on the outcome variables like willingness to return to the same hospital and reuse its services or recommend them to others. The relationship between the service quality and patient's loyalty proves the strategic importance of improving the service quality for dragging and retaining patients and expanding the market share.

77 FR 42696 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... construction awards, 30 requests for amendments to non-construction awards, 2 project service maps). Average Hours Per Response: 2 hours for an amendment to a construction award, 1 hour for an amendment to a non-construction award, 6 hours for a project service map. Burden Hours: 1,242. Needs and Uses: A recipient must...

The role of the physical environment in crossing the quality chasm.

PubMed

Henriksen, Kerm; Isaacson, Sandi; Sadler, Blair L; Zimring, Craig M

2007-11-01

Evidence-based design findings are available to help inform hospital decision makers of opportunities for ensuring that quality and safety are designed into new and refurbished facilities. The Institute of Medicine's six quality aims of patient centeredness, safety, effectiveness, efficiency, timeliness, and equity provide an organizing framework for introducing a representative portion of the evidence. Design improvements include single-bed and variable-acuity rooms; electronic access to medical records; greater accommodation for families and visitors; handrails to prevent patient falls; standardization (room layout, equipment, and supplies for improved efficiencies); improved work process flow to reduce delays and wait times; and better assessment of changing demographics, disease conditions, and community needs for appropriately targeted health care services. A recent analysis of the business case suggests that a slight, one-time incremental cost for ensuring safety and quality would be paid back in two to three years in the form of operational savings and increased revenues. Hospitals leaders anticipating new construction projects should take advantage of evidence-based design findings that have the potential of raising the quality of acute care for decades to come.

Assessing quality of pre-service physics teachers' written arguments

NASA Astrophysics Data System (ADS)

Aydeniz, Mehmet; Gürçay, Deniz

2013-11-01

Purpose: The purpose of this study was to assess the quality of scientific arguments developed by pre-service physics teachers. Sample: The participants were 171 pre-service physics teachers recruited from two universities: 86 from University A and 85 from University B. Design and method: Participants were prompted to develop a written argument to either support or challenge the Turkish government's decision to invest in nuclear power plants. Data consist of written arguments developed by the participants and information on participants' knowledge of the topic, their confidence in their knowledge and the source of their knowledge related to the topic. Data were analyzed using the CER framework. Results: The results show that participants did not perform at the expected level. The majority of students failed to develop strong scientific arguments. While almost all of the participants provided evidence to justify their claims, they failed to effectively coordinate evidence, claim and theory to develop an argument. Students struggled the most in the warrant/reasoning category of the CER framework. We also identified several misconceptions that students held related to nuclear power plants. Conclusions: In our discussion we problematize college science teaching and advocate integration of instructional strategies such as argumentation that can effectively engage students in construction, evaluation and justification of knowledge.

Technical Handbook for Facilities Engineering and Construction Manual, Part 2: Federally Assisted Activities. Guide for Project Applicants-Construction Management Services. Department Technical Handbook Series.

ERIC Educational Resources Information Center

Department of Health , Education, and Welfare, Washington., DC. Office of the Secretary.

This handbook provides a basis for consideration of acceptable approaches which are available and may be used to initiate the use of construction management services in the planning, design, and construction of federally assisted construction projects. It includes the mandatory federal requirements as well as acceptable procedures for selecting…

Time-Aware Service Ranking Prediction in the Internet of Things Environment

PubMed Central

Huang, Yuze; Huang, Jiwei; Cheng, Bo; He, Shuqing; Chen, Junliang

2017-01-01

With the rapid development of the Internet of things (IoT), building IoT systems with high quality of service (QoS) has become an urgent requirement in both academia and industry. During the procedures of building IoT systems, QoS-aware service selection is an important concern, which requires the ranking of a set of functionally similar services according to their QoS values. In reality, however, it is quite expensive and even impractical to evaluate all geographically-dispersed IoT services at a single client to obtain such a ranking. Nevertheless, distributed measurement and ranking aggregation have to deal with the high dynamics of QoS values and the inconsistency of partial rankings. To address these challenges, we propose a time-aware service ranking prediction approach named TSRPred for obtaining the global ranking from the collection of partial rankings. Specifically, a pairwise comparison model is constructed to describe the relationships between different services, where the partial rankings are obtained by time series forecasting on QoS values. The comparisons of IoT services are formulated by random walks, and thus, the global ranking can be obtained by sorting the steady-state probabilities of the underlying Markov chain. Finally, the efficacy of TSRPred is validated by simulation experiments based on large-scale real-world datasets. PMID:28448451

Time-Aware Service Ranking Prediction in the Internet of Things Environment.

PubMed

Huang, Yuze; Huang, Jiwei; Cheng, Bo; He, Shuqing; Chen, Junliang

2017-04-27

With the rapid development of the Internet of things (IoT), building IoT systems with high quality of service (QoS) has become an urgent requirement in both academia and industry. During the procedures of building IoT systems, QoS-aware service selection is an important concern, which requires the ranking of a set of functionally similar services according to their QoS values. In reality, however, it is quite expensive and even impractical to evaluate all geographically-dispersed IoT services at a single client to obtain such a ranking. Nevertheless, distributed measurement and ranking aggregation have to deal with the high dynamics of QoS values and the inconsistency of partial rankings. To address these challenges, we propose a time-aware service ranking prediction approach named TSRPred for obtaining the global ranking from the collection of partial rankings. Specifically, a pairwise comparison model is constructed to describe the relationships between different services, where the partial rankings are obtained by time series forecasting on QoS values. The comparisons of IoT services are formulated by random walks, and thus, the global ranking can be obtained by sorting the steady-state probabilities of the underlying Markov chain. Finally, the efficacy of TSRPred is validated by simulation experiments based on large-scale real-world datasets.

Dependence in Alzheimer's disease and service use costs, quality of life, and caregiver burden: the DADE study.

PubMed

Jones, Roy W; Romeo, Renee; Trigg, Richard; Knapp, Martin; Sato, Azusa; King, Derek; Niecko, Timothy; Lacey, Loretto

2015-03-01

Most models determining how patient and caregiver characteristics and costs change with Alzheimer's disease (AD) progression focus on one aspect, for example, cognition. AD is inadequately defined by a single domain; tracking progression by focusing on a single aspect may mean other important aspects are insufficiently addressed. Dependence has been proposed as a better marker for following disease progression. This was a cross-sectional observational study (18 UK sites). Two hundred forty-nine community or institutionalized patients, with possible/probable AD, Mini-Mental State Examination (3-26), and a knowledgeable informant participated. Significant associations noted between dependence (Dependence Scale [DS]) and clinical measures of severity (cognition, function, and behavior). Bivariate and multivariate models demonstrated significant associations between DS and service use cost, patient quality of life, and caregiver perceived burden. The construct of dependence may help to translate the combined impact of changes in cognition, function, and behavior into a more readily interpretable form. The DS is useful for assessing patients with AD in clinical trials/research. Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Patient engagement as an emerging challenge for healthcare services: mapping the literature.

PubMed

Barello, Serena; Graffigna, Guendalina; Vegni, Elena

2012-01-01

Patients' engagement in healthcare is at the forefront of policy and research practice and is now widely recognized as a critical ingredient for high-quality healthcare system. This study aims to analyze the current academic literature (from 2002 to 2012) about patient engagement by using bibliometric and qualitative content analyses. Extracting data from the electronic databases more likely to cover the core research publications in health issues, the number of yearly publications, the most productive countries, and the scientific discipline dealing with patient engagement were quantitatively described. Qualitative content analysis of the most cited articles was conducted to distinguish the core themes. Our data showed that patient engagement is gaining increasing attention by all the academic disciplines involved in health research with a predominance of medicine and nursing. Engaging patients is internationally recognized as a key factor in improving health service delivery and quality. Great attention is up to now paid to the clinical and organizational outcomes of engagement, whereas there is still a lack of an evidence-based theoretical foundation of the construct as well as of the organizational dimensions that foster it.

Patient Engagement as an Emerging Challenge for Healthcare Services: Mapping the Literature

PubMed Central

Barello, Serena; Graffigna, Guendalina; Vegni, Elena

2012-01-01

Patients' engagement in healthcare is at the forefront of policy and research practice and is now widely recognized as a critical ingredient for high-quality healthcare system. This study aims to analyze the current academic literature (from 2002 to 2012) about patient engagement by using bibliometric and qualitative content analyses. Extracting data from the electronic databases more likely to cover the core research publications in health issues, the number of yearly publications, the most productive countries, and the scientific discipline dealing with patient engagement were quantitatively described. Qualitative content analysis of the most cited articles was conducted to distinguish the core themes. Our data showed that patient engagement is gaining increasing attention by all the academic disciplines involved in health research with a predominance of medicine and nursing. Engaging patients is internationally recognized as a key factor in improving health service delivery and quality. Great attention is up to now paid to the clinical and organizational outcomes of engagement, whereas there is still a lack of an evidence-based theoretical foundation of the construct as well as of the organizational dimensions that foster it. PMID:23213497

Management commitments and primary care: another lesson from Costa Rica for the world?

PubMed

Soors, Werner; De Paepe, Pierre; Unger, Jean-Pierre

2014-01-01

Maintained dedication to primary care has fostered a public health delivery system with exceptional outcomes in Costa Rica. For more than a decade, management commitments have been part of Costa Rican health reform. We assessed the effect of the Costa Rican management commitments on access and quality of care and on compliance with their intended objectives. We constructed seven hypotheses on opinions of primary care providers. Through a mixed qualitative and quantitative approach, we tested these hypotheses and interpreted the research findings. Management commitments consume an excessive proportion of consultation time, inflate recordkeeping, reduce comprehensiveness in primary care consultations, and induce a disproportionate consumption of hospital emergency services. Their formulation relies on norms in need of optimization, their control on unreliable sources. They also affect professionalism. In Costa Rica, management commitments negatively affect access and quality of care and pose a threat to the public service delivery system. The failures of this pay-for-performance-like initiative in an otherwise well-performing health system cast doubts on the appropriateness of pay-for-performance for health systems strengthening in less advanced environments.

Cultural values and health service quality in China.

PubMed

Polsa, Pia; Fuxiang, Wei; Sääksjärvi, Maria; Shuyuan, Pei

2013-01-01

Several service quality studies show how cultural features may influence the way service quality is perceived. However, few studies specifically describe culture's influence on health service quality. Also, there are few studies that take into account patients' health service quality perceptions. This article seeks to present a first step to fill these gaps by examining patients' cultural values and their health service quality assessments. The study draws on published work and applies its ideas to Chinese healthcare settings. Data consist of hospital service perceptions in the People's Republic of China (PRC), a society that is socially, economically and culturally undergoing major changes. In total, 96 patients were surveyed. Data relationships were tested using partial least square (PLS) analysis. Findings show that Chinese patients' cultural values and their health service assessments are related and that the cultural values themselves seem to be changing. Additionally, further analyses provided interesting results pointing to which cultural values influenced service quality perceptions. The strongest service quality predictor was power distance. The sample is relatively small and collected from only one major hospital in China. Therefore, future research should extend the sample size and scope. Follow-up research could also include cross-cultural investigations of perceived health service quality to substantiate cultural influences on health service quality perceptions. In line with similar research in other contexts, the study confirms that power distance has a significant relationship with service quality perceptions. The study contributes to existing health service literature by offering patients' views on health service quality and by describing relationships between health service perceptions and cultural values--the study's main contribution.

47 CFR 101.527 - Construction requirements for 24 GHz operations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... it. (d) The frequencies associated with incumbent authorizations, licensed on a SMSA basis, that have... SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES 24 GHz Service and Digital Electronic Message Service § 101.527 Construction requirements for 24 GHz operations. (a) Each licensee must make a showing of...

47 CFR 101.527 - Construction requirements for 24 GHz operations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... it. (d) The frequencies associated with incumbent authorizations, licensed on a SMSA basis, that have... SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES 24 GHz Service and Digital Electronic Message Service § 101.527 Construction requirements for 24 GHz operations. (a) Each licensee must make a showing of...

47 CFR 101.527 - Construction requirements for 24 GHz operations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... it. (d) The frequencies associated with incumbent authorizations, licensed on a SMSA basis, that have... SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES 24 GHz Service and Digital Electronic Message Service § 101.527 Construction requirements for 24 GHz operations. (a) Each licensee must make a showing of...

47 CFR 101.527 - Construction requirements for 24 GHz operations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... it. (d) The frequencies associated with incumbent authorizations, licensed on a SMSA basis, that have... SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES 24 GHz Service and Digital Electronic Message Service § 101.527 Construction requirements for 24 GHz operations. (a) Each licensee must make a showing of...

47 CFR 101.527 - Construction requirements for 24 GHz operations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... it. (d) The frequencies associated with incumbent authorizations, licensed on a SMSA basis, that have... SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES 24 GHz Service and Digital Electronic Message Service § 101.527 Construction requirements for 24 GHz operations. (a) Each licensee must make a showing of...

47 CFR 22.946 - Service commencement and construction systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

... telephone network (PSTN) and must be providing service to mobile stations operated by its subscribers and roamers. A cellular system is considered to be providing service only if mobile stations can originate... 47 Telecommunication 2 2011-10-01 2011-10-01 false Service commencement and construction systems...

A Quality Process Approach to Electronic System Reliability: Supplier Quality Assessment Procedure. Volume 2

DTIC Science & Technology

1993-11-01

AND SUPPORT SERVICE QUALITY ....... 16 3.5.7 SUPPLIER QUALITY ............................................................................. 16 3.6...RESULTS ......................................................................................................... 16 3.6.1 PRODUCT AND SERVICE QUALITY RESULTS...10 5.6 Business Process and Support Service Quality 20 5.7 Supplier Quality 20 6.0 Results 180 6.1 Product and Service Quality Results 90 6.2 Business

Quantitative comparison of measurements of urgent care service quality.

PubMed

Qin, Hong; Prybutok, Victor; Prybutok, Gayle

2016-01-01

Service quality and patient satisfaction are essential to health care organization success. Parasuraman, Zeithaml, and Berry introduced SERVQUAL, a prominent service quality measure not yet applied to urgent care. We develop an instrument to measure perceived service quality and identify the determinants of patient satisfaction/ behavioral intentions. We examine the relationships among perceived service quality, patient satisfaction and behavioral intentions, and demonstrate that urgent care service quality is not equivalent using measures of perceptions only, differences of expectations minus perceptions, ratio of perceptions to expectations, and the log of the ratio. Perceptions provide the best measure of urgent care service quality.

Factors Affecting Medical Service Quality.

PubMed

Mosadeghrad, Ali Mohammad

2014-02-01

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

47 CFR 1.946 - Construction and coverage requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Wireless Radio Services, requirements for construction and commencement of service or commencement of... certain Wireless Radio Services, licensees must comply with geographic coverage requirements or... Section 1.946 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Wireless...

47 CFR 1.946 - Construction and coverage requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Wireless Radio Services, requirements for construction and commencement of service or commencement of... certain Wireless Radio Services, licensees must comply with geographic coverage requirements or... Section 1.946 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Wireless...

Quality site seasonal report: Army Air Force Exchange Service Headquarters Building, SFBP 1343, August 1984 through May 1985

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

Pollock, E.O. Jr.

1987-10-15

The active solar Domestic Hot Water (DHW) system at the HQ Army-Air Force Exchange Service (AAFES) Building was designed and constructed as part of the Solar in Federal Buildings Programs (SFBP). This retrofitted system is one of eight of the systems in the SFBP selected for quality monitoring. The purpose of this monitoring effort is to document the performance of quality state-of-the-art solar systems in large federal building applications. The six-story HQ AAFES Building houses a cafeteria, officer's mess and club and office space for 2400 employees. The siphon-return drainback system uses 1147 ft/sup 2/ of Aircraftsman flat-plate collectors tomore » collect solar energy which is used to preheat domestic hot water. Solar energy is stored in a 1329-gallon tank and transferred to the hot water load through a heat exchanger located in the 356-gallon DHW preheat tank. Auxiliary energy is supplied by two gas fired boilers which boost the temperature to 130/sup 0/F before it is distributed to the load. Highlights of the performance of the HQ AAFES Building solar system during the monitoring period from August 1984 through May 1985 are presented in this report.« less

Client satisfaction with reproductive health-care quality: integrating business approaches to modeling and measurement.

PubMed

Alden, Dana L; Do, Mai Hoa; Bhawuk, Dharm

2004-12-01

Health-care managers are increasingly interested in client perceptions of clinic service quality and satisfaction. While tremendous progress has occurred, additional perspectives on the conceptualization, modeling and measurement of these constructs may further assist health-care managers seeking to provide high-quality care. To that end, this study draws on theories from business and health to develop an integrated model featuring antecedents to and consequences of reproductive health-care client satisfaction. In addition to developing a new model, this study contributes by testing how well Western-based theories of client satisfaction hold in a developing, Asian country. Applied to urban, reproductive health clinic users in Hanoi, Vietnam, test results suggest that hypothesized antecedents such as pre-visit expectations, perceived clinic performance and how much performance exceeds expectations impact client satisfaction. However, the relative importance of these predictors appears to vary depending on a client's level of service-related experience. Finally, higher levels of client satisfaction are positively related to future clinic use intentions. This study demonstrates the value of: (1) incorporating theoretical perspectives from multiple disciplines to model processes underlying health-care satisfaction and (2) field testing those models before implementation. It also furthers research designed to provide health-care managers with actionable measures of the complex processes related to their clients' satisfaction.

Designing a valid and reliable Likert attitude scale on the generation of electricity from nuclear power plants

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

Calhoun, L.D.

A 15-step flowchart model was applied to the construction of a 20-item long form and a 6-item short form of the scale. Both scales were field-tested on 829 respondents representing a diverse range of subjects: high school juniors and seniors, nuclear engineering students, pre-service teachers, and members of a citizens action group. Both scales are available for immediate use. The 20-item scale appears to be reliable, content valid, and construct valid. Content validity was examined through factor analysis and the use of two separate juries of nuclear experts. Construct validity was examined by application of the known-groups approach. Scale reliabilitymore » and homogeneity were evidenced by a 0.93 coefficient alpha, a range of positive interim correlations of 0.15 to 0.73, and a range of adjusted item-total correlations of 0.46 to 0.80. The 20-item scale also has evaluative quality; means ranged from 2.80 to 3.70. Content validity for the 6-item scale was examined by a jury of nuclear experts. An obtained coefficient alpha of 0.82, a range of interim correlations of 0.51 to 0.72 suggest the scale is reliable and homogeneous. The 6-item short form also appears to have evaluative quality; means ranged from 2.37 to 3.18.« less

The Analysis of Basic Public Service Supply Regional Equalization in China’s Provinces——Based on the Theil Index Evaluation

NASA Astrophysics Data System (ADS)

Liao, Zangyi

2017-12-01

Accomplishing the regional equalization of basic public service supply among the provinces in China is an important objective that can promote the people’s livelihood construction. In order to measure the problem which is about the non-equalization of basic public service supply, this paper takes these aspects as the first index, such as the infrastructure construction, basic education services, public employment services, public health service and social security service. At the same time, it cooperates with 16 index as the second index to construct the performance evaluation systems, and then use the Theil index to evaluate the performance in provinces that using the panel data from the year 2000 to 2012.

47 CFR 101.131 - Transmitter construction and installation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 5 2013-10-01 2013-10-01 false Transmitter construction and installation. 101.131 Section 101.131 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Technical Standards § 101.131 Transmitter construction and...

47 CFR 101.131 - Transmitter construction and installation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Transmitter construction and installation. 101.131 Section 101.131 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Technical Standards § 101.131 Transmitter construction and...

47 CFR 101.131 - Transmitter construction and installation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Transmitter construction and installation. 101.131 Section 101.131 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Technical Standards § 101.131 Transmitter construction and...

47 CFR 101.131 - Transmitter construction and installation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Transmitter construction and installation. 101.131 Section 101.131 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Technical Standards § 101.131 Transmitter construction and...

Gender differences in job quality and job satisfaction among doctors in rural western China.

PubMed

Miao, Yang; Li, Lingui; Bian, Ying

2017-12-28

Few studies about gender differences in job quality and job satisfaction among medical professionals have been carried out in China. So the objectives of this study were to examine whether and to what extent gender differences existed in job quality and job satisfaction of doctors in rural western China. From 2009 to 2011, a total of 1472 doctors from 103 selected county-level health care facilities in rural western China were recruited into the study. Information about the doctors' demographic characteristics, job quality, and job satisfaction was collected through a designed questionnaire. Besides examining gender differences in single dimensions of job quality and job satisfaction, principal component analysis was used to construct a composite job quality index to measure the differences in the comprehensive job quality, and exploratory factor analysis was applied to evaluate the differences in the overall job satisfaction. Chi-square test was used to calculate differences between proportions, and t-test was used to compare differences between means. Among the doctors, there were 705 males and 767 females (ratio 1:1.09). Male doctors had significantly higher monthly salaries, longer working hours, more times of night shifts per month, longer continuous working hours, and longer years of service at current facilities, and marginally significantly higher hourly wage and longer years of service in current professions. However, female doctors showed greater overall job qualities. Significant and marginally significant gender differences were only found in satisfaction with remuneration compared to workload, the chance of promotion and working environment. But female showed greater satisfaction in the overall job satisfaction and the factor including sub-aspects of working environment, remuneration compared to workload, the chance of promotion, utilization of subjective initiative, and sense of achievement. Gender differences in job quality and job satisfaction did exist among doctors in rural western China. The participating female doctors were shown to have better job quality and greater job satisfaction.

The Effect of Service Quality on Patient loyalty: a Study of Private Hospitals in Tehran, Iran

PubMed Central

Arab, M; Tabatabaei, SM Ghazi; Rashidian, A; Forushani, A Rahimi; Zarei, E

2012-01-01

Background: Service quality is perceived as an important factor for developing patient’s loyalty. The aim of this study was to determine the hospital service quality from the patients’ viewpoints and the relative importance of quality dimensions in predicting the patient’s loyalty. Methods: A cross-sectional study was conducted in 2010. The study sample was composed of 943 patients selected from eight private general hospitals in Tehran. The survey instrument was a questionnaire included 24 items about the service quality and 3 items about the patient’s loyalty. Exploratory factor analysis was employed to extracting the dimensions of service quality. Also, regression analysis was performed to determining the relative importance of the service quality dimensions in predicting the patient’s loyalty. Result: The mean score of service quality and patient’s loyalty was 3.99 and 4.16 out of 5, respectively. About 29% of the loyalty variance was explained by the service quality dimensions. Four quality dimensions (Costing, Process Quality, Interaction Quality and Environment Quality) were found to be key determinants of the patient’s loyalty in the private hospitals of Tehran. Conclusion: The patients’ experience in relation to the private hospitals’ services has strong impact on the outcome variables like willingness to return to the same hospital and reuse its services or recommend them to others. The relationship between the service quality and patient’s loyalty proves the strategic importance of improving the service quality for dragging and retaining patients and expanding the market share. PMID:23193509

Service quality in community pharmacy: an exploration of determinants.

PubMed

White, Lesley; Klinner, Christiane

2012-01-01

Although various instruments have been developed to measure customer satisfaction with community pharmacy services, there is limited research regarding pharmacy staffs' understanding of service quality and its determinants. This study aimed to explore the perceptions of pharmacy staff regarding the factors that constitute a high level of service quality using the service quality determinants proposed by the Conceptual Model of Service Quality. Structured interviews were conducted with 27 pharmacy assistants and 6 pharmacists in 3 community pharmacies in Sydney. The interview questions focused on the participants' perceptions of consumer expectations, the translation of these perceptions into service quality specifications, the actual service delivery, and the communication to customers. From the pharmacy staff perspective, service quality is significantly limited by insufficient internal communication and control processes that impede role clarity and the resolution of conflicting role expectations among customer service personnel. Participants indicated that these problems could be alleviated through the implementation of more transparent, realistic, measurable, and accepted quality specifications by pharmacy management. The study indicates that the extent to which pharmacy management sets, maintains, and communicates service quality specifications to staff directly affects role clarity, role conflict, and organizational commitment among customer service staff, which in turn directly influence the level of service quality provided to the customers. Copyright © 2012 Elsevier Inc. All rights reserved.

7 CFR 1753.15 - General.

Code of Federal Regulations, 2012 CFR

2012-01-01

... funds, postloan architectural or engineering services shall be obtained if (1) the construction cost... TELECOMMUNICATIONS SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Engineering Services § 1753.15 General. (a)(1) The standard RUS loan documents contain provisions regarding engineering and architectural services performed...

7 CFR 1753.15 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... funds, postloan architectural or engineering services shall be obtained if (1) the construction cost... TELECOMMUNICATIONS SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Engineering Services § 1753.15 General. (a)(1) The standard RUS loan documents contain provisions regarding engineering and architectural services performed...

7 CFR 1753.15 - General.

Code of Federal Regulations, 2014 CFR

2014-01-01

... funds, postloan architectural or engineering services shall be obtained if (1) the construction cost... TELECOMMUNICATIONS SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Engineering Services § 1753.15 General. (a)(1) The standard RUS loan documents contain provisions regarding engineering and architectural services performed...

7 CFR 1753.15 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... funds, postloan architectural or engineering services shall be obtained if (1) the construction cost... TELECOMMUNICATIONS SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Engineering Services § 1753.15 General. (a)(1) The standard RUS loan documents contain provisions regarding engineering and architectural services performed...

7 CFR 1753.15 - General.

Code of Federal Regulations, 2013 CFR

2013-01-01

... funds, postloan architectural or engineering services shall be obtained if (1) the construction cost... TELECOMMUNICATIONS SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Engineering Services § 1753.15 General. (a)(1) The standard RUS loan documents contain provisions regarding engineering and architectural services performed...

42 CFR 137.344 - May a Self-Governance Tribe reallocate funds among construction project agreements?

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF... construction project agreements to the extent not prohibited by applicable appropriation law(s). Roles of Self...

Measuring Environmental Factors: Unique and Overlapping International Classification of Functioning, Disability and Health Coverage of 5 Instruments.

PubMed

Heinemann, Allen W; Miskovic, Ana; Semik, Patrick; Wong, Alex; Dashner, Jessica; Baum, Carolyn; Magasi, Susan; Hammel, Joy; Tulsky, David S; Garcia, Sofia F; Jerousek, Sara; Lai, Jin-Shei; Carlozzi, Noelle E; Gray, David B

2016-12-01

To describe the unique and overlapping content of the newly developed Environmental Factors Item Banks (EFIB) and 7 legacy environmental factor instruments, and to evaluate the EFIB's construct validity by examining associations with legacy instruments. Cross-sectional, observational cohort. Community. A sample of community-dwelling adults with stroke, spinal cord injury, and traumatic brain injury (N=568). None. EFIB covering domains of the built and natural environment; systems, services, and policies; social environment; and access to information and technology; the Craig Hospital Inventory of Environmental Factors (CHIEF) short form; the Facilitators and Barriers Survey/Mobility (FABS/M) short form; the Home and Community Environment Instrument (HACE); the Measure of the Quality of the Environment (MQE) short form; and 3 of the Patient Reported Outcomes Measurement Information System's (PROMIS) Quality of Social Support measures. The EFIB and legacy instruments assess most of the International Classification of Functioning, Disability and Health (ICF) environmental factors chapters, including chapter 1 (products and technology; 75 items corresponding to 11 codes), chapter 2 (natural environment and human-made changes; 31 items corresponding to 7 codes), chapter 3 (support and relationships; 74 items corresponding to 7 codes), chapter 4 (attitudes; 83 items corresponding to 8 codes), and chapter 5 (services, systems, and policies; 72 items corresponding to 16 codes). Construct validity is provided by moderate correlations between EFIB measures and the CHIEF, MQE barriers, HACE technology mobility, FABS/M community built features, and PROMIS item banks and by small correlations with other legacy instruments. Only 5 of the 66 legacy instrument correlation coefficients are moderate, suggesting they measure unique aspects of the environment, whereas all intra-EFIB correlations were at least moderate. The EFIB measures provide a brief and focused assessment of ICF environmental factor chapters. The pattern of correlations with legacy instruments provides initial evidence of construct validity. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Beyond the material grave: Life Cycle Impact Assessment of leaching from secondary materials in road and earth constructions

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

Schwab, Oliver; Karlsruhe Institute of Technology, Institute for Geography and Geoecology, Adenauerring 20, 76131 Karlsruhe; Bayer, Peter, E-mail: bayer@erdw.ethz.ch

Highlights: • We model environmental impacts of leaching from secondary construction material. • Industrial wastes in construction contain up to 45,000 t heavy metals per year (D). • In a scenario, 150 t are leached to the environment within 100 years after construction. • All heavy metals but As, Sb and Mo are adsorbed by 20 cm subsoil in this scenario. • Environmental impacts depend on material, pollutant, construction type, and geography. - Abstract: In industrialized countries, large amounts of mineral wastes are produced. They are re-used in various ways, particularly in road and earth constructions, substituting primary resources suchmore » as gravel. However, they may also contain pollutants, such as heavy metals, which may be leached to the groundwater. The toxic impacts of these emissions are so far often neglected within Life Cycle Assessments (LCA) of products or waste treatment services and thus, potentially large environmental impacts are currently missed. This study aims at closing this gap by assessing the ecotoxic impacts of heavy metal leaching from industrial mineral wastes in road and earth constructions. The flows of metals such as Sb, As, Pb, Cd, Cr, Cu, Mo, Ni, V and Zn originating from three typical constructions to the environment are quantified, their fate in the environment is assessed and potential ecotoxic effects evaluated. For our reference country, Germany, the industrial wastes that are applied as Granular Secondary Construction Material (GSCM) carry more than 45,000 t of diverse heavy metals per year. Depending on the material quality and construction type applied, up to 150 t of heavy metals may leach to the environment within the first 100 years after construction. Heavy metal retardation in subsoil can potentially reduce the fate to groundwater by up to 100%. One major challenge of integrating leaching from constructions into macro-scale LCA frameworks is the high variability in micro-scale technical and geographical factors, such as material qualities, construction types and soil types. In our work, we consider a broad range of parameter values in the modeling of leaching and fate. This allows distinguishing between the impacts of various road constructions, as well as sites with different soil properties. The findings of this study promote the quantitative consideration of environmental impacts of long-term leaching in Life Cycle Assessment, complementing site-specific risk assessment, for the design of waste management strategies, particularly in the construction sector.« less

Applying social impact assessment to nursing research.

PubMed

Bradbury-Jones, Caroline; Taylor, Julie

2014-08-05

Many nurses need to construct a research proposal at some stage of their career and there are multiple texts that provide guidance on doing so. However, most texts do not provide explicit guidance on the issue of social impact--the effect of research on the social health and wellbeing of individuals, families and communities and on the improved performance of relevant services. This article proposes that social impact should be considered from the beginning of a research project. It outlines a framework for assessing social impact to help strengthen the quality of research proposals and assist nurses constructing the proposal and also those evaluating it, including academic assessors or funding body reviewers. Nursing research should be useful and should have a positive effect on practice. Focusing on social impact can increase the chances of this desirable outcome.

49 CFR 173.474 - Quality control for construction of packaging.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Quality control for construction of packaging. 173...-GENERAL REQUIREMENTS FOR SHIPMENTS AND PACKAGINGS Class 7 (Radioactive) Materials § 173.474 Quality control for construction of packaging. Prior to the first use of any packaging for the shipment of Class 7...

49 CFR 173.474 - Quality control for construction of packaging.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Quality control for construction of packaging. 173...-GENERAL REQUIREMENTS FOR SHIPMENTS AND PACKAGINGS Class 7 (Radioactive) Materials § 173.474 Quality control for construction of packaging. Prior to the first use of any packaging for the shipment of Class 7...

Effects of highway construction on stream water quality and macroinvertebrate condition in a Mid-Atlantic Highlands watershed, USA

USGS Publications Warehouse

Chen, Y.; Viadero, R.C.; Wei, X.; Fortney, Ronald H.; Hedrick, Lara B.; Welsh, S.A.; Anderson, James T.; Lin, L.-S.

2009-01-01

Refining best management practices (BMPs) for future highway construction depends on a comprehensive understanding of environmental impacts from current construction methods. Based on a before-after-control impact (BACI) experimental design, long-term stream monitoring (1997-2006) was conducted at upstream (as control, n = 3) and downstream (as impact, n = 6) sites in the Lost River watershed of the Mid-Atlantic Highlands region, West Virginia. Monitoring data were analyzed to assess impacts of during and after highway construction on 15 water quality parameters and macroinvertebrate condition using the West Virginia stream condition index (WVSCI). Principal components analysis (PCA) identified regional primary water quality variances, and paired t tests and time series analysis detected seven highway construction-impacted water quality parameters which were mainly associated with the second principal component. In particular, impacts on turbidity, total suspended solids, and total iron during construction, impacts on chloride and sulfate during and after construction, and impacts on acidity and nitrate after construction were observed at the downstream sites. The construction had statistically significant impacts on macroinvertebrate index scores (i.e., WVSCI) after construction, but did not change the overall good biological condition. Implementing BMPs that address those construction-impacted water quality parameters can be an effective mitigation strategy for future highway construction in this highlands region. Copyright ?? 2009 by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America. All rights reserved.

Using fuzzy gap analysis to measure service quality of medical tourism in Taiwan.

PubMed

Ho, Li-Hsing; Feng, Shu-Yun; Yen, Tieh-Min

2015-01-01

The purpose of this paper is intended to create a model to measure quality of service, using fuzzy linguistics to analyze the quality of service of medical tourism in Taiwan so as to find the direction for improvement of service quality in medical tourism. The study developed fuzzy questionnaires based on the characteristics of medical tourism quality of service in Taiwan. Questionnaires were delivered and recovered from February to April 2014, using random sampling according to the proportion of medical tourism companies in each region, and 150 effective samples were obtained. The critical quality of service level is found through the fuzzy gap analysis using questionnaires examining expectations and perceptions of customers, as the direction for continuous improvement. From the study, the primary five critical service items that improve the quality of service for medical tourism in Taiwan include, in order: the capability of the service provider to provide committed medical tourism services reliably and accurately, facility service providers in conjunction with the services provided, the cordial and polite attitude of the service provider eliciting a sense of trust from the customer, professional ability of medical (nursing) personnel in hospital and reliability of service provider. The contribution of this study is to create a fuzzy gap analysis to assess the performance of medical tourism service quality, identify key quality characteristics and provide a direction for improvement and development for medical tourism service quality in Taiwan.

23 CFR 637.207 - Quality assurance program.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Quality assurance program. 637.207 Section 637.207... CONSTRUCTION INSPECTION AND APPROVAL Quality Assurance Procedures for Construction § 637.207 Quality assurance program. (a) Each STD's quality assurance program shall provide for an acceptance program and an...

42 CFR 137.352 - What is contained in a construction project progress report?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false What is contained in a construction project progress report? 137.352 Section 137.352 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE...

42 CFR 137.294 - What is the typical IHS environmental review process for construction projects?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false What is the typical IHS environmental review process for construction projects? 137.294 Section 137.294 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL...

42 CFR 137.294 - What is the typical IHS environmental review process for construction projects?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false What is the typical IHS environmental review process for construction projects? 137.294 Section 137.294 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL...

42 CFR 137.294 - What is the typical IHS environmental review process for construction projects?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false What is the typical IHS environmental review process for construction projects? 137.294 Section 137.294 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL...

Preaward Evaluation and Responsibility Determination of Foreign Contractors.

DTIC Science & Technology

1988-12-01

abroad. In fiscal year 1987 (FY 87) alone more than $2.1 billion in DOD contracts (exclusive of subsistence, petroleum, construction and support services...dollars. More than $1.1 billion in DOD contracts and subcontracts (exclusive of subsistence, petroleum, construction and support services) were awarded to...Germany, in FY 87 [Ref. 21. Significant amounts in construction and base services contracts are also awarded yearly to support American troops stationed

Parents of children with cancer: which factors explain differences in health-related quality of life.

PubMed

Klassen, Anne F; Raina, Parminder; McIntosh, Cameron; Sung, Lillian; Klaassen, Robert J; O'Donnell, Maureen; Yanofsky, Rochelle; Dix, David

2011-09-01

Research with parents of children with cancer has identified factors related to their adjustment and coping, but it is not fully understood why some parents do well and others do not. Guided by a stress process model, we examined the interrelationships among a comprehensive set of factors to identify the most important determinants of health-related quality of life (HRQoL) in parents of children in active treatment for cancer. A cross-sectional survey of 411 parents (80% response rate) of children receiving cancer treatment in Canada was conducted between November 2004 and February 2007. The following constructs were measured: background and context factors, child characteristics, family-centered service delivery, caregiver strain, intrapsychic factors, coping/supportive factors and parental HRQoL. The model was evaluated using structural equation modeling. Analysis was stratified by time since diagnosis (i.e., <12 months and ≥12 months). For those within 12 months of their child's diagnosis, family-centred service provision, caregiver strain, and self-perception accounted for 58% of the variation in psychosocial health, whereas caregiver strain and social support explained 50% of the variation in physical health. For parents in the >12 month group, caregiving strain was the only factor with a direct relationship with parental psychosocial and physical health, accounting for 66% and 55% of the variance in these constructs, respectively. Our findings reinforce the need for health professionals to be particularly attuned to family caregivers in the early stages of treatment and identify potential areas for interventions to promote parental health. Copyright © 2010 UICC.

E-Service Quality, E-Satisfaction and E-Loyalty of Online Shoppers in Business to Consumer Market; Evidence form Malaysia

NASA Astrophysics Data System (ADS)

Ting, Ong Soo; Ariff, Mohd Shoki Md; Zakuan, Norhayati; Sulaiman, Zuraidah; Zameri Mat Saman, Muhamad

2016-05-01

The growing usage of internet and online shopping in Malaysia presents a huge prospect in e-commerce market, specifically for B2C segment. As a result, electronic service quality (e-SQ), electronic satisfaction (e-Satisfaction) and electronic loyalty (e-Loyalty) become vital for online retailers to attract and retain online shoppers in this virtual environment. The association between e-SQ, e-Satisfaction and e-Loyalty should be continuously examined to cope with the advancement in information and communication technology, and the changing expectation of online shoppers. However, construct of e-SQ for online retailers in B2C market is still debatable. In this research, E-SERVQUAL was integrated with the other e-SQ scales to measure e-SQ of a prominent online retailer in Malaysia. Specifically, the e-SQ constructs are Efficiency, Privacy and Trust, Fulfilment, Responsiveness, Contact and Website Design. 390 sets of completed and usable questionnaires were gathered using online questionnaire and convenience sampling procedure. The result indicated that the five proposed dimensions of e-SQ constitute e-SQ of online retailer in B2C market. All the dimensions of e-SQ were found to have positive and significant effect on e-Satisfaction of online shoppers. Responsiveness of e-SQ had the strongest impact on e-satisfaction of online shoppers. The shoppers e-Satisfaction was positively and significantly affected their e-Loyalty towards continuous usage of online retailer's website. Managerial and theoretical implications are discussed based on the results of the study.

An overview of 2016 WISE Urban Summer Observation Campaign (WUSOC 2016) in the Seoul metropolitan area of South Korea

NASA Astrophysics Data System (ADS)

Jung, Jae-Won; Kim, Sang-Woo; Shim, Jae-Kwan; Kwak, Kyung-Hwan

2017-04-01

The Weather Information Service Engine (WISE), launched project of the Korea Meteorological Administration (KMA), aims to operate the urban meteorological observation network from 2012 to 2019 and to test and operate the application weather service (e.g., flash flood, road weather, city ecology, city microclimate, dispersion of hazardous substance etc.) in 2019 through the development of Advanced Storm-scale Analysis Prediction System(ASAPS) for the production of storm-scale hazard weather monitoring and prediction system. The WISE institute has completed construction of 31 urban meteorological observation cities in Seoul metropolitan area and has built a real-time test operation and verification system by improving the ASAPS that produces 1 km and 6 hour forecast information based on the 5 km forecast information of KMA. Field measurements of 2016 WISE Urban Summer Observation Campaign (WUSOC 2016) was conducted in the Seoul metropolitan area of South Korea from August 22 to October 14, 2016. Involving over 70 researchers from more than 12 environmental and atmospheric science research groups in South Korea, WUSOC2016 focused on special observations, severe rain storm observations using mobile observation car and radiosonde, wind profile observations using Wind Doppler Lidar and radiosonde, etc., around the Seoul metropolitan area. WUSOC2016 purpose at data quality control, accuracy verification, usability check, and quality improvement of ASAPS at observation stations constructed in WISE. In addition, we intend to contribute to the activation of urban fusion weather research and risk weather research through joint observation and data sharing.

78 FR 54813 - Approval and Promulgation of Air Quality Implementation Plans; Colorado; Construction Permit...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-06

...] Approval and Promulgation of Air Quality Implementation Plans; Colorado; Construction Permit Program Fee Increases; Construction Permit Regulation of PM 2.5 ; Regulation 3 AGENCY: Environmental Protection Agency... construction permit processing fees. EPA proposes approval of Colorado's May 25, 2011 submittal, which...

Establishing the effectiveness of patient decision aids: key constructs and measurement instruments

PubMed Central

2013-01-01

Background Establishing the effectiveness of patient decision aids (PtDA) requires evidence that PtDAs improve the quality of the decision-making process and the quality of the choice made, or decision quality. The aim of this paper is to review the theoretical and empirical evidence for PtDA effectiveness and discuss emerging practical and research issues in the measurement of effectiveness. Methods This updated overview incorporates: a) an examination of the instruments used to measure five key decision-making process constructs (i.e., recognize decision, feel informed about options and outcomes, feel clear about goals and preferences, discuss goals and preferences with health care provider, and be involved in decisions) and decision quality constructs (i.e., knowledge, realistic expectations, values-choice agreement) within the 86 trials in the Cochrane review; and b) a summary of the 2011 Cochrane Collaboration’s review of PtDAs for these key constructs. Data on the constructs and instruments used were extracted independently by two authors from the 86 trials and any disagreements were resolved by discussion, with adjudication by a third party where required. Results The 86 studies provide considerable evidence that PtDAs improve the decision-making process and decision quality. A majority of the studies (76/86; 88%) measured at least one of the key decision-making process or decision quality constructs. Seventeen different measurement instruments were used to measure decision-making process constructs, but no single instrument covered all five constructs. The Decisional Conflict Scale was most commonly used (n = 47), followed by the Control Preference Scale (n = 9). Many studies reported one or more constructs of decision quality, including knowledge (n = 59), realistic expectation of risks and benefits (n = 21), and values-choice agreement (n = 13). There was considerable variability in how values-choice agreement was defined and determined. No study reported on all key decision-making process and decision quality constructs. Conclusions Evidence of PtDA effectiveness in improving the quality of the decision-making process and decision quality is strong and growing. There is not, however, consensus or standardization of measurement for either the decision-making process or decision quality. Additional work is needed to develop and evaluate measurement instruments and further explore theoretical issues to advance future research on PtDA effectiveness. PMID:24625035

Establishing the effectiveness of patient decision aids: key constructs and measurement instruments.

PubMed

Sepucha, Karen R; Borkhoff, Cornelia M; Lally, Joanne; Levin, Carrie A; Matlock, Daniel D; Ng, Chirk Jenn; Ropka, Mary E; Stacey, Dawn; Joseph-Williams, Natalie; Wills, Celia E; Thomson, Richard

2013-01-01

Establishing the effectiveness of patient decision aids (PtDA) requires evidence that PtDAs improve the quality of the decision-making process and the quality of the choice made, or decision quality. The aim of this paper is to review the theoretical and empirical evidence for PtDA effectiveness and discuss emerging practical and research issues in the measurement of effectiveness. This updated overview incorporates: a) an examination of the instruments used to measure five key decision-making process constructs (i.e., recognize decision, feel informed about options and outcomes, feel clear about goals and preferences, discuss goals and preferences with health care provider, and be involved in decisions) and decision quality constructs (i.e., knowledge, realistic expectations, values-choice agreement) within the 86 trials in the Cochrane review; and b) a summary of the 2011 Cochrane Collaboration's review of PtDAs for these key constructs. Data on the constructs and instruments used were extracted independently by two authors from the 86 trials and any disagreements were resolved by discussion, with adjudication by a third party where required. The 86 studies provide considerable evidence that PtDAs improve the decision-making process and decision quality. A majority of the studies (76/86; 88%) measured at least one of the key decision-making process or decision quality constructs. Seventeen different measurement instruments were used to measure decision-making process constructs, but no single instrument covered all five constructs. The Decisional Conflict Scale was most commonly used (n = 47), followed by the Control Preference Scale (n = 9). Many studies reported one or more constructs of decision quality, including knowledge (n = 59), realistic expectation of risks and benefits (n = 21), and values-choice agreement (n = 13). There was considerable variability in how values-choice agreement was defined and determined. No study reported on all key decision-making process and decision quality constructs. Evidence of PtDA effectiveness in improving the quality of the decision-making process and decision quality is strong and growing. There is not, however, consensus or standardization of measurement for either the decision-making process or decision quality. Additional work is needed to develop and evaluate measurement instruments and further explore theoretical issues to advance future research on PtDA effectiveness.

Validating MEDIQUAL Constructs

NASA Astrophysics Data System (ADS)

Lee, Sang-Gun; Min, Jae H.

In this paper, we validate MEDIQUAL constructs through the different media users in help desk service. In previous research, only two end-users' constructs were used: assurance and responsiveness. In this paper, we extend MEDIQUAL constructs to include reliability, empathy, assurance, tangibles, and responsiveness, which are based on the SERVQUAL theory. The results suggest that: 1) five MEDIQUAL constructs are validated through the factor analysis. That is, importance of the constructs have relatively high correlations between measures of the same construct using different methods and low correlations between measures of the constructs that are expected to differ; and 2) five MEDIQUAL constructs are statistically significant on media users' satisfaction in help desk service by regression analysis.

The role of hydrological and water quality models in the application of the ecosystem services framework for the EU Water Framework Directive

NASA Astrophysics Data System (ADS)

Hallouin, Thibault; Bruen, Michael; Feeley, Hugh B.; Christie, Michael; Bullock, Craig; Kelly, Fiona; Kelly-Quinn, Mary

2017-04-01

The hydrological cycle is intimately linked with environmental processes that are essential for human welfare in many regards including, among others, the provision of safe water from surface and subsurface waterbodies, rain-fed agricultural production, or the provision of aquatic-sourced food. As well as being a receiver of these natural benefits, the human population is also a manager of the water and other natural resources and, as such, can affect their future sustainable provision. With global population growth and climate change, both the dependence of the human population on water resources and the threat they pose to these resources are likely to intensify so that the sustainability of the coupled natural and human system is threatened. In the European Union, the Water Framework Directive is driving policy and encouraging member states to manage their water resources wisely in order to maintain or restore ecological quality. To this end, the ecosystem services framework can be a useful tool to link the requirements in terms of ecological status into more tangible descriptors, that is the ecosystem services. In the ESManage Project, existing environmental system models such as hydrological models and water quality models are used as the basis to quantify the provision of many hydrological and aquatic ecosystem services by constructing indicators for the ecosystem services from the modelled environmental variables. By allowing different management options and policies to be compared, these models can be a valuable source of information for policy makers when they are used for climate and land use scenario analyses. Not all hydrological models developed for flood forecasting are suitable for this application and inappropriate models can lead to questionable conclusions. This paper demonstrates the readily available capabilities of a specially developed catchment hydrological model coupled with a water quality model to quantify a wide range of biophysically quantifiable water-related ecosystem services such as water provision (river flows, groundwater recharge and vegetation transpiration), flood regulation or nutrient and sediment retention. This combination of models will be used to carry out scenario analyses on IPCC climate change scenarios as well as various land use scenarios. Results will be presented for a test catchment in the Republic of Ireland.

Peer workers' perceptions and experiences of barriers to implementation of peer worker roles in mental health services: A literature review.

PubMed

Vandewalle, Joeri; Debyser, Bart; Beeckman, Dimitri; Vandecasteele, Tina; Van Hecke, Ann; Verhaeghe, Sofie

2016-08-01

To identify peer workers' perceptions and experiences of barriers to implementation of peer worker roles in mental health services. Review of qualitative and quantitative studies. A comprehensive electronic database search was conducted between October 2014 and December 2015 in PubMed, CINAHL, Web of Science, The Cochrane Library, and PsycARTICLES. Additional articles were identified through handsearch. All articles were assessed on quality. A thematic analysis informed by a multi-level approach was adopted to identify and discuss the main themes in the individual studies. Reporting was in line with the 'Enhancing transparency in reporting the synthesis of qualitative research' statement. Eighteen articles met the inclusion criteria. All studies adopted qualitative research methods, of which three studies used additional quantitative methods. Peer workers' perceptions and experiences cover a range of themes including the lack of credibility of peer worker roles, professionals' negative attitudes, tensions with service users, struggles with identity construction, cultural impediments, poor organizational arrangements, and inadequate overarching social and mental health policies. This review can inform policy, practice and research from the unique perspective of peer workers. Mental health professionals and peer workers should enter into an alliance to address barriers in the integration of peer workers and to enhance quality of service delivery. Longitudinal research is needed to determine how to address barriers in the implementation of peer worker roles. Copyright © 2016 Elsevier Ltd. All rights reserved.

Technology usage, quality management system, and service quality in Thailand.

PubMed

Sivabrovornvatana, Nilubon; Siengthai, Sununta; Krairit, Donyaprueth; Paul, Himangshu

2005-01-01

This article aims to explore the relationship between technology and quality management for enhancing Thai hospital service quality. The paper presents the findings of an exploratory study that investigates service quality from the customer and service provider perception. In-depth interviews were conducted with respondents in Thai hospitals. The interviews explored service-related factors that patients and service providers perceive to be important for hospital services. The first interview group consisted of professionals as internal customers in direct contact with external customers, while the second group consisted of external customers of the same hospitals. The study's outcomes clearly suggest factors that make significant contribution to service quality. These factors can be categorized according to five SERVQUAL dimensions (reliability, responsiveness, assurance, empathy, and tangibility), although some factors required slightly different interpretation. The findings suggest that hospitals can develop an appropriate approach to their advantage, which can yield sustainable improvement in service quality as perceived by patients and professionals. Hospitals can make better quality decisions based on structured measurement and knowledge. It is recommended that managers apply this knowledge for successful implementation of activities related to service quality in their organizations.

Environmental Assessment: Construct Mass/Mobility Parking Lot at Grand Forks AFB, North Dakota

DTIC Science & Technology

2004-02-13

Water: Surface water quality could be degraded, both in the short-term, during actual construction, and over the long-term due to reduced storm water quality caused...term, during actual construction, and over the long-term due to reduced storm water quality caused by the increase of exposed soil. The short-term

Patients' perceptions of service quality in China: An investigation using the SERVQUAL model.

PubMed

Fan, Li-Hua; Gao, Lei; Liu, Xin; Zhao, Shi-Hong; Mu, Hui-Tong; Li, Zhe; Shi, Lei; Wang, Ling-Ling; Jia, Xiao-Li; Ha, Min; Lou, Feng-Ge

2017-01-01

The doctor-patient relationship has been a major focus of society. Hospitals' efforts to improve the quality of their medical services have been to reduce the probability of doctor-patient conflicts. In this study, we aimed to determine the gap between expectations and perceptions of service quality according to patients to provide reference data for creating strategies to improve health care quality. Twenty-seven hospitals in 15 provinces (municipalities directly beneath the central government) were selected for our survey; we sent out 1,589 questionnaires, of which 1,520 were collected (response rate 95.65%) and 1,303 were valid (85.72% effective recovery rate). Paired t-tests were used to analyze whether there were significant differences between patients' expectations and perceived service quality. A binary logistic regression analysis was used to determine whether there were significant differences in the gap between expectation and perception of service quality according to patients' demographic characteristics. There was a significant difference between the expected and perceived service quality (p < 0.05) according to patients both before and after receiving medical services. Furthermore, the service quality gap of each service dimension was negative. Specifically, the gaps in service quality were as follows: economy, responsiveness, empathy, assurance, reliability, and tangibles. Overall, we can conclude that patients' perceptions of service quality are lower than their expectations. According to the study results, the quality of health care services as perceived by patients was lower than expected. Hospitals should make adjustments according to the actual situation and should strive to constantly improve the quality of medical services for patients.

47 CFR 22.873 - Construction requirements for commercial aviation air-ground systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Construction requirements for commercial aviation air-ground systems. 22.873 Section 22.873 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service Commercial...

48 CFR 36.702 - Forms for use in contracting for architect-engineer services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... contracting for architect-engineer services. 36.702 Section 36.702 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Standard and Optional Forms for Contracting for Construction, Architect-Engineer Services, and...

48 CFR 36.702 - Forms for use in contracting for architect-engineer services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... contracting for architect-engineer services. 36.702 Section 36.702 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Standard and Optional Forms for Contracting for Construction, Architect-Engineer Services, and...

48 CFR 36.702 - Forms for use in contracting for architect-engineer services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... contracting for architect-engineer services. 36.702 Section 36.702 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Standard and Optional Forms for Contracting for Construction, Architect-Engineer Services, and...

Patient Experience and Satisfaction with Inpatient Service: Development of Short Form Survey Instrument Measuring the Core Aspect of Inpatient Experience

PubMed Central

Wong, Eliza L. Y.; Coulter, Angela; Hewitson, Paul; Cheung, Annie W. L.; Yam, Carrie H. K.; Lui, Siu fai; Tam, Wilson W. S.; Yeoh, Eng-kiong

2015-01-01

Patient experience reflects quality of care from the patients’ perspective; therefore, patients’ experiences are important data in the evaluation of the quality of health services. The development of an abbreviated, reliable and valid instrument for measuring inpatients’ experience would reflect the key aspect of inpatient care from patients’ perspective as well as facilitate quality improvement by cultivating patient engagement and allow the trends in patient satisfaction and experience to be measured regularly. The study developed a short-form inpatient instrument and tested its ability to capture a core set of inpatients’ experiences. The Hong Kong Inpatient Experience Questionnaire (HKIEQ) was established in 2010; it is an adaptation of the General Inpatient Questionnaire of the Care Quality Commission created by the Picker Institute in United Kingdom. This study used a consensus conference and a cross-sectional validation survey to create and validate a short-form of the Hong Kong Inpatient Experience Questionnaire (SF-HKIEQ). The short-form, the SF-HKIEQ, consisted of 18 items derived from the HKIEQ. The 18 items mainly covered relational aspects of care under four dimensions of the patient’s journey: hospital staff, patient care and treatment, information on leaving the hospital, and overall impression. The SF-HKIEQ had a high degree of face validity, construct validity and internal reliability. The validated SF-HKIEQ reflects the relevant core aspects of inpatients’ experience in a hospital setting. It provides a quick reference tool for quality improvement purposes and a platform that allows both healthcare staff and patients to monitor the quality of hospital care over time. PMID:25860775

[Qualitative research methodology in health care].

PubMed

Bedregal, Paula; Besoain, Carolina; Reinoso, Alejandro; Zubarew, Tamara

2017-03-01

Health care research requires different methodological approaches such as qualitative and quantitative analyzes to understand the phenomena under study. Qualitative research is usually the least considered. Central elements of the qualitative method are that the object of study is constituted by perceptions, emotions and beliefs, non-random sampling by purpose, circular process of knowledge construction, and methodological rigor throughout the research process, from quality design to the consistency of results. The objective of this work is to contribute to the methodological knowledge about qualitative research in health services, based on the implementation of the study, “The transition process from pediatric to adult services: perspectives from adolescents with chronic diseases, caregivers and health professionals”. The information gathered through the qualitative methodology facilitated the understanding of critical points, barriers and facilitators of the transition process of adolescents with chronic diseases, considering the perspective of users and the health team. This study allowed the design of a transition services model from pediatric to adult health services based on the needs of adolescents with chronic diseases, their caregivers and the health team.

Migration of optical core network to next generation networks - Carrier Grade Ethernet Optical Transport Network

NASA Astrophysics Data System (ADS)

Glamočanin, D.

2017-05-01

In order to maintain the continuity of the telecom operators’ network construction, while monitoring development needs, increasing customers’ demands and application of technological improvements, it is necessary to migrate optical transport core network to the next generation networks - Carrier Grade Ethernet Optical Transport Network (OTN CE). The primary objective of OTN CE is to realize an environment that is based solely on the switching in the optical domain, i.e. the realization of transparent optical networks and optical switching to the second layer of ISO / OSI model. The realization of such a network provides opportunities for further development of existing, but also technologically more demanding, new services. It is also a prerequisite to provide higher scalability, reliability, security and quality of QoS service, as well as prerequisites for the establishment of SLA (Service Level Agreement) for existing services, especially traffic in real time. This study aims to clarify the proposed model, which has the potential to be eventually adjusted in accordance with new scientific knowledge in this field as well as market requirements.

Quality planning in Construction Project

NASA Astrophysics Data System (ADS)

Othman, I.; Shafiq, Nasir; Nuruddin, M. F.

2017-12-01

The purpose of this paper is to investigate deeper on the factors that contribute to the effectiveness of quality planning, identifying the common problems encountered in quality planning, practices and ways for improvements in quality planning for construction projects. This paper involves data collected from construction company representatives across Malaysia that are obtained through semi-structured interviews as well as questionnaire distributions. Results shows that design of experiments (average index: 4.61), inspection (average index: 4.45) and quality audit as well as other methods (average index: 4.26) rank first, second and third most important factors respectively.

Experiencing menopause in the context of cancer: Women's constructions of gendered subjectivities.

PubMed

Parton, Chloe; Ussher, Jane M; Perz, Janette

2017-09-01

Many women experience premature menopause following cancer treatment, accompanied by psychological distress, and poor health-related quality of life. In this qualitative study, we examined how women construct their gendered subjectivities - their sense of self as a woman - in the context of premature menopause after cancer. We analysed data from open-ended survey items and semi-structured interviews with women who had experienced cancer. Six hundred and ninety-five women completed the online survey and 61 took part in a semi-structured interview. A thematic decomposition was conducted to identify the subject positions associated with menopause taken up by the women. Three overall themes were identified: 'The Incomplete Woman,' 'The Abject, Asexual Woman' and 'Out of Time and Social Isolation.' Menopause was predominantly constructed as a negative experience, similar to older post-menopausal women and dissimilar to peers, contributing to experiences of social isolation. Menopause also signified the presence of a medically diagnosed cancer condition, and uncertainty around cancer prognosis. It is important for cancer support group leaders and other service providers to be sensitive to women's negotiation of menopause following cancer, in the context of broader cultural constructions, in order to provide appropriate information and support.

7 CFR 1724.32 - Inspection and certification of work order construction.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND... construction. The provisions of this section apply to all borrower electric system facilities regardless of the... performed within 6 months of the completion of construction, and are performed by a licensed engineer...

7 CFR 1724.32 - Inspection and certification of work order construction.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND... construction. The provisions of this section apply to all borrower electric system facilities regardless of the... performed within 6 months of the completion of construction, and are performed by a licensed engineer...

42 CFR 423.894 - Construction.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Construction. 423.894 Section 423.894 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE... Prescription Drug Plans § 423.894 Construction. Nothing in this part must be interpreted as prohibiting or...

42 CFR 423.894 - Construction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Construction. 423.894 Section 423.894 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE... Plans § 423.894 Construction. Nothing in this part must be interpreted as prohibiting or restricting: (a...

42 CFR 423.894 - Construction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Construction. 423.894 Section 423.894 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE... Plans § 423.894 Construction. Nothing in this part must be interpreted as prohibiting or restricting: (a...

42 CFR 423.894 - Construction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Construction. 423.894 Section 423.894 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE... Prescription Drug Plans § 423.894 Construction. Nothing in this part must be interpreted as prohibiting or...

42 CFR 423.894 - Construction.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Construction. 423.894 Section 423.894 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE... Prescription Drug Plans § 423.894 Construction. Nothing in this part must be interpreted as prohibiting or...

36 CFR 223.100 - Award to highest bidder.

Code of Federal Regulations, 2010 CFR

2010-07-01

... bidder has elected Forest Service road construction in response to an advertisement extending such an option, the Forest Service cannot perform the construction and in response to solicitation has not received a satisfactory bid for such construction within the period stated in the prospectus and the high...

13 CFR 305.6 - Allowable methods of procurement for construction services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Approved Projects § 305.6 Allowable methods of procurement for construction services. (a) Recipients may use alternate construction procurement methods to the traditional design/bid/build procedures... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Allowable methods of procurement...

The economics of dentistry: a neglected concern.

PubMed

Shariati, Batoul; MacEntee, Michael I; Yazdizadeh, Maryam

2013-10-01

Demand for economic evaluations in health care is growing with expectations that they will help to develop regional and national policies on health and social programmes. We present here the scope, quality and content of systematic reviews and meta-analyses relating to the economics of dentistry published over the last 15 years. To review the quality and outcome of systematic reviews and meta-analyses relating to the economics of dental treatments, preventions and services. A systematic search was conducted in 14 electronic databases for systematic reviews and meta-analyses published between January 1997 and July 2011 on the economics of oral disorders and oral health care. Review papers were extracted by two independent investigators to identify the characteristics, results and quality of the reviews and to highlight gaps in knowledge about the economics of dentistry. From 3150 unique references, we found 73 systematic reviews or meta-analyses of dental economics as primary or secondary outcomes. The focus of 12 of them was on the cost or cost-effectiveness of dental prevention, 54 on treatment, five on prevention and treatment and two on delivery of dental services. However, only 12 of the systematic reviews drew conclusions from economic data, and four of them constructed an economic model from synthesized data. Overall, the quality was good in the 12 systematic reviews but poor in the original studies. There is very little helpful data published on the economics of dentistry. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Satisfaction according to health care insurance systems in an emergency department].

PubMed

Dávila, F A; Herrera, J S; Yasnó, D A; Forero, L C; Alvarado, M V

Health satisfaction is a fundamental measure of the quality of health services. This study aims to validate and analyse the results of a quality of care questionnaire to assess the level of satisfaction of patients attended in the emergency department of a high complexity hospital. Observational, cross-sectional study, with a questionnaire designed to assess the quality of service and satisfaction at the end of care in the emergency department. Descriptive statistics of scale were established and presented, as well as determining the construct validity, overall reliability, internal and concurrent validity of an overall against a uni-dimensional scale. A total of 5,961 records were reviewed, most of them (77.3%) reported by patients in the Mandatory Health Plan. High levels of satisfaction overall and by subgroups were found. There were no significant differences between subgroups, with 86.8 for those with Pre-paid Medical Care Plan and 84.4 for mandatory health plan. Cronbach's alpha for the questionnaire was 0.90. The questionnaire proved to be reliable and valid in determining the quality and satisfaction with care. The results showed high levels of satisfaction overall and in the domains. A low consistency between the results of the multidimensional and unidimensional satisfaction scales suggests that there were aspects of satisfaction not investigated on the multidimensional scale. Ecologically-designed before and after studies are required to evaluate the effectiveness of interventions in satisfaction. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Predictors of motivation for abstinence at the end of outpatient substance abuse treatment

PubMed Central

Laudet, Alexandre B.; Stanick, Virginia

2010-01-01

Commitment to abstinence, a motivational construct, is a strong predictor of reductions in drug and alcohol use. Level of commitment to abstinence at treatment end predicts sustained abstinence, a requirement for recovery. This study sought to identify predictors of commitment to abstinence at treatment end to guide clinical practice and to inform the conceptualization of motivational constructs. Polysubstance users (N = 250) recruited at the start of outpatient treatment were re-interviewed at the end of services. Based on the extant literature, potential predictors were during treatment measures of substance use and related cognitions, psychological functioning, recovery supports, stress, quality of life satisfaction, and treatment experiences. In multivariate analyses, perceived harm of future drug use, abstinence self-efficacy, quality of life satisfaction, and number of network members in 12-step recovery contributed 26.6% of the variance explained in the dependent variable, a total of 49.6% when combined with the control variables (demographics and baseline level of the outcome). Gender subgroup analyses yielded largely similar results. Clinical implications of findings for maximizing commitment to abstinence when clients leave treatment are discussed as are future research directions. PMID:20185267

17 CFR 250.81 - Exempted transactions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... orders of the Commission pertaining to the performance of services or construction or the sale of goods shall not be applicable to the sale of water, telephone service, transportation, or a similar commodity... RULES AND REGULATIONS, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 Service, Sales and Construction...

17 CFR 250.81 - Exempted transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... orders of the Commission pertaining to the performance of services or construction or the sale of goods shall not be applicable to the sale of water, telephone service, transportation, or a similar commodity... RULES AND REGULATIONS, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 Service, Sales and Construction...

Measuring patient-perceived hospital service quality: a conceptual framework.

PubMed

Pai, Yogesh P; Chary, Satyanarayana T

2016-04-18

Purpose - Although measuring healthcare service quality is not a new phenomenon, the instruments used to measure are timeworn. With the shift in focus to patient centric processes in hospitals and recognizing healthcare to be different compared to other services, service quality measurement needs to be tuned specifically to healthcare. The purpose of this paper is to design a conceptual framework for measuring patient perceived hospital service quality (HSQ), based on existing service quality literature. Design/methodology/approach - Using HSQ theories, expanding existing healthcare service models and literature, a conceptual framework is proposed to measure HSQ. The paper outlines patient perceived service quality dimensions. Findings - An instrument for measuring HSQ dimensions is developed and compared with other service quality measuring instruments. The latest dimensions are in line with previous studies, but a relationship dimension is added. Practical implications - The framework empowers managers to assess healthcare quality in corporate, public and teaching hospitals. Originality/value - The paper helps academics and practitioners to assess HSQ from a patient perspective.

Primary Health Care and tuberculosis: services evaluation.

PubMed

Wysocki, Anneliese Domingues; Ponce, Maria Amélia Zanon; Brunello, Maria Eugênia Firmino; Beraldo, Aline Ale; Vendramini, Silvia Helena Figueiredo; Scatena, Lúcia Marina; Ruffino, Antonio; Villa, Tereza Cristina Scatena

2017-01-01

In order to control tuberculosis, the Brazilian Ministry of Health recommends the decentralization of control actions directed to the Primary Health Care, and there are few studies on the performance of the Tuberculosis Control Program in decentralized contexts. To evaluate the performance of Primary Health Care services in tuberculosis treatment. This is an evaluative study with cross-sectional approach conducted in 2011. Two hundred and thirty-nine health professionals from Primary Health Care units were interviewed using a structured instrument based on the evaluation reference of the health services quality (structure - process - results). The performance of these services was analyzed applying techniques of descriptive statistics, validation, and construction of indicators and by determining the reduced variable "Z". The indicators "participation of professionals in tuberculosis patients' care" (structure) and "reference and counterreference" (process) had the best evaluations, whereas "professional training" (structure) and "external actions for tuberculosis control" (process) had the worst results. The decentralization of tuberculosis control actions has been taking place in a vertical manner in Primary Health Care. The challenge of controlling tuberculosis involves overcoming constraints related to the engagement, training, and turnover rates among health professionals, which is a coordination between services and monitoring of control actions in Primary Health Care.

[The assessment of family resources and need for help: Construct validity and reliability of the Systematic Exploration and Process Inventory for health professionals in early childhood intervention services (SEVG)].

PubMed

Scharmanski, Sara; Renner, Ilona

2016-12-01

Health professionals in early childhood intervention and prevention make an important contribution by helping burdened families with young children cope with everyday life and child raising issues. A prerequisite for success is the health professionals' ability to tailor their services to the specific needs of families. The "Systematic Exploration and Process Inventory for health professionals in early childhood intervention services (SEVG)" can be used to identify each family's individual resources and needs, enabling a valid, reliable and objective assessment of the conditions and the process of counseling service. The present paper presents the statistical analyses that were used to confirm the reliability of the inventory. Based on the results of the reliability analysis and principal component analysis (PCA), the SEVG seems to be a reliable and objective inventory for assessing families' need for support. It also allows for calculation of average values of each scale. The development of valid and reliable assessments is essential to quality assurance and the professionalization of interventions in early childhood service. Copyright © 2016. Published by Elsevier GmbH.

Experiencing health care service quality: through patients' eyes.

PubMed

Schembri, Sharon

2015-02-01

The primary aim of the present study was to consider health care service quality from the patients' perspective, specifically through the patient's eyes. A narrative analysis was performed on 300 patient stories. This rigorous analysis of patient stories is designed to identify and describe health care service quality through patients' eyes in an authentic and accurate, experiential manner. The findings show that there are variant and complex ways that patients experience health care service quality. Patient stories offer an authentic view of the complex ways that patients experience health care service quality. Narrative analysis is a useful tool to identify and describe how patients experience health care service quality. Patients experience health care service quality in complex and varying ways.

13 CFR 305.6 - Allowable methods of procurement for construction services.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Approved Projects § 305.6 Allowable methods of procurement for construction services. (a) Recipients may... design/build, construction management at risk and force account. If an alternate method is used, the... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Allowable methods of procurement...

Item Construction and Psychometric Models Appropriate for Constructed Responses

DTIC Science & Technology

1991-08-01

which involve only one attribute per item. This is especially true when we are dealing with constructed-response items, we have to measure much more...Service University of Ilinois Educacional Testing Service Rosedal Road Capign. IL 61801 Princeton. K3 08541 Princeton. N3 08541 Dr. Charles LeiS Dr

17 CFR 250.90 - Transactions limited to cost.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) GENERAL RULES AND REGULATIONS, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 Service, Sales and Construction... service or construction for, or sell any goods to, any associate company thereof which is a public utility... construction for, or selling goods to, associate public utility companies, or enter into any contract to do so...

7 CFR Appendix D to Subpart E of... - Alcohol Production Facilities Planning, Performing, Development and Project Control

Code of Federal Regulations, 2014 CFR

2014-01-01

... imposed by construction, equipment, material or service contracts, penalty payments, damage claims, awards... consultants with suitable experience, training and professional competence in the design and construction of... engineering services for design and construction inspection for all project facilities. Resident inspection by...

7 CFR Appendix D to Subpart E of... - Alcohol Production Facilities Planning, Performing, Development and Project Control

Code of Federal Regulations, 2011 CFR

2011-01-01

... imposed by construction, equipment, material or service contracts, penalty payments, damage claims, awards... consultants with suitable experience, training and professional competence in the design and construction of... engineering services for design and construction inspection for all project facilities. Resident inspection by...

77 FR 12355 - Hours of Service of Drivers: Underwater Construction Corporation Application for Exemption

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-29

...-0376] Hours of Service of Drivers: Underwater Construction Corporation Application for Exemption AGENCY...; request for comments. SUMMARY: FMCSA has received an application from the Underwater Construction... duty status for each 24 hour period using methods prescribed in that section. UCC claims that...

Patients’ perceptions of service quality in China: An investigation using the SERVQUAL model

PubMed Central

Zhao, Shi-hong; Mu, Hui-tong; Li, Zhe; Shi, Lei; Wang, Ling-ling; Jia, Xiao-li; Ha, Min; Lou, Feng-ge

2017-01-01

Background and aim The doctor–patient relationship has been a major focus of society. Hospitals’ efforts to improve the quality of their medical services have been to reduce the probability of doctor–patient conflicts. In this study, we aimed to determine the gap between expectations and perceptions of service quality according to patients to provide reference data for creating strategies to improve health care quality. Methods Twenty–seven hospitals in 15 provinces (municipalities directly beneath the central government) were selected for our survey; we sent out 1,589 questionnaires, of which 1,520 were collected (response rate 95.65%) and 1,303 were valid (85.72% effective recovery rate). Paired t-tests were used to analyze whether there were significant differences between patients' expectations and perceived service quality. A binary logistic regression analysis was used to determine whether there were significant differences in the gap between expectation and perception of service quality according to patients' demographic characteristics. Results There was a significant difference between the expected and perceived service quality (p < 0.05) according to patients both before and after receiving medical services. Furthermore, the service quality gap of each service dimension was negative. Specifically, the gaps in service quality were as follows: economy, responsiveness, empathy, assurance, reliability, and tangibles. Overall, we can conclude that patients’ perceptions of service quality are lower than their expectations. Conclusions According to the study results, the quality of health care services as perceived by patients was lower than expected. Hospitals should make adjustments according to the actual situation and should strive to constantly improve the quality of medical services for patients. PMID:29272312

Service quality and patient experiences of ambulatory care in a specialized clinic vs. a general hospital.

PubMed

De Regge, Melissa; De Groote, Hélène; Trybou, Jeroen; Gemmel, Paul; Brugada, Pedro

2017-04-01

Health care organizations are constantly looking for ways to establish a differential advantage to attract customers. To this end, service quality has become an important differentiator in the strategy of health care organizations. In this study, we compared the service quality and patient experience in an ambulatory care setting of a physician-owned specialized facility with that of a general hospital. A comparative case study with a mixed method design was employed. Data were gathered through a survey on health service quality and patient experience, completed with observations, walkthroughs, and photographic material. Service quality and patient experiences are high in both the investigated health care facilities. A significant distinction can be made between the two facilities in terms of interpersonal quality (p = 0.001) and environmental quality (P ≤ 0.001), in favor of the medical center. The difference in environmental quality is also indicated by the scores given by participants who had been in both facilities. Qualitative analysis showed higher administrative quality in the medical center. Environmental quality and patient experience can predict the interpersonal quality; for environmental quality, interpersonal quality and age are significant predictors. Service quality and patient experiences are high in both facilities. The medical center has higher service quality for interpersonal and environmental service quality and is more process-centered.

Mission-Related Execution and Planning Through Quality of Service Methods

DTIC Science & Technology

2010-06-01

which maximizes a mission effectiveness functions is the ideal driver of QoS mechanisms. Service Quality Quality of Service may also exist in other...However, service quality is the originating concept of QoS and is the level of performance which one entity expects from another, including non-IT SoSs... Service quality may also be reflected in the context of a system’s purpose or an organization’s mission. Putting level of service values and

Non-Academic Service Quality: Comparative Analysis of Students and Faculty as Users

ERIC Educational Resources Information Center

Sharif, Khurram; Kassim, Norizan Mohd

2012-01-01

The research focus was a non-academic service quality assessment within higher education. In particular, non-academic service quality perceptions of faculty and students were evaluated using a service profit chain. This enabled a comparison which helped understanding of non-academic service quality orientation from a key users' perspective. Data…

Experienced and potential medical tourists' service quality expectations.

PubMed

Guiry, Michael; Scott, Jeannie J; Vequist, David G

2013-01-01

The paper's aim is to compare experienced and potential US medical tourists' foreign health service-quality expectations. Data were collected via an online survey involving 1,588 US consumers engaging or expressing an interest in medical tourism. The sample included 219 experienced and 1,369 potential medical tourists. Respondents completed a SERVQUAL questionnaire. Mann-Whitney U-tests were used to determine significant differences between experienced and potential US medical tourists' service-quality expectations. For all five service-quality dimensions (tangibles, reliability, responsiveness, assurance and empathy) experienced medical tourists had significantly lower expectations than potential medical tourists. Experienced medical tourists also had significantly lower service-quality expectations than potential medical tourists for 11 individual SERVQUAL items. Results suggest using experience level to segment medical tourists. The study also has implications for managing medical tourist service-quality expectations at service delivery point and via external marketing communications. Managing medical tourists' service quality expectations is important since expectations can significantly influence choice processes, their experience and post-consumption behavior. This study is the first to compare experienced and potential US medical tourist service-quality expectations. The study establishes a foundation for future service-quality expectations research in the rapidly growing medical tourism industry.

42 CFR 136.110 - Facilities construction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... application: (1) Provide its assessment of the environmental impact of the project as called for by section... 42 Public Health 1 2014-10-01 2014-10-01 false Facilities construction. 136.110 Section 136.110 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE...

42 CFR 136.110 - Facilities construction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... application: (1) Provide its assessment of the environmental impact of the project as called for by section... 42 Public Health 1 2011-10-01 2011-10-01 false Facilities construction. 136.110 Section 136.110 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE...

42 CFR 136.110 - Facilities construction.

Code of Federal Regulations, 2013 CFR

2013-10-01

... application: (1) Provide its assessment of the environmental impact of the project as called for by section... 42 Public Health 1 2013-10-01 2013-10-01 false Facilities construction. 136.110 Section 136.110 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE...

42 CFR 136.110 - Facilities construction.

Code of Federal Regulations, 2012 CFR

2012-10-01

... application: (1) Provide its assessment of the environmental impact of the project as called for by section... 42 Public Health 1 2012-10-01 2012-10-01 false Facilities construction. 136.110 Section 136.110 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE...

42 CFR 137.367 - May the Secretary issue a stop work order under a construction project agreement?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false May the Secretary issue a stop work order under a construction project agreement? 137.367 Section 137.367 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF...

42 CFR 137.367 - May the Secretary issue a stop work order under a construction project agreement?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false May the Secretary issue a stop work order under a construction project agreement? 137.367 Section 137.367 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF...

Library Services and Construction Act (LSCA). Texas State-Administered Annual Program FY 1993.

ERIC Educational Resources Information Center

Texas State Library, Austin. Dept. of Library Development.

The documentation required under the Federal Library Services and Construction Act for the 1993 annual program of the Texas State Library is assembled. Under Title I, Public Library Services to Areas Without Services, the state plans total expenditures of $12,066,877, including $5,019,151 in federal funds and $7,047,726 in state funds for services…

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.

Disclosure of domestic violence in mental health settings: A qualitative meta-synthesis

PubMed Central

Trevillion, Kylee; Hughes, Bryony; Feder, Gene; Borschmann, Rohan; Oram, Siân

2014-01-01

Little is known about how psychiatric services respond to service users’ experiences of domestic violence. This qualitative meta-synthesis examined the healthcare experiences and expectations of mental health service users experiencing domestic violence. Twenty-two biomedical, social science, grey literature databases and websites were searched, supplemented by citation tracking and expert recommendations. Qualitative studies which included mental health service users (aged ≥ 16 years) with experiences of domestic violence were eligible for inclusion. Two reviewers independently extracted data from included papers and assessed quality. Findings from primary studies were combined using meta-synthesis techniques. Twelve studies provided data on 140 female and four male mental health service users. Themes were generally consistent across studies. Overarching theoretical constructs included the role of professionals in identifying domestic violence and facilitating disclosures, implementing personalized care and referring appropriately. Mental health services often failed to identify and facilitate disclosures of domestic violence, and to develop responses that prioritized service users’ safety. Mental health services were reported to give little consideration to the role of domestic violence in precipitating or exacerbating mental illness and the dominance of the biomedical model and stigma of mental illness were found to inhibit effective responses. Mental health services often fail to adequately address the violence experienced by mental health service users. This meta-synthesis highlights the need for mental health services to establish appropriate strategies and responses to domestic violence to ensure optimal care of this vulnerable population. PMID:25137109

Support as a complement, intrusion and right--evidence from ageing and disability support service users in Sweden and Australia.

PubMed

Laragy, Carmel; Fisher, Karen R; Cedersund, Elisabet; Campbell-McLean, Carolyn

2011-12-01

How service users conceptualise their personal support services is under researched, even though this understanding is important for responsive policy development and service implementation. This paper tests the proposition that service users understand formal support in three ways: support is a complement to their other arrangements, an intrusion into their personal life and a right. These three concepts were identified using discourse analysis in a Swedish study of older people wanting in-home support services. To test generalisability of these concepts, they were applied to data from an Australian study of people using disability personal support. The analysis found that the three concepts were core to people's views of their support, although the construction of the concepts differed in the two countries. Service users in Sweden asserted their right to services more forcefully than those in Australia, and they had higher expectations that their support needs would be met. These differences reflect the impact of each country's social policy environment on service users' expectations. The analysis suggests that service users and their families want to control their formal support arrangements to complement their informal care and their life preferences and to minimise the intrusive aspects of formal support. The findings imply that the three concepts have utility for theorising service users' perspectives, informing policy and developing implementation strategies which enhance peoples' quality of life. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

Achieving Organizational Vision at the DeWitt Army Health Care System Through a Focus on Service Quality.

DTIC Science & Technology

1995-05-01

based upon the variables ’ service quality ’ and ’customer satisfaction.’ Service quality was operationally defined as a gap score by subtracting...regression analysis, a statistically significant relationship was shown to exist: (1) between customer satisfaction and service quality , t(387)=13.566... service quality , customer satisfaction and future choice behavior may assist in preparation for the TRICARE initiative.

Inpatient Dialysis Unit Project Development: Redesigning Acute Hemodialysis Care.

PubMed

Day, Jennifer

2017-01-01

Executive leaders of an acute care hospital performed a market and financial analysis, and created a business plan to establish an inpatient hemodialysis unit operated by the hospital to provide safe, high-quality, evidence-based care to the population of individuals experiencing end stage renal disease (ESRD) within the community. The business plan included a SWOT (Strengths - Weaknesses - Opportunities - Threats) analysis to assess advantages of the hospital providing inpatient hemodialysis services versus outsourcing the services with a contracted agency. The results of the project were a newly constructed tandem hemodialysis room and an operational plan with clearly defined key performance indicators, process improvement initiatives, and financial goals. This article provides an overview of essential components of a business plan to guide the establishment of an inpatient hemodialysis unit. Copyright© by the American Nephrology Nurses Association.

Design and Testing of an Air Force Services Mystery Shopping Program.

DTIC Science & Technology

1998-11-01

Base level Air Force Services’ lodging and foodservice activities use limited service quality measurement tools to determine customer perceptions of... service quality . These tools, specifically management observation and customer comment cards, do not provide a complete picture of service quality . Other... service quality measurement methods such as mystery shopping are rarely used. Bases do not consider using mystery shopping programs because of the

Environmental Assessment: Construct POV Parking Lot Main Gate-Separated at Grand Forks AFB, North Dakota

DTIC Science & Technology

2004-09-01

water quality could be degraded, both in the short-term, during actual construction, and over the long-term due to reduced storm water quality caused by...due to reduced storm water quality caused by the increase of 37 paved area. The short-term effects come from possible erosion contributing to...construction, and over the long-term due to reduced storm water quality caused by the increase of paved area. The short-term effects come from

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

Not Available

The 1-acre Central Illinois Public Service (CIPS) site is a former manufactured gas plant in Taylorville, Christian County, Illinois. The plant produced a low-quality gas from coal, which was used for lighting and heating. Onsite contamination by coal tar was discovered in 1985 during site construction. The ROD addressesses a final remedy for the remaining principal threat posed by ground water contamination at the site, and also documents the prior 1987 removal action. The primary contaminants of concern affecting the soil, sediment, debris, and ground water at the site are VOCs, including benzene, toluene, and xylenes; and other organics, includingmore » PAHs and phenols.« less

A Multiple-Item Scale for Assessing E-Government Service Quality

NASA Astrophysics Data System (ADS)

Papadomichelaki, Xenia; Mentzas, Gregoris

A critical element in the evolution of e-governmental services is the development of sites that better serve the citizens’ needs. To deliver superior service quality, we must first understand how citizens perceive and evaluate online citizen service. This involves defining what e-government service quality is, identifying its underlying dimensions, and determining how it can be conceptualized and measured. In this article we conceptualise an e-government service quality model (e-GovQual) and then we develop, refine, validate, confirm and test a multiple-item scale for measuring e-government service quality for public administration sites where citizens seek either information or services.

Using mobile technology to improve healthcare service quality.

PubMed

Chao, Chia Chen; Jen, Wen Yuan; Li, Yu-Chuan; Chi, Y P; Chen, Chang-I; Feng, Chen Chjeh

2005-01-01

Improving healthcare service quality for illness of treatment, illness prevention and patient service is difficult for most hospitals because the hospitals are lack adequate resources and labor. In order to provide better healthcare service quality for patients, mobile technology can be used to manage healthcare in a way that provides the optimal healthcare service for patients. Pursuing utilization of mobile technology for better patient service, Taipei Medical University Municipal W. F. Teaching Hospital has implemented a mobile healthcare service (m-HS) system to increase healthcare service quality. The m-HS system improves the quality of medical care as well as healthcare service. The m-HS is a multi-functional healthcare management agent, meets the mobile tendency of the present society. This study seeks to discuss the m-HS architecture and workflow processes. We believe the m-HS does have the potential to improve healthcare service quality. Finally, the conclusions and suggestions for the m-HS are given.

Gender Differences in the Structure of Marital Quality.

PubMed

Beam, Christopher R; Marcus, Katherine; Turkheimer, Eric; Emery, Robert E

2018-05-01

Marriages consist of shared experiences and interactions between husbands and wives that may lead to different impressions of the quality of the relationship. Few studies, unfortunately, have tested gender differences in the structure of marital quality, and even fewer studies have evaluated whether genetic and environmental influences on marital quality differ across gender. In this study, we evaluated gender differences in the structure of marital quality using independent samples of married male (n = 2406) and married female (n = 2215) participants from the National Survey of Midlife Development in the United States who provided ratings on twenty-eight marital quality items encompassing six marital quality constructs. We further explored gender differences in genetic and environmental influences on marital quality constructs in a subsample of 491 pairs of twins. Results suggest partial metric invariance across gender but structural variability in marital quality constructs. Notably, correlations between constructs were stronger in women than men. Results also support gender differences in the genetic and environmental influences on different aspects of marital quality. We discuss that men and women may approach and react to marriage differently as the primary reason why we observed differences in the structure of marital quality.

17 CFR 250.82 - Temporary exemption from section 13.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (CONTINUED) GENERAL RULES AND REGULATIONS, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 Service, Sales and... principally engaged in performing services or construction for, or making sales to, associates of such... performance of services or construction for associate companies on the basis of cost and with the provisions...

22 CFR 228.35 - Construction services from foreign-owned local firms.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Construction services from foreign-owned local firms. 228.35 Section 228.35 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES ON SOURCE, ORIGIN AND NATIONALITY FOR COMMODITIES AND SERVICES FINANCED BY USAID Conditions Governing the...

76 FR 28333 - Electric Engineering, Architectural Services, Design Policies and Construction Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-17

... CFR Parts 1724 and 1726 RIN 0572-AC20 Electric Engineering, Architectural Services, Design Policies... standard forms of contracts promulgated by RUS for construction, procurement, engineering services and... XVII of title 7 of the Code of Federal Regulations as follows: PART 1724--ELECTRIC ENGINEERING...

42 CFR 137.304 - May Self-Governance Tribes buy back environmental services from the IHS?

Code of Federal Regulations, 2010 CFR

2010-10-01

... project agreement, including design and construction engineering, and environmental compliance services... 42 Public Health 1 2010-10-01 2010-10-01 false May Self-Governance Tribes buy back environmental...-GOVERNANCE Construction Nepa Process § 137.304 May Self-Governance Tribes buy back environmental services...

47 CFR 22.143 - Construction prior to grant of application.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES PUBLIC MOBILE SERVICES Licensing Requirements and Procedures Applications and Notifications § 22... Mobile services prior to grant of their applications, subject to the provisions of this section, but must... 47 Telecommunication 2 2010-10-01 2010-10-01 false Construction prior to grant of application. 22...

National Park Service Primer on the construction of Ferry Boats and Ferry Terminal Facilities Program (FBP)

DOT National Transportation Integrated Search

2014-12-01

Many National Park Service units are located in areas which are served by vehicle or passenger ferry. These National Park : Service units and their partners may be eligible to use funding from the FHWA Construction of Ferry Boats and Ferry : Terminal...

Annual Program: Library Services and Construction Act, 1987-1988.

ERIC Educational Resources Information Center

South Carolina State Library, Columbia.

This report presents the 1978-1988 annual Library Services and Construction Act (LSCA) program for the South Carolina State Library. This program includes fiscal information and project descriptions for the following LCSA projects under Title I-Library Services: (1) Projects IA-General Administration; (2) IB-Library Interpretation; (3) IIA-General…

Quality of Services and Quality of Life from Service Providers' Perspectives: Analysis with Focus Groups

ERIC Educational Resources Information Center

Jenaro, C.; Vega, V.; Flores, N.; Cruz, M.

2013-01-01

Background: Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this…

Quality of Care in the Social Services: Research Agenda and Methods

ERIC Educational Resources Information Center

McMillen, J. Curtis; Proctor, Enola K.; Megivern, Deborah; Striley, Catherine Woodstock; Cabassa, Leopoldo J.; Munson, Michelle R.; Dickey, Barbara

2005-01-01

In an era of heightened accountability, remarkably little is known empirically about the quality of social work services. This article applies insights from health services research to propose a research agenda on the quality of care in the social services. The agenda calls for studies that address the definition of quality service, variations in…

42 CFR 456.6 - Review by State medical agency of appropriateness and quality of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... and quality of services. 456.6 Section 456.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Provisions § 456.6 Review by State medical agency of appropriateness and quality of services. (a) The... professional health personnel of the appropriateness and quality of Medicaid services. (b) The purpose of this...

[Neighborhood environment quality, individual-level social capital, and depressive symptoms among adolescents].

PubMed

Asakura, Takashi

2011-09-01

We aimed to develop measures to assess features of neighborhood quality and individual social capital, as well as their associations with depressive symptoms among early adolescents. To determine whether relations of depressive symptoms with neighborhood quality might be contingent upon the level of individual cognitive social capital, neighborhood-by-cognitive social capital interaction terms were examined. A qualitative study was conducted to elicit the perceptions of early adolescents about their neighborhood environment. Subsequently, we recruited 2,002 eighth graders and asked for responses to a self-administered questionnaire. The variables analyzed in this study were the Center for Epidemiologic Studies-Depression scale (10 items), features of neighborhood quality, cognitive and structural individual social capital, and demographics. We adopted a generalized estimating equation regression model for the multivariate analysis. The analytic sample was 1,786 with no missing variable in the models. Seven subscales were devised to assess quality features of neighborhood environments with an examination of validity and reliability: "availability of services," "good neighborhood relations," "spaces for recreation," "insecurity and danger of accidents," "dirty-looking, squalid, unclean," "civic communities," and "aesthetic look." We also developed a scale of individual cognitive social capital, which consisted of three constructs: "social trust," "reciprocity," and "social norms." Additionally, the number of social activities in which subjects participated was counted as an indicator of the structural aspect of individual social capital. On examination with the generalized estimating equation regression model, "availability of services," "insecurity and danger of accidents," "dirty-looking, squalid, unclean," and cognitive social capital were significantly associated with the CES-D scores controlling for demographics. We also found a significant interplay between "dirty-looking, squalid, unclean" and the cognitive social capital for estimating scores of depressive symptoms. Improvement in features of neighborhood quality such as availability of services, cleanliness, and security and social order in terms of public policy as well as civic activities could contribute to promotion of mental health in adolescents. Individual cognitive social capital accumulated through experiencs of good social relationshisp in a community could also play important roles in maximizing mental health.

Promoting Quality in NAVFAC (Naval Facilities Engineering Command) Construction.

DTIC Science & Technology

1986-01-01

experience. Inspector Checklists To assist their field construction engineers, Owens - Corning Fiberglas Corporation, in conjunction with Texas A&M...that developed by Owens - Corning Fiberglas A I Corporation to assist government inspectors to maintain high - quality standards in their construction...105, No. C03 (September 1979), 187-199. Information in a letter to the author from D.R. Eberts, Quality Assurance Engineer, Owens - Corning Fiberglas

Quality Assessment of University Studies as a Service: Dimensions and Criteria

ERIC Educational Resources Information Center

Pukelyte, Rasa

2010-01-01

This article reviews a possibility to assess university studies as a service. University studies have to be of high quality both in their content and in the administrative level. Therefore, quality of studies as a service is an important constituent part of study quality assurance. When assessing quality of university studies as a service, it is…

Social and cultural meanings of self-efficacy.

PubMed

Burke, Nancy J; Bird, Joyce A; Clark, Melissa A; Rakowski, William; Guerra, Claudia; Barker, Judith C; Pasick, Rena J

2009-10-01

This article describes the influences of social context on women's health behavior through illustration of the powerful influences of social capital (the benefits and challenges that accrue from participation in social networks and groups) on experiences and perceptions of self-efficacy. The authors conducted inductive interviews with Latino and Filipino academics and social service providers and with U.S.-born and immigrant Latinas and Filipinas to explore direct and indirect influences of social context on health behaviors such as mammography screening. Iterative thematic analysis identified themes (meanings of efficacy, spheres of efficacy, constraints on efficacy, sources of social capital, and differential access to and quality of social capital) that link the domain of social capital with the behavioral construct perceived self-efficacy. The authors conclude that social capital addresses aspects of social context absent in the current self-efficacy construct and that these aspects have important implications for scholars' and practitioners' understandings of health behavior and intervention development.

[Construction-cost assessment of a program designed to promote physical and sports activities and prevent doping behaviors: PN-APSD - on 2002-2007].

PubMed

Bérard, A; Bréchat, P-H; Rymer, R; Londsdorfer, J

2009-02-01

According to the framework legislation promulgated as part of the reform of finance laws in France, quality is a mandatory feature of all governmental actions. In this context, this work was conducted to assess the construction cost of a national health program designed to promote physical and sports activities and prevent doping behaviors. This program was considered to have the characteristic features of a successful governmental health intervention. Four cost categories were evaluated: cost of the activity itself, transportation costs, communication costs and promotion costs. It was found that the program costs for 2002-2007 were 100,000 euro, with 15% of the costs in the communication category. Economic elements could be associated with factors of successful health service interventions in order to help decision makers responsible for the public interest and the consistency of public health actions.

Development of a Personal Integrated Environmental Monitoring System

PubMed Central

Wong, Man Sing; Yip, Tsan Pong; Mok, Esmond

2014-01-01

Environmental pollution in the urban areas of Hong Kong has become a serious public issue but most urban inhabitants have no means of judging their own living environment in terms of dangerous threshold and overall livability. Currently there exist many low-cost sensors such as ultra-violet, temperature and air quality sensors that provide reasonably accurate data quality. In this paper, the development and evaluation of Integrated Environmental Monitoring System (IEMS) are illustrated. This system consists of three components: (i) position determination and sensor data collection for real-time geospatial-based environmental monitoring; (ii) on-site data communication and visualization with the aid of an Android-based application; and (iii) data analysis on a web server. This system has shown to be working well during field tests in a bus journey and a construction site. It provides an effective service platform for collecting environmental data in near real-time, and raises the public awareness of environmental quality in micro-environments. PMID:25420154

Integrating watershed hydrology and economics to establish a local market for water quality improvement: A field experiment.

PubMed

Uchida, Emi; Swallow, Stephen K; Gold, Arthur; Opaluch, James; Kafle, Achyut; Merrill, Nathaniel; Michaud, Clayton; Gill, Carrie Anne

2018-04-01

Innovative market mechanisms are being increasingly recognized as effective decision-making institutions to incorporate the value of ecosystem services into the economy. We present a field experiment that integrates an economic auction and a biophysical water flux model to develop a local market process consisting of both the supply and demand sides. On the supply side, we operate an auction with small-scale livestock owners who bid for contracts to implement site-specific manure management practices that reduce phosphorus loadings to a major reservoir. On the demand side, we implement a real money, multi-unit public good auction for these contracts with residents who potentially benefit from reduced water quality risks. The experiments allow us to construct supply and demand curves to find an equilibrium price for water quality improvement. The field experiments provide a proof-of-concept for practical implementation of a local market for environmental improvements, even for the challenging context of nonpoint pollution.

Fault Tree Analysis.

PubMed

McElroy, Lisa M; Khorzad, Rebeca; Rowe, Theresa A; Abecassis, Zachary A; Apley, Daniel W; Barnard, Cynthia; Holl, Jane L

The purpose of this study was to use fault tree analysis to evaluate the adequacy of quality reporting programs in identifying root causes of postoperative bloodstream infection (BSI). A systematic review of the literature was used to construct a fault tree to evaluate 3 postoperative BSI reporting programs: National Surgical Quality Improvement Program (NSQIP), Centers for Medicare and Medicaid Services (CMS), and The Joint Commission (JC). The literature review revealed 699 eligible publications, 90 of which were used to create the fault tree containing 105 faults. A total of 14 identified faults are currently mandated for reporting to NSQIP, 5 to CMS, and 3 to JC; 2 or more programs require 4 identified faults. The fault tree identifies numerous contributing faults to postoperative BSI and reveals substantial variation in the requirements and ability of national quality data reporting programs to capture these potential faults. Efforts to prevent postoperative BSI require more comprehensive data collection to identify the root causes and develop high-reliability improvement strategies.

'Smart' homes and telecare for independent living.

PubMed

Tang, P; Venables, T

2000-01-01

Telecare services and 'smart' homes share a common technological base in information technology and telecommunications. There is growing interest in both telecare services and smart homes, although they have been studied in isolation. Telecare has been driven largely by perceived cost savings and improved service delivery to the home, leading to improved quality of life and independent living. Smart homes are also expected to provide better and safer living conditions. The integration of the two should produce more secure and autonomous living. There are different forms of telecare services, as there are different types of smart homes, each ranging from basic systems involving the use of alarms and the ordinary telephone to intelligent monitoring with sensors and interactive communication. The introduction of these systems has policy implications, such as the need for coordination between health, social services and housing policy makers, which will reduce duplication and inefficient allocation of resources. Successful delivery of telecare to the home is as much dependent on the construction and condition of the housing stock as it is on the ability of the care provider to meet users' needs. If the UK National Health Service (NHS) could replace a significant proportion of domiciliary nursing visits by telephone calls, then savings of up of 200 million Pounds per annum would be possible.

Estimation and Evaluation of Future Demand and Supply of Healthcare Services Based on a Patient Access Area Model

PubMed Central

Doi, Shunsuke; Ide, Hiroo; Takeuchi, Koichi; Fujita, Shinsuke; Takabayashi, Katsuhiko

2017-01-01

Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the patient access area model (PAAM), which simulates patients’ access time to healthcare service institutions using a geographic information system (GIS). Using this model, to evaluate the balance of future healthcare services demand and supply in small areas, we estimated the number of inpatients every five years in each area and compared it with the number of hospital beds within a one-hour drive from each area. In an experiment with the Tokyo metropolitan area as a target area, when we assumed hospital bed availability to be 80%, it was predicted that over 78,000 inpatients would not receive inpatient care in 2030. However, this number would decrease if we lowered the rate of inpatient care by 10% and the average length of the hospital stay. Using this model, recommendations can be made regarding what action should be undertaken and by when to prevent a dramatic increase in healthcare demand. This method can help plan the geographical resource allocation in healthcare services for healthcare policy. PMID:29125585

Service quality that improves customer satisfaction in a university: a case study in Institut Teknologi Indonesia

NASA Astrophysics Data System (ADS)

Theresia, L.; Bangun, R.

2017-12-01

Universities should provide better service quality to get more customers. The purpose of this study was to find service quality which has impact on the increasing of customer satisfaction in a university. This study is a case study in Institut Teknologi Indonesia (ITI). The result of the study will help ITI to improve its service quality to increase customer satisfaction. This study employs path analysis technique. The data were collected through questionnaires developed from the literature. Questionnaires have two parts namely 1) service quality and 2) customer satisfaction. Service quality is measured through 22 questions with five service quality dimensions: 1) Tangibles, 2) Reliability, 3) Responsiveness, 4) Assurance and 5) Empathy. Customer Satisfaction is measured through 4 questions. The data then are processed by SPSS. The results showed that the students preferred to tangible quality improvement than intangible aspect.

78 FR 7416 - Notice of Intent To Prepare an Environmental Impact Statement for Land-Water Interface and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-01

... Statement for Land-Water Interface and Service Pier Extension, Naval Base Kitsap Bangor, Silverdale, WA and... Land-Water Interface (LWI) structures and (2) the proposed construction and operation of a Service Pier... waterfront. Construction is anticipated to take two years. Construction activities occurring in the water...

Servant Leadership and Constructive Development Theory: How Servant Leaders Make Meaning of Service

ERIC Educational Resources Information Center

Phipps, Kelly A.

2010-01-01

A connection between servant leadership and constructive developmental theory is proposed. A theoretical framework is offered that examines the subject and object relationship for servant leaders at progressive stages of meaning making, showing how the way leaders make meaning of service evolves with their constructive development. The framework…

A conceptual model of the role of complexity in the care of patients with multiple chronic conditions.

PubMed

Grembowski, David; Schaefer, Judith; Johnson, Karin E; Fischer, Henry; Moore, Susan L; Tai-Seale, Ming; Ricciardi, Richard; Fraser, James R; Miller, Donald; LeRoy, Lisa

2014-03-01

Effective healthcare for people with multiple chronic conditions (MCC) is a US priority, but the inherent complexity makes both research and delivery of care particularly challenging. As part of AHRQ Multiple Chronic Conditions Research Network (MCCRN) efforts, the Network developed a conceptual model to guide research in this area. To synthesize methodological and topical issues relevant to MCC patient care into a framework that can improve the delivery of care and advance future research about caring for patients with MCC. The Network synthesized essential constructs for MCC research identified from roundtable discussion, input from expert advisors, and previously published models. The AHRQ MCCRN conceptual model defines complexity as the gap between patient needs and healthcare services, taking into account both the multiple considerations that affect the needs of MCC patients, as well as the contextual factors that influence service delivery. The model reframes processes and outcomes to include not only clinical care quality and experience, but also patient health, well being, and quality of life. The single-condition paradigm for treating needs one-by-one falls apart and highlights the need for care systems to address dynamic patient needs. Defining complexity in terms of the misalignment between patient needs and services offers new insights in how to research and develop solutions to patient care needs.

Interventions to prevent injuries in construction workers.

PubMed

van der Molen, Henk F; Lehtola, Marika M; Lappalainen, Jorma; Hoonakker, Peter L T; Hsiao, Hongwei; Haslam, Roger; Hale, Andrew R; Frings-Dresen, Monique H W; Verbeek, Jos H

2012-12-12

Construction workers are frequently exposed to various types of injury-inducing hazards. A number of injury prevention interventions have been proposed, yet their effectiveness is uncertain. To assess the effects of interventions to prevent injuries in construction workers. We searched the Cochrane Injuries Group's specialised register, CENTRAL, MEDLINE, EMBASE, PsycINFO, OSH-ROM (including NIOSHTIC and HSELINE), Scopus, Web of Science and EI Compendex to September 2011. The searches were not restricted by language or publication status. The reference lists of relevant papers and reviews were also searched. Randomised controlled trials, controlled before-after (CBA) studies and interrupted time series (ITS) of all types of interventions for preventing fatal and non-fatal injuries among workers at construction sites. Two review authors independently selected studies, extracted data and assessed study quality. For ITS, we re-analysed the studies and used an initial effect, measured as the change in injury-rate in the year after the intervention, as well as a sustained effect, measured as the change in time trend before and after the intervention. Thirteen studies, 12 ITS and one CBA study met the inclusion criteria. The ITS evaluated the effects of the introduction or change of regulations (N = 7), a safety campaign (N = 2), a drug-free workplace programme (N = 1), a training programme (N = 1), and safety inspections (N = 1) on fatal and non-fatal occupational injuries. One CBA study evaluated the introduction of occupational health services such as risk assessment and health surveillance.The overall risk of bias among the included studies was high as it was uncertain for the ITS studies whether the intervention was independent from other changes and thus could be regarded as the main reason of change in the outcome.The regulatory interventions at national or branch level showed a small but significant initial and sustained increase in fatal (effect sizes of 0.79; 95% confidence interval (CI) 0.00 to 1.58) and non-fatal injuries (effect size 0.23; 95% CI 0.03 to 0.43).The safety campaign intervention resulted in a decrease in injuries at the company level but an increase at the regional level. Training interventions, inspections or the introduction of occupational health services did not result in a significant reduction of non-fatal injuries in single studies.A multifaceted drug-free workplace programme at the company level reduced non-fatal injuries in the year following implementation by -7.6 per 100 person-years (95% CI -11.2 to -4.0) and in the years thereafter by -2.0 per 100 person-years per year (95% CI -3.5 to -0.5). The vast majority of technical, human and organisational interventions that are recommended by standard texts of safety, consultants and safety courses have not been adequately evaluated. There is no evidence that introducing regulations for reducing fatal and non-fatal injuries are effective as such. There is neither evidence that regionally oriented safety campaigns, training, inspections nor the introduction of occupational health services are effective at reducing non-fatal injuries in construction companies. There is low-quality evidence that company-oriented safety interventions such as a multifaceted safety campaign and a multifaceted drug workplace programme can reduce non-fatal injuries among construction workers. Additional strategies are needed to increase the compliance of employers and workers to the safety measures that are prescribed by regulation. Continuing company-oriented interventions among management and construction workers, such as a targeted safety campaign or a drug-free workplace programme, seem to have an effect in reducing injuries in the longer term.

Effective interventions on service quality improvement in a physiotherapy clinic.

PubMed

Gharibi, Farid; Tabrizi, JafarSadegh; Eteraf Oskouei, MirAli; AsghariJafarabadi, Mohammad

2014-01-01

Service quality is considered as a main domain of quality associ-ated with non-clinical aspect of healthcare. This study aimed to survey and im-proves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reli-able researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (P<0.001). Service quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.

Service quality framework for clinical laboratories.

PubMed

Ramessur, Vinaysing; Hurreeram, Dinesh Kumar; Maistry, Kaylasson

2015-01-01

The purpose of this paper is to illustrate a service quality framework that enhances service delivery in clinical laboratories by gauging medical practitioner satisfaction and by providing avenues for continuous improvement. The case study method has been used for conducting the exploratory study, with focus on the Mauritian public clinical laboratory. A structured questionnaire based on the SERVQUAL service quality model was used for data collection, analysis and for the development of the service quality framework. The study confirms the pertinence of the following service quality dimensions within the context of clinical laboratories: tangibility, reliability, responsiveness, turnaround time, technology, test reports, communication and laboratory staff attitude and behaviour. The service quality framework developed, termed LabSERV, is vital for clinical laboratories in the search for improving service delivery to medical practitioners. This is a pioneering work carried out in the clinical laboratory sector in Mauritius. Medical practitioner expectations and perceptions have been simultaneously considered to generate a novel service quality framework for clinical laboratories.

Distributor- Retailer Interface in Pharmaceutical Supply Chain: Service Quality Measurement Scale.

PubMed

Mehralian, Gholamhossein; Babapour, Jafar; Peiravian, Farzad

2016-01-01

In the current competitive market, service quality management is the key to the survival and success of businesses. SERVQUAL is a popular service quality measurement scale (SQMS) that has served as a basis for subsequent research on service quality; it has been used for testing different aspects of service quality in a market. The purpose of our study is, therefore, to develop a service quality measurement scale (SQMS) for the distributor-retailer interface of Pharm supply chains (PSC) in Iran. A survey was performed to collect data from pharmacies located in Tehran. A valid and reliable questionnaire delivered to pharmacies, and 400 pharmacies were intended to participate in our survey. Confirmatory factor analysis (CFA) was used to develop an SQMS in this study. Sufficient sampling was undertaken to do CFA. Consistent with other service quality studies, this Res developed an SQMS with five dimensions and 20 items for PSC, and contributes to mangers to regularly measure service quality. This is an initial study to develop a framework for measuring service quality in Iranian PCS. The framework can be used effectively to achieve competitive advantage at the distributor-retailer interface.

Distributor– Retailer Interface in Pharmaceutical Supply Chain: Service Quality Measurement Scale

PubMed Central

Mehralian, Gholamhossein; Babapour, Jafar; peiravian, farzad

2016-01-01

In the current competitive market, service quality management is the key to the survival and success of businesses. SERVQUAL is a popular service quality measurement scale (SQMS) that has served as a basis for subsequent research on service quality; it has been used for testing different aspects of service quality in a market. The purpose of our study is, therefore, to develop a service quality measurement scale (SQMS) for the distributor–retailer interface of Pharm supply chains (PSC) in Iran. A survey was performed to collect data from pharmacies located in Tehran. A valid and reliable questionnaire delivered to pharmacies, and 400 pharmacies were intended to participate in our survey. Confirmatory factor analysis (CFA) was used to develop an SQMS in this study. Sufficient sampling was undertaken to do CFA. Consistent with other service quality studies, this Res developed an SQMS with five dimensions and 20 items for PSC, and contributes to mangers to regularly measure service quality. This is an initial study to develop a framework for measuring service quality in Iranian PCS. The framework can be used effectively to achieve competitive advantage at the distributor–retailer interface. PMID:28243297