7 CFR 1737.31 - Area Coverage Survey (ACS).

Code of Federal Regulations, 2014 CFR

2014-01-01

... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage Survey (ACS) is a market forecast of service requirements of subscribers in a proposed service area. (b... 7 Agriculture 11 2014-01-01 2014-01-01 false Area Coverage Survey (ACS). 1737.31 Section 1737.31...

Racial/ethnic disparities in the use of mental health services in poverty areas.

PubMed

Chow, Julian Chun-Chung; Jaffee, Kim; Snowden, Lonnie

2003-05-01

This study examined racial/ethnic disparities in mental health service access and use at different poverty levels. We compared demographic and clinical characteristics and service use patterns of Whites, Blacks, Hispanics, and Asians living in low-poverty and high-poverty areas. Logistic regression models were used to assess service use patterns of minority racial/ethnic groups compared with Whites in different poverty areas. Residence in a poverty neighborhood moderates the relationship between race/ethnicity and mental health service access and use. Disparities in using emergency and inpatient services and having coercive referrals were more evident in low-poverty than in high-poverty areas. Neighborhood poverty is a key to understanding racial/ethnic disparities in the use of mental health services.

Utilization of Maternal and Child Health Care Services by Primigravida Females in Urban and Rural Areas of India

PubMed Central

2014-01-01

Maternal complications and poor perinatal outcome are highly associated with nonutilisation of antenatal and delivery care services and poor socioeconomic conditions of the patient. It is essential that all pregnant women have access to high quality obstetric care throughout their pregnancies. Present longitudinal study was carried out to compare utilization of maternal and child health care services by urban and rural primigravida females. A total of 240 study participants were enrolled in this study. More illiteracy and less mean age at the time of marriage were observed in rural population. Poor knowledge about prelacteal feed, colostrums, tetanus injection and iron-follic acid tablet consumption was noted in both urban and rural areas. Very few study participants from both areas were counselled for HIV testing before pregnancy. More numbers of abortions (19.2%) were noted in urban study participants compared to rural area. Thus utilization of maternal and child health care (MCH) services was poor in both urban and rural areas. A sustained and focussed IEC campaign to improve the awareness amongst community on MCH will help in improving community participation. This may improve the quality, accessibility, and utilization of maternal health care services provided by the government agencies in both rural and urban areas. PMID:24977099

A State of the Field Study of Child Welfare Services for Migrant Children and Their Families Who are In-Stream, Home-Based, or Settled-Out. Literature Review.

ERIC Educational Resources Information Center

Porteous, Sandra McClure

Part of a study of migrant child welfare services, this review synthesizes all available materials on the issues affecting migrant child welfare. Each chapter discusses the importance of a particular service area, assesses the migrant child's needs in that area, describes existing barriers to service delivery, and presents a history and the…

How size matters: exploring the association between quality of mental health services and catchment area size.

PubMed

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

2016-08-12

The diversity of mental health and substance abuse services (MHS) available to service users is seen as an indicator of the quality of the service system. In most countries MHS are provided by a mix of public, private and third sector providers. In Finland, officially, the municipalities are responsible for organizing the services needed, but the real extent and roles of private and third sector service providers are not known. Our previous study showed that the catchment area population size was strongly associated with diversity of mental health services. It is not known whether this was due to some types of services or some provider types being more sensitive to the size effect than others. The aim of this study was to investigate the association between area population size and diversity of mental health services, i.e. which types of services and which service providers' contributions are sensitive to population size. To map and classify services, we used the ESMS-R. The diversity of services was defined as the count of main types of care. Providers were classified as public, private or third sectors. The diversity of outpatient, residential and voluntary services correlated positively with catchment area population size. The strongest positive correlation between the size of population and services available was found in third sector activities followed by public providers, but no correlation was found for diversity of private services. The third sector and public corporations each provided 44 % of the service units. Third sector providers produced all self-help services and most of the day care services. Third sector and private companies provided a significant part (59 %) of the residential care service units. Significant positive correlations were found between size of catchment area population and diversity of residential, outpatient and voluntary services, indicating that these services concentrate on areas with larger population bases. The third sector seems to significantly complement the public sector in providing different services. Thus the third sector be needs to be functionally integrated with other MHS services to achieve a diversified and integrated service system.

Ecosystem Services Modeling as a Tool for Defining Priority Areas for Conservation

PubMed Central

Duarte, Gabriela Teixeira; Ribeiro, Milton Cezar; Paglia, Adriano Pereira

2016-01-01

Conservationists often have difficulty obtaining financial and social support for protected areas that do not demonstrate their benefits for society. Therefore, ecosystem services have gained importance in conservation science in the last decade, as these services provide further justification for appropriate management and conservation of natural systems. We used InVEST software and a set of GIS procedures to quantify, spatialize and evaluated the overlap between ecosystem services—carbon stock and sediment retention—and a biodiversity proxy–habitat quality. In addition, we proposed a method that serves as an initial approach of a priority areas selection process. The method considers the synergism between ecosystem services and biodiversity conservation. Our study region is the Iron Quadrangle, an important Brazilian mining province and a conservation priority area located in the interface of two biodiversity hotspots, the Cerrado and Atlantic Forest biomes. The resultant priority area for the maintenance of the highest values of ecosystem services and habitat quality was about 13% of the study area. Among those priority areas, 30% are already within established strictly protected areas, and 12% are in sustainable use protected areas. Following the transparent and highly replicable method we proposed in this study, conservation planners can better determine which areas fulfill multiple goals and can locate the trade-offs in the landscape. We also gave a step towards the improvement of the habitat quality model with a topography parameter. In areas of very rugged topography, we have to consider geomorfometric barriers for anthropogenic impacts and for species movement and we must think beyond the linear distances. Moreover, we used a model that considers the tree mortality caused by edge effects in the estimation of carbon stock. We found low spatial congruence among the modeled services, mostly because of the pattern of sediment retention distribution. PMID:27145031

Using the NCHEC Areas of Responsibility to Assess Service Learning Outcomes in Undergraduate Health Education Students

ERIC Educational Resources Information Center

Champagne, Nicole

2006-01-01

This study used the areas of responsibility developed by the National Commission for Health Education Credentialing (NCHEC) as a framework for the assessment of Service Learning experiences of undergraduate health education students. In the present study, six Service Learning projects involving 12 students were evaluated using multiple strategies,…

Racial/Ethnic Disparities in the Use of Mental Health Services in Poverty Areas

PubMed Central

Chow, Julian Chun-Chung; Jaffee, Kim; Snowden, Lonnie

2003-01-01

Objectives. This study examined racial/ethnic disparities in mental health service access and use at different poverty levels. Methods. We compared demographic and clinical characteristics and service use patterns of Whites, Blacks, Hispanics, and Asians living in low-poverty and high-poverty areas. Logistic regression models were used to assess service use patterns of minority racial/ethnic groups compared with Whites in different poverty areas. Results. Residence in a poverty neighborhood moderates the relationship between race/ethnicity and mental health service access and use. Disparities in using emergency and inpatient services and having coercive referrals were more evident in low-poverty than in high-poverty areas. Conclusions. Neighborhood poverty is a key to understanding racial/ethnic disparities in the use of mental health services. PMID:12721146

Ecosystem services of human-dominated watersheds and land use influences: a case study from the Dianchi Lake watershed in China.

PubMed

Hou, Ying; Li, Bo; Müller, Felix; Chen, Weiping

2016-11-01

Watersheds provide multiple ecosystem services. Ecosystem service assessment is a promising approach to investigate human-environment interaction at the watershed scale. The spatial characteristics of ecosystem services are closely related to land use statuses in human-dominated watersheds. This study aims to investigate the effects of land use on the spatial variations of ecosystem services at the Dianchi Lake watershed in Southwest China. We investigated the spatial variations of six ecosystem services-food supply, net primary productivity (NPP), habitat quality, evapotranspiration, water yield, and nitrogen retention. These services were selected based on their significance at the Dianchi Lake watershed and the availability of their data. The quantification of these services was based on modeling, value transference, and spatial analysis in combination with biophysical and socioeconomic data. Furthermore, we calculated the values of ecosystem services provided by different land use types and quantified the correlations between ecosystem service values and land use area proportions. The results show considerable spatial variations in the six ecosystem services associated with land use influences in the Dianchi Lake watershed. The cropland and forest land use types had predominantly positive influences on food productivity and NPP, respectively. The rural residential area and forest land use types reduced and enhanced habitat quality, respectively; these influences were identical to those of evapotranspiration. Urban area and rural residential area exerted significantly positive influences on water yield. In contrast, water yield was negatively correlated with forest area proportion. Finally, cropland and forest had significantly positive and negative influences, respectively, on nitrogen retention. Our study emphasizes the importance of consideration of the influences from land use composition and distribution on ecosystem services for managing the ecosystems of human-dominated watersheds.

Climate-dependence of ecosystem services in a nature reserve in northern China

PubMed Central

Fang, Jiaohui; Song, Huali; Zhang, Yiran; Li, Yanran

2018-01-01

Evaluation of ecosystem services has become a hotspot in terms of research focus, but uncertainties over appropriate methods remain. Evaluation can be based on the unit price of services (services value method) or the unit price of the area (area value method). The former takes meteorological factors into account, while the latter does not. This study uses Kunyu Mountain Nature Reserve as a study site at which to test the effects of climate on the ecosystem services. Measured data and remote sensing imagery processed in a geographic information system were combined to evaluate gas regulation and soil conservation, and the influence of meteorological factors on ecosystem services. Results were used to analyze the appropriateness of the area value method. Our results show that the value of ecosystem services is significantly affected by meteorological factors, especially precipitation. Use of the area value method (which ignores the impacts of meteorological factors) could considerably impede the accuracy of ecosystem services evaluation. Results were also compared with the valuation obtained using the modified equivalent value factor (MEVF) method, which is a modified area value method that considers changes in meteorological conditions. We found that MEVF still underestimates the value of ecosystem services, although it can reflect to some extent the annual variation in meteorological factors. Our findings contribute to increasing the accuracy of evaluation of ecosystem services. PMID:29438427

Climate-dependence of ecosystem services in a nature reserve in northern China.

PubMed

Fang, Jiaohui; Song, Huali; Zhang, Yiran; Li, Yanran; Liu, Jian

2018-01-01

Evaluation of ecosystem services has become a hotspot in terms of research focus, but uncertainties over appropriate methods remain. Evaluation can be based on the unit price of services (services value method) or the unit price of the area (area value method). The former takes meteorological factors into account, while the latter does not. This study uses Kunyu Mountain Nature Reserve as a study site at which to test the effects of climate on the ecosystem services. Measured data and remote sensing imagery processed in a geographic information system were combined to evaluate gas regulation and soil conservation, and the influence of meteorological factors on ecosystem services. Results were used to analyze the appropriateness of the area value method. Our results show that the value of ecosystem services is significantly affected by meteorological factors, especially precipitation. Use of the area value method (which ignores the impacts of meteorological factors) could considerably impede the accuracy of ecosystem services evaluation. Results were also compared with the valuation obtained using the modified equivalent value factor (MEVF) method, which is a modified area value method that considers changes in meteorological conditions. We found that MEVF still underestimates the value of ecosystem services, although it can reflect to some extent the annual variation in meteorological factors. Our findings contribute to increasing the accuracy of evaluation of ecosystem services.

Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

PubMed

Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

2017-12-01

  Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

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

PubMed

Fallon, Karen A; Katz, Lauren A

2011-01-01

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

Use and Distribution of Rehabilitation Services: A Register Linkage Study in One Hospital District Area in Finland

ERIC Educational Resources Information Center

Pulkki, Jutta Maarit; Rissanen, Pekka; Raitanen, Jani A.; Viitanen, Elina A.

2011-01-01

This study focuses on a large set of rehabilitation services used between 2004 and 2005 in one hospital district area in Finland. The rehabilitation system consists of several subsystems. This complex system is suggested to produce arbitrary rehabilitation services. Despite the criticisms against the system during decades, no attempts have been…

A decade of experience evolving visiting dental services in partnership with rural remote Aboriginal communities.

PubMed

Dyson, K; Kruger, E; Tennant, M

2014-06-01

Embedding research capabilities and workforce development activities with clinical service entities promotes the development of sustainable, innovative, quality-focused oral health care services. Clinical and strategic governance is an important area of consideration for rural and remote dental services, posing particular challenges for smaller service structures. Sustaining remote area dental services has some significant complexities beyond those involved in urban service models. This study describes the sustaining structure of a remote area dental service with a decade of history. In the current climate, chief among these challenges may be those associated with dental workforce shortages as these impact most heavily in the public sector, and most particularly, in remote areas. As sustained workforce solutions come from developing a future workforce, an essential element of the workforce governance framework for remote dental service provision should be the inclusion of a student participation programme. Collaborative partnership approaches with Aboriginal health services promote the development and maintenance of effective, culturally sensitive dental services within rural and remote Aboriginal communities. Having sustained care for 10 years, this collaborative model of integrated research, education and service has demonstrated its effectiveness as a service model for Aboriginal communities in Western Australia. This descriptive study finds the core values for this success have been communication, clinical leadership, mentorship within effective governance systems all linked to an integrated education and research agenda. © 2014 Australian Dental Association.

US Forest Service and National Park Service Wilderness Aircraft Overflight Study: Sociological background and study plans

NASA Technical Reports Server (NTRS)

Harrison, Robin T.; Hartmann, Lawrence

1990-01-01

The background and sociological aspects of the combined U.S. Forest Service and National Park Service Wilderness Aircraft Overflight Study (WACOS) are presented. The WACOS broaches a new area of research by combining aspects of outdoor recreation sociology and aircraft noise response studies. The tasks faced create new challenges and require innovative solutions. Background information on the WACOS is presented with special emphasis on sociological considerations. At the time of this writing, no data have yet been collected, so this paper will present background information, related issues, and plans for data collection. Some recent studies indicate that managers of Forest Service wildernesses and National Park Service areas consider aircraft overflights to be a problem to their users in some areas. Additional relevant background research from outdoor recreation sociology is discussed, followed by presentation of the authors' opinions of the most salient sociological issues faced by this study. The goals and desired end products are identified next, followed by a review of the methods anticipated to be used to obtain these results. Finally, a discussion and conclusion section is provided.

Do targeted child health promotion services meet the needs of the most disadvantaged? A qualitative study of the views of health visitors working in inner-city and urban areas in England.

PubMed

Condon, Louise

2011-10-01

The aim of this study was to explore health visitors' views on the effects of policy change on the services they offer to preschool children in areas of high health inequalities in England. Child health promotion services are offered throughout the world to maintain and improve children's health. It is not known how the policy shift to a more overtly targeted service, which has occurred in some countries, has affected child health promotion practice in areas of deprivation. An in-depth telephone interview study was conducted between October 2006 and January 2007. All participants (n = 25) were registered health visitors who had taken part in a 2005 National Survey of Child Health Promotion Practice in England and were delivering health promotion services to preschool children in inner-city and urban areas. Despite high levels of need, some children who would have benefited from an enhanced health visiting service were offered only the core programme. Local interpretation of national policy is a key factor in determining the level of service offered, and the extent of targeting. This study illustrates the importance, in any country, of exploring the effects of national policy change from the perspective of practitioners, to identify unintended outcomes. Reductions in the core child health promotion programme can lead to difficulties in monitoring and improving children's health outcomes in areas of deprivation. © 2011 Blackwell Publishing Ltd.

Making the Invisible of Learning Visible: Pre-Service Teachers Identify Connections between the Use of Literacy Strategies and Their Content Area Assessment Practices

ERIC Educational Resources Information Center

Mitton-Kukner, Jennifer; Orr, Anne Murray

2014-01-01

In this paper we describe four ways secondary pre-service teachers appeared to be developing assessment practices during field experience, after taking a content area literacy course. This paper arises from a multi-year study exploring pre-service and beginning content area teachers' use of literacy strategies in teaching mathematics, science, and…

Service-Learning and Natural Resource Leadership

ERIC Educational Resources Information Center

Newman, Peter; Bruyere, Brett L.; Beh, Adam

2007-01-01

This paper reports on a study conducted in a service-learning protected-areas management class at Colorado State University, Warner College of Natural Resources. The research questions addressed for this paper were "What are the leadership skills needed in today's culture of protected-area management?" and "Can service-learning…

A study on the relationship between carbon budget and ecosystem service in urban areas according to urbanization

NASA Astrophysics Data System (ADS)

Lee, S. J.; Lee, W. K.

2017-12-01

The study on the analysis of carbon storage capacity of urban green spaces with increasing urban forest. Modern cities have experienced rapid economic development since Industrial Revolution in the 18th century. The rapid economic growth caused an exponential concentration of population to the cities and decrease of green spaces due to the conversion of forest and agricultural lands to build-up areas with rapid urbanization. As green areas including forests, grasslands, and wetlands provide diverse economic, environmental, and cultural benefits, the decrease of green areas might be a huge loss. Also, the process of urbanization caused pressure on the urban environment more than its natural capacity, which accelerates global climate change. This study tries to see the relations between carbon budget and ecosystem services according to the urbanization. For calculating carbon dynamics, this study used VISIT(Vegetation Integrated Simulator for trace gases) model. And the value that ecosystem provides is explained with the concept of ecosystem service and calculated by InVEST model. Study sites are urban and peri-urban areas in Northeast Asia. From the result of the study, the effect of the urbanization can be understood in regard to carbon storage and ecosystem services.

Determinants of contraceptives use amongst youth: an exploratory study with family planning service providers in Karachi Pakistan.

PubMed

Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Hasnain, Farid Ul

2013-01-05

In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers' perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers' improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods.

Determinants of Contraceptives Use amongst Youth: An Exploratory Study with Family Planning Service Providers in Karachi Pakistan

PubMed Central

Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Farid-Ul-Hasnain

2013-01-01

Introduction: In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers’ perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Method: Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Results: Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers’ improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Conclusion: Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods. PMID:23618469

Telecommunications for Metropolitan Areas: Opportunities for the 1980's.

ERIC Educational Resources Information Center

National Academy of Sciences - National Research Council, Washington, DC. Assembly of Engineering.

This report intended for officials responsible for solving metropolitan problems identifies ways that telecommunications could improve the delivery of public services to metropolitan communities during the 1980's. Areas included in this study are delivery of public services to the home, operation of mobile public services, personal security…

Ecosystem services

Treesearch

Trista Patterson

2014-01-01

Since its inception, the ecosystem service approach has stimulated interest from numerous planning, management, and partnership perspectives. To date, however, research that quantifies ecosystem services in the study area (in the form of explicit ecosystem service studies) has been limited. This chapter reviews and synthesizes the concept of ecosystem services,...

Determinants of farmers' choice for veterinary service providers in Nepal Mountains.

PubMed

Lamichhane, Dirga Kumar; Shrestha, Sabina

2012-08-01

This study was aimed to analyze factors that affect farmers' choice for major actors of veterinary service providers in village areas of Kaski district of Nepal, with the objective of identifying choice-specific attributes which could be addressed for improving the penetration of professional veterinary services in village areas. The information was obtained from 125 farmers using a structured questionnaire. A proportional hazard model was used for data analysis because of its ability to accommodate the attributes of both the chooser and the choice simultaneously. The results showed that village animal health workers (VAHWs) were the most preferred service providers followed by veterinarians and mid-level technicians. The farmers' age and education level had a significant but inverse relationship with the probability of choosing any of the three service providers. From our study, we found that the main choice-specific attributes with a significant impact on the choice probability was the distance to the preferred service provider. Since there was a high preference for VAHW, this suggests the possibility of poorly trained service providers dominating veterinary service market in village areas of Kaski district. Hence, the efforts put forward in the legalization of VAHW system in Nepal should first address the constraints that obstruct the accessibility of professional veterinary service providers in village areas.

Mental Health Services in Pilot Study Areas: Report on a European Study.

ERIC Educational Resources Information Center

World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

The World Health Organization (WHO) conducted a study to collect data on mental health resources of pilot areas within several European countries. This report presents data from the study and provides a detailed and reliable description of the development of mental health services within the WHO European Region. Part I of the report describes the…

Reconceptualising Child Care in Rural Areas.

ERIC Educational Resources Information Center

Morda, Romana; Kapsalakis, Anthoula; Clyde, Margaret

A study examining child care services in rural and remote areas conducted focus group interviews and distributed questionnaires to parents living in 15 towns in the Mallee region of Western Victoria (Australia). Barriers to accessing child care in rural areas included limited availability of formal services, costs, stereotypes associated with life…

A Systematic Review of Services to DHH Children in Rural and Remote Regions

ERIC Educational Resources Information Center

Barr, Megan; Duncan, Jill; Dally, Kerry

2018-01-01

Children in regional, rural and remote areas have less access to services than those living in urban areas. Practitioners serving children with a hearing loss have attempted to address this gap, however there are few studies investigating service access and experiences of non-metropolitan families and professionals. This systematic review…

Comparing private and public transport access to diabetic health services across inner, middle, and outer suburbs of Melbourne, Australia.

PubMed

Madill, Rebecca; Badland, Hannah; Mavoa, Suzanne; Giles-Corti, Billie

2018-04-13

Melbourne, Australia is experiencing rapid population growth, with much of this occurring in metropolitan outer suburban areas, also known as urban growth areas. Currently little is known about differences in travel times when using private and public transport to access primary and secondary services across Melbourne's urban growth areas. Plan Melbourne Refresh, a recent strategic land use document has called for a 20 min city, which is where essential services including primary health care, can be accessed within a 20 min journey. Type 2 diabetes mellitus (T2DM) is a major chronic condition in Australia, with some of Melbourne's growth areas having some of the highest prevalence across Australia. This study explores travel times to diabetic health care services for populations residing in inner, middle and outer suburbs of metropolitan Melbourne. Geographic information systems (GIS) software were used to map the location of selected diabetic primary and secondary health care service providers across metropolitan inner, middle, outer established, outer urban growth and outer fringe areas of Melbourne. An origin-destination matrix was used to estimate travel distances from point of origin (using a total of approximately 50,000 synthetic residential addresses) to the closest type of each diabetic health care service provider (destinations) across Melbourne. ArcGIS was used to estimate travel times for private transport and public transport; comparisons were made by area. Our study indicated increased travel times to diabetic health services for people living in Melbourne's outer growth and outer fringe areas compared with the rest of Melbourne (inner, middle and outer established). Compared with those living in inner city areas, the median time spent travelling to diabetic services was between 2.46 and 23.24 min (private motor vehicle) and 12.01 and 43.15 min (public transport) longer for those living in outer suburban areas. Irrespective of travel mode used, results indicate that those living in inner and middle suburbs of Melbourne have shorter travel times to access diabetic health services, compared with those living in outer areas of Melbourne. Private motor vehicle travel times were approximately 4 to 5 times faster than public transport modes to access diabetic health services in all areas. Those living in new urban growth communities spend considerably more time travelling to access diabetic health services - particularly specialists - than those living in established areas across Melbourne.

Measuring the equity of inpatient utilization in Chinese rural areas

PubMed Central

2011-01-01

Background As an important outcome of the health system, equity in health service utilization has attracted an increasing amount of attention in the literature on health reform in China in recent years. The poor, who frequently require more services, are often the least able to pay, while the wealthy utilize disproportionately more services although they have less need. Whereas equity in health service utilization between richer and poorer populations has been studied in urban areas, the equity in health service utilization in rural areas has received little attention. With improving levels of economic development, the introduction of health insurance and increasing costs of health services, health service utilization patterns have changed dramatically in rural areas in recent years. However, previous studies have shown neither the extent of utilization inequity, nor which factors are associated with utilization inequity in rural China. Methods This paper uses previously unavailable country-wide data and focuses on income-related inequity of inpatient utilization and its determinants in Chinese rural areas. The data for this study come from the Chinese National Health Services Surveys (NHSS) conducted in 2003 and 2008. To measure the level of inequity in inpatient utilization over time, the concentration index, decomposition of the concentration index, and decomposition of change in the concentration index are employed. Results This study finds that even with the same need for inpatient services, richer individuals utilize more inpatient services than poorer individuals. Income is the principal determinant of this pro-rich inpatient utilization inequity- wealthier individuals are able to pay for more services and therefore use more services regardless of need. However, rising income and increased health insurance coverage have reduced the inequity in inpatient utilization in spite of increasing inpatient prices. Conclusions There remains a strong pro-rich inequity of inpatient utilization in rural China. However, a narrowing income gap between the rich and poor and greater access to health insurance has effectively reduced income inequality, equalizing access to care. This suggests that the most effective way to reduce the inequity is to narrow the gap of income between the rich and poor while adopting social risk protection. PMID:21854641

Carer and service providers' experiences of individual funding models for children with a disability in rural and remote areas.

PubMed

Dew, Angela; Bulkeley, Kim; Veitch, Craig; Bundy, Anita; Lincoln, Michelle; Brentnall, Jennie; Gallego, Gisselle; Griffiths, Scott

2013-07-01

There is a global movement for people with a disability towards person-centred practices with opportunities for self-determination and choice. Person-centred approaches may involve individual funding (IF) for the purchase of required support. A shift to a person-centred model and IF should allow people with a disability and their carers greater choice in therapy access. However, individuals who live in rural and remote areas have less choice and access to therapy services than their metropolitan counterparts. Drawing on data from a larger study into therapy service delivery in a rural and remote area of New South Wales, Australia, this study describes some benefits and barriers to using IF to access therapy services in rural areas. Ten carers and 60 service providers participated in audio-recorded focus groups and individual interviews during which IF was discussed. Transcribed data were analysed using thematic analysis and constant comparison. Greater access to and choice of therapy providers were identified as benefits of IF. Four barriers were identified: (i) lack of information and advice; (ii) limited local service options and capacity; (iii) higher costs and fewer services and (iv) complexity of self-managing packages. A range of strategies is required to address the barriers to using IF in rural and remote areas. Carers indicated a need for: accessible information; a local contact person for support and guidance; adequate financial compensation to offset additional travel expenses and coordinated eligibility and accountability systems. Service providers required: coordinated cross-sector approaches; local workforce planning to address therapist shortages; certainty around service viability and growth; clear policies and procedures around implementation of IF. This study highlights the need for further discussion and research about how to overcome the barriers to the optimal use of an IF model for those living in rural and remote areas. © 2013 John Wiley & Sons Ltd.

Do socially deprived urban areas have lesser supplies of cancer care services?

PubMed

Lamont, Elizabeth B; He, Yulei; Subramanian, S V; Zaslavsky, Alan M

2012-09-10

Area social deprivation is associated with unfavorable health outcomes of residents across the full clinical course of cancer from the stage at diagnosis through survival. We sought to determine whether area social factors are associated with the area health care supply. We studied the area supply of health services required for the provision of guideline-recommended care for patients with breast cancer and colorectal cancer (CRC) in each of the following three distinct clinical domains: screening, treatment, and post-treatment surveillance. We characterized area social factors in 3,096 urban zip code tabulation areas by using Census Bureau data and the health care supply in the corresponding 465 hospital service areas by using American Hospital Association, American Medical Association, and US Food and Drug Administration data. In two-level hierarchical models, we assessed associations between social factors and the supply of health services across areas. We found no clear associations between area social factors and the supply of health services essential to the provision of guideline recommended breast cancer and CRC care in urban areas. The measures of health service included the supply of physicians who facilitate screening, treatment, and post-treatment care and the supply of facilities required for the same services. Because we found that the supply of types of health care required for the provision of guideline-recommended cancer care for patients with breast cancer and CRC did not vary with markers of area socioeconomic disadvantage, it is possible that previously reported unfavorable breast cancer and CRC outcomes among individuals living in impoverished areas may have occurred despite an apparent adequate area health care supply.

Geographic accessibility and utilization of orthodontic services among Medicaid children and adolescents

PubMed Central

McKernan, Susan C.; Kuthy, Raymond A.; Momany, Elizabeth T.; McQuistan, Michelle R.; Hanley, Paul F.; Jones, Michael P.; Damiano, Peter C.

2014-01-01

Objectives To describe rates of Medicaid-funded services provided by orthodontists in Iowa to children and adolescents, identify factors associated with utilization, and describe geographic barriers to care. Methods We analyzed enrollment and claims data from the Iowa Medicaid program for a 3-year period, January 2008 through December 2010. Descriptive, bivariate, and multivariable logistic regression analyses were performed with utilization of orthodontic services as the main outcome variable. Service areas were identified by small area analysis in order to examine regional variability in utilization. Results The overall rate of orthodontic utilization was 3.1 percent. Medicaid enrollees living in small towns and rural areas were more likely to utilize orthodontic services than those living in urban areas. Children who had an oral evaluation by a primary care provider in the year prior to the study period were more likely to receive orthodontic services. Service areas with lower population density and greater mean travel distance to participating orthodontists had higher utilization rates than smaller, more densely populated areas. Conclusions Rural residency and increased travel distances do not appear to act as barriers to orthodontic care for this population. The wide variability of utilization rates seen across service areas may be related to workforce supply in the form of orthodontists who accept Medicaid-insured patients. Referrals to orthodontists from primary care dentists may improve access to specialty care for Medicaid enrollees. PMID:23289856

Consumer knowledge and availability of maternal and child health services: a challenge for achieving MDG 4 and 5 in Southeast Nigeria

PubMed Central

2013-01-01

Background Reducing child mortality and improving maternal health occupies a prominent space in the Millennium Development Goals (MDGs), and it has been noted that some reductions have taken place, but not enough. If consumers know what and where services are available, they may be motivated to use them. This study therefore evaluated consumers’ knowledge about available maternal and child health services and where these services can be obtained in the study area. Although knowledge of available health services does not translate to utilization of these services, this study is important as knowledge of available health services can prompt the informed use of services. The study determined the consumers’ knowledge about available Maternal and Child Health services and where these services are available. Methods The study was a cross-sectional research design. The sample for the study consisted of a total of 450 women of child bearing age selected from the 20 political wards that make up Ezeagu Local Government Area. The 20 political wards constituted 20 clusters (cluster sampling technique) i.e. one cluster per political ward. Simple random sampling method by balloting was used to select five (5) wards out of the 20 political wards. Finally, a total of 90 women of childbearing age were selected from each of the five wards (clusters) using simple random method. Results The study showed that majority of the women (37.3%) were between 36-45 years, married [49.5%], had more than five children [21.6%], hold at least SSCE [23.7%], and were farmers and Christians [32.3% and 81.8%] respectively. Maternal health services available are mainly antenatal [57%] and delivery services [54.3%]. Other available services are described at the results section. In the same vein, immunization [63.8%] was the most available child health service in the area. Both Maternal and Child Health services were available mainly at public and private hospitals [53.6% and 52.3% for maternal services; 56.1% and 53.9% respectively for child health services] respectively [see result section for details]. Conclusions Available Maternal and Child Health services known to mothers in the study area were not encouraging, and these are structurally contextual. ANC and delivery services for mothers, and immunization for children were found to be available as indicated by at least more than half of the respondents. The women knew that these services were available mostly in public and private hospitals which should constitute referral points instead of the health centers that offer primary care at community level. Knowledge of available services is important for consumers to make use of the services. Awareness programmes should be targeted more on the consumers if the MDG 4 and 5 must be reached by 2015. This suggests that the women in the study area do not use primary health care services adequately, and may be incurring huge indirect costs and at the same time travel too far to obtain primary care. This is therefore quite challenging for reducing child mortality and improving maternal health in southeast Nigeria. Knowledge of available services is important for consumers to make use of the services. Awareness programmes should be targeted more on the consumers if the MDG 4 and 5 must be reached by 2015. PMID:23394481

Consumer knowledge and availability of maternal and child health services: a challenge for achieving MDG 4 and 5 in Southeast Nigeria.

PubMed

Emmanuel, Nwala K; Gladys, Ebunoha N; Cosmas, Ugwu U

2013-02-09

Reducing child mortality and improving maternal health occupies a prominent space in the Millennium Development Goals (MDGs), and it has been noted that some reductions have taken place, but not enough. If consumers know what and where services are available, they may be motivated to use them. This study therefore evaluated consumers' knowledge about available maternal and child health services and where these services can be obtained in the study area. Although knowledge of available health services does not translate to utilization of these services, this study is important as knowledge of available health services can prompt the informed use of services. The study determined the consumers' knowledge about available Maternal and Child Health services and where these services are available. The study was a cross-sectional research design. The sample for the study consisted of a total of 450 women of child bearing age selected from the 20 political wards that make up Ezeagu Local Government Area. The 20 political wards constituted 20 clusters (cluster sampling technique) i.e. one cluster per political ward. Simple random sampling method by balloting was used to select five (5) wards out of the 20 political wards. Finally, a total of 90 women of childbearing age were selected from each of the five wards (clusters) using simple random method. The study showed that majority of the women (37.3%) were between 36-45 years, married [49.5%], had more than five children [21.6%], hold at least SSCE [23.7%], and were farmers and Christians [32.3% and 81.8%] respectively. Maternal health services available are mainly antenatal [57%] and delivery services [54.3%]. Other available services are described at the results section. In the same vein, immunization [63.8%] was the most available child health service in the area. Both Maternal and Child Health services were available mainly at public and private hospitals [53.6% and 52.3% for maternal services; 56.1% and 53.9% respectively for child health services] respectively [see result section for details]. Available Maternal and Child Health services known to mothers in the study area were not encouraging, and these are structurally contextual. ANC and delivery services for mothers, and immunization for children were found to be available as indicated by at least more than half of the respondents. The women knew that these services were available mostly in public and private hospitals which should constitute referral points instead of the health centers that offer primary care at community level. Knowledge of available services is important for consumers to make use of the services. Awareness programmes should be targeted more on the consumers if the MDG 4 and 5 must be reached by 2015. This suggests that the women in the study area do not use primary health care services adequately, and may be incurring huge indirect costs and at the same time travel too far to obtain primary care. This is therefore quite challenging for reducing child mortality and improving maternal health in southeast Nigeria. Knowledge of available services is important for consumers to make use of the services. Awareness programmes should be targeted more on the consumers if the MDG 4 and 5 must be reached by 2015.

LED Provides Effective and Efficient Parking Area Lighting at the NAVFAC Engineering Service Center

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

None

2010-08-12

U.S. Department of Energy (DOE) Federal Energy Management Program (FEMP) emerging technology case study showcasing LED lighting to improve energy efficiency in parking areas at the NAVFAC Engineering Services Center.

Estimates of future water demand for selected water-service areas in the Upper Duck River basin, central Tennessee; with a section on Methodology used to develop population forecasts for Bedford, Marshall, and Maury counties, Tennessee, from 1993 through 2050

USGS Publications Warehouse

Hutson, S.S.; Schwarz, G.E.

1996-01-01

Estimates of future water demand were determined for selected water-service areas in the upper Duck River basin in central Tennessee through the year 2050. The Duck River is the principal source of publicly-supplied water in the study area providing a total of 15.6 million gallons per day (Mgal/d) in 1993 to the cities of Columbia, Lewisburg, Shelbyville, part of southern Williamson County, and several smaller communities. Municipal water use increased 19 percent from 1980 to 1993 (from 14.5 to 17.2 Mgal/d). Based on certain assumptions about socioeconomic conditions and future development in the basin, water demand should continue to increase through 2050. Projections of municipal water demand for the study area from 1993 to 2015 were made using econometric and single- coefficient (unit-use) requirement models of the per capita type. The models are part of the Institute for Water Resources-Municipal and Industrial Needs System, IWR-MAIN. Socioeconomic data for 1993 were utilized to calibrate the models. Projections of water demand in the study area from 2015 to 2050 were made using a single- coefficient requirement model. A gross per capita use value (unit-requirement) was estimated for each water-service area based on the results generated by IWR-MAIN for year 2015. The gross per capita estimate for 2015 was applied to population projections for year 2050 to calculate water demand. Population was projected using the log-linear form of the Box-Cox regression model. Water demand was simulated for two scenarios. The scenarios were suggested by various planning agencies associated with the study area. The first scenario reflects a steady growth pattern based on present demographic and socioeconomic conditions in the Bedford, Marshall, and Maury/southern Williamson water-service areas. The second scenario considers steady growth in the Bedford and Marshall water-service areas and additional industrial and residential development in the Maury/southern Williamson water-service area beginning in 2000. For the study area, water demand for scenario one shows an increase of 121 percent (from 17.2 to 38 Mgal/d) from 1993 to 2050. In scenario two, simulated water demand increases 150 percent (17.2 to 43 Mgal/d) from 1993 to 2050.

Cost-effectiveness of dryland forest restoration evaluated by spatial analysis of ecosystem services

PubMed Central

Birch, Jennifer C.; Newton, Adrian C.; Aquino, Claudia Alvarez; Cantarello, Elena; Echeverría, Cristian; Kitzberger, Thomas; Schiappacasse, Ignacio; Garavito, Natalia Tejedor

2010-01-01

Although ecological restoration is widely used to combat environmental degradation, very few studies have evaluated the cost-effectiveness of this approach. We examine the potential impact of forest restoration on the value of multiple ecosystem services across four dryland areas in Latin America, by estimating the net value of ecosystem service benefits under different reforestation scenarios. The values of selected ecosystem services were mapped under each scenario, supported by the use of a spatially explicit model of forest dynamics. We explored the economic potential of a change in land use from livestock grazing to restored native forest using different discount rates and performed a cost–benefit analysis of three restoration scenarios. Results show that passive restoration is cost-effective for all study areas on the basis of the services analyzed, whereas the benefits from active restoration are generally outweighed by the relatively high costs involved. These findings were found to be relatively insensitive to discount rate but were sensitive to the market value of carbon. Substantial variation in values was recorded between study areas, demonstrating that ecosystem service values are strongly context specific. However, spatial analysis enabled localized areas of net benefits to be identified, indicating the value of this approach for identifying the relative costs and benefits of restoration interventions across a landscape. PMID:21106761

Cost-effectiveness of dryland forest restoration evaluated by spatial analysis of ecosystem services.

PubMed

Birch, Jennifer C; Newton, Adrian C; Aquino, Claudia Alvarez; Cantarello, Elena; Echeverría, Cristian; Kitzberger, Thomas; Schiappacasse, Ignacio; Garavito, Natalia Tejedor

2010-12-14

Although ecological restoration is widely used to combat environmental degradation, very few studies have evaluated the cost-effectiveness of this approach. We examine the potential impact of forest restoration on the value of multiple ecosystem services across four dryland areas in Latin America, by estimating the net value of ecosystem service benefits under different reforestation scenarios. The values of selected ecosystem services were mapped under each scenario, supported by the use of a spatially explicit model of forest dynamics. We explored the economic potential of a change in land use from livestock grazing to restored native forest using different discount rates and performed a cost-benefit analysis of three restoration scenarios. Results show that passive restoration is cost-effective for all study areas on the basis of the services analyzed, whereas the benefits from active restoration are generally outweighed by the relatively high costs involved. These findings were found to be relatively insensitive to discount rate but were sensitive to the market value of carbon. Substantial variation in values was recorded between study areas, demonstrating that ecosystem service values are strongly context specific. However, spatial analysis enabled localized areas of net benefits to be identified, indicating the value of this approach for identifying the relative costs and benefits of restoration interventions across a landscape.

Assessment of Coastal Ecosystem Services for Conservation Strategies in South Korea.

PubMed

Chung, Min Gon; Kang, Hojeong; Choi, Sung-Uk

2015-01-01

Despite the fact that scientific and political consideration for ecosystem services has dramatically increased over the past decade, few studies have focused on marine and coastal ecosystem services for conservation strategies. We used an ecosystem services approach to assess spatial distributions of habitat risks and four ecosystem services (coastal protection, carbon storage, recreation, and aesthetic quality), and explored the tradeoffs among them in coastal areas of South Korea. Additionally, we analyzed how the social and ecological characteristics in coastal areas interact with conservation and development policies by using this approach. We found strong negative associations between the habitat risks and ecosystem services (aquaculture, carbon storage, recreation, and aesthetic quality) across the coastal counties. Our results showed that the intensity of the habitat risks and the provision of ecosystem services were significantly different between reclamation-dominated and conservation-dominated counties, except for coastal vulnerability. A generalized linear model suggested that reclamation projects were dependent on economic efficiency, whereas demographic pressures and habitat conditions influenced the designation of protected areas at a county level. The ecosystem services approach provided guidelines to achieve both sustainable development and environment conservation. By using the approach, we can select the priority areas for developments while we can minimize the degradation of biodiversity and ecosystem services. As cultural ecosystem services are evenly distributed throughout coastal areas of South Korea, decision makers may employ them to improve the conditions of coastal wetlands outside of protected areas.

Assessment of Coastal Ecosystem Services for Conservation Strategies in South Korea

PubMed Central

Chung, Min Gon; Kang, Hojeong; Choi, Sung-Uk

2015-01-01

Despite the fact that scientific and political consideration for ecosystem services has dramatically increased over the past decade, few studies have focused on marine and coastal ecosystem services for conservation strategies. We used an ecosystem services approach to assess spatial distributions of habitat risks and four ecosystem services (coastal protection, carbon storage, recreation, and aesthetic quality), and explored the tradeoffs among them in coastal areas of South Korea. Additionally, we analyzed how the social and ecological characteristics in coastal areas interact with conservation and development policies by using this approach. We found strong negative associations between the habitat risks and ecosystem services (aquaculture, carbon storage, recreation, and aesthetic quality) across the coastal counties. Our results showed that the intensity of the habitat risks and the provision of ecosystem services were significantly different between reclamation-dominated and conservation-dominated counties, except for coastal vulnerability. A generalized linear model suggested that reclamation projects were dependent on economic efficiency, whereas demographic pressures and habitat conditions influenced the designation of protected areas at a county level. The ecosystem services approach provided guidelines to achieve both sustainable development and environment conservation. By using the approach, we can select the priority areas for developments while we can minimize the degradation of biodiversity and ecosystem services. As cultural ecosystem services are evenly distributed throughout coastal areas of South Korea, decision makers may employ them to improve the conditions of coastal wetlands outside of protected areas. PMID:26221950

Patient satisfaction with health care services at a national institute of ophthalmology.

PubMed

Van Huy, Nguyen; Dung, Nguyen Ngoc; Thang, Cao Duc; Hanh, Le Thuy

2018-01-01

Little is known about how patients in developing countries, such as Vietnam, are satisfied with eye care services. The purpose of this study was to assess the satisfaction with health services and its associated factors among patients attending a national institute of ophthalmology in Vietnam. In a cross-sectional study utilizing quantitative methods, 500 inpatients and their relatives attending a national institute of ophthalmology in Vietnam were approached for data collection. The results indicated that under 50% of the patients were satisfied with eye care services. However, when classified by level of satisfaction, only 6.8% were very satisfied with all domains of care. There was no significant difference in satisfaction by gender and income, while significant differences by department, residence, and education were found. Patients who were from rural areas, were better educated, and used the services of the glaucoma department, were more satisfied with eye care than those from urban areas, were less educated, and used the services of treatment-on-demand department. Multivariable regression detected 2 main factors, gender and location, associated with patient satisfaction. Patients who were female and came from rural and remote areas were more likely to be satisfied than patients who were male and living in urban areas. The study suggests that to continue to improve health care quality, it is important to eliminate differences in providing eye care services regardless of whether patients are male or female, and whether they come from a rural or urban area. Copyright © 2017 John Wiley & Sons, Ltd.

Area-socioeconomic disparities in mental health service use among children involved in the child welfare system.

PubMed

Kim, Minseop; Garcia, Antonio R; Yang, Shuyan; Jung, Nahri

2018-06-01

Relying on data from a nationally representative sample of youth involved in the child welfare system (CWS) in 1999-2000 (the National Survey of Child and Adolescent Well-Being, Cohort 1) and 2008-2009 (Cohort 2), this study implemented a diverse set of disparity indicators to estimate area-socioeconomic disparities in mental health (MH) services use and changes in area-socioeconomic disparities between the two cohorts. Our study found that there are area-socioeconomic disparities in MH service use, indicating that the rates of MH service use among youth referred to the CWS differ by area-socioeconomic positions defined by county-level poverty rates. We also found that area-socioeconomic disparities increased over time. However, the magnitude of the increase varied widely across disparity measures, suggesting that there are different conclusions about the trend and magnitude of area-socioeconomic disparities, depending upon which disparity measures are implemented. A greater understanding of the methodological differences among disparity measures is warranted, which will in turn impact how interventions are designed to reduce socioeconomic disparities among children in the CWS. Copyright © 2018 Elsevier Ltd. All rights reserved.

Identifying hotspots and management of critical ecosystem services in rapidly urbanizing Yangtze River Delta Region, China.

PubMed

Cai, Wenbo; Gibbs, David; Zhang, Lang; Ferrier, Graham; Cai, Yongli

2017-04-15

Rapid urbanization has altered many ecosystems, causing a decline in many ecosystem services, generating serious ecological crisis. To cope with these challenges, we presented a comprehensive framework comprising five core steps for identifying and managing hotspots of critical ecosystem services in a rapid urbanizing region. This framework was applied in the case study of the Yangtze River Delta (YRD) Region. The study showed that there was large spatial heterogeneity in the hotspots of ecosystem services in the region, hotspots of supporting services and regulating services aggregately distributing in the southwest mountainous areas while hotspots of provisioning services mainly in the northeast plain, and hotspots of cultural services widespread in the waterbodies and southwest mountainous areas. The regionalization of the critical ecosystem services was made through the hotspot analysis. This study provided valuable information for environmental planning and management in a rapid urbanizing region and helped improve China's ecological redlines policy at regional scale. Copyright © 2017 Elsevier Ltd. All rights reserved.

Marketing Strategies Preferred by South Carolina One-Stop Career Center Area Directors to Attract Dislocated Workers under the Workforce Investment Act of 1998: Policy Implications

ERIC Educational Resources Information Center

Ratliff, Eugene F.

2011-01-01

The purpose of this study was to determine the marketing strategies South Carolina One-Stop Career Centers Area Directors felt provided the best opportunity for dislocated workers to learn about their services. Two theories emerged: the Service Marketing Theory and the Word-of-Mouth Marketing Theory. Of the 36 area directors cited for this study,…

Specialized care for people with AIDS in the state of Ceara, Brazil

PubMed Central

Pedrosa, Nathália Lima; Santos, Vanessa da Frota; Paiva, Simone de Sousa; Galvão, Marli Teresinha Gimeniz; de Almeida, Rosa Lívia Freitas; Kerr, Ligia Regina Franco Sansigolo

2015-01-01

OBJECTIVE To analyze if the distribution of specialized care services for HIV/AIDS is associated with AIDS rates. METHODS Ecological study, for which the distribution of 10 specialized care services in the Ceara state, Northeastern Brazil, was obtained, and the mean rates of the disease were estimated per mesoregion. We evaluated 7,896 individuals who had been diagnosed with AIDS, were aged 13 years or older, lived in Ceara, and had been informed of their condition between 2001 and 2011. Maps were constructed to verify the relationship between the distribution of AIDS cases and institutionalized support networks in the 2001-2006 and 2007-2011 periods. BoxMap and LisaMap were used for data analysis. The Voronoi diagram was applied for the distribution of the studied services. RESULTS Specialized care services concentrated in AIDS clusters in the metropolitan area. The Noroeste Cearense and west of the Sertoes Cearenses had high AIDS rates, but a low number of specialized care services over time. Two of these services were implemented where clusters of the disease exist in the second period. The application of the Voronoi diagram showed that the specialized care services located outside the metropolitan area covered a large territory. We identified one polygon that had no services. CONCLUSIONS The scenario of AIDS cases spread away from major urban areas demands the creation of social support services in areas other than the capital and the metropolitan area of the state; this can reduce access barriers to these institutions. It is necessary to create specialized care services for HIV/AIDS in the Noroeste Cearense and north of Jaguaribe. PMID:26487292

Regional scale prioritisation for key ecosystem services, renewable energy production and urban development.

PubMed

Casalegno, Stefano; Bennie, Jonathan J; Inger, Richard; Gaston, Kevin J

2014-01-01

Although the importance of addressing ecosystem service benefits in regional land use planning and decision-making is evident, substantial practical challenges remain. In particular, methods to identify priority areas for the provision of key ecosystem services and other environmental services (benefits from the environment not directly linked to the function of ecosystems) need to be developed. Priority areas are locations which provide disproportionally high benefits from one or more service. Here we map a set of ecosystem and environmental services and delineate priority areas according to different scenarios. Each scenario is produced by a set of weightings allocated to different services and corresponds to different landscape management strategies which decision makers could undertake. Using the county of Cornwall, U.K., as a case study, we processed gridded maps of key ecosystem services and environmental services, including renewable energy production and urban development. We explored their spatial distribution patterns and their spatial covariance and spatial stationarity within the region. Finally we applied a complementarity-based priority ranking algorithm (zonation) using different weighting schemes. Our conclusions are that (i) there are two main patterns of service distribution in this region, clustered services (including agriculture, carbon stocks, urban development and plant production) and dispersed services (including cultural services, energy production and floods mitigation); (ii) more than half of the services are spatially correlated and there is high non-stationarity in the spatial covariance between services; and (iii) it is important to consider both ecosystem services and other environmental services in identifying priority areas. Different weighting schemes provoke drastic changes in the delineation of priority areas and therefore decision making processes need to carefully consider the relative values attributed to different services.

Regional Scale Prioritisation for Key Ecosystem Services, Renewable Energy Production and Urban Development

PubMed Central

Casalegno, Stefano; Bennie, Jonathan J.; Inger, Richard; Gaston, Kevin J.

2014-01-01

Although the importance of addressing ecosystem service benefits in regional land use planning and decision-making is evident, substantial practical challenges remain. In particular, methods to identify priority areas for the provision of key ecosystem services and other environmental services (benefits from the environment not directly linked to the function of ecosystems) need to be developed. Priority areas are locations which provide disproportionally high benefits from one or more service. Here we map a set of ecosystem and environmental services and delineate priority areas according to different scenarios. Each scenario is produced by a set of weightings allocated to different services and corresponds to different landscape management strategies which decision makers could undertake. Using the county of Cornwall, U.K., as a case study, we processed gridded maps of key ecosystem services and environmental services, including renewable energy production and urban development. We explored their spatial distribution patterns and their spatial covariance and spatial stationarity within the region. Finally we applied a complementarity-based priority ranking algorithm (zonation) using different weighting schemes. Our conclusions are that (i) there are two main patterns of service distribution in this region, clustered services (including agriculture, carbon stocks, urban development and plant production) and dispersed services (including cultural services, energy production and floods mitigation); (ii) more than half of the services are spatially correlated and there is high non-stationarity in the spatial covariance between services; and (iii) it is important to consider both ecosystem services and other environmental services in identifying priority areas. Different weighting schemes provoke drastic changes in the delineation of priority areas and therefore decision making processes need to carefully consider the relative values attributed to different services. PMID:25250775

Contract management in USA hospitals: service duplication and access within local markets.

PubMed

Carey, Kathleen; Dor, Avi

2008-08-01

This paper examines the extent to which hospitals that are under external contract management engage in service duplication, as well as the degree to which the various services they offer contribute to or detract from community access. The study incorporates all USA hospitals using data from the American Hospital Association Annual Survey Database, supplemented by county level measures obtained from the area resource file (ARF). Using data on the 3794 hospitals classified as acute care facilities in 2002, we performed a set of logistic regressions that analyzed whether a hospital offered each of 74 distinct services. For each service (regression), key independent variables measured the number of other hospitals in the local market area that also offered the service. Local area market definitions are the areas circumscribed by the hospital within distances of 10 and 20 miles. Results suggest that contract-managed (CM) hospitals display a more competitive pattern (service duplication) than hospitals in general, but CM hospitals that are the sole provider of services locally are less likely to offer services than traditionally managed sole hospital providers. Contract management does not appear to offer any particular advantages in improving access to hospital services.

Applying Quality Function Deployment Model in Burn Unit Service Improvement.

PubMed

Keshtkaran, Ali; Hashemi, Neda; Kharazmi, Erfan; Abbasi, Mehdi

2016-01-01

Quality function deployment (QFD) is one of the most effective quality design tools. This study applies QFD technique to improve the quality of the burn unit services in Ghotbedin Hospital in Shiraz, Iran. First, the patients' expectations of burn unit services and their priorities were determined through Delphi method. Thereafter, burn unit service specifications were determined through Delphi method. Further, the relationships between the patients' expectations and service specifications and also the relationships between service specifications were determined through an expert group's opinion. Last, the final importance scores of service specifications were calculated through simple additive weighting method. The findings show that burn unit patients have 40 expectations in six different areas. These expectations are in 16 priority levels. Burn units also have 45 service specifications in six different areas. There are four-level relationships between the patients' expectations and service specifications and four-level relationships between service specifications. The most important burn unit service specifications have been identified in this study. The QFD model developed in the study can be a general guideline for QFD planners and executives.

The Feasibility and Value of Broadband Communications in Rural Areas. A Preliminary Evaluation, April 1976.

ERIC Educational Resources Information Center

Mills, William; And Others

The study was conducted to determine the feasibility and value of using broadband communications (transmission of many television, voice and/or data signals through a single system) to provide public services for rural areas. Applications of broadband communications to rural areas were divided into public services (health, education, law…

Services for Children with Autism Spectrum Disorder: Comparing Rural and Non-Rural Communities

ERIC Educational Resources Information Center

Mello, Maria P.; Urbano, Richard C.; Goldman, Samantha E.; Hodapp, Robert M.

2016-01-01

This study compared service use for families of children with autism spectrum disorder (ASD) who live in rural vs. non-rural areas. Participants were 415 caregivers of children with ASD, of whom 101 (23.7%) lived in rural areas of a southeastern state. Participants completed an online survey regarding access and quality of different services. For…

Identifying key areas of ecosystem services potential to improve ecological management in Chongqing City, southwest China.

PubMed

Xiao, Yang; Xiao, Qiang

2018-03-29

Because natural ecosystems and ecosystem services (ES) are both critical to the well-being of humankind, it is important to understand their relationships and congruence for conservation planning. Spatial conservation planning is required to set focused preservation priorities and to assess future ecological implications. This study uses the combined measures of ES models and ES potential to estimate and analyze all four groups of ecosystem services to generate opportunities to maximize ecosystem services. Subsequently, we identify the key areas of conservation priorities as future forestation and conservation hotspot zones to improve the ecological management in Chongqing City, located in the upper reaches of the Three Gorges Reservoir Area, China. Results show that ecosystem services potential is extremely obvious. Compared to ecosystem services from 2000, we determined that soil conservation could be increased by 59.11%, carbon sequestration by 129.51%, water flow regulation by 83.42%, and water purification by 84.42%. According to our prioritization results, approximately 48% of area converted to forests exhibited high improvements in all ecosystem services (categorized as hotspot-1, hotspot-2, and hotspot-3). The hotspots identified in this study can be used as an excellent surrogate for evaluation ecological engineering benefits and can be effectively applied in improving ecological management planning.

Breast cancer services in Vietnam: a scoping review.

PubMed

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

2018-01-01

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

Breast cancer services in Vietnam: a scoping review

PubMed Central

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

2018-01-01

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

Peninsula transportation district commission route deviation feasibility study.

DOT National Transportation Integrated Search

1998-11-01

Many urban transit providers are faced with the problem of declining ridership on traditional fixed route services in low density suburban areas. As a result, many fixed route services in such areas are not economically viable for the transit provide...

Agency and Market Area Factors Affecting Home Health Agency Supply Changes

PubMed Central

Porell, Frank W; Liu, Korbin; Brungo, David P

2006-01-01

Objective To use the natural experiment created by the Medicare interim payment system (IPS) to study supply change behavior of home health agencies (HHAs) in local market areas. Data Sources One hundred percent Medicare home health claims for 1996 and 1999, linked with Medicare Provider of Service and Denominator files, and the Area Resource File. Study Design Medicare home health care (HHC) claims data were used to distinguish HHAs that changed the local market supply of Medicare HHC by their market exit or by significant expansion or contraction of their geographic service area between 1996 and 1999 from other HHAs. Multinomial logit models were estimated to analyze how characteristics of agencies and the market areas in which they served were associated with these different agency-level supply changes. Principal Findings Changes in local HHA supply stemming from geographic service area expansions and contractions rivaled those owing to agency closures and market entries. Agencies at greater risk of closure and service area contraction tended to be smaller, newer, freestanding agencies, operating with more visit-intensive practice styles in markets with more competitor agencies. Except for having much less visit-intensive practice styles, similar attributes characterized agencies that increased local supply through service area expansion. Conclusions Supply changes by HHAs largely reflected rational market responses by agencies to significant changes in financial incentives associated with the Medicare IPS. Recently certified agencies were among the most dynamic providers. Supply changes were more likely among agencies operating in more competitive market environments. PMID:16987305

The Empirical Study on the Labor Export of Three Gorges Reservoir Area in China

NASA Astrophysics Data System (ADS)

Hu, Bangyong

There are many large surplus labor force in the three gorges reservoir area, export of labor services is one way to tackle the problem of employment of the surplus-labor and increase farmers income, export of labor is also a effective way to solve three rural issues. This paper analyzes the need for the development of service economy, study the problems of export of labor services, at last the author give some suggestion to develop labor economy.

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

NASA Astrophysics Data System (ADS)

Li, D.; Li, S.

2016-12-01

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

Land Use and Land Cover Change in the Qinghai Lake Region of the Tibetan Plateau and Its Impact on Ecosystem Services

PubMed Central

Gong, Jian; Yang, Jianxin; Tang, Wenwu

2017-01-01

Exploration of land use and land cover change (LULCC) and its impacts on ecosystem services in Tibetan plateau is valuable for landscape and environmental conservation. In this study, we conduct spatial analysis on empirical land use and land cover data in the Qinghai Lake region for 1990, 2000, and 2010 and simulate land cover patterns for 2020. We then evaluate the impacts of LULCC on ecosystem service value (ESV), and analyze the sensitivity of ESV to LULCC to identify the ecologically sensitive area. Our results indicate that, from 1990 to 2010, the area of forest and grassland increased while the area of unused land decreased. Simulation results suggest that the area of grassland and forest will continue to increase and the area of cropland and unused land will decrease for 2010–2020. The ESV in the study area increased from 694.50 billion Yuan in 1990 to 714.28 billion Yuan in 2000, and to 696.72 billion Yuan in 2020. Hydrology regulation and waste treatment are the top two ecosystem services in this region. The towns surrounding the Qinghai Lake have high ESVs, especially in the north of the Qinghai Lake. The towns with high ESV sensitivity to LULCC are located in the northwest, while the towns in the north of the Qinghai Lake experienced substantial increase in sensitivity index from 2000–2010 to 2010–2020, especially for three regulation services and aesthetic landscape provision services. PMID:28754029

Land Use and Land Cover Change in the Qinghai Lake Region of the Tibetan Plateau and Its Impact on Ecosystem Services.

PubMed

Gong, Jian; Li, Jingye; Yang, Jianxin; Li, Shicheng; Tang, Wenwu

2017-07-21

Exploration of land use and land cover change (LULCC) and its impacts on ecosystem services in Tibetan plateau is valuable for landscape and environmental conservation. In this study, we conduct spatial analysis on empirical land use and land cover data in the Qinghai Lake region for 1990, 2000, and 2010 and simulate land cover patterns for 2020. We then evaluate the impacts of LULCC on ecosystem service value (ESV), and analyze the sensitivity of ESV to LULCC to identify the ecologically sensitive area. Our results indicate that, from 1990 to 2010, the area of forest and grassland increased while the area of unused land decreased. Simulation results suggest that the area of grassland and forest will continue to increase and the area of cropland and unused land will decrease for 2010-2020. The ESV in the study area increased from 694.50 billion Yuan in 1990 to 714.28 billion Yuan in 2000, and to 696.72 billion Yuan in 2020. Hydrology regulation and waste treatment are the top two ecosystem services in this region. The towns surrounding the Qinghai Lake have high ESVs, especially in the north of the Qinghai Lake. The towns with high ESV sensitivity to LULCC are located in the northwest, while the towns in the north of the Qinghai Lake experienced substantial increase in sensitivity index from 2000-2010 to 2010-2020, especially for three regulation services and aesthetic landscape provision services.

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

Mobile information and communication in the hospital outpatient service.

PubMed

Jen, Wen-Yuan; Chao, Chia-Chen; Hung, Ming-Chien; Li, Yu-Chuan; Chi, Y P

2007-08-01

Most healthcare providers provide mobile service for their medical staff; however, few healthcare providers provide mobile service as part of their outpatient service. The mobile outpatient service system (MOSS) focuses on illness treatment, illness prevention and patient relation management for outpatient service users. Initiated in a local hospital in Taiwan, the MOSS pilot project was developed to improve outpatient service quality and pursue higher patient safety. This study focuses on the development of the MOSS. The workflow, architecture and target users of the MOSS are delineated. In addition, there were two surveys conducted as part of this study. After a focus group of medical staff identified areas in which outpatient services might be improved by the MOSS, the first survey was administered to outpatients to confirm the focus group's intuitions. The second administration of the survey explored outpatient satisfaction after they used the MOSS service. With regard to outpatient attitudes, about 93% of participants agreed that the mobile outpatient service improved outpatient service quality. In the area of outpatient satisfaction, about 89% of participants indicated they were satisfied with the mobile outpatient service. Supported by our study finding, we propose that more diverse mobile outpatient services can be provided in the future.

An investigation of toll plaza capacity and level of service.

DOT National Transportation Integrated Search

1991-01-01

This study was undertaken to accomplish two objectives pertinent to traffic characteristics at toll plaza areas: (1) to develop a methodology for evaluating the capacity of a toll plaza, and (2) to establish level-of-service criteria for toll area tr...

DART Fixed-Route Service Review Study: Executive Summary

DOT National Transportation Integrated Search

1995-02-01

This study analyzes the probable impact of new light rail transit and commuter rail service into the Dallas Central Business District on existing Dallas Area Rapid Transit (DART) bus service. It looks at possible route and schedule modifications to e...

Cost and Time Effectiveness Analysis of a Telemedicine Service in Bangladesh.

PubMed

Sorwar, Golam; Rahamn, Md Mustafizur; Uddin, Ramiz; Hoque, Md Rakibul

2016-01-01

Telemedicine has great potential to overcome geographical barriers to providing access to equal health care services, particularly for people living in remote and rural areas in developing countries like Bangladesh. A number of telemedicine systems have been implemented in Bangladesh. However, no significant studies have been conducted to determine either their cost effectiveness or efficiency in reducing travel time required by patients. In addition, very few studies have analyzed the attitude and level of satisfaction of telemedicine service recipients in Bangladesh. The aim of this study was to analyze the cost and time effectiveness of a telemedicine service, implemented through locally developed PC based diagnostic equipment and software in Bangladesh, compared to conventional means of providing those services. The study revealed that the introduced telemedicine service reduced cost and travel time on average by 56% and 94% respectively compared to its counterpart conventional approach. The study also revealed that majority of users were highly satisfied with the newly introduced telemedicine service. Therefore, the introduced telemedicine service can be considered as a low cost and time efficient health service solution to improve health care facilities in the remote rural areas in Bangladesh.

Sexual Health Services for Young People in a Rural Area of Northern Ireland: A Study of the Key Issues for Those Who Provide Them

ERIC Educational Resources Information Center

McCann, Lyndsey; Donnelly, Lyn; Quinn, Phelim; McAnerney, Rosemary

2008-01-01

Objective: To identify the key issues for service providers in delivering high quality sexual health services, responsive to the needs of young people, in a rural area of Northern Ireland. Design: A triangulation survey approach using questionnaires, in-depth interviews and focus groups was undertaken with a range of organizations and…

The northeastern area's objectives and beliefs toward national forests and grasslands

Treesearch

Lori B. Shelby; Deborah J. Shields; Brian M. Kent

2008-01-01

The Northeastern Area, an organizational unit of the State and Private Forestry branch of the U.S. Forest Service, serves the Northeastern and Midwestern United States. For this study, residents of the Northeastern Area were asked about their objectives for the management, use, and conservation of forests and grasslands and beliefs about the role the Forest Service...

Assessing the Local Need for Family and Child Care Services: A Small Area Utilization Analysis.

ERIC Educational Resources Information Center

Percy, Andrew; Carr-Hill, Roy; Dixon, Paul; Jamison, James Q.

2000-01-01

Describes study of administrative data from Northern Ireland on the costs of family and child care services, using small area utilization modeling, to derive a new set of needs indicators that could be used within the family and child care capitation funding formula. Argues that small area utilization modeling produces a fairer and more equitable…

Public Health Services for Foreign Workers in Malaysia.

PubMed

Noh, Normah Awang; Wahab, Haris Abd; Bakar Ah, Siti Hajar Abu; Islam, M Rezaul

2016-01-01

The objective of this study was to know the status of the foreign workers' access to public health services in Malaysia based on their utilization pattern. The utilization pattern covered a number of areas, such as frequency of using health services, status of using health services, choice and types of health institutions, and cost of health treatment. The study was conducted on six government hospitals in the Klang Valley area in Kuala Lumpur, Malaysia. Data were collected from 600 foreign patients working in the country, using an interview method with a structured questionnaire. The results showed that the foreign workers' access to public health services was very low. The findings would be an important guideline to formulate an effective health service policy for the foreign workers in Malaysia.

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

ERIC Educational Resources Information Center

Fallon, Karen A.; Katz, Lauren A.

2011-01-01

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

Self-Study and Evaluation Guide. Section C-2: Accounting for Services and Finances.

ERIC Educational Resources Information Center

National Accreditation Council for Agencies Serving the Blind and Visually Handicapped, New York, NY.

The self study and evaluation guide, one of 16 documents for accreditation of agencies serving the blind and visually handicapped, focuses on accounting for services and finances. Standards address five areas: planning for accounting for services and finances, service accounting systems, financial accounting systems, evaluation, and public…

47 CFR 101.523 - Service areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES 24 GHz Service and Digital Electronic Message Service § 101.523 Service areas. (a) The service areas for 24 GHz are Economic Areas (EAs) as defined in this paragraph (a). The Bureau of Economic.... See 60 FR 13114 (March 10, 1995). Additionally, there are four FCC-created EA-like areas: (1) Guam and...

Performance needs assessment of maternal and newborn health service delivery in urban and rural areas of Osun State, South-West, Nigeria.

PubMed

Esan, Oluwaseun T; Fatusi, Adesegun O

2014-06-01

The study aimed to determine performance and compare gaps in maternal and newborn health (MNH) services in urban and rural areas of Osun State, Nigeria, to inform decisions for improved services. This study involved 14 urban and 10 rural-based randomly selected PHC facilities. Using a Performance Needs Assessment framework, desired performances were determined by key stakeholders and actual performances measured by conducting facility survey. Questionnaire interview of 143 health workers and 153 antenatal clients were done. Performance gaps were determined for the urban and rural areas and compared using Chi-square tests with SPSS version 17. PHC facilities and health workers in Osun State, Nigeria, were found to have significant gaps in MNH service performance and this was worse in the rural areas. Root cause of most of the performance gaps was poor political will of local government authorities. Improved government commitment to MNH is needful to address most of the gaps.

Exploring the influence of Internet-based caregiver support on experiences of isolation for older spouse caregivers in rural areas: a qualitative interview study.

PubMed

Blusi, Madeleine; Kristiansen, Lisbeth; Jong, Mats

2015-09-01

Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence. This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas. An intervention study where 63 older rural caregivers received an Internet-based caregiver support service. A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis. Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends. Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence. Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers. © 2014 John Wiley & Sons Ltd.

A Pilot Study of Service-Learning in a Spanish Heritage Speaker Course: Community Engagement, Identity, and Language in the Chicago Area

ERIC Educational Resources Information Center

Petrov, Lisa Amor

2013-01-01

This article presents research findings from a pilot study of the use of service-learning in an intermediate-high class ("Spanish Language and Culture for Heritage Speakers") in the fall semesters of 2010 and 2011. Students reported gains in the areas of communication skills, dispositional learning, language, identity formation, and…

Neighbourhood Deprivation, Health Inequalities and Service Access by Adults with Intellectual Disabilities: A Cross-Sectional Study

ERIC Educational Resources Information Center

Cooper, S. A.; McConnachie, A.; Allan, L. M.; Melville, C.; Smiley, E.; Morrison, J.

2011-01-01

Background: Adults with intellectual disabilities (IDs) experience health inequalities and are more likely to live in deprived areas. The aim of this study was to determine whether the extent of deprivation of the area a person lives in affects their access to services, hence contributing to health inequalities. Method: A cross-sectional study…

Identifying areas of need relative to liver disease: geographic clustering within a health service district.

PubMed

El-Atem, Nathan; Irvine, Katharine M; Valery, Patricia C; Wojcik, Kyle; Horsfall, Leigh; Johnson, Tracey; Janda, Monika; McPhail, Steven M; Powell, Elizabeth E

2017-08-01

Background Many people with chronic liver disease (CLD) are not detected until they present to hospital with advanced disease, when opportunities for intervention are reduced and morbidity is high. In order to build capacity and liver expertise in the community, it is important to focus liver healthcare resources in high-prevalence disease areas and specific populations with an identified need. The aim of the present study was to examine the geographic location of people seen in a tertiary hospital hepatology clinic, as well as ethnic and sociodemographic characteristics of these geographic areas. Methods The geographic locations of hepatology out-patients were identified via the out-patient scheduling database and grouped into statistical area (SA) regions for demographic analysis using data compiled by the Australian Bureau of Statistics. Results During the 3-month study period, 943 individuals from 71 SA Level 3 regions attended clinic. Nine SA Level 3 regions accounted for 55% of the entire patient cohort. Geographic clustering was seen especially for people living with chronic hepatitis B virus. There was a wide spectrum of socioeconomic advantage and disadvantage in areas with high liver disease prevalence. Conclusions The geographic area from which people living with CLD travel to access liver health care is extensive. However, the greatest demand for tertiary liver disease speciality care is clustered within specific geographic areas. Outreach programs targeted to these areas may enhance liver disease-specific health service resourcing. What is known about the topic? The demand for tertiary hospital clinical services in CLD is rising. However, there is limited knowledge about the geographic areas from which people living with CLD travel to access liver services, or the ethnic, socioeconomic and education characteristics of these areas. What does this paper add? The present study demonstrates that a substantial proportion of people living with CLD and accessing tertiary hospital liver services are clustered within specific geographic areas. The most striking geographic clustering was seen for people living with chronic hepatitis B, in regions with a relatively high proportion of people born in Vietnam and China. In addition to ethnicity, the data show an apparent ecological association between liver disease and both socioeconomic and educational and/or occupational disadvantage. What are the implications for practitioners? Identifying where demand for clinical services arises is an important step for service planning and preparing for potential outreach programs to optimise community-based care. It is likely that outreach programs to engage and enhance primary care services in geographic areas from which the greatest demand for tertiary liver disease speciality care arises would yield greater relative return on investment than non-targeted outreach programs.

An exploratory study of services marketing in global markets: major areas of inquiry for the health care services industry.

PubMed

Young, S; Erdem, S A

1996-01-01

It has been stated that one of the major challenges for the international marketer is the design of an efficient strategy for marketing services to international markets. This paper reviews some of the issues associated with services marketing in global markets along with the basic variables of service industries. An exploratory assessment of the health care services industry results in a list composed of several inquiry areas which should be examined by multinational companies. It is hoped that the review of the issues raised in this paper provides a basis for decision making and further research.

Functional approach in estimation of cultural ecosystem services of recreational areas

NASA Astrophysics Data System (ADS)

Sautkin, I. S.; Rogova, T. V.

2018-01-01

The article is devoted to the identification and analysis of cultural ecosystem services of recreational areas from the different forest plant functional groups in the suburbs of Kazan. The study explored two cultural ecosystem services supplied by forest plants by linking these services to different plant functional traits. Information on the functional traits of 76 plants occurring in the forest ecosystems of the investigated area was collected from reference books on the biological characteristics of plant species. Analysis of these species and traits with the Ward clustering method yielded four functional groups with different potentials for delivering ecosystem services. The results show that the contribution of species diversity to services can be characterized through the functional traits of plants. This proves that there is a stable relationship between biodiversity and the quality and quantity of ecosystem services. The proposed method can be extended to other types of services (regulating and supporting). The analysis can be used in the socio-economic assessment of natural ecosystems for recreation and other uses.

Mapping Ecological Processes and Ecosystem Services for Prioritizing Restoration Efforts in a Semi-arid Mediterranean River Basin

NASA Astrophysics Data System (ADS)

Trabucchi, Mattia; O'Farrell, Patrick J.; Notivol, Eduardo; Comín, Francisco A.

2014-06-01

Semi-arid Mediterranean regions are highly susceptible to desertification processes which can reduce the benefits that people obtain from healthy ecosystems and thus threaten human wellbeing. The European Union Biodiversity Strategy to 2020 recognizes the need to incorporate ecosystem services into land-use management, conservation, and restoration actions. The inclusion of ecosystem services into restoration actions and plans is an emerging area of research, and there are few documented approaches and guidelines on how to undertake such an exercise. This paper responds to this need, and we demonstrate an approach for identifying both key ecosystem services provisioning areas and the spatial relationship between ecological processes and services. A degraded semi-arid Mediterranean river basin in north east Spain was used as a case study area. We show that the quantification and mapping of services are the first step required for both optimizing and targeting of specific local areas for restoration. Additionally, we provide guidelines for restoration planning at a watershed scale; establishing priorities for improving the delivery of ecosystem services at this scale; and prioritizing the sub-watersheds for restoration based on their potential for delivering a combination of key ecosystem services for the entire basin.

Mapping ecological processes and ecosystem services for prioritizing restoration efforts in a semi-arid Mediterranean river basin.

PubMed

Trabucchi, Mattia; O'Farrell, Patrick J; Notivol, Eduardo; Comín, Francisco A

2014-06-01

Semi-arid Mediterranean regions are highly susceptible to desertification processes which can reduce the benefits that people obtain from healthy ecosystems and thus threaten human wellbeing. The European Union Biodiversity Strategy to 2020 recognizes the need to incorporate ecosystem services into land-use management, conservation, and restoration actions. The inclusion of ecosystem services into restoration actions and plans is an emerging area of research, and there are few documented approaches and guidelines on how to undertake such an exercise. This paper responds to this need, and we demonstrate an approach for identifying both key ecosystem services provisioning areas and the spatial relationship between ecological processes and services. A degraded semi-arid Mediterranean river basin in north east Spain was used as a case study area. We show that the quantification and mapping of services are the first step required for both optimizing and targeting of specific local areas for restoration. Additionally, we provide guidelines for restoration planning at a watershed scale; establishing priorities for improving the delivery of ecosystem services at this scale; and prioritizing the sub-watersheds for restoration based on their potential for delivering a combination of key ecosystem services for the entire basin.

An examination of the operation and motorist usage of Virginia's highway rest areas and welcome centers.

DOT National Transportation Integrated Search

1988-01-01

This study was conducted to examine existing conditions at Virginia's interstate rest areas and welcome centers and to assess what impact additional services, such as vending machines, might have on the service delivery of these facilities. A selecte...

47 CFR 36.622 - National and study area average unseparated loop costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... companies which did not make an update filing by the most recent filing date. (b) Study Area Average... 47 Telecommunication 2 2011-10-01 2011-10-01 false National and study area average unseparated... Universal Service Fund Calculation of Loop Costs for Expense Adjustment § 36.622 National and study area...

47 CFR 36.622 - National and study area average unseparated loop costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... companies which did not make an update filing by the most recent filing date. (b) Study Area Average... 47 Telecommunication 2 2010-10-01 2010-10-01 false National and study area average unseparated... Universal Service Fund Calculation of Loop Costs for Expense Adjustment § 36.622 National and study area...

Clients’ Willingness to Pay for Immunization Services in the Urban and Rural Primary Health Centers of Enugu State, Nigeria

PubMed Central

Ossai, Edmund Ndudi; Fatiregun, Akinola Ayoola

2015-01-01

Our study aims at determining the pattern of willingness of clients to pay for childhood immunization services in urban and rural primary health centers of Enugu state, Nigeria. Using a cross-sectional design, 800 clients who presented with their children/wards to receive childhood immunization services were selected at the primary health center in rural and urban local government areas of the state. The mean age was 28.9±4.5 and 26.7±5.1 years in the urban and rural areas respectively. About 54.5% of clients in the urban and 55.3% in the rural area were willing to pay for immunization services. The clients willingness to pay was influenced by: non satisfaction with immunization services, (OR=0.3, 95%CI: 0.2-0.5), younger age, (OR=1.4, 95%CI: 1.0-2.0) marital status (OR=2.8, 95%CI: 1.2-6.5), proximity to health centers (OR=0.6, 95%CI: 0.4-0.8), and delivering in a private health facility (OR=0.4, 95%CI: 0.1-0.9). The study suggests that the economic value that clients give to immunization services was similar in the rural and urban areas, and this could be increased by improving the level of clients’ satisfaction for the services among others. PMID:28299135

Valuing ecosystem services of an impacted waterway in the Southwestern US

EPA Science Inventory

While many studies of ecosystem services focus on unaltered areas such as wilderness, management insight is also needed for those more impacted. This case study values ecosystem services of the Santa Cruz River, an effluent-dominated waterway in southern Arizona. Wastewater treat...

Travel for HIV care in England: a choice or a necessity?

PubMed

Huntington, S; Chadborn, T; Rice, B D; Brown, A E; Delpech, V C

2011-07-01

The aims of the study were (1) to measure the distance required to travel, and the distance actually travelled, to HIV services by HIV-infected adults, and (2) to calculate the proportion of patients who travelled beyond local services and identify socio-demographic and clinical predictors of use of non-local services. The straight-line distance between a patient's residence and HIV services was determined for HIV-infected patients in England in 2007. 'Local services' were defined as the closest HIV service to a patient's residence and other services within an additional 5 km radius. Multivariable logistic regression was used to identify socio-demographic and clinical predictors of accessing non-local services. In 2007, nearly 57 000 adults with diagnosed HIV infection accessed HIV services in England; 42% lived in the most deprived areas. Overall, 81% of patients lived within 5 km of a service, and 8.7% used their closest HIV service. The median distance to the closest HIV service was 2.5 km [interquartile range (IQR) 1.5-4.2 km] and the median actual distance travelled was 4.8 km (IQR 2.5-9.7 km). A quarter of patients used a 'non-local' service. Patients living in the least deprived areas were twice as likely to use non-local services as those living in the most deprived areas [adjusted odds ratio (AOR) 2.16; 95% confidence interval (CI) 1.98-2.37]. Other predictors for accessing non-local services included living in an urban area (AOR 0.77; 95% CI 0.69-0.85) and being diagnosed more than 12 months (AOR 1.48; 95% CI 1.38-1.59). In England, 81% of HIV-infected patients live within 5 km of HIV services and a quarter of HIV-infected adults travel to non-local HIV services. Those living in deprived areas are less likely to travel to non-local services. © 2010 British HIV Association.

Service Learning in Policy and Practice: A Study of Service Learning across Three Universities

ERIC Educational Resources Information Center

Ahmed, Zahra G.

2010-01-01

This dissertation studies the creation and implementation of service learning policy and the implications of these programs for democratic citizenship and political participation. The project focuses on service learning centers at three universities in the Los Angeles area, framing the creation and implementation of these campus-wide centers as an…

Mapping and quantifying ecosystem services: analysis of trade-offs and synergies at the different spatial scales

NASA Astrophysics Data System (ADS)

Tomczyk, Aleksandra; Ewertowski, Marek

2014-05-01

The importance of conserving the natural environment has been known for a long time. It can be fulfilled by designation of protected areas as well as proper management of broader landscapes. During past two decades, conservation has shifted from a predominantly species- and habitat-focus to a more holistic "ecosystem approach" with an emphasis on "ecosystem services", which underpin the benefits which society can obtain (directly or indirectly) from ecosystems. This study aims to investigate and compare existing land use prioritization models and to develop new GIS-based frameworks for analysis for different spatial scales. Research were carried out in several conservation areas in UK and Poland. Main focus was on regulating (including regulation of soil erosion and landslide susceptibility) and recreation services. A new GIS-based model was developed which enabled to analysis of this services. Different spatial scales, ranging from whole conservation areas to single catchments were chosen for mapping and quantifying. Based on different scenarios three sets of ecosystem services were calculated. Data contained specific land-cover/land-use resulting from the different strategy of the natural conservation for each of the study sites. Modelling was carried out based on the trends identified on the basis of past changes in land-use/land-cover (based on analysis of time-series satellite images), and the probability of a particular class of land-use/land-cover for the chosen scenario. Comparison between results revealed ecosystem service tradeoffs (when the obtaining of one service results in the reducing of another service) and synergies (when multiple services can be provides simultaneously). Results of the study shows where (and under which condition): (1) conservation areas can accommodate more visitors and in the same time provide regulation of soil erosion and protection against landslide developments, (2) further development of recreation services will lead to inevitable degradation of environment. Based on these results several further activities were proposed: from changing of conservation strategy for some part of the areas to changing of the land cover/land use.

Transportation Services in Rural Areas. January 1979-December 1988. Quick Bibliography Series.

ERIC Educational Resources Information Center

La Caille John, Patricia, Comp.

This bibliography contains 137 entries of English-language materials available from the National Agricultural Library's (NAL) AGRICOLA database. Each of the bibliography's 137 entries pertains to some aspect of transportation services in rural areas. Each entry, including books, reports, studies, and so forth, offers bibliographical information…

A study of headway maintenance for bus routes : causes and effects of "bus bunching" in extensive and congested service areas.

DOT National Transportation Integrated Search

2012-07-01

A healthy and efficient public transit system is indispensable to reduce congestion, emissions, energy consumption, and car : dependency in urban areas. The objective of this research is to 1) develop methods to evaluate and visualize bus service rel...

Best practices for providing traveler information services to motorists at rest areas and welcome centers.

DOT National Transportation Integrated Search

2009-06-01

The objective of this study to look at what Kentucky and other states are doing to provide wireless Internet connectivity (i.e., Wi-Fi service) for motorists at rest areas, weigh stations, and truck rest havens, and to identify technologies and best ...

Transit services for sprawling areas with relatively low demand density : a pilot study in the Texas border's colonias.

DOT National Transportation Integrated Search

2009-02-01

The colonias along the Texas-Mexico border are one of the most rapidly growing areas in Texas. : Because of the relatively low-income of the residents and an inadequate availability of : transportation services, the need for basic social activities f...

Pre-Service Teachers' Construction of Professional Identity through Peer Collaboration during Professional Experience: A Case Study in Australia

ERIC Educational Resources Information Center

Nguyen, Hoa Thi Mai; Loughland, Tony

2018-01-01

Much research in the area of pre-service teacher (PST) identity formation has focused on the mentoring relationship between PSTs and their supervising teachers. While this is important to identity formation, interaction with peers is another area that needs to be examined. Using Wenger's matrix as a theoretical framework, this study aimed to…

A Study of the Role of the Elementary School Librarian in Reading Instruction in the Region II, Education Service Center Area of Texas

ERIC Educational Resources Information Center

Earp, Vanessa Jane

2006-01-01

The purpose of this research project was to study the role of elementary school librarians in reading instruction in Region II, Education Service Center area of Texas. By using school web sites and telephoning schools it was found that 51 of the 104 elementary schools did indeed have school librarians while 46 did not. The study found that 7…

Extravehicular Crewman Work System (ECWS) study program. Volume 3: Satellite service

NASA Technical Reports Server (NTRS)

Wilde, R. C.

1980-01-01

The satellite service portion of the Extravehicular Crewman Work System Study defines requirements and service equipment concepts for performing satellite service from the space shuttle orbiter. Both normal and contingency orbital satellite service is required. Service oriented satellite design practices are required to provide on orbit satellite service capability for the wide variety of satellites at the subsystem level. Development of additional satellite service equipment is required. The existing space transportation system provides a limited capability for performing satellite service tasks in the shuttle payload bay area.

Ecosystem services response to urbanization in metropolitan areas: Thresholds identification.

PubMed

Peng, Jian; Tian, Lu; Liu, Yanxu; Zhao, Mingyue; Hu, Yi'na; Wu, Jiansheng

2017-12-31

Ecosystem service is the key comprehensive indicator for measuring the ecological effects of urbanization. Although various studies have found a causal relationship between urbanization and ecosystem services degradation, the linear or non-linear characteristics are still unclear, especially identifying the impact thresholds in this relationship. This study quantified four ecosystem services (i.e. soil conservation, carbon sequestration and oxygen production, water yield, and food production) and total ecosystem services (TES), and then identified multiple advantageous area of ecosystem services in the peri-urban area of Beijing City. Using piecewise linear regression, the response of TES to urbanization (i.e., population density, GDP density, and construction land proportion) and its thresholds were detected. The results showed that, the TES was high in the north and west and low in the southeast, and there were seven multiple advantageous areas (distributed in the new urban development zone and ecological conservation zone), one single advantageous area (distributed in the ecological conservation zone), and six disadvantageous areas (mainly distributed in the urban function extended zone). TES response to population and economic urbanization each had a threshold (229personkm -2 and 107.15millionyuankm -2 , respectively), above which TES decreased rapidly with intensifying urbanization. However, there was a negative linear relationship between land urbanization and TES, which indicated that the impact of land urbanization on ecosystem services was more direct and effective than that of population and economic urbanization. It was also found that the negative impact of urbanization on TES was highest in the urban function extended zone, followed in descending order by that in the new urban development zone and ecological conservation zone. According to the detected relationships between urbanization and TES, the economic and population urbanization should be strengthened accompanied by slowing or even reducing land urbanization, so as to achieve urban ecological sustainability with less ecosystem services degradation. Copyright © 2017 Elsevier B.V. All rights reserved.

41 CFR 102-83.95 - After an agency has identified that its geographic service area and delineated area are in an...

Code of Federal Regulations, 2010 CFR

2010-07-01

... identified that its geographic service area and delineated area are in an urban area, what is the next step... Location of Space Urban Areas § 102-83.95 After an agency has identified that its geographic service area... identifies its geographic service area and delineated area within which it wishes to locate specific...

41 CFR 102-83.95 - After an agency has identified that its geographic service area and delineated area are in an...

Code of Federal Regulations, 2013 CFR

2013-07-01

... identified that its geographic service area and delineated area are in an urban area, what is the next step... Location of Space Urban Areas § 102-83.95 After an agency has identified that its geographic service area... identifies its geographic service area and delineated area within which it wishes to locate specific...

41 CFR 102-83.95 - After an agency has identified that its geographic service area and delineated area are in an...

Code of Federal Regulations, 2012 CFR

2012-01-01

... identified that its geographic service area and delineated area are in an urban area, what is the next step... Location of Space Urban Areas § 102-83.95 After an agency has identified that its geographic service area... identifies its geographic service area and delineated area within which it wishes to locate specific...

41 CFR 102-83.95 - After an agency has identified that its geographic service area and delineated area are in an...

Code of Federal Regulations, 2014 CFR

2014-01-01

... identified that its geographic service area and delineated area are in an urban area, what is the next step... Location of Space Urban Areas § 102-83.95 After an agency has identified that its geographic service area... identifies its geographic service area and delineated area within which it wishes to locate specific...

41 CFR 102-83.95 - After an agency has identified that its geographic service area and delineated area are in an...

Code of Federal Regulations, 2011 CFR

2011-01-01

... identified that its geographic service area and delineated area are in an urban area, what is the next step... Location of Space Urban Areas § 102-83.95 After an agency has identified that its geographic service area... identifies its geographic service area and delineated area within which it wishes to locate specific...

Fish, benthic macroinvertebrate, and stream habitat data from the Houston-Galveston Area Council service area, Texas, 1997-98

USGS Publications Warehouse

Moring, J. Bruce; Rosendale, John C.; Ansley, Stephen P.; Brown, Dexter W.

1998-01-01

The U.S. Geological Survey collected fish, benthic macroinvertebrate, and stream habitat data at sampling sites in the Houston-Galveston Area Council service area, a 15-county area with a population of about 4.3 million people. The data were collected for a 1997?98 study in cooperation with the Houston-Galveston Area Council to provide data for the Texas Clean Rivers Program for watersheds near Houston, Texas. Fish community and stream habitat data were collected at all 56 sites selected, and benthic macroinvertebrate data were collected at 39 of the sites.

Stakeholders' relationships with the USDA Forest Service at the Spruce Knob-Seneca Rocks National Recreation Area, West Virginia

Treesearch

Katherine A. Thompson; Chad D. Pierskalla; Steven W. Selin

2007-01-01

The Spruce Knob-Seneca Rocks National Recreation Area (NRA) is developing a collaborative management plan. To develop a public involvement strategy, it is necessary to assess the social conditions in the area. The purpose of this study was to determine the relationship local stakeholders in the NRA have with the USDA Forest Service (USFS) with regard to the...

Evaluation of the Quality of Health Service Providers: The Iranian People Perspective 2014.

PubMed

Asefzadeh, Saeed; Gholami, Soheyla; Rajaee, Roya; Najafi, Marziye; Alijanzadeh, Mehran

2016-03-01

Quality is the center of attention in all service providing organizations that are effective in promoting satisfaction of patients who are referred to medical centers. The aim of this study was to investigate the quality of health service providers in a case study of Qazvin, Iran, in 2014. This descriptive study was conducted on 1,002 people who were residents of Qazvin Province (Iran) in 2014. The people were selected randomly from the population of the study area. The main variables studied were education, perceptions, expectations, and gaps in service quality. The data collection tool was the standard Servequal questionnaire. To determine the reliability of the research tool, we used Cronbach's Alpha coefficient and the test-retest method. Statistical analyses were conducted using SPSS and the ANOVA test. The mean age of people included in the study was 32 ± 9.9 years, and the average waiting time to receive services was 73 ± 47 minutes. Hospitals and doctors' offices had the highest quality gap of -1.420 ± 0.82 and -1.01 ± 0.75, respectively. The service quality gaps in medical centers, health providers of rural area, and health providers of urban area were -0.883 ± 0.67, -0.882 ± 0.83, and -0.804 ± 0.62, respectively. There was a significant relationship between peoples' perceptions and expectations concerning the quality of health services and their educational levels. The higher gaps in quality in hospitals and in doctors' offices require more attention. Managers and policy makers should consider developing and implementing plans to reduce these gaps in quality and to promote better health services in these two sectors.

Evaluation of the Quality of Health Service Providers: The Iranian People Perspective 2014

PubMed Central

Asefzadeh, Saeed; Gholami, Soheyla; Rajaee, Roya; Najafi, Marziye; Alijanzadeh, Mehran

2016-01-01

Introduction Quality is the center of attention in all service providing organizations that are effective in promoting satisfaction of patients who are referred to medical centers. The aim of this study was to investigate the quality of health service providers in a case study of Qazvin, Iran, in 2014. Methods This descriptive study was conducted on 1,002 people who were residents of Qazvin Province (Iran) in 2014. The people were selected randomly from the population of the study area. The main variables studied were education, perceptions, expectations, and gaps in service quality. The data collection tool was the standard Servequal questionnaire. To determine the reliability of the research tool, we used Cronbach’s Alpha coefficient and the test-retest method. Statistical analyses were conducted using SPSS and the ANOVA test. Results The mean age of people included in the study was 32 ± 9.9 years, and the average waiting time to receive services was 73 ± 47 minutes. Hospitals and doctors’ offices had the highest quality gap of −1.420 ± 0.82 and −1.01 ± 0.75, respectively. The service quality gaps in medical centers, health providers of rural area, and health providers of urban area were −0.883 ± 0.67, −0.882 ± 0.83, and −0.804 ± 0.62, respectively. There was a significant relationship between peoples’ perceptions and expectations concerning the quality of health services and their educational levels. Conclusion The higher gaps in quality in hospitals and in doctors’ offices require more attention. Managers and policy makers should consider developing and implementing plans to reduce these gaps in quality and to promote better health services in these two sectors. PMID:27123214

A Comparison of Homeless Male Veterans in Metropolitan and Micropolitan Areas in Nebraska: A Methodological Caveat.

PubMed

Tsai, Jack; Ramaswamy, Sriram; Bhatia, Subhash C; Rosenheck, Robert A

2015-12-01

This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff conducted structured interviews with homeless veterans. Results showed that compared to homeless veterans in metropolitans, those in micropolitans were more likely to be White, unmarried, living in transitional settings, and were far more transient but reported greater social support and housing satisfaction. Veterans in micropolitans also reported more medical problems, diagnoses of anxiety and personality disorders, and unexpectedly, were more likely to report using various health services and less travel time for services. Together, these findings suggest access to homeless and health services for veterans in micropolitan areas may be facilitated through Veterans Affairs facilities and community providers that work in close proximity to one another. Many homeless veterans in these areas are transient, making them a difficult population to study and serve. Innovative ways to provide outreach to homeless veterans in micropolitan and more rural areas are needed.

Predictors of safe delivery service utilization in arsi zone, South-East ethiopia.

PubMed

Abera, Mulumebet; Gebremariam, Abebe; Belachew, Tefera

2011-08-01

Evidence show that lack of access to and use of, essential obstetric care services to be a crucial factor that contributes to the high maternal morbidity and mortality. Skilled attendance during labor, delivery and early post-partum period could reduce deaths due to obstructed labor, hemorrhage, sepsis and eclampsia. There is limited information on the mothers' use of skilled delivery services in the study area. This study assessed the predictors of safe delivery service utilization in Arsi Zone, Southeast Ethiopia. A cross- sectional community based study using quantitative and qualitative methods was conducted from February 15(th) to March 15(th) 2006. A total of 1089 women who had at least one birth one year prior to the study were involved in the study from nine rural and four urban kebeles in three Woredas (Districts) selected using a systematic sampling method from all households in the study area. A pre-tested structured interviewer administered questionnaire was used to collect data. Information on the utilization of safe delivery service and socio-demographic, individual and institutional factors and past obstetric history were collected. Focus Group Discussion guide was used for qualitative data collection. The data were edited, cleaned, and entered into a computer and analyzed using SPSS for windows version 12.0. One thousand seventy four women who had at least one birth were interviewed making a response rate 98.6%. Two hundred seventy one (75.0%) of urban and 373(52.0%) rural women received antenatal care from skilled health professional at least once during their last pregnancy. Thirty-one (4.3%) of rural and 145 (40.4%) of urban women delivered in health institution. In multivariate analysis showed that residential area OR= 8.5, 95%CI; (5.1,13.9), parity OR=0.18, 95%CI; (0.08, 0.42), and ANC service use OR= 4.5, 95%CI; (2.2,8.9), and maternal education OR=4.6, 95%CI; (1.7,12.8), were most significant predictors of safe delivery service use by mothers (P< 0.01). Birth attended by skilled personnel was low in the study area. Maternal education, her birth experience and her use of prenatal services are important predictors. Promoting information, education and communication on safe delivery service utilization, expansion of health service and empowerment of women are needed.

47 CFR 27.1208 - BTA service areas.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false BTA service areas. 27.1208 Section 27.1208 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1208 BTA service areas...

47 CFR 27.1208 - BTA service areas.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false BTA service areas. 27.1208 Section 27.1208 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1208 BTA service areas...

47 CFR 27.1208 - BTA service areas.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false BTA service areas. 27.1208 Section 27.1208 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1208 BTA service areas...

47 CFR 27.1208 - BTA service areas.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false BTA service areas. 27.1208 Section 27.1208 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1208 BTA service areas...

Technology Integration Support Levels for In-Service Teachers

ERIC Educational Resources Information Center

Williams, Mable Evans

2017-01-01

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

Health Occupations Trends and Issues: Issue Paper.

ERIC Educational Resources Information Center

Covelli, Nicholas J.; And Others

A study was conducted to identify the trends occurring within the health service industry and their impact on the providers of health care; determine shifts or emerging occupational areas within health services; and assess local health service providers' staffing patterns and anticipated needs. The study involved meetings with local hospital…

Assessment of economic viability of solid waste service provision in small settlements in developing countries: case study Rosetta, Egypt.

PubMed

Abdrabo, Mohamed Abdel-Karim

2008-12-01

Problems associated with solid waste management (SWM) service provision in developing countries are reaching an ever increasing magnitude, leading to considerable adverse impacts on the environment and quality of life of the inhabitants. Such problems are usually associated with limited managerial, technical and financial capabilities of municipal authorities. Municipal authorities in Egypt that are responsible for SWM services have always been accused of providing a less than satisfactory service, leading to huge quantities of solid waste being uncollected. This study assesses the potential for the provision of an effective and sustainable service, by estimating willingness of the residents to pay for such a service and the cost involved in its provision. The study covered the Rosetta urban centre and its adjacent areas, which are located in the northwestern part of the Nile Delta. It was found that, from an economic perspective, a viable SWM service could be provided in the study area using local funds. In order to increase the likelihood of success of such a service, it may be provided by a local firm or a cooperative to be established for that purpose.

Distribution and utilization of curative primary healthcare services in Lahej, Yemen.

PubMed

Bawazir, A A; Bin Hawail, T S; Al-Sakkaf, K A Z; Basaleem, H O; Muhraz, A F; Al-Shehri, A M

2013-09-01

No evidence-based data exist on the availability, accessibility and utilization of healthcare services in Lahej Governorate, Yemen. The aim of this study was to assess the distribution and utilization of curative services in primary healthcare units and centres in Lahej. Cross-sectional study (clustering sample). This study was conducted in three of the 15 districts in Lahej between December 2009 and August 2010. Household members were interviewed using a questionnaire to determine sociodemographic characteristics and types of healthcare services available in the area. The distribution of health centres, health units and hospitals did not match the size of the populations or areas of the districts included in this study. Geographical accessibility was the main obstacle to utilization. Factors associated with the utilization of curative services were significantly related to the time required to reach the nearest facility, seeking curative services during illness and awareness of the availability of health facilities (P < 0.01). There is an urgent need to look critically and scientifically at the distribution of healthcare services in the region in order to ensure accessibility and quality of services. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Effects of geodemographic profiles on healthcare service utilization: a case study on cardiac care in Ontario, Canada

PubMed Central

2013-01-01

Background Although literature has associated geodemographic factors with healthcare service utilization, little is known about how these factors — such as population size, age profile, service accessibility, and educational profile — interact to influence service utilization. This study fills this gap in the literature by examining both the direct and the moderating effects of geodemographic profiles on the utilization of cardiac surgery services. Methods We aggregated secondary data obtained from Statistics Canada and Cardiac Care Network of Ontario to derive the geodemographic profiles of Ontario and the corresponding cardiac surgery service utilization in the years between 2004 and 2007. We conducted a two-step test using Partial Least Squares-based structural equation modeling to investigate the relationships between geodemographic profiles and healthcare service utilization. Results Population size and age profile have direct positive effects on service utilization (β=0.737, p<0.01; β=0.284, p<0.01, respectively), whereas service accessibility is negatively associated with service utilization (β=−0.210, p<0.01). Service accessibility decreases the effect of population size on service utilization (β=−0.606, p<0.01), and educational profile weakens the effects of population size and age profile on service utilization (β=−0.595, p<0.01; β=−0.286, p<0.01, respectively). Conclusions In this study, we found that (1) service accessibility has a moderating effect on the relationship between population size and service utilization, and (2) educational profile has moderating effects on both the relationship between population size and service utilization, and the relationship between age profile and service utilization. Our findings suggest that reducing regional disparities in healthcare service utilization should take into account the interaction of geodemographic factors such as service accessibility and education. In addition, the allocation of resources for a particular healthcare service in one area should consider the geographic distribution of the same services in neighboring areas, as patients may be willing to utilize these services in areas not far from where they reside. PMID:23816201

Career Services at Colleges and Universities: A 30-Year Replication Study

ERIC Educational Resources Information Center

Vinson, Bonita M.; Reardon, Robert C.; Bertoch, Sara C.

2014-01-01

This study examines career planning programs and career services offices at colleges and universities in the United States as viewed by senior student affairs officers (SSAOs). Findings from a 1979 study of career services offices (CSOs) were compared to the current findings. Additionally, new areas of research were examined in order to provide…

An Examination of the Concept of Social Integration as Related to Preventive Medical Care in Poverty Families in Rural and Urban Areas.

ERIC Educational Resources Information Center

Slesinger, Doris P.

Based on an in-depth study of 125 mothers of young infants in both urban and rural areas of Wisconsin, this study analyzed the utilization of preventive medical services for the infant. The hypothesis that "mothers who are more socially integrated will be more likely to use preventive medical services than those who are less integrated,…

Solid Waste Management in Recreational Forest Areas.

ERIC Educational Resources Information Center

Spooner, Charles S.

The Forest Service, U. S. Department of Agriculture, requested the Bureau of Solid Waste Management to conduct a study of National Forest recreation areas to establish waste generation rates for major recreation activities and to determine the cost of solid waste handling for selected Forest Service Districts. This report describes the 1968 solid…

Microbial air quality and bacterial surface contamination in ambulances during patient services.

PubMed

Luksamijarulkul, Pipat; Pipitsangjan, Sirikun

2015-03-01

We sought to assess microbial air quality and bacterial surface contamination on medical instruments and the surrounding areas among 30 ambulance runs during service. We performed a cross-sectional study of 106 air samples collected from 30 ambulances before patient services and 212 air samples collected during patient services to assess the bacterial and fungal counts at the two time points. Additionally, 226 surface swab samples were collected from medical instrument surfaces and the surrounding areas before and after ambulance runs. Groups or genus of isolated bacteria and fungi were preliminarily identified by Gram's stain and lactophenol cotton blue. Data were analyzed using descriptive statistics, t-test, and Pearson's correlation coefficient with a p-value of less than 0.050 considered significant. The mean and standard deviation of bacterial and fungal counts at the start of ambulance runs were 318±485cfu/m(3) and 522±581cfu/m(3), respectively. Bacterial counts during patient services were 468±607cfu/m(3) and fungal counts were 656±612cfu/m(3). Mean bacterial and fungal counts during patient services were significantly higher than those at the start of ambulance runs, p=0.005 and p=0.030, respectively. For surface contamination, the overall bacterial counts before and after patient services were 0.8±0.7cfu/cm(2) and 1.3±1.1cfu/cm(2), respectively (p<0.001). The predominant isolated bacteria and fungi were Staphylococcus spp. and Aspergillus spp., respectively. Additionally, there was a significantly positive correlation between bacterial (r=0.3, p<0.010) and fungal counts (r=0.2, p=0.020) in air samples and bacterial counts on medical instruments and allocated areas. This study revealed high microbial contamination (bacterial and fungal) in ambulance air during services and higher bacterial contamination on medical instrument surfaces and allocated areas after ambulance services compared to the start of ambulance runs. Additionally, bacterial and fungal counts in ambulance air showed a significantly positive correlation with the bacterial surface contamination on medical instruments and allocated areas. Further studies should be conducted to determine the optimal intervention to reduce microbial contamination in the ambulance environment.

Ecosystem Services Assessment of the Nemunas River Delta

EPA Science Inventory

The concept of ecosystem services recognizes the services, and benefits, provided to people by ecosystems. The Nemunas River Delta, in Lithuania, is a valued area that can provide a range of services. We conducted a meta-analysis of existing studies done on the region to identify...

Relocating from out-of-area treatments: service users' perspective.

PubMed

Rambarran, D D

2013-10-01

Asylum closures over recent decades resulted in mental health services being increasingly sited in the community. However, under provision of highly supported accommodation led to service users being placed away from their local area in 'out-of-area treatments' (OATs). OATs have raised major concerns in relation to enabling service users' recovery, owing to limitations in promoting autonomy, social dislocation and costs. In 2004, an OATs project was set up in a London Borough to address these concerns. In the first 4 years, the project succeeded in relocating 22 service users to less restrictive environments locally. This study aims to explore the outcome of relocation from service users' perspective. A qualitative methodology was utilized. Semi-structured interviews were carried out with seven service users who relocated. All seven service users shared a strong aspiration for independent living but there was associated loneliness. Five welcomed increased contact with family and friends, but lacked social confidence, inhibiting social inclusion. Service users with long-term and consistent care managers were more able to address fears. Five out of seven service users concluded that relocation increased their autonomy thus enhanced their quality of life. © 2012 John Wiley & Sons Ltd.

47 CFR 22.911 - Cellular geographic service area.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Cellular geographic service area. 22.911 Section 22.911 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.911 Cellular geographic service area. The...

47 CFR 22.912 - Service area boundary extensions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Service area boundary extensions. 22.912 Section 22.912 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.912 Service area boundary extensions. This...

47 CFR 22.912 - Service area boundary extensions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Service area boundary extensions. 22.912 Section 22.912 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.912 Service area boundary extensions. This...

47 CFR 22.912 - Service area boundary extensions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Service area boundary extensions. 22.912 Section 22.912 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.912 Service area boundary extensions. This...

Geographic variations of ecosystem service intensity in Fuzhou City, China.

PubMed

Hu, Xisheng; Hong, Wei; Qiu, Rongzu; Hong, Tao; Chen, Can; Wu, Chengzhen

2015-04-15

Ecosystem services are strongly influenced by the landscape configuration of natural and human systems. So they are heterogeneous across landscapes. However lack of the knowledge of spatial variations of ecosystem services constrains the effective management and conservation of ecosystems. We presented a spatially explicit and quantitative assessment of the geographic variations in ecosystem services for the Fuzhou City in 2009 using exploratory spatial data analysis (ESDA) and semivariance analysis. Results confirmed a significant and positive spatial autocorrelation, and revealed several hot-spots and cold-spots for the spatial distribution of ecosystem service intensity (ESI) in the study area. Also the trend surface analysis indicated that the level of ESI tended to be reduced gradually from north to south and from west to east, with a trough in the urban central area, which was quite in accordance with land-use structure. A more precise cluster map was then developed using the range of lag distance, deriving from semivariance analysis, as neighborhood size instead of default value in the software of ESRI ArcGIS 10.0, and geographical clusters where population growth and land-use pressure varied significantly and positively with ESI across the city were also created by geographically weighted regression (GWR). This study has good policy implications applicable to prioritize areas for conservation or construction, and design ecological corridor to improve ecosystem service delivery to benefiting areas. Copyright © 2015 Elsevier B.V. All rights reserved.

Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review.

PubMed

Lassi, Zohra S; Aftab, Wafa; Ariff, Shabina; Kumar, Rohail; Hussain, Imtiaz; Musavi, Nabiha B; Memon, Zahid; Soofi, Sajid B; Bhutta, Zulfiqar A

2015-01-01

Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas. The literature search revealed ten studies that described MNH service delivery platforms. The results from the systematic review showed that with utilisation of community outreach services, the greatest impacts were observed in skilled birth attendance and antenatal consultation rates. Facility level services, on the other hand, showed that labour room services for an internally displaced population (IDP) improved antenatal care coverage, contraceptive prevalence rate and maternal mortality. Consultative meetings and discussions conducted in Quetta and Peshawar (capitals of conflict affected provinces) with relevant stakeholders revealed that no systematic models of MNH service delivery, especially tailored for conflict areas, are available. During conflict, even previously available services and infrastructure suffered due to various barriers specific to times of conflict and unrest. A number of barriers that hinder MNH services were discussed. Suggestions for improving MNH services in conflict areas were also laid down by participants. The review identified some important steps that can be undertaken to mitigate the effects of conflict on MNH services, which include: improve provision and access to infrastructure and equipment; development and training of healthcare providers; and advocacy at different levels for free access to healthcare services and for the introduction of the programme model in existing healthcare system. The obligation is enormous, however, for a sustainable programme, it is important to work closely with both the IDP and host community, and collaborating with the government and non-government organisations.

Geochemical baseline studies of soil in Finland

NASA Astrophysics Data System (ADS)

Pihlaja, Jouni

2017-04-01

The soil element concentrations regionally vary a lot in Finland. Mostly this is caused by the different bedrock types, which are reflected in the soil qualities. Geological Survey of Finland (GTK) is carrying out geochemical baseline studies in Finland. In the previous phase, the research is focusing on urban areas and mine environments. The information can, for example, be used to determine the need for soil remediation, to assess environmental impacts or to measure the natural state of soil in industrial areas or mine districts. The field work is done by taking soil samples, typically at depth between 0-10 cm. Sampling sites are chosen to represent the most vulnerable areas when thinking of human impacts by possible toxic soil element contents: playgrounds, day-care centers, schools, parks and residential areas. In the mine districts the samples are taken from the areas locating outside the airborne dust effected areas. Element contents of the soil samples are then analyzed with ICP-AES and ICP-MS, Hg with CV-AAS. The results of the geochemical baseline studies are published in the Finnish national geochemical baseline database (TAPIR). The geochemical baseline map service is free for all users via internet browser. Through this map service it is possible to calculate regional soil baseline values using geochemical data stored in the map service database. Baseline data for 17 elements in total is provided in the map service and it can be viewed on the GTK's web pages (http://gtkdata.gtk.fi/Tapir/indexEN.html).

Limited Service Availability, Readiness, and Use of Facility-Based Delivery Care in Haiti: A Study Linking Health Facility Data and Population Data

PubMed Central

Wang, Wenjuan; Winner, Michelle; Burgert-Brucker, Clara R

2017-01-01

Background: Understanding the barriers that women in Haiti face to giving birth at a health facility is important for improving coverage of facility delivery and reducing persistently high maternal mortality. We linked health facility survey data and population survey data to assess the role of the obstetric service environment in affecting women's use of facility delivery care. Methods: Data came from the 2012 Haiti Demographic and Health Survey (DHS) and the 2013 Haiti Service Provision Assessment (SPA) survey. DHS clusters and SPA facilities were linked with their geographic coordinate information. The final analysis sample from the DHS comprised 4,921 women who had a live birth in the 5 years preceding the survey. Service availability was measured with the number of facilities providing delivery services within a specified distance from the cluster (within 5 kilometers for urban areas and 10 kilometers for rural areas). We measured facility readiness to provide obstetric care using 37 indicators defined by the World Health Organization. Random-intercept logistic regressions were used to model the variation in individual use of facility-based delivery care and cluster-level service availability and readiness, adjusting for other factors. Results: Overall, 39% of women delivered their most recent birth at a health facility and 61% delivered at home, with disparities by residence (about 60% delivered at a health facility in urban areas vs. 24% in rural areas). About one-fifth (18%) of women in rural areas and one-tenth (12%) of women in nonmetropolitan urban areas lived in clusters where no facility offered delivery care within the specified distances, while nearly all women (99%) in the metropolitan area lived in clusters that had at least 2 such facilities. Urban clusters had better service readiness compared with rural clusters, with a wide range of variation in both areas. Regression models indicated that in both rural and nonmetropolitan urban areas availability of delivery services was significantly associated with women's greater likelihood of using facility-based delivery care after controlling for other covariates, while facilities' readiness to provide delivery services was also important in nonmetropolitan urban areas. Conclusion: Increasing physical access to delivery care should become a high priority in rural Haiti. In urban areas, where delivery services are more available than in rural areas, improving quality of care at facilities could potentially lead to increased coverage of facility delivery. PMID:28539502

Area-level variations in cancer care and outcomes.

PubMed

Keating, Nancy L; Landrum, Mary Beth; Lamont, Elizabeth B; Bozeman, Samuel R; McNeil, Barbara J

2012-05-01

: Substantial regional variations in health-care spending exist across the United States; yet, care and outcomes are not better in higher-spending areas. Most studies have focused on care in fee-for-service Medicare; whether spillover effects exist in settings without financial incentives for more care is unknown. : We studied care for cancer patients in fee-for-service Medicare and the Veterans Health Administration (VA) to understand whether processes and outcomes of care vary with area-level Medicare spending. : An observational study using logistic regression to assess care by area-level measures of Medicare spending. : Patients with lung, colorectal, or prostate cancers diagnosed during 2001-2004 in Surveillance, Epidemiology, and End Results (SEER) areas or the VA. The SEER cohort included fee-for-service Medicare patients aged older than 65 years. : Recommended and preference-sensitive cancer care and mortality. : In fee-for-service Medicare, higher-spending areas had higher rates of recommended care (curative surgery and adjuvant chemotherapy for early-stage non-small-cell lung cancer and chemotherapy for stage III colon cancer) and preference-sensitive care (chemotherapy for stage IV lung and colon cancer and primary treatment of local/regional prostate cancer) and had lower lung cancer mortality. In the VA, we observed minimal variation in care by area-level Medicare spending. : Our findings suggest that intensity of care for Medicare beneficiaries is not driving variations in VA care, despite some overlap in physician networks. Although the Dartmouth Atlas work has been of unprecedented importance in demonstrating variations in Medicare spending, new measures may be needed to better understand variations in other populations.

The Food Service Manager; A Study of the Need for a Food Service Management Program in Ocean County.

ERIC Educational Resources Information Center

Ocean County Coll., Toms River, NJ.

Ocean County College conducted a feasibility study for the purpose of determining whether there was a need for a food service management program within its service area and to ascertain an estimate of the potential student pool for such a program. Surveys were sent to 243 restaurants and institutions and were administered to students from county…

What Do Information Technology Support Services Really Cost?

ERIC Educational Resources Information Center

Leach, Karen; Smallen, David

1998-01-01

A study examined the cost of information-technology support services in higher education institutions. The report describes the project's origins and work to date and reports initial results in three areas: network services, desktop repair services, and administrative information systems, looking in each case at economies of scale, outsourcing…

47 CFR 101.56 - Partitioned service areas (PSAs) and disaggregated spectrum.

Code of Federal Regulations, 2013 CFR

2013-10-01

... area will be treated as a separate protected service area. (d)(1) When any area within an EA becomes a...) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Applications and Licenses License Transfers.... (a)(1) The holder of an EA authorization to provide service pursuant to the competitive bidding...

47 CFR 101.56 - Partitioned service areas (PSAs) and disaggregated spectrum.

Code of Federal Regulations, 2014 CFR

2014-10-01

... area will be treated as a separate protected service area. (d)(1) When any area within an EA becomes a...) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Applications and Licenses License Transfers.... (a)(1) The holder of an EA authorization to provide service pursuant to the competitive bidding...

47 CFR 101.56 - Partitioned service areas (PSAs) and disaggregated spectrum.

Code of Federal Regulations, 2011 CFR

2011-10-01

... area will be treated as a separate protected service area. (d)(1) When any area within an EA becomes a...) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Applications and Licenses License Transfers.... (a)(1) The holder of an EA authorization to provide service pursuant to the competitive bidding...

47 CFR 101.56 - Partitioned service areas (PSAs) and disaggregated spectrum.

Code of Federal Regulations, 2012 CFR

2012-10-01

... area will be treated as a separate protected service area. (d)(1) When any area within an EA becomes a...) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Applications and Licenses License Transfers.... (a)(1) The holder of an EA authorization to provide service pursuant to the competitive bidding...

Alabama Army Ammunition Plant, Talladega County, Alabama

DTIC Science & Technology

1995-05-10

Facility 21 5.2 Study Area 3 - Sanitary Landfill and Lead Facility 21 5.3 Study Area 4 - Manhattan Project Area 22 5.4 Study Area 5 - Red-Water Storage...were also collected and analyzed. One sample contained a low level of extractable lead. 5.3 Study Area 4 - Manhattan Project Area: Located in the...western portion of the General Services Administration area, the Manhattan Project used a small part of the ALAAP from 1943 to 1945. According to a lefter

[Impacts of land use change on ecosystem services in the agricultural area of North China Plain: A case study of Shangqiu City, Henan Province, China.

PubMed

Liu, Ya Ru; Wang, Cong; Yan, Li Jiao

2018-05-01

Under the rapid urbanization, quantitatively assessing the impacts of land use and cover change (LUCC) on ecosystem service is of great significance for regional ecological environment construction. Based on the land use maps of Shangqiu City (as the typical agricultural area of North China Plain) in the year of 1990, 2005 and 2015, the spatio-temporal dynamics of land use and ecosystem service were analyzed, and the impacts of LUCC on ecosystem services was quantified with the impact assessment model. The results showed that, from 1990 to 2015, farmland and construction land area, which covered more than 95% of the total area of the research area, changed the most in quantity as -104.38 and 201.59 km 2 respectively, while forestland, grassland and water area changed the most by 79.3%, -73.7% and -24.2%, respectively. The total value of ecosystem service continuously decreased by 1.005 billion yuan, among which the value of hydrolo-gical regulation service suffered the most. The value of ecosystem service (ESV) presented an increasing trend in the west and a decreasing trend in the east. Extending from the center of the city to the outside, the value of ecosystem services was "high-low-high" in the east to west direction. The rate of farmland and water area contributed more than 95% to the total ecosystem service value, which had the greatest impact. The main drivers for the changes of land use and ESV in Shangqiu were population pressure, economic growth, regional policy, and urban planning. In the urban and rural development planning of Shangqiu City, more attention should be paid to the protection of na-tural resources and rational adjustment of the land use structure to realize sustainable development based on the harmony of economy, society and environment.

Development of a Web-based tool to collect and display water system customer service areas for public health action.

PubMed

Wong, Michelle; Wolff, Craig; Collins, Natalie; Guo, Liang; Meltzer, Dan; English, Paul

2015-01-01

Significant illness is associated with biological contaminants in drinking water, but little is known about health effects from low levels of chemical contamination in drinking water. To examine these effects in epidemiological studies, the sources of drinking water of study populations need to be known. The California Environmental Health Tracking Program developed an online application that would collect data on the geographic location of public water system (PWS) customer service areas in California, which then could be linked to demographic and drinking water quality data. We deployed the Water Boundary Tool (WBT), a Web-based geospatial crowdsourcing application that can manage customer service boundary data for each PWS in California and can track changes over time. We also conducted a needs assessment for expansion to other states. The WBT was designed for water system operators, local and state regulatory agencies, and government entities. Since its public launch in 2012, the WBT has collected service area boundaries for about 2300 individual PWS, serving more than 90% of the California population. Results of the needs assessment suggest interest and utility for deploying such a tool among states lacking statewide PWS service area boundary data. Although the WBT data set is incomplete, it has already been used for a variety of applications, including fulfilling legislatively mandated reporting requirements and linking customer service areas to drinking water quality data to better understand local water quality issues. Development of this tool holds promise to assist with outbreak investigations and prevention, environmental health monitoring, and emergency preparedness and response.

Development of a Knowledge Management Model for the Development of a Quality Public Sector Management System for the Office of the Primary Educational Service Area

ERIC Educational Resources Information Center

Khotbancha, Wijitra; Chantarasombat, Chalard; Sriampai, Anan

2015-01-01

The objectives of this research were: 1) to study the current situation and problem of Knowledge Management of the office of the primary education service area, 2) to develop a Knowledge Management model, 3) to study the success of the implementation of the Knowledge Management system. There were 25 persons in the target group. There were 2 kinds…

Sustainability of community based family planning services: experience from rural Ethiopia.

PubMed

Genna, Shimeles; Fantahun, Mesganaw; Berhane, Yemane

2006-01-01

The important role of active Community Based Reproductive Health Services (CBRHS), formerly known us Community Based Distribution (CBD) of family planning program, in increasing contraceptive uptake has been reported from several studies. However, the sustainability of project based services has not been documented in Ethiopia. This study was conducted to assess the effectiveness and sustainability of community based Family planning services in rural communities of Ethiopia. The study was carried out in three sets of 30 peasant villages selected from five districts of Eastern Showa Zone in Ethiopia. Comparison was made between never former; and current CBRHS areas. Relevant information was collected using a structured and pre-tested questionnaire. The respondents were women in the reproductive age groups (15-49 years). Knowledge about contraception was higher in both former and current CBRHS communities as compared to never CBRHS areas [MH-OR (95% CI) = 6.89 (4.69, 10.17) and 12.48 (7.84, 20.25)], respectively. Ever use of modern contraception was significantly greater among women from former and current CBRHS communities as compared to never CBRHS communities [MH-OR (95% CI) = 3.75 (2.54, 5.97) and 5.72 (3.93, 9.39), respectively]. Current use of modern contraception methods was however significantly better only in current CBRHS areas [MH-OR (95% CI) = 2.42; (1.16, 5.37)]; there was no statistically significant difference with former CBRHS areas [MH-OR (95% CI) = 1.13; (0.51, 2.49)]. Results of this study indicate that the effect of CBRHS in raising the level of modern contraception use in rural communities is transient. In order to sustain the effects of a good community based family planning services appropriate mechanisms must be designed to motivate and enable women to continuously utilize the services.

32 CFR 1605.61 - Staff of area offices for selective service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Staff of area offices for selective service... SERVICE SYSTEM SELECTIVE SERVICE SYSTEM ORGANIZATION Area Office Administration § 1605.61 Staff of area... staff of each area office shall consist of as many compensated employees, either military or civilian...

Financial incentives for return of service in underserved areas: a systematic review

PubMed Central

Bärnighausen, Till; Bloom, David E

2009-01-01

Background In many geographic regions, both in developing and in developed countries, the number of health workers is insufficient to achieve population health goals. Financial incentives for return of service are intended to alleviate health worker shortages: A (future) health worker enters into a contract to work for a number of years in an underserved area in exchange for a financial pay-off. Methods We carried out systematic literature searches of PubMed, the Excerpta Medica database, the Cumulative Index to Nursing and Allied Health Literature, and the National Health Services Economic Evaluation Database for studies evaluating outcomes of financial-incentive programs published up to February 2009. To identify articles for review, we combined three search themes (health workers or students, underserved areas, and financial incentives). In the initial search, we identified 10,495 unique articles, 10,302 of which were excluded based on their titles or abstracts. We conducted full-text reviews of the remaining 193 articles and of 26 additional articles identified in reference lists or by colleagues. Forty-three articles were included in the final review. We extracted from these articles information on the financial-incentive programs (name, location, period of operation, objectives, target groups, definition of underserved area, financial incentives and obligation) and information on the individual studies (authors, publication dates, types of study outcomes, study design, sample criteria and sample size, data sources, outcome measures and study findings, conclusions, and methodological limitations). We reviewed program results (descriptions of recruitment, retention, and participant satisfaction), program effects (effectiveness in influencing health workers to provide care, to remain, and to be satisfied with work and personal life in underserved areas), and program impacts (effectiveness in influencing health systems and health outcomes). Results Of the 43 reviewed studies 34 investigated financial-incentive programs in the US. The remaining studies evaluated programs in Japan (five studies), Canada (two), New Zealand (one) and South Africa (one). The programs started between 1930 and 1998. We identified five different types of programs (service-requiring scholarships, educational loans with service requirements, service-option educational loans, loan repayment programs, and direct financial incentives). Financial incentives to serve for one year in an underserved area ranged from year-2000 United States dollars 1,358 to 28,470. All reviewed studies were observational. The random-effects estimate of the pooled proportion of all eligible program participants who had either fulfilled their obligation or were fulfilling it at the time of the study was 71% (95% confidence interval 60–80%). Seven studies compared retention in the same (underserved) area between program participants and non-participants. Six studies found that participants were less likely than non-participants to remain in the same area (five studies reported the difference to be statistically significant, while one study did not report a significance level); one study did not find a significant difference in retention in the same area. Thirteen studies compared provision of care or retention in any underserved area between participants and non-participants. Eleven studies found that participants were more likely to (continue to) practice in any underserved area (nine studies reported the difference to be statistically significant, while two studies did not provide the results of a significance test); two studies found that program participants were significantly less likely than non-participants to remain in any underserved area. Seven studies investigated the satisfaction of participants with their work and personal lives in underserved areas. Conclusion Financial-incentive programs for return of service are one of the few health policy interventions intended to improve the distribution of human resources for health on which substantial evidence exists. However, the majority of studies are from the US, and only one study reports findings from a developing country, limiting generalizability. The existing studies show that financial-incentive programs have placed substantial numbers of health workers in underserved areas and that program participants are more likely than non-participants to work in underserved areas in the long run, even though they are less likely to remain at the site of original placement. As none of the existing studies can fully rule out that the observed differences between participants and non-participants are due to selection effects, the evidence to date does not allow the inference that the programs have caused increases in the supply of health workers to underserved areas. PMID:19480656

A GPS coverage model

NASA Technical Reports Server (NTRS)

Skidmore, Trent A.

1994-01-01

The results of several case studies using the Global Positioning System coverage model developed at Ohio University are summarized. Presented are results pertaining to outage area, outage dynamics, and availability. Input parameters to the model include the satellite orbit data, service area of interest, geometry requirements, and horizon and antenna mask angles. It is shown for precision-landing Category 1 requirements that the planned GPS 21 Primary Satellite Constellation produces significant outage area and unavailability. It is also shown that a decrease in the user equivalent range error dramatically decreases outage area and improves the service availability.

Distribution of Employment Growth in 10 Ozark Communities. A Case Study.

ERIC Educational Resources Information Center

Oliveira, Victor J.; Kuehn, John A.

Service industries, some manufacturing, and a concentration of retirees can provide a strong economic base in a rural area. Rapid growth of service businesses, especially wholesale and retail firms and other businesses related to tourism and recreation, attracted job-seekers to a 10-county area in the Ozark Mountains of Arkansas and Missouri…

National heritage areas: examining organizational development and the role of the National Park Service as federal partner

Treesearch

Susan Martin-Williams; Steven Selin

2007-01-01

Understanding the organizational development of National Heritage Areas (NHAs) and defining the National Park Service's (NPS) role within individual NHAs guided this qualitative study. Information gained during telephone interviews led to the development of an a priori model of the evolutionary stages of NHAs' organizational development and...

Plant functional traits predict green roof ecosystem services.

PubMed

Lundholm, Jeremy; Tran, Stephanie; Gebert, Luke

2015-02-17

Plants make important contributions to the services provided by engineered ecosystems such as green roofs. Ecologists use plant species traits as generic predictors of geographical distribution, interactions with other species, and ecosystem functioning, but this approach has been little used to optimize engineered ecosystems. Four plant species traits (height, individual leaf area, specific leaf area, and leaf dry matter content) were evaluated as predictors of ecosystem properties and services in a modular green roof system planted with 21 species. Six indicators of ecosystem services, incorporating thermal, hydrological, water quality, and carbon sequestration functions, were predicted by the four plant traits directly or indirectly via their effects on aggregate ecosystem properties, including canopy density and albedo. Species average height and specific leaf area were the most useful traits, predicting several services via effects on canopy density or growth rate. This study demonstrates that easily measured plant traits can be used to select species to optimize green roof performance across multiple key services.

Sustainable sewerage servicing options for peri-urban areas with failing septic systems.

PubMed

Sharma, A K; Tjandraatmadja, G; Grant, A L; Grant, T; Pamminger, F

2010-01-01

The provision of water and wastewater services to peri-urban areas faces very different challenges to providing services to cities. Sustainable solutions for such areas are increasingly being sought, in order to solve the environmental and health risks posed by failing septic systems. These solutions should have the capability to reduce potable water demand, provide fit for purpose reuse options, and minimise impacts on the local and global environment. A methodology for the selection of sustainable sewerage servicing systems and technologies is presented in this paper. This paper describes the outcomes of applying this methodology to a case study in rural community near Melbourne, Australia, and describes the economic and environmental implications of various sewerage servicing options. Applying this methodology has found that it is possible to deliver environmental improvements at a lower community cost, by choosing servicing configurations not historically used by urban water utilities. The selected solution is currently being implemented, with the aim being to generate further transferable learnings for the water industry.

Patients’ perception of pharmaceutical services available in a community pharmacy among patients living in a rural area of the United Kingdom

PubMed Central

2016-01-01

Objective: Patients’ opinion about prevalence of pharmaceutical services available in a community pharmacy among patients living in a rural area of the United Kingdom. The secondary objective was to identify appropriate action(s) to enhance patients’ awareness of pharmaceutical services in rural areas. Methods: A self-administered, anonymous questionnaire was distributed to patients visiting a community pharmacy in Eye, Suffolk, United Kingdom between July and August, 2015. The main inclusion criterion was living in a rural area. Comparisons were performed using chi-square tests and logistic regression. Results: The study included 103 respondents: 70 women (69.0%) and 33 men (32.0%), aged 16–85 years. Most respondents declared the primary tasks of a community pharmacy were dispensing medicines (86.4% of respondents) and repeat dispensing (72.8% of respondents). Additionally, 23.3% of respondents treated minor ailments at the pharmacy, including bacterial/viral infections, minor injuries, stomach problems, and allergies. The Medicines Use Review service was the only advanced service used in this pharmacy (12.6% of respondents), primarily by men. Younger patients were more familiar with the term of pharmaceutical care (p<0.05; OR=0.33). Conclusions: Only a few pharmaceutical services are utilized by people living in rural areas in the UK, namely prescription dispensing, repeat dispensing, and sale of medications that support self-care for minor ailments. We found an overall poor awareness of the expanded variety of pharmaceutical services encouraged by the community pharmacy contract introduced in the UK in 2005. Therefore, politicians, pharmacists, and pharmacy experts should actively promote these advanced pharmaceutical services in rural areas. PMID:27785163

Identifying priority areas for ecosystem service management in South African grasslands.

PubMed

Egoh, Benis N; Reyers, Belinda; Rouget, Mathieu; Richardson, David M

2011-06-01

Grasslands provide many ecosystem services required to support human well-being and are home to a diverse fauna and flora. Degradation of grasslands due to agriculture and other forms of land use threaten biodiversity and ecosystem services. Various efforts are underway around the world to stem these declines. The Grassland Programme in South Africa is one such initiative and is aimed at safeguarding both biodiversity and ecosystem services. As part of this developing programme, we identified spatial priority areas for ecosystem services, tested the effect of different target levels of ecosystem services used to identify priority areas, and evaluated whether biodiversity priority areas can be aligned with those for ecosystem services. We mapped five ecosystem services (below ground carbon storage, surface water supply, water flow regulation, soil accumulation and soil retention) and identified priority areas for individual ecosystem services and for all five services at the scale of quaternary catchments. Planning for individual ecosystem services showed that, depending on the ecosystem service of interest, between 4% and 13% of the grassland biome was required to conserve at least 40% of the soil and water services. Thirty-four percent of the biome was needed to conserve 40% of the carbon service in the grassland. Priority areas identified for five ecosystem services under three target levels (20%, 40%, 60% of the total amount) showed that between 17% and 56% of the grassland biome was needed to conserve these ecosystem services. There was moderate to high overlap between priority areas selected for ecosystem services and already-identified terrestrial and freshwater biodiversity priority areas. This level of overlap coupled with low irreplaceability values obtained when planning for individual ecosystem services makes it possible to combine biodiversity and ecosystem services in one plan using systematic conservation planning. Copyright © 2011 Elsevier Ltd. All rights reserved.

Spatial analysis to identify hotspots of prevalence of schizophrenia.

PubMed

Moreno, Berta; García-Alonso, Carlos R; Negrín Hernández, Miguel A; Torres-González, Francisco; Salvador-Carulla, Luis

2008-10-01

The geographical distribution of mental health disorders is useful information for epidemiological research and health services planning. To determine the existence of geographical hotspots with a high prevalence of schizophrenia in a mental health area in Spain. The study included 774 patients with schizophrenia who were users of the community mental health care service in the area of South Granada. Spatial analysis (Kernel estimation) and Bayesian relative risks were used to locate potential hotspots. Availability and accessibility were both rated in each zone and spatial algebra was applied to identify hotspots in a particular zone. The age-corrected prevalence rate of schizophrenia was 2.86 per 1,000 population in the South Granada area. Bayesian analysis showed a relative risk varying from 0.43 to 2.33. The area analysed had a non-uniform spatial distribution of schizophrenia, with one main hotspot (zone S2). This zone had poor accessibility to and availability of mental health services. A municipality-based variation exists in the prevalence of schizophrenia and related disorders in the study area. Spatial analysis techniques are useful tools to analyse the heterogeneous distribution of a variable and to explain genetic/environmental factors in hotspots related with a lack of easy availability of and accessibility to adequate health care services.

Agency and market area factors affecting home health agency supply changes.

PubMed

Porell, Frank W; Liu, Korbin; Brungo, David P

2006-10-01

To use the natural experiment created by the Medicare interim payment system (IPS) to study supply change behavior of home health agencies (HHAs) in local market areas. One hundred percent Medicare home health claims for 1996 and 1999, linked with Medicare Provider of Service and Denominator files, and the Area Resource File. Medicare home health care (HHC) claims data were used to distinguish HHAs that changed the local market supply of Medicare HHC by their market exit or by significant expansion or contraction of their geographic service area between 1996 and 1999 from other HHAs. Multinomial logit models were estimated to analyze how characteristics of agencies and the market areas in which they served were associated with these different agency-level supply changes. Changes in local HHA supply stemming from geographic service area expansions and contractions rivaled those owing to agency closures and market entries. Agencies at greater risk of closure and service area contraction tended to be smaller, newer, freestanding agencies, operating with more visit-intensive practice styles in markets with more competitor agencies. Except for having much less visit-intensive practice styles, similar attributes characterized agencies that increased local supply through service area expansion. Supply changes by HHAs largely reflected rational market responses by agencies to significant changes in financial incentives associated with the Medicare IPS. Recently certified agencies were among the most dynamic providers. Supply changes were more likely among agencies operating in more competitive market environments.

HIV policy and implementation: a national policy review and an implementation case study of a rural area of northern Malawi.

PubMed

Dasgupta, Aisha N Z; Wringe, Alison; Crampin, Amelia C; Chisambo, Christina; Koole, Olivier; Makombe, Simon; Sungani, Charles; Todd, Jim; Church, Kathryn

2016-09-01

Malawi is a global leader in the design and implementation of progressive HIV policies. However, there continues to be substantial attrition of people living with HIV across the "cascade" of HIV services from diagnosis to treatment, and program outcomes could improve further. Ability to successfully implement national HIV policy, especially in rural areas, may have an impact on consistency of service uptake. We reviewed Malawian policies and guidelines published between 2003 and 2013 relating to accessibility of adult HIV testing, prevention of mother-to-child transmission and HIV care and treatment services using a policy extraction tool, with gaps completed through key informant interviews. A health facility survey was conducted in six facilities serving the population of a demographic surveillance site in rural northern Malawi to investigate service-level policy implementation. Survey data were analyzed using descriptive statistics. Policy implementation was assessed by comparing policy content and facility practice using pre-defined indicators covering service access: quality of care, service coordination and patient tracking, patient support, and medical management. ART was rolled out in Malawi in 2004 and became available in the study area in 2005. In most areas, practices in the surveyed health facilities complied with or exceeded national policy, including those designed to promote rapid initiation onto treatment, such as free services and task-shifting for treatment initiation. However, policy and/or practice were/was lacking in certain areas, in particular those strategies to promote retention in HIV care (e.g., adherence monitoring and home-based care). In some instances, though, facilities implemented alternative progressive practices aimed at improving quality of care and encouraging adherence. While Malawi has formulated a range of progressive policies aiming to promote rapid initiation onto ART, increased investment in policy implementation strategies and quality service delivery, in particular to promote long-term retention on treatment may improve outcomes further.

Mixed-method exploratory study of general practitioner and nurse perceptions of a new community based nurse-led heart failure service.

PubMed

MacKenzie, Emma; Smith, Amanda; Angus, Neil; Menzies, Sue; Brulisauer, Franz; Leslie, Stephen J

2010-01-01

The treatment of patients with chronic heart failure (CHF) remains sub-optimal. Specialist CHF nurses are proven to improve care and reduce admission but developing such services, especially in remote areas, can be difficult. This study aimed: first, to assess the perceived acceptability and effectiveness of a new community based nurse-led heart failure service by general practitioners (GPs) in an area with a dispersed population; second, to assess the knowledge and learning needs of GPs; and third, to assess perceptions of the use of national guidelines and telehealth on heart failure management. The study was conducted in the Scottish Highlands, a large geographical area in the north of the UK which includes both rural and urban populations. The area has a total population of 240 000, approximately 60% of whom are within 1 hour travel time of the largest urban centre. A postal survey of all GPs (n = 260) and structured email survey of all CHF specialist nurses (n = 3) was performed. All responses were entered into a Microsoft Excel spreadsheet, summarised and subjected to thematic analysis. Differences between GPs in 'rural', 'urban' or both 'urban & rural' was investigated using an F-test for continuous variables and a three-sample test for equality of proportions for nominal data. Questionnaires were returned from 83 GPs (32%) and all three CHF specialist nurses. In this sample there were only a few differences between GPs from 'rural', 'urban' and 'urban & rural'. There also appeared to be little difference in responses between those who had the experience of the CHF nurse service and those who had not. Overall, 32 GPs (39%) wished better, local access to echocardiography, while 63 (76%) wished access to testing for brain natriuretic peptide (BNP). Only 27 GPs (33%) referred all patients with CHF to hospital. A number of GPs stated that this was dependant on individual circumstances and the patient's ability to travel. The GPs were confident to initiate standard heart failure drugs although only 54 (65%) were confident in the initiation of beta-blockers. Most GPs (69%) had had experience of the CHF specialist nurse service and the responses were mixed. The GPs who had experienced the service appeared less confident that it would lead to reduced admission of patients to hospital (51% vs 77%, p = 0.046). Three main themes emerged from the nurse responses: service planning, communication and attitudinal changes after service embedment. This study demonstrates that a community based heart failure nurse service was not universally valued. Differences between urban and rural localities (communication) suggest that models of care derived from evidence based practice in urban areas may not be directly transferable to remote areas. Clearly, good communication among staff groups at all stages of implementation is important; however, despite best efforts and clinical trial evidence, specialist nurse services will not be welcomed by all doctors. Service providers and commissioners should be cognisant of the different roles of urban and rural GPs when designing such services. Among GPs there was a high degree of confidence with initiation and titration of drugs for heart failure with the exception of beta-blockers so clearly this is an area of ongoing educational need and support. Education and support should focus on ensuring that all doctors who care for patients with CHF have the skills and confidence to use medical therapies and specialist services as appropriate.

Quantifying and Mapping the Supply of and Demand for Carbon Storage and Sequestration Service from Urban Trees.

PubMed

Zhao, Chang; Sander, Heather A

2015-01-01

Studies that assess the distribution of benefits provided by ecosystem services across urban areas are increasingly common. Nevertheless, current knowledge of both the supply and demand sides of ecosystem services remains limited, leaving a gap in our understanding of balance between ecosystem service supply and demand that restricts our ability to assess and manage these services. The present study seeks to fill this gap by developing and applying an integrated approach to quantifying the supply and demand of a key ecosystem service, carbon storage and sequestration, at the local level. This approach follows three basic steps: (1) quantifying and mapping service supply based upon Light Detection and Ranging (LiDAR) processing and allometric models, (2) quantifying and mapping demand for carbon sequestration using an indicator based on local anthropogenic CO2 emissions, and (3) mapping a supply-to-demand ratio. We illustrate this approach using a portion of the Twin Cities Metropolitan Area of Minnesota, USA. Our results indicate that 1735.69 million kg carbon are stored by urban trees in our study area. Annually, 33.43 million kg carbon are sequestered by trees, whereas 3087.60 million kg carbon are emitted by human sources. Thus, carbon sequestration service provided by urban trees in the study location play a minor role in combating climate change, offsetting approximately 1% of local anthropogenic carbon emissions per year, although avoided emissions via storage in trees are substantial. Our supply-to-demand ratio map provides insight into the balance between carbon sequestration supply in urban trees and demand for such sequestration at the local level, pinpointing critical locations where higher levels of supply and demand exist. Such a ratio map could help planners and policy makers to assess and manage the supply of and demand for carbon sequestration.

Participation and Learning Relationships: A Service-Learning Case Study

ERIC Educational Resources Information Center

Jensen, Shawn V.; Burr, Kevin

2006-01-01

Much research has been compiled on service-learning, its benefits, and its influence on intrinsic motivation. Service-learning has been used as a method of teaching content in science education, civic education and history, business and marketing education, as well as other areas. However, a review of literature found no service-learning studies…

Mental Health and Mental Retardation Services in Nevada. Executive Summary.

ERIC Educational Resources Information Center

Kakalik, J. S.; And Others

Summarized are the findings and recommendations of a 2-year study of all major services and service delivery systems in Nevada for persons with mental health disorders, mentally retarded persons, and abusers of alcohol and other drugs. Considered are the following areas of basic service needs: prevention of the mentally handicapping conditions,…

The Impact of a Service-Learning Experience in Mentoring At-Risk Youth

ERIC Educational Resources Information Center

Wasburn-Moses, Leah; Fry, Jay; Sanders, Kari

2014-01-01

Service-learning experiences for college students are increasing in popularity. Although youth mentoring is thought to be a significant service-learning experience for students, data in this area are lacking. This study evaluates a unique school-based service-learning mentoring experience at a midsized Midwestern university. Data were collected…

Implementing Service-Learning to the Information Systems and Technology Management Program: A Study of an Undergraduate Capstone Course

ERIC Educational Resources Information Center

Wei, Kangning; Siow, Jane; Burley, Diana L.

2007-01-01

Service-learning has been identified as an extremely valuable educational tool and applied to different disciplines and areas, but literature review on service learning has indicated that service-learning is little used in Information Systems education. This paper presents our design and development of a service-learning capstone course for…

The Relationship between the Pre-Service Classroom Teachers' Techno Pedagogical Instructional Competencies and Epistemological Beliefs

ERIC Educational Resources Information Center

Yorulmaz, Alper; Can, Süleyman; Çokçaliskan, Halil

2017-01-01

The purpose of the current study is to determine the relationship between the pre-service classroom teachers' epistemological beliefs and techno pedagogical subject-area competencies. While the universe of the study is comprised of a total of 187 senior pre-service teachers attending the Department of Classroom Teacher Education in Mugla Sitki…

Blogs as a Representation of Student Experiences in a Service Learning Course

ERIC Educational Resources Information Center

Gerstenblatt, Paula

2014-01-01

Research on service learning has demonstrated positive outcomes in several areas of student learning; however, there is a scarcity of research examining the lived experiences of students. This study consisted of seventeen students from two cohorts enrolled in a service learning class working in a rural town. The current study suggests the…

Developing a quality assurance program for online services.

PubMed Central

Humphries, A W; Naisawald, G V

1991-01-01

A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas. PMID:1909197

Developing a quality assurance program for online services.

PubMed

Humphries, A W; Naisawald, G V

1991-07-01

A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas.

Relationship between race and community water and sewer service in North Carolina, USA

PubMed Central

MacDonald Gibson, Jacqueline

2018-01-01

Previous evidence has identified potential racial disparities in access to community water and sewer service in peri-urban areas adjacent to North Carolina municipalities. We performed the first quantitative, multi-county analysis of these disparities. Using publicly available data, we identified areas bordering municipalities and lacking community water and/or sewer service in 75 North Carolina counties. Logistic regression was performed to evaluate the relationship between race and access to service in peri-urban areas, controlling for population density, median home value, urban status, and percent white in the adjacent municipality. In the peri-urban areas analyzed, 67% of the population lacked community sewer service, and 33% lacked community water service. In areas other than those with no black residents, odds of having community water service (p<0.01) or at least one of the two services (p<0.05) were highest for census blocks with a small proportion of black residents and lowest in 100% black census blocks, though this trend did not hold for access to community sewer service alone. For example, odds of community water service were 85% higher in areas that were greater than 0% but less than 22% black than in 100% black areas (p<0.001). Peri-urban census blocks without black populations had the lowest odds of community water service, community sewer service, and at least one of the two services, but this difference was only statistically significant for sewer. Peri-urban areas lacking service with no black residents were wealthier than 100% black areas and areas with any percent black greater than 0%. Findings suggest two unserved groups of differing racial and socioeconomic status: (1) lower-income black populations potentially excluded from municipal services during the era of legal racial segregation and (2) higher-income non-black populations. Findings also suggest greater racial disparities in community water than community sewer services statewide. PMID:29561859

Quasi-experimental Study of Systematic Screening for Family Planning Services among Postpartum Women Attending Village Health and Nutrition Days in Jharkhand, India.

PubMed

Balasubramaniam, Sudharsanam; Kumar, Somesh; Sethi, Reena; Charurat, Elaine; Lalchandani, Kamlesh; Schuster, Anne; Sood, Bulbul

2018-01-25

Systematic screening helps increase family planning uptake through integration with other services, including immunization. Though successfully demonstrated at health facilities, this strategy has not been demonstrated in communities. This study assessed the effectiveness of systematic screening to increase postpartum family planning use during community health days in India without adversely affecting immunization services. The study was conducted during 180 individual Village Health and Nutrition Days in Jharkhand, India. All health workers were trained in postpartum family planning counseling. Intervention providers were also trained in systematic screening. 217 postpartum women aged 15-49 years participated in baseline and endline exit interviews and routine service statistics were analyzed from 2,485 facility visits at affiliated health centers. No difference in family planning service use was found in the intervention group, but significantly fewer interviewed women reported receiving family planning services at endline in the comparison group (p = 0.014). Family planning acceptance at affiliated health centers increased significantly in intervention areas (p < 0.001) but not in comparison areas, while immunization service use increased in both groups (p = 0.002 intervention, p < 0.001 comparison). The use of the postpartum systematic screening tool appears to increase acceptance of family planning services when integrated with community-based services in Jharkhand.

Timing Discrepancies of Early Intervention Hearing Services in Urban and Rural Cochlear Implant Recipients

PubMed Central

Bush, Matthew L.; Burton, Mary; Loan, Ashley; Shinn, Jennifer B.

2013-01-01

Objective The purpose of this study was to examine the timing of early intervention diagnostic and therapeutic services in cochlear implant recipients from rural and urban areas. Study design Retrospective case series review Setting Tertiary referral center Patients Cochlear implant recipients from a single comprehensive hearing institute born with severe congenital sensorineural hearing loss were examined. Timing of diagnostic and therapeutic services was examined. Intervention(s) Diagnosis, amplification, and eventual cochlear implantation for all patients in the study Main outcome measure(s) Time points of definitive diagnosis, amplification, and cochlear implantation for children from urban and rural regions were examined. Correlation analysis of distance to testing center and timing of services was also assessed. Results 40 children born with congenital hearing loss were included in the study and were diagnosed at a median age of 13 weeks after birth. Children from rural regions obtained amplification at a median age of 47.7 weeks after birth, while urban children were amplified at 26 weeks after birth. Cochlear implantation was performed at a median age of 182 weeks after birth in those from rural areas and at 104 weeks after birth in urban-dwelling patients. A linear relationship was identified between distance to the implant center and timing of hearing aid amplification (r=0.5, p=0.033) and cochlear implantation (r=0.5, p=0.016). Conclusions Children residing outside of metro areas may be at higher risk of delayed rehabilitative services and cochlear implantation than those residing in urban areas that may be closer in proximity to tertiary care centers. PMID:24136305

Patients' satisfaction with inpatient services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2011-2013

PubMed Central

Makarem, Jalil; Larijani, Bagher; Joodaki, Kobra; Ghaderi, Sahar; Nayeri, Fatemeh; Mohammadpoor, Masoud

2016-01-01

Implementation of patient feedback is considered as a critical part of effective and efficient management in developed countries. The main objectives of this study were to assess patient satisfaction with the services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, identify areas of patient dissatisfaction, and find ways to improve patient satisfaction with hospital services. This cross-sectional study was conducted in 3 phases. After 2 initial preparation phases, the valid instrument was applied through telephone interviews with 21476 participants from 26 hospitals during August, 2011 to February, 2013.Using the Satisfaction Survey tool, information of patient's demographic characteristics were collected and patient satisfaction with 15 areas of hospital services and the intent to return the same hospitals were assessed. The mean score of overall satisfaction with hospital services was 16.86 ± 2.72 out of 20. It was found that 58% of participants were highly satisfied with the services provided. Comparison of mean scores showed physician and medical services (17.75 ± 4.02), laboratory and radiology services (17.67 ± 3.66), and privacy and religious issues (17.55 ± 4.32) had the highest satisfaction. The patients were the most dissatisfied with the food services (15.50 ± 5.54). It was also found that 83.7% of the participants intended to return to the same hospital in case of need, which supported the measured satisfaction level. Patient satisfaction in hospitals affiliated to Tehran University of Medical Sciences was high. It seems that the present study, with its large sample size, has sufficient reliability to express the patient satisfaction status. Moreover, appropriate measures should be taken in some areas (food, cost, and etc.) to increase patient satisfaction. PMID:27471589

78 FR 21343 - New Ski Area Water Rights Clause

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-10

... DEPARTMENT OF AGRICULTURE Forest Service New Ski Area Water Rights Clause AGENCY: Forest Service... initial public input on a new water rights clause for ski area permits issued by the Forest Service. There... comments and suggestions that the Forest Service will consider in developing a new ski area water rights...

Visual resource inventory and Imnaha Valley study: Hells Canyon National Recreation Area

Treesearch

David H. Blau; Michael C. Bowie; Frank Hunsaker

1979-01-01

Hells Canyon National Recreation Area was established by an Act of Congress in December 1975. At that time, the U.S. Forest Service, which administers most of the land included, was given the responsibility of developing a Comprehensive Management Plan for the NRA within five years. In order to minimize future visual degradation, the Forest Service planning team for...

The role of an NHS library service in the UK: the perceptions of clinical managers in Portsmouth, UK.

PubMed

Blagden, Pauline

2007-06-01

Portsmouth NHS Library Service is exploring methods of raising its profile within its host organization and wishes to demonstrate its contribution to achieving organizational goals, perhaps by means of an impact study. The objective of this small scale study, regarded as a possible precursor to an impact study, was to identify areas where there is potential to increase awareness among clinical managers of the Library's contribution. An e-mail survey was sent to clinical managers to elicit their opinions regarding the contribution of the Library Service to organizational goals. Perhaps unsurprisingly, the role of the Library Service in education, research and effectiveness was most widely recognized. Of responses, 30/42 (71%) rated it as 'very important' and a further 11 (26%) rated it as 'important'. The low appreciation of the Library Service to Clinical Services is a disappointment in view of the body of research evidence. Only 12 respondents (29%) thought that the Library Service contributed 'significantly' by 'supporting informed and timely clinical decision making'. The study suggested areas where there might be scope to raise awareness of the Library contribution. In considering how best to achieve this, the benefits need to be weighed against the resource implications. Portsmouth NHS Library Service decided to increase its marketing efforts but not to carry out an impact study in the short term.

Long-duration drought variability and impacts on ecosystem services: A case study from Glacier National Park, Montana

USGS Publications Warehouse

Pederson, Gregory T.; Gray, Stephen T.; Fagre, Daniel B.; Graumlich, Lisa J.

2006-01-01

Using a suite of paleoproxy reconstructions and information from previous studies examining the relationship between climate variability and natural processes, the authors explore how such persistent moisture anomalies affect the delivery of vital goods and services provided by Glacier NP and surrounding areas. These analyses show that regional water resources and tourism are particularly vulnerable to persistent moisture anomalies in the Glacier NP area. Many of these same decadal-scale wet and dry events were also seen among a wider network of hydroclimatic reconstructions along a north–south transect of the Rocky Mountains. Such natural climate variability can, in turn, have enormous impacts on the sustainable provision of natural resources over wide areas. Overall, these results highlight the susceptibility of goods and services provided by protected areas like Glacier NP to natural climate variability, and show that this susceptibility will likely be compounded by the effects of future human-induced climate change.

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

PubMed

Dyson, Kate; Kruger, Estie; Tennant, Marc

2012-12-01

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

Characteristics of HIV-infected adults in the Deep South and their utilization of mental health services: A rural vs. urban comparison.

PubMed

Reif, Susan; Whetten, Kathryn; Ostermann, Jan; Raper, James L

2006-01-01

Insufficient utilization of mental health services has been described among HIV-infected individuals in urban areas; however, little is known about utilization of mental health services among rural-living HIV-infected individuals. This article examines use of mental health services by HIV-infected adults in the Southern U.S., where approximately two-thirds of rural HIV cases reside, and compares mental health services use between those in rural and urban areas. Data were obtained from surveys of HIV-infected individuals receiving care at tertiary Infectious Diseases clinics in the Southern U.S. (n = 474). Study findings indicated that participants living in areas with a higher proportion of rural-living individuals were less likely to report seeing a mental health provider (p < .001) in the last year even though there were no differences in level of psychological distress by degree of rurality. Participants living in more rural areas also reported significantly fewer mental health visits in the previous month (p = .025). Furthermore, rural living was significantly associated with being African-American, heterosexual, less educated, and having minor children in the home. Due to differences in characteristics and mental health services use by degree of rurality, efforts are needed to assess and address the specific mental health and other needs of HIV-infected individuals in rural areas.

43 CFR 5.1 - Areas administered by U.S. Fish and Wildlife Service or National Park Service.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Wildlife Service or National Park Service. 5.1 Section 5.1 Public Lands: Interior Office of the Secretary... JURISDICTION OF THE DEPARTMENT OF THE INTERIOR § 5.1 Areas administered by U.S. Fish and Wildlife Service or... track made on any area administered by the U.S. Fish and Wildlife Service or the National Park Service...

43 CFR 5.1 - Areas administered by U.S. Fish and Wildlife Service or National Park Service.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Wildlife Service or National Park Service. 5.1 Section 5.1 Public Lands: Interior Office of the Secretary... JURISDICTION OF THE DEPARTMENT OF THE INTERIOR § 5.1 Areas administered by U.S. Fish and Wildlife Service or... track made on any area administered by the U.S. Fish and Wildlife Service or the National Park Service...

43 CFR 5.1 - Areas administered by U.S. Fish and Wildlife Service or National Park Service.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Wildlife Service or National Park Service. 5.1 Section 5.1 Public Lands: Interior Office of the Secretary... JURISDICTION OF THE DEPARTMENT OF THE INTERIOR § 5.1 Areas administered by U.S. Fish and Wildlife Service or... track made on any area administered by the U.S. Fish and Wildlife Service or the National Park Service...

A Collaborative Approach for Scoping Ecosystem Services with Stakeholders: The Case of Arrábida Natural Park.

PubMed

Lopes, Rita; Videira, Nuno

2016-08-01

This paper presents an innovative approach for conducting collaborative scoping processes aiming to elicit multiple values of ecosystem services. The proposed methodology rests on three steps combining different participatory tools that promote a comprehensive examination of the perceptions hold by relevant stakeholder groups. The first step consists of an institutional and stakeholder analysis developed in the study area. The second includes a participatory workshop, where a sequence of scoping exercises is conducted with the active collaboration of the invited stakeholders. The final step aims to validate scoping results and develop dependency networks between organizations and the identified ecosystem services. The approach was tested in the Arrábida Natural Park, a marine and coastal protected area in Portugal. Invited participants were able to identify an extensive list of ecosystem services in the natural area, establish linkages between those services and human wellbeing, identify drivers of change and perform a preliminary screening of the associated ecological, social, and economic values. The case study evaluation provided positive feedback on the usefulness of the approach, which advances the existing set of methods for participatory identification of ecosystem services and sets the scene for involvement of stakeholder groups in assessment and management processes.

A Collaborative Approach for Scoping Ecosystem Services with Stakeholders: The Case of Arrábida Natural Park

NASA Astrophysics Data System (ADS)

Lopes, Rita; Videira, Nuno

2016-08-01

This paper presents an innovative approach for conducting collaborative scoping processes aiming to elicit multiple values of ecosystem services. The proposed methodology rests on three steps combining different participatory tools that promote a comprehensive examination of the perceptions hold by relevant stakeholder groups. The first step consists of an institutional and stakeholder analysis developed in the study area. The second includes a participatory workshop, where a sequence of scoping exercises is conducted with the active collaboration of the invited stakeholders. The final step aims to validate scoping results and develop dependency networks between organizations and the identified ecosystem services. The approach was tested in the Arrábida Natural Park, a marine and coastal protected area in Portugal. Invited participants were able to identify an extensive list of ecosystem services in the natural area, establish linkages between those services and human wellbeing, identify drivers of change and perform a preliminary screening of the associated ecological, social, and economic values. The case study evaluation provided positive feedback on the usefulness of the approach, which advances the existing set of methods for participatory identification of ecosystem services and sets the scene for involvement of stakeholder groups in assessment and management processes.

Microbial Air Quality and Bacterial Surface Contamination in Ambulances During Patient Services

PubMed Central

Luksamijarulkul, Pipat; Pipitsangjan, Sirikun

2015-01-01

Objectives We sought to assess microbial air quality and bacterial surface contamination on medical instruments and the surrounding areas among 30 ambulance runs during service. Methods We performed a cross-sectional study of 106 air samples collected from 30 ambulances before patient services and 212 air samples collected during patient services to assess the bacterial and fungal counts at the two time points. Additionally, 226 surface swab samples were collected from medical instrument surfaces and the surrounding areas before and after ambulance runs. Groups or genus of isolated bacteria and fungi were preliminarily identified by Gram’s stain and lactophenol cotton blue. Data were analyzed using descriptive statistics, t-test, and Pearson’s correlation coefficient with a p-value of less than 0.050 considered significant. Results The mean and standard deviation of bacterial and fungal counts at the start of ambulance runs were 318±485cfu/m3 and 522±581cfu/m3, respectively. Bacterial counts during patient services were 468±607cfu/m3 and fungal counts were 656±612cfu/m3. Mean bacterial and fungal counts during patient services were significantly higher than those at the start of ambulance runs, p=0.005 and p=0.030, respectively. For surface contamination, the overall bacterial counts before and after patient services were 0.8±0.7cfu/cm2 and 1.3±1.1cfu/cm2, respectively (p<0.001). The predominant isolated bacteria and fungi were Staphylococcus spp. and Aspergillus spp., respectively. Additionally, there was a significantly positive correlation between bacterial (r=0.3, p<0.010) and fungal counts (r=0.2, p=0.020) in air samples and bacterial counts on medical instruments and allocated areas. Conclusions This study revealed high microbial contamination (bacterial and fungal) in ambulance air during services and higher bacterial contamination on medical instrument surfaces and allocated areas after ambulance services compared to the start of ambulance runs. Additionally, bacterial and fungal counts in ambulance air showed a significantly positive correlation with the bacterial surface contamination on medical instruments and allocated areas. Further studies should be conducted to determine the optimal intervention to reduce microbial contamination in the ambulance environment. PMID:25960835

45 CFR 1321.65 - Responsibilities of service providers under area plans.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING Service Requirements § 1321.65... area agency on aging shall assure that providers of services shall: (a) Provide the area agency, in a...

45 CFR 1321.65 - Responsibilities of service providers under area plans.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING Service Requirements § 1321.65... area agency on aging shall assure that providers of services shall: (a) Provide the area agency, in a...

45 CFR 1321.65 - Responsibilities of service providers under area plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING Service Requirements § 1321.65... area agency on aging shall assure that providers of services shall: (a) Provide the area agency, in a...

45 CFR 1321.65 - Responsibilities of service providers under area plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING Service Requirements § 1321.65... area agency on aging shall assure that providers of services shall: (a) Provide the area agency, in a...

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

ERIC Educational Resources Information Center

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

2018-01-01

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

Projects That Matter: Concepts and Models for Service-Learning in Engineering. AAHE's Series on Service-Learning in the Disciplines.

ERIC Educational Resources Information Center

Tsang, Edmund, Ed.

This volume, the 14th in a series of monographs on service learning and academic disciplinary areas, is designed as a practical guide for faculty seeking to integrate service learning into an engineering course. The volume also deals with larger issues in engineering education and provides case studies of service-learning courses. The articles…

Rationing is a reality in rural physiotherapy: a qualitative exploration of service level decision-making.

PubMed

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

2015-03-27

Deciding what health services are provided is a key consideration in delivering appropriate and accessible health care for rural and remote populations. Despite residents of rural communities experiencing poorer health outcomes and exhibiting higher health need, workforce shortages and maldistribution mean that rural communities do not have access to the range of services available in metropolitan centres. Where demand exceeds available resources, decisions about resource allocation are required. A qualitative approach enabled the researchers to explore participant perspectives about decisions informing rural physiotherapy service provision. Stakeholder perspectives were obtained through surveys and in-depth interviews. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of rural, regional and remote communities. Thirty-nine surveys were received from participants in eleven communities. Nineteen in-depth interviews were conducted with physiotherapist and key decision-makers. Increasing demand, organisational priorities, fiscal austerity measures and workforce challenges were identified as factors influencing both decision-making and service provision. Rationing of physiotherapy services was common to all sites of this study. Rationing of services, more commonly expressed as service prioritisation, was more evident in responses of public sector physiotherapy participants compared to private physiotherapists. However, private physiotherapists in rural areas reported capacity limits, including expertise, space and affordability that constrained service provision. The imbalance between increasing service demands and limited physiotherapy capacity meant making choices was inevitable. Decreased community access to local physiotherapy services and increased workforce stress, a key determinant of retention, are two results of such choices or decisions. Decreased access was particularly evident for adults and children requiring neurological rehabilitation and for people requiring post-acute physiotherapy. It should not be presumed that rural private physiotherapy providers will cover service gaps that may emerge from changes to public sector service provision. Clinician preference combines with capacity limits and the imperative of financial viability to negate such assumptions. This study provides insight into rural physiotherapy service provision not usually evident and can be used to inform health service planning and decision-making and education of current and future rural physiotherapists.

Library Services for State Government; An Evaluation of the Resources of the Oregon State Library.

ERIC Educational Resources Information Center

Hill, Mildred M.

This study outlines the types of library service required to furnish quality reference services to state agencies. The services provided by the Oregon State Library were evaluated according to the standards established by the American Library Association. Evaluation of the collection for scope and coverage in subject areas of automation,…

The Relationship between Pre-Service Teachers' Lifelong Learning Tendencies and Teaching Profession Anxiety Levels

ERIC Educational Resources Information Center

Özen, Rasit; Öztürk, Duygu Saniye

2016-01-01

The present study aims to examine the relationship between pre-service teachers' lifelong learning tendencies and teaching profession anxiety levels with respect to certain variables (their gender and subject area) and is designed as a survey study. The fourth year pre-service teachers (n=455) in the spring semester of the 2015-2016 academic year…

A Comparative Study of Pre-Service Education for Preschool Teachers in China and the United States

ERIC Educational Resources Information Center

Gong, Xin; Wang, Pengcheng

2017-01-01

This study provides a comparative analysis of the pre-service education system for preschool educators in China and the United States. Based on collected data and materials (literature, policy documents, and statistical data), we compare two areas of pre-service training: (1) the formal system; (2) the informal system. In the formal system, most…

Satisfaction with primary care and mental health care among individuals with severe mental illness in a rural area: a seven-year follow-up study of a clinical cohort.

PubMed

Ruud, Torleif; Aarre, Trond F; Boeskov, Berit; le Husevåg, Per Stå; Klepp, Rigmor; Kristiansen, Synnøve Alet; Sandvik, Jorunn

2016-01-01

Most studies of services for people with severe mental illness have been performed in cities. Our 7-year follow-up study aimed to investigate clinical course and satisfaction with services among individuals with severe mental illness who received community mental health services in a rural area. The services were provided by primary care and a community mental health center (CMHC), which worked in close collaboration and emphasized individually tailored case management, relationship-building and continuity of care. All 57 patients with severe mental illness who were seen by the CMHC in 1992-1993 and were still alive in 1999 were asked to participate. Retrospective ratings were performed for the first month of contact in 1992-1993 based on patient records and detailed notes. A semi-structured interview was conducted in 1999-2000 with the 40 patients (70.2 %) who gave written consent to participate in the study. DSM-IV diagnoses were made using OPCRIT. The retrospective baseline ratings and the follow-up interview included assessments of symptoms and functioning using the following instruments: the Brief Psychiatric Rating Scale Expanded version 4 (BPRS-E), the Health of the Nation Outcome Scales (HoNOS), the Global Assessment of Functioning Scale (split version), and the Practical and Social Functioning Scale (PSF). The ratings revealed improvements in psychiatric problems and functioning. Patients with schizophrenia spectrum disorders improved primarily in psychotic symptoms, while patients with severe affective disorders improved primarily in affective symptoms. Large variations in the use of primary care and mental health services were observed, with more intensive specialized mental health services for individuals with schizophrenia spectrum disorders than severe affective disorders. Overall, the patients were satisfied with the provided services. They were most satisfied with GPs and more satisfied with local outpatient and inpatient services than with hospital inpatient services and medication. Patients with severe mental illness in a rural area value local services that emphasize relationships and close collaborations among the CMHC, GPs and primary health and social care. Even in an area with a fairly well-staffed CMHC, the highest patient satisfaction was reported for GPs, indicating the potential key role of GPs for this patient group.

Web Based Rapid Mapping of Disaster Areas using Satellite Images, Web Processing Service, Web Mapping Service, Frequency Based Change Detection Algorithm and J-iView

NASA Astrophysics Data System (ADS)

Bandibas, J. C.; Takarada, S.

2013-12-01

Timely identification of areas affected by natural disasters is very important for a successful rescue and effective emergency relief efforts. This research focuses on the development of a cost effective and efficient system of identifying areas affected by natural disasters, and the efficient distribution of the information. The developed system is composed of 3 modules which are the Web Processing Service (WPS), Web Map Service (WMS) and the user interface provided by J-iView (fig. 1). WPS is an online system that provides computation, storage and data access services. In this study, the WPS module provides online access of the software implementing the developed frequency based change detection algorithm for the identification of areas affected by natural disasters. It also sends requests to WMS servers to get the remotely sensed data to be used in the computation. WMS is a standard protocol that provides a simple HTTP interface for requesting geo-registered map images from one or more geospatial databases. In this research, the WMS component provides remote access of the satellite images which are used as inputs for land cover change detection. The user interface in this system is provided by J-iView, which is an online mapping system developed at the Geological Survey of Japan (GSJ). The 3 modules are seamlessly integrated into a single package using J-iView, which could rapidly generate a map of disaster areas that is instantaneously viewable online. The developed system was tested using ASTER images covering the areas damaged by the March 11, 2011 tsunami in northeastern Japan. The developed system efficiently generated a map showing areas devastated by the tsunami. Based on the initial results of the study, the developed system proved to be a useful tool for emergency workers to quickly identify areas affected by natural disasters.

Service contacts prior to death in people dying by suicide in the Scottish Highlands.

PubMed

Stark, Cameron R; Vaughan, Susan; Huc, Sara; O'Neill, Noelle

2012-01-01

Many people who die by suicide have been in contact with health services prior to their death. This study examined service contacts in people in urban and rural areas of the Scottish Highlands. Highland residents dying by suicide or undetermined intent in 2001-2004 were identified using routine death records. Health service databases were searched to identify general hospital, mental health and general practice notes. 177 residents died in the time period (136 males). At least one type of record was identified on 175 people, including general practice records (167 people, 94.4%), psychiatric hospital records (n=87, 49.2%) and general hospital records (n=142, 80.2%). Of these, 52.5% had been in contact with at least one health service in the month before their death, including 18.6% with mental health services, and 46.4% with general practice. In total, 68.9% had a previous diagnosis of mental illness, 52.5% of substance misuse problems, and 40.1% of self-harm. The commonest mental illness diagnosis was depression (n=97, 54.8%). There was no difference in rates of GP contact in rural and urban areas. Of those dying in urban areas, 32% had been in contact with mental health services in the previous month, compared with 21% in Accessible Rural/Accessible Small Towns, and 11% in Remote Rural/Remote Small Towns (p<0.01). People in rural areas were less likely to have had contact with mental health services in the year before their death (p<0.01), and to have had lower recorded lifetime rates of mental health service contact (p<0.001), deliberate self-harm (p<0.005) and mental illness (p<0.001). Overall service contact rates prior to death by suicide were very similar to the results of a previous meta-analysis. Rates of contact with specialist mental health services were significantly lower in rural than urban areas, and this finding increased with greater rurality.

Evaluation of municipal solid waste management in egyptian rural areas.

PubMed

El-Messery, Mamdouh A; Ismail, Gaber A; Arafa, Anwaar K

2009-01-01

A two years study was conducted to evaluate the solid waste management system in 143 villages representing the Egyptian rural areas. The study covers the legal responsibilities, service availability, environmental impacts, service providers, financial resources, private sector participation and the quality of collection services. According to UN reports more than 55% of Egyptian population lives in rural areas. A drastic change in the consumption pattern altered the quantity and quality of the generated solid wastes from these areas. Poor solid waste management systems are stigmata in most of the Egyptian rural areas. This causes several environmental and health problems. It has been found that solid waste collection services cover only 27% of the surveyed villages, while, the statistics show that 75% of the surveyed villages are formally covered. The service providers are local villager units, private contractors and civil community associations with a percentage share 71%, 24% and 5% respectively. The operated services among these sectors were 25%, 71% and 100% respectively. The share of private sector in solid waste management in rural areas is still very limited as a result of the poverty of these communities and the lack of recyclable materials in their solid waste. It has been found that direct throwing of solid waste on the banks of drains and canals as well as open dumping and uncontrolled burning of solid waste are the common practice in most of the Egyptian rural areas. The available land for landfill is not enough, pitiable designed, defectively constructed and unreliably operated. Although solid waste generated in rural areas has high organic contents, no composting plant was installed. Shortage in financial resources allocated for valorization of solid waste management in the Egyptian rural areas and lower collection fees are the main points of weakness which resulted in poor solid waste management systems. On the other hand, the farmer's participation in solid waste management through the composting of organic matter and using of food waste as an animal feed are considered strength points. However, throwing of solid waste on the banks of water streams, open dumping and uncontrolled burning of solid waste are environmental damaging behaviors that need to be changed. Integrated solid waste management in the Egyptian rural areas is not yet among the priorities of the Egyptian government.

Hospitals in rural or remote areas: An exploratory review of policies in 8 high-income countries.

PubMed

Rechel, Bernd; Džakula, Aleksandar; Duran, Antonio; Fattore, Giovanni; Edwards, Nigel; Grignon, Michel; Haas, Marion; Habicht, Triin; Marchildon, Gregory P; Moreno, Antonio; Ricciardi, Walter; Vaughan, Louella; Smith, Tina Anderson

2016-07-01

Our study reviewed policies in 8 high-income countries (Australia, Canada, United States, Italy, Spain, United Kingdom, Croatia and Estonia) in Europe, Australasia and North America with regard to hospitals in rural or remote areas. We explored whether any specific policies on hospitals in rural or remote areas are in place, and, if not, how countries made sure that the population in remote or rural areas has access to acute inpatient services. We found that only one of the eight countries (Italy) had drawn up a national policy on hospitals in rural or remote areas. In the United States, although there is no singular comprehensive national plan or vision, federal levers have been used to promote access in rural or remote areas and provide context for state and local policy decisions. In Australia and Canada, intermittent policies have been developed at the sub-national level of states and provinces respectively. In those countries where access to hospital services in rural or remote areas is a concern, common challenges can be identified, including the financial sustainability of services, the importance of medical education and telemedicine and the provision of quick transport to more specialized services. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Towards social inclusion through lifelong learning in mental health: analysis of change in the lives of the EMILIA project service users.

PubMed

Ramon, Shulamit; Griffiths, Christopher A; Nieminen, Irja; Pedersen, Marialouise; Dawson, Ian

2011-05-01

The application of formal lifelong learning to enhance social inclusion in mental health is rarely investigated in terms of change in the lives of service users on a cross-country comparative scale. This study was aimed at examining changes in key areas of the lives of mental health service users across eight European mental health sites. A before and after case study design was applied. Users of mental health services who participated in the lifelong leaning interventions reviewed the changes in key areas of their lives at baseline and 10 months later, through the thematic analysis of qualitative data collected in semi-structured interviews (27 and 21, respectively) and self-reports (138 and 99, respectively). In-depth examples from one site are provided. Most users reported positive changes in the areas of training and social networks, with a sizeable minority moving onto unpaid and paid employment. In addition most users reported active planning for job search and other goals. Obstacles that were highlighted included the negative effects of having a mental illness, difficulties in close relationships and economic disadvantages. The lifelong learning intervention offered within an EU Framework 6 project to mental health service users in eight demonstration sites had a largely positive impact on key areas of their lives at 10 months, though obstacles remained which may be less amenable to change by social interventions.

47 CFR 90.745 - Phase I licensee service areas.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Phase I licensee service areas. 90.745 Section... 220-222 MHz Band § 90.745 Phase I licensee service areas. (a) A Phase I licensee's service area shall... its license to relocate its initially authorized base station. The Phase I licensee's predicted 38 dBu...

47 CFR 54.806 - Calculation by the Administrator of interstate access universal service support for areas served...

Code of Federal Regulations, 2010 CFR

2010-10-01

... access universal service support for areas served by price cap local exchange carriers. 54.806 Section 54... Administrator of interstate access universal service support for areas served by price cap local exchange... calculate the Interstate Access Universal Service Support for areas served by price cap local exchange...

A Study of the Views of Information Technologies Teachers Regarding In-Service Training

ERIC Educational Resources Information Center

Arslan, Halit; Sahin, Ismail; Akturk, Ahmet Oguz; Celik, Ismail

2014-01-01

Today, the means of following the developments in the area of science and technology is to keep up with the pace of the advancements in this area. As is in every profession, apart from their personal efforts, the training of teachers in the period after they start their careers is only possible through in-service training. The aim of the present…

Disparities in the use of mobile phone for seeking childbirth services among women in the urban areas: Bangladesh Urban Health Survey.

PubMed

Bishwajit, Ghose; Hoque, Md Rakibul; Yaya, Sanni

2017-12-29

In Bangladesh, similar to its other South Asian counterparts, shortage of health workers along with inadequate infrastructure constitute some of the major obstacles for the equitable provision of reproductive healthcare services, particularly among the marginalized and underserved neighbourhoods. However, given the rapidly expanding broadband communication and mobile phone market in the country, the application of eHealth and mHealth technologies offer a window of opportunities to minimise the impact of socioeconomic barriers and promote the utilization of maternal healthcare services thereby. In the present study we aimed to investigate 1) the prevalence of usage of mobile phones for seeking childbirth services, 2) neighbourhood and socioeconomic disparities in the use, and 3) association between using mobile phones and the uptake of postnatal care among mothers and neonates. Data for the present study came from Bangladesh Urban Health Survey 2013. Study subjects were 9014 married women aged between 15 and 49 years. The overall rate of use of mobile phone was highest in City Corporation non-Slum areas (16.2%) and lowest in City Corporation Slum areas (7.4%). The odds of using mobile for seeking childbirth services were significantly higher among those who were living in non-slum areas, and lower among those who never attended school and lived in poorer households. Results also indicated that women in the slum areas who used mobile phone for childbirth service seeking, were 4.3 times [OR = 4.250;95% CI = 1.856-9.734] more likely to receive postnatal care for themselves, and those from outside the city-corporation areas were 2.7 times [OR = 2.707;95% CI = 1.712-4.279] more likely to receive postnatal care for the newborn. Neighbourhood, educational and economic factors were significantly associated with the mobile phone utilization status among urban women. Promoting access to better education and sustainable income earning should be regarded as an integral part to the expansion of mHealth for maternal healthcare seeking behaviour.

Delayed increase in male suicide rates in tsunami disaster-stricken areas following the great east japan earthquake: a three-year follow-up study in Miyagi Prefecture.

PubMed

Orui, Masatsugu; Sato, Yasuhiro; Tazaki, Kanako; Kawamura, Ikuko; Harada, Shuichiro; Hayashi, Mizuho

2015-03-01

Devastating natural disasters and their aftermath are known to cause psychological distress. However, little information is available regarding suicide rates following tsunami disasters that destroy regional social services and networks. The aim of the present study was to determine whether the tsunami disaster following the Great East Japan Earthquake in March 2011 has influenced suicide rates. The study period was from March 2009 to February 2014. Tsunami disaster-stricken areas were defined as the 16 municipalities facing the Pacific Ocean in Miyagi Prefecture. Inland areas were defined as other municipalities in Miyagi that were damaged by the earthquake. Suicide rates in the tsunami disaster-stricken areas were compared to national averages, using a time-series analysis and the Poisson distribution test. In tsunami disaster-stricken areas, male suicide rates were significantly lower than the national average during the initial post-disaster period and began to increase after two years. Likewise, male suicide rates in the inland areas decreased for seven months, and then increased to exceed the national average. In contrast, female post-disaster suicide rates did not change in both areas compared to the national average. Importantly, the male suicide rates in the inland areas started to increase earlier compared to the tsunami-stricken areas, which may reflect the relative deficiency of mental healthcare services in the inland areas. Considering the present status that many survivors from the tsunami disaster still live in temporary housing and face various challenges to rebuild their lives, we should continue intensive, long-term mental healthcare services in the tsunami-stricken areas.

7 CFR 27.11 - Area Director, Marketing Services Office; responsibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Area Director, Marketing Services Office... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY... Regulations Administration § 27.11 Area Director, Marketing Services Office; responsibility. Subject to this...

Evaluating the impact of social franchising on family planning use in Kenya.

PubMed

Chakraborty, Nirali M; Mbondo, Mwende; Wanderi, Joyce

2016-06-18

In Kenya, as in many low-income countries, the private sector is an important component of health service delivery and of providing access to preventive and curative health services. The Tunza Social Franchise Network, operated by Population Services Kenya, is Kenya's largest network of private providers, comprising 329 clinics. Franchised clinics are only one source of family planning (FP), and this study seeks to understand whether access to a franchise increases the overall use or provides another alternative for women who would have found FP services in the public sector. A quasi-experimental study compared 50 catchment areas where there is a Tunza franchise and no other franchised provider with 50 purposively matched control areas within 20 km of each selected Tunza area, with a health facility, but no franchised facility. Data from 5609 women of reproductive age were collected on demographic and socioeconomic status, FP use, and care-seeking behavior. Multivariate logistic regression, with intervention and control respondents matched using coarsened exact matching, was conducted. Overall modern contraceptive use in this population was 53 %, with 24.8 % of women using a long-acting or permanent method (LAPM). There was no significant difference in odds of current or new FP use by group, adjusted for age. However, respondents in Tunza catchment areas are significantly more likely to be LAPM users (adj. OR = 1.49, p = 0.015). Further, women aged 18-24 and 41-49 in Tunza catchment areas have a significantly higher marginal probability of LAPM use than those in control areas. This study indicates that access to a franchise is correlated with access to and increased use of LAPMs, which are more effective, and cost-effective, methods of FP. While franchised facilities may provide additional points of access for FP and other services, the presence of the franchise does not, in and of itself, increase the use of FP in Kenya.

Assessing the changes in land use and ecosystem services in an oasis agricultural region of Yanqi Basin, Northwest China.

PubMed

Wang, Shuixian; Wu, Bin; Yang, Pengnian

2014-12-01

The Yanqi Basin, one of the most productive agricultural areas, has a high population density in Xinjiang, Northwest China. Land use changes, mainly driven by oasis expansion, significantly impact ecosystem services and functions, but these effects are difficult to quantify. The valuation of ecosystem services is important to clarify the ecological and environmental changes caused by agriculturalization of oasis. This study aimed to investigate variations in ecosystem services in response to land use changes during oasis agricultural expansion activities in the Yanqi Basin from 1964 to 2009. The methods used were based on formula of ecosystem service value (ESV) and ESV coefficients. Satellite data were combined with the ESV coefficients to quantify land use changes and ecosystem service changes in the study area. Sensitivity analysis determined the effect of manipulating the coefficients on the estimated values. The results show that the total ESVs in the Yanqi Basin were $1,674, $1,692, $1,471, $1,732, and $1,603 million in 1964, 1973, 1989, 1999, and 2009, respectively. The net deline in ESV was $71 million in the past 46 years, but the ESVs of each types of landscape changed significantly. The aggregated ESVs of water areas and wetlands were approximately 80 % of the total ESV. Water supply and waste treatment were the two largest service functions and contributed approximately 65 % of the total ESV. The estimated ESVs in this study were elastic with respect to the value coefficients. Therefore, the estimations were robust in spite of uncertainties on the value coefficients. These significant changes in land use occur within the entire basin over the study period. These changes cause environmental problems, such as land degradation, vegetation degeneracy, and changes in aquatic environment.

Environmental Inventory Upper Cumberland River, Harlan, Kentucky.

DTIC Science & Technology

1981-12-01

presents a vicini- ty map for the area. The nearest major city is Knoxville, Tennessee, approxi- mately 140 miles southwest of the study area. Corbin...Harlan study area lies within the Cumberland Mountains section of the Ap- palachian Plateau Physiographic Province. This section has a topography typi...or unpublished mapping was available, instead a specific soils survey of the study area was implemented by the Soil Conser- vation Service (SCS) office

Influence of psychiatric morbidity and sociodemographic determinants on use of service in a catchment area in the city of São Paulo, Brazil.

PubMed

Andrade, Laura Helena; Viana, Maria Carmen; Tófoli, Luis Fernando Farah; Wang, Yuan-Pang

2008-01-01

Recent population-based studies in Latin American and the Caribbean (LAC) countries brought evidence of the growing burden of mental illness in this region. The objective of this study is to examine determinants of health service utilization by individuals with psychiatric disorders in a defined area in the city of São Paulo, Brazil. Data were derived from São Paulo Catchment Area Study (SP-ECA), a cross-sectional household prevalence survey, based on a representative adult sample (N=1,464) living in two defined boroughs. The psychiatric diagnosis was assessed through the CIDI 1.1 interview, yielding ICD-10 diagnoses. The past-month use of health services--for general medical (GM) care and mental health (MH) care sectors--was investigated in their relationship with sociodemographic features, insurance coverage, GM conditions, and psychiatric morbidity. Nearly one-third (32.2%) of the total sample used health services in the last month: 29.0% attended GM care and 7.8% used MH care. Logistic regression models showed that being female, older than 60 years, having private insurance coverage, and presence of psychiatric morbidity increased the level GM care seeking in the total sample. For those with 12-month psychiatric disorders, the determinants for GM sector use were female gender, age 45-59 years old, and private insurance coverage, whereas separated, divorced, or widowed women had the highest odds (OR 9.9; 95% CI: 2.7-36.5) for using MH service. Low-income people were less likely to seek MH services. The major contribution of this article is to underscore the impact of MH on health care systems, in a LAC country where service use information is scarce. The main finding is that inequalities in the access to MH care occurred, with low-income people having less likelihood of receiving treatment for their mental disorder. Access to health service in this catchment area reflected the great degree of deregulation and lack of integration. Additional efforts should address the barriers to the utilization of MH services in Brazil, including social inequities in the access to care.

Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service.

PubMed

Reeve, Carole; Humphreys, John; Wakerman, John; Carroll, Vicki; Carter, Maureen; O'Brien, Tim; Erlank, Carol; Mansour, Rafik; Smith, Bec

2015-01-01

The aim of this study was to describe the reorientation of a remote primary health-care service, in the Kimberley region of Australia, its impact on access to services and the factors instrumental in bringing about change. A unique community-initiated health service partnership was developed between a community-controlled Aboriginal health organisation, a government hospital and a population health unit, in order to overcome the challenges of delivering primary health care to a dispersed, highly disadvantaged Aboriginal population in a very remote area. The shared goals and clear delineation of responsibilities achieved through the partnership reoriented an essentially acute hospital-based service to a prevention-focussed comprehensive primary health-care service, with a focus on systematic screening for chronic disease, interdisciplinary follow up, health promotion, community advocacy and primary prevention. This formal partnership enabled the primary health-care service to meet the major challenges of providing a sustainable, prevention-focussed service in a very remote and socially disadvantaged area.

Extreme climatic conditions and health service utilisation across rural and metropolitan New South Wales

NASA Astrophysics Data System (ADS)

Jegasothy, Edward; McGuire, Rhydwyn; Nairn, John; Fawcett, Robert; Scalley, Benjamin

2017-08-01

Periods of successive extreme heat and cold temperature have major effects on human health and increase rates of health service utilisation. The severity of these events varies between geographic locations and populations. This study aimed to estimate the effects of heat waves and cold waves on health service utilisation across urban, regional and remote areas in New South Wales (NSW), Australia, during the 10-year study period 2005-2015. We divided the state into three regions and used 24 over-dispersed or zero-inflated Poisson time-series regression models to estimate the effect of heat waves and cold waves, of three levels of severity, on the rates of ambulance call-outs, emergency department (ED) presentations and mortality. We defined heat waves and cold waves using excess heat factor (EHF) and excess cold factor (ECF) metrics, respectively. Heat waves generally resulted in increased rates of ambulance call-outs, ED presentations and mortality across the three regions and the entire state. For all of NSW, very intense heat waves resulted in an increase of 10.8% (95% confidence interval (CI) 4.5, 17.4%) in mortality, 3.4% (95% CI 0.8, 7.8%) in ED presentations and 10.9% (95% CI 7.7, 14.2%) in ambulance call-outs. Cold waves were shown to have significant effects on ED presentations (9.3% increase for intense events, 95% CI 8.0-10.6%) and mortality (8.8% increase for intense events, 95% CI 2.1-15.9%) in outer regional and remote areas. There was little evidence for an effect from cold waves on health service utilisation in major cities and inner regional areas. Heat waves have a large impact on health service utilisation in NSW in both urban and rural settings. Cold waves also have significant effects in outer regional and remote areas. EHF is a good predictor of health service utilisation for heat waves, although service needs may differ between urban and rural areas.

Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA.

PubMed

Smith, Matthew Lee; Prohaska, Thomas R; MacLeod, Kara E; Ory, Marcia G; Eisenstein, Amy R; Ragland, David R; Irmiter, Cheryl; Towne, Samuel D; Satariano, William A

2017-02-10

Background : Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods : Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results : Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions : Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients.

Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA

PubMed Central

Smith, Matthew Lee; Prohaska, Thomas R.; MacLeod, Kara E.; Ory, Marcia G.; Eisenstein, Amy R.; Ragland, David R.; Irmiter, Cheryl; Towne, Samuel D.; Satariano, William A.

2017-01-01

Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results: Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions: Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients. PMID:28208610

Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas.

PubMed

Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

2016-01-01

Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In particular, the results show that the low access neighbourhoods tend to be clustered in the neighbourhoods at the urban periphery and immediately surrounding the downtown area.

Evaluating the effectiveness of different approaches to home support for people in later stage dementia: a protocol for an observational study.

PubMed

Chester, Helen; Clarkson, Paul; Hughes, Jane; Russell, Ian; Beresford, Joan; Davies, Linda; Jolley, David; Peconi, Julie; Poland, Fiona; Roberts, Chris; Sutcliffe, Caroline; Challis, David

2017-07-01

Dementia is a major health problem with a growing number of people affected by the condition, both directly and indirectly through caring for someone with dementia. Many live at home but little is known about the range and intensity of the support they receive. Previous studies have mainly reported on discrete services within a single geographical area. This paper presents a protocol for study of different services across several sites in England. The aim is to explore the presence, effects, and cost-effectiveness of approaches to home support for people in later stage dementia and their carers. This is a prospective observational study employing mixed methods. At least 300 participants (people with dementia and their carers) from geographical areas with demonstrably different ranges of services available for people with dementia will be selected. Within each area, participants will be recruited from a range of services. Participants will be interviewed on two occasions and data will be collected on their characteristics and circumstances, quality of life, carer health and burden, and informal and formal support for the person with dementia. The structured interviews will also collect qualitative data to explore the perceptions of older people and carers. This national study will explore the components of appropriate and effective home support for people with late stage dementia and their carers. It aims to inform commissioners and service providers across health and social care.

42 CFR 486.316 - Re-certification and competition processes.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-certified OPO is not permitted to compete for its open area or any other open area. An OPO competing for an open service area must submit information and data that describe the barriers in its service area, how... in the open area. An OPO competing for an open service area must submit information and data that...

42 CFR 486.316 - Re-certification and competition processes.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-certified OPO is not permitted to compete for its open area or any other open area. An OPO competing for an open service area must submit information and data that describe the barriers in its service area, how... in the open area. An OPO competing for an open service area must submit information and data that...

42 CFR 486.316 - Re-certification and competition processes.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-certified OPO is not permitted to compete for its open area or any other open area. An OPO competing for an open service area must submit information and data that describe the barriers in its service area, how... in the open area. An OPO competing for an open service area must submit information and data that...

The changing food outlet distributions and local contextual factors in the United States.

PubMed

Chen, Hsin-Jen; Wang, Youfa

2014-01-16

Little is known about the dynamics of the food outlet distributions associated with local contextual factors in the U.S. This study examines the changes in food stores/services at the 5-digit Zip Code Tabulated Area (ZCTA5) level in the U.S., and assesses contextual factors associated with the changes. Data from 27,878 ZCTA5s in the contiguous United States without an extreme change in the number of 6 types of food stores/services (supermarkets, small-size grocery stores, convenience stores, fresh/specialty food markets, carry-out restaurants, and full-service restaurants) were used. ZCTA5s' contextual factors were from the 2000 Census. Numbers of food stores/services were derived from the Census Business Pattern databases. Linear regression models assessed contextual factors' influences (racial/ethnic compositions, poverty rate, urbanization level, and foreign-born population%) on 1-year changes in food stores/services during 2000-2001, adjusted for population size, total business change, and census regions. Small-size grocery stores and fresh/specialty food markets increased more and convenience stores decreased more in Hispanic-predominant than other areas. Among supermarket-free places, new supermarkets were less likely to be introduced into black-predominant than white-predominant areas (odds ratio (OR) = 0.52, 95% CI = 0.30-0.92). However, among areas without the following type of store at baseline, supermarket (OR = 0.48 (0.33-0.70)), small-size grocery stores (OR = 1.32 (1.08-1.62)), and fresh/specialty food markets (OR = 0.70 (0.53-0.92)) were less likely to be introduced into areas of low foreign-born population than into areas of high foreign-born population. Higher poverty rate was associated with a greater decrease in supermarket, a less decrease in small-size grocery stores, and a less increase in carry-out restaurants (all p for trends <0.001). Urban areas experienced more increases in full-service and carry-out restaurants than suburban areas. Local area characteristics affect 1-year changes in food environment in the U.S. Hispanic population was associated with more food stores/services capable of supplying fresh food items. Black-predominant and poverty-afflicted areas had a greater decrease in supermarkets. Full-service and carry-out restaurants increased more in urban than suburban areas. Foreign-born population density was associated with introduction of grocery stores and fresh/specialty food markets into the areas.

The changing food outlet distributions and local contextual factors in the United States

PubMed Central

2014-01-01

Background Little is known about the dynamics of the food outlet distributions associated with local contextual factors in the U.S. This study examines the changes in food stores/services at the 5-digit Zip Code Tabulated Area (ZCTA5) level in the U.S., and assesses contextual factors associated with the changes. Methods Data from 27,878 ZCTA5s in the contiguous United States without an extreme change in the number of 6 types of food stores/services (supermarkets, small-size grocery stores, convenience stores, fresh/specialty food markets, carry-out restaurants, and full-service restaurants) were used. ZCTA5s’ contextual factors were from the 2000 Census. Numbers of food stores/services were derived from the Census Business Pattern databases. Linear regression models assessed contextual factors’ influences (racial/ethnic compositions, poverty rate, urbanization level, and foreign-born population%) on 1-year changes in food stores/services during 2000–2001, adjusted for population size, total business change, and census regions. Results Small-size grocery stores and fresh/specialty food markets increased more and convenience stores decreased more in Hispanic-predominant than other areas. Among supermarket-free places, new supermarkets were less likely to be introduced into black-predominant than white-predominant areas (odds ratio (OR) = 0.52, 95% CI = 0.30-0.92). However, among areas without the following type of store at baseline, supermarket (OR = 0.48 (0.33-0.70)), small-size grocery stores (OR = 1.32 (1.08-1.62)), and fresh/specialty food markets (OR = 0.70 (0.53-0.92)) were less likely to be introduced into areas of low foreign-born population than into areas of high foreign-born population. Higher poverty rate was associated with a greater decrease in supermarket, a less decrease in small-size grocery stores, and a less increase in carry-out restaurants (all p for trends <0.001). Urban areas experienced more increases in full-service and carry-out restaurants than suburban areas. Conclusions Local area characteristics affect 1-year changes in food environment in the U.S. Hispanic population was associated with more food stores/services capable of supplying fresh food items. Black-predominant and poverty-afflicted areas had a greater decrease in supermarkets. Full-service and carry-out restaurants increased more in urban than suburban areas. Foreign-born population density was associated with introduction of grocery stores and fresh/specialty food markets into the areas. PMID:24433323

Applying an ecosystem service approach to unravel links between ecosystems and society in the coast of central Chile.

PubMed

de Juan, Silvia; Gelcich, Stefan; Ospina-Alvarez, Andres; Perez-Matus, Alejandro; Fernandez, Miriam

2015-11-15

Ecosystem-based management implies understanding feedbacks between ecosystems and society. Such understanding can be approached with the Drivers-Pressures-State change-Impacts-Response framework (DPSIR), incorporating stakeholders' preferences for ecosystem services to assess impacts on society. This framework was adapted to six locations in the central coast of Chile, where artisanal fisheries coexist with an increasing influx of tourists, and a set of fisheries management areas alternate with open access areas and a no-take Marine Protected Area (MPA). The ecosystem services in the study area were quantified using biomass and species richness in intertidal and subtidal areas as biological indicators. The demand for ecosystem services was elicited by interviews to the principal groups of users. Our results evidenced decreasing landings and a negative perception of fishermen on temporal trends of catches. The occurrence of recreational fishing was negligible, although the consumption of seafood by tourists was relatively high. Nevertheless, the consumption of organisms associated to the study system was low, which could be linked, amongst other factors, to decreasing catches. The comparison of biological indicators between management regimens provided variable results, but a positive effect of management areas and the MPA on some of the metrics was observed. The prioritising of ecosystem attributes by tourists was highly homogenous across the six locations, with "scenic beauty" consistently selected as the preferred attribute, followed by "diversity". The DPSIR framework illustrated the complex interactions existing in these locations, with weak linkages between society's priorities, existing management objectives and the state of biological communities. Overall, this work improved our knowledge on relations between components of coastal areas in central Chile, of paramount importance to advance towards an ecosystem-based management in the area. Copyright © 2015 Elsevier B.V. All rights reserved.

Reducing under-five mortality through Hôpital Albert Schweitzer's integrated system in Haiti.

PubMed

Perry, Henry; Cayemittes, Michel; Philippe, Francois; Dowell, Duane; Dortonne, Jean Richard; Menager, Henri; Bottex, Erve; Berggren, Warren; Berggren, Gretchen

2006-05-01

The degree to which local health systems contribute to reductions in under-five mortality in severely impoverished settings has not been well documented. The current study compares the under-five mortality in the Hôpital Albert Schweitzer (HAS) Primary Health Care Service Area with that for Haiti in general. HAS provides an integrated system of community-based primary health care services, hospital care and community development. A sample of 10% of the women of reproductive age in the HAS service area was interviewed, and 2390 live births and 149 child deaths were documented for the period 1995-99. Under-five mortality rates were computed and compared with rates for Haiti. In addition, available data regarding inputs, processes and outputs for the HAS service area and for Haiti were assembled and compared. Under-five mortality was 58% less in the HAS service area, and mortality for children 12-59 months of age was 76% less. These results were achieved with an input of fewer physicians and hospital beds per capita than is available for Haiti nationwide, but with twice as many graduate nurses and auxiliary nurses per capita than are available nationwide, and with three cadres of health workers that do not exist nationwide: Physician Extenders, Health Agents and Community Health Volunteers. The population coverage of targeted child survival services was generally 1.5-2 times higher in the HAS service area than in rural Haiti. These findings support the conclusion that a well-developed system of primary health care, with outreach services to the household level, integrated with hospital referral care and community development programmes, can make a strong contribution to reducing infant and child mortality in severely impoverished settings.

Decentralized nursing education in Northern Norway: towards a sustainable recruitment and retention model in rural Arctic healthcare services

PubMed Central

Norbye, Bente; Skaalvik, Mari Wolff

2013-01-01

Introduction Decentralized nursing education (DNE) was established at Tromsø University College in 1990 and has since become a part of the bachelor programme in nursing at UiT The Arctic University of Norway. The objective of the study was to investigate whether and to what degree the first DNE programme established in Norway has contributed to recruitment and retention of registered nurses (RNs) in rural healthcare services. Methods The quantitative survey took place in 2012. A questionnaire was distributed to 315 former students who had graduated from the DNE programme from 1994 to 2011. Results The primary finding of this study is that the DNE successfully recruits students from rural areas of Northern Norway. Nearly, 87.5% have their first employment in community healthcare services. They continued to work in the rural areas and 85% still worked as nurses in 2012. The DNE programme has been successful regarding recruitment and retention of RNs to community healthcare services. Fifty-six percent have attended a variety of postgraduate programmes. Conclusion The DNE programme demonstrates itself as a successful study model regarding recruitment and retention of RNs to rural and remote areas. PMID:24286063

Decentralized nursing education in Northern Norway: towards a sustainable recruitment and retention model in rural Arctic healthcare services.

PubMed

Norbye, Bente; Skaalvik, Mari Wolff

2013-01-01

Decentralized nursing education (DNE) was established at Tromsø University College in 1990 and has since become a part of the bachelor programme in nursing at UiT The Arctic University of Norway. The objective of the study was to investigate whether and to what degree the first DNE programme established in Norway has contributed to recruitment and retention of registered nurses (RNs) in rural healthcare services. The quantitative survey took place in 2012. A questionnaire was distributed to 315 former students who had graduated from the DNE programme from 1994 to 2011. The primary finding of this study is that the DNE successfully recruits students from rural areas of Northern Norway. Nearly, 87.5% have their first employment in community healthcare services. They continued to work in the rural areas and 85% still worked as nurses in 2012. The DNE programme has been successful regarding recruitment and retention of RNs to community healthcare services. Fifty-six percent have attended a variety of postgraduate programmes. The DNE programme demonstrates itself as a successful study model regarding recruitment and retention of RNs to rural and remote areas.

Inequity of Human Services: The Rural Tennessee Dilemma.

ERIC Educational Resources Information Center

Tennessee State Univ., Nashville.

Davidson, Williamson, Rutherford, and Cheatham counties of Tennessee were the setting for a study that sought to determine the types of health and social services provided to residents of rural areas and to assess the present status of the service delivery system. Interviews with both agency representatives and randomly selected household…

The Dynamics of Service of Higher Education: A Comparative Study

ERIC Educational Resources Information Center

Abukari, Abdulai

2010-01-01

Higher education institutions seem to be becoming increasingly flexible with different functions. Most universities' mission statements involve teaching, research and service, but while the teaching and research missions are clearly defined and located within certain areas of the university activities, service is less clear and more ambiguous,…

Inequalities in the use of dental services among adults in inner South East London.

PubMed

Al-Haboubi, Mustafa; Klass, Charlotte; Jones, Kate; Bernabé, Eduardo; Gallagher, Jennifer E

2013-06-01

Improving access to National Health Service (NHS) dentistry is a public health issue that has been a focus for successive governments and policy makers in the UK. To inform this process, commissioners of services need to understand trends in service use and demands of the local population. This study explored inequalities in dental services use among adults in a socially deprived, ethnically diverse metropolitan area of London; satisfaction with services; and public views for improvement of services. Data from 695 adults were analysed for this study (56% of the eligible sample). Inequalities in dental services use and satisfaction with care according to sociodemographic factors were assessed in unadjusted and fully adjusted models. The proportion of participants who reported attending the dentist in the last 24 months was 69%, with inequalities according to social grade, ethnicity, sex and age but not according to borough of residence. The most common areas identified by respondents for service improvement were availability of dentists, affordability of care, and accommodation of services. Among those who visited the dentist in the last 24 months, 90% were satisfied with the quality of care provided. However, there were inequalities in satisfaction with care according to borough and reason for the last dental visit. © 2013 Eur J Oral Sci.

Urban Forest Ecosystem Service Optimization, Tradeoffs, and Disparities

NASA Astrophysics Data System (ADS)

Bodnaruk, E.; Kroll, C. N.; Endreny, T. A.; Hirabayashi, S.; Yang, Y.

2014-12-01

Urban land area and the proportion of humanity living in cities is growing, leading to increased urban air pollution, temperature, and stormwater runoff. These changes can exacerbate respiratory and heat-related illnesses and affect ecosystem functioning. Urban trees can help mitigate these threats by removing air pollutants, mitigating urban heat island effects, and infiltrating and filtering stormwater. The urban environment is highly heterogeneous, and there is no tool to determine optimal locations to plant or protect trees. Using spatially explicit land cover, weather, and demographic data within biophysical ecosystem service models, this research expands upon the iTree urban forest tools to produce a new decision support tool (iTree-DST) that will explore the development and impacts of optimal tree planting. It will also heighten awareness of environmental justice by incorporating the Atkinson Index to quantify disparities in health risks and ecosystem services across vulnerable and susceptible populations. The study area is Baltimore City, a location whose urban forest and environmental justice concerns have been studied extensively. The iTree-DST is run at the US Census block group level and utilizes a local gradient approach to calculate the change in ecosystem services with changing tree cover across the study area. Empirical fits provide ecosystem service gradients for possible tree cover scenarios, greatly increasing the speed and efficiency of the optimization procedure. Initial results include an evaluation of the performance of the gradient method, optimal planting schemes for individual ecosystem services, and an analysis of tradeoffs and synergies between competing objectives.

Rural and remote dental services shortages: filling the gaps through geo-spatial analysis evidence-based targeting.

PubMed

Shiika, Yulia; Kruger, Estie; Tennant, Marc

Australia has a significant mal-distribution of its limited dental workforce. Outside the major capital cities, the distribution of accessible dental care is at best patchy. This study applied geo-spatial analysis technology to locate gaps in dental service accessibility for rural and remote dwelling Australians, in order to test the hypothesis that there are a few key location points in Australia where further dental services could make a significant contribution to ameliorating the immediate shortage crisis. A total of 2,086 dental practices were located in country areas, covering a combined catchment area of 1.84 million square kilometers, based on 50 km catchment zones around each clinic. Geo-spatial analysis technology was used to identify gaps in the accessibility of dental services for rural and remote dwelling Australians. An extraction of data was obtained to analyse the integrated geographically-aligned database. Results: Resolution of the lack of dental practices for 74 townships (of greater than 500 residents) across Australia could potentially address access for 104,000 people. An examination of the socio-economic mix found that the majority of the dental practices (84%) are located in areas classified as less disadvantaged. Output from the study provided a cohesive national map that has identified locations that could have health improvement via the targeting of dental services to that location. The study identified potential location sites for dental clinics, to address the current inequity in accessing dental services in rural and remote Australia.

Trade-offs between maintenance of ecosystem services and socio-economic development in rural mountainous communities in southern Spain: a dynamic simulation approach.

PubMed

Vidal-Legaz, Beatriz; Martínez-Fernández, Julia; Picón, Andrés Sánchez; Pugnaire, Francisco I

2013-12-15

Mountainous rural communities have traditionally managed their land extensively, resulting in land uses that provide important ecosystem services for both rural and urban areas. Over recent decades, these communities have undergone drastic changes in economic structure, population size and land use. Our understanding of the exact mechanisms that drive these changes is limited, and there is also a lack of integrative approaches to enable decision makers to steer rural development towards a more sustainable path. In this study, we build a dynamic simulation model to calculate the trade-offs between the provisions of two ecosystem services - landscape aesthetic value and water supply for human use - and the economic development associated with different land use changes. The study area for the simulation comprises two rural communities located in southern Spain. Our results show trade-offs between economic development and the provision of the selected ecosystem services in the selected study area. Land use intensification results in economic development but is not enough to prevent population loss and has a negative impact on both the water supply and on aesthetic services. We conclude that more proactive management policies are needed to mitigate a loss in ecosystem services. Simulation models like ours may facilitate the choice of these policies, as they could test the result of land use planning policies contributing therefore, to a more integrative and sustainable management of rural communities. Copyright © 2013 Elsevier Ltd. All rights reserved.

Recommendations of the Committee to Study Underserved Areas: Enhancing Educational Opportunities. Item #6.

ERIC Educational Resources Information Center

Illinois State Board of Higher Education, Springfield.

This document presents recommendations of the Illinois Committee to Study Underserved Areas concerning areas of the state in need of additional educational services. The document urges the Illinois' Board of Higher Education to adopt the Committee's recommendations as the Board's official policy. In summary, the Committee proposes the…

Residual Barriers for Utilization of Maternal and Child Health Services: Community Perceptions From Rural Pakistan

PubMed Central

Memon, Zahid; Zaidi, Shehla; Riaz, Atif

2016-01-01

Low utilization of maternal and child care services in rural areas has constrained Pakistan from meeting targets of Millennium Development Goals (MDGs) 4 and 5. This study explores community barriers in accessing Maternal and Child Health (MCH) services in ten remote rural districts of Pakistan. It further presents how the barriers differ across a range of MCH services, and also whether the presence of Community Health Workers (CHWs) reduces client barriers. Qualitative methods were used involving altogether sixty focus group discussions with mothers, their spouses and community health workers. Low awareness, formidable distances, expense, and poorly functional services were the main barriers reported, while cultural and religious restrictions were lesser reported. For preventive services including antenatal care (ANC), facility deliveries, postnatal care (PNC), childhood immunization and family planning, the main barrier was low awareness. Conversely, formidable distances and poorly functional services were the main reported constraints in the event of maternal complications and acute child illnesses. The study also found that clients residing in areas served by CHWs had better awareness only of ANC and family planning, while other MCH services were overlooked by the health worker program. The paper highlights that traditional policy emphasis on health facility infrastructure expansion is not likely to address poor utilization rates in remote rural areas. Preventive MCH services require concerted attention to building community awareness, task shifting from facility to community for services provision, and re-energization of CHW program. For maternal and child emergencies there is strong community demand to utilize health facilities, but this will require catalytic support for transport networks and functional health care centers. PMID:26925902

Socioeconomic influences on biodiversity, ecosystem services and human well-being: a quantitative application of the DPSIR model in Jiangsu, China.

PubMed

Hou, Ying; Zhou, Shudong; Burkhard, Benjamin; Müller, Felix

2014-08-15

One focus of ecosystem service research is the connection between biodiversity, ecosystem services and human well-being as well as the socioeconomic influences on them. Despite existing investigations, exact impacts from the human system on the dynamics of biodiversity, ecosystem services and human well-being are still uncertain because of the insufficiency of the respective quantitative analyses. Our research aims are discerning the socioeconomic influences on biodiversity, ecosystem services and human well-being and demonstrating mutual impacts between these items. We propose a DPSIR framework coupling ecological integrity, ecosystem services as well as human well-being and suggest DPSIR indicators for the case study area Jiangsu, China. Based on available statistical and surveying data, we revealed the factors significantly impacting biodiversity, ecosystem services and human well-being in the research area through factor analysis and correlation analysis, using the 13 prefecture-level cities of Jiangsu as samples. The results show that urbanization and industrialization in the urban areas have predominant positive influences on regional biodiversity, agricultural productivity and tourism services as well as rural residents' living standards. Additionally, the knowledge, technology and finance inputs for agriculture also have generally positive impacts on these system components. Concerning regional carbon storage, non-cropland vegetation cover obviously plays a significant positive role. Contrarily, the expansion of farming land and the increase of total food production are two important negative influential factors of biodiversity, ecosystem's food provisioning service capacity, regional tourism income and the well-being of the rural population. Our study provides a promising approach based on the DPSIR model to quantitatively capture the socioeconomic influential factors of biodiversity, ecosystem services and human well-being for human-environmental systems at regional scales. Copyright © 2014 Elsevier B.V. All rights reserved.

Valuing ecosystem services using benefit transfer: separating credible and incredible approaches: chapter 3

USGS Publications Warehouse

Loomis, John H.; Richardson, Leslie; Kroeger, Timm; Casey, Frank

2014-01-01

Ecosystem goods and services are now widely recognized as the benefits that humans derive from the natural environment around them including abiotic (e.g. atmosphere) and biotic components. The work by Costanza et al. (1997) to value the world’s ecosystem services brought the concept of ecosystem service valuation to the attention of the world press and environmental economists working in the area of non-market valuation. The article’s US$33 trillion estimate of these services, despite world GDP being only US$18 trillion, was definitely headline grabbing. This ambitious effort was undertaken with reliance on transferring existing values per unit from other (often site specific) valuation studies. Benefit transfer (see Boyle and Bergstrom, 1992; Rosenberger and Loomis, 2000, 2001) involves transfers of values per unit from an area that has been valued using primary valuation methods such as contingent valuation, travel cost or hedonic property methods (Champ et al., 2003) to areas for which values are needed. Benefit transfer often provides a reasonable approximation of the benefit of unstudied ecosystem services based on transfer of benefits estimates per unit (per visitor day, per acre) from existing studies. An appropriate benefit transfer should be performed on the same spatial scale of analysis (e.g. reservoir to reservoir, city to city) as the original study. However, the reasonableness of benefit transfer may be strained when applying locally derived per acre values from studies of several thousand acres of a resource such as wetlands to hundreds of millions of acres of wetlands.

The gravitational force of mental health services: distance decay effects in a rural Swiss service area.

PubMed

Stulz, Niklaus; Pichler, Eva-Maria; Kawohl, Wolfram; Hepp, Urs

2018-02-05

Previous research suggested a distance decay effect in health services systems, with people living closer to service facilities being more likely to use them. In this ecological cross sectional study, we conducted spatial and statistical analyses in a Swiss mental health services system being legally bound to provide primary mental health care to approximately 620,000 inhabitants. We examined a cohort of all patients who were over 18 years old and who were treated in the mental health services system between January and December 2011. There were 5574 treatment cases during the 12-month period, 2161 inpatient cases and 3413 outpatient cases. Travel time by public transportation between patients' residence and the closest mental health service facility negatively predicted the utilization of outpatient services for all mental disorders, even after controlling for variability in ecological (e.g. socioeconomic) characteristics of the communities in the service provision area. For utilization of inpatient wards no geographical distance decay effect was observed, except for organic mental disorders. Based on these findings, outpatient clinics should be most effectively located decentralized and in the largest communities to meet the needs of the population as close as possible to where people live and to avoid remote areas being insufficiently supplied with mental health care. For mental hospitals and inpatient services decentralized location seems to be less important.

Memorandum on ground-water investigation of four proposed stock wells in Puertocito Area, Socorro County and Canoncito Area, Bernalillo and Valencia Counties, New Mexico

USGS Publications Warehouse

Repenning, C.A.; Galloway, S.E.

1952-01-01

At the request of the Navajo Service, Office ot Indian Affairs, a groundwater iinvestigation of four proposed stock wells in the Puertocito Area, Socorro county and the Canoncito Area., Bernalillo and Valencia counties,New Mexico, was made in November, 1951 (see fig. 1). Although these areas are not on the Navajo Indian Reservation, they were included in the program of study of ground-water resources or the Navajo and Hopi Indian Reservations now being conducted by the Ground Water Branch of the United States Geological Survey. The work was financed by and was in cooperation with the Navajo Service, Office of Indian Affairs.

47 CFR 27.6 - Service areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... defined in paragraph (a) of this section. (c) 698-746 MHz band. WCS service areas for the 698-746 MHz band... paragraphs (a)(1) and (a)(2) of this section. (2) Service areas for Block C in the 746-757 MHz and 776-787... section. In the event that no licenses with respect to service areas for Block C in the 746-757 MHz and...

Comparing the Differences and Commonalities between Service-Learning in the USA and Social Practice in China

ERIC Educational Resources Information Center

Xu, Ruifang

2010-01-01

Service-learning as a popular term refers to an educational model that combines academic study with social activism and civic service. However, some countries, such as China, use different terms. This article explores the differences and commonalities between service-learning in the USA and social practice in China in the following areas:…

How Service Works. Summary of the W. K. Kellogg Foundation's "Service Works": A Retrospective Evaluation of Higher Education Service Programs.

ERIC Educational Resources Information Center

Kellogg Foundation, Battle Creek, MI.

Service learning is an undergraduate education strategy found across four program areas funded by the W. K. Kellogg Foundation (WKKF). This cross-foundation, retrospective evaluation examines 35 projects of $100,000 or more funded between 1985-95. Study information was based on qualitative data and approaches, with the majority of project…

Perceived Quality of Service and Behavioral Intentions of First-Time Students Enrolled at The University of North Carolina Asheville

ERIC Educational Resources Information Center

Mitchell, Patrice Black

2011-01-01

The purpose of this study was to use the SERVQUAL (Service Quality Instrument) to examine the perceptions of first-time enrolled students at University of North Carolina Asheville regarding the services they receive from a selected group of departments in the university's One Stop area. In addition, the study examined whether a relationship…

The Economic Impact of Piedmont Virginia Community College upon Its Service Region. Research Report Number 2-94.

ERIC Educational Resources Information Center

Head, Ronald B.

A study was conducted to determine the economic impact of Piedmont Virginia Community College (PVCC) on its service area for fiscal year 1992-93. Three models of economic impact were used in the study: the "short cut" method (SCM) calculating impact based on data on college, employee, and student expenditures in the service region; the…

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

ERIC Educational Resources Information Center

Sancar Tokmak, Hatice; Ozgelen, Sinan

2013-01-01

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

Availability and distribution of safe abortion services in rural areas: a facility assessment study in Madhya Pradesh, India

PubMed Central

Chaturvedi, Sarika; Ali, Sayyed; Randive, Bharat; Sabde, Yogesh; Diwan, Vishal; De Costa, Ayesha

2015-01-01

Background Unsafe abortion contributes to a significant portion of maternal mortality in India. Access to safe abortion care is known to reduce maternal mortality. Availability and distribution of abortion care facilities can influence women's access to these services, especially in rural areas. Objectives To assess the availability and distribution of abortion care at facilities providing childbirth care in three districts of Madhya Pradesh (MP) province of India. Design Three socio demographically heterogeneous districts of MP were selected for this study. Facilities conducting at least 10 deliveries a month were surveyed to assess availability and provision of abortion services using UN signal functions for emergency obstetric care. Geographical Information System was used for visualisation of the distribution of facilities. Results The three districts had 99 facilities that conducted >10 deliveries a month: 74 in public and 25 in private sector. Overall, 48% of facilities reported an ability to provide safe surgical abortion service. Of public centres, 32% reported the ability compared to 100% among private centres while 18% of public centres and 77% of private centres had performed an abortion in the last 3 months. The availability of abortion services was higher at higher facility levels with better equipped and skilled personnel availability, in urban areas and in private sector facilities. Conclusions Findings showed that availability of safe abortion care is limited especially in rural areas. More emphasis on providing safe abortion services, particularly at primary care level, is important to more significantly dent maternal mortality in India. PMID:25797220

[Land use change and its effects on ecosystem services value in Ji' nan City of Shandong Province, East China].

PubMed

Liu, Jin-Yong; Kong, Fan-Hua; Yin, Hai-Wei; Yan, Wei-Jiao; Sun, Chang-Feng; Xu, Feng

2013-05-01

Based on the GIS software platform, referring to the China 'Terrestrial ecosystem services per unit area value', and by using transition matrix, Costanza evaluation formula, and sensitivity analysis, this paper studied the change characteristics of land use and ecosystem services value in Ji' nan City in 1989-2009. During the study period, the built-up area in the City increased by 99.65 km2, while agriculture land and green space reduced by 103.21 km2, 90.4% of which was taken by the built-up land. The total ecosystem services value decreased from 256.22 x 10(6) yento 214.16 x 10(6) yen, with a decrement of 42.06 x 10(6) yen, mainly due to the decrease in the areas of agriculture land and green space. For the sustainable development of the population, resources, and environment in Ji'nan City, future urban planning should pay more attention on the natural resources protection, reasonable planning of land use structure, and maintenance of ecosystem stability and balance.

Subsidies to target specialist outreach services into more remote locations: a national cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-07-01

Objective Targeting rural outreach services to areas of highest relative need is challenging because of the higher costs it imposes on health workers to travel longer distances. This paper studied whether subsidies have the potential to support the provision of specialist outreach services into more remote locations. Methods National data about subsidies for medical specialist outreach providers as part of the Wave 7 Medicine in Australia: Balancing Employment and Life (MABEL) Survey in 2014. Results Nearly half received subsidies: 19% (n=110) from a formal policy, namely the Australian Government Rural Health Outreach Fund (RHOF), and 27% (n=154) from other sources. Subsidised specialists travelled for longer and visited more remote locations relative to the non-subsidised group. In addition, compared with non-subsidised specialists, RHOF-subsidised specialists worked in priority areas and provided equally regular services they intended to continue, despite visiting more remote locations. Conclusion This suggests the RHOF, although limited to one in five specialist outreach providers, is important to increase targeted and stable outreach services in areas of highest relative need. Other subsidies also play a role in facilitating remote service distribution, but may need to be more structured to promote regular, sustained outreach practice. What is known about this topic? There are no studies describing subsidies for specialist doctors to undertake rural outreach work and whether subsidies, including formal and structured subsidies via the Australian Government RHOF, support targeted outreach services compared with no financial support. What does this paper add? Using national data from Australia, we describe subsidisation among specialist outreach providers and show that specialists subsidised via the RHOF or another source are more likely to provide remote outreach services. What are the implications for practitioners? Subsidised specialist outreach providers are more likely to provide remote outreach services. The RHOF, as a formally structured comprehensive subsidy, further targets the provision of priority services into such locations on a regular, ongoing basis.

47 CFR 27.1206 - Geographic Service Area.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Geographic Service Area. 27.1206 Section 27.1206 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27...

47 CFR 27.1206 - Geographic Service Area.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Geographic Service Area. 27.1206 Section 27.1206 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27...

47 CFR 27.1206 - Geographic Service Area.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Geographic Service Area. 27.1206 Section 27.1206 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27...

47 CFR 27.1206 - Geographic Service Area.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Geographic Service Area. 27.1206 Section 27.1206 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27...

The Access Vermont Initiative: An Investigation of Team Development in Two Vermont Catchment Areas Providing Services to Children with Severe Emotional Disturbances and Their Families.

ERIC Educational Resources Information Center

Fox, Barbara J.; Wright, Leanne M.

This study was designed to document the processes and dynamics of two multidisciplinary teams under the Access Vermont program, which provides services for children and youth with serious emotional disabilities and their families. In both cases, local interagency teams in the largely rural catchment areas developed plans for an initiative focused…

Asian Studies: A Catalogue of Asian Resources in Connecticut. Area Studies Resources Guides, Number One.

ERIC Educational Resources Information Center

Kelly, Colleen A., Comp.

This directory cites Asian resources, services, institutions, and groups in Connecticut. It is intended to strengthen international studies through improved state-wide cooperation and communication. The directory is organized by the following topics: educational centers (including descriptions of the services provided and, in some cases, materials…

Strategic Planning Study Team. Final Report.

ERIC Educational Resources Information Center

Tennessee Univ., Chattanooga.

This final report presents the results of a University of Tennessee at Chattanooga's (UTC) strategic planning study team, which was charged with documenting computerized services currently available and recommending to the UTC administration areas in which new services should be introduced at the university. A questionnaire was administered to…

77 FR 15375 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-15

... OMB Review; Comment Request Title: Head Start Health Managers Descriptive Study. OMB No.: New... Human Services (HHS), is proposing a data collection activity that will provide descriptive data about the Head Start Health Services Area. The goals of the Head Start Health Manager Descriptive Study are...

Promoting smoking cessation in Pakistani and Bangladeshi men in the UK: pilot cluster randomised controlled trial of trained community outreach workers

PubMed Central

2011-01-01

Background Smoking prevalence is high among Pakistani and Bangladeshi men in the UK, but there are few tailored smoking cessation programmes for Pakistani and Bangladeshi communities. The aim of this study was to pilot a cluster randomised controlled trial comparing the effectiveness of Pakistani and Bangladeshi smoking cessation outreach workers with standard care to improve access to and the success of English smoking cessation services. Methods A pilot cluster randomised controlled trial was conducted in Birmingham, UK. Geographical lower layer super output areas were used to identify natural communities where more than 10% of the population were of Pakistani and Bangladeshi origin. 16 agglomerations of super output areas were randomised to normal care controls vs. outreach intervention. The number of people setting quit dates using NHS services, validated abstinence from smoking at four weeks, and stated abstinence at three and six months were assessed. The impact of the intervention on choice and adherence to treatments, attendance at clinic appointments and patient satisfaction were also assessed. Results We were able to randomise geographical areas and deliver the outreach worker-based services. More Pakistani and Bangladeshi men made quit attempts with NHS services in intervention areas compared with control areas, rate ratio (RR) 1.32 (95%CI: 1.03-1.69). There was a small increase in the number of 4-week abstinent smokers in intervention areas (RR 1.30, 95%CI: 0.82-2.06). The proportion of service users attending weekly appointments was lower in intervention areas than control areas. No difference was found between intervention and control areas in choice and adherence to treatments or patient satisfaction with the service. The total cost of the intervention was £124,000; an estimated cost per quality-adjusted life year (QALY) gained of £8,500. Conclusions The intervention proved feasible and acceptable. Outreach workers expanded reach of smoking cessation services in diverse locations of relevance to Pakistani and Bangladeshi communities. The outreach worker model has the potential to increase community cessation rates and could prove cost-effective, but needs evaluating definitively in a larger, appropriately powered, randomised controlled trial. These future trials of outreach interventions need to be of sufficient duration to allow embedding of new models of service delivery. Trial registration Current Controlled Trials ISRCTN82127540 PMID:21854596

Professional ideologies and the development of syringe exchange: Wales as a case study.

PubMed

Keene, J M; Stimson, G V

1997-12-01

This paper is derived from an evaluative study of HIV prevention programs for drug injectors across Wales. It considers how different professional territories and ideologies, concepts of drug misuse and models of HIV prevention may influence policy development. The research involved monitoring the introduction and development of agency and community based syringe exchange schemes and initiatives taken by community pharmacists. Interviews with staff, managers and administrators, and descriptions of service history, development and delivery inform the discussion. HIV prevention varied in different areas of Wales depending on the particular professional group involved, local ideologies regarding drug use treatment, and the extent to which HIV prevention was seen either as a specialist area of expertise and specific remit of drug workers or a generic health care task. Drug agencies with an abstinence policy rejected syringe exchange; instead, prevention in those areas developed in ad hoc ways as health care workers and pharmacists attempted to develop a community based service. Drug agencies with a pre-existing harm minimisation model easily integrated syringe exchange into their work and played the major part in establishing the service, but there was difficulty in extending it beyond their professional caseloads. As there were disincentives to use treatment agencies, and their catchment areas were limited, these factors influenced effective service provision.

47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

Comparing Effects of Different Applications on Pre-Service Teachers: A Meta-Analysis

ERIC Educational Resources Information Center

Elaldi, Senel; Batdi, Veli

2016-01-01

This study attempts to reveal whether different applications have effects on retention and attitude of pre-service teachers studying in various branches in Turkey through meta-analysis. Studies carried out between 2005 and 2015 in national and international area, 324 (218 articles, 106 theses) were chosen. However, 23 studies (9 retention and 14…

The dynamics of social-ecological systems in urban landscapes: Stockholm and the National Urban Park, Sweden.

PubMed

Elmqvist, T; Colding, J; Barthel, S; Borgstrom, S; Duit, A; Lundberg, J; Andersson, E; Ahrné, K; Ernstson, H; Folke, C; Bengtsson, J

2004-06-01

This study addresses social-ecological dynamics in the greater metropolitan area of Stockholm County, Sweden, with special focus on the National Urban Park (NUP). It is part of the Millennium Ecosystem Assessment (MA) and has the following specific objectives: (1) to provide scientific information on biodiversity patterns, ecosystem dynamics, and ecosystem services generated; (2) to map interplay between actors and institutions involved in management of ecosystem services; and (3) to identify strategies for strengthening social-ecological resilience. The green areas in Stockholm County deliver numerous ecosystem services, for example, air filtration, regulation of microclimate, noise reduction, surface water drainage, recreational and cultural values, nutrient retention, and pollination and seed dispersal. Recreation is among the most important services and NUP, for example, has more than 15 million visitors per year. More than 65 organizations representing 175,000 members are involved in management of ecosystem services. However, because of population increase and urban growth during the last three decades, the region displays a quite dramatic loss of green areas and biodiversity. An important future focus is how management may reduce increasing isolation of urban green areas and enhance connectivity. Comanagement should be considered where locally managed green space may function as buffer zones and for management of weak links that connect larger green areas; for example, there are three such areas around NUP identified. Preliminary results indicate that areas of informal management represent centers on which to base adaptive comanagement, with the potential to strengthen biodiversity management and resilience in the landscape.

Partitioning Stakeholders for the Economic Valuation of Ecosystem Services: Examples of a Mangrove System

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

Micheletti, Tatiane, E-mail: micheletti@forst.tu-dresden.de; Jost, François; Berger, Uta

Although the importance of ecosystem services provided by natural forests, especially mangroves, is well known, the destruction of these environments is still ubiquitous and therefore protection measures are urgently needed. The present study compares the current approach of economic valuation of ecosystem services to a proposed one, using a study case of a mangrove system as an example. We suggest that a cost-benefit analysis for economically valuing environmental services should be performed with three additional modifications consisting of (i) a categorization of local stakeholders as demanders of particular ecosystem services, (ii) acknowledgement of the government as one of these demandermore » groups, and (iii) the inclusion of opportunity costs in the valuation. The application of this approach to the mangrove area in the east portion of Great Abaco Island, the Bahamas, reveals that not only the ecosystem services received differ between demander groups, but the monetary benefits and costs are also specific to each of these groups. We show that the economic valuation of the ecosystem should be differentiated for each category, instead of being calculated as a net ‘societal value’ as it is currently. Applying this categorization of demanders enables a better understanding of the cost and benefit structure of the protection of a natural area. The present paper aims to facilitate discussions regarding benefit and cost sharing related to the protection of natural areas.« less

The Unfit Majority: A Research Study of the Rehabilitation of Selective Service Rejectees in South Carolina. Final Report for: Experimental Demonstration Project for Servicing Selective Service Rejectees.

ERIC Educational Resources Information Center

Clements, Hubert M.; And Others

A 3-year demonstration project focused on the vocational rehabilitation rehabilitation of selective service rejectees in a five-county area in Central South Carolina. In 1962, over 50 percent of South Carolina's young men who were examined for military service were rejected for failure to meet physical and/or mental requirements. Of 1,450…

Spatial analysis of ecosystem service relationships to improve targeting of payments for hydrological services

PubMed Central

Manson, Robert H.; Ricketts, Taylor H.; Geissert, Daniel

2018-01-01

Payment for hydrological services (PHS) are popular tools for conserving ecosystems and their water-related services. However, improving the spatial targeting and impacts of PHS, as well as their ability to foster synergies with other ecosystem services (ES), remain challenging. We aimed at using spatial analyses to evaluate the targeting performance of México’s National PHS program in central Veracruz. We quantified the effectiveness of areas targeted for PHS in actually covering areas of high HS provision and social priority during 2003–2013. First, we quantified provisioning and spatial distributions of two target (water yield and soil retention), and one non-target ES (carbon storage) using InVEST. Subsequently, pairwise relationships among ES were quantified by using spatial correlation and overlap analyses. Finally, we evaluated targeting by: (i) prioritizing areas of individual and overlapping ES; (ii) quantifying spatial co-occurrences of these priority areas with those targeted by PHS; (iii) evaluating the extent to which PHS directly contribute to HS delivery; and (iv), testing if PHS targeted areas disproportionately covered areas with high ecological and social priority. We found that modelled priority areas exhibited non-random distributions and distinct spatial patterns. Our results show significant pairwise correlations between all ES suggesting synergistic relationships. However, our analysis showed a significantly lower overlap than expected and thus significant mismatches between PHS targeted areas and all types of priority areas. These findings suggest that the targeting of areas with high HS provisioning and social priority by Mexico’s PHS program could be improved significantly. This study underscores: (1) the importance of using maps of HS provisioning as main targeting criteria in PHS design to channel payments towards areas that require future conservation, and (2) the need for future research that helps balance ecological and socioeconomic targeting criteria. PMID:29462205

System-level change in mental health services in North Wales: An observational study using systems thinking.

PubMed

Evans, S; Huxley, P J; Maxwell, N; Huxley, K L S

2014-06-01

To describe changes to mental health services using systems thinking. Structured standardized quality of life assessment (Manchester Short Quality of Life Assessment: MANSA) was used to establish service user priorities for changes to service provision (part of a process known as check in systems thinking). Current service performance in these priority areas was identified, and changes to service arrangements were planned, implemented and monitored by task and finish (T&F) groups (making use of a process known as flow in systems thinking). 81 MANSA assessments were completed at the check stage (by NM). Work finances and leisure activities emerged as service user priority areas for change, and T&F groups were established with representation of all sectors and service users. Ways to make improvements were observed, planned and implemented by T&F groups (the flow stage). The systems approach reveals how services and quality of life have been changed for patients in Wrexham. Further generalizable research is needed into the potential benefits of using systems thinking in mental health service evaluation. © The Author(s) 2013.

Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana.

PubMed

Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

2016-08-30

In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC). The aim of this study was to get a better understanding of how Ghana's health insurance institutions interact with stakeholders and other health sector programmes in promoting primary health care (PHC). Specifically, the study identified the key areas of misalignment between the operations of the NHIS and that of PHC. Using qualitative and survey methods, this study involved interviews with various stakeholders in six selected districts in the Upper East region of Ghana. The key stakeholders included the National Health Insurance Authority (NHIA), district coordinators of the National Health Insurance Schemes (NHIS), the Ghana Health Service (GHS) and District Health Management Teams (DHMTs) who supervise the district hospitals, health centers/clinics and the Community-based Health and Planning Services (CHPS) compounds as well as other public and private PHC providers. A stakeholders' workshop was organized to validate the preliminary results which provided a platform for stakeholders to deliberate on the key areas of misalignment especially, and to elicit additional information, ideas and responses, comments and recommendations from participants for the achievement of the goals of UHC and PHC. The key areas of misalignments identified during this pilot study included: delays in reimbursements of claims for services provided by health care providers, which serves as a disincentive for service providers to support the NHIS, inadequate coordination among stakeholders in PHC delivery; and inadequate funding for PHC, particularly on preventive and promotive services. Other areas are: the bypassing of PHC facilities due to lack of basic services at the PHC level such as laboratory services, as well as proximity to the district hospitals; and finally the lack of clear understanding of the national policy on PHC. This study suggests that despite the progress that has been made since the establishment of the NHIS in Ghana, there are still huge gaps that need urgent attention to ensure that the goals of UHC and PHC are met. The key areas of misalignment identified in this study, particularly on the delays in reimbursements need to be taken seriously. It is also important for more dialogue between the NHIA and service providers to address key concerns in the implementation of the NHIS which is key to achieving UHC.

Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana.

PubMed

Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

2016-09-05

In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC). The aim of this study was to get a better understanding of how Ghana's health insurance institutions interact with stakeholders and other health sector programmes in promoting primary health care (PHC). Specifically, the study identified the key areas of misalignment between the operations of the NHIS and that of PHC. Using qualitative and survey methods, this study involved interviews with various stakeholders in six selected districts in the Upper East region of Ghana. The key stakeholders included the National Health Insurance Authority (NHIA), district coordinators of the National Health Insurance Schemes (NHIS), the Ghana Health Service (GHS) and District Health Management Teams (DHMTs) who supervise the district hospitals, health centers/clinics and the Community-based Health and Planning Services (CHPS) compounds as well as other public and private PHC providers. A stakeholders' workshop was organized to validate the preliminary results which provided a platform for stakeholders to deliberate on the key areas of misalignment especially, and to elicit additional information, ideas and responses, comments and recommendations from respondents for the achievement of the goals of UHC and PHC. The key areas of misalignments identified during this pilot study included: delays in reimbursements of claims for services provided by health care providers, which serves as a disincentive for service providers to support the NHIS; inadequate coordination among stakeholders in PHC delivery; and inadequate funding for PHC, particularly on preventive and promotive services. Other areas are: the bypassing of PHC facilities due to lack of basic services at the PHC level such as laboratory services, as well as proximity to the district hospitals; and finally the lack of clear understanding of the national policy on PHC. This study suggests that despite the progress that has been made since the establishment of the NHIS in Ghana, there are still huge gaps that need urgent attention to ensure that the goals of UHC and PHC are met. The key areas of misalignment identified in this study, particularly on the delays in reimbursements need to be taken seriously. It is also important for more dialogue between the NHIA and service providers to address key concerns in the implementation of the NHIS which is key to achieving UHC.

Insert Student Here: Why Content Area Constructions of Literacy Matter for Pre-Service Teachers

ERIC Educational Resources Information Center

Gritter, Kristine

2010-01-01

This article explores content area pre-service teacher beliefs about disciplinary knowledge, perceptions of effective content area teaching, and existing beliefs about how to integrate literacy into the content areas. Ten pre-service teachers across ten secondary content areas were asked to describe three important variables in secondary teaching:…

Vocational Home Economics Curriculum Guide for Occupational Home and Institutional Services.

ERIC Educational Resources Information Center

Dewald, Margaret R.

The training program outlined in this guide focuses upon the development of students for gainful employment through a two-year course of study in home and institutional services. Instructional topics are provided in nine areas: orientation to home and institutional services, cleaning supplies and equipment, cleaning surfaces, cleaning clothes and…

Personnel Training and Employment Needs of Hospital Food Services in Tennessee.

ERIC Educational Resources Information Center

Peay, Moiselle

Personnel training and employment needs in connection with food service were studied through interviews with hospital administrators and food service managers in 25 selected Tennessee hospitals. Mentioned most often by managers as important were the areas of communications and human relations for all job classifications except food preparation,…

Act Local or Global?: Comparing Student Experiences in Domestic and International Service-Learning Programs

ERIC Educational Resources Information Center

Niehaus, Elizabeth; Crain, Léna Kavaliauskas

2013-01-01

International service-learning (ISL) is a popular way to facilitate student growth in the areas of cross-cultural learning and civic engagement. However, many have questioned whether international trips provide any added value compared to domestic service-learning. Using the context of Alternative Break programs, this study compares student…

The Service Station.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center for Vocational and Technical Education.

The purpose of the teacher's guide is to encourage the primary student to expand his or her awareness of jobs within the community. The role of the service station worker is examined, with emphasis on the goods and services provided. Subject areas for which the materials in this guide have potential are social studies, art, and language. Each set…

Emergency Presentations to an Inner-City Psychiatric Service for Children and Adolescents

ERIC Educational Resources Information Center

Dil, L. M.; Vuijk, P. J.

2012-01-01

Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of the function of mental health services in the…

Contracting for Facilities Services. Critical Issues in Facilities Management. No. 9.

ERIC Educational Resources Information Center

APPA: Association of Higher Education Facilities Officers, Alexandria, VA.

This book has been designed to provide practical information to managers on how to work with outside contractors in the higher education facilities area, and provides "real world" advice on the opportunities and pitfalls of privatization. Overviews and detailed case studies of contracting-out for services such as custodial services and…

Adult Services in the Eighties: Final Report.

ERIC Educational Resources Information Center

Heim, Kathleen M.

The American Library Association's (ALA) Adult Services in the Eighties (ASE) project was undertaken to supply information about areas of current and unique concentration to aid librarians in identifying, describing, and planning the scope of adult services in their own libraries. The ASE project updates a study conducted in 1954--the most recent…

The Reading Experiences and Beliefs of Secondary Pre-Service Teachers

ERIC Educational Resources Information Center

Daisey, Peggy

2009-01-01

The purpose of this study was to describe secondary pre-service teachers' past reading experiences, present attitudes and beliefs about reading, their attitudes and beliefs about a required content area literacy course, and their predicted use of reading in future instruction. Secondary pre-service teachers (N = 124) of diverse subject areas…

Quantifying and Mapping the Supply of and Demand for Carbon Storage and Sequestration Service from Urban Trees

PubMed Central

Zhao, Chang; Sander, Heather A.

2015-01-01

Studies that assess the distribution of benefits provided by ecosystem services across urban areas are increasingly common. Nevertheless, current knowledge of both the supply and demand sides of ecosystem services remains limited, leaving a gap in our understanding of balance between ecosystem service supply and demand that restricts our ability to assess and manage these services. The present study seeks to fill this gap by developing and applying an integrated approach to quantifying the supply and demand of a key ecosystem service, carbon storage and sequestration, at the local level. This approach follows three basic steps: (1) quantifying and mapping service supply based upon Light Detection and Ranging (LiDAR) processing and allometric models, (2) quantifying and mapping demand for carbon sequestration using an indicator based on local anthropogenic CO2 emissions, and (3) mapping a supply-to-demand ratio. We illustrate this approach using a portion of the Twin Cities Metropolitan Area of Minnesota, USA. Our results indicate that 1735.69 million kg carbon are stored by urban trees in our study area. Annually, 33.43 million kg carbon are sequestered by trees, whereas 3087.60 million kg carbon are emitted by human sources. Thus, carbon sequestration service provided by urban trees in the study location play a minor role in combating climate change, offsetting approximately 1% of local anthropogenic carbon emissions per year, although avoided emissions via storage in trees are substantial. Our supply-to-demand ratio map provides insight into the balance between carbon sequestration supply in urban trees and demand for such sequestration at the local level, pinpointing critical locations where higher levels of supply and demand exist. Such a ratio map could help planners and policy makers to assess and manage the supply of and demand for carbon sequestration. PMID:26317530

Accessibility, affordability and use of health services in an urban area in South Africa.

PubMed

Stellenberg, Ethelwynn L

2015-03-10

Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured) population in the Western Cape, South Africa. A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6%) was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. The hypothesis was accepted. The statistical association between affordability (p = < 0.01), accessibility (p = < 0.01) and the use of health services was found to be significant using the Chi-square (χ²) test. The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.

Gateway National Recreation Area, Jamaica Bay Unit alternative transportation feasibility study

DOT National Transportation Integrated Search

2013-07-31

The National Park Service Gateway National Recreation Area (GATE) was created to provide convenient access to outdoor recreation in the National Park System for residents and visitors to the New York City (NYC) area. The Volpe Center completed a numb...

Perceptions of Pre-Service Teachers and Education Professors on the Abilities of Pre-Service Teachers to Effectively Instruct Students with Disabilities in an Inclusionary Environment

ERIC Educational Resources Information Center

Rogers, Wendy Lynn

2014-01-01

Utilizing intrinsic case study, the researcher compared the perceptions of dual certification pre-service teachers and education professors regarding the knowledge and ability of pre-service teachers to instruct students with disabilities in an inclusionary environment. The specific areas of inquiry were established in accordance with the…

Prevalence of Internet addiction and risk of developing addiction as exemplified by a group of Polish adolescents from urban and rural areas.

PubMed

Pawłowska, Beata; Zygo, Maciej; Potembska, Emilia; Kapka-Skrzypczak, Lucyna; Dreher, Piotr; Kędzierski, Zbigniew

2015-01-01

The objective of the study was to determine the prevalence of Internet addiction and the risk of developing this addiction in Polish adolescents attending junior high schools and high school in Lublin Province, to indicate the differences regarding the intensity of Internet addiction symptoms, and the types of online activity of adolescents residing in urban and rural areas. The examined group comprised 1,860 participants (1,320 girls and 540 boys) with an average age of 17 years. 760 students lived in urban areas and 1,100 lived in rural areas. The following were used in the study: the Socio-demographic Questionnaire designed by the authors, the Internet Addiction Questionnaire designed by Potembska, the Internet Addiction Test by Young and the Internet Addiction Questionnaire (Kwestionariusz do Badania Uzależnienia od Internetu - KBUI) designed by Pawłowska and Potembska. The adolescents living in urban areas showed a significantly greater intensity of Internet and computer addiction symptoms measured by the KBUI Questionnaire, compared to those living in rural areas. The Internet addiction criteria were fulfilled by 0.45% of adolescents living in urban areas and 2.9% of those living in rural areas, whereas 35.55% of urban dwelling students and 30.18% of students living in rural areas showed a risk of developing this addiction. More adolescents living in urban areas, compared to those living in rural areas, use Internet pornography, play computer games, disclose their personal data to unknown individuals encountered on the Internet, use Instant Messaging (IM) services, electronic mail and Facebook social networking service. Compared to their peers from urban areas, significantly more adolescents from rural areas use 'Nasza Klasa' (Our Classmates) online social networking service.

Rural Youth: Images from West Dorset. A Study of Young People in a Rural Area and the Extent of Youth Service Provision Afforded Them.

ERIC Educational Resources Information Center

Kennedy, J. A.

A study of youth and the Youth Service in rural West Dorset (England) to determine what work and recreational opportunities are available, how youth view their adolescent years, and how the Youth Service is helping them adjust to adulthood, indicates that within the present system youth are afforded few considerations. Many become alienated. Many…

Ecosystem service value assessment in temporal and spatial scales in Dalian, China: implications for urban development policy

NASA Astrophysics Data System (ADS)

Xin, Z.; Chen, X.; Fu, G.; Li, C.

2017-12-01

Landscapes differ in their capacities to provide ecosystem good and services, which are the benefits humans obtain from nature. Valuation of ecosystem services is recognized as one effective way for improving the recognition and implementation for disposition of land resource and ecosystem protection. In this content, this study aims to reveal the changes in provision of ecosystem services induced by land use changes in both temporal and spatial scales in Dalian, China. Land use changes were firstly characterized based on Landsat TM images from 1984 to 2013. Results showed a severe increase in urban area, with an average increasing rate of 39.5%. Dry land occupied the largest portion of the total area which is mainly developed on the expenses of forest loss; meanwhile, policies of water-saving irrigation has promoted a conversion of paddy fields to dry land. Other categories including water, wetland, brush grass and salting were found to have relative small contrition to the total area. Assigning ecosystem service value (ESV) coefficient to each land use category, changes in ESV of the study area were assessed. Results indicated that the total ESV decreased by 21 billion from 1984 to 2013. Forest, dry land and water are the primary contributors. As for ecosystem functions, the regulation service is the most prominent which contributed to 60% of the total ESV, followed by support, supply and culture services. In addition, ESV changes were found to have a spatial variability, which shows a maximum decreasing rate in the central city, and a highest net value in the surrounding islands. The changes and distributions in land use pattern and ESV were further linked with the local city landscape planning, which has provided implications on city landscape policy making for sustaining the provision of ecosystem services and achieving sustainable development goals.

Food Service Follow-up Study.

ERIC Educational Resources Information Center

Scott, David C.

Bakersfield City College reports on a followup study done to evaluate their Food Service Management Program. The program offers courses in three areas: certification and skill updating for those already employed in school cafeteria work, an A.A. degree program, and avocational courses for extended day students. Identical questionnaires were sent…

Skills Conversion Project, Chapter 4, Health Care and Health Services Industry.

ERIC Educational Resources Information Center

National Society of Professional Engineers, Washington, DC.

The Skills Conversion Project conducted by the National Society of Professional Engineers sought to study the transition mechanisms required to transfer available technical manpower from aerospace and defense industries into other areas of employment in private industry and public service. Fourteen study teams assessed the likelihood of future…

Estimating Demand for and Supply of Pediatric Preventive Dental Care for Children and Identifying Dental Care Shortage Areas, Georgia, 2015.

PubMed

Cao, Shanshan; Gentili, Monica; Griffin, Paul M; Griffin, Susan O; Harati, Pravara; Johnson, Ben; Serban, Nicoleta; Tomar, Scott

Demand for dental care is expected to outpace supply through 2025. The objectives of this study were to determine the extent of pediatric dental care shortages in Georgia and to develop a general method for estimation that can be applied to other states. We estimated supply and demand for pediatric preventive dental care for the 159 counties in Georgia in 2015. We compared pediatric preventive dental care shortage areas (where demand exceeded twice the supply) designated by our methods with dental health professional shortage areas designated by the Health Resources & Services Administration. We estimated caries risk from a multivariate analysis of National Health and Nutrition Examination Survey data and national census data. We estimated county-level demand based on the time needed to perform preventive dental care services and the proportion of time that dentists spend on pediatric preventive dental care services from the Medical Expenditure Panel Survey. Pediatric preventive dental care supply exceeded demand in Georgia in 75 counties: the average annual county-level pediatric preventive dental care demand was 16 866 hours, and the supply was 32 969 hours. We identified 41 counties as pediatric dental care shortage areas, 14 of which had not been designated by the Health Resources & Services Administration. Age- and service-specific information on dental care shortage areas could result in more efficient provider staffing and geographic targeting.

Progress in the utilization of antenatal and delivery care services in Bangladesh: where does the equity gap lie?

PubMed

Pulok, Mohammad Habibullah; Sabah, Md Nasim-Us; Uddin, Jalal; Enemark, Ulrika

2016-07-29

Universal access to health care services does not automatically guarantee equity in the health system. In the post Millennium Development Goals (MDGs) era, the progress towards universal access to maternal health care services in a developing country, like Bangladesh requires an evaluation in terms of equity lens. This study, therefore, analysed the trend in inequity and identified the equity gap in the utilization of antenatal care (ANC) and delivery care services in Bangladesh between 2004 and 2011. The data of this study came from the Bangladesh Demographic and Health Survey. We employed rate ratio, concentration curve and concentration index to examine the trend in inequity of ANC and delivery care services. We also used logistic regression models to analyse the relationship between socioeconomic factors and maternal health care services. The concentration index for 4+ ANC visits dropped from 0.42 in 2004 to 0.31 in 2011 with a greater decline in urban area. There was almost no change in the concentration index for ANC services from medically trained providers during this period. We also found a decreasing trend in inequity in the utilization of both health facility delivery and skilled birth assistance but this trend was again more pronounced in urban area compared to rural area. The concentration index for C-section delivery decreased by about 33 % over 2004-2011 with a similar rate in both urban and rural areas. Women from the richest households were about 3 times more likely to have 4+ ANC visits, delivery at a health facility and skilled birth assistance compared to women from the poorest households. Women's and their husbands' education were significantly associated with greater use of maternal health care services. In addition, women's exposure to mass media, their involvement in microcredit programs and autonomy in healthcare decision-making appeared as significant predictors of using some of these health care services. Bangladesh faces not only a persistent pro-rich inequity but also a significant rural-urban equity gap in the uptake of maternal health care services. An equity perspective in policy interventions is much needed to ensure safe motherhood and childbirth in Bangladesh.

Land use pattern, socio-economic development, and assessment of their impacts on ecosystem service value: study on natural wetlands distribution area (NWDA) in Fuzhou city, southeastern China.

PubMed

Cai, Yuan-Bin; Zhang, Hao; Pan, Wen-Bin; Chen, Yan-Hong; Wang, Xiang-Rong

2013-06-01

This paper quantifies the allocation of ecosystem services value (ESV) associated with land use pattern and qualitatively examined impacts of land use changes and socio-economic factors on spatiotemporal variation of ESV in the Natural Wetland Distribution Area (NWDA), Fuzhou city, China. The results showed that total ESV of the study area decreased from 4,332.16 × 10(6) RMB Yuan in 1989 to 3,697.42 × 10(6) RMB Yuan in 2009, mainly due to the remarkable decreases in cropland (decreased by 55.3 %) and wetland (decreased by 74.2 %). Forest, water, and wetland played major roles in providing ecosystem services, accounting for over 90 % of the total ESV. Based on time series Landsat TM/ETM+ imagery, geographic information system, and historical data, analysis of the spatiotemporal variation of ESV from 1989 to 2009 was performed. It indicated that rapid expansion of urban areas along the Minjiang River resulted in significant changes in land use types, leading to a dramatic decline in ecosystem services. Meanwhile, because of land scarcity and unique ecosystem functions, the emergency of wetland and cropland protection in built-up area has become an urgent task of local authorities to the local government. Furthermore, there was still a significant negative correlation between ESV of cropland and wetland and the GDP. The results suggest that future planning of land use pattern should control encroachment of urban areas into cropland and wetland in addition to scientific and rational policies towards minimizing the adverse effects of urbanization.

Association Between Loss of Hospital-Based Obstetric Services and Birth Outcomes in Rural Counties in the United States.

PubMed

Kozhimannil, Katy B; Hung, Peiyin; Henning-Smith, Carrie; Casey, Michelle M; Prasad, Shailendra

2018-03-27

Hospital-based obstetric services have decreased in rural US counties, but whether this has been associated with changes in birth location and outcomes is unknown. To examine the relationship between loss of hospital-based obstetric services and location of childbirth and birth outcomes in rural counties. A retrospective cohort study, using county-level regression models in an annual interrupted time series approach. Births occurring from 2004 to 2014 in rural US counties were identified using birth certificates linked to American Hospital Association Annual Surveys. Participants included 4 941 387 births in all 1086 rural counties with hospital-based obstetric services in 2004. Loss of hospital-based obstetric services in the county of maternal residence, stratified by adjacency to urban areas. Primary outcomes were county rates of (1) out-of-hospital births; (2) births in hospitals without obstetric units; and (3) preterm births (<37 weeks' gestation). Between 2004 and 2014, 179 rural counties lost hospital-based obstetric services. Of the 4 941 387 births studied, the mean (SD) maternal age was 26.2 (5.8) years. A mean (SD) of 75.9% (23.2%) of women who gave birth were non-Hispanic white, and 49.7% (15.6%) were college graduates. Rural counties not adjacent to urban areas that lost hospital-based obstetric services had significant increases in out-of-hospital births (0.70 percentage points [95% CI, 0.30 to 1.10]); births in a hospital without an obstetric unit (3.06 percentage points [95% CI, 2.66 to 3.46]); and preterm births (0.67 percentage points [95% CI, 0.02 to 1.33]), in the year after loss of services, compared with those with continual obstetric services. Rural counties adjacent to urban areas that lost hospital-based obstetric services also had significant increases in births in a hospital without obstetric services (1.80 percentage points [95% CI, 1.55 to 2.05]) in the year after loss of services, compared with those with continual obstetric services, and this was followed by a decreasing trend (-0.19 percentage points per year [95% CI, -0.25 to -0.14]). In rural US counties not adjacent to urban areas, loss of hospital-based obstetric services, compared with counties with continual services, was associated with increases in out-of-hospital and preterm births and births in hospitals without obstetric units in the following year; the latter also occurred in urban-adjacent counties. These findings may inform planning and policy regarding rural obstetric services.

Comparing Methodologies for Evaluating Emergency Medical Services Ground Transport Access to Time-critical Emergency Services: A Case Study Using Trauma Center Care.

PubMed

Doumouras, Aristithes G; Gomez, David; Haas, Barbara; Boyes, Donald M; Nathens, Avery B

2012-09-01

The regionalization of medical services has resulted in improved outcomes and greater compliance with existing guidelines. For certain "time-critical" conditions intimately associated with emergency medicine, early intervention has demonstrated mortality benefits. For these conditions, then, appropriate triage within a regionalized system at first diagnosis is paramount, ideally occurring in the field by emergency medical services (EMS) personnel. Therefore, EMS ground transport access is an important metric in the ongoing evaluation of a regionalized care system for time-critical emergency services. To our knowledge, no studies have demonstrated how methodologies for calculating EMS ground transport access differ in their estimates of access over the same study area for the same resource. This study uses two methodologies to calculate EMS ground transport access to trauma center care in a single study area to explore their manifestations and critically evaluate the differences between the methodologies. Two methodologies were compared in their estimations of EMS ground transport access to trauma center care: a routing methodology (RM) and an as-the-crow-flies methodology (ACFM). These methodologies were adaptations of the only two methodologies that had been previously used in the literature to calculate EMS ground transport access to time-critical emergency services across the United States. The RM and ACFM were applied to the nine Level I and Level II trauma centers within the province of Ontario by creating trauma center catchment areas at 30, 45, 60, and 120 minutes and calculating the population and area encompassed by the catchments. Because the methodologies were identical for measuring air access, this study looks specifically at EMS ground transport access. Catchments for the province were created for each methodology at each time interval, and their populations and areas were significantly different at all time periods. Specifically, the RM calculated significantly larger populations at every time interval while the ACFM calculated larger catchment area sizes. This trend is counterintuitive (i.e., larger catchment should mean higher populations), and it was found to be most disparate at the shortest time intervals (under 60 minutes). Through critical evaluation of the differences, the authors elucidated that the ACFM could calculate road access in areas with no roads and overestimates access in low-density areas compared to the RM, potentially affecting delivery of care decisions. Based on these results, the authors believe that future methodologies for calculating EMS ground transport access must incorporate a continuous and valid route through the road network as well as use travel speeds appropriate to the road segments traveled; alternatively, we feel that variation in methods for calculating road distances would have little effect on realized access. Overall, as more complex models for calculating EMS ground transport access become used, there needs to be a standard methodology to improve and to compare it to. Based on these findings, the authors believe that this should be the RM. © 2012 by the Society for Academic Emergency Medicine.

Area Handbook Series. Albania: A Country Study

DTIC Science & Technology

1992-04-01

128 Population and Work Force .................... 130 Women in the Work Force ..................... 132 Trade Unions...155 RETAIL TRADE , SERVICES, AND TOURISM ......... 156 Retail Trade and Services ..................... 156 Black M arket...158 Tourism .................................... 158 FOREIGN ECONOMIC RELATIONS .................. 159 Foreign Trade

Impacts of climate change on prioritizing conservation areas of hydrological ecosystem services

NASA Astrophysics Data System (ADS)

Lien, Wan Yu; Lin, Yu Pin

2015-04-01

Ecosystem services (ESs) including hydrological services play important roles in our daily life and provide a lot of benefits for human beings from ecological systems. The systems and their services may be threatened by climate change from global to local scales. We herein developed a systematic approach to assess the impacts of climate change on the hydrological ecosystem services, such as water yield, nutrient (nitrogen and phosphorous) retention, and soil retention in a watershed in Northern Taiwan. We first used an ecosystem service evaluation model, InVEST, to estimate the amount and spatial patterns of annual and monthly hydrological ecosystem services under historical weather data, and different climate change scenarios based on five GMSs. The monthly and annual spatiotemporal variations of the ESs were analyzed in this study. Finally, the multiple estimated ESs were considered as the protection conservation targets and regarded as the input data of the systematic conservation planning software, Zonation, to systematically prioritize reserve areas of the ESs under the climate change scenarios. The ES estimation results indicated that the increasing rainfall in wet season leads to the higher water yield and results in the higher sediment and nutrient export indirectly. The Zonation successfully fielded conservation priorities of the ESs. The conservation priorities of the ESs significantly varied spatially and monthly under the climate change scenarios. The ESs results also indicated that the areas where ESs values and conservation priorities with low resilience under climate change should be considered as high priority protected area to ensure the hydrological services in future. Our proposed approach is a novel systematic approach which can be applied to assess impacts of climate change on spatiotemporal variations of ESs as well as prioritize protected area of the ESs under various climate change scenarios. Keyword: climate change, ecosystem service, conservation planning, spatial analysis.

Changes in the mean hearing threshold levels in military aircraft maintenance conscripts.

PubMed

Park, Won-Ju; Moon, Jai-Dong

2016-11-01

Aircraft maintenance crews are constantly exposed to severe aircraft noise. The purpose of this study was to verify whether noise from aircraft adversely affects the hearing threshold levels (HTLs) of aircraft maintenance conscripts during their 2 years of mandatory military service. This study included 3,000 male aircraft maintenance conscripts who work in the military runway area. We measured and analyzed HTLs at 2-4 kHz. The duration of exposure to noise increased with an increase in rank; however, HTLs showed a tendency to decrease. We attributed such contradicting results to the learning effect and adaptation to military service. However, we suspected that sudden deafness in 6 conscripts (0.2%) was due to loud noise in the runway area during military service. The effectiveness of the hearing conservation program for short-term military service personnel could be increased by focusing on preventing sudden deafness and preenlistment baseline audiogram tests.

Noah's Ark-Red Cross Foundation: a Swedish model.

PubMed

Florence, M E

1993-01-01

During the Spring of 1991, the author spent many weeks at the Noah's Ark-Red Cross Foundation, a support service for HIV infected persons, and their families and friends, located in Stockholm, Sweden. The purpose was to study, through interviews, observation and participation, the foundation's interactive model in order to discover what makes it work and share that knowledge with other professionals. The Noah's Ark Model consists of three spheres of activity: service, including reception services and the volunteer programme; information and education, including the Hot Line and the Newsletter; and counselling and support, including the guest house. Staff from each area interact freely with and participate in the activities of other areas. The foundation also utilizes the services of carefully trained volunteers. This use of volunteers makes it unique in Sweden. It is the dedication and flexibility of the staff and volunteers that make this model work. The report of the study follows.

Feasibility study of shared-ride auto transit. Final report

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

Kocur, G.; Zaelke, D.; Neumann, L.

1977-09-01

The report examines the feasibility of the implementation of shared-ride auto transit (SRAT), which is an innovative approach for increasing auto occupancy in rural and urban areas. The report focuses on operational concepts, potential usage, legal and regulatory issues, and institutional issues. Formulation of the SRAT concept was motivated by several concerns, such as: (1) energy conservation; (2) transit service to areas unable to economically justify conventional transit services, and to travel disadvantaged groups; (3) transit service replacement to achieve greater efficiency and to reduce transit deficits; (4) provision of inexpensive transit service; and (5) the increase of safety andmore » reliability of hitchhiking. Four case study sites (Boulder, Colorado; Boston, Massachusetts; Portland, Oregon; and Tidewater, Virginia), were used to identify the specific institutional issues likely to impact SRAT implementation for that site, and to identify the opportunities for designing, implementing and operating SRAT in a variety of institutional settings.« less

Scoping the context of programs and services for maintaining wellness of older people in rural areas of Indonesia.

PubMed

Kadar, K S; McKenna, L; Francis, K

2014-09-01

Ageing and problems concerning the aged are an increasing and concerning reality in developing and underdeveloped countries such as Indonesia. Improving service quality is important to promote and maintain wellness of older persons, especially in rural areas. To explore programs and services offered to the elderly in a rural area of Indonesia to support them in promoting and maintaining their wellness. To describe roles and practices of health professionals and teams responsible for delivering services to older people. Action research was used with mixed method data collection (interview and survey). Results demonstrated that activities related to the elderly health programs were limited due to budget and facilities. Practices of health staff for elderly in the community focused on intervention tasks, rather than prevention. Lack of available information on the range of programs and services implemented in Indonesia for the elderly in community settings was a limitation of this study. Programs and services for older people have been implemented in Indonesia. However, these do not yet meet their needs, especially in rural areas. There is a need for greater focus on health promotion and illness prevention. Findings contribute to development of international knowledge in community health nursing, as these issues may not be only relevant to Indonesia. It is timely for governments, including in Indonesia, to evaluate health workforce needs in the community and appropriate educational qualifications for delivering optimal health services for older people. © 2014 International Council of Nurses.

Community outreach library services in the UK: a case study of Wirral Hospital NHS Trust (WHNT).

PubMed

Dowse, Frances Maria; Sen, Barbara

2007-09-01

The study evaluates the Community Outreach Library Service at Wirral Hospital National Health Service Trust (WHNT). It considers the information seeking behaviour and information needs of primary care staff, and service effectiveness in meeting those needs. A literature review established the current context and areas of best practice. The investigative case study used postal questionnaires to 250 primary care staff and an interview with the Community Outreach Librarian. Themes emerged from the literature regarding information seeking behaviour, information needs, and meeting user needs through effective service delivery. Outreach services have value in terms of improving information skills and providing services at point of need. Time is a major constraint for both users and service providers. Investment is needed from appropriate funding sources to support the provision and marketing of outreach library services. Librarians benefit from sharing best practice. The continued evaluation of outreach library services is recommended.

[Effects of small hydropower substitute fuel project on forest ecosystem services].

PubMed

Yu, Hai Yan; Zha, Tong Gang; Nie, Li Shui; Lyu, Zhi Yuan

2016-10-01

Based on the Forest Ecosystem Services Assessment Standards (LY/T 1721－2008) issued by the State Forestry Administration, this paper evaluated four key functions of forest ecosystems, i.e., water conservation, soil conservation, carbon fixation and oxygen release, and nutrient accumulation. Focusing on the project area of Majiang County in Guizhou Province, this study provided some quantitative evidence that the implementation of the small hydropower substituting fuel project had positive effects on the values and material quantities of ecosystem service functions. The results showed that the small hydropower substituting fuel project had a significant effect on the increase of forest ecosystem services. Water conservation quantity of Pinus massoniana and Cupressus funebris plantations inside project area was 20662.04 m 3 ·hm -2 ·a -1 , 20.5% higher than outside project area, with soil conservation quantity of 119.1 t·hm -2 ·a -1 , 29.7% higher than outside project area, carbon fixation and oxygen release of 220.49 t·hm -2 ·a -1 , 40.2% higher than outside project area, and forest tree nutrition accumulation of 3.49 t·hm -2 ·a -1 , 48.5% higher than outside project area. Small hydropower substituting fuel project for increasing the quota of forest ecosystem service function value was in the order of carbon fixation and oxygen release function (71400 yuan·hm -2 ·a -1 ) > water conservation function (60100 yuan·hm -2 ·a -1 ) > tree nutrition accumulation function (13800 yuan·hm -2 ·a -1 ) > soil conservation function (8100 yuan·hm -2 ·a -1 ). Small hydropower substituting fuel project played an important role for improving the forest ecological service function value and realizing the sustainable development of forest.

A transaction assessment method for allocation of transmission services

NASA Astrophysics Data System (ADS)

Banunarayanan, Venkatasubramaniam

The purpose of this research is to develop transaction assessment methods for allocating transmission services that are provided by an area/utility to power transactions. Transmission services are the services needed to deliver, or provide the capacity to deliver, real and reactive power from one or more supply points to one or more delivery points. As the number of transactions increase rapidly in the emerging deregulated environment, accurate quantification of the transmission services an area/utility provides to accommodate a transaction is becoming important, because then appropriate pricing schemes can be developed to compensate for the parties that provide these services. The Allocation methods developed are based on the "Fair Resource Allocation Principle" and they determine for each transaction the following: the flowpath of the transaction (both real and reactive power components), generator reactive power support from each area/utility, real power loss support from each area/utility. Further, allocation methods for distributing the cost of relieving congestion on transmission lines caused by transactions are also developed. The main feature of the proposed methods is representation of actual usage of the transmission services by the transactions. The proposed method is tested extensively on a variety of systems. The allocation methods developed in this thesis for allocation of transmission services to transactions is not only useful in studying the impact of transactions on a transmission system in a multi-transaction case, but they are indeed necessary to meet the criteria set forth by FERC with regard to pricing based on actual usage. The "consistency" of the proposed allocation methods has also been investigated and tested.

25 CFR 175.11 - Procedures for setting service fees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Area Director shall establish, and amend as needed, service fees to cover the expense of customer service. Service fees shall be set by unilateral action of the Area Director and remain in effect until amended by the Area Director pursuant to this section. At least 30 days prior to the effective date, a...

Estimating the economic value of cultural ecosystem services in an urbanizing area using hedonic pricing.

PubMed

Sander, Heather A; Haight, Robert G

2012-12-30

A need exists to increase both knowledge and recognition of the values associated with ecosystem services and amenities. This article explores the use of hedonic pricing as a tool for eliciting these values. We take a case study approach, valuing several services provided by ecosystems, namely aesthetic quality (views), access to outdoor recreation, and the benefits provided by tree cover in Dakota County, Minnesota, USA. Our results indicate that these services are valued by local residents and that hedonic pricing can be used to elicit at least a portion of this value. We find that many aspects of the aesthetic environment significantly impact home sale prices. Total view area as well as the areas of some land-cover types (water and lawn) in views positively influenced home sale prices while views of impervious surfaces generally negatively influenced home sale price. Access to outdoor recreation areas significantly and positively influenced home sale prices as did tree cover in the neighborhood surrounding a home. These results illustrate the ability of hedonic pricing to identify partial values for ecosystem services and amenities in a manner that is highly relevant to local and regional planning. These values could be used to increase policy-maker and public awareness of ecosystem services and could improve their consideration in planning and policy decisions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Temporal and Spatial Patterns in Utilization of Mental Health Services During and After Hurricane Sandy: Emergency Department and Inpatient Hospitalizations in New York City.

PubMed

He, Fangtao Tony; Lundy De La Cruz, Nneka; Olson, Donald; Lim, Sungwoo; Levanon Seligson, Amber; Hall, Gerod; Jessup, Jillian; Gwynn, Charon

2016-06-01

Hurricane Sandy made landfall on October 29, 2012, causing a coastal storm surge and extensive flooding, which led to the closure of several health care facilities in New York City (NYC) and prolonged interruptions in service delivery. The impact on mental health-related emergency department (ED) and inpatient hospital service utilization was studied. Data came from the New York Statewide Planning and Research Cooperative System. We obtained mental health-related data among NYC residents from 2010 to 2013. Patients were grouped into 5 geographic areas, including service areas of closed hospitals, the Hurricane Sandy evaluation zone, and all of NYC. The Farrington method was used to detect increases in ED visits and hospitalizations for the post-Sandy period. Open hospitals experienced a substantial increase in psychiatric ED visits from patients living in the service areas of closed hospitals. This surge in psychiatric ED visits persisted for 4 to 6 months after Hurricane Sandy. However, the increase in psychiatric hospitalizations was observed for 1 to 3 months. Several NYC hospitals received a substantially larger number of ED patients from service areas of closed hospitals after Hurricane Sandy, unlike other hospitals that experienced a decrease. Because of potential surges in the number of psychiatric ED visits, resource allocation to hospitals should be considered. (Disaster Med Public Health Preparedness. 2016;10:512-517).

Potential use of mobile phones in improving animal health service delivery in underserved rural areas: experience from Kilosa and Gairo districts in Tanzania.

PubMed

Karimuribo, Esron D; Batamuzi, Emmanuel K; Massawe, Lucas B; Silayo, Richard S; Mgongo, Frederick O K; Kimbita, Elikira; Wambura, Raphael M

2016-10-07

Sub-optimal performance of the animal health delivery system in rural areas is common in developing countries including Tanzania. However, penetration of mobile phones and availability of good road network and public transport systems offer opportunities for improving the access of rural communities to diagnostic and advisory services from facilities and expertise located in urban areas. A questionnaire survey on possession and use of mobile phones by pastoral and agro-pastoral communities in Kilosa and Gairo districts was carried out between November and December 2015. A total number of 138 livestock keepers from three villages of Chakwale (54), Mvumi (41) and Parakuyo (43) participated in the study. An e-based system was designed and tested to link rural communities with urban diagnostic facilities. It was observed that the average number of phones possessed by individuals interviewed and household families was 1.1 ± 0.26 (1-2) and 3.5 ± 2.23 (1-10), respectively. It was further observed that out of 138 livestock keepers interviewed, 133 (96.4 %) had feature phones while 10 (7.2 %) of them possessed smartphones. Mobile phone is currently used to support livestock production by communicating on animal health in Parakuyo (18, 41.9 %), Mvumi (18, 43.9 %) and Chakwale (14, 25.9 %). Other contributions of mobile phones in livestock and crop agriculture observed in the study area include: exchange of livestock price information, crop price information, communicating on plant health/diseases, livestock extension and advisory services as well as crop farming extension and advisory services. We also designed and tested an e-based SUAVetDiag® system to support timely diagnosis of infectious disease conditions and prompt advice on case management in veterinary underserved areas. Availability of mobile phones in rural areas, in combination with supporting infrastructure and facilities in urban areas, has potential to stimulate local development and improving delivery of animal health and extension services. It is recommended that more development and refinement of the system should be conducted to ensure that this potential is tapped to revolutionalise delivery of animal health services in rural areas.

Urban versus rural populations' views of health care in Scotland.

PubMed

Farmer, Jane; Hinds, Kerstin; Richards, Helen; Godden, David

2005-10-01

To compare satisfaction with, and expectations of, health care of people in rural and urban areas of Scotland. Questions were included in the 2002 Scottish Social Attitudes Survey (SSAS). The Scottish House-hold Survey urban-rural classification was used to categorize locations. A random sample of 2707 people was contacted to participate in a face-to-face interview and a self-completion questionnaire survey. SPSS (v.10) was used to analyse the data. Relationships between location category and responses were explored using logistic regression analysis. In all, 1665 (61.5%) interviews were conducted and 1507 (56.0%) respondents returned self-completion questionnaires. Satisfaction with local doctors and hospital services was higher in rural locations. While around 40% of those living in remote areas thought A&E services too distant, this did not rank as a top priority for health service improvement. This could be due to expectations that general practitioners would assist in out-of-hours emergencies. Most Scots thought services should be good in rural areas even if this was costly, and that older people should not be discouraged from moving to rural areas because of their likely health care needs. In all, 79% of respondents thought that care should be as good in rural as urban areas. Responses to many questions were independently significantly affected by rural/urban location. Most Scots want rural health care to continue to be good, but the new UK National Health Service (NHS) general practitioner contract and service redesign will impact on provision. Current high satisfaction, likely to be due to access and expectations about local help, could be affected. This study provides baseline data on attitudes and expectations before potential service redesign, which should be monitored at intervals in future.

Geohazard monitoring and modelling using Persistent Scatterer Interferometry in the framework of the European project Terrafirma

NASA Astrophysics Data System (ADS)

Cooksley, Geraint; Arnaud, Alain; Banwell, Marie-Josée

2013-04-01

Increasingly, geohazard risk managers are looking to satellite observations as a promising option for supporting their risk management and mitigation strategies. The Terrafirma project, aimed at supporting civil protection agencies, local authorities in charge of risk assessment and mitigation is a pan-European ground motion information service funded by the European Space Agency's Global Monitoring for Environment and Security initiative. Over 100 services were delivered to organizations over the last ten years. Terrafirma promotes the use of Synthetic Aperture Radar Interferometry (InSAR) and Persistent Scatterer InSAR (PSI) within three thematic areas for terrain motion analysis: Tectonics, Flooding and Hydrogeology (ground water, landslides and inactive mines), as well as the innovative Wide Area mapping service, aimed at measuring land deformation over very large areas. Terrafirma's thematic services are based on advanced satellite interferometry products; however they exploit additional data sources, including non-EO, coupled with expert interpretation specific to each thematic line. Based on the combination of satellite-derived ground-motion information products with expert motion interpretation, a portfolio of services addressing geo-hazard land motion issues was made available to users. Although not a thematic in itself, the Wide Area mapping product constitutes the fourth quarter of the Terrafirma activities. The wide area processing chain is nearly fully automatic and requires only a little operator interaction. The service offers an operational PSI processing for wide-area mapping with mm accuracy of ground-deformation measurement at a scale of 1:250,000 (i.e. one cm in the map corresponds to 2.5 Km on the ground) on a country or continent level. The WAP was demonstrated using stripmap ERS data however it is foreseen to be a standard for the upcoming Sentinel-1 mission that will be operated in Terrain Observation by Progressive Scan (TOPS) mode. Within each theme, a series of products are offered. The Hydrogeology service delivers geo-information for hydrogeological hazards affecting urban areas, mountainous zones and infra-structures. Areas where groundwater has been severely exploited often experience subsidence as a result. Likewise, many European towns and cities built above abandoned and inactive mines experience strong ground deformation. The hydrogeology theme products study these phenomenon as well as slope instability in mountainous areas. The Tectonics service presents information on seismic hazards. The crustal block boundaries service provides users with information on terrain motion related to major and local faults, earthquake cycles, and vertical deformation sources. The vulnerability map service combines radar satellite date with in situ measurements to identify regions that may be vulnerable in the case of an earthquake. Within the Coastal Lowland and Flood Risk service, the flood plain hazard product assesses flood risk in coastal lowland areas and flood-prone river basins. The advanced subsidence mapping service combines PSI with levelling data and GPS to enable users to interpret subsidence maps within their geodetic reference systems. The flood defence monitoring service focuses on flood protection systems such as dykes and dams. Between 2003 and 2013, Terrafirma delivered services to 51 user organizations in over 25 countries. The archive of datasets is available to organisations involved in geohazard risk management and mitigation. Keywords: Persistent Scatterer Interferometry, Synthetic Aperture Radar, ground motion monitoring, Terrafirma project, multi-hazard analysis

Need for and Access to Supportive Services in the Child Welfare System

PubMed Central

Freisthler, Bridget

2011-01-01

Objective The purpose of this paper is to examine how geographical availability of social services is related to foster care entry rates and referrals for child maltreatment investigations. The primary concerns are to (1) determine locations across Los Angeles County where the availability of social services is low but display a high need for those services and (2) begin to examine how the geographic distribution of social services is related to rates of referrals and foster care entries in child maltreatment. Methods Archival data for all 288 zip codes within Los Angeles County were collected on rates of referrals, foster care entries, location and types of social service agencies, and zip code demographics. Data were analyzed using point process models and spatial regressions. Results Higher densities of child welfare services in local areas (for referrals) and lagged areas (for referrals and foster care entries) were related to lower rates of child maltreatment. The density of housing and housing-related services was negatively related to referrals in local areas and foster care entry rates in lagged areas. Areas with higher densities of substance abuse and domestic violence service agencies had significantly higher rates of both Child Protective Services (CPS) referrals and entries into foster care in local areas. Conclusions While the total density of child welfare services within and surrounding zip code areas is related to lower rates of referrals and foster care entries, the findings are less clear about what those specific services are. Living in and around “resource rich” zip codes may reduce rates of child maltreatment. PMID:23788827

42 CFR 136a.15 - Health Service Delivery Areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible To...

42 CFR 136a.15 - Health Service Delivery Areas.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible To...

42 CFR 136a.15 - Health Service Delivery Areas.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible To...

42 CFR 136a.15 - Health Service Delivery Areas.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible To...

13 CFR 130.310 - Area of service.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CENTERS § 130.310 Area of service. The AA/SBDC shall designate in writing the Area of Service of each... in a State or Territory if the AA/SBDC determines it is necessary or beneficial to implement the...

13 CFR 130.310 - Area of service.

Code of Federal Regulations, 2012 CFR

2012-01-01

... CENTERS § 130.310 Area of service. The AA/SBDC shall designate in writing the Area of Service of each... in a State or Territory if the AA/SBDC determines it is necessary or beneficial to implement the...

13 CFR 130.310 - Area of service.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CENTERS § 130.310 Area of service. The AA/SBDC shall designate in writing the Area of Service of each... in a State or Territory if the AA/SBDC determines it is necessary or beneficial to implement the...

13 CFR 130.310 - Area of service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... CENTERS § 130.310 Area of service. The AA/SBDC shall designate in writing the Area of Service of each... in a State or Territory if the AA/SBDC determines it is necessary or beneficial to implement the...

Service Quality Assessment of Hospitals in Asian Context: An Empirical Evidence From Pakistan

PubMed Central

Shafiq, Muhammad; Naeem, Muhammad Azhar; Munawar, Zartasha; Fatima, Iram

2017-01-01

Hospitals vary from one another in terms of their specialty, services offered, and resource availability. Their services are widely measured with scales that gauge patients’ perspective. Therefore, there is a need for research to develop a scale that measures hospital service quality in Asian hospitals, regardless of their nature or ownership. To address this research need, this study adapted the SERVQUAL instrument to develop a service quality measurement scale. Data were collected from inpatients and outpatients at 9 different hospitals, and the scale was developed using structural equation modeling. The developed scale was then validated by identifying service quality gaps and ranking the areas that require managerial effort. The findings indicated that all 5 dimensions of SERVQUAL are valid in Asian countries such as Pakistan, with 13 items retained. Reliability, tangibility, responsiveness, empathy, and assurance were ranked first, second, third, fourth, and fifth, respectively, in terms of the size of the quality gap. The gaps were statistically significant, with values ≤.05; therefore, hospital administrators must focus on each of these areas. By focusing on the identified areas of improvement, health care authorities, managers, practitioners, and decision makers can bring substantial change within hospitals. PMID:28660771

Service Quality Assessment of Hospitals in Asian Context: An Empirical Evidence From Pakistan.

PubMed

Shafiq, Muhammad; Naeem, Muhammad Azhar; Munawar, Zartasha; Fatima, Iram

2017-01-01

Hospitals vary from one another in terms of their specialty, services offered, and resource availability. Their services are widely measured with scales that gauge patients' perspective. Therefore, there is a need for research to develop a scale that measures hospital service quality in Asian hospitals, regardless of their nature or ownership. To address this research need, this study adapted the SERVQUAL instrument to develop a service quality measurement scale. Data were collected from inpatients and outpatients at 9 different hospitals, and the scale was developed using structural equation modeling. The developed scale was then validated by identifying service quality gaps and ranking the areas that require managerial effort. The findings indicated that all 5 dimensions of SERVQUAL are valid in Asian countries such as Pakistan, with 13 items retained. Reliability, tangibility, responsiveness, empathy, and assurance were ranked first, second, third, fourth, and fifth, respectively, in terms of the size of the quality gap. The gaps were statistically significant, with values ≤.05; therefore, hospital administrators must focus on each of these areas. By focusing on the identified areas of improvement, health care authorities, managers, practitioners, and decision makers can bring substantial change within hospitals.

Mapping Ecosystem Services in the Jordan Valley, Jordan

NASA Astrophysics Data System (ADS)

Luz, Ana; Marques, Ana; Ribeiro, Inês; Alho, Maria; Catarina Afonso, Ana; Almeida, Erika; Branquinho, Cristina; Talozi, Samer; Pinho, Pedro

2016-04-01

In the last decade researchers started using ecosystem services as a new framework to understand the relationships between environment and society. Habitat quality and water quality are related with ecosystem services regulation and maintenance, or even provision. According to the Common International Classification of Ecosystem Services (CICES) both habitat quality and water quality are associated with lifecycle maintenance, habitat and gene pool protection, and water conditions, among others. As there is increased pressure on habitats and rivers especially for agricultural development, mapping and evaluating habitat and water quality has important implications for resource management and conservation, as well as for rural development. Here, we model and map habitat and water quality in the Jordan Valley, Jordan. In this study, we aim to identify and analyse ecosystem services both through 1) habitat quality and 2) water quality modelling using InVest, an integrated valuation of ecosystem services and tradeoffs. The data used in this study mainly includes the LULC, Jordan River watershed and main threats and pollutants in the study area, such as agriculture, industry, fish farms and urbanization. Results suggest a higher pressure on natural habitats in the Northern region of the Jordan Valley, where industry is dominant. Agriculture is present along the Jordan Valley and limits the few natural forested areas. Further, water pollution is mainly concentrated in disposal sites due to the low flow of the Jordan River. Our results can help to identify areas where natural resources and water resource management is most needed in the Jordan Valley. Acknowledgements: Transbasin FP7 project

Immunization, urbanization and slums - a systematic review of factors and interventions.

PubMed

Crocker-Buque, Tim; Mindra, Godwin; Duncan, Richard; Mounier-Jack, Sandra

2017-06-08

In 2014, over half (54%) of the world's population lived in urban areas and this proportion will increase to 66% by 2050. This urbanizing trend has been accompanied by an increasing number of people living in urban poor communities and slums. Lower immunization coverage is found in poorer urban dwellers in many contexts. This study aims to identify factors associated with immunization coverage in poor urban areas and slums, and to identify interventions to improve coverage. We conducted a systematic review, searching Medline, Embase, Global Health, CINAHL, Web of Science and The Cochrane Database with broad search terms for studies published between 2000 and 2016. Of 4872 unique articles, 327 abstracts were screened, leading to 63 included studies: 44 considering factors and 20 evaluating interventions (one in both categories) in 16 low or middle-income countries. A wide range of socio-economic characteristics were associated with coverage in different contexts. Recent rural-urban migration had a universally negative effect. Parents commonly reported lack of awareness of immunization importance and difficulty accessing services as reasons for under-immunization of their children. Physical distance to clinics and aspects of service quality also impacted uptake. We found evidence of effectiveness for interventions involving multiple components, especially if they have been designed with community involvement. Outreach programmes were effective where physical distance was identified as a barrier. Some evidence was found for the effective use of SMS (text) messaging services, community-based education programmes and financial incentives, which warrant further evaluation. No interventions were identified that provided services to migrants from rural areas. Different factors affect immunization coverage in different urban poor and slum contexts. Immunization services should be designed in collaboration with slum-dwelling communities, considering the local context. Interventions should be designed and tested to increase immunization in migrants from rural areas.

Can it be done? Implementing adolescent clinical preventive services.

PubMed Central

Ozer, E M; Adams, S H; Lustig, J L; Millstein, S G; Camfield, K; El-Diwany, S; Volpe, S; Irwin, C E

2001-01-01

OBJECTIVE: To evaluate the implementation of an intervention to increase the delivery of adolescent preventive services within a large managed care organization. Target health areas were tobacco, alcohol, sexual behavior, and safety (seat belt and helmet use). DATA SOURCE/STUDY DESIGN: Adolescent reports of clinician screening and counseling were obtained from adolescents who attended well visits with their primary care providers. A prepost study design was used to evaluate the preventive services intervention. The intervention had three components: (1) 89 clinicians from three outpatient pediatric clinics attended a training to increase the delivery of preventive services; (2) customized adolescent screening and provider charting forms were integrated into the clinics; and (3) the resources of a health educator were provided to the clinics. DATA COLLECTION: Following a visit, adolescents completed surveys reporting on clinician screening and counseling for each of the target risk areas. Preimplementation (three months), 104 adolescents completed surveys. Postimplementation of the training, tools, and health educator intervention, 211 adolescents completed surveys (five months). For 18 months postimplementation clinicians delivered services and 998 adolescents completed surveys. PRINCIPAL FINDINGS: Chi-square analyses of changes in screening from preimplementation to postimplementation showed that screening increased in all areas (p < .000), with an average increase in screening rates from 47 percent to 94 percent. Postimplementation counseling in all areas also increased significantly, with an average increase in counseling rates from 39 percent to 91 percent. There were slight decreases in screening from postimplementation to follow-up. CONCLUSIONS: This study offers support for the efficacy of providing training, tools, and resources as a method for increasing preventive screening and counseling of adolescents across multiple risky health behaviors during a routine office visit. PMID:16148966

Characteristics of clients who access mobile compared to clinic HIV counselling and testing services: a matched study from Cape Town, South Africa.

PubMed

Meehan, Sue-Ann; Naidoo, Pren; Claassens, Mareli M; Lombard, Carl; Beyers, Nulda

2014-12-20

Studies within sub-Saharan African countries have shown that mobile services increase uptake of HIV counselling and testing (HCT) services when compared to clinics and are able to access different populations, but these have included provider-initiated HCT in clinics. This study aimed to compare the characteristics of clients who self-initiated HCT at either a mobile or a clinic service in terms of demographic and socio-economic variables, also comparing reasons for accessing a particular health service provider. This study took place in eight areas around Cape Town. A matched design was used with one mobile HCT service matched with one or more clinics (offering routine HCT services) within each of the eight areas. Adult clients who self-referred for an HIV test within a specified time period at either a mobile or clinic service were invited to participate in the study. Data were collected between February and April 2011 using a questionnaire. Summary statistics were calculated for each service type within a matched pair and differences of outcomes from pairs were used to calculate effect sizes and 95% confidence intervals. 1063 participants enrolled in the study with 511 from mobile and 552 from clinic HCT services. The proportion of males accessing mobile HCT significantly exceeded that of clinic HCT (p < 0.001). The mean age of participants attending mobile HCT was higher than clinic participants (p = 0.023). No significant difference was found for socio-economic variables between participants, with the exception of access to own piped water (p = 0.029). Participants who accessed mobile HCT were significantly more likely to report that they were just passing, deemed an "opportunistic" visit (p = 0.014). Participants who accessed clinics were significantly more likely to report the service being close to home or work (p = 0.035). An HCT strategy incorporating a mobile HCT service, has a definite role to play in reaching those population groups who do not typically access HCT services at a clinic, especially males and those who take advantage of the opportunity to test. Mobile HCT services can complement clinic services.

Microbiological quality of open ready-to-eat salad vegetables: effectiveness of food hygiene training of management.

PubMed

Sagoo, S K; Little, C L; Mitchell, R T

2003-09-01

During September and October 2001, a microbiological study of open, ready-to-eat, prepared salad vegetables from catering or retail premises was undertaken to determine their microbiological quality. The study focused on those salad vegetables that were unwrapped and handled either by staff or customers in the premises where the sample was taken. Examination of salad vegetables from food service areas and customer self-service bars revealed that most (97%; 2,862 of 2,950) were of satisfactory or acceptable microbiological quality, 3% (87) were of unsatisfactory microbiological quality because of Escherichia coli levels in the range of 10(2) to 10(5) colony-forming units per gram. One (<1%) sample was of unacceptable microbiological quality because of the presence of Listeria monocytogenes at 840 colony-forming units per gram. The pathogens E. coli O157, Campylobacter spp., and salmonellas were not detected in any of the samples examined. The display area for most food service and preparation areas (95%) and self-service salad bars (98%) that were visited was judged to be visibly clean by the sampling officer. Most self-service bars (87%) were regularly supervised or inspected by staff during opening hours, and designated serving utensils were used in most salad bars (92%) but in only a minority of food service areas (35%). A hazard analysis system was in place in most (80%) premises, and in 61%, it was documented. Most (90%) managers had received food hygiene training. A direct relationship was shown between increased confidence in the food business management and the presence of food safety procedures and the training of management in food hygiene.

[Ecology-economy harmonious development based on the ecological services value change in Yanqi Basin, Northwest China].

PubMed

Mamat, Zulpiya; Halik, Umut; Aji, Rouzi; Nurmemet, Ilyas; Anwar, Mirigul; Keyimu, Maierdang

2015-03-01

In this paper, we used land use/cover ecosystem service value estimation model and ecological economic coordination degree model to analyze the changes of the ecosystem service value by the land use/cover changes during 1985, 1990, 1996, 2000, 2005 and 2011 in Yanqi Basin, Xin-jiang. Then we evaluated the ecology-economy harmony and the regional differences. The results showed that during 1985-2011, there was an increasing trend in the areas of waters, wetland, sand, cultivated land and construction land in Yanqi Basin. In contrast, that of the saline-alkali land, grassland and woodland areas exhibited a decreasing trend. The ecosystem service value in Yanqi Basin during this period presented an increasing trend, among which the waters and cultivated land contributed most to the total value of ecosystem services, while the grassland and the woodland had obviously declined contribution to the total value of ecosystem services. The research showed that the development of ecological economy in the study area was at a low conflict and low coordination level. So, taking reasonable and effective use of the regional waters and soil resources is the key element to maintain the ecosystem service function and sustainable and harmonious development of economy in Yanqi Basin.

Towards equity and sustainability of rural and remote health services access: supporting social capital and integrated organisational and professional development.

PubMed

Schoo, Adrian; Lawn, Sharon; Carson, Dean

2016-04-02

Access to rural health services is compromised in many countries including Australia due to workforce shortages. The issues that consequently impact on equity of access and sustainability of rural and remote health services are complex. The purpose of this paper is to describe a number of approaches from the literature that could form the basis of a more integrated approach to health workforce and rural health service enhancement that can be supported by policy. A case study is used to demonstrate how such an approach could work. Disjointed health services are common in rural areas due to the 'tyranny of distance.' Recruitment and retention of health professionals in rural areas and access to and sustainability of rural health services is therefore compromised. Strategies to address these issues tend to have a narrow focus. An integrated approach is needed to enhance rural workforce and health services; one that develops, acknowledges and accounts for social capital and social relations within the rural community.

Montana intercity bus service study.

DOT National Transportation Integrated Search

2011-12-01

Intercity bus service funding from the Federal Transit Administration (FTAs) Section 5311(f) program is a part : of the larger 5311 program known as Formula Grants for Other than Urbanized Areas. The S.5311(f), requires : that 15% of the total 531...

47 CFR 74.787 - Digital licensing.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES EXPERIMENTAL RADIO... licensee that demonstrates in its application that a portion of the station's pre-transition analog service... demonstrated loss area within the full-service station's pre-transition analog service area. “Analog service...

47 CFR 74.787 - Digital licensing.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES EXPERIMENTAL RADIO... licensee that demonstrates in its application that a portion of the station's pre-transition analog service... demonstrated loss area within the full-service station's pre-transition analog service area. “Analog service...

47 CFR 74.787 - Digital licensing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES EXPERIMENTAL RADIO... licensee that demonstrates in its application that a portion of the station's pre-transition analog service... demonstrated loss area within the full-service station's pre-transition analog service area. “Analog service...

47 CFR 74.787 - Digital licensing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES EXPERIMENTAL RADIO... licensee that demonstrates in its application that a portion of the station's pre-transition analog service... demonstrated loss area within the full-service station's pre-transition analog service area. “Analog service...

47 CFR 74.787 - Digital licensing.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES EXPERIMENTAL RADIO... licensee that demonstrates in its application that a portion of the station's pre-transition analog service... demonstrated loss area within the full-service station's pre-transition analog service area. “Analog service...

Quantifying the contribution of riparian soils to the provision of ecosystem services.

PubMed

de Sosa, Laura L; Glanville, Helen C; Marshall, Miles R; Prysor Williams, A; Jones, Davey L

2018-05-15

Riparian areas, the interface between land and freshwater ecosystems, are considered to play a pivotal role in the supply of regulating, provisioning, cultural and supporting services. Most previous studies, however, have tended to focus on intensive agricultural systems and only on a single ecosystem function. Here, we present the first study which attempts to assess a wide range of ecological processes involved in the provision of the ecosystem service of water quality regulation across a diverse range of riparian typologies. Specifically, we focus on 1) evaluating the spatial variation in riparian soils properties with respect to distance with the river and soil depth in contrasting habitat types; 2) gaining further insights into the underlying mechanisms of pollutant removal (i.e. pesticide sorption/degradation, denitrification, etc.) by riparian soils; and 3) quantify and evaluate how riparian vegetation across different habitat types contribute to the provision of watercourse shading. All the habitats were present within a single large catchment and included: (i) improved grassland, (ii) unimproved (semi-natural) grassland, (iii) broadleaf woodland, (iv) coniferous woodland, and (iv) mountain, heath and bog. Taking all the data together, the riparian soils could be statistically separated by habitat type, providing evidence that they deliver ecosystem services to differing extents. Overall, however, our findings seem to contradict the general assumption that soils in riparian area are different from neighbouring (non-riparian) areas and that they possess extra functionality in terms of ecosystem service provision. Watercourse shading was highly habitat specific and was maximal in forests (ca. 52% shade cover) in comparison to the other habitat types (7-17%). Our data suggest that the functioning of riparian areas in less intensive agricultural areas, such as those studied here, may be broadly predicted from the surrounding land use, however, further research is required to critically test this across a wider range of ecosystems. Copyright © 2017 Elsevier B.V. All rights reserved.

Youth Services in Rural Areas: Strategies for Service Delivery.

ERIC Educational Resources Information Center

Schwartz, Charles L.

1982-01-01

Pinpoints several problems in youth services in general and in rural areas in particular. Suggests strategies for overcoming these obstacles: packaging services which meet child's total needs, establishing youth service bureaus to coordinate families and human services resources, and using natural helping networks of the community. (Author/AH)

Measuring geographical accessibility to rural and remote health care services: Challenges and considerations.

PubMed

Shah, Tayyab Ikram; Milosavljevic, Stephan; Bath, Brenna

2017-06-01

This research is focused on methodological challenges and considerations associated with the estimation of the geographical aspects of access to healthcare with a focus on rural and remote areas. With the assumption that GIS-based accessibility measures for rural healthcare services will vary across geographic units of analysis and estimation techniques, which could influence the interpretation of spatial access to rural healthcare services. Estimations of geographical accessibility depend on variations of the following three parameters: 1) quality of input data; 2) accessibility method; and 3) geographical area. This research investigated the spatial distributions of physiotherapists (PTs) in comparison to family physicians (FPs) across Saskatchewan, Canada. The three-steps floating catchment areas (3SFCA) method was applied to calculate the accessibility scores for both PT and FP services at two different geographical units. A comparison of accessibility scores to simple healthcare provider-to-population ratios was also calculated. The results vary considerably depending on the accessibility methods used and the choice of geographical area unit for measuring geographical accessibility for both FP and PT services. These findings raise intriguing questions regarding the nature and extent of technical issues and methodological considerations that can affect GIS-based measures in health services research and planning. This study demonstrates how the selection of geographical areal units and different methods for measuring geographical accessibility could affect the distribution of healthcare resources in rural areas. These methodological issues have implications for determining where there is reduced access that will ultimately impact health human resource priorities and policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Parents with Learning Disabilities and Speech and Language Therapy. A Service Evaluation of Referrals and Episodes of Care

ERIC Educational Resources Information Center

Stansfield, Jois

2012-01-01

The speech and language therapy (SLT) service in an area of northern England receives referrals of parents who have learning disabilities. The aim of this study was to identify current referral patterns and quantify the level of demand upon the SLT service from this relatively new referral population to enable to service to meet the needs of these…

The impact of standalone call centres and GP cooperatives on access to after hours GP care: a before and after study adjusted for secular trend.

PubMed

Dunt, David; Day, Susan E; Kelaher, Margaret; Montalto, Michael

2006-08-01

The After Hours Primary Medical Trials were initiated by the Australian government to redress difficulties in after hours (AH) GP care in areas of high need. The study's objective is to study the impact of two standalone call centres and one GP cooperative offering comprehensive services, in improving consumer access to services for residents of a defined geographic area. A pre-post design was used to evaluate their impact after adjusting for secular trend at a national level. Access was considered in terms of availability, accessibility, affordability, acceptability and responsiveness of care. Unmet need and ease of obtaining AH telephone professional medical advice were also considered. Pre-trial and post-trial telephone surveys of two separate random samples of approximately 350 households using AH services in each trial area as well as in a national sample outside the trial areas. Consumer acceptability and affordability increased in residents in the area served by the GP cooperative. Access, however measured, did not improve in either of the standalone call centre areas. Reduction in unmet need approached but did not achieve statistical significance in most but not all trial areas. Improvements in access in the GP cooperative conformed to expectations based on current and pre-existing AH care arrangements put in place. Absence of improvements in access in the standalone call centres did not conform to expectations but may be partly explained by the reductions in consumer acceptability, following introduction of telephone triage systems reported elsewhere.

Who Hires Social Workers? Structural and Contextual Determinants of Social Service Staffing in Nursing Homes.

PubMed

Roberts, Amy Restorick; Bowblis, John R

2017-02-01

Although nurse staffing has been extensively studied within nursing homes (NHs), social services has received less attention. The study describes how social service departments are organized in NHs and examines the structural characteristics of NHs and other macro-focused contextual factors that explain differences in social service staffing patterns using longitudinal national data (Certification and Survey Provider Enhanced Reports, 2009-2012). NHs have three patterns of staffing for social services, using qualified social workers (QSWs); paraprofessional social service staff; and interprofessional teams, consisting of both QSWs and paraprofessionals. Although most NHs employ a QSW (89 percent), nearly half provide social services through interprofessional teams, and 11 percent rely exclusively on paraprofessionals. Along with state and federal regulations that depend on facility size, other contextual and structural factors within NHs also influence staffing. NHs most likely to hire QSWs are large facilities in urban areas within a health care complex, owned by nonprofit organizations, with more payer mixes associated with more profitable reimbursement. QSWs are least likely to be hired in small facilities in rural areas. The influence of policy in supporting the professionalization of social service staff and the need for QSWs with expertise in gerontology, especially in rural NHs, are discussed. © 2016 National Association of Social Workers.

75 FR 4138 - Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

..., and suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 5 Taxpayer Advocacy...: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 5...

76 FR 6187 - Open Meeting of the Area 4 Taxpayer Advocacy Panel (Including the States of Illinois, Indiana...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-03

..., and suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 4 Taxpayer Advocacy...: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 4...

76 FR 37198 - Open Meeting of the Area 4 Taxpayer Advocacy Panel (Including the States of Illinois, Indiana...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

..., and suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 4 Taxpayer Advocacy...: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 4...

47 CFR 22.228 - Cellular rural service area licenses subject to competitive bidding.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Licensing Requirements and Procedures Competitive Bidding... initial applications for Cellular Rural Service Area licenses are subject to competitive bidding. The...

The Comparative Labor Market Role of Newspaper Help Wanted Ads and Public Employment Service Job Listings. Final Report.

ERIC Educational Resources Information Center

Johnson, Miriam; Sugarman, Marged

A 1-year study of 12 U.S. labor market areas compared job listings in the help wanted ads of local newspapers to job orders in the local public employment services to help determine what the role of the public employment service should be. The study gathered two types of data. One type was used to compare the "stock," or inventory, of…

Assessing Satisfaction with Selected Student Services Using SERVQUAL, a Market-Driven Model of Service Quality.

ERIC Educational Resources Information Center

Ruby, Carl A.

1998-01-01

Demonstrates how the use of SERVQUAL, a market-driven assessment model adapted from business, can be used to study student satisfaction with four areas of support services hypothetically related to enrollment management. The sample included 748 students enrolled in general education courses at ten different private institutions. (Contains 27…

The Usage of Homebound Instruction: Training, Preparation, and Perceptions of Service Providers

ERIC Educational Resources Information Center

Petit, Constance C.

2013-01-01

This study presents the findings related to the use of homebound instruction as a special education service model and to the practices and perceptions of service providers in the areas of personal effectiveness, model effectiveness, and administrator support. A self-administered survey was distributed to a national sample of 484 educators from two…

Investigating Content Knowledge Gains in Academic Service-Learning: A Quasi-Experimental Study in an Educational Psychology Course.

ERIC Educational Resources Information Center

Shastri, Anuradhaa

Research on service learning spanning the last three decades has revealed that service learning facilitates the development of leadership skills, self esteem, teamwork, communication skills, and acceptance of cultural diversity. Perhaps the most difficult arena has been the area of intellectual, cognitive, and academic efforts. A study…

Creating Space for Teacher Activism in Environmental Education: Pre-Service Teachers' Experiences

ERIC Educational Resources Information Center

Campigotto, Rachelle; Barrett, Sarah E.

2017-01-01

Ontario, Canada mandates integrating environmental education (EE) into all subject areas from K-12, but pre-service teachers receive little to no instruction on how to do so. This study focusses on the experiences of 13 pre-service students who demonstrated their passion for EE through their own activism and volunteerism. Findings include the…

Howard Community College Staff Services Evaluation, Spring 1985. Research Report Number 41.

ERIC Educational Resources Information Center

Radcliffe, Susan K.; Novak, Virginia E.

In spring 1985, Howard Community College conducted a study to evaluate its performance of services for fiscal year 1985. All members of the faculty and management of the college were asked to complete a 153-item questionnaire arranged in 28 service areas. Questionnaires were completed by 25 faculty members (51% of total faculty), 30 management…

Preparing Pre-Service Teachers to Teach Primary Science: An Integrated Approach Using the Theme of Sustainability

ERIC Educational Resources Information Center

King, Donna

2014-01-01

An integrated approach to assessment afforded pre-service teachers the opportunity to learn about a local sustainability issue through three learning areas: science and technology, the arts and studies of society and environment (SOSE). Three sustainability issues chosen by the pre-service teachers are presented in this paper highlighting the…

Taking Action in Rural Mississippi: Uniting Academic Studies and Community Service through Project D.R.E.A.M.S.

ERIC Educational Resources Information Center

Oliver, Helen T.

This paper describes an innovative service learning program developed at Rust College in Holly Springs, Mississippi, a historically black college in a poor rural area. Project DREAMS (Developing Responsibility through Education, Affirmation, Mentoring, and Service) involves college student volunteers serving as tutors and mentors to elementary…

Radio broadcasting via satellite

NASA Astrophysics Data System (ADS)

Helm, Neil R.; Pritchard, Wilbur L.

1990-10-01

Market areas offering potential for future narrowband broadcast satellites are examined, including international public diplomacy, government- and advertising-supported, and business-application usages. Technical issues such as frequency allocation, spacecraft types, transmission parameters, and radio receiver characteristics are outlined. Service and system requirements, advertising revenue, and business communications services are among the economic issues discussed. The institutional framework required to provide an operational radio broadcast service is studied, and new initiatives in direct broadcast audio radio systems, encompassing studies, tests, in-orbit demonstrations of, and proposals for national and international commercial broadcast services are considered.

Impact of Computerized Student Information System.

ERIC Educational Resources Information Center

San Diego Community Coll. District, CA. Research Office.

A two-part study was conducted by the San Diego Community College District to assess the post-automation impact of the Student Information System (SIS) on the cost of providing student services. The study first determined the service areas most affected by the SIS and then assessed the savings potential of automation by: (1) interviewing personnel…

A multi-ethnic comparison of perceptions of forest recreation service quality

Treesearch

Chieh-Lu Li; James D. Absher; Harry C. Zinn; Alan R. Graefe; Garry E. Chick

2010-01-01

This study examines perceptions of service quality on an ethnically diverse national forest adjacent to a large metropolitan area, specifically looking for differences among whites, Hispanics, and Asians. Published studies of recreation and ethnicity have focused primarily on activity participation rates and patterns. The literature contains few cross–cultural...

Place-Based Education and Pre-Service Teachers: A Case Study from India

ERIC Educational Resources Information Center

Molyneux, Paul; Tyler, Debra

2014-01-01

Case studies of successful place-based education that involve international partnerships are rare. This article reports on an inclusive educational collaboration between pre-service teachers at an Australian university and primary and secondary school-aged children in a slum area of Delhi, India. Encouraged to undertake teaching that affirmed and…

Diabetes and Adult Day Health Services

ERIC Educational Resources Information Center

Dabelko, Holly I.; DeCoster, Vaughn A.

2007-01-01

The purpose of this study is to provide a profile of individuals with diabetes who receive services in adult day centers. This exploratory study uses an administrative data set (N = 280) from five programs in central Ohio to examine four areas: demographics, health and mental health, financial and social resources, and disenrollment status. Older…

Pre-Service Visual Art Teachers' Perceptions of Assessment in Online Learning

ERIC Educational Resources Information Center

Allen, Jeanne Maree; Wright, Suzie; Innes, Maureen

2014-01-01

This paper reports on a study conducted into how one cohort of Master of Teaching pre-service visual art teachers perceived their learning in a fully online learning environment. Located in an Australian urban university, this qualitative study provided insights into a number of areas associated with higher education online learning, including…

Changes in the selected reproductive health indicators among married women of reproductive age in low performing areas of Bangladesh: findings from an evaluation study

PubMed Central

2014-01-01

Background Three-year duration Demand-Based Reproductive Commodity Project (DBRHCP) was launched in three low performing areas: rural Nabiganj (population 323,357), Raipur (population 260,983) and urban slum in Dhaka (population 141,912). Objectives: Assessing changes in knowledge among married women of reproductive age on selected reproductive health issues and to explore their service utilization patterns over the project period in selected low performing areas of Bangladesh. Methods The study adopted a pre- posts design. In the project areas, the entire chain of service provision were modified through the interventions under the DBRHCP, including training of the providers, enhanced behavioral change communication activities, follow-up and counseling, record keeping, reporting and monitoring, as well as improvement in logistics and supplies. Peer promoters were established as linkages between clients and service providers. All households were enlisted. Baseline and end line surveys were done using representative simple random sampling method, capturing changes over one year intervention period. Descriptive analysis was done using SPSS package, version 10. Proportional tests using Stata, version 8 were done to assess changes from baseline to end line. Results The overall contraceptive prevalence was markedly different in the three study areas but significantly increased in both Dhaka urban slums and Nabiganj. In the rural areas, a higher proportion of the women in endline compared to baseline obtained contraceptive methods from the public sectors. Irrespective of study sites, significantly higher proportion of women received ANC (Antenatal Care) and PNC (Post natal care) in endline compared to baseline. In all study sites higher proportions of women were aware of maternal complications at endline. Services were obtained from qualified persons for reported symptoms of sexually transmitted infections by a higher proportion of women at endline compared to baseline. There were improvements in other RH indicators, such as use of skilled birth attendants and overall utilization of health care facilities by women. Conclusions The improvements in several important RH indicators in the intervention areas suggest that the interventions affected selected outcomes reported in the study. The study findings also suggest that investment in the reproductive health sector, particularly in existing government programs, improves RH outcomes. PMID:24886357

Towards understanding the availability of physiotherapy services in rural Australia.

PubMed

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

2016-01-01

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

Mobile radio alternative systems study traffic model

NASA Astrophysics Data System (ADS)

Tucker, W. T.; Anderson, R. E.

1983-06-01

The markets for mobile radio services in non-urban areas of the United States are examined for the years 1985-2000. Three market categories are identified. New Services are defined as those for which there are different expressed ideas but which are not now met by any application of available technology. The complete fulfillment of the needs requires nationwide radio access to vehicles without knowledge of vehicle location, wideband data transmission from remote sites, one- and two way exchange of short data and control messages between vehicles and dispatch or control centers, and automatic vehicle location (surveillance). The commercial and public services market of interest to the study is drawn from existing users of mobile radio in non-urban areas who are dissatisfied with the geographical range or coverage of their systems. The mobile radio telephone market comprises potential users who require access to the public switched telephone network in areas that are not likely to be served by the traditional growth patterns of terrestrial mobile telephone services. Conservative, likely, and optimistic estimates of the markets are presented in terms of numbers of vehicles that will be served and the radio traffic they will generate.

Mobile radio alternative systems study. Volume 1: Traffic model

NASA Technical Reports Server (NTRS)

Tucker, W. T.; Anderson, R. E.

1983-01-01

The markets for mobile radio services in non-urban areas of the United States are examined for the years 1985-2000. Three market categories are identified. New Services are defined as those for which there are different expressed ideas but which are not now met by any application of available technology. The complete fulfillment of the needs requires nationwide radio access to vehicles without knowledge of vehicle location, wideband data transmission from remote sites, one- and two way exchange of short data and control messages between vehicles and dispatch or control centers, and automatic vehicle location (surveillance). The commercial and public services market of interest to the study is drawn from existing users of mobile radio in non-urban areas who are dissatisfied with the geographical range or coverage of their systems. The mobile radio telephone market comprises potential users who require access to the public switched telephone network in areas that are not likely to be served by the traditional growth patterns of terrestrial mobile telephone services. Conservative, likely, and optimistic estimates of the markets are presented in terms of numbers of vehicles that will be served and the radio traffic they will generate.

Horizontal inequity in public health care service utilization for non-communicable diseases in urban Vietnam

PubMed Central

Kien, Vu Duy; Van Minh, Hoang; Giang, Kim Bao; Weinehall, Lars; Ng, Nawi

2014-01-01

Background A health system that provides equitable health care is a principal goal in many countries. Measuring horizontal inequity (HI) in health care utilization is important to develop appropriate and equitable public policies, especially policies related to non-communicable diseases (NCDs). Design A cross-sectional survey of 1,211 randomly selected households in slum and non-slum areas was carried out in four urban districts of Hanoi city in 2013. This study utilized data from 3,736 individuals aged 15 years and older. Respondents were asked about health care use during the previous 12 months; information included sex, age, and self-reported NCDs. We assessed the extent of inequity in utilization of public health care services. Concentration indexes for health care utilization and health care needs were constructed via probit regression of individual utilization of public health care services, controlling for age, sex, and NCDs. In addition, concentration indexes were decomposed to identify factors contributing to inequalities in health care utilization. Results The proportion of healthcare utilization in the slum and non-slum areas was 21.4 and 26.9%, respectively. HI in health care utilization in favor of the rich was observed in the slum areas, whereas horizontal equity was achieved among the non-slum areas. In the slum areas, we identified some key factors that affect the utilization of public health care services. Conclusion Our results suggest that to achieve horizontal equity in utilization of public health care services, policy should target preventive interventions for NCDs, focusing more on the poor in slum areas. PMID:25095780

Using a new incentive mechanism to improve wastewater sector performance: the case study of Italy.

PubMed

De Gisi, Sabino; Petta, Luigi; Farina, Roberto; De Feo, Giovanni

2014-01-01

The system of "Service Objectives", introduced by the Italian National Strategic Framework 2007-2013, is an innovative results-oriented programme concerning 4 thematic areas (education, care for the elderly and children, management of municipal solid wastes and integrated water service) in which the Ministry of Economic Development and eight Southern Italy districts are involved. The system was initially associated to an incentive mechanism which provided subsidies for a total amount of EUR 3 billion from the national Underdeveloped Areas Fund, according to the achievement of specific targets set for 11 service indicators in 2013. The indicators used for the integrated water service refer to the efficiency in water supply service as well as the coverage of wastewater treatment service. The aim of the study is to describe the activities carried out in Italy by the ENEA Agency in order to define a new performance indicator for wastewater treatment service taking into account the appropriateness and efficiency of existing plants equipment and, consequently, evaluating economic incentives. The proposed procedure takes into account both wastewater treatment demand and quality of wastewater treatment service offered to citizens. Input data, provided by the National Institute of Statistics (ISTAT), were elaborated in order to define appropriate parameters, with a multi-criteria analysis being used to define the new performance indicator. The applicability of the proposed procedure was verified considering all the 8 Southern Italy and Island districts (Abruzzo, Molise, Campania, Apulia, Basilicata, Calabria, Sicily and Sardinia) involved in the programme. The obtained results show that the quality of municipal wastewater may influence the calculation of the incentive amount. The performance indicators defined in this work might be conveniently extended to other contexts similar to the assessed geographical area (Southern Italy and Islands). Copyright © 2013 Elsevier Ltd. All rights reserved.

Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas

PubMed Central

Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

2016-01-01

Background Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. Methods This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. Results The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. Conclusions The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In particular, the results show that the low access neighbourhoods tend to be clustered in the neighbourhoods at the urban periphery and immediately surrounding the downtown area. PMID:27997577

Promoting small towns for rural development: a view from Nepal.

PubMed

Bajracharya, B N

1995-06-01

Two small villages in Nepal are the subjects of case studies that illustrate the role of small towns in provision of services, employment, and market operations. Some general findings are that small towns act as service centers for distribution of basic essential goods such as food grains, salt, kerosene, and fabric for hill and mountain areas. The role of small towns as market centers and in the provision of employment is limited. In resource-poor areas small towns are less diversified. Towns with agricultural surpluses are more developed. Small hill towns satisfy consumption rather than production needs. The growth of rural areas and towns in rural areas in Nepal is dependent on arable land and levels of production in hill areas. Limited land and low levels of production have an adverse impact. Movement of people, goods, and services is limited by difficult terrain and lack of access to good roads. Variability in access to off-farm jobs and services available in small towns varies with ethnicity and place of residence. The best development strategy for small towns in Nepal is market-oriented territorial development, which retains surpluses in the local area and integrates markets in the larger economy. The strategy would decentralize planning into small territorial units that include both small towns and groups of villages, provide institutional support for the rural poor, expand off-farm employment, and include investment in region-serving functions. Subsistence agriculture needs to include diversification of high value cash crops based on local comparative advantage suitable for hill climate and terrain. Small farmers must produce both cash and subsistence crops. Government should provide market space and paved areas, weighing facilities, and overnight storage facilities. Products would be processed at the village level. Subdistricts must be established according to spatial and social linkages between villages and the service center and coordinated at the district level. Group marketing, transport to large urban centers, and agricultural technical services are needed.

Temporal changes in potential regulating ecosystem services driven by urbanization

NASA Astrophysics Data System (ADS)

Ferreira, Carla; Amorim, Inês; Pires, Evanilton; Kalantari, Zahra; Walsh, Rory; Ferreira, António

2017-04-01

Ecosystem services (ES) are understood to be the capacity of the landscape of a particular area to provide goods and services to society. In terms of human benefits, four categories of ES are usually considered: provisioning (e.g. seafood), regulating (e.g. climate regulation, air quality, water purification and natural hazard protection), supporting (e.g. maintenance of biodiversity), and cultural (e.g. recreation). The potential supply of ecosystem services has receive increasing interest as a tool for natural resource management. Nevertheless, the capacity to supply ES depends on biophysical conditions, as well as climate and land-use changes, induced by human activities. This study aims to investigate the potential for regulating ecosystem service supply of a Portuguese peri-urban catchment, and attempts to understand the temporal changes in ES over the last decades driven by urbanization. The study was developed in Ribeira dos Covões catchment (6.2 km2), in Portugal. Due to its proximity to Coimbra, a major city in the central region of Portugal, the catchment has undergone major land-use changes over the last half-century. Since 1958, the agricultural area, comprising mainly olives and arable land, has declined from 48% to 4%, due to increases in urban land (from 8% to 40%) and forest (from 44% to 53%), as well as a temporary creation of open spaces (from 0% to 3%). The nature of forest cover also changed, from native species, such as oaks (Quercus sp.), to commercial timber plantations, mostly of Pinus pinaster L. and Eucaliptus globulus L.. Urbanization became more pronounced after 1973, exhibiting a discontinuous pattern until 1995, and then later more continuous urban areas through the infilling of areas between the earlier urban cores. Quantification of regulating ES in the study catchment was achieved using GIS techniques, in order to gain a spatial dimension of ES distribution (Burkhard et al., 2009). Mapping ecosystem service capacities at a 5×5m resolution involved the use of CORINE land cover data and aerial photographs, available for the years 1958, 1973, 1979, 1990, 1995, 2002, 2007 and 2012. The resulting land-use maps include 11 land cover classes: equipment and infrastructure, discontinuous urban fabric, continuous urban fabric, natural areas with shrubs and herbaceous plants, softwoods, hardwoods, mixed forest, permanent crops, arable land, bare soil and water bodies. Quantitative assessment of regulating services of these land-use classes was achieved based on interviews with 31 experts. Each expert prepared a matrix using a scale from "0" to "5", where "0" refers to the land cover as having no capacity to provide regulating services, while 5 indicates that the land cover provides a wide range of ecosystem services. A final matrix was prepared based on mean values of all the experts. This matrix was then integrated with the land-use maps of different years to generate a spatially explicit potential ecosystem service supply model. The results showed decreasing ecosystem regulation services over time, mainly due to increasing urban area but also changes on forest types. The methodology used can be easily applied to test distinct urbanization scenarios, thus, providing a valuable support for urban planning.

33 CFR 161.25 - Vessel Traffic Service New York Area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Vessel Traffic Service New York... Movement Reporting System Areas and Reporting Points § 161.25 Vessel Traffic Service New York Area. The area consists of the navigable waters of the Lower New York Harbor bounded on the east by a line drawn...

47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

Code of Federal Regulations, 2011 CFR

2011-10-01

... purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section... Zone. (2) Gulf of Mexico Coastal Zone. The geographical area within the Gulf of Mexico Service Area... unserved area licensing procedure for the GMEZ. (d) Operation within the Gulf of Mexico Coastal Zone (GMCZ...

Research Natural Areas of the Northern Region: Status and Needs Assessment

Treesearch

Steve W. Chadde; Shannon F. Kimball; Angela G. Evenden

1996-01-01

A major objective of the Forest Service Research Natural Area (RNA) program is to maintain a representative array of all significant natural ecosystems as baseline areas for research and monitoring (Forest Service Manual 4063, USDA Forest Service 1991). The National Forest Management Act of 1976 directs the agency to establish research natural areas typifying important...

Evaluating the service quality of paratransit systems : an exploratory study of the Toledo area regional transit authority.

DOT National Transportation Integrated Search

2009-11-01

Paratransit systems are created to improve mobility, employment opportunities, and : access to community services for individuals who are mentally or physically : disadvantaged. Though essential for the community, paratransit systems are more : expen...

LYNX community advocacy & service engagement (CASE) project final report.

DOT National Transportation Integrated Search

2009-05-14

This report is a final assessment of the Community Advocacy & Service Engagement (CASE) project, a LYNX-FTA research project designed : to study transit education and public engagement methods in Central Florida. In the Orlando area, as in other part...

47 CFR 101.1007 - Geographic service areas and number of licenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Geographic service areas and number of licenses. 101.1007 Section 101.1007 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Local Multipoint Distribution Service § 101.1007...

47 CFR 22.911 - Cellular geographic service area.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Section 22.911 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.911 Cellular geographic service area. The... Communications Act of 1934, as amended, is applicable. [59 FR 59507, Nov. 17, 1994, as amended at 59 FR 59954...

47 CFR 22.911 - Cellular geographic service area.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Section 22.911 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.911 Cellular geographic service area. The... Communications Act of 1934, as amended, is applicable. [59 FR 59507, Nov. 17, 1994, as amended at 59 FR 59954...

47 CFR 101.1007 - Geographic service areas and number of licenses.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Geographic service areas and number of licenses. 101.1007 Section 101.1007 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Local Multipoint Distribution Service § 101.1007...

47 CFR 101.1007 - Geographic service areas and number of licenses.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 5 2013-10-01 2013-10-01 false Geographic service areas and number of licenses. 101.1007 Section 101.1007 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Local Multipoint Distribution Service § 101.1007...

47 CFR 101.1007 - Geographic service areas and number of licenses.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Geographic service areas and number of licenses. 101.1007 Section 101.1007 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Local Multipoint Distribution Service § 101.1007...

What older people want: evidence from a study of remote Scottish communities.

PubMed

King, Gerry; Farmer, Jane

2009-01-01

The growing proportions of older people in rural areas have implications for the provision of health and social care services. Older people are more likely to have complex health needs compared with other age groups, requiring a full range of primary, community and acute hospital services. The provision of services to older people in rural areas is challenged by diseconomies of scale, travel costs and difficulties in attracting staff. Policy-makers are requested to include the 'voice' of older people to help provide services that match needs and context. In spite of this, what older people want from health and social care services is a neglected area of investigation. The reported study was conducted in 2005/2006 as part of a European Union Northern Periphery Programme (EU NPP) project called Our Life as Elderly. Its aims were to explore the views of those aged 55 years and over and living in remote communities about current and future health and social care service provision for older people. Evidence was to be collected that could inform policy-makers about changing or improving service delivery. This article summarises emergent themes and considers their implications. The study selected two small remote mainland Scottish Highland communities for in-depth case study. Semi-structured interviews (n = 23), 10 'informal conversations' and 4 focus groups were held with community members aged 55 years and over, in order to provide different types of qualitative data and 'layers' of data to allow reflection. Data analysis was assisted by computerised data management software and performed using the 'framework analysis' approach. Participants did not consider themselves 'old' and expressed the need for independence in older age to be supported by services. Several aspects of services that were undergoing change or restructuring were identified, including arrangements for home care services, meals provision and technological support. Participants valued elements of the traditional model of care they had been receiving: these were local, personal emphasis and continuity. They were suspicious of new arrangements perceived to emphasise technical efficiency. Health and care services were described as inter-linked with other aspects of rural living, including transport and housing (which might have to be relinquished to pay for care). Proximity to family was desired for social and domestic support only; health and related support should be from generic service providers. Community members were involved in reciprocal help-giving of many types. The findings compare with results of other studies of older rural people internationally, and generic 'principles' of service derived could guide restructuring. There may be systemic challenges to empowering older people's 'voice' in designing sustainable rural services that stem from society's views of older people, attitudes of communities to collective roles and responsibilities, and the fragmented ways that services are sometimes provided.

Measures of Social Deprivation That Predict Health Care Access and Need within a Rational Area of Primary Care Service Delivery

PubMed Central

Butler, Danielle C; Petterson, Stephen; Phillips, Robert L; Bazemore, Andrew W

2013-01-01

Objective To develop a measure of social deprivation that is associated with health care access and health outcomes at a novel geographic level, primary care service area. Data Sources/Study Setting Secondary analysis of data from the Dartmouth Atlas, AMA Masterfile, National Provider Identifier data, Small Area Health Insurance Estimates, American Community Survey, Area Resource File, and Behavioural Risk Factor Surveillance System. Data were aggregated to primary care service areas (PCSAs). Study Design Social deprivation variables were selected from literature review and international examples. Factor analysis was used. Correlation and multivariate analyses were conducted between index, health outcomes, and measures of health care access. The derived index was compared with poverty as a predictor of health outcomes. Data Collection/Extraction Methods Variables not available at the PCSA level were estimated at block level, then aggregated to PCSA level. Principal Findings Our social deprivation index is positively associated with poor access and poor health outcomes. This pattern holds in multivariate analyses controlling for other measures of access. A multidimensional measure of deprivation is more strongly associated with health outcomes than a measure of poverty alone. Conclusions This geographic index has utility for identifying areas in need of assistance and is timely for revision of 35-year-old provider shortage and geographic underservice designation criteria used to allocate federal resources. PMID:22816561

[State of supply services for industrial hygiene and safety in Colombia].

PubMed

Varona, Marcela E; Torres, Carlos Humberto; Díaz, Sonia M; Palma, Ruth Marién; Checa, Diana Milena; Conde, Juan Vicente

2012-01-01

Institutions that supply occupational health services must offer services that are reliable and of high quality across the spectrum of industrial hygiene and safety needs. Services for occupational health were identified at several institutions, and the technical quality and reliability of these services were compared in different regions of Colombia. This descriptive study identified the services available for industrial hygiene and safety in 15 cities of Colombia. A survey was conducted in 192 institutions offering such services and a statistical analysis of these results was undertaken. This sample was taken from a nationwide list of institutions purportedly licensed for this activity. Thirty-two percent (61) of the evaluated institutions provided hygiene services, and 48% (93) provided safety services. The range of health services was provided on a subcontract basis both for professional personnel and the equipment. Six institutions in the area of industrial hygiene and 1 in the area of industrial security were supplying services with pending or suspended institutional licenses. Deficiencies in the quality, infrastructure and levels of automation were identified at institutions that supply services of hygiene and industrial security. The resulting recommendatios are that the Ministry of the Social Protection fortifies mechanisms for (1) the evaluation and control of the supplied services, and (2) verify that the institutional activity is in accordance with current and valid licensing.

Free preconceptual screening examination service in rural areas of Hubei Province, China in 2012.

PubMed

Li, Cui-ling; Zhao, Kai; Li, Hui; Farah, Omar Ibrahim; Wang, Jiao-jiao; Sun, Rong-ze; Zhang, Hui-ping

2014-01-01

This work aims to collect and summarize the outcomes on free preconceptual screening examination in rural areas of Hubei Province in 2012. Moreover, this review promotes further understanding of the status of this activity to provide the Family Planning Commission valid scientific data upon which to construct effective policies. Couples, who complied with the family planning policy and were the residents in agricultural areas or lived in a local rural area for more than six months, were encouraged to participate in the free preconceptual screening examination service provided by the Hubei Provincial Population and Family Planning Commission. This service included 19 screening tests. All the data, including forms, manuals, and test results, were collected from 1 January 2012 to 31 December 2012 in rural areas in Hubei Province. A total of 497,860 individuals participated in the free preconceptual screening examination service, with a coverage rate of 97.1%. 4.0% and 4.8% of the participants exhibited with abnormal blood levels of ALT and creatinine, respectively; 0.36% of the participants tested positive for syphilis; 0.44% and 3.6% of the female participants tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis, respectively; and 0.84% and 1.8% of the female participants tested positive for cytomegalovirus (IgM) and Toxoplasma gondii (IgM), respectively. After risk assessment, 59,935 participants might have high-risk of adverse pregnancy outcomes. In 2012, the prevalence of birth defects among the parturient who participated in the preconceptual screening examination service was 0.04%, while the prevalence was 0.08% among those who did not participate in the service. Preconceptual screening examination service may help to address the risk factors that can lead to adverse pregnancy outcome. More studies on the relationship between preconceptual screening examination service and prevalence of birth defect or other adverse pregnancy outcomes should be conducted.

47 CFR 22.949 - Unserved area licensing process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Unserved area licensing process. 22.949 Section 22.949 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.949 Unserved area licensing process. This section...

A Study of Policy, Organisation and Provision in Community Education and Leisure and Recreation in Three Scottish Regions.

ERIC Educational Resources Information Center

Alexander, D. J.; And Others

This document describes a study conducted to examine the effectiveness and efficiency of the provision of leisure and recreation services and community education services in selected areas of the Tayside, Central, and Fife Regions of Scotland. The 18-month-long study gathered 826 responses from 1,060 questionnaires issued in order to study the…

Dynamics of Ecosystem Services during Forest Transitions in Reventazón, Costa Rica.

PubMed

Vallet, Améline; Locatelli, Bruno; Levrel, Harold; Brenes Pérez, Christian; Imbach, Pablo; Estrada Carmona, Natalia; Manlay, Raphaël; Oszwald, Johan

2016-01-01

The forest transition framework describes the temporal changes of forest areas with economic development. A first phase of forest contraction is followed by a second phase of expansion once a turning point is reached. This framework does not differentiate forest types or ecosystem services, and describes forests regardless of their contribution to human well-being. For several decades, deforestation in many tropical regions has degraded ecosystem services, such as watershed regulation, while increasing provisioning services from agriculture, for example, food. Forest transitions and expansion have been observed in some countries, but their consequences for ecosystem services are often unclear. We analyzed the implications of forest cover change on ecosystem services in Costa Rica, where a forest transition has been suggested. A review of literature and secondary data on forest and ecosystem services in Costa Rica indicated that forest transition might have led to an ecosystem services transition. We modeled and mapped the changes of selected ecosystem services in the upper part of the Reventazón watershed and analyzed how supply changed over time in order to identify possible transitions in ecosystem services. The modeled changes of ecosystem services is similar to the second phase of a forest transition but no turning point was identified, probably because of the limited temporal scope of the analysis. Trends of provisioning and regulating services and their tradeoffs were opposite in different spatial subunits of our study area, which highlights the importance of scale in the analysis of ecosystem services and forest transitions. The ecosystem services transition framework proposed in this study is useful for analyzing the temporal changes of ecosystem services and linking socio-economic drivers to ecosystem services demand at different scales.

Dynamics of Ecosystem Services during Forest Transitions in Reventazón, Costa Rica

PubMed Central

Vallet, Améline; Locatelli, Bruno; Levrel, Harold; Brenes Pérez, Christian; Imbach, Pablo; Estrada Carmona, Natalia; Manlay, Raphaël; Oszwald, Johan

2016-01-01

The forest transition framework describes the temporal changes of forest areas with economic development. A first phase of forest contraction is followed by a second phase of expansion once a turning point is reached. This framework does not differentiate forest types or ecosystem services, and describes forests regardless of their contribution to human well-being. For several decades, deforestation in many tropical regions has degraded ecosystem services, such as watershed regulation, while increasing provisioning services from agriculture, for example, food. Forest transitions and expansion have been observed in some countries, but their consequences for ecosystem services are often unclear. We analyzed the implications of forest cover change on ecosystem services in Costa Rica, where a forest transition has been suggested. A review of literature and secondary data on forest and ecosystem services in Costa Rica indicated that forest transition might have led to an ecosystem services transition. We modeled and mapped the changes of selected ecosystem services in the upper part of the Reventazón watershed and analyzed how supply changed over time in order to identify possible transitions in ecosystem services. The modeled changes of ecosystem services is similar to the second phase of a forest transition but no turning point was identified, probably because of the limited temporal scope of the analysis. Trends of provisioning and regulating services and their tradeoffs were opposite in different spatial subunits of our study area, which highlights the importance of scale in the analysis of ecosystem services and forest transitions. The ecosystem services transition framework proposed in this study is useful for analyzing the temporal changes of ecosystem services and linking socio-economic drivers to ecosystem services demand at different scales. PMID:27390869

Behavioral medicine as a part of a comprehensive small animal medical program.

PubMed

Burghardt, W F

1991-03-01

The rationale of incorporating behavioral medicine into veterinary practice is that it can expand the range of medical services offered, help obtain happier, more acceptable pets, and lead to longer pet ownership. In doing so, veterinarians should be able to increase their business both through an actual increase in pet ownership and retention and through increased services for individual pets. The range of services offered can differ from practice to practice but may include preventive, interventive, and ancillary services, as with other areas in contemporary veterinary medical practice. Each area of behavioral practice can be an economically feasible addition to veterinary practice from the perspective of medical services rendered, as a method of practice promotion, or as an area of public service. The choice depends on the level of competence of the practitioner, the practice philosophy, and the need for the services in a given service area.

Variability and dilemmas in harm reduction for anabolic steroid users in the UK: a multi-area interview study

PubMed Central

2014-01-01

Background The UK continues to experience a rise in the number of anabolic steroid-using clients attending harm reduction services such as needle and syringe programmes. Methods The present study uses interviews conducted with harm reduction service providers as well as illicit users of anabolic steroids from different areas of England and Wales to explore harm reduction for this group of drug users, focussing on needle distribution policies and harm reduction interventions developed specifically for this population of drug users. Results The article addresses the complexity of harm reduction service delivery, highlighting different models of needle distribution, such as peer-led distribution networks, as well as interventions available in steroid clinics, including liver function testing of anabolic steroid users. Aside from providing insights into the function of interventions available to steroid users, along with principles adopted by service providers, the study found significant tensions and dilemmas in policy implementation due to differing perspectives between service providers and service users relating to practices, risks and effective interventions. Conclusion The overarching finding of the study was the tremendous variability across harm reduction delivery sites in terms of available measures and mode of operation. Further research into the effectiveness of different policies directed towards people who use anabolic steroids is critical to the development of harm reduction. PMID:24986546

Research priorities of the Canadian chiropractic profession: a consensus study using a modified Delphi technique.

PubMed

French, Simon D; Beliveau, Peter J H; Bruno, Paul; Passmore, Steven R; Hayden, Jill A; Srbely, John; Kawchuk, Greg N

2017-01-01

Research funds are limited and a healthcare profession that supports research activity should establish research priority areas. The study objective was to identify research priority areas for the Canadian chiropractic profession, and for stakeholders in the chiropractic profession to rank these in order of importance. We conducted a modified Delphi consensus study between August 2015 and May 2017 to determine the views of Canadian chiropractic organisations (e.g. Canadian Chiropractic Association; provincial associations) and stakeholder groups (e.g. chiropractic educational institutions; researchers). Participants completed three online Delphi survey rounds. In Round 1, participants suggested research areas within four broad research themes: 1) Basic science; 2) Clinical; 3) Health services; and 4) Population health. In Round 2, researchers created sub-themes by categorising the areas suggested in Round 1, and participants judged the importance of the research sub-themes. We defined consensus as at least 70% of participants agreeing that a research area was "essential" or "very important". In Round 3, results from Round 2 were presented to the participants to re-evaluate the importance of sub-themes. Finally, participants completed an online pairwise ranking activity to determine the rank order of the list of important research sub-themes. Fifty-seven participants, of 85 people invited, completed Round 1 (response rate 67%). Fifty-six participants completed Round 2, 55 completed Round 3, and 53 completed the ranking activity. After three Delphi rounds and the pairwise ranking activity was completed, the ranked list of research sub-themes considered important were: 1) Integration of chiropractic care into multidisciplinary settings; 2) Costs and cost-effectiveness of chiropractic care; 3) Effect of chiropractic care on reducing medical services; 4) Effects of chiropractic care; 5) Safety/side effects of chiropractic care; 6) Chiropractic care for older adults; 7) Neurophysiological mechanisms and effects of spinal manipulative therapy; 8) General mechanisms and effects of spinal manipulative therapy. This project identified research priority areas for the Canadian chiropractic profession. The top three priority areas were all in the area of health services research: 1) Integration of chiropractic care into multidisciplinary settings; 2) Costs and cost-effectiveness of chiropractic care; 3) Effect of chiropractic care on reducing medical services.

76 FR 22863 - Designation for the Lewiston, ID Area

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-25

... the Lewiston, ID Area AGENCY: Grain Inspection, Packers and Stockyards Administration, USDA. ACTION... official services in the geographic area previously serviced by Lewiston Grain Inspection Service, Inc. (Lewiston). Applications were due by February 3, 2011. Washington was the sole applicant for designation to...

47 CFR 101.56 - Partitioned service areas (PSAs) and disaggregated spectrum.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Partitioned service areas (PSAs) and disaggregated spectrum. 101.56 Section 101.56 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED..., Modifications, Conditions and Forfeitures § 101.56 Partitioned service areas (PSAs) and disaggregated spectrum...

Mapping bundles of ecosystem services reveals distinct types of multifunctionality within a Swedish landscape.

PubMed

Queiroz, Cibele; Meacham, Megan; Richter, Kristina; Norström, Albert V; Andersson, Erik; Norberg, Jon; Peterson, Garry

2015-01-01

Ecosystem services (ES) is a valuable concept to be used in the planning and management of social-ecological landscapes. However, the understanding of the determinant factors affecting the interaction between services in the form of synergies or trade-offs is still limited. We assessed the production of 16 ES across 62 municipalities in the Norrström drainage basin in Sweden. We combined GIS data with publically available information for quantifying and mapping the distribution of services. Additionally, we calculated the diversity of ES for each municipality and used correlations and k-means clustering analyses to assess the existence of ES bundles. We found five distinct types of bundles of ES spatially agglomerated in the landscape that could be explained by regional social and ecological gradients. Human-dominated landscapes were highly multifunctional in our study area and urban densely populated areas were hotspots of cultural services.

Estimating the economic value of cultural ecosystem services in an urbanizing area using hedonic pricing

Treesearch

Heather A. Sander; Robert G. Haight

2012-01-01

A need exists to increase both knowledge and recognition of the values associated with ecosystem services and amenities. This article explores the use of hedonic pricing as a tool for eliciting these values. We take a case study approach, valuing several services provided by ecosystems, namely aesthetic quality (views), access to outdoor recreation, and the benefits...

Spanish Faculty Preferences and Usage of Library Services in the Field of Science and Technology

ERIC Educational Resources Information Center

Pinto, Maria; Fernandez-Ramos, Andres

2010-01-01

The authors compare Spanish faculty use of library services and the interest they express in value-added services and improvement actions. The results are based on data from a survey of 546 faculty in the field of science and technology. The study differentiates between the areas of pure science, engineering and architecture, and life sciences.…

Recreation ecosystem services from chaparral dominated landscapes: a baseline assessment from national forests in Southern California

Treesearch

Cloé Garnache; Lorie Srivastava; José J Sánchez; Frank  Lupi

2018-01-01

This chapter examines recreation ecosystem services provided by chaparral dominated landscapes. Such areas are popular around the world amongst recreation users, including hikers, mountain bikers, campers, and nature enthusiasts. Yet, relatively few studies have documented the recreation services provided by chaparral landscapes such as national forests. For policy...

Differentiated Instruction: Hong Kong Prospective Teachers' Teaching Efficacy and Beliefs

ERIC Educational Resources Information Center

Wan, Sally Wai-Yan

2016-01-01

Catering for learner diversity is one of the key areas in the recent educational reform in Hong Kong. Pre-service teacher education acts as a fundamental way to equip pre-service teachers ready for accommodating diverse learning needs and to build up pre-service teachers' self-efficacy. The purpose of the study is to examine prospective teachers'…

47 CFR 36.214 - Long distance message revenue-Account 5100.

Code of Federal Regulations, 2011 CFR

2011-10-01

... relative number of minutes-of-use in the study area. Effective July 1, 2001 through June 30, 2012, all study areas shall apportion Wideband Message Service revenues among the jurisdictions using the relative... are directly assigned based on their subsidiary record categories or on the basis of analysis and...

Reproductive health services in Malawi: an evaluation of a quality improvement intervention.

PubMed

Rawlins, Barbara J; Kim, Young-Mi; Rozario, Aleisha M; Bazant, Eva; Rashidi, Tambudzai; Bandazi, Sheila N; Kachale, Fannie; Sanghvi, Harshad; Noh, Jin Won

2013-01-01

this study was to evaluate the impact of a quality improvement initiative in Malawi on reproductive health service quality and related outcomes. (1) post-only quasi-experimental design comparing observed service quality at intervention and comparison health facilities, and (2) a time-series analysis of service statistics. sixteen of Malawi's 23 district hospitals, half of which had implemented the Performance and Quality Improvement (PQI) intervention for reproductive health at the time of the study. a total of 98 reproductive health-care providers (mostly nurse-midwives) and 139 patients seeking family planning (FP), antenatal care (ANC), labour and delivery (L&D), or postnatal care (PNC) services. health facility teams implemented a performance and quality improvement (PQI) intervention over a 3-year period. Following an external observational assessment of service quality at baseline, facility teams analysed performance gaps, designed and implemented interventions to address weaknesses, and conducted quarterly internal assessments to assess progress. Facilities qualified for national recognition by complying with at least 80% of reproductive health clinical standards during an external verification assessment. key measures include facility readiness to provide quality care, observed health-care provider adherence to clinical performance standards during service delivery, and trends in service utilisation. intervention facilities were more likely than comparison facilities to have the needed infrastructure, equipment, supplies, and systems in place to offer reproductive health services. Observed quality of care was significantly higher at intervention than comparison facilities for PNC and FP. Compared with other providers, those at intervention facilities scored significantly higher on client assessment and diagnosis in three service areas, on clinical management and procedures in two service areas, and on counselling in one service area. Service statistics suggest that the PQI intervention increased the number of Caesarean sections, but showed no impact on other indicators of service utilisation and skilled care. the PQI intervention showed a positive impact on the quality of reproductive health services. The effects of the intervention on service utilisation had likely not yet been fully realized, since none of the facilities had achieved national recognition before the evaluation. Staff turnover needs to be reduced to maximise the effectiveness of the intervention. the PQI intervention evaluated here offers an effective way to improve the quality of health services in low-resource settings and should continue to be scaled up in Malawi. Copyright © 2011 Elsevier Ltd. All rights reserved.

A return on investment study of the Hampton Roads Safety Service Patrol program.

DOT National Transportation Integrated Search

2007-01-01

Safety Service Patrol (SSP) programs are widely used to help mitigate the effects of nonrecurring congestion on our nation's highways and have become an increasingly vital element of incident management programs. SSPs are typically deployed in areas ...

32 CFR 199.1 - General provisions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... authority to make benefit determinations or obligate Government funds. Advice given to beneficiaries as to... research activities in the health care area to assist in formulating policy required to guide OCHAMPUS in... for claims processing services, studies and research, supplies, equipment, an other services necessary...

Perceptions of biopsychosocial services needs among older adults with severe mental illness: met and unmet needs.

PubMed

Cummings, Sherry M; Cassie, Kimberly McClure

2008-05-01

This study sought to identify the psychiatric, physical, and social services needs experienced by older adults with severe mental illness (SMI) and to examine factors influencing their experience of need and service provision adequacy. Seventy-five older adults with SMI were recruited from a community mental health center to participate in the study. The typical client experienced a need for care in 10 areas, with the greatest needs occurring in the areas of psychological pain, physical illness, social contacts, looking after the home, and daily activities. The total number of unmet needs ranged from zero to 10, with the typical client having an average of 2.3 unmet needs (SD = 2.4). The highest proportions of unmet needs were in the areas of social contact, benefits, sight or hearing difficulties, and intimate relationships. Linear hierarchical regression analyses revealed that clients with lower income, greater impairments in independent daily living skills, and higher levels of depression experienced increased needs for care. Older clients who lived in private homes or apartments had higher levels of depression, and those who required assistance in the areas of intimate relationships and benefits experienced higher levels of unmet needs. Research and practice implications are discussed.

Spatio-temporal variations of conservation hotspots based on ecosystem services in Xishuangbanna, Southwest China.

PubMed

Liu, Shiliang; Yin, Yijie; Cheng, Fangyan; Hou, Xiaoyun; Dong, Shikui; Wu, Xue

2017-01-01

Integrating biodiversity and ecosystem services (BES) has been viewed as an appropriate approach to identifying conservation priorities. Taking Xishuangbanna tropical region in Southwest China, different BESs (habitat quality [used as a proxy for biodiversity], carbon storage, and water yield) were quantified using the InVEST model and conservation hotspots from 1976, 1990, and 2010 were identified by overlapping and ranking the service layers. Results showed that BESs areas were unevenly distributed. High habitat quality and carbon storage areas located in the eastern part of the region were mainly occupied by broad-leaved forest, while high water yield areas were covered by grassland and tropical forests. Recognized hotspots were primarily composed of the broad-leaved forest and shrub grassland. However, these habitat types declined by nearly 50% from 1.25×105 ha to 0.63×105 ha and became more fragmented during the study period. We also found that the sub-watersheds which decreased in BES had fewer hotspots distributed and suffered greater landscape fragmentation. Our study further explored the impacts of land-use conversion on BES, and illustrated the necessity and feasibility of BESs in identifying potential conservation areas.

Spatio-temporal variations of conservation hotspots based on ecosystem services in Xishuangbanna, Southwest China

PubMed Central

Liu, Shiliang; Yin, Yijie; Cheng, Fangyan; Hou, Xiaoyun; Dong, Shikui; Wu, Xue

2017-01-01

Integrating biodiversity and ecosystem services (BES) has been viewed as an appropriate approach to identifying conservation priorities. Taking Xishuangbanna tropical region in Southwest China, different BESs (habitat quality [used as a proxy for biodiversity], carbon storage, and water yield) were quantified using the InVEST model and conservation hotspots from 1976, 1990, and 2010 were identified by overlapping and ranking the service layers. Results showed that BESs areas were unevenly distributed. High habitat quality and carbon storage areas located in the eastern part of the region were mainly occupied by broad-leaved forest, while high water yield areas were covered by grassland and tropical forests. Recognized hotspots were primarily composed of the broad-leaved forest and shrub grassland. However, these habitat types declined by nearly 50% from 1.25×105 ha to 0.63×105 ha and became more fragmented during the study period. We also found that the sub-watersheds which decreased in BES had fewer hotspots distributed and suffered greater landscape fragmentation. Our study further explored the impacts of land-use conversion on BES, and illustrated the necessity and feasibility of BESs in identifying potential conservation areas. PMID:29232370

Do You Live Happily? Exploring the Impact of Physical Environment on Residents’ Sense of Happiness

NASA Astrophysics Data System (ADS)

Chen, Chiu-lin; Zhang, Heng

2018-01-01

From the beginning of human civilization, human beings have been exploring the source of happiness. Capitalists believed that economic growth would bring us happiness, but a small, poor Buddhist country—Bhutan—has dispelled the myth with the concept of Gross National Happiness. Today, the concept of happiness has evolved from the field of psychology to all disciplines. Many researchers are exploring how environmental psychology/behavioral psychology influences residents’ sense of happiness. The goal of this study is to explore how various environmental factors influence residents’ sense of happiness. Through statistical analysis of 473 samples, the results showed that factors like green area, community layout, aesthetics, transportation service and social service significantly influenced residents’ sense of happiness. Among all the factors, transportation service and social service simultaneously influence “satisfied” and “joyful”, the two factors related to residents’ sense of happiness; community layout and aesthetics are significantly correlated to “satisfied” green area and business service significantly influences “joyful”. The results of this study can be used as reference for professionals as they make relevant decisions.

Activities of Intellectual Disability Clinical Nurse Specialists in Ireland.

PubMed

Doody, Owen; Slevin, Eamonn; Taggart, Laurence

The aim of this study was to identify the contribution of Irish intellectual disability clinical nurse specialists (ID CNSs) to service delivery. A nonexperimental descriptive design was selected to survey ID CNSs presently working in Ireland. The questionnaire was developed based on focus group interviews, available literature, and expert panel views. Ethical approval and access were granted to all ID CNSs in Ireland. Thirty-two responded (33.68% response rate) from all work areas (voluntary organizations or health service executive) practicing within residential, community, or school services. Respondents were surveyed across a range of areas (demographic details and support to client, staff, family, organization, community, other agencies, and professional development). Findings identify that ID CNSs are active in all aspects of their roles as clinical specialist, educator, communicator, researcher, change agent, and leader, thus supporting person-centered care and improving service delivery. To meet changing healthcare demands, promote person-centered care, and improve service delivery, the CNS role in ID should be developed and supported. The findings merit a further study on ID CNS role activity, possible variables influencing role activity, and team members' views.

76 FR 56482 - Notice and Request For Comments: LSC Elimination of the West Virginia Migrant Service Area...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-13

... LEGAL SERVICES CORPORATION Notice and Request For Comments: LSC Elimination of the West Virginia Migrant Service Area Beginning January 1, 2012 AGENCY: Legal Services Corporation. ACTION: Notice and Request for Comments. SUMMARY: The Legal Services Corporation will eliminate the West Virginia migrant...

78 FR 49445 - Wildlife Services Policy on Wildlife Damage Management in Urban Areas

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-14

...] Wildlife Services Policy on Wildlife Damage Management in Urban Areas AGENCY: Animal and Plant Health... Health Inspection Service's Wildlife Services (APHIS-WS) program is making a policy decision on how to.... FOR FURTHER INFORMATION CONTACT: Mr. William H. Clay, Deputy Administrator, Wildlife Services, APHIS...

Church attendee help seeking priorities after Hurricane Katrina in Mississippi and Louisiana: a brief report.

PubMed

Aten, Jamie D; Gonzalez, Rose A; Boan, David M; Topping, Sharon; Livingston, William V; Hosey, John M

2012-01-01

After a disaster, survivors find themselves seeking many types of help from others in their communities. The purpose of this exploratory study was to assist in mental health service planning by determining the type and priority of support services sought by church attendees after Hurricane Katrina. Surveys were given to church attendees from two Mississippi coast and four New Orleans area churches that were directly affected by Hurricane Katrina participants were asked to review a list of 12 potential sources of help and were asked to rank the items chronologically from whom they had sought help first after Hurricane Katrina. Overall, participants sought out assistance from informal social networks such as family and friends first, followed by governmental and clergy support. This study also showed there may be differences in help-seeking behaviors between church attendees in more urban areas versus church attendees in more rural areas. Moreover, findings highlighted that very few church attendees seek out mental health services during the initial impact phase of a disaster. Since timely engagement with mental health services is important for resolving trauma, strategies that link professional mental health services with clergy and government resources following a disaster could improve the engagement with mental health professionals and improve mental health outcomes. Disaster mental health clinical implications and recommendations are offered for psychologists based on these findings.

Open solutions to distributed control in ground tracking stations

NASA Technical Reports Server (NTRS)

Heuser, William Randy

1994-01-01

The advent of high speed local area networks has made it possible to interconnect small, powerful computers to function together as a single large computer. Today, distributed computer systems are the new paradigm for large scale computing systems. However, the communications provided by the local area network is only one part of the solution. The services and protocols used by the application programs to communicate across the network are as indispensable as the local area network. And the selection of services and protocols that do not match the system requirements will limit the capabilities, performance, and expansion of the system. Proprietary solutions are available but are usually limited to a select set of equipment. However, there are two solutions based on 'open' standards. The question that must be answered is 'which one is the best one for my job?' This paper examines a model for tracking stations and their requirements for interprocessor communications in the next century. The model and requirements are matched with the model and services provided by the five different software architectures and supporting protocol solutions. Several key services are examined in detail to determine which services and protocols most closely match the requirements for the tracking station environment. The study reveals that the protocols are tailored to the problem domains for which they were originally designed. Further, the study reveals that the process control model is the closest match to the tracking station model.

Perceptions of family-centred services in a paediatric rehabilitation programme: strengths and complexities from multiple stakeholders.

PubMed

Arcuri, G G; McMullan, A E; Murray, A E; Silver, L K; Bergthorson, M; Dahan-Oliel, N; Coutinho, F

2016-03-01

Family-centred services (FCS) are best practice in paediatric rehabilitation and describe philosophies and approaches to medical care that emphasize the partnership and involvement of parents. While evidence supports FCS, there are complexities to its successful implementation. This mixed-methods study aimed to measure the extent to which parents and the healthcare provider (HCP) perceive service provision as being family centred, and to describe barriers and facilitators to the delivery of FCS. Parents of children participating in a rehabilitation programme and HCPs providing services participated in this study. Parents completed the measure of processes of care-20 and participated in interviews, while HCPs completed the measure of processes of care-service providers and participated in a focus group. Quantitative analysis revealed that parents were mostly satisfied with features of FCS, which included communication and support between parents and HCPs, respect of diversity and parental collaboration and participation. Parents identified communication methods and psychosocial needs as areas that facilitated but sometimes detracted from FCS. Institutional barriers led to the identification of areas for improvement identified by multiple stakeholders. HCPs identified more areas for improvement than parents. When considering these barriers, it is evident that implementation is a complex process, impacted by institutional barriers. FCS needs to be investigated further, and systemic interventions should be used to facilitate its implementation. © 2015 John Wiley & Sons Ltd.

Estimation of the real population and its impact on the utilisation of healthcare services in Mediterranean resort regions: an ecological study

PubMed Central

Perea-Milla, Emilio; Pons, Sergi Mari; Rivas-Ruiz, Francisco; Gallofre, Anna; Jurado, Enrique Navarro; Ales, Marco A Navarro; Jimenez-Puente, Alberto; Fernandez-Nieto, Fidel; Cerda, Joan C March; Carrasco, Manuel; Martin, Lydia; Cano, Damian Lopez; Gutierrez, Gonzalo E; Macías, Rafael Cortes; Garcia-Ruiz, Jose A

2007-01-01

Background The demographic structure has a significant influence on the use of healthcare services, as does the size of the population denominators. Very few studies have been published on methods for estimating the real population such as tourist resorts. The lack of information about these problems means there is a corresponding lack of information about the behaviour of populational denominators (the floating population or tourist load) and the effect of this on the use of healthcare services. The objectives of the study were: a) To determine the Municipal Solid Waste (MSW) ratio, per person per day, among populations of known size; b) to estimate, by means of this ratio, the real population in an area where tourist numbers are very significant; and c) to determine the impact on the utilisation of hospital emergency healthcare services of the registered population, in comparison to the non-resident population, in two areas where tourist numbers are very significant. Methods An ecological study design was employed. We analysed the Healthcare Districts of the Costa del Sol and the island of Menorca. Both are Spanish territories in the Mediterranean region. Results In the two areas analysed, the correlation coefficient between the MSW ratio and admissions to hospital emergency departments exceeded 0.9, with p < 0.001. On the basis of MSW generation ratios, obtained for a control zone and also measured in neighbouring countries, we estimated the real population. For the summer months, when tourist activity is greatest and demand for emergency healthcare at hospitals is highest, this value was found to be double that of the registered population. Conclusion The MSW indicator, which is both ecological and indirect, can be used to estimate the real population in areas where population levels vary significantly during the year. This parameter is of interest in planning and dimensioning the provision of healthcare services. PMID:17266744

Estimation of the real population and its impact on the utilisation of healthcare services in Mediterranean resort regions: an ecological study.

PubMed

Perea-Milla, Emilio; Pons, Sergi Mari; Rivas-Ruiz, Francisco; Gallofre, Anna; Jurado, Enrique Navarro; Ales, Marco A Navarro; Jimenez-Puente, Alberto; Fernandez-Nieto, Fidel; Cerda, Joan C March; Carrasco, Manuel; Martin, Lydia; Cano, Damian Lopez; Gutierrez, Gonzalo E; Macías, Rafael Cortes; Garcia-Ruiz, Jose A

2007-01-31

The demographic structure has a significant influence on the use of healthcare services, as does the size of the population denominators. Very few studies have been published on methods for estimating the real population such as tourist resorts. The lack of information about these problems means there is a corresponding lack of information about the behaviour of populational denominators (the floating population or tourist load) and the effect of this on the use of healthcare services. The objectives of the study were: a) To determine the Municipal Solid Waste (MSW) ratio, per person per day, among populations of known size; b) to estimate, by means of this ratio, the real population in an area where tourist numbers are very significant; and c) to determine the impact on the utilisation of hospital emergency healthcare services of the registered population, in comparison to the non-resident population, in two areas where tourist numbers are very significant. An ecological study design was employed. We analysed the Healthcare Districts of the Costa del Sol and the island of Menorca. Both are Spanish territories in the Mediterranean region. In the two areas analysed, the correlation coefficient between the MSW ratio and admissions to hospital emergency departments exceeded 0.9, with p < 0.001. On the basis of MSW generation ratios, obtained for a control zone and also measured in neighbouring countries, we estimated the real population. For the summer months, when tourist activity is greatest and demand for emergency healthcare at hospitals is highest, this value was found to be double that of the registered population. The MSW indicator, which is both ecological and indirect, can be used to estimate the real population in areas where population levels vary significantly during the year. This parameter is of interest in planning and dimensioning the provision of healthcare services.

Postgraduate training at the ends of the earth - a way to retain physicians?

PubMed

Straume, Karin; Søndenå, Mona S; Prydz, Peter

2010-01-01

The recruitment and retention of health workers, crucial to health service delivery, is a major challenge in many rural and remote areas. Finnmark, the most remote and northern county in Norway, has faced recurrent shortages during the last 5 decades, especially of primary care physicians. This article describes a postgraduate training model for family physicians and public health/community medicine physicians, based on group tutorial and in-service training in rural areas. The effect of the training programs on physician retention in Finnmark is evaluated by a longitudinal cohort study. In total, 65-67% of the physicians from the programs are still working in the county 5 years after completion of the group tutorial. Rural practice provides good learning conditions when accompanied by appropriate tutelage, and in-service training allows the trainees and their families to 'grow roots' in the remote area while in training. The group tutorial develops peer support and professional networks to alleviate professional isolation. On the basis of these findings, traditional centralistic training models are challenged. Postgraduate (vocational) training (residency) for primary care physicians can be successfully carried out in-service in remote areas, in a manner that enhances retention without compromising the quality of the training.

A Description of Weekend Physiotherapy Services in Three Tertiary Hospitals in the Greater Toronto Area

PubMed Central

Hill, Kylie

2010-01-01

ABSTRACT Purpose: The aims of this study were (1) to describe the cardiorespiratory physiotherapy weekend service (PWS) at three tertiary hospitals in the Greater Toronto Area (GTA) and (2) to compare measures of staff burden among the clinical service areas in one of the hospitals that had a programme-based management structure. Method: Two focus-group meetings were held with physiotherapists from hospitals within the GTA. Thereafter, variables characterizing the PWS were collected over 8 months, using a standardized data-collection form. Results: A total of 632 data-collection forms were received. Response rates exceeded 75% at each hospital. Workload variables, including the number of patient visits, new referrals per hour, and the proportion of staff completing unpaid overtime, differed between the hospitals (p<0.002). There was no difference in any variable when data were compared between Saturday, Sunday, and statutory holidays (p>0.13). Workload measures varied between clinical service areas at the hospital that provided PWS using a programme-based approach. Conclusions: These findings highlight the important shortcomings of a programme-based management approach to providing PWS and may constitute a catalyst for change. PMID:21359048

The Physical Learning Environment for Teaching: Child Care Services, Clothing Services, Food Services, Health Services, Home Furnishings Service, Housekeeping Services, and Management Services. Home Economics Occupational Education.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

Suggestions are given to aid school administrators, area directors, teachers, advisory committees, and architects in planning for the home economics occupational education facility. Requirements are listed for space and equipment for instructional classrooms, laboratories, and laundry and storage areas, as well as space allocation in square feet…

Distribution of cause of death in rural Bangladesh during 2003-2010: evidence from two rural areas within Matlab Health and Demographic Surveillance site.

PubMed

Alam, Nurul; Chowdhury, Hafizur R; Ahmed, Ali; Rahman, Mahfuzur; Streatfield, P Kim

2014-01-01

This study used the InterVA-4 computerised model to assign probable cause of death (CoD) to verbal autopsies (VAs) generated from two rural areas, with a difference in health service provision, within the Matlab Health and Demographic Surveillance site (HDSS). This study aimed to compare CoD by gender, as well as discussing possible factors which could influence differences in the distribution of CoD between the two areas. Data for this study came from the Matlab the HDSS maintained by the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) since 1966. In late 1977, icddr,b divided HDSS and implemented a high-quality maternal, newborn and child health and family planning (MNCH-FP) services project in one half, called the icddr,b service area (SA), in addition to the usual public and private MNCH-FP services that serve the other half, called the government SA. HDSS field workers registered 12,144 deaths during 2003-2010, and trained interviewers obtained VA for 98.9% of them. The probabilistic model InterVA-4 probabilistic model (version 4.02) was used to derive probable CoD from VA symptoms. Cause-specific mortality rates and fractions were compared across gender and areas. Appropriate statistical tests were applied for significance testing. Mortality rates due to neonatal causes and communicable diseases (CDs) were lower in the icddr,b SA than in the government SA, where mortality rates due to non-communicable diseases (NCDs) were lower. Cause-specific mortality fractions (CSMFs) due to CDs (23.2% versus 18.8%) and neonatal causes (7.4% versus 6%) were higher in the government SA, whereas CSMFs due to NCDs were higher (58.2% versus 50.7%) in the icddr,b SA. The rank-order of CSMFs by age group showed marked variations, the largest category being acute respiratory infection/pneumonia in infancy, injury in 1-4 and 5-14 years, neoplasms in 15-49 and 50-64 years, and stroke in 65+ years. Automated InterVA-4 coding of VA to determine probable CoD revealed the difference in the structure of CoD between areas with prominence of NCDs in both areas. Such information can help local planning of health services for prevention and management of disease burden.

Incorporating threat in hotspots and coldspots of biodiversity and ecosystem services.

PubMed

Schröter, Matthias; Kraemer, Roland; Ceauşu, Silvia; Rusch, Graciela M

2017-11-01

Spatial prioritization could help target conservation actions directed to maintain both biodiversity and ecosystem services. We delineate hotspots and coldspots of two biodiversity conservation features and five regulating and cultural services by incorporating an indicator of 'threat', i.e. timber harvest profitability for forest areas in Telemark (Norway). We found hotspots, where high values of biodiversity, ecosystem services and threat coincide, ranging from 0.1 to 7.1% of the area, depending on varying threshold levels. Targeting of these areas for conservation follows reactive conservation approaches. In coldspots, high biodiversity and ecosystem service values coincide with low levels of threat, and cover 0.1-3.4% of the forest area. These areas might serve proactive conservation approaches at lower opportunity cost (foregone timber harvest profits). We conclude that a combination of indicators of biodiversity, ecosystem services and potential threat is an appropriate approach for spatial prioritization of proactive and reactive conservation strategies.

Combined effects of compact cevelopment, transportation investments, and road user pricing on vehicle miles traveled in urbanized areas

USGS Publications Warehouse

Ewing, Reid; Hamidi, Shima; Gallivan, Frank; Nelson, Arthur C.; Grace, James B.

2014-01-01

Vehicle miles traveled (VMT) is the primary determinant of traffic congestion, vehicle crashes, greenhouse gas emissions, and other effects of transportation. Two previous studies have sought to explain VMT levels in urbanized areas. This study updates and expands on previous work with more recent data, additional metrics, and structural equation modeling (SEM) to explain VMT levels in 315 urbanized areas. According to SEM, population, income, and gasoline prices are primary exogenous drivers of VMT. Development density is a primary endogenous driver. Urbanized areas with more freeway capacity are significantly less dense and have significantly higher VMT per capita. Areas with more transit service coverage and service frequency have higher development densities and per capita transit use, which leads to lower VMT per capita. The indirect effect of transit on VMT through land use, the so-called land use multiplier, is more than three times greater than the direct effect through transit ridership.

Improving the Virtual Reference Experience: How Closely Do Academic Libraries Adhere to RUSA Guidelines?

ERIC Educational Resources Information Center

Platt, Jessica; Benson, Pete

2010-01-01

The purpose of this study was to measure the degree to which academic libraries or library staff members throughout the United States adhere to the Guidelines for Virtual Reference Services provided by the Reference & User Services Association (RUSA). The results of the study were analyzed to identify specific areas where improvement is needed…

Mammalian Toxicology Testing: Problem Definition Study, Technical Plan.

DTIC Science & Technology

1981-03-01

Acute Oral Exposure Area, Rzdent 2. Subchrcnic Oral Exposure Area, .odent 3. Chronic Oral Exposure Area, Rodent 4. Subchronic Oral Eposure Area, "og...Alarms Fire Extinguisher First Aid Fiscal Year Record Fixtures (See Jigs, Fixtures & Molds Control System) Food Preparation/Blending Forms Control...Insurance Invoicing (See Bookkeeping) Janitorial Service Jigs, Fixtures & Molds Control System Key Control System Keypunch Control System Label

The role of fire in Research Natural Areas in the Northern Rockies and Pacific Northwest

Treesearch

Sarah E. Greene; Angela Evenden

1996-01-01

Forest Service Research Natural Areas are established to preserve examples of all significant natural ecosystems for comparison with those influenced andlor managed by humans, to provide educational and research areas for ecological and environmental studies, and to preserve gene pools for typical and rare and endangered species. The Research Natural Area program in...

What are your priorities right now? Identifying service needs across recovery stages to inform service development.

PubMed

Laudet, Alexandre B; White, William

2010-01-01

Substance use disorders (SUD) are, for many, chronic conditions that are typically associated with severe impairments in multiple areas of functioning. "Recovery" from SUD is, for most, a lengthy process; improvements in other areas of functioning do not necessarily follow the attainment of abstinence. The current SUD service model providing intense, short-term, symptom-focused services is ill-suited to address these issues. A recovery-oriented model of care is emerging, which provides coordinated recovery-support services using a chronic-care model of sustained recovery management. Information is needed about substance users' priorities, particularly persons in recovery who are not currently enrolled in treatment, to guide the development of recovery-oriented systems. As a first step in filling this gap, we present qualitative data on current life priorities among a sample of individuals that collectively represent successive recovery stages (N = 356). Findings suggest that many areas of functioning remain challenging long after abstinence is attained, most notably employment and education, family/social relations, and housing. Although the ranking of priorities changes somewhat across recovery stages, employment is consistently the second most important priority, behind working on one's recovery. Study limitations are noted, and the implications of findings for the development and evaluation of recovery-oriented services are discussed.

Impacts of fire exclusion and recent managed fire on forest structure in old growth Sierra Nevada mixed-conifer forests

Treesearch

Brandon M. Collins; Richard G. Everett; Scott L. Stephens

2011-01-01

We re-sampled areas included in an unbiased 1911 timber inventory conducted by the U.S. Forest Service over a 4000 ha study area. Over half of the re-sampled area burned in relatively recent management- and lightning-ignited fires. This allowed for comparisons of both areas that have experienced recent fire and areas with no recent fire, to the same areas historically...

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

[Equity-based considerations for transforming the Ecuadorian health system].

PubMed

López-Cevallos, Daniel; Chi, Chunhuei; Ortega, Fernando

2014-01-01

The present study was aimed at analysing socioeconomic inequity regarding the use of health services in Ecuador, inequity regarding the geographic distribution of healthcare-related human resources and reflecting on the challenges concerning equity which the Ecuadorian health system is currently facing. The Ecuadorian Demographic, Maternal and Infant Health Survey (2004) was used as the main data source, as its sample was representative of the Ecuadorian population. Multilevel multivariate analysis (MLWiN 2.02 statistical software) and spatial data analysis regarding health resources (GeoDa 1.0.1) were used for estimating the effects of using health services. It was found that social, economic and geographic inequity limited access to health services in Ecuador. People living in low economic resource households or indigenous housing and people living in rural areas (many of them having all three characteristics at the same time) had less possibility of using health services. In spite of a marked concentration of health-service providers in urban areas, it was found that the presence of healthcare personnel (excluding doctors) in rural public entities increased the possibility of using preventative and curative services. Efforts at transforming the Ecuadorian health system must be aimed at reducing social, cultural and financial barriers and inequality regarding the distribution de healthcare-related human resources, particularly in rural areas. Community and family orientation of the services and increasing spaces for citizen participation are necessary for reducing such inequity.

47 CFR 27.1208 - BTA service areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... Except for incumbent BRS licenses, BRS service areas are Basic Trading Areas (BTAs) or additional service... in places where Rand McNally has not defined BTAs: American Samoa; Guam; Gulf of Mexico Zone A; Gulf of Mexico Zone B; Gulf of Mexico Zone C; Northern Mariana Islands; Mayaguez/Aguadilla-Ponce, Puerto...

47 CFR 101.1421 - Coordination of adjacent area MVDDS stations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Multichannel Video Distribution and Data Service Rules for... compatible with adjacent and co-channel operations in the adjacent areas on all its frequencies; and (2... adjacent and co-channel operations in adjacent areas. (b) Harmful interference to public safety stations...

Consider long-term care as service alternative.

PubMed

Loria, L S

1987-04-01

The increasing demand for elderly care services, pressures on inpatient average length of stay and payment levels, and potential financial rewards from providing additional services, makes long-term care look attractive to hospitals. Long-term care, however, is not for every hospital. Before deciding to establish long-term care services, management should examine how the service fits within the hospital's strategic plan. The action plan below provides guidance in evaluating a decision to use hospital facilities for long-term care. Examine how long-term care services fit within the hospital's strategic plan. Study area demographics and competitors to assess the need and supply of long-term care services. Survey the medical staff, consumers and payers to determine attitudes, perceptions and interests regarding long-term care services. Develop a facility plan that identifies areas of excess capacity that can be most easily converted into long-term care with minimal effects on hospital operations. Prepare a financial feasibility analysis of the contribution margin and return on investment attributable to long-term care services. Include an impact analysis on hospital operations. Establish a management task force to develop a detailed implementation plan including assigned individual responsibilities and related timetable. Develop an effective marketing plan designed to generate increased patient market share.

Value Assessment of Ecosystem Services in Nature Reserves in Ningxia, China: A Response to Ecological Restoration

PubMed Central

Wang, Yan; Gao, Jixi; Wang, Jinsheng; Qiu, Jie

2014-01-01

Changes in land use can cause significant changes in the ecosystem structure and process variation of ecosystem services. This study presents a detailed spatial, quantitative assessment of the variation in the value of ecosystem services based on land use change in national nature reserves of the Ningxia autonomous region in China. We used areas of land use types calculated from the remote sensing data and the adjusted value coefficients to assess the value of ecosystem services for the years 2000, 2005, and 2010, analyzing the fluctuations in the valuation of ecosystem services in response to land use change. With increases in the areas of forest land and water bodies, the value of ecosystem services increased from 182.3×107 to 223.8×107 US$ during 2000–2010. Grassland and forest land accounted for 90% of this increase. The values of all ecosystem services increased during this period, especially the value of ecosystem services for biodiversity protection and soil formation and protection. Ecological restoration in the reserves had a positive effect on the value of ecosystem services during 2000–2010. PMID:24586571

Linking biophysical models and public preferences for ecosystem service assessments: a case study for the Southern Rocky Mountains

USGS Publications Warehouse

Bagstad, Kenneth J.; Reed, James; Semmens, Darius J.; Sherrouse, Ben C.; Troy, Austin

2016-01-01

Through extensive research, ecosystem services have been mapped using both survey-based and biophysical approaches, but comparative mapping of public values and those quantified using models has been lacking. In this paper, we mapped hot and cold spots for perceived and modeled ecosystem services by synthesizing results from a social-values mapping study of residents living near the Pike–San Isabel National Forest (PSI), located in the Southern Rocky Mountains, with corresponding biophysically modeled ecosystem services. Social-value maps for the PSI were developed using the Social Values for Ecosystem Services tool, providing statistically modeled continuous value surfaces for 12 value types, including aesthetic, biodiversity, and life-sustaining values. Biophysically modeled maps of carbon sequestration and storage, scenic viewsheds, sediment regulation, and water yield were generated using the Artificial Intelligence for Ecosystem Services tool. Hotspots for both perceived and modeled services were disproportionately located within the PSI’s wilderness areas. Additionally, we used regression analysis to evaluate spatial relationships between perceived biodiversity and cultural ecosystem services and corresponding biophysical model outputs. Our goal was to determine whether publicly valued locations for aesthetic, biodiversity, and life-sustaining values relate meaningfully to results from corresponding biophysical ecosystem service models. We found weak relationships between perceived and biophysically modeled services, indicating that public perception of ecosystem service provisioning regions is limited. We believe that biophysical and social approaches to ecosystem service mapping can serve as methodological complements that can advance ecosystem services-based resource management, benefitting resource managers by showing potential locations of synergy or conflict between areas supplying ecosystem services and those valued by the public.

Service Networks and Patterns of Utilization: Mental Health Programs, Indian Health Service (IHS). Volume 8: Phoenix Area, 1966-1974.

ERIC Educational Resources Information Center

Attneave, Carolyn L.; Beiser, Morton

The eighth volume in a 10-volume report on the historical development (1966-1973) of the 8 administrative Area Offices of the Indian Health Service (IHS) Mental Health Programs, this report presents information on the Phoenix Area Office and the Tucson Sub-Area Office. Included in this document are: (1) The Context: Political and Geographic (the…

Telehealth services in rural and remote Australia: a systematic review of models of care and factors influencing success and sustainability.

PubMed

Bradford, Natalie K; Caffery, Liam J; Smith, Anthony C

2016-01-01

With the escalating costs of health care, issues with recruitment and retention of health practitioners in rural areas, and poor economies of scale, the question of delivering people to services or services to people is a dilemma for health authorities around the world. People living in rural areas have poorer health outcomes compared to their urban counterparts, and the problem of how to provide health care and deliver services in rural locations is an ongoing challenge. Telehealth services can efficiently and effectively improve access to healthcare for people living in rural and remote areas of Australia. However, telehealth services are not mainstream or routinely available in many rural and remote locations. The barriers to integration of telehealth into mainstream practice have been well described, but not the factors that may influence the success and sustainability of a service. Our aim was to collate, review and synthesise the available literature regarding telehealth services in rural and remote locations of Australia, and to identify the factors associated with their sustained success. A systematic literature review of peer-reviewed and grey literature was undertaken. Electronic databases were searched for potentially relevant articles. Reference lists of retrieved articles and the grey literature were also searched. Searches identified 970 potentially eligible articles published between 1988 and 2015. Studies and manuscripts of any type were included if they described telehealth services (store-and-forward or real-time videoconferencing) to provide clinical service or education and training related to health care in rural or remote locations of Australia. Data were extracted according to pre-defined criteria and checked for completeness and accuracy by a second reviewer. Any disagreements were resolved with discussion with a third researcher. All articles were appraised for quality and levels of evidence. Data were collated and grouped into categories including clinical speciality, disciplines involved, geographical location and the role of the service. Data relating to the success or sustainability of services were grouped thematically. Inclusion criteria were met by 116 articles that described 72 discrete telehealth services. Telehealth services in rural and remote Australia are described and we have identified six key factors associated with the success and sustainability of services: vision, ownership, adaptability, economics, efficiency and equipment. Telehealth has the potential to address many of the key challenges to providing health in Australia, with its substantial land area and widely dispersed population. This review collates information regarding the telehealth services in Australia and describes models of care and characteristics of successful and sustainable services. We identified a wide variety of telehealth services being provided in rural and remote areas of Australia. There is great potential to increase this number by scaling up and replicating successful services. This review provides information for policy makers, governments and public and private health services that wish to integrate telehealth into routine practice and for telehealth providers to enhance the sustainability of their service.

SCHOOL PLANT MANAGEMENT FOR SCHOOL ADMINISTRATORS.

ERIC Educational Resources Information Center

ENGMAN, JOHN DAVID

THIS REPORT IS A COMPILATION OF STUDIES ON SIGNIFICANT ASPECTS IN SCHOOL PLANNING AND OPERATION. A RELATIONSHIP IS SHOWN BETWEEN CURRICULUM, PERSONNEL AND AUXILIARY SERVICES IN EDUCATIONAL PROGRAM OPERATIONS. THE REPORT INCLUDES PLANNING, MANAGEMENT AND OPERATION OF SUCH AREAS AS--NONINSTRUCTIONAL PERSONNEL POLICIES, CUSTODIAL SERVICES,…

Quality of life in epilepsy (QOLIE): insights about epilepsy and support groups from people with epilepsy (San Francisco Bay Area, USA).

PubMed

Chung, Kenny; Liu, Yuan; Ivey, Susan L; Huang, Debbie; Chung, Corina; Guo, Wenting; Tseng, Winston; Ma, Daveena

2012-06-01

This study evaluated quality of life (QOL) in people with epilepsy (PWE) in the San Francisco Bay Area. This was a qualitative study examining QOL through the use of focus groups and of the QOLIE-31-P survey instrument. Six focus groups were conducted to examine self-reported challenges due to epilepsy. Focus groups were conducted for individuals who did and did not attend support groups. Individuals with epilepsy reported substantial difficulties with finances, physical and psychosocial functioning. Also, limited knowledge about services and relatively negative feelings toward self were common among newly diagnosed participants. Many of the issues surrounding QOL and challenges were shared across groups. Epilepsy-related social services appeared to be useful in helping PWE cope and in increasing PWE's awareness of key enabling services. Although many individuals with epilepsy reported poor QOL and other challenges, epilepsy-related services may be under-utilized due to a lack of awareness. Copyright © 2012 Elsevier Inc. All rights reserved.

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.

Spatio-temporal evolution of water-related ecosystem services: Taihu Basin, China.

PubMed

Chen, Junyu; Cui, Tao; Wang, Huimin; Liu, Gang; Gilfedder, Mat; Bai, Yang

2018-01-01

Water-related ecosystem services (WESs) arise from the interaction between water ecosystems and their surrounding terrestrial ecosystems. They are critical for human well-being as well as for the whole ecological circle. An urgent service-oriented reform for the utilization and supervision of WESs can assist in avoiding ecological risks and achieving a more sustainable development in the Taihu Basin, China (THB). Spatially distributed models allow the multiple impacts of land use/land cover conversion and climate variation on WESs to be estimated and visualized efficiently, and such models can form a useful component in the toolbox for integrated water ecosystem management. The Integrated Valuation of Ecosystem Services and Tradeoffs model is used here to evaluate and visualize the spatio-temporal evolution of WESs in the THB from 2000 to 2010. Results indicate that water retention service experienced a decline from 2000 to 2005 with a recovery after 2005, while there was ongoing water scarcity in urban areas. Both the water purification service and the soil retention service underwent a slight decrease over the study period. Nutrients export mainly came from developed land and cultivated land, with the hilly areas in the south of the THB forming the primary area for soil loss. The quantity and distribution of WESs were impacted significantly by the shrinkage of cultivated land and the expansion of developed land. These findings will lay a foundation for a service-oriented management of WESs in the THB and support evidence-based decision making.

Aircraft concepts for service to small communities

NASA Technical Reports Server (NTRS)

Galloway, T. L.

1976-01-01

Small communities are served by trunk, local-service, and commuter carriers having a wide variety in route structure, type of service, and economic character, operating over stage lengths less than 400 statute miles. NASA studies have investigated various aircraft concepts for short-haul that have potential in this market area. Aircraft concepts for this market require a careful balancing of performance, technology, and design-to-cost considerations. This paper summarizes some results of recent NASA sponsored air transportation system studies applicable to small community arenas.

Deployment of sustainable fueling/charging systems at California highway safety roadside rest areas : a research report from the National Center for Sustainable Transportation.

DOT National Transportation Integrated Search

2016-12-01

The objectives of this research were to study the feasibility of the deployment of renewable hydrogen fueling/DC fast charging stations at California Safety Roadside Rest Areas (SRRAs), not at service areas with commercial activity, and the integrati...

Transition Management and Social Innovation in Rural Areas: Lessons from Social Farming

ERIC Educational Resources Information Center

Di Iacovo, Francesco; Moruzzo, Roberta; Rossignoli, Cristiano; Scarpellini, Paola

2014-01-01

Purpose: The article reflects on transition management in rural areas and the possible implications for extension services able to support social innovation and rural change, starting from experiences on social farming in different areas of Italy. Design/methodology/approach: By presenting three case studies we investigate the role of social…

Linking ecosystem services with state-and-transition models to evaluate rangeland management decisions

NASA Astrophysics Data System (ADS)

Lohani, S.; Heilman, P.; deSteiguer, J. E.; Guertin, D. P.; Wissler, C.; McClaran, M. P.

2014-12-01

Quantifying ecosystem services is a crucial topic for land management decision making. However, market prices are usually not able to capture all the ecosystem services and disservices. Ecosystem services from rangelands, that cover 70% of the world's land area, are even less well-understood since knowledge of rangelands is limited. This study generated a management framework for rangelands that uses remote sensing to generate state and transition models (STMs) for a large area and a linear programming (LP) model that uses ecosystem services to evaluate natural and/or management induced transitions as described in the STM. The LP optimization model determines the best management plan for a plot of semi-arid land in the Empire Ranch in southeastern Arizona. The model allocated land among management activities (do nothing, grazing, fire, and brush removal) to optimize net benefits and determined the impact of monetizing environmental services and disservices on net benefits, acreage allocation and production output. The ecosystem services under study were forage production (AUM/ac/yr), sediment (lbs/ac/yr), water runoff (inches/yr), soil loss (lbs/ac/yr) and recreation (thousands of number of visitors/ac/yr). The optimization model was run for three different scenarios - private rancher, public rancher including environmental services and excluding disservices, and public rancher including both services and disservices. The net benefit was the highest for the public rancher excluding the disservices. A result from the study is a constrained optimization model that incorporates ecosystem services to analyze investments on conservation and management activities. Rangeland managers can use this model to understand and explain, not prescribe, the tradeoffs of management investments.

[Satisfaction with child and adolescent mental health services by user and clinician sex].

PubMed

Bunge, Eduardo L; Barilá, Carina V; Sánchez, Natalia A; Maglio, Ana L

2014-01-01

Client Satisfaction with mental health services is an important aspect in the evaluation of quality of those services. In youth mental health field, a few studies had being made about this characteristic. The aim of this study is to evaluate the relationship between satisfaction of parents, children and adolescents according to sex of patients and therapists. The sample included 382 subjects who attended to Buenos Aires private services who completed the questionnaire of experiences with the service. The results in teenagers' group showed differences in the satisfaction with the service matching the sex of teenagers with the sex of therapist, however in children and parent groups we haven't found significant differences. We discuss the implications of the results in order to improve the services given in youth area.

7 CFR 1806.22 - Areas of responsibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Areas of responsibility. 1806.22 Section 1806.22 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE GENERAL...

47 CFR 87.345 - Scope of service.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AVIATION SERVICES... communications for vehicles operating on an airport movement area. An airport movement area is defined as the... communications outlet station (RCO) or FAA flight service station in operation, communications by an aeronautical...

Assessing obstetric patient experience: a SERVQUAL questionnaire.

PubMed

Garrard, Francesca; Narayan, Harini

2013-01-01

Across health services, there is a drive to respond to patient feedback and to incorporate their views into service improvement. The SERVQUAL method has been used in several clinical settings to quantify whether services meet patient expectations. However, work has been limited in the obstetric population. This paper seeks to address these issues. This study used an adapted SERVQUAL questionnaire to assess a reconfigured antenatal clinic service. The most important care aspects, as rated by patients, were used to construct the SERVQUAL questions. The questionnaire was administered to eligible women in two parts. The first was completed before their first hospital antenatal appointment and the second either at home (a postal-chasing exercise) or while waiting for their next appointment. Only fully completed questionnaires (both parts) were analysed. Service strengths included staff politeness, patient respect and privacy. Areas for improvement included hand cleanliness, women's involvement in decision making and communicating risk. However, the low variability in patient responses makes concrete conclusions difficult and methodological issues complicate evaluating hand cleanliness. The new antenatal clinic service received low negative weighted and un-weighted overall scores. The SERVQUAL measure was developed from patient feedback and used to further improve services. The SERVQUAL-based measure allowed an internal evaluation of patient experience and highlighted areas for improvement. However, without validation, the questionnaire cannot be used as an outcome measure and variation between published SERVQUAL questionnaires makes comparisons difficult. This highlights an important balance in patient evaluation measures--between locally responsive and externally comparable. The SERVQUAL approach allows healthcare teams to evaluate patient experience, while accounting for variation in their expectations and priorities. The study highlights several areas that are important to obstetric patients, where expectation scores are high. However, the similar means and small samples left little difference between excellence and room for improvement.

Land use changes and their effects on the value of ecosystem services in the small Sanjiang plain in China.

PubMed

Chen, Jing; Sun, Bo-Ming; Chen, Dan; Wu, Xin; Guo, Long-Zhu; Wang, Gang

2014-01-01

The small Sanjiang plain is one of the most important commodity grain production bases and the largest fresh water wetland in China. Due to the rapid expansion of agricultural activities in the past 30 years, the contradiction between economic development and the loss of ecosystem services has become an issue of increasing concern in the area. In this study, we analysed land use changes and the loss of ecosystem services value caused by these changes. We found that cropland sprawl was predominant and occurred in forest, wetland, and grassland areas in the small Sanjiang plain from 1980 to 2010. Using a model to evaluate ecosystem services value, we calculated that the decreased values of ecosystem services were 169.88 × 10(8) Yuan from 1980 to 2000 and 120.00 × 10(8) Yuan from 2000 to 2010. All of the ecosystem services were diminished from 1980 to 2010 except for food production. Therefore, the loss of ecosystem services value should be considered by the policymakers of land use and development.

[Nursing and marketing: an introduction to the subject].

PubMed

de Moura, Gisela Maria Schebella Souto

2003-08-01

The administration of health care services is becoming more and more professional. New models and strategies used by service companies, in other areas, are being introduced in these organizations. Through this importation process of models, marketing concepts and tools have been incorporated. The objective of this theoretical essay is offering the nurses an introductory view about marketing. In order to reach this objective, the text was organized into sections that approach its history and basic concepts, social marketing, a few subjects under discussion currently and studies carried out in the marketing area, which involve nursing and health care services. In this way, it is expected to contribute to the professional improvement of nursing.

The National Security Education Program and Its Service Requirement: An Exploratory Study of What Areas of Government and for What Duration National Security Education Program Recipients Have Worked

ERIC Educational Resources Information Center

Comp, David J.

2013-01-01

The National Security Education Program, established under the National Security Education Act of 1991, has had a post-funding service requirement in the Federal Government for undergraduate scholarship and graduate fellowship recipients since its inception. The service requirement, along with the concern that the National Security Education…

Carbon stocks on forestland of the United States, with emphasis on USDA Forest Service ownership

Treesearch

Linda S. Heath; James E. Smith; Christopher W. Woodall; David L. Azuma; Karen L. Waddell

2011-01-01

The U.S. Department of Agriculture Forest Service (USFS) manages one-fifth of the area of forestland in the United States. The Forest Service Roadmap for responding to climate change identified assessing and managing carbon stocks and change as a major element of its plan. This study presents methods and results of estimating current forest carbon stocks and change in...

Carbon stocks on forestland of the United States, with emphaisis on USDA Forest Service ownership

Treesearch

Linda S. Heath; James E. Smith; Christopher W. Woodall; Dave Azuma; Karen L. Waddell

2011-01-01

The U.S. Department of Agriculture Forest Service (USFS) manages one-fifth of the area of forestland in the United States. The Forest Service Roadmap for responding to climate change identified assessing and managing carbon stocks and change as a major element of its plan. This study presents methods and results of estimating current forest carbon stocks and change in...

Job Training Partnership Act: Participants, Services, and Outcomes. Statement before the Committee on Education and Labor, United States House of Representatives.

ERIC Educational Resources Information Center

Thompson, Lawrence H.

The U.S. General Accounting Office studied the characteristics of individual participants in training provided by the Job Training Partnership Act (JTPA), the kinds and intensity of services they received, and the occupations in which they were employed after leaving the program. Visits to 63 randomly selected service delivery areas provided…

Drop-in Services: Findings from an Evaluation of the Healthy Living Centre Programme in Scotland

ERIC Educational Resources Information Center

Truman, J.; Rankin, D.; Backett-Milburn, K.; Platt, S.

2007-01-01

Objective: To explore the diverse roles of drop-in services in the HLC sector; to develop further the classification of drop-in services offered by earlier studies; and to provide an example of some the challenges faced by HLCs in their attempts to tackle poor health using area-based methods with vulnerable, hard-to-reach users. Setting: Scottish…

Service provider perceptions of transitioning from audio to video capability in a telehealth system: a qualitative evaluation.

PubMed

Clay-Williams, Robyn; Baysari, Melissa; Taylor, Natalie; Zalitis, Dianne; Georgiou, Andrew; Robinson, Maureen; Braithwaite, Jeffrey; Westbrook, Johanna

2017-08-14

Telephone consultation and triage services are increasingly being used to deliver health advice. Availability of high speed internet services in remote areas allows healthcare providers to move from telephone to video telehealth services. Current approaches for assessing video services have limitations. This study aimed to identify the challenges for service providers associated with transitioning from audio to video technology. Using a mixed-method, qualitative approach, we observed training of service providers who were required to switch from telephone to video, and conducted pre- and post-training interviews with 15 service providers and their trainers on the challenges associated with transitioning to video. Two full days of simulation training were observed. Data were transcribed and analysed using an inductive approach; a modified constant comparative method was employed to identify common themes. We found three broad categories of issues likely to affect implementation of the video service: social, professional, and technical. Within these categories, eight sub-themes were identified; they were: enhanced delivery of the health service, improved health advice for people living in remote areas, safety concerns, professional risks, poor uptake of video service, system design issues, use of simulation for system testing, and use of simulation for system training. This study identified a number of unexpected potential barriers to successful transition from telephone to the video system. Most prominent were technical and training issues, and personal safety concerns about transitioning from telephone to video media. Addressing identified issues prior to implementation of a new video telehealth system is likely to improve effectiveness and uptake.

Leadership styles of service professionals aiding women of abuse: enhancing service delivery.

PubMed

Haeseler, Lisa Ann

2013-01-01

Leadership styles of service professionals--including social workers and teachers--in the area of family abuse were investigated. Leadership characteristics of the professionals were measured by their responses to a survey. Results indicated that the interviewed service professionals demonstrated productive leadership traits. Study findings are congruent with leadership styles described in the research. Holistic and collaborative services are required to enhance care for women of abuse, as their needs are multifaceted and complex. Specific leadership styles promote better care for women; leaders need to collaboratively initiate and deliver more interdisciplinary and unified service.

Provision of CT Scanning Capability to VA/DoD (Veterans Administration/ Department of Defense) Health Care Facilities through a Shared Mobile CT Unit: A Feasibility Study

DTIC Science & Technology

1984-07-27

all Federal sectoT facilities. Shared services have long been recna, nzed as one way to reduce costs, throuph optima’ itilizaticn of capacity, but...stock arguments against shared services . A CT scanner may be installed in a mobile van and the service moved in its entirety from hospital to hospital...annually. This severely restricted further acquisition by hospitals in most health service areas (5,9,14). Shared Services : A Response to Regulation

The Technological Growth in eHealth Services.

PubMed

Srivastava, Shilpa; Pant, Millie; Abraham, Ajith; Agrawal, Namrata

2015-01-01

The infusion of information communication technology (ICT) into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services.

The Technological Growth in eHealth Services

PubMed Central

Srivastava, Shilpa; Pant, Millie; Abraham, Ajith; Agrawal, Namrata

2015-01-01

The infusion of information communication technology (ICT) into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services. PMID:26146515

Can I risk using public services? Perceived consequences of seeking help and health care among households living in poverty: qualitative study

PubMed Central

Canvin, Krysia; Jones, Chris; Marttila, Anneli; Burström, Bo; Whitehead, Margaret

2007-01-01

Objectives To improve understanding of how families living in adverse conditions perceive their encounters with public services and how past experiences influence current and future attempts to seek help. Design Qualitative interviews with adult members of households living in poverty in deprived areas, plus observations conducted in the surrounding neighbourhoods and service settings. Participants Purposive sample of 25 adults living in a deprived area, on welfare benefits. Setting Eight sites in disadvantaged areas in Merseyside, North Wales, London and Greater Manchester in 2004/05. Results Participants generally perceived public services as a source of distrust and a potential risk to well‐being. Encounters with a range of services were perceived as risky in terms of losing resources, being misunderstood or harshly judged, and carrying the ultimate threat of losing custody of their children. Participants perceived that they were subjected to increasing levels of surveillance, with fear of “being told on” by neighbours, in addition to service providers, adding to anxiety. Adverse consequences included avoiding child health and social services, anxiety and self‐imposed isolation. Conclusions Approaching services was perceived as akin to taking a gamble that might or might not result in their needs being met. Faced with this “choice”, participants employed strategies to minimise the risks that on the surface may appear risky to health. If public services are to succeed in providing support to disadvantaged families, greater efforts are needed to build trust and demonstrate understanding for the strategies these families use to maintain their well‐being against formidable odds. PMID:17933957

Can I risk using public services? Perceived consequences of seeking help and health care among households living in poverty: qualitative study.

PubMed

Canvin, Krysia; Jones, Chris; Marttila, Anneli; Burström, Bo; Whitehead, Margaret

2007-11-01

To improve understanding of how families living in adverse conditions perceive their encounters with public services and how past experiences influence current and future attempts to seek help. Qualitative interviews with adult members of households living in poverty in deprived areas, plus observations conducted in the surrounding neighbourhoods and service settings. Purposive sample of 25 adults living in a deprived area, on welfare benefits. Eight sites in disadvantaged areas in Merseyside, North Wales, London and Greater Manchester in 2004/05. Participants generally perceived public services as a source of distrust and a potential risk to well-being. Encounters with a range of services were perceived as risky in terms of losing resources, being misunderstood or harshly judged, and carrying the ultimate threat of losing custody of their children. Participants perceived that they were subjected to increasing levels of surveillance, with fear of "being told on" by neighbours, in addition to service providers, adding to anxiety. Adverse consequences included avoiding child health and social services, anxiety and self-imposed isolation. Approaching services was perceived as akin to taking a gamble that might or might not result in their needs being met. Faced with this "choice", participants employed strategies to minimise the risks that on the surface may appear risky to health. If public services are to succeed in providing support to disadvantaged families, greater efforts are needed to build trust and demonstrate understanding for the strategies these families use to maintain their well-being against formidable odds.

Factors influencing choice of veterinary service provider by pastoralist in Kenya.

PubMed

Onono, Joshua Orungo; Wieland, Barbara; Rushton, Jonathan

2013-08-01

This study analyzed the determinants for choice of animal health providers in a semiarid pastoral area with an aim of identifying specific attributes that could be targeted for intervention to enhance pastoralist access to quality veterinary services. The data were collected through administration of semi-structured questionnaires to 350 randomly selected household heads in different locations in Narok County of Kenya. Most of these respondents had no formal education (66.9%), and most households were headed by men (88.9%). The men were in control of sales (84.2%), purchases (83.7%), and treatment of sick cattle (70.3%), while women were responsible for milking (83.8%). Animal health services were delivered by drug stockists (87.76%) and government veterinarians (12.24%). The time spent while seeking animal health services and transport cost were specific attributes with impact on the probability of choice for service providers. Although distance covered to the preferred service provider was a significant attribute, it was inversely related to the probability of choice. The other factors including herd sizes, age and sex of household head, cost incurred per visit, level of education of household head, and the number of visits did not have significant impact on choices. These findings support commercialization of veterinary services in marginalized areas where the delivery of essential animal health services such as disease control programs are often viewed as a public good. In order to enhance delivery of veterinary services in these areas, it is proposed that public and private means are investigated to support qualified veterinarians and to strengthen the activities of untrained personnel operating drug outlets.

Financing geriatric programs in community health centers.

PubMed Central

Yeatts, D E; Ray, S; List, N; Duggar, B

1991-01-01

There are approximately 600 Community and Migrant Health Centers (C/MHCs) providing preventive and primary health care services principally to medically underserved rural and urban areas across the United States. The need to develop geriatric programs within C/MHCs is clear. Less clear is how and under what circumstances a comprehensive geriatric program can be adequately financed. The Health Resources and Services Administration of the Public Health Service contracted with La Jolla Management Corporation and Duke University Center on Aging to identify successful techniques for obtaining funding by examining 10 "good practice" C/MHC geriatric programs. The results from this study indicated that effective techniques included using a variety of funding sources, maintaining accurate cost-per-user information, developing a marketing strategy and user incentives, collaborating with the area agency on aging and other community organizations, and developing special services for the elderly. Developing cost-per-user information allowed for identifying appropriate "drawing card" services, negotiating sound reimbursement rates and contracts with other providers, and assessing the financial impact of changing service mixes. A marketing strategy was used to enhance the ability of the centers to provide a comprehensive package of services. Collaboration with the area agency on aging and other community organizations and volunteers in the aging network was found to help establish referral networks and subsequently increase the number of elderly patients served. Finally, development of special services for the elderly, such as adult day care, case management, and health education, was found to increase program visibility, opportunities to work with the network of services for the aging, and clinical utilization. PMID:1908588

Geologic map of the Cameron 30' x 60' quadrangle, Coconino County, northern Arizona

USGS Publications Warehouse

Billingsley, George H.; Priest, Susan S.; Felger, Tracey J.

2007-01-01

This geologic map is the result of a cooperative effort of the U.S. Geological Survey and the National Park Service in collaboration with the Navajo Nation and the Hopi Tribe to provide regional geologic information for resource management officials of the National Park Service, U.S. Forest Service, Navajo Indian Reservation (herein the Navajo Nation), the Hopi Tribe, and for visitor information services at Grand Canyon National Park, Arizona as well as private enterprises that have lands within the area. The Cameron 30’ x 60’ quadrangle encompasses approximately 5,018 km2 (1,960 mi2) within Coconino County, northern Arizona and is bounded by longitude 111° to 112° W., and latitude 35°30’ to 36° N. The map area is within the southern Colorado Plateaus geologic province (herein Colorado Plateau). The map area is locally subdivided into six physiographic areas: the Grand Canyon (including the Little Colorado River Gorge), Coconino Plateau, Marble Plateau, Little Colorado River Valley, Moenkopi Plateau, and the San Francisco Volcanic Field as defined by Billingsley and others, 1997 (fig. 1). Elevations range from about 2,274 m (7,460 ft) at the south rim of Grand Canyon along State Highway 64 to about 994 m (3,260 ft) in the Grand Canyon, northeast quarter of the map area.The Cameron quadrangle is one of the few remaining areas near the Grand Canyon where uniform geologic mapping was needed for geologic connectivity of the regional geologic framework that will be useful to federal, state, and private land resource managers who direct environmental and land management programs such as range management, biological studies, flood control, and water resource investigations. The geologic information presented will support future and ongoing local geologic investigations and associated scientific studies of all disciplines within the Cameron quadrangle area.

Outcomes research in pediatric settings: recent trends and future directions.

PubMed

Forrest, Christopher B; Shipman, Scott A; Dougherty, Denise; Miller, Marlene R

2003-01-01

Pediatric outcomes research examines the effects of health care delivered in everyday medical settings on the health of children and adolescents. It is an area of inquiry in its nascent stages of development. We conducted a systematic literature review that covered articles published during the 6-year interval 1994-1999 and in 39 peer-reviewed journals chosen for their likelihood of containing child health services research. This article summarizes the article abstraction, reviews the literature, describes recent trends, and makes recommendations for future work. In the sample of journals that we examined, the number of pediatric outcomes research articles doubled between 1994 and 1999. Hospitals and primary care practices were the most common service sectors, accounting for more than half of the articles. Common clinical categories included neonatal conditions, asthma, psychosocial problems, and injuries. Approximately 1 in 5 studies included multistate or national samples; 1 in 10 used a randomized controlled trial study design. Remarkably few studies examined the health effects of preventive, diagnostic, long-term management, or curative services delivered to children and adolescents. Outcomes research in pediatric settings is a rapidly growing area of inquiry that is acquiring breadth but has achieved little depth in any single content area. Much work needs to be done to inform decision making regarding the optimal ways to finance, organize, and deliver child health care services. To improve the evidence base of pediatric health care, more effectiveness research is needed to evaluate the overall and relative effects of services delivered to children and adolescents in everyday settings.

Research gaps: adaptive management to cross-cutting issues

Treesearch

Jonathan W. Long; Carl Skinner; Malcolm North; Lenya Quinn-Davidson

2014-01-01

A number of studies undertaken by the Forest Service within the synthesis area have been designed and implemented to better understand both more immediate and long-term effects of treatments, including the Blacks Mountain Ecological Research Project (Oliver 2000); Goosenest Adaptive Management Area Project (Ritchie 2005); Long-Term Soil Productivity Study (Powers 2006...

Stroke survivors' levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area.

PubMed

Kusambiza-Kiingi, Adrian; Maleka, Douglas; Ntsiea, Veronica

2017-01-01

Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. To determine stroke survivors' levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% ( n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services ( r = 0.27, p < 0.0001) and QOL ( r = 0.51, p < 0.0001). A negative correlation was found between community reintegration and caregiver strain ( r = -0.37, p < 0.0001). Most stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services.

Stroke survivors’ levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area

PubMed Central

Kusambiza-Kiingi, Adrian; Maleka, Douglas

2017-01-01

Background Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. Aim To determine stroke survivors’ levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. Method This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. Results A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% (n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p < 0.0001) and QOL (r = 0.51, p < 0.0001). A negative correlation was found between community reintegration and caregiver strain (r = -0.37, p < 0.0001). Conclusion Most stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services. PMID:28730068

Maternal Health: A Case Study of Rajasthan

PubMed Central

Iyengar, Kirti; Gupta, Vikram

2009-01-01

This case study has used the results of a review of literature to understand the persistence of poor maternal health in Rajasthan, a large state of north India, and to make some conclusions on reasons for the same. The rate of reduction in Rajasthan's maternal mortality ratio (MMR) has been slow, and it has remained at 445 per 1000 livebirths in 2003. The government system provides the bulk of maternal health services. Although the service infrastructure has improved in stages, the availability of maternal health services in rural areas remains poor because of low availability of human resources, especially midwives and clinical specialists, and their non-residence in rural areas. Various national programmes, such as the Family Planning, Child Survival and Safe Motherhood and Reproductive and Child Health (phase 1 and 2), have attempted to improve maternal health; however, they have not made the desired impact either because of an earlier emphasis on ineffective strategies, slow implementation as reflected in the poor use of available resources, or lack of effective ground-level governance, as exemplified by the widespread practice of informally charging users for free services. Thirty-two percent of women delivered in institutions in 2005-2006. A 2006 government scheme to give financial incentives for delivering in government institutions has led to substantial increase in the proportion of institutional deliveries. The availability of safe abortion services is limited, resulting in a large number of informal abortion service providers and unsafe abortions, especially in rural areas. The recent scheme of Janani Suraksha Yojana provides an opportunity to improve maternal and neonatal health, provided the quality issues can be adequately addressed. PMID:19489421

Distance Learning: Information Access and Services for Virtual Users.

ERIC Educational Resources Information Center

Iyer, Hemalata, Ed.

This volume centers broadly on information support services for distance education. The articles in this book can be categorized into two areas: access to information resources for distance learners, and studies of distance learning programs. Contents include: "The Challenges and Benefits of Asynchronous Learning Networks" (Daphne…

Strategies for providing healthcare services to street-dwellers in Dhaka city: evidence from an operations research.

PubMed

Uddin, Jasim; Koehlmoos, Tracey P; Saha, Nirod C; Islam, Ziaul; Khan, Iqbal A; Quaiyum, M A

2012-06-13

In almost every major urban city, thousands of people live in overcrowded slums, streets, or other public places without any health services. Bangladesh has experienced one of the highest rates of urban population growth in the last three decades compared to the national population growth rate. The numbers of the urban poor and street-dwellers are likely to increase at least in proportion to the overall population growth of the country. The street-dwellers in Bangladesh are extremely vulnerable in terms of their health needs and healthcare-seeking behaviours. In Bangladesh, there is no health service-delivery mechanism targeting this marginalized group of people. This study, therefore, assessed the effectiveness of two models to provide primary healthcare (PHC) services to street-dwellers. This study of experimental pre-post design tested two models, such as static clinic and satellite clinics, for providing PHC services to street-dwellers in the evening through paramedics in Dhaka city during May 2009-April 2010. Both quantitative and qualitative techniques were used for collecting data. Data were analyzed comparing before and after the implementation of the clinics for the assessment of selected health and family-planning indicators using the statistical t-test. Services received from the model l and model 2 clinics were also compared by calculating the absolute difference to determine the relative effectiveness of one model over another. The use of healthcare services by the street-dwellers increased at endline compared to baseline in both the model clinic areas, and the difference was highly significant (p < 0.001). Institutional delivery among the female street-dwellers increased at endline compared to baseline in both the clinic areas. The use of family-planning methods among females also significantly (p < 0.001) increased at endline compared to baseline in both the areas. As the findings of the study showed the promise of this approach, the strategies could be implemented in all other cities of Bangladesh and in other countries which encounter similar problems.

Accountable Care Organizations in the United States: market and demographic factors associated with formation.

PubMed

Lewis, Valerie A; Colla, Carrie H; Carluzzo, Kathleen L; Kler, Sarah E; Fisher, Elliott S

2013-12-01

The Accountable Care Organization (ACO) model is rapidly being implemented by Medicare, private payers, and states, but little is known about the scope of ACO implementation. To determine the number of accountable care organizations in the United States, where they are located, and characteristics associated with ACO formation. Cross-sectional study of all ACOs in the United States as of August 2012. We identified ACOs from multiple sources; documented service locations (practices, clinics, hospitals); and linked service locations to local areas, defined as Dartmouth Atlas hospital service areas. We used multivariate analysis to assess what characteristics were associated with local ACO presence. We examined demographic characteristics (2010 American Community Survey) and health care system characteristics (2010 Medicare fee-for-service claims data). We identified 227 ACOs located in 27 percent of local areas. Fifty-five percent of the US population resides in these areas. HSA-level characteristics associated with ACO presence include higher performance on quality, higher Medicare per capita spending, fewer primary care physician groups, greater managed care penetration, lower poverty rates, and urban location. Much of the US population resides in areas where ACOs have been established. ACO formation has taken place where it may be easier to meet quality and cost targets. Wider adoption of the ACO model may require tailoring to local context. © Health Research and Educational Trust.

Patient satisfaction with primary health care rendered by community midwives in the area of Poznań.

PubMed

Niewiadomski, Tomasz; Biskupska, Maria; Wysocki, Jacek

2014-01-01

The main objective of this study was to examine the level of patient satisfaction with the care rendered by community midwives in the area of Poznań. A patient survey was distributed using face-to-face recruitment and with mail collection. Eight hundred new mothers were asked to participate in the study by filling out the questionnaire after eight weeks of the postpartum period. One hundred seventy seven (22.12%) returned completed questionnaires which were then analyzed. This paper provides information on the high level of patient satisfaction with the services provided by community midwives and the important role community midwives play in caring for and supporting women in the post partum period. The results of this study indicate that women in the area of Poznań, are satisfied with the care they receive from midwives. They also indicate a lack of association of patient satisfaction scores between groups of patients based on demographic data and reason for using community midwife services. It was also found that the overall patient satisfaction score depends most heavily on the time frame of receiving community midwife services.

Carbon sequestration through urban ecosystem services: A case study from Finland.

PubMed

Kuittinen, Matti; Moinel, Caroline; Adalgeirsdottir, Kristjana

2016-09-01

Plants and soil are natural regulators of atmospheric CO2. Whereas plants sequester atmospheric carbon, soils deposit it for decades. As cities become increasingly more densely built, the available land area for such ecosystem services may decrease. We studied seven different housing areas in the Finnish city of Espoo to ascertain the extent to which site efficiency affects to the ecosystem services if the full life-cycle GHG emissions of these areas are taken into account. The results show that the impact of CO2 uptake through carbon sinks in growing plants and the uptake of soil organic carbon vary greatly. Its share of all emissions varied from a marginal value of 1.2% to a more considerable value of 11.9%. The highest potential was calculated for a detached house located on a large site, while the weakest was calculated for compact apartment blocks. The study revealed that in order to quantify this potential more accurately, several knowledge gaps must first be addressed. These include impartial growth algorithms for Nordic wood species, missing accumulation factors for soil organic carbon in cold climates and statistical maintenance scenarios for gardens. Copyright © 2016 Elsevier B.V. All rights reserved.

Understanding the Psychosocial and Environmental Factors and Barriers Affecting Utilization of Maternal Healthcare Services in Kalomo, Zambia: A Qualitative Study

ERIC Educational Resources Information Center

Sialubanje, Cephas; Massar, Karlijn; Hamer, Davidson H.; Ruiter, Robert A. C.

2014-01-01

This qualitative study aimed to identify psychosocial and environmental factors contributing to low utilization of maternal healthcare services in Kalomo, Zambia. Twelve focus group discussions (n = 141) and 35 in-depth interviews were conducted in six health centre catchment areas. Focus group discussions comprised women of reproductive age…

Do Pre-Service Teachers Feel Ready to Teach in Inclusive Classrooms? A Four Country Study of Teaching Self-Efficacy

ERIC Educational Resources Information Center

Loreman, Tim; Sharma, Umesh; Forlin, Chris

2013-01-01

This paper reports the results of an international study examining pre-service teacher reports of teaching self-efficacy for inclusive education; principally focusing on the explanatory relationship between a scale designed to measure teaching self-efficacy in this area and key demographic variables within Canada, Australia, Hong Kong, and…

Transition into and out of Special Education Services by Young Australian School Children between 2006 and 2010

ERIC Educational Resources Information Center

Dempsey, Ian

2014-01-01

The extent to which school students continue to receive special education services over time is largely unknown because longitudinal studies are rare in this area. The present study examined a large Australian longitudinal database to track the status of children who received special education support in 2006 and whether they continued to access…

[Cross-sectional study of the variability of work-related stress among post-graduate medical residents at the main University Polyclinic of Sicily].

PubMed

Costantino, Claudio; Albeggiani, Valentina; Bonfante, Maria Stefania; Monte, Caterina; Lo Cascio, Nunzio; Mazzucco, Walter

2015-02-10

Among health care workers (HCWs), work-related stress is one of the main topics in risk assessment and prevention at the workplace. Post-graduate medical residents (MRs) are a group of HCWs comparable to medical doctors in terms of occupational exposure and occurrence of work-related stress syndromes. Risk assessment of work-related stress among MRs attending the major University Hospital of Sicily. A cross-sectional survey via an anonymous and self-administered questionnaire. 45% of clinical MRs and 37% of surgical MRs had access to compensatory rest days against 92% of MRs of the services area (p<0.001). A work attendance recording system for MRs was available in 80% of the postgraduate medical schools of the services area, in 60% of the clinical postgraduate schools and in 50% of the surgical postgraduate schools (p<0.001). MRs of the postgraduate surgical schools reported having access to work breaks (41%) with less frequency compared to clinical (60%) and services MRs (74%) (p<0.001). Both clinical (47%) and surgical MRs (47%) were more exposed to work-related stress than MRs of the services area (27%) (p<0.001). The survey demonstrated excess exposure to work-related stress for all the considered variables in MRs of the surgical area, compared with MRs of clinical and services areas. It is strongly recommended to provide specific training programmes aimed at managing the MRs' risk of exposure to work-related stress, focusing both on the workers and the work environment.

[Evaluation of cultural service value of aquaculture pond ecosystem: a case study in a water conservation area of Shanghai].

PubMed

Li, Sheng; Guo, Zong-xiang; Yang, Huai-yu; Yang, Zheng-yong

2009-12-01

Pond aquaculture has existed in China for thousands of years, which has not only contributed great economic value, but also presented cultural value for human beings. With the development and upgrading of Chinese economy and culture, these values will be highlighted further. To evaluate the cultural service value of pond aquaculture ecosystem would provide a scientific base to the policy-making to avoid or reduce the wrong design-making or avoid the policy-malfunction, and also, to promote the development of aquaculture and related recreational fishing industry, increase the added value of aquaculture and the income of fish-farmers, and promote the economic development of rural area. Based on the survey data from the aquaculture ponds in the water conservation area of Dianshan Lake in Qingpu District of Shanghai and the related statistical data, the cultural service value including recreational value and existence value of the aquaculture pond ecosystem in the area was estimated by means of travel cost method (TCM) and contingent valuation method (CVM). The total cultural service value of this ecosystem was about 213 million Yuan x a(-1) or 231296. 69 Yuan x hm(-2) x a(-1), being 5. 25 times of the market value of aquaculture products, among which, recreational value was about 189 million Yuan x a(-1), and existence value was about 24 million Yuan x a(-1). It was suggested that in the construction of new rural areas of Shanghai, sufficient attention should be paid on the full play of the cultural service value of aquaculture pond ecosystem.

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

PubMed

Ferraro, Paul J; Hanauer, Merlin M

2014-03-18

To develop effective environmental policies, we must understand the mechanisms through which the policies affect social and environmental outcomes. Unfortunately, empirical evidence about these mechanisms is limited, and little guidance for quantifying them exists. We develop an approach to quantifying the mechanisms through which protected areas affect poverty. We focus on three mechanisms: changes in tourism and recreational services; changes in infrastructure in the form of road networks, health clinics, and schools; and changes in regulating and provisioning ecosystem services and foregone production activities that arise from land-use restrictions. The contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program have not yet been empirically estimated. Nearly two-thirds of the poverty reduction associated with the establishment of Costa Rican protected areas is causally attributable to opportunities afforded by tourism. Although protected areas reduced deforestation and increased regrowth, these land cover changes neither reduced nor exacerbated poverty, on average. Protected areas did not, on average, affect our measures of infrastructure and thus did not contribute to poverty reduction through this mechanism. We attribute the remaining poverty reduction to unobserved dimensions of our mechanisms or to other mechanisms. Our study empirically estimates previously unidentified contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program. We demonstrate that, with existing data and appropriate empirical methods, conservation scientists and policymakers can begin to elucidate the mechanisms through which ecosystem conservation programs affect human welfare.

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

PubMed Central

Ferraro, Paul J.; Hanauer, Merlin M.

2014-01-01

To develop effective environmental policies, we must understand the mechanisms through which the policies affect social and environmental outcomes. Unfortunately, empirical evidence about these mechanisms is limited, and little guidance for quantifying them exists. We develop an approach to quantifying the mechanisms through which protected areas affect poverty. We focus on three mechanisms: changes in tourism and recreational services; changes in infrastructure in the form of road networks, health clinics, and schools; and changes in regulating and provisioning ecosystem services and foregone production activities that arise from land-use restrictions. The contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program have not yet been empirically estimated. Nearly two-thirds of the poverty reduction associated with the establishment of Costa Rican protected areas is causally attributable to opportunities afforded by tourism. Although protected areas reduced deforestation and increased regrowth, these land cover changes neither reduced nor exacerbated poverty, on average. Protected areas did not, on average, affect our measures of infrastructure and thus did not contribute to poverty reduction through this mechanism. We attribute the remaining poverty reduction to unobserved dimensions of our mechanisms or to other mechanisms. Our study empirically estimates previously unidentified contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program. We demonstrate that, with existing data and appropriate empirical methods, conservation scientists and policymakers can begin to elucidate the mechanisms through which ecosystem conservation programs affect human welfare. PMID:24567397

Customer Churn Prediction for Broadband Internet Services

NASA Astrophysics Data System (ADS)

Huang, B. Q.; Kechadi, M.-T.; Buckley, B.

Although churn prediction has been an area of research in the voice branch of telecommunications services, more focused studies on the huge growth area of Broadband Internet services are limited. Therefore, this paper presents a new set of features for broadband Internet customer churn prediction, based on Henley segments, the broadband usage, dial types, the spend of dial-up, line-information, bill and payment information, account information. Then the four prediction techniques (Logistic Regressions, Decision Trees, Multilayer Perceptron Neural Networks and Support Vector Machines) are applied in customer churn, based on the new features. Finally, the evaluation of new features and a comparative analysis of the predictors are made for broadband customer churn prediction. The experimental results show that the new features with these four modelling techniques are efficient for customer churn prediction in the broadband service field.

Modelling catchment areas for secondary care providers: a case study.

PubMed

Jones, Simon; Wardlaw, Jessica; Crouch, Susan; Carolan, Michelle

2011-09-01

Hospitals need to understand patient flows in an increasingly competitive health economy. New initiatives like Patient Choice and the Darzi Review further increase this demand. Essential to understanding patient flows are demographic and geographic profiles of health care service providers, known as 'catchment areas' and 'catchment populations'. This information helps Primary Care Trusts (PCTs) to review how their populations are accessing services, measure inequalities and commission services; likewise it assists Secondary Care Providers (SCPs) to measure and assess potential gains in market share, redesign services, evaluate admission thresholds and plan financial budgets. Unlike PCTs, SCPs do not operate within fixed geographic boundaries. Traditionally, SCPs have used administrative boundaries or arbitrary drive times to model catchment areas. Neither approach satisfactorily represents current patient flows. Furthermore, these techniques are time-consuming and can be challenging for healthcare managers to exploit. This paper presents three different approaches to define catchment areas, each more detailed than the previous method. The first approach 'First Past the Post' defines catchment areas by allocating a dominant SCP to each Census Output Area (OA). The SCP with the highest proportion of activity within each OA is considered the dominant SCP. The second approach 'Proportional Flow' allocates activity proportionally to each OA. This approach allows for cross-boundary flows to be captured in a catchment area. The third and final approach uses a gravity model to define a catchment area, which incorporates drive or travel time into the analysis. Comparing approaches helps healthcare providers to understand whether using more traditional and simplistic approaches to define catchment areas and populations achieves the same or similar results as complex mathematical modelling. This paper has demonstrated, using a case study of Manchester, that when estimating the catchment area of a planned new hospital, the extra level of detail provided by the gravity model may prove necessary. However, in virtually all other applications, the Proportional Flow method produced the optimal model for catchment populations in Manchester, based on several criteria: it produced the smallest RMS error; it addressed cross-boundary flows; the data used to create the catchment was readily available to SCPs; and it was simpler to reproduce than the gravity model method. Further work is needed to address how the Proportional Flow method can be used to reflect service redesign and handle OAs with zero or low activity. A next step should be the rolling out of the method across England and looking at further drill downs of data such as catchment by Healthcare Resource Group (HRG) rather than specialty level.

Health Service Areas (HSAs) - Small Area Estimates

Cancer.gov

Health Service Areas (HSAs) are a compromise between the 3000 counties and the 50 states. An HSA may be thought of as an area that is relatively self-contained with respect to hospital care and may cross over state boundries.

Are there any differences in medical emergency team interventions between rural and urban areas? A single-centre cohort study.

PubMed

Aftyka, Anna; Rybojad, Beata; Rudnicka-Drozak, Ewa

2014-10-01

To compare interventions of medical emergency teams in urban and rural areas with particular emphasis on response time and on-site medical rescue activities. A retrospective analysis of ambulance call reports from two emergency medical service substations: one in the city and the other in a rural area. Two emergency medical service substations: one in the city and the other in a rural area. Medical emergency teams. Interventions in the city were associated with a substantially shorter response time in comparison to rural areas. In the city, the distances were generally less than 10 km. In the rural area, however, such short distances accounted for only 7.2% of events, while 33.8% were over 30 km. Medical emergency teams more often acted exclusively on-site or ceased any interventions in rural areas. Compared with the city, actions in the rural setting were associated with significantly increased use of cervical collars and decreased use of intravenous access. The presence of a physician in the team raised the probability of pharmacotherapy. The relationship between medical emergency teams activities and the location of intervention shows the real diversity of the functioning of emergency medical service within a city and rural areas. Further research should aim to improve the generalisability of these findings. © 2014 National Rural Health Alliance Inc.

47 CFR 101.1401 - Service areas.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE... Estimates, September 2002, plus four FCC-defined DMA-like service areas. (a) Alaska—Balance of State (all...; and (d) American Samoa. ...