Sample records for service system involvement

  1. Service user involvement for mental health system strengthening in India: a qualitative study.

    PubMed

    Samudre, Sandesh; Shidhaye, Rahul; Ahuja, Shalini; Nanda, Sharmishtha; Khan, Azaz; Evans-Lacko, Sara; Hanlon, Charlotte

    2016-07-28

    There is a wide recognition that involvement of service users and their caregivers in health system policy and planning processes can strengthen health systems; however, most evidence and experience has come from high-income countries. This study aimed to explore baseline experiences, barriers and facilitators to service user-caregiver involvement in the emerging mental health system in India, and stakeholders' perspectives on how greater involvement could be achieved. A qualitative study was conducted in Sehore district of Madhya Pradesh, India. In-depth interviews (n = 27) and a focus group discussion were conducted among service users, caregivers and their representatives at district, state and national levels and policy makers, service providers and mental health researchers. The topic guide explored the baseline situation in India, barriers and facilitators to service user and caregiver involvement in the following aspects of mental health systems: policy-making and planning, service development, monitoring and quality control, as well as research. Framework analysis was employed. Respondents spoke of the limited involvement of service users and caregivers in the current Indian mental health system. The major reported barriers to this involvement were (1) unmet treatment and economic needs arising from low access to mental health services coupled with the high burden of illness, (2) pervasive stigmatising attitudes operating at the level of service user, caregiver, community, healthcare provider and healthcare administrators, and (3) entrenched power differentials between service providers and service users. Respondents prioritised greater involvement of service users in the planning of their own individual-level mental health care before considering involvement at the mental health system level. A stepwise progression was endorsed, starting from needs assessment, through empowerment and organization of service users and caregivers, leading finally to meaningful involvement. Societal and system level barriers need to be addressed in order to facilitate the involvement of service users and caregivers to strengthen the Indian mental health system. Shifting from a largely 'provider-centric' to a more 'user-centric' model of mental health care may be a fundamental first step to sustainable user involvement at the system level.

  2. Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: a cross-country qualitative study.

    PubMed

    Lempp, H; Abayneh, S; Gurung, D; Kola, L; Abdulmalik, J; Evans-Lacko, S; Semrau, M; Alem, A; Thornicroft, G; Hanlon, C

    2018-02-01

    The aims of this paper are to: (i) explore the experiences of involvement of mental health service users, their caregivers, mental health centre heads and policy makers in mental health system strengthening in three low- and middle-income countries (LMICs) (Ethiopia, Nepal and Nigeria); (ii) analyse the potential benefits and barriers of such involvement; and (iii) identify strategies required to achieve greater service user and caregiver participation. A cross-country qualitative study was conducted, interviewing 83 stakeholders of mental health services. Our analysis showed that service user and caregiver involvement in the health system strengthening process was an alien concept for most participants. They reported very limited access to direct participation. Stigma and poverty were described as the main barriers for involvement. Several strategies were identified by participants to overcome existing hurdles to facilitate service user and caregiver involvement in the mental health system strengthening process, such as support to access treatment, mental health promotion and empowerment of service users. This study suggests that capacity building for service users, and strengthening of user groups would equip them to contribute meaningfully to policy development from informed perspectives. Involvement of service users and their caregivers in mental health decision-making is still in its infancy in LMICs. Effective strategies are required to overcome existing barriers, for example making funding more widely available for Ph.D. studies in participatory research with service users and caregivers to develop, implement and evaluate approaches to involvement that are locally and culturally acceptable in LMICs.

  3. Predictors of justice system involvement: Maltreatment and education.

    PubMed

    Robertson, Angela A; Walker, Courtney S

    2018-02-01

    Decades of research have established that experience of abuse and/or neglect in childhood is related to negative outcomes, such as juvenile delinquency. Existing research has shown that involvement in child welfare services is also related to juvenile delinquency, particularly for children who are victims of neglect. Research has also identified educational factors such as chronic absenteeism as significant predictors of involvement in the juvenile justice system. However, little research has investigated the combined influence of educational factors, child abuse, and involvement in child protective services on justice system involvement. The current study examined the influence of educational factors and involvement in child protective services on justice system involvement. The study utilized records from an educational database of children who attended a school within a county of Mississippi in any year from 2003 through 2013. Cases were then matched with records from the county Youth Court, Law Enforcement agencies, and Child Protection Services. A multivariate logistic regression controlling for gender, race, current age, and time at risk was conducted to involvement in the justice system. In general, educational factors were stronger predictors of justice system involvement than allegations of maltreatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: systematic review.

    PubMed

    Semrau, Maya; Lempp, Heidi; Keynejad, Roxanne; Evans-Lacko, Sara; Mugisha, James; Raja, Shoba; Lamichhane, Jagannath; Alem, Atalay; Thornicroft, Graham; Hanlon, Charlotte

    2016-03-01

    The involvement of mental health service users and their caregivers in health system policy and planning, service monitoring and research can contribute to mental health system strengthening, but as yet there have been very few efforts to do so in low- and middle-income countries (LMICs). This systematic review examined the evidence and experience of service user and caregiver involvement in mental health system strengthening, as well as models of best practice for evaluation of capacity-building activities that facilitate their greater participation. Both the peer-reviewed and the grey literature were included in the review, which were identified through database searches (MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, SciELO, Google Scholar and Cochrane), as well as hand-searching of reference lists and the internet, and a snowballing process of contacting experts active in the area. This review included any kind of study design that described or evaluated service user, family or caregiver (though not community) involvement in LMICs (including service users with intellectual disabilities, dementia, or child and adolescent mental health problems) and that were relevant to mental health system strengthening across five categories. Data were extracted and summarised as a narrative review. Twenty papers matched the inclusion criteria. Overall, the review found that although there were examples of service user and caregiver involvement in mental health system strengthening in numerous countries, there was a lack of high-quality research and a weak evidence base for the work that was being conducted across countries. However, there was some emerging research on the development of policies and strategies, including advocacy work, and to a lesser extent the development of services, service monitoring and evaluation, with most service user involvement having taken place within advocacy and service delivery. Research was scarce within the other health system strengthening areas. Further research on service user and caregiver involvement in mental health system strengthening in LMICs is recommended, in particular research that includes more rigorous evaluation. A series of specific recommendations are provided based on the review.

  5. The Challenge and Opportunity of Parental Involvement in Juvenile Justice Services.

    PubMed

    Burke, Jeffrey D; Mulvey, Edward P; Schubert, Carol A; Garbin, Sara R

    2014-04-01

    The active involvement of parents - whether as recipients, extenders, or managers of services - during their youth's experience with the juvenile justice system is widely assumed to be crucial. Parents and family advocacy groups note persisting concerns with the degree to which successful parental involvement is achieved. Justice system providers are highly motivated and actively working to make improvements. These coalescing interests provide a strong motivation for innovation and improvement regarding family involvement, but the likely success of these efforts is severely limited by the absence of any detailed definition of parental involvement or validated measure of this construct. Determining whether and how parental involvement works in juvenile justice services depends on the development of clear models and sound measurement. Efforts in other child serving systems offer guidance to achieve this goal. A multidimensional working model developed with parents involved in child protective services is presented as a template for developing a model for parental involvement in juvenile justice. Features of the model requiring changes to make it more adaptable to juvenile justice are identified. A systematic research agenda for developing methods and measures to meet the present demands for enhanced parental involvement in juvenile justice services is presented.

  6. The Challenge and Opportunity of Parental Involvement in Juvenile Justice Services

    PubMed Central

    Burke, Jeffrey D.; Mulvey, Edward P.; Schubert, Carol A.; Garbin, Sara R.

    2014-01-01

    The active involvement of parents – whether as recipients, extenders, or managers of services - during their youth’s experience with the juvenile justice system is widely assumed to be crucial. Parents and family advocacy groups note persisting concerns with the degree to which successful parental involvement is achieved. Justice system providers are highly motivated and actively working to make improvements. These coalescing interests provide a strong motivation for innovation and improvement regarding family involvement, but the likely success of these efforts is severely limited by the absence of any detailed definition of parental involvement or validated measure of this construct. Determining whether and how parental involvement works in juvenile justice services depends on the development of clear models and sound measurement. Efforts in other child serving systems offer guidance to achieve this goal. A multidimensional working model developed with parents involved in child protective services is presented as a template for developing a model for parental involvement in juvenile justice. Features of the model requiring changes to make it more adaptable to juvenile justice are identified. A systematic research agenda for developing methods and measures to meet the present demands for enhanced parental involvement in juvenile justice services is presented. PMID:24748704

  7. Service user involvement in mental health system strengthening in a rural African setting: qualitative study.

    PubMed

    Abayneh, Sisay; Lempp, Heidi; Alem, Atalay; Alemayehu, Daniel; Eshetu, Tigist; Lund, Crick; Semrau, Maya; Thornicroft, Graham; Hanlon, Charlotte

    2017-05-18

    It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. Thirty nine semi-structured interviews were carried out with purposively selected mental health service users (n = 13), caregivers (n = 10), heads of primary care facilities (n = 8) and policy makers/planners/service developers (n = 8). The interviews were audio-recorded and transcribed in Amharic, and translated into English. Thematic analysis was applied. All groups of participants supported service user and caregiver involvement in mental health system strengthening. Potential benefits were identified as (i) improved appropriateness and quality of services, and (ii) greater protection against mistreatment and promotion of respect for service users. However, hardly any respondents had prior experience of service user involvement. Stigma was considered to be a pervasive barrier, operating within the health system, the local community and individuals. Competing priorities of service users included the need to obtain adequate individual care and to work for survival. Low recognition of the potential contribution of service users seemed linked to limited empowerment and mobilization of service users. Potential health system facilitators included a culture of community oversight of primary care services. All groups of respondents identified a need for awareness-raising and training to equip service users, caregivers, service providers and local community for involvement. Empowerment at the level of individual service users (information about mental health conditions, care and rights) and the group level (for advocacy and representation) were considered essential, alongside improved, accessible mental health care and livelihood interventions. As Ethiopia increases access to mental health care, a fundamental barrier to service user involvement is beginning to be addressed. Our study identified further barriers that need to be tackled, including a supportive political climate, and receptiveness amongst stakeholders. The findings will inform the development of a model of service user involvement, which will be piloted and evaluated.

  8. Service user and care giver involvement in mental health system strengthening in Nepal: a qualitative study on barriers and facilitating factors.

    PubMed

    Gurung, Dristy; Upadhyaya, Nawaraj; Magar, Jananee; Giri, Nir Prakash; Hanlon, Charlotte; Jordans, Mark J D

    2017-01-01

    Service user and caregiver involvement has become an increasingly common strategy to enhance mental health outcomes, and has been incorporated in the mental healthpolicies of many developed nations. However, this practice is non-existent or fragmented in low and middle income countries (LMICs). Instances of service user and caregiver involvement have been rising slowly in a few LMICs, but are rarely described in the literature. Very little is known about the context of user and caregiver participation in mental health system strengthening processes in a low-income, disaster- and conflict-affected state such as Nepal. This study explores (a) the extent and experiences of service user and caregiver involvement in policy making, service planning, monitoring, and research in Nepal; (b) perceived barriers to such involvement; and (c) possible strategies to overcome barriers. Key Informant Interviews (n = 24) were conducted with service users and caregivers who were either affiliated to a mental health organization or receiving menta health care integrated within primary care. Purposive sampling was employed. Data collection was carried out in 2014 in Chitwan and Kathmandu districts of Nepal. Data analysis was carried out in NVivo10 using a framework approach. The involvement of service users affiliated to mental health organizations in policy development was reported to be 'tokenistic'. Involvement of caregivers was non-existent. Perceived barriers to greater involvement included lack of awareness, stigma and discrimination, poor economic conditions, the centralized health system, and lack of strong leadership and unity among user organizations. Increased focus on reducing public as well as self-stigma, improved policy frameworks and initiatives, and decentralization of care are some strategies that may facilitate service user and caregiver involvement. The study highlighted need for user and caregiver networks free from competing interests and priorities. Improved policy frameworks and decentralization of care may support meaningful service user and caregiver involvement.

  9. The impact on fatal involvement of commercial vehicle operation ITS user services

    DOT National Transportation Integrated Search

    1997-01-01

    Various Intelligent Transportation Systems (ITS) user services for Commercial Vehicle Operations (CVO) have the potential of reducing fatal involvements of commercial vehicles. Commercial vehicle operators subscribing to these user services, because ...

  10. The Role of Quality Service Systems in Involving Families in Mental Health Treatment for Children with Severe Emotional Disturbances

    ERIC Educational Resources Information Center

    Mayberry, Lindsay Satterwhite; Heflinger, Craig Anne

    2012-01-01

    Family involvement in the planning and execution of mental health treatment has been shown to positively influence child outcomes; however, there is wide variability in the levels of involvement by families. The current study investigated the influence of child, family caregiver, service system, and community factors on the level of family…

  11. Profiles of criminal justice system involvement of mentally ill homeless adults.

    PubMed

    Roy, Laurence; Crocker, Anne G; Nicholls, Tonia L; Latimer, Eric; Gozdzik, Agnes; O'Campo, Patricia; Rae, Jennifer

    2016-01-01

    This study aims to examine the rates of self-reported contacts with the criminal justice system among homeless adults with mental illness, to identify the characteristics of participants who have had contacts with the criminal justice system, to report the dimensional structure of criminal justice system involvement in this sample, and to identify typologies of justice-involved participants. Self-report data on criminal justice system involvement of 2221 adults participating in a Canadian Housing First trial were analyzed using multiple correspondence and cluster analysis. Almost half of the participants had at least one contact with the criminal justice system in the 6months prior to study enrollment. Factors associated with justice involvement included age, gender, ethnic background, diagnosis, substance misuse, impulse control, compliance, victimization, service use, and duration of homelessness. A typology of criminal justice involvement was developed. Seven criminal justice system involvement profiles emerged; substance use and impulse control distinguished the clusters, whereas demographic and contextual variables did not. The large number of profiles indicates the need for a diverse and flexible range of interventions that could be integrated within or in addition to current support of housing services, including integrated substance use and mental health interventions, risk management strategies, and trauma-oriented services. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. What systems participants know about access and service entry and why managers should listen.

    PubMed

    Duncombe, Rohena

    2017-08-01

    Objective The present study looked at the views of people directly involved in the entry process for community health counselling using the frame of the health access literature. The concurrence of system participants' views with the access literature highlights access issues, particularly for people who are vulnerable or disadvantaged. The paper privileges the voices of the system participants, inviting local health services to consider using participatory design to improve access at the entry point. Methods People involved in the entry process for community health counselling explored the question, 'What, for you, are the features of a good intake system?' They also commented on themes identified during pilot interviews. These were thematically analysed for each participant group by the researcher to develop a voice for each stakeholder group. Results People accessing the service could be vulnerable and the entry process failed to take that into account. People directly involved in the counselling service entry system, system participants, consisted of: professionals referring in, people seeking services and reception staff taking first enquiries. They shared substantially the same concerns as each other. The responses from these system participants are consistent with the international literature on access and entry into health services. Conclusion Participatory service design could improve primary healthcare service entry at the local level. Canvassing the experiences of system participants is important for delivering services to those who have the least access and, in that way, could contribute to health equity. What is known about the topic? People with the highest health needs receive the fewest services. Health inequality is increasing. What does this paper add? System participants can provide advice consistent with the academic research literature that is useful for improving service entry at the local level. What are the implications for practitioners? Participatory design can inform policy makers and service providers. Entry systems could acknowledge the potential vulnerability or disadvantage of people approaching the service.

  13. Implementation of Service Learning and Civic Engagement for Students of Computer Information Systems through a Course Project at the Hashemite University

    ERIC Educational Resources Information Center

    Al-Khasawneh, Ahmad; Hammad, Bashar K.

    2015-01-01

    Service learning methodologies provide students of information systems with the opportunity to create and implement systems in real-world, public service-oriented social contexts. This paper presents a case study which involves integrating a service learning project into an undergraduate Computer Information Systems course entitled…

  14. Tractor Mechanics: Maintaining and Servicing the Fuel System. Learning Activity Packages 20-33.

    ERIC Educational Resources Information Center

    Clemson Univ., SC. Vocational Education Media Center.

    Learning activity packages are presented for instruction in tractor mechanics. The packages deal with the duties involved in maintaining the fuel system. The following fourteen learning activity packages are included: servicing fuel and air filters, servicing fuel tanks and lines, adjusting a carburetor, servicing a carburetor, servicing the…

  15. Human service delivery in a multi-tier system: the subtleties of collaboration among partners.

    PubMed

    Mayhew, Fred

    2012-01-01

    This article examines the nature of interorganizational relationships that are formed within a multi-tier human service delivery system. Taking into account the hierarchical structure of a statewide initiative to support early childhood education, the study investigates the differences in the relationships between organizations at the service and administrative levels of the system. Forty-nine administrative level and 146 service delivery level relationships are evaluated. Findings indicate that organizations involved in direct service delivery form more collaborative relationships. Thus, when government provides funding for human services, policymakers must seek to balance public accountability with the advantages believed to be inherent in devolved service delivery. Furthermore, practitioners who appreciate the importance and nuances of interorganizational relationships will be in a position to better manage their organizations in an environment of increased collaborative activity and joint delivery of services. Going forward, human service systems will continue to involve organizations from the public, nonprofit, and private sector. A better understanding of how these organizations work together is crucial to the effective delivery of these essential services.

  16. NDTAC Practice Guide: Quality Education Services Are Critical for Youth Involved with the Juvenile Justice and Child Welfare Systems

    ERIC Educational Resources Information Center

    Gonsoulin, Simon; Clark, Heather Griller; Rankin, Victoria E.

    2015-01-01

    This National Evaluation and Technical Assistance Center for the Education of Children and Youth Who are Neglected, Delinquent, or At-Risk (NDTAC) practice guide examines the principle that quality education services are critical for youth involved with the juvenile justice and child welfare systems. This principle asserts that, to address the…

  17. Planning and Implementing Social Service Information Systems: A Guide for Management and Users. Human Services Monograph Series Number 25. Project Share.

    ERIC Educational Resources Information Center

    Cotter, Barbara

    Intended to aid administrators and users of social services in establishing information systems, this comprehensive guide to the design of such systems identifies the elements, effective strategies, and potential pitfalls involved in their planning, implementation, and utilization. Detailed discussions of management strategies for system…

  18. An Evaluation of Food Service Systems at Fort Myer, Bolling Air Force Base and Fort Benjamin Harrison

    DTIC Science & Technology

    1974-09-01

    A comparative evaluation of the food service operations at Fort Myer, Virginia; Bolling Air Force Base, Maryland; and Fort Benjamin Harrison, Indiana...was conducted. These three bases each represent different types of food service systems, which are respectively: contract provided food and labor...Operations Research and Systems Analysis Office had the responsibility for comparing the costs, nutritional aspects and consumer attitudes involved in these three different systems of food service .

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

    PubMed

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

    1999-08-01

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

  20. Employee Involvement. Issues for Agencies To Consider in Designing and Implementing Programs. Report to the Ranking Minority Member, Subcommittee on Federal Services, Post Office, and Civil Service, Committee on Governmental Affairs, U.S. Senate.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. General Government Div.

    An investigation identified issues that are important for federal agencies to consider in designing and implementing employee involvement programs. Employee involvement programs in the private sector and in the federal government were studied. The use of seven involvement practices was examined: suggestion systems, survey feedback, quality…

  1. 47 CFR 101.701 - Eligibility.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Common Carrier Fixed Point-to-Point Microwave Service § 101.701 Eligibility. (a) Authorizations... the customers (or points of service) on the microwave system involved, including those served through...

  2. 47 CFR 101.701 - Eligibility.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Common Carrier Fixed Point-to-Point Microwave Service § 101.701 Eligibility. (a) Authorizations... the customers (or points of service) on the microwave system involved, including those served through...

  3. 47 CFR 101.701 - Eligibility.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Common Carrier Fixed Point-to-Point Microwave Service § 101.701 Eligibility. (a) Authorizations... the customers (or points of service) on the microwave system involved, including those served through...

  4. 47 CFR 101.701 - Eligibility.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Common Carrier Fixed Point-to-Point Microwave Service § 101.701 Eligibility. (a) Authorizations... the customers (or points of service) on the microwave system involved, including those served through...

  5. Evaluation of the Salt Lake City Computerized Rider Information System

    DOT National Transportation Integrated Search

    1985-11-01

    The Utah Transit Authority (UTA) Computerized Rider Information System (CRIS) project involved the installation of an automated telephone service to quickly provide bus stop-specific schedule and service information to residents throughout the Author...

  6. Specialist Advocacy Services for Parents with Learning Disabilities Involved in Child Protection Proceedings

    ERIC Educational Resources Information Center

    Tarleton, Beth

    2008-01-01

    Parents with learning disabilities frequently become involved with child protection and judicial proceedings. Parents report not understanding and being disempowered by the child protection system. This paper presents fourteen parents' views regarding how two specialist advocacy services supported them during child protection. The parents believed…

  7. Mothers in methadone treatment and their involvement with the child protection system: a replication and extension study.

    PubMed

    Taplin, Stephanie; Mattick, Richard P

    2013-08-01

    Although a high level of involvement with the child protection system has been identified in families where parental substance use is a feature, not all such parents abuse or neglect their children or have contact with the child protection system. Identifying parents with substance-use histories who are able to care for their children without intervention by the child protection system, and being able to target interventions to the families who need them the most is important. This study interviewed a relatively large sample of mothers about their histories, their children and their involvement with the child protection system. We hypothesized that mothers in opioid pharmacological treatment who are involved with child protection services are different in characteristics to those mothers who are not involved. One hundred and seventy-one women, with at least one child aged under 16 years, were interviewed at nine treatment clinics providing pharmacological treatment for opioid dependence across Sydney, Australia. Just over one-third of the women were involved with child protection services at the time of interview, mostly with children in out-of-home care. Logistic regression analyses revealed that factors which significantly increased the likelihood of the mother being involved with the child protection system were: (1) having a greater number of children, (2) being on psychiatric medication, and (3) having less than daily contact with her own parents. This study replicates and extends the work of Grella, Hser, and Huang (2006) and the limited literature published to date examining the factors which contribute to some substance-using mothers becoming involved with the child protection system while others do not. The finding that mental health problems and parental supports (along with the number of children) were significantly associated with child protection system involvement in this study, indicates a need for improved interventions and the provision of treatment and support services if we are to reduce the involvement of the child protection system with these families. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. The Pinchot Institute System for Environmental Forestry Studies

    Treesearch

    Institute The Pinchot

    1973-01-01

    NOTE large file size. This paper describes a prototype system for research planning and administration to meet man's needs for forest vegetation in and around metropolitan areas. The system's components involve social needs or services, technological developments, environmental effects, and the locales where the services, developments, and environmental...

  9. Satellite services system analysis study. Volume 2: Satellite and services user model

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Satellite services needs are analyzed. Topics include methodology: a satellite user model; representative servicing scenarios; potential service needs; manned, remote, and automated involvement; and inactive satellites/debris. Satellite and services user model development is considered. Groundrules and assumptions, servicing, events, and sensitivity analysis are included. Selection of references satellites is also discussed.

  10. Involvement of Youths with Autism Spectrum Disorders or Intellectual Disabilities in Multiple Public Service Systems

    ERIC Educational Resources Information Center

    Brookman-Frazee, Lauren; Baker-Ericzen, Mary; Stahmer, Aubyn; Mandell, David; Haine, Rachel A.; Hough, Richard L.

    2009-01-01

    The objectives of this study were to estimate the prevalence of autism spectrum disorders (ASD) and intellectual disability (ID) among youths active in at least one of five public service systems: mental health (MH), educational services for youth with serious emotional disturbance (SED), child welfare (CW), juvenile justice (JJ), and alcohol and…

  11. Providing Services for Handicapped Persons in Rural/Sparsely Populated Areas.

    ERIC Educational Resources Information Center

    Weatherman, Richard

    The experiences of the 3-year Minnesota Severely Handicapped Delivery System Project have led to a model which utilizes resources of regional systems as key elements of a differentiated system for educational service delivery to the handicapped in rural areas and involves state education agencies, statewide regional centers, local education units,…

  12. The impact of autism services on mothers' psychological wellbeing.

    PubMed

    Hodgetts, S; McConnell, D; Zwaigenbaum, L; Nicholas, D

    2017-01-01

    Families with a child diagnosed with autism spectrum disorder (ASD) often utilize a variety of professional services. The provision of these services has many potential benefits for families; however, these services also place demands on parents, particularly mothers, to access, navigate and participate. Little is known about how involvement with these services and service systems influences the psychological wellbeing of mothers of children diagnosed with ASD. We examined the relationship between professional services and psychological wellbeing for mothers of children diagnosed with ASD. Mothers (n = 119) of children (mean child age 10.1 years; range 2-24 years) diagnosed with ASD anonymously completed a comprehensive survey. The survey included data related to maternal psychological wellbeing, professional services received and perceptions of these services, and child, mother and household characteristics. Regression analyses revealed that maternal psychological wellbeing was positively associated with the perceived continuity of services, and negatively associated with the number of professionals involved. Child and maternal age, and household income were also statistically significant predictors of maternal psychological wellbeing. The study findings draw attention to the potentially negative impact of systems-level challenges, especially fragmentation of services, on maternal psychological wellbeing, despite positive front-line services. In particular, our data suggest that psychological wellbeing among mothers of children with ASD may vary more as a function of service system variables than practitioner-level or child-level variables. © 2016 John Wiley & Sons Ltd.

  13. Engaging fathers in child protection services: A review of factors and strategies across ecological systems

    PubMed Central

    Gordon, Derrick M.; Oliveros, Arazais; Hawes, Samuel W.; Iwamoto, Derek K.; Rayford, Brett S.

    2014-01-01

    Current policy regarding child protection services places increasing demands for providers to engage fathers whose children are involved in the child protection process. This requisite brings to the fore the ongoing challenges that fathers have historically faced in working within these systems. Despite this need, there is little empirical evidence regarding the factors and strategies that impact the engagement of fathers in interventions relevant to child protection services. This comprehensive and systemic review synthesizes the available literature regarding factors and strategies that may foster paternal involvement in the child protection system and their services. We organize the literature concerning paternal engagement in child and family services around an ecological model that examines paternal engagement from individual, family, service provider, program, community, and policy levels. We consider factors and strategies along a continuum of engagement through intent to enroll, enrollment, and retention. This review advances theory by elucidating key factors that foster father engagement. The review also highlights the gaps in the literature and provides strategies for how researchers can address these areas. Future directions in the arenas of practice and policy are discussed. PMID:25232202

  14. Mothers in Substance Abuse Treatment: Differences in Characteristics Based on Involvement with Child Welfare Services

    ERIC Educational Resources Information Center

    Grella, Christine E.; Hser, Yih-Ing; Huang; Yu-Chuang

    2006-01-01

    Problem: Greater awareness of the role of parental substance abuse in child maltreatment makes it imperative that the substance abuse treatment and child welfare systems coordinate services for these parents. Yet little is known about the characteristics of child-welfare involved parents (primarily mothers) who enter into substance abuse…

  15. The SIGNAL expert system

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

    Struve, R.

    The SIGNAL insurance companies have developed an expert system for the support of its customer sales service. It was introduced at the end of 1993 and is currently used by approximately 500 customer service representatives. It involves a counseling system, which enables customer sales personnel to produce high-quality benefit analyses at the point of sale. It is not only an information system for the agent but involves the customer in an active role (through the implementation of sales talks, the conscious visualization of facts, the generation of natural language explanations etc.). Thus, the customer is not faced with a faitmore » accompli but is actively involved in solving the problem. To meet these requirements, several Al techniques are used, as described further below. The application has increased sales efficiency, optimized customer contact time and decreased training requirements. The system is developed with KEE (and reimplemented in Allegro CL/PC) and runs on notebooks with 8 MB RAM.« less

  16. System services and architecture of the TMI satellite mobile data system

    NASA Technical Reports Server (NTRS)

    Gokhale, D.; Agarwal, A.; Guibord, A.

    1993-01-01

    The North American Mobile Satellite Service (MSS) system being developed by AMSC/TMI and scheduled to go into service in early 1995 will include the provision for real time packet switched services (mobile data service - MDS) and circuit switched services (mobile telephony service - MTS). These services will utilize geostationary satellites which provide access to mobile terminals (MT's) through L-band beams. The MDS system utilizes a star topology with a centralized data hub (DH) and will support a large number of mobile terminals. The DH, which accesses the satellite via a single Ku band beam, is responsible for satellite resource management, for providing mobile users with access to public and private data networks, and for comprehensive network management of the system. This paper describes the various MDS services available for the users, the ground segment elements involved in the provisioning of these services, and a summary description of the channel types, protocol architecture, and network management capabilities provided within the system.

  17. Becoming customer-driven: one health system's story.

    PubMed

    Bagnell, A

    1998-01-01

    Market research was done by Crozer-Keystone Health System to better understand the new health care consumer. The information will assist in developing, promoting, and delivering products and services of maximum value to current and prospective consumers. The system is responding by bundling and delivering products and services around consumer-based dimensions, developing new and better ways to improve customer convenience, access, and service. Operationalizing these initiatives for change involves building an information infrastructure of extensive content and customer databases, using new technologies to customize communications and ultimately service components.

  18. Common Misconceptions About Service-Oriented Architecture

    DTIC Science & Technology

    2007-11-01

    addition, the architect(s) must make decisions on how services are implemented. Service implementations may involve developing new software , wrapping a...legacy software system, incor- porating services provided by third par- ties, or a combination of these options. Information about the quality attrib...temperature. However, there 28 CROSSTALK The Journal of Defense Software Engineering November 2007 Common Misconceptions About Service -Oriented

  19. New applications for the EUTELTRACS service

    NASA Technical Reports Server (NTRS)

    Colcy, Jean-Noel; Vanderbrouck, Laurent

    1995-01-01

    The EUTELTRACS two-way Mobile Satellite Messaging and Automatic Satellite Position Reporting (ASPR) service is Europe's first commercially operated Mobile Satellite Service. It was introduced by the European Telecommunications Satellite Organization (EUTELSAT) for commercial service in 1991. The system is based on a centralized network architecture organized around a single hub station operated by EUTELSAT. Initially the system was designed with a close user group architecture enabling a mobile user to communicate exclusively with its own headquarters. This paper describes the new applications (design and tests prior to their introduction into service) especially developed for the European market and particularly the Double Hop Services opening the system to authorized external entities. In addition, the European Commission (EC) pilot demonstrations in which the EUTELTRACS system is involved are described.

  20. Volunteerism: You Say!

    ERIC Educational Resources Information Center

    Hobbs, Stephen

    This paper discusses the volunteer resources system and presents key models used in the field of volunteer resources for experiential education. For volunteer practitioners to encourage volunteer involvement, they must understand the body of knowledge, the vision, the system, and the people involved directly and indirectly in voluntary service.…

  1. The C3-System User. Volume II. Workshop Notes

    DTIC Science & Technology

    1977-02-01

    system that provides the means for operational direction and technical administrative support involved in the function of command and control of U.S...information systems of the Headquarters of the Military Depart- ments; the command and control systems of the Headquarters of the Service Component Commands...the Service Component Commands - Military Airlift Command - Military Sealift Command - Military Traffic Management Command - 3.2.5 Command and

  2. Assessing Service Delivery Systems for Assitive Technology in Brazil using HEART Study quality indicators.

    PubMed

    Maximo, Tulio; Clift, Laurence

    2015-01-01

    recently in Brazil, there have been investments and improvements in the service delivery system for assistive technology provision. However, there is little documentation of this process, or evidence that users are being involved appropriately. to understand how a ssistive technology service provision currently functions in Belo Horizonte city, Brazil, in order to provide context-specific interventions and recommendations to improve services. Qualitative research design, including visits to key institutions and semi-structured interviews with key stakeholders. Interview questions were divided with two purposes: 1) Exploratory, aiming to understand present service functioning; 2) Evaluative, aiming to assess staff difficulties in applying best existing best practices. Assistive Technology services in Belo Horizonte fall under the 'medical model' definition of service delivery developed by AAATE. It was also found that staff lack training and knowledge support to assess user requirements and involve them during the decision process. Additionally, there is no follow up stage after the device is delivered. The study clearly defines the service provision function and the staff difficulties at Belo Horizonte city, providing information for further studies.

  3. Divided care and the Third Way: user involvement in statutory and voluntary sector cancer services.

    PubMed

    Tritter, J Q; Barley, V; Daykin, N; Evans, Simon; McNeill, Judith; Rimmer, James; Sanidas, M; Turton, Pat

    2003-07-01

    In health care, as in much of the public sphere, the voluntary sector is playing an increasingly large role in the funding, provision and delivery of services and nowhere is this more apparent than in cancer care. Simultaneously the growth of privatisation, marketisation and consumerism has engendered a rise in the promotion of 'user involvement' in health care. These changes in the organisation and delivery of health care, in part inspired by the 'Third Way' and the promotion of public and citizen participation, are particularly apparent in the British National Health Service. This paper presents initial findings from a three-year study of user involvement in cancer services. Using both case study and survey data, we explore the variation in the definition, aims, usefulness and mechanisms for involving users in the evaluation and development of cancer services across three Health Authorities in South West England. The findings have important implications for understanding shifts in power, autonomy and responsibility between patients, carers, clinicians and health service managers. The absence of any common definition of user involvement or its purpose underlines the limited trust between the different actors in the system and highlights the potentially negative impact of a Third Way health service.

  4. Servicer system demonstration plan and capability development

    NASA Technical Reports Server (NTRS)

    1987-01-01

    An orbital maneuvering vehicle (OMV) front end kit is defined which is capable of performing in-situ fluid resupply and modular maintenance of free flying spacecraft based on the integrated orbital servicing system (IOSS) concept. The compatibility of the IOSS to perform gas and fluid umbilical connect and disconnect functions utilizing connect systems currently available or in development is addressed. A series of tasks involving on-orbit servicing and the engineering test unit (ETU) of the on-orbit service were studied. The objective is the advancement of orbital servicing by expanding the Spacecraft Servicing Demonstration Plan (SSDP) to include detail demonstration planning using the Multimission Modular Spacecraft (MMS) and upgrading the ETU control.

  5. Biofluid mechanics of special organs and the issue of system control. Sixth International Bio-Fluid Mechanics Symposium and Workshop, March 28-30, 2008 Pasadena, California.

    PubMed

    Zamir, Mair; Moore, James E; Fujioka, Hideki; Gaver, Donald P

    2010-03-01

    In the field of fluid flow within the human body, focus has been placed on the transportation of blood in the systemic circulation since the discovery of that system; but, other fluids and fluid flow phenomena pervade the body. Some of the most fascinating fluid flow phenomena within the human body involve fluids other than blood and a service other than transport--the lymphatic and pulmonary systems are two striking examples. While transport is still involved in both cases, this is not the only service which they provide and blood is not the only fluid involved. In both systems, filtration, extraction, enrichment, and in general some "treatment" of the fluid itself is the primary function. The study of the systemic circulation has also been conventionally limited to treating the system as if it were an open-loop system governed by the laws of fluid mechanics alone, independent of physiological controls and regulations. This implies that system failures can be explained fully in terms of the laws of fluid mechanics, which of course is not the case. In this paper we examine the clinical implications of these issues and of the special biofluid mechanics issues involved in the lymphatic and pulmonary systems.

  6. Converting Student Support Services to Online Delivery.

    ERIC Educational Resources Information Center

    Brigham, David E.

    2001-01-01

    Uses a systems framework to analyze the creation of student support services for distance education at Regents College: electronic advising, electronic peer network, online course database, online bookstore, virtual library, and alumni services website. Addresses the issues involved in converting distance education programs from print-based and…

  7. A Transparently-Scalable Metadata Service for the Ursa Minor Storage System

    DTIC Science & Technology

    2010-06-25

    provide application-level guarantees. For example, many document editing programs imple- ment atomic updates by writing the new document ver- sion into a...Transparently-Scalable Metadata Service for the Ursa Minor Storage System 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...operations that could involve multiple servers, how close existing systems come to transparent scala - bility, how systems that handle multi-server

  8. Developing Inclusive Schools: A Systemic Approach

    ERIC Educational Resources Information Center

    Kinsella, William; Senior, Joyce

    2008-01-01

    This paper emerges from an ongoing study which involved, firstly, key informant interviews with strategic personnel within the Irish education system, such personnel representing both service providers and service users. The first part of this paper provides a brief summary of the findings of that aspect of the study in relation to the key…

  9. NASA Earth Resources Survey Symposium. Volume 1-B: Geology, Information Systems and Services

    NASA Technical Reports Server (NTRS)

    1975-01-01

    A symposium was conducted on the practical applications of earth resources survey technology including utilization and results of data from programs involving LANDSAT, the Skylab earth resources experiment package, and aircraft. Topics discussed include geological structure, landform surveys, energy and extractive resources, and information systems and services.

  10. Organizational Issues Involved in the Development and Operation of Farm Informational Systems for Modernizing Agriculture.

    ERIC Educational Resources Information Center

    Lionberger, Herbert F.

    The need for an information development system for farmers is discussed in this paper. Issues and alternatives are described in terms of the research-extension-teaching trinity, extension services, role combinations, specialist advisor issues, innovations, research orientation, reward structures, and information services. Information gathered in…

  11. The impact of emotional involvement on online service buying decisions: an event-related potentials perspective

    PubMed Central

    Wang, Jing; Han, Weiwei

    2015-01-01

    When examining a buying process, changes in human brain signals and their event-related potential (ERP) components can be considered a reflection of the consumers’ emotions. In this experiment, participants were shown 12 products and related services that were available for purchase. After recording ERP components, we used a questionnaire to measure the individuals’ emotional involvement toward the services (i.e. the same services shown in the stimuli) of the 12 products to measure the emotional valence of the services. The emotional ERP components and the late positive potential (LPP) were elicited under the service conditions and distributed over the left frontal regions. We determined that the services may evoke an LPP and that services with a high emotional value may evoke a larger LPP, which suggests that positive emotion may be measured using the LPP amplitude in the left frontal regions. This result helps elucidate whether positive emotions are stimulated during the product-service system decision-making process and helps understand the emotional valences of different services. Our analysis of the emotional motivation of the consumer suggests that the LPP may be useful as an emotional indicator for measuring consumers’ evaluation of services that provides a neural view of product-service system buying decisions. PMID:26457370

  12. The impact of emotional involvement on online service buying decisions: an event-related potentials perspective.

    PubMed

    Zhao, Meina; Wang, Jing; Han, Weiwei

    2015-12-02

    When examining a buying process, changes in human brain signals and their event-related potential (ERP) components can be considered a reflection of the consumers' emotions. In this experiment, participants were shown 12 products and related services that were available for purchase. After recording ERP components, we used a questionnaire to measure the individuals' emotional involvement toward the services (i.e. the same services shown in the stimuli) of the 12 products to measure the emotional valence of the services. The emotional ERP components and the late positive potential (LPP) were elicited under the service conditions and distributed over the left frontal regions. We determined that the services may evoke an LPP and that services with a high emotional value may evoke a larger LPP, which suggests that positive emotion may be measured using the LPP amplitude in the left frontal regions. This result helps elucidate whether positive emotions are stimulated during the product-service system decision-making process and helps understand the emotional valences of different services. Our analysis of the emotional motivation of the consumer suggests that the LPP may be useful as an emotional indicator for measuring consumers' evaluation of services that provides a neural view of product-service system buying decisions.

  13. Who wants to be involved in health care decisions? Comparing preferences for individual and collective involvement in England and Sweden.

    PubMed

    Fredriksson, Mio; Eriksson, Max; Tritter, Jonathan

    2017-07-14

    Patient and public involvement (PPI) is framed as positive for individuals, the health system, public health, as well as for communities and society as a whole. We investigated whether preferences for PPI differed between two countries with Beveridge type health systems-Sweden and England. We measured willingness to be involved in individual treatment decisions and in decisions about the organization and provision of local health and social care services. This was a comparative cross-sectional study of the general population's preferences. Together, the two samples included 3125 respondents; 1625 in England and 1500 in Sweden. Country differences were analysed in a multinomial regression model controlling for gender, age and educational attainment. Overall, 68% of respondents wanted a passive patient role and 44% wanted to be involved in local decisions about organization and provision of services. In comparison with in Sweden, they were in England less likely to want a health professional such as a GP or consultant to make decisions about their treatment and also more likely to want to make their own decisions. They were also less likely to want to be involved in local service development decisions. An increased likelihood of wanting to be involved in organizational decision-making was associated with individuals wanting to make their own treatment decisions. Women were less likely to want health professionals to make decisions and more likely to want to be involved in organizational decisions. An effective health system that ensures public health must integrate an effective approach to PPI both in individual treatment decisions and shaping local health and social care priorities. To be effective, involvement activities must take in to account the variation in the desire for involvement and the implications that this has for equity. More work is needed to understand the relationship between the desire to be involved and actually being involved, but both appear related to judgements of the impact of involvement on health care decisions.

  14. Services used by perinatal substance-users with child welfare involvement: a descriptive study

    PubMed Central

    2010-01-01

    Background Substance use during pregnancy often leads to involvement in the child welfare system, resulting in multiple social service systems and service providers working with families to achieve successful child welfare outcomes. The Vulnerable Infants Program of Rhode Island (VIP-RI) is a care coordination program developed to work with perinatal substance-users to optimize opportunities for reunification and promote permanency for substance-exposed infants. This paper describes services used by VIP-RI participants and child welfare outcomes. Methods Data collected during the first four years of VIP-RI were used to identify characteristics of program participants, services received, and child welfare outcomes: closed child welfare cases, reunification with biological mothers and identified infant permanent placements. Descriptive Results Medical and financial services were associated with positive child welfare outcomes. Medical services included family planning, pre- and post-natal care and HIV test counseling. Financial services included assistance with obtaining entitlement benefits and receiving tangible support such as food and clothing. Conclusions Findings from this study suggest services that address basic family needs were related to positive child welfare outcomes. The provision of basic services, such as health care and financial assistance through entitlement benefits and tangible donations, may help to establish a foundation so mothers can concentrate on recovery and parenting skills. Identification of services for perinatal substance users that are associated with more successful child welfare outcomes has implications for the child welfare system, treatment providers, courts and families. PMID:20807432

  15. Services used by perinatal substance-users with child welfare involvement: a descriptive study.

    PubMed

    McCann, Kenneth J; Twomey, Jean E; Caldwell, Donna; Soave, Rosemary; Fontaine, Lynne Andreozzi; Lester, Barry M

    2010-08-31

    Substance use during pregnancy often leads to involvement in the child welfare system, resulting in multiple social service systems and service providers working with families to achieve successful child welfare outcomes. The Vulnerable Infants Program of Rhode Island (VIP-RI) is a care coordination program developed to work with perinatal substance-users to optimize opportunities for reunification and promote permanency for substance-exposed infants. This paper describes services used by VIP-RI participants and child welfare outcomes. Data collected during the first four years of VIP-RI were used to identify characteristics of program participants, services received, and child welfare outcomes: closed child welfare cases, reunification with biological mothers and identified infant permanent placements. DESCRIPTIVE RESULTS: Medical and financial services were associated with positive child welfare outcomes. Medical services included family planning, pre- and post-natal care and HIV test counseling. Financial services included assistance with obtaining entitlement benefits and receiving tangible support such as food and clothing. Findings from this study suggest services that address basic family needs were related to positive child welfare outcomes. The provision of basic services, such as health care and financial assistance through entitlement benefits and tangible donations, may help to establish a foundation so mothers can concentrate on recovery and parenting skills. Identification of services for perinatal substance users that are associated with more successful child welfare outcomes has implications for the child welfare system, treatment providers, courts and families.

  16. Beyond Enterprise Resource Planning (ERP): The Next Generation Enterprise Resource Planning Environment

    DTIC Science & Technology

    2012-02-01

    Software as a Service ( SaaS )— SaaS solutions involve conforming an organization’s...consumer of the utilized service . Service Models Software as a Service ( SaaS ) The capability provided to the consumer is to use the provider’s...operating system, platforms, and software installed. In contrast, Software as a Service ( SaaS ) abstracts the entire stack except for a few

  17. An Integrative Approach to Ecosystem Goods and Services – Putting the Pieces Together for the Tampa Bay Region

    EPA Science Inventory

    Ecosystem goods and services production, delivery, and use by humans involve multiple systems working together at various different spatial and temporal scales. Assessments of ecosystem goods and services and their benefits to current and or future human populations in any given ...

  18. Developing nursing capacity for health systems and services research in Cuba, 2008-2011.

    PubMed

    Martínez, Nelcy

    2012-07-01

    Health systems and services research by nursing personnel could inform decision-making and nursing care, providing evidence concerning quality of and patient satisfaction. Such studies are rather uncommon in Cuban research institutes, where clinical research predominates. Assess the results of a strategy implemented between 2008 and 2011 to develop nursing capacity for health systems and services research in 14 national research institutes based in Havana. The study comprised four stages: description of approaches to health systems and services research by nurses worldwide and in Cuba; analysis of current capacities for such research in Cuba; intervention design and implementation; and evaluation. Various techniques were used including: literature review, bibliometric analysis, questionnaire survey, consultation with experts, focus groups, and workshops for participant orientation and design and followup of research projects. Qualitative information reduction and quantitative information summary methods were used. Initially, 32 nursing managers participated; a further 105 nurses from the institutes were involved in research teams formed during intervention implementation. Of all published nursing research articles retrieved, 8.9% (185 of 2081) concerned health systems and services research, of which 26.5% (49 of 185) dealt with quality assessment. At baseline, 75% of Cuban nurses surveyed had poor knowledge of health systems and services research. Orientation, design and followup workshops for all institute teams developed individual and institutional capacity for health systems and services research. Post-intervention, 84.7% (27) of nurses reached good knowledge and 14.3% (5) fair; institutional research teams were formed and maintained in 9 institutes, and 13 projects designed and implemented (11 institutional, 2 addressing ministerial-level priorities) to research nursing issues at selected centers. A systematic strategy to build nursing capacity for health systems and services research can be effective in involving nurses in such research and in developing institutional support for it, fostering compliance with Cuban and international professional development priorities for nursing, as well as contributing to quality of patient services.

  19. Carers' experiences of involvement in care planning: a qualitative exploration of the facilitators and barriers to engagement with mental health services.

    PubMed

    Cree, Lindsey; Brooks, Helen L; Berzins, Kathryn; Fraser, Claire; Lovell, Karina; Bee, Penny

    2015-08-29

    Formal recognition and involvement of carers in mental health services has been the focus of recent policy and practice initiatives as well as being supported by carers themselves. However, carers still report feeling marginalised and distanced from services. A prominent theme is that that they are not listened to and their concerns are not taken seriously. Compared to service user views, the reasons underpinning carers' dissatisfaction with care-planning procedures have been relatively neglected in the research literature, despite the substantial and significant contribution that they make to mental health services. The aim of the study was to explore carers' experiences of the care planning process for people with severe mental illness. Qualitative interviews and focus groups were undertaken with carers. Data were combined and analysed using framework analysis. Whilst identifying a shared desire for involvement and confirming a potential role for carers within services, our data highlighted that many carers perceive a lack of involvement in care planning and a lack of recognition and appreciation of their role from health professionals. Barriers to involvement included structural barriers, such as the timing and location of meetings, cultural barriers relating to power imbalances within the system and specific barriers relating to confidentiality. This qualitative study led by a researcher who was a carer herself has developed the understanding of the potential role of carers within the care planning process within mental health services, along with the facilitators and barriers to achieving optimal involvement.

  20. The impact of sexual abuse in the lives of young women involved or at risk of involvement with the juvenile justice system.

    PubMed

    Goodkind, Sara; Ng, Irene; Sarri, Rosemary C

    2006-05-01

    Girls in the juvenile justice system have high rates of past sexual abuse. To better understand the relationship between sexual abuse and justice system involvement, we analyzed survey interviews with 169 young women involved or at risk of involvement with juvenile justice, comparing girls who experienced sexual abuse with those who did not. Girls experiencing sexual abuse had more negative mental health, school, substance use, risky sexual behavior, and delinquency outcomes. These findings highlight a need for interventions to assist girls who have experienced abuse and efforts to prevent abuse and improve child welfare and social service systems.

  1. Lunar lander ground support system

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This year's project, like the previous Aerospace Group's project, involves a lunar transportation system. The basic time line will be the years 2010-2030 and will be referred to as a second generation system, as lunar bases would be present. The project design completed this year is referred to as the Lunar Lander Ground Support System (LLGSS). The area chosen for analysis encompasses a great number of vehicles and personnel. The design of certain elements of the overall lunar mission are complete projects in themselves. For this reason the project chosen for the Senior Aerospace Design is the design of specific servicing vehicles and additions or modifications to existing vehicles for the area of concern involving servicing and maintenance of the lunar lander while on the surface.

  2. Juvenile Justice, Mental Health, and the Transition to Adulthood: A Review of Service System Involvement and Unmet Needs in the U.S

    PubMed Central

    Zajac, Kristyn; Sheidow, Ashli J.; Davis, Maryann

    2015-01-01

    Although adolescents are the primary focus of juvenile justice, a significant number of young people involved with this system are considered transition age youth (i.e., 16–25 years of age). The aim of this review is to summarize the specific needs of transition age youth with mental health conditions involved with the juvenile justice system, identify the multiple service systems relevant to this group, and offer recommendations for policies and practice. A comprehensive search strategy was used to identify and synthesize the literature. Findings highlight the paucity of research specific to transition age youth. Thus, we also summarized relevant research on justice-involved adolescents, with a focus evaluating its potential relevance in the context of the unique milestones of the transition age, including finishing one’s education, setting and working towards vocational goals, and transitioning from ones’ family of origin to more independent living situations. Existing programs and initiatives relevant to transition age youth with mental health conditions are highlighted, and nine specific recommendations for policy and practice are offered. PMID:26273119

  3. Juvenile Justice, Mental Health, and the Transition to Adulthood: A Review of Service System Involvement and Unmet Needs in the U.S.

    PubMed

    Zajac, Kristyn; Sheidow, Ashli J; Davis, Maryann

    2015-09-01

    Although adolescents are the primary focus of juvenile justice, a significant number of young people involved with this system are considered transition age youth (i.e., 16-25 years of age). The aim of this review is to summarize the specific needs of transition age youth with mental health conditions involved with the juvenile justice system, identify the multiple service systems relevant to this group, and offer recommendations for policies and practice. A comprehensive search strategy was used to identify and synthesize the literature. Findings highlight the paucity of research specific to transition age youth. Thus, we also summarized relevant research on justice-involved adolescents, with a focus evaluating its potential relevance in the context of the unique milestones of the transition age, including finishing one's education, setting and working towards vocational goals, and transitioning from ones' family of origin to more independent living situations. Existing programs and initiatives relevant to transition age youth with mental health conditions are highlighted, and nine specific recommendations for policy and practice are offered.

  4. The role of complaint management in the service recovery process.

    PubMed

    Bendall-Lyon, D; Powers, T L

    2001-05-01

    Patient satisfaction and retention can be influenced by the development of an effective service recovery program that can identify complaints and remedy failure points in the service system. Patient complaints provide organizations with an opportunity to resolve unsatisfactory situations and to track complaint data for quality improvement purposes. Service recovery is an important and effective customer retention tool. One way an organization can ensure repeat business is by developing a strong customer service program that includes service recovery as an essential component. The concept of service recovery involves the service provider taking responsive action to "recover" lost or dissatisfied customers and convert them into satisfied customers. Service recovery has proven to be cost-effective in other service industries. The complaint management process involves six steps that organizations can use to influence effective service recovery: (1) encourage complaints as a quality improvement tool; (2) establish a team of representatives to handle complaints; (3) resolve customer problems quickly and effectively; (4) develop a complaint database; (5) commit to identifying failure points in the service system; and (6) track trends and use information to improve service processes. Customer retention is enhanced when an organization can reclaim disgruntled patients through the development of effective service recovery programs. Health care organizations can become more customer oriented by taking advantage of the information provided by patient complaints, increasing patient satisfaction and retention in the process.

  5. Marketing strategies nurses can employ to promote health.

    PubMed

    McCormack, D

    1994-01-01

    Marketing strategies are employed to ensure the success of new products, services or programs. Both profit and non-profit organizations have used social marketing strategies to inform, to motivate interest, and to engage the involvement of the consumer. A client-dependent health care system did not find it necessary to market services, but a health care system that encourages clients to choose the most appropriate health promotion service available must market services. Nurses are in the business of promoting the health of clients. Therefore, it is essential that nurses become familiar with, and involved in, the development of marketing plans and strategies. The connection between the four variables of the marketing mix (product, promotion, place, and price) and promoting the health of clients is described. A case example recapitulating the marketing strategies employed to raise public awareness of a self-help group for family caregivers is related, the marketing response is evaluated, and future recommendations are proposed.

  6. The impact of state behavioral health reform on Native American individuals, families, and communities.

    PubMed

    Willging, Cathleen E; Goodkind, Jessica; Lamphere, Louise; Saul, Gwendolyn; Fluder, Shannon; Seanez, Paula

    2012-07-01

    In 2005, the State of New Mexico undertook a sweeping transformation of all publicly funded behavioral health services. The reform was intended to enhance the cultural responsiveness and appropriateness of these services. To examine achievement of this objective, we conducted a qualitative study of the involvement of Native Americans in reform efforts and the subsequent impacts of reform on services for Native Americans. We found that the reform was relatively unsuccessful at creating mechanisms for genuine community input or improving behavioral health care for this population. These shortcomings were related to limited understandings of administrators concerning how tribal governments and health care systems operate, and the structural limitations of a managed care system that does not allow flexibility for culturally appropriate utilization review, screening, or treatment. However, interaction between the State and tribes increased, and we conclude that aspects of the reform could be strengthened to achieve more meaningful involvement and service improvements.

  7. Patient empowerment as a component of health system reforms: rights, benefits and vested interests.

    PubMed

    Colombo, Cinzia; Moja, Lorenzo; Gonzalez-Lorenzo, Marien; Liberati, Alessandro; Mosconi, Paola

    2012-04-01

    Different strategies have been developed across countries to foster citizens' and patients' involvement, from health policies to patients' active participation in decisions regarding their health. The spectrum varies from systems where patients lead the reform of health care services, to others where a paternalistic approach still limits patients' autonomy in decision-making. This paper describes: (1) different interventions for involving patients; (2) experiences to promote consumer evidence-based advocacy; and (3) barriers to consumer involvement in health system reforms, including vested interests in patients' associations. Citizens' involvement in health systems can vary substantially, but is gaining increasing weight.

  8. Factors Leading African Americans and Black Caribbeans to Use Social Work Services for Treating Mental and Substance Use Disorders

    ERIC Educational Resources Information Center

    Cheng, Tyrone C.; Robinson, Michael A.

    2013-01-01

    This secondary analysis of 5,000 African Americans and black Caribbeans explored how their use of social work services to address mental and substance use disorders was associated with the disorder involved as well as their perceived need for services, belief system, family resources, proximity to services, social-structural factors, and…

  9. Data forwarding mechanism for supporting real-time services during relocations in UMTS systems

    NASA Astrophysics Data System (ADS)

    Cai, Wei; Liao, Xianglong; Zheng, Liang; Liu, Zehong

    2004-04-01

    To minimize the interruption during the handovers or relocations invoked by subscribers moving is a very critical factor to enhance the performance of the UMTS systems. We know that the 2G systems have been optimized to minimize the interruption of speech during handovers by two main technologies: one is the bi-casting for the DL traffic and the other is the fast radio resynchronization by the UE for the UL traffic. In the UMTS systems, we have also implemented lossless relocations for non real-time services with high reliability by data buffering in the source RNC and target RNC for the UE. However, the UMTS systems support four QoS classes traffic flow: conversational class, streaming class, interactive class and background class. The main distinguishing factor between these QoS classes is how delay sensitive the traffic is: Conversational and Streaming classes are mainly used to carry real-time traffic flows, like video telephony, interactive and background classes are mainly used by traditional Internet applications like WWW, E-mail and FTP. It"s essential to provide the solutions for supporting real-time services to meet the requirement for QoS in UMTS systems. Apparently, the Data buffering mechanism is not adapted to real-time services because of it"s delay may exceed the basic requirement for real-time services. Under this background, the paper discussed two data forwarding solutions for real-time services from the PS domain in the UMTS systems: packet duplication and Core Network bi-casting. The former mechanism does not require any new procedures, messages nor information elements. The later mechanism requires that the GGSN or SGSN is able to bi-cast the DL traffic to the target RNC according to the relocations involving two SGSNs or just involving one SGSN. It also implicitly shows that we need change procedures at the nodes SGSN, GGSN and RNC which are involved in the relocation procedure based on existing procedures that we have already designed if adopt the later solution. In a detail way, the paper analyzed the characteristic for these two solutions respectively, concentrated on the packet flows and the message flows in those nodes involved in relocations. Additionally, also gave out the impact on present transport technologies in the wireless communication systems. However we shall minimize the impact of evolution of transport mechanism and utilize the resource efficiently according to the general requirements for QoS in UMTS systems.

  10. Providing Individually Tailored Academic and Behavioral Support Services for Youth in the Juvenile Justice and Child Welfare Systems. Practice Guide

    ERIC Educational Resources Information Center

    Gonsoulin, S.; Darwin, M. J.; Read, N. W.

    2012-01-01

    Youth who are involved with the juvenile justice and child welfare systems face many challenges and barriers to academic and vocational success. Regardless of the reasons for their involvement, youth in these systems are "disproportionately children and youth of color who currently have, or have experienced, a host of risk factors that are…

  11. The School Media Centre and the Public Library: Combination or Co-Operation.

    ERIC Educational Resources Information Center

    Haycock, Ken

    In considering possible combinations of public and school library services, thought must be given to the varying roles of the two kinds of libraries, the location of facilities, the collection and circulation of materials, hours of services, qualifications of staff, system services, and community involvement. Some school-housed public libraries…

  12. Achieving Service-Learning Goals in a Financial Accounting Class Project

    ERIC Educational Resources Information Center

    Yu, Darwin D.

    2011-01-01

    Background: A financial accounting class in a Philippine university has a service-learning group project that involves setting up a simple accounting system for microenterprises. Aims: This paper examines the extent to which service-learning goals such as course learning, teamwork, civic responsibility, and impact on the client organization are…

  13. The Quality of Work in the Belgian Service Voucher System.

    PubMed

    Mousaid, Sarah; Huegaerts, Kelly; Bosmans, Kim; Julià, Mireia; Benach, Joan; Vanroelen, Christophe

    2017-01-01

    Several European countries implemented initiatives to boost the growth of the domestic cleaning sector. Few studies investigated the quality of work in these initiatives, although effects on workers' health and on social health inequalities can be expected. This study contributes to the scant research on this subject, by investigating the quality of work in the Belgian service voucher system - a subsidized system for domestic work. The applied research methodology includes a qualitative content analysis of parliamentary debates, legislation and previous research about the service voucher system and of 40 in-depth interviews with service voucher workers. The study shows that the legal framework that regulates the system must be further enhanced in order to improve the quality of work in the service voucher system. In addition, the actors involved must be better controlled, and sanctioned in case of non-compliance with legislation. © The Author(s) 2016.

  14. Mobile aviation services in the 1545-1559/1646.5-1660.5 MHz band

    NASA Astrophysics Data System (ADS)

    Kiesling, J. D.

    1986-09-01

    Plans in the U.S. for a national mobile satellite service (MSS) including satellite services to aviation for air traffic control and airline operational control are outlined. The MSS provides affordable mobile services in nonurban areas where terrestrially based systems are uneconomic. The MSS system also is available on a priority basis for aviation services, specifically AMSS(R) services involving safety and regularity of flight and other aviation services. The U.S. plan is expected to change the U.S. Tables of Allocations and proposes to change the International Table of Allocations so that MSS facilities can and will provide AMSS(R) services on a priority basis. Such arrangements can be implemented worldwide by administrations and organizations having similar interests.

  15. An Indoor Location-Based Control System Using Bluetooth Beacons for IoT Systems.

    PubMed

    Huh, Jun-Ho; Seo, Kyungryong

    2017-12-19

    The indoor location-based control system estimates the indoor position of a user to provide the service he/she requires. The major elements involved in the system are the localization server, service-provision client, user application positioning technology. The localization server controls access of terminal devices (e.g., Smart Phones and other wireless devices) to determine their locations within a specified space first and then the service-provision client initiates required services such as indoor navigation and monitoring/surveillance. The user application provides necessary data to let the server to localize the devices or allow the user to receive various services from the client. The major technological elements involved in this system are indoor space partition method, Bluetooth 4.0, RSSI (Received Signal Strength Indication) and trilateration. The system also employs the BLE communication technology when determining the position of the user in an indoor space. The position information obtained is then used to control a specific device(s). These technologies are fundamental in achieving a "Smart Living". An indoor location-based control system that provides services by estimating user's indoor locations has been implemented in this study (First scenario). The algorithm introduced in this study (Second scenario) is effective in extracting valid samples from the RSSI dataset but has it has some drawbacks as well. Although we used a range-average algorithm that measures the shortest distance, there are some limitations because the measurement results depend on the sample size and the sample efficiency depends on sampling speeds and environmental changes. However, the Bluetooth system can be implemented at a relatively low cost so that once the problem of precision is solved, it can be applied to various fields.

  16. An Indoor Location-Based Control System Using Bluetooth Beacons for IoT Systems

    PubMed Central

    Huh, Jun-Ho; Seo, Kyungryong

    2017-01-01

    The indoor location-based control system estimates the indoor position of a user to provide the service he/she requires. The major elements involved in the system are the localization server, service-provision client, user application positioning technology. The localization server controls access of terminal devices (e.g., Smart Phones and other wireless devices) to determine their locations within a specified space first and then the service-provision client initiates required services such as indoor navigation and monitoring/surveillance. The user application provides necessary data to let the server to localize the devices or allow the user to receive various services from the client. The major technological elements involved in this system are indoor space partition method, Bluetooth 4.0, RSSI (Received Signal Strength Indication) and trilateration. The system also employs the BLE communication technology when determining the position of the user in an indoor space. The position information obtained is then used to control a specific device(s). These technologies are fundamental in achieving a “Smart Living”. An indoor location-based control system that provides services by estimating user’s indoor locations has been implemented in this study (First scenario). The algorithm introduced in this study (Second scenario) is effective in extracting valid samples from the RSSI dataset but has it has some drawbacks as well. Although we used a range-average algorithm that measures the shortest distance, there are some limitations because the measurement results depend on the sample size and the sample efficiency depends on sampling speeds and environmental changes. However, the Bluetooth system can be implemented at a relatively low cost so that once the problem of precision is solved, it can be applied to various fields. PMID:29257044

  17. Student experiences of the adolescent diversion project: a community-based exemplar in the pedagogy of service-learning.

    PubMed

    Davidson, William S; Jimenez, Tiffeny R; Onifade, Eyitayo; Hankins, Sean S

    2010-12-01

    Service-learning partnerships between universities and surrounding communities striving to create systems-level change must consider an emphasis in critical community service; a community centered paradigm where students are taught to work with communities to better understand contexts surrounding a social problem, as opposed to merely volunteering to provide a service to a community. The Adolescent Diversion Project (ADP), which has been operating for over 30 years, demonstrates critical community service through the type of relationship built between students and the local community. This article describes: a qualitative study with ADP students, the historical context of ADP, what and how students learned through their involvement in ADP, and reframes the work of this project as a form of service-learning pedagogy. Inductive content analysis was employed to identify underlying themes across participants related to their personal experiences of ADP and its impact in their lives. Findings were compared with service-learning outcomes and other quantitative studies conducted with past ADP cohorts from the literature. Consistent with past studies, ADP students become more negative toward social systems involved with their youth. This finding may explain an increase in feelings of political commitment following involvement in ADP. Consistent with service-learning outcomes, results demonstrate that ADP should be further documented as not only an effective community-based program but also as an exemplar in the pedagogy of service-learning. This study highlights why service-learning opportunities for students are not just one way to teach students, they are opportunities to bridge relationships within communities, bring life to theoretical concepts, and build the foundations necessary for educated citizens that will one day take lead roles in our society.

  18. Design, development and deployment of public service photovoltaic power/load systems for the Gabonese Republic

    NASA Technical Reports Server (NTRS)

    Kaszeta, William J.

    1987-01-01

    Five different types of public service photovoltaic power/load systems installed in the Gabonese Republic are discussed. The village settings, the systems, performance results and some problems encountered are described. Most of the systems performed well, but some of the systems had problems due to failure of components or installation errors. The project was reasonably successful in collecting and reporting data for system performance evaluation that will be useful for guiding officials and system designers involved in village power applications in developing countries.

  19. Fixing the system? The experience of service users of the quasi-market in disability services in Australia.

    PubMed

    Spall, Pam; McDonald, Catherine; Zetlin, Di

    2005-01-01

    A qualitative study involving semi-structured interviews with 31 people with disabilities and 32 carers in the state of Queensland, Australia, found that their experience of supportive service delivery had not improved despite reforms of the service delivery system driven by a version of the quasi-market model. Instead of delivering increased consumer choice and improved efficiency in service delivery, service users experienced inadequate service supply, service cutbacks, and an increased emphasis on cost subsidisation and assessment processes. Additionally, few consumers felt that individualised funding arrangements had personally delivered the benefits which the quasi-market model and associated policy paradigm had indicated that they should receive. For many consumers, the notion of consumer 'choice' around service provision was fictitious and they felt that any efficiency gains were at the agency level, largely at the consumers' cost. It is concluded that there appears to be no particular benefit to service users of quasi-market reforms, particularly in policy contexts where service delivery systems are historically under-funded.

  20. 47 CFR 5.63 - Supplementary statements required.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... experimental authorization involving a satellite system must submit a description of the design and operational... 5.63 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EXPERIMENTAL RADIO SERVICE (OTHER... for an authorization in the Experimental Radio Service must enclose with the application a narrative...

  1. 47 CFR 5.63 - Supplementary statements required.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... experimental authorization involving a satellite system must submit a description of the design and operational... 5.63 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EXPERIMENTAL RADIO SERVICE (OTHER... for an authorization in the Experimental Radio Service must enclose with the application a narrative...

  2. Examination of Regional Transit Service Under Contracting : A Case Study in the Greater New Orleans Region

    DOT National Transportation Integrated Search

    2011-04-01

    Many local governments and transit agencies in the United States face financial difficulties in providing adequate public transit service in individual systems, and in providing sufficient regional coordination to accommodate transit trips involving ...

  3. The pursuit of excellence and innovation in service user involvement in nurse education programmes: report from a travel scholarship.

    PubMed

    Terry, Julia M

    2013-05-01

    The involvement of service users and carers in nurse education is increasing, with the new standards for pre-registration nurse education in the UK, which require nurse education providers to demonstrate how they are involving users and carers in the planning, delivery, teaching and evaluation of nursing curricula (Nursing and Midwifery Council, 2010). A travel scholarship provided the opportunity to explore best practice in this area, focussing on identifying support systems and processes that enable user involvement. The scholarship was undertaken in the UK and Ireland during a 4 week study tour between June and July 2011, during which I visited 15 universities, and met with nurse education staff, users and carers involved in nurse education programmes. Prerequisite processes, the spectrum and variety of involvement activities, quality assurance and evaluation; and sustainability of user involvement in nurse education are reported in this paper. Service users and carers are an under-utilised resource, and as experts by experience have much to offer students and staff by increased involvement in nurse education programmes. The importance of values, enthusiasm and relationships, the cornerstones that strengthen user involvement; often sustain such partnerships. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. 42 CFR 480.143 - QIO involvement in shared health data systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.143 QIO involvement in shared health data...

  5. 42 CFR 480.143 - QIO involvement in shared health data systems.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.143 QIO involvement in shared health data...

  6. 42 CFR 480.143 - QIO involvement in shared health data systems.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.143 QIO involvement in shared health data...

  7. Classification of processes involved in sharing individual participant data from clinical trials.

    PubMed

    Ohmann, Christian; Canham, Steve; Banzi, Rita; Kuchinke, Wolfgang; Battaglia, Serena

    2018-01-01

    Background: In recent years, a cultural change in the handling of data from research has resulted in the strong promotion of a culture of openness and increased sharing of data. In the area of clinical trials, sharing of individual participant data involves a complex set of processes and the interaction of many actors and actions. Individual services/tools to support data sharing are available, but what is missing is a detailed, structured and comprehensive list of processes/subprocesses involved and tools/services needed. Methods : Principles and recommendations from a published data sharing consensus document are analysed in detail by a small expert group. Processes/subprocesses involved in data sharing are identified and linked to actors and possible services/tools. Definitions are adapted from the business process model and notation (BPMN) and applied in the analysis. Results: A detailed and comprehensive list of individual processes/subprocesses involved in data sharing, structured according to 9 main processes, is provided. Possible tools/services to support these processes/subprocesses are identified and grouped according to major type of support. Conclusions: The list of individual processes/subprocesses and tools/services identified is a first step towards development of a generic framework or architecture for sharing of data from clinical trials. Such a framework is strongly needed to give an overview of how various actors, research processes and services could form an interoperable system for data sharing.

  8. Classification of processes involved in sharing individual participant data from clinical trials

    PubMed Central

    Ohmann, Christian; Canham, Steve; Banzi, Rita; Kuchinke, Wolfgang; Battaglia, Serena

    2018-01-01

    Background: In recent years, a cultural change in the handling of data from research has resulted in the strong promotion of a culture of openness and increased sharing of data. In the area of clinical trials, sharing of individual participant data involves a complex set of processes and the interaction of many actors and actions. Individual services/tools to support data sharing are available, but what is missing is a detailed, structured and comprehensive list of processes/subprocesses involved and tools/services needed. Methods: Principles and recommendations from a published data sharing consensus document are analysed in detail by a small expert group. Processes/subprocesses involved in data sharing are identified and linked to actors and possible services/tools. Definitions are adapted from the business process model and notation (BPMN) and applied in the analysis. Results: A detailed and comprehensive list of individual processes/subprocesses involved in data sharing, structured according to 9 main processes, is provided. Possible tools/services to support these processes/subprocesses are identified and grouped according to major type of support. Conclusions: The list of individual processes/subprocesses and tools/services identified is a first step towards development of a generic framework or architecture for sharing of data from clinical trials. Such a framework is strongly needed to give an overview of how various actors, research processes and services could form an interoperable system for data sharing. PMID:29623192

  9. Effects of high-involvement work systems on employee satisfaction and service costs in veterans healthcare.

    PubMed

    Harmon, Joel; Scotti, Dennis J; Behson, Scott; Farias, Gerard; Petzel, Robert; Neuman, Joel H; Keashly, Loraleigh

    2003-01-01

    Two strong imperatives for healthcare managers are reducing costs of service and attracting and retaining highly dedicated and competent patient care and support employees. Is there a trade-off or are there organizational practices that can further both objectives at the same time? High-involvement work systems (HIWS) represent a holistic work design that includes interrelated core features such as involvement, empowerment, development, trust, openness, teamwork, and performance-based rewards. HIWS have been linked to higher productivity, quality, employee and customer satisfaction, and market and financial performance in Fortune 1000 firms. Apparently, few prior studies have looked at the impacts of this holistic design within the healthcare sector. This research found that HIWS were associated with both greater employee satisfaction and lower patient service costs in 146 Veterans Health Administration centers, indicating that such practices pay off in both humanistic and financial terms. This suggests that managers implementing HIWS will incur real expenses that are likely to be more than offset by more satisfied employees, less organizational turmoil, and lower service delivery costs, which, in this study, amounted to over $1.2 million in savings for an average VHA facility.

  10. Eight essentials of performance measurement.

    PubMed

    Moullin, Max

    2004-01-01

    A well-designed performance measurement system is vital for ensuring that organisations deliver cost-effective, high-quality services that meet the needs of service users. Without feedback on all important aspects and a system for ensuring that the organisation acts on that information, managers are struggling in the dark to improve services. However, performance measurement is not easy, particularly in health and public services where a wide range of stakeholders is involved. This article discusses what the author considers to be the eight essentials of performance measurement. Though described in the context of health and social care, they are important for organisations in all sectors.

  11. 42 CFR 480.143 - QIO involvement in shared health data systems.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.143 QIO involvement in shared health data...

  12. 42 CFR 480.143 - QIO involvement in shared health data systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.143 QIO involvement in shared health data...

  13. ATLAS from Data Research Associates: A Fully Integrated Automation System.

    ERIC Educational Resources Information Center

    Mellinger, Michael J.

    1987-01-01

    This detailed description of a fully integrated, turnkey library system includes a complete profile of the system (functions, operational characteristics, hardware, operating system, minimum memory and pricing); history of the technologies involved; and descriptions of customer services and availability. (CLB)

  14. Diversification of health care services: the effects of ownership, environment, and strategy.

    PubMed

    Shortell, S M; Morrison, E M; Hughes, S L; Friedman, B S; Vitek, J L

    1987-01-01

    The present findings suggest that the trend toward greater diversification of hospital services is likely to be most strongly influenced by state Medicaid policies and certain hospital characteristics. Increasing Medicaid eligibility and payment levels is likely to have a positive effect on services diversification. Growth in the number of inpatient services provided and a more severe case mix are also likely to be involved with greater service diversification. Affiliation with a not-for-profit hospital system is likely to be associated with more diversified hospital services but not affiliation with an investor-owned system. There is also some indication that the overall portfolio of services which a hospital offers in regard to market share and market growth characteristics influences diversification. Specifically, a low market share portfolio is likely to be associated with less diversification. Competition is likely to be associated with more diversification; particularly for hospitals belonging to systems. The effect of competition on hospital strategy and services diversification is a particularly important area for further investigation. Increasing Medicaid payment and eligibility levels are also likely to have a positive effect on the provision of services which are usually unprofitable. Raising such levels is likely to be particularly beneficial to inner-city hospitals who are already providing a greater number of such services. However, the present data suggest that investor-owned hospitals are least likely to provide such services. Increasing Medicaid eligibility levels is also likely to be associated with fewer services for which charity care has to be provided. State regulation in the form of rate review and certificate of need is likely to be associated with more services for which hospitals provide some charity care. But such policies alone do not deal with the larger issue of how to finance care for the medically indigent. Present data suggest the charity care issue may be particularly salient in markets characterized by a relatively high degree of competition. Finally, investor-owned hospitals provide as many services involving charity care as not-for-profit system hospitals, although investor-owned system hospitals provide fewer such services than not-for-profit freestanding hospitals. Throughout, the findings indicate the importance of distinguishing between ownership and system affiliation. Previous research has failed to make a distinction between ownership form and system affiliation, thus attributing to ownership form differences which, as present findings suggest, appear to be more associated with system affiliation.(ABSTRACT TRUNCATED AT 400 WORDS)

  15. Management of health care services for flood victims: the case of the shelter at Nakhon Pathom Rajabhat University Central Thailand.

    PubMed

    Buajaroen, Hathaichanok

    2013-08-01

    In Central Thailand basic health care services were affected by a natural disaster in the form of a flood situation. Flood Relief Operations Centers were established from the crisis. Nakhon Pathom Rajabhat University and including the faculty of nursing volunteered to care for those affected and assist in re-establishing a functioning health care system. The aim of this study was to make explicit knowledge of concept, lesson learned, and the process of management for re-establishing a health care service system at a flood victims at Relief Operations Center, Nakhon Pathom Rajabhat University. We used a qualitative design with mixed methods. This involved in-depth interviews, focus group, observational participation and non-observational participation. Key informants included university administrators, instructors, leaders of flood victims and the flood victims. Data was collected during October-December, 2010. Data were analysed using content analysis and compared matrix. We found that the concept and principle of health care services management were community based and involved home care and field hospital services. We had prepared a management system that placed emphasise on a community based approach and holistic caring such as 24h Nursing Clinic Home, visits with family, a referral system, field hospital. The core of management was to achieve integrated instruction started from nursing students were practiced skills as Health promotion and nursing techniques practicum. Rules were established regarding the health care service system. The outcomes of Health Care Service at the Flood Relief Operations Center were direct and sincere help without conditions, administrations concerned and volunteer nursing students instructors, University Officer have sympathetic and charitable with flood victims and environment. Copyright © 2013 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Experiences Obtained with Integration of Student Response Systems for iPod Touch and iPhone into e-Learning Environments

    ERIC Educational Resources Information Center

    Stav, John; Nielsen, Kjetil; Hansen-Nygard, Gabrielle; Thorseth, Trond

    2010-01-01

    A new type of Student Response System (SRS) based up on the latest wireless technologies and hand held mobile devices has been developed to enhance active learning methods and assess students' understanding. The key services involve a set of XML technologies, web services and modern mobile devices. A group consisting of engineers, scientists and…

  17. Different approaches to contracting in health systems.

    PubMed Central

    Perrot, Jean

    2006-01-01

    Contracting is one of the tools increasingly being used to enhance the performance of health systems in both developed and developing countries; it takes different forms and cannot be limited to the mere purchase of services. Actors adopt contracting to formalize all kinds of relations established between them. A typology for this approach will demonstrate its diversity and provide a better understanding of the various issues raised by contracting. In recent years the way health systems are organized has changed significantly. To remedy the under-performance of their health systems, most countries have undertaken reforms that have resulted in major institutional overhaul, including decentralization of health and administrative services, autonomy for public service providers, separation of funding bodies and service providers, expansion of health financing options and the development of the profit or nonprofit private sector. These institutional reshuffles lead not only to multiplication and diversification of the actors involved, but also to greater separation of the service provision and administrative functions. Health systems are becoming more complex and can no longer operate in isolation. Actors are gradually realizing that they need to forge relations. The simplest way to do that is through dialogue, although some prefer a more formal commitment. Interaction between actors may take various forms and be on different scales. There are several types of contractual relations: some are based on the nature of the contract (public or private), others on the parties involved and yet others on the scope of the contract. Here they are classified into three categories according to the object of the contract: delegation of responsibility, act of purchase of services, or cooperation. PMID:17143459

  18. Intelligent Transportation System Strategic Plan For Las Vegas Valley

    DOT National Transportation Integrated Search

    1996-11-01

    "INTELLIGENT TRANSPORTATION SYSTEMS" (ITS) IS A COLLECTIVE TERM FOR MEASURES TARGETING THE EFFICIENT OPERATIONS AND MANAGEMENT OF TRANSPORTATION FACILITIES AND SERVICES, USUALLY INVOLVING THE USE OF ELECTRONIC EQUIPMENT FOR COLLECTING,. PROCESSING, R...

  19. The Impact of State Behavioral Health Reform on Native American Individuals, Families, and Communities

    PubMed Central

    Willging, Cathleen E.; Goodkind, Jessica; Lamphere, Louise; Saul, Gwendolyn; Fluder, Shannon; Seanez, Paula

    2012-01-01

    In 2005, the State of New Mexico undertook a sweeping transformation of all publicly funded behavioral health services. The reform was intended to enhance the cultural responsiveness and appropriateness of these services. To examine achievement of this objective, we conducted a qualitative study of the involvement of Native Americans in reform efforts and the subsequent impacts of reform on services for Native Americans. We found that the reform was relatively unsuccessful at creating mechanisms for genuine community input or improving behavioral health care for this population. These shortcomings were related to limited understandings of administrators concerning how tribal governments and health care systems operate, and the structural limitations of a managed care system that does not allow flexibility for culturally appropriate utilization review, screening, or treatment. However, interaction between the State and tribes increased, and we conclude that aspects of the reform could be strengthened to achieve more meaningful involvement and service improvements. PMID:22427455

  20. The role of the primary care team in the rapid response system.

    PubMed

    O'Horo, John C; Sevilla Berrios, Ronaldo A; Elmer, Jennifer L; Velagapudi, Venu; Caples, Sean M; Kashyap, Rahul; Jensen, Jeffrey B

    2015-04-01

    The purpose of the study is to evaluate the impact of primary service involvement on rapid response team (RRT) evaluations. The study is a combination of retrospective chart review and prospective survey-based evaluation. Data included when and where the activations occurred and the patient's code status, primary service, and ultimate disposition. These data were correlated with survey data from each event. A prospective survey evaluated the primary team's involvement in decision making and the overall subjective quality of the interaction with primary service through a visual analog scale. We analyzed 4408 RRTs retrospectively and an additional 135 prospectively. The primary team's involvement by telephone or in person was associated with significantly more transfers to higher care levels in retrospective (P < .01) and prospective data sets. Code status was addressed more frequently in primary team involvement, with more frequent changes seen in the retrospective analysis (P = .01). Subjective ratings of communication by the RRT leader were significantly higher when the primary service was involved (P < .001). Active primary team involvement influences RRT activation processes of care. The RRT role should be an adjunct to, but not a substitute for, an engaged and present primary care team. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. A series on optimizing satellite systems. I - Restoring interruptions of communications sattelite service: Logistical and cost comparisons of mature and newly operational systems

    NASA Astrophysics Data System (ADS)

    Snow, Marcellus S.

    1989-09-01

    A mathematical model is presented of costs and operational factors involved in provision for service interruptions of both a mature and typically large incumbent satellite system and of a smaller, more recently operational system. The equation expresses the required launch frequency for the new system as a function of the launch spacing of the mature system; the time disparity between the inauguration of the two systems; and the rate of capacity depreciation. In addition, a technique is presented to compare the relative extent to which the discounted costs of the new system exceed those of the mature system in furnishing the same effective capacity in orbit, and thus the same service liability, at a given point in time. It is determined that a mature incumbent communications satellite system, having more capacity in orbit, will on balance have a lower probability of service interruption than a newer, smaller system.

  2. Integrating Systems-Based Practice, Community Psychiatry, and Recovery into Residency Training

    ERIC Educational Resources Information Center

    LeMelle, Stephanie; Arbuckle, Melissa R.; Ranz, Jules M.

    2013-01-01

    Background: Behavioral health services involving multiple systems of care are increasingly being provided in community as well as hospital settings. Residents therefore should be familiar with multiple systems and the role of the psychiatrist in these systems. The authors describe a curriculum incorporating principles of systems-based practice…

  3. Cortisol production patterns in young children living with birth parents vs children placed in foster care following involvement of Child Protective Services.

    PubMed

    Bernard, Kristin; Butzin-Dozier, Zachary; Rittenhouse, Joseph; Dozier, Mary

    2010-05-01

    To examine differences in waking to bedtime cortisol production between children who remained with birth parents vs children placed in foster care following involvement of Child Protective Services (CPS). Between-subject comparison of cortisol patterns among 2 groups of children. Children referred from the child welfare system. Three hundred thirty-nine children aged 2.9 to 31.4 months who were living with birth parents (n = 155) or placed in foster care (n = 184) following CPS involvement as well as 96 unmatched children from low-risk environments. Main Exposures Involvement by CPS and foster care. Main Outcome Measure Salivary cortisol samples obtained at waking and bedtime for children on 2 days. Child Protective Services-involved children who continued to live with birth parents and CPS-involved children placed in foster care differed in cortisol production, with children living with their birth parents showing flatter slopes in waking to bedtime values. Continuing to live with birth parents following involvement of CPS is associated with greater perturbation to the diurnal pattern of cortisol production than living with foster parents. Foster care may have a regulating influence on children's cortisol among children who have experienced maltreatment.

  4. Consultant-based otolaryngology emergency service: a five-year experience.

    PubMed

    Barnes, M L; Hussain, S S M

    2011-12-01

    To present our experience of running a consultant-based otolaryngology emergency care service for more than five years. In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled. Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service. Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.

  5. Design theory, modelling and the application for the Internet of Things service

    NASA Astrophysics Data System (ADS)

    Shang, Xiaopu; Zhang, Runtong; Zhu, Xiaomin; Zhou, Quan

    2016-03-01

    The Internet of Things (IoT) makes it possible for us to sense the physical world and locate objects in it using the enabling technologies associated with IoT. Compared with traditional information systems, IoT enabling technologies can help acquire real-time data necessary for managing enterprise business process. An IoT system should have an ability beyond integrating enabling technologies and traditional information systems that are only used to access environmental data. This paper begins with a literature review of IoT-related issues and a discussion of the difference between traditional information service and IoT service. Three principles for IoT service design from the perceptive of service classification, coordination and compatibility are proposed. The paper also proposes a utility model for resource allocation in order to improve IoT service performance, and an application involving a cold chain visibility platform is given to illustrate our research.

  6. School Leadership: A Blueprint for Change.

    ERIC Educational Resources Information Center

    Thomson, Scott D., Ed.

    The new age of education shows an increasing focus on human development through family involvement, community learning resources, community social service, staff development, involvement, technology, learning climate, and motivation/reward systems. Integration of these areas calls for skills that are not traditionally taught to school leaders.…

  7. Licensing of future mobile satellite systems

    NASA Technical Reports Server (NTRS)

    Lepkowski, Ronald J.

    1990-01-01

    The regulatory process for licensing mobile satellite systems is complex and can require many years to complete. This process involves frequency allocations, national licensing, and frequency coordination. The regulatory process that resulted in the establishment of the radiodetermination satellite service (RDSS) between 1983 and 1987 is described. In contrast, each of these steps in the licensing of the mobile satellite service (MSS) is taking a significantly longer period of time to complete.

  8. Multiple service use: the impact of consistency in service quality for vulnerable youth.

    PubMed

    Sanders, Jackie; Munford, Robyn; Liebenberg, Linda; Ungar, Michael

    2014-04-01

    Little is known about the way in which variations in service quality influence outcomes when youth are clients of more than one service system. This article reports on a study of 1,210 adolescents (aged 13-17 years), half were concurrent clients of two or more services and half were not involved in two or more services. Youth completed a self-report questionnaire administered by a trained interviewer. It was hypothesized that youth reporting two positive service experiences would report lower risks, higher resilience, and better outcomes than youth reporting inconsistent or two negative service experiences and that their resilience, risks, and outcomes would be similar to those of youth not involved in two or more services. MANCOVA was used to determine the relationship among service quality and resilience, risk, and outcomes with four covariates that assessed family and neighborhood environments, history of abuse and neglect, and chronic need. Results indicate that service quality had an effect on resilience, risks, and outcomes. These relationships were mediated quite strongly by the influence of the risks youth faced in their neighborhoods and to a lesser extent by the other three covariates. Of the three dependent variables, risk appeared to be the most consistently influenced by all the covariates, and it also differentiated service experience groups. Results point to the importance of services developing strategies to effectively address risks confronted by youth and also to ensure that when more than one service is involved with youth, consistency in service delivery is achieved. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Meeting the Complex Needs of Urban Youth and Their Families through the 4Rs 2Ss Family Strengthening Program: The "Real World" Meets Evidence-Informed Care

    ERIC Educational Resources Information Center

    Small, Latoya A.; Jackson, Jerrold; Gopalan, Geetha; McKay, Mary McKernan

    2015-01-01

    Background: Youth living in poverty face compounding familial and environmental was challenges in utilizing effective community mental health services. Ongoing stressors increase their drop-out rate in mental health service use. Difficulties also exist in staying engaged in services when involved with the child welfare system. This study examines…

  10. Youth Development Needs and Capacities in the District of Columbia.

    ERIC Educational Resources Information Center

    Cave, George

    This report examines, ward-by-ward, indicators of need for youth development services in the District of Columbia (DC), including high school dropout rates, unemployment, poverty, involvement with the criminal justice system, teen parenting, and youth mortality. It discusses capacity to provide various youth development services to address those…

  11. Technology: nursing the system. Technology and the potential for entrepreneurship.

    PubMed

    Simpson, R L

    1997-10-01

    Many nurses are stepping beyond the boundaries of traditional practice and creating their own business or service centers. New entrepreneurial opportunities include working on computer-based patient records, providing consulting services, developing policies and more. Getting involved--joining informatics groups, taking classes--is the first step.

  12. The Benefits of Community and Juvenile Justice Involvement in Organizational Research

    PubMed Central

    Leukefeld, Carl G.; Cawood, Margaret; Wiley, Tisha; Robertson, Angela A.; Fisher, Jacqueline Horan; Arrigona, Nancy; Donohue, Patricia; Staples-Horne, Michelle; Harris, Philip W.; Dembo, Richard; Roysden, Judy; Marks, Katherine R.

    2017-01-01

    The Juvenile Justice (JJ) system has a number of local behavioral health service community linkages for substance abuse, mental health, and HIV services. However, there have only been a few systemic studies that examine and seek to improve these community behavioral health linkages for justice-involved youth. Implementation research is a way of identifying, testing, and understanding effective strategies for translating evidence-based treatment and prevention approaches into service delivery. This article explores benefits and challenges of participatory research within the context of the National Institute on Drug Abuse (NIDA)’s Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) implementation behavioral health study. The JJ-TRIALS study has involved JJ partners (representatives from state-level JJ agencies) throughout the study development, design, and implementation. Proponents of participatory research argue that such participation strengthens relations between the community and academia; ensures the relevancy of research questions; increases the capacity of data collection; and enhances program recruitment, sustainability, and extension. The extent of the impact that JJ partners have had on the JJ-TRIALS study will be discussed, as well as the benefits local JJ agencies can derive from both short- and long-term participation. Issues associated with the site selection, participation, and implementation of evidence-based practices also will be discussed. PMID:28828202

  13. The Benefits of Community and Juvenile Justice Involvement in Organizational Research.

    PubMed

    Leukefeld, Carl G; Cawood, Margaret; Wiley, Tisha; Robertson, Angela A; Fisher, Jacqueline Horan; Arrigona, Nancy; Donohue, Patricia; Staples-Horne, Michelle; Harris, Philip W; Dembo, Richard; Roysden, Judy; Marks, Katherine R

    2017-01-01

    The Juvenile Justice (JJ) system has a number of local behavioral health service community linkages for substance abuse, mental health, and HIV services. However, there have only been a few systemic studies that examine and seek to improve these community behavioral health linkages for justice-involved youth. Implementation research is a way of identifying, testing, and understanding effective strategies for translating evidence-based treatment and prevention approaches into service delivery. This article explores benefits and challenges of participatory research within the context of the National Institute on Drug Abuse (NIDA)'s Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) implementation behavioral health study. The JJ-TRIALS study has involved JJ partners (representatives from state-level JJ agencies) throughout the study development, design, and implementation. Proponents of participatory research argue that such participation strengthens relations between the community and academia; ensures the relevancy of research questions; increases the capacity of data collection; and enhances program recruitment, sustainability, and extension. The extent of the impact that JJ partners have had on the JJ-TRIALS study will be discussed, as well as the benefits local JJ agencies can derive from both short- and long-term participation. Issues associated with the site selection, participation, and implementation of evidence-based practices also will be discussed.

  14. Information Service for Educators

    ERIC Educational Resources Information Center

    Doyle, James E.

    1970-01-01

    Describes the Regional Information System (RIS), an information system developed and field tested by the Michigan Ohio Regional Educational Laboratory (MOREL) to locate research information on educational innovation as well as information on people and agencies involved with innovative programs. (JB)

  15. Manipulating Scrip Systems: Sybils and Collusion

    NASA Astrophysics Data System (ADS)

    Kash, Ian A.; Friedman, Eric J.; Halpern, Joseph Y.

    Game-theoretic analyses of distributed and peer-to-peer systems typically use the Nash equilibrium solution concept, but this explicitly excludes the possibility of strategic behavior involving more than one agent. We examine the effects of two types of strategic behavior involving more than one agent, sybils and collusion, in the context of scrip systems where agents provide each other with service in exchange for scrip. Sybils make an agent more likely to be chosen to provide service, which generally makes it harder for agents without sybils to earn money and decreases social welfare. Surprisingly, in certain circumstances it is possible for sybils to make all agents better off. While collusion is generally bad, in the context of scrip systems it actually tends to make all agents better off, not merely those who collude. These results also provide insight into the effects of allowing agents to advertise and loan money.

  16. [A method of education at a distance for nurses' aides in the community area of Guatemala].

    PubMed

    García Pastor de Domínguez, E; Robles de Sandoval, A; Martínez Chopen, O

    1988-01-01

    The authors describe in detail a self-tutorial system that has been used for some ten years in Guatemala to train auxiliary nursing personnel. This model addressed both training and service objectives, and it proved to be consistent with a health policy of integrating teaching and service which the country was implementing at the time. The system involved a national effort to develop self-tutorial units and materials on basic subjects such as nursing procedures, mother and child health, first aid, management, guided therapy, community development and health education. Materials were divided into three categories: for self-tutorial instruction, for recording, supervision and evaluation, and for coordination and feedback within the system. Lastly, greater detail is given on the functions and tasks performed at the different levels of staff involved in managing the system, and the mechanisms which were implemented in the country's health areas are described.

  17. Integrated Distributed Directory Service for KSC

    NASA Technical Reports Server (NTRS)

    Ghansah, Isaac

    1997-01-01

    This paper describes an integrated distributed directory services (DDS) architecture as a fundamental component of KSC distributed computing systems. Specifically, an architecture for an integrated directory service based on DNS and X.500/LDAP has been suggested. The architecture supports using DNS in its traditional role as a name service and X.500 for other services. Specific designs were made in the integration of X.500 DDS for Public Key Certificates, Kerberos Security Services, Network-wide Login, Electronic Mail, WWW URLS, Servers, and other diverse network objects. Issues involved in incorporating the emerging Microsoft Active Directory Service MADS in KSC's X.500 were discussed.

  18. Knowledge Management, User Education and Librarianship.

    ERIC Educational Resources Information Center

    Koenig, Michael E. D.

    2003-01-01

    Discusses the role of librarians in knowledge management in terms of designing information systems, creating classification systems and taxonomies, and implementing and operating the systems. Suggests the need for librarians to be involved in user education and training, including database searching, using current awareness services, and using…

  19. Vulnerable Populations and the Transition to Adulthood

    ERIC Educational Resources Information Center

    Osgood, D. Wayne; Foster, E. Michael; Courtney, Mark E.

    2010-01-01

    D. Wayne Osgood, E. Michael Foster, and Mark E. Courtney examine the transition to adulthood for youth involved in social service and justice systems during childhood and adolescence. They survey the challenges faced by youth in the mental health system, the foster care system, the juvenile justice system, the criminal justice system, and special…

  20. Enabling NVM for Data-Intensive Scientific Services

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

    Carns, Philip; Jenkins, John; Seo, Sangmin

    Specialized, transient data services are playing an increasingly prominent role in data-intensive scientific computing. These services offer flexible, on-demand pairing of applications with storage hardware using semantics that are optimized for the problem domain. Concurrent with this trend, upcoming scientific computing and big data systems will be deployed with emerging NVM technology to achieve the highest possible price/productivity ratio. Clearly, therefore, we must develop techniques to facilitate the confluence of specialized data services and NVM technology. In this work we explore how to enable the composition of NVM resources within transient distributed services while still retaining their essential performance characteristics.more » Our approach involves eschewing the conventional distributed file system model and instead projecting NVM devices as remote microservices that leverage user-level threads, RPC services, RMA-enabled network transports, and persistent memory libraries in order to maximize performance. We describe a prototype system that incorporates these concepts, evaluate its performance for key workloads on an exemplar system, and discuss how the system can be leveraged as a component of future data-intensive architectures.« less

  1. Older persons' navigation through the service system towards home modification resources.

    PubMed

    Johansson, Karin; Borell, Lena; Lilja, Margareta

    2009-01-01

    Home modifications are part of the occupational therapy interventions provided to persons with functional limitations in the home environment. Home modification services often involve many different actors, and persons experiencing a need for home modifications have to navigate through a network of service organizations and professional actors. The aim of this study was to explore and describe how older adults in one Swedish municipality tried to find their way and navigate through the service system in order to receive home modification services that could meet their experienced needs. A case study design was used, including four older adults with different experiences and expectations of home modification services. The relationship between the participants' expectations, experiences, and their ways to navigate through the service system was described through the metaphor of a "geographical map". Satisfaction with the service process was found when there was a match in understandings of responsibilities and eligibility between what could be read from the older persons' map and the professionals' perspective. The findings have implications for client-centred occupational therapy practice, indicating that this match can be achieved when professionals translate clients' experienced problems in everyday life into a terminology that fits into the service system.

  2. Changing times? Gender roles and relationships in maternal, newborn and child health in Malawi.

    PubMed

    Manda-Taylor, Lucinda; Mwale, Daniel; Phiri, Tamara; Walsh, Aisling; Matthews, Anne; Brugha, Ruairi; Mwapasa, Victor; Byrne, Elaine

    2017-09-25

    For years, Malawi remained at the bottom of league tables on maternal, neonatal and child health. Although maternal mortality ratios have reduced and significant progress has been made in reducing neonatal morality, many challenges in achieving universal access to maternal, newborn and child health care still exist in Malawi. In Malawi, there is still minimal, though increasing, male involvement in ANC/PMTCT/MNCH services, but little understanding of why this is the case. The aim of this paper is to explore the role and involvement of men in MNCH services, as part of the broader understanding of those community system factors. This paper draws on the qualitative data collected in two districts in Malawi to explore the role and involvement of men across the MNCH continuum of care, with a focus on understanding the community systems barriers and enablers to male involvement. A total of 85 IDIs and 20 FGDs were conducted from August 2014 to January 2015. Semi-structure interview guides were used to guide the discussion and a thematic analysis approach was used for data analysis. Policy changes and community and health care provider initiatives stimulated men to get involved in the health of their female partners and children. The informal bylaws, the health care provider strategies and NGO initiatives created an enabling environment to support ANC and delivery service utilisation in Malawi. However, traditional gender roles in the home and the male 'unfriendly' health facility environments still present challenges to male involvement. Traditional notions of men as decision makers and socio-cultural views on maternal health present challenges to male involvement in MNCH programs. Health care provider initiatives need to be sensitive and mindful of gender roles and relations by, for example, creating gender inclusive programs and spaces that aim at reducing perceptions of barriers to male involvement in MNCH services so that programs and spaces that are aimed at involving men are designed to welcome men as full partners in the overall goals for improving maternal, neonatal and child health outcomes.

  3. Iraqi primary care system in Kurdistan region: providers' perspectives on problems and opportunities for improvement.

    PubMed

    Shabila, Nazar P; Al-Tawil, Namir G; Al-Hadithi, Tariq S; Sondorp, Egbert; Vaughan, Kelsey

    2012-09-27

    As part of a comprehensive study on the primary health care system in Iraq, we sought to explore primary care providers' perspectives about the main problems influencing the provision of primary care services and opportunities to improve the system. A qualitative study based on four focus groups involving 40 primary care providers from 12 primary health care centres was conducted in Erbil governorate in the Iraqi Kurdistan region between July and October 2010. A topic guide was used to lead discussions and covered questions on positive aspects of and current problems with the primary care system in addition to the priority needs for its improvement. The discussions were fully transcribed and the qualitative data was analyzed by content analysis, followed by a thematic analysis. Problems facing the primary care system included inappropriate health service delivery (irrational use of health services, irrational treatment, poor referral system, poor infrastructure and poor hygiene), health workforce challenges (high number of specialists, uneven distribution of the health workforce, rapid turnover, lack of training and educational opportunities and discrepancies in the salary system), shortage in resources (shortage and low quality of medical supplies and shortage in financing), poor information technology and poor leadership/governance. The greatest emphasis was placed on poor organization of health services delivery, particularly the irrational use of health services and the related overcrowding and overload on primary care providers and health facilities. Suggestions for improving the system included application of a family medicine approach and ensuring effective planning and monitoring. This study has provided a comprehensive understanding of the factors that negatively affect the primary care system in Iraq's Kurdistan region from the perspective of primary care providers. From their experience, primary care providers have a role in informing the community and policy makers about the main problems affecting this system, though improvements to the health care system must be taken up at the national level and involve other key stakeholders.

  4. Communication Systems in Healthcare

    PubMed Central

    Coiera, Enrico

    2006-01-01

    The care of patients now almost inevitably seems to involve many different individuals, all needing to share patient information and discuss their management. As a consequence there is increasing interest in, and use of, information and communication technologies to support health services. Yet, while there is significant discussion of, and investment in, information technologies, communication systems receive much less attention and the clinical adoption of even simpler services like voice-mail or electronic mail is still not commonplace in many health services. There remain enormous gaps in our broad understanding of the role of communication services in health care delivery. Laboratory medicine is perhaps even more poorly studied than many other areas, such as the interface between primary care and hospital services. Given this lack of specific information about laboratory communication services, this paper will step back and generally review the components of a communication system, including the basic concepts of a communication channel, service, device and interaction mode. The review will then try and summarise some of what is known about specific communication problems that arise across health services in the main, including the community and hospital service delivery. PMID:17077879

  5. Reusing models of actors and services in smart homecare to improve sustainability.

    PubMed

    Walderhaug, Ståle; Stav, Erlend; Mikalsen, Marius

    2008-01-01

    Industrial countries are faced with a growing elderly population. Homecare systems with assistive smart house technology enable elderly to live independently at home. Development of such smart home care systems is complex and expensive and there is no common reference model that can facilitate service reuse. This paper proposes reusable actor and service models based on a model-driven development process where end user organizations and domain healthcare experts from four European countries have been involved. The models, specified using UML can be reused actively as assets in the system design and development process and can reduce development costs, and improve interoperability and sustainability of systems. The models are being evaluated in the European IST project MPOWER.

  6. 75 FR 52993 - Records Schedules; Availability and Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-30

    ... information system used to track case files involving internal agency investigations. 13. Department of... Inspection Service (N1-463-09-10, 1 item, 1 temporary item). Master files of an electronic information system... an electronic information system containing data that supports financial management and accounting...

  7. Influence of Criminal Justice Involvement and Psychiatric Diagnoses on Treatment Costs Among Adults With Serious Mental Illness

    PubMed Central

    Robertson, Allison G.; Swanson, Jeffrey W.; Lin, Hsiuju; Easter, Michele M.; Frisman, Linda K.; Swartz, Marvin S.

    2015-01-01

    The impact of criminal justice involvement and clinical characteristics on the cost of public treatment services for adults with serious mental illnesses is unknown. The authors examined differential effects of justice involvement on behavioral health treatment costs by primary psychiatric diagnosis (schizophrenia or bipolar disorder) and also by substance use diagnosis among 25,133 adult clients of Connecticut’s public behavioral health system in fiscal years 2006 and 2007. Justice-involved adults with schizophrenia had the highest costs, strongly driven by forensic hospitalizations. Addressing the cross-system burdens of forensic hospitalizations may be a sensible starting point in the effort to reduce costs in both the public behavioral health and justice systems. PMID:25975893

  8. IFLA General Conference, 1990. IFLA Presession Seminar on Public Library Policy.

    ERIC Educational Resources Information Center

    International Federation of Library Associations, The Hague (Netherlands).

    Five of the six papers in this collection focus on public library services, collection development problems, and involvement in literacy campaigns in developing countries; the sixth paper is concerned with public library services in Norway. (1) In "Big Cities, Its Inhabitants and Public Libraries Systems," May Brooking Negrao examines…

  9. Design, Delivery and Evaluation of Teaching by Service Users and Carers

    ERIC Educational Resources Information Center

    Benbow, Susan Mary; Taylor, Louise; Mustafa, Nageen; Morgan, Kathleen

    2011-01-01

    Education influences individual health and social care professionals and the systems in which they work. We describe a postgraduate educational program that did this through involving service users and carers in designing and facilitating teaching programs. A module of teaching was designed and delivered in partnership with users and carers from…

  10. Peer Review: The CHAMPUS Program.

    ERIC Educational Resources Information Center

    Stricker, George

    This paper examines the use of the peer review system in evaluating out-patient clinical services for a third-party payer seeking justification for payment of services. Peer review is defined as a process by which one professional, in an official capacity, makes a judgment about a co-professional in a matter involving professional functioning. The…

  11. The economic impact of several hospitals on their community.

    PubMed

    Rotarius, Timothy; Liberman, Aaron; Trujillo, Antonio; Oetjen, Reid

    2003-01-01

    This study quantifies the value that several hospitals in a hospital system have on their local communities. Also included is an analysis of the types of value-added services and resources offered by the hospitals. The hospitals are assessed in 3 arenas: as an employer, as a major provider of healthcare services, and as a contributor to the quality of life of the region through the involvement of its employees in community services activities. The results indicate that the hospital system contributes almost dollars 1.7 billion (or 6.6%) toward the dollars 25 billion local economy.

  12. Multi-faceted informatics system for digitising and streamlining the reablement care model.

    PubMed

    Bond, Raymond R; Mulvenna, Maurice D; Finlay, Dewar D; Martin, Suzanne

    2015-08-01

    Reablement is new paradigm to increase independence in the home amongst the ageing population. And it remains a challenge to design an optimal electronic system to streamline and integrate reablement into current healthcare infrastructure. Furthermore, given reablement requires collaboration with a range of organisations (including national healthcare institutions and community/voluntary service providers), such a system needs to be co-created with all stakeholders involved. Thus, the purpose of this study is, (1) to bring together stakeholder groups to elicit a comprehensive set of requirements for a digital reablement system, (2) to utilise emerging technologies to implement a system and a data model based on the requirements gathered and (3) to involve user groups in a usability assessment of the system. In this study we employed a mixed qualitative approach that included a series of stakeholder-involved activities. Collectively, 73 subjects were recruited to participate in an ideation event, a quasi-hackathon and a usability study. The study unveiled stakeholder-led requirements, which resulted in a novel cloud-based system that was created using emerging web technologies. The system is driven by a unique data model and includes interactive features that are necessary for streamlining the reablement care model. In summary, this system allows community based interventions (or services) to be prescribed to occupants whilst also monitoring the occupant's progress of independent living. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Monitoring of the infrastructure and services used to handle and automatically produce Alignment and Calibration conditions at CMS

    NASA Astrophysics Data System (ADS)

    Sipos, Roland; Govi, Giacomo; Franzoni, Giovanni; Di Guida, Salvatore; Pfeiffer, Andreas

    2017-10-01

    The CMS experiment at CERN LHC has a dedicated infrastructure to handle the alignment and calibration data. This infrastructure is composed of several services, which take on various data management tasks required for the consumption of the non-event data (also called as condition data) in the experiment activities. The criticality of these tasks imposes tights requirements for the availability and the reliability of the services executing them. In this scope, a comprehensive monitoring and alarm generating system has been developed. The system has been implemented based on the Nagios open source industry standard for monitoring and alerting services, and monitors the database back-end, the hosting nodes and key heart-beat functionalities for all the services involved. This paper describes the design, implementation and operational experience with the monitoring system developed and deployed at CMS in 2016.

  14. 12 CFR 611.1153 - General restrictions and prohibitions on the use of UBEs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... than the functions and services that one or more System institutions owning the UBE are authorized to... collateral at issue involves a multi-lender transaction that includes System and non-System lenders. (g... designated as the primary beneficiary of a third-party UBE, either alone or with other System institutions...

  15. Total Quality Management of Information System for Quality Assessment of Pesantren Using Fuzzy-SERVQUAL

    NASA Astrophysics Data System (ADS)

    Faizah, Arbiati; Syafei, Wahyul Amien; Isnanto, R. Rizal

    2018-02-01

    This research proposed a model combining an approach of Total Quality Management (TQM) and Fuzzy method of Service Quality (SERVQUAL) to asses service quality. TQM implementation was as quality management orienting on customer's satisfaction by involving all stakeholders. SERVQUAL model was used to measure quality service based on five dimensions such as tangible, reliability, responsiveness, assurance, and empathy. Fuzzy set theory was to accommodate subjectivity and ambiguity of quality assessment. Input data consisted of indicator data and quality assessment aspect. Input data was, then, processed to be service quality assessment questionnaires of Pesantren by using Fuzzy method to get service quality score. This process consisted of some steps as follows : inputting dimension and questionnaire data to data base system, filling questionnaire through system, then, system calculated fuzzification, defuzzification, gap of quality expected and received by service receivers, and calculating each dimension rating showing quality refinement priority. Rating of each quality dimension was, then, displayed at dashboard system to enable users to see information. From system having been built, it could be known that tangible dimension had the highest gap, -0.399, thus it needs to be prioritized and gets evaluation and refinement action soon.

  16. Laminar Flow Control Leading Edge Systems in Simulated Airline Service

    NASA Technical Reports Server (NTRS)

    Wagner, R. D.; Maddalon, D. V.; Fisher, D. F.

    1988-01-01

    Achieving laminar flow on the wings of a commercial transport involves difficult problems associated with the wing leading edge. The NASA Leading Edge Flight Test Program has made major progress toward the solution of these problems. The effectiveness and practicality of candidate laminar flow leading edge systems were proven under representative airline service conditions. This was accomplished in a series of simulated airline service flights by modifying a JetStar aircraft with laminar flow leading edge systems and operating it out of three commercial airports in the United States. The aircraft was operated as an airliner would under actual air traffic conditions, in bad weather, and in insect infested environments.

  17. How do abused elderly persons and their adult protective services caseworkers view law enforcement involvement and criminal prosecution, and what impact do these views have on case processing?

    PubMed

    Jackson, Shelly L; Hafemeister, Thomas L

    2013-01-01

    This study examined law enforcement and prosecution involvement in 71 cases of elder abuse where pure financial exploitation (PFE), physical abuse (PA), neglect (Neglect), or hybrid financial exploitation (HFE) (financial exploitation co-occurring with physical abuse and/or neglect) occurred in a domestic setting. Victims of elder abuse and assigned Adult Protective Services (APS) caseworkers were systematically interviewed. Law enforcement officials were involved in 54% of the cases, and 18% of the cases were prosecuted. PA was significantly more likely to trigger a law enforcement response and to be prosecuted than Neglect or PFE. HFE involved prosecution for assault rather than financial exploitation. Generally, the victims of elder abuse were not receptive to criminal justice involvement, which appears to have a significant impact upon the level of this involvement. The reasons for this reluctance are discussed, as well as the challenges and limitations of criminal justice system involvement and related implications for policy and practice.

  18. International lessons for promoting transit connections to high-speed rail systems.

    DOT National Transportation Integrated Search

    2016-04-01

    As the California High-Speed Rail (HSR) project becomes reality, many communities involved in, or affected by, the California : HSR project have considered how to connect the new HSR passenger services to local urban transportation systems such a...

  19. 10 CFR 205.352 - Information to be reported.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric Power System Permits and Reports; Applications; Administrative Procedures and Sanctions Report of Major Electric Utility System Emergencies § 205... involved; and whether any known critical services such as hospitals, military installations, pumping...

  20. 10 CFR 205.352 - Information to be reported.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric Power System Permits and Reports; Applications; Administrative Procedures and Sanctions Report of Major Electric Utility System Emergencies § 205... involved; and whether any known critical services such as hospitals, military installations, pumping...

  1. 10 CFR 205.352 - Information to be reported.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric Power System Permits and Reports; Applications; Administrative Procedures and Sanctions Report of Major Electric Utility System Emergencies § 205... involved; and whether any known critical services such as hospitals, military installations, pumping...

  2. 10 CFR 205.352 - Information to be reported.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric Power System Permits and Reports; Applications; Administrative Procedures and Sanctions Report of Major Electric Utility System Emergencies § 205... involved; and whether any known critical services such as hospitals, military installations, pumping...

  3. 48 CFR 370.304 - Contract clauses.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Contract clauses. 370.304 Section 370.304 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES HHS SUPPLEMENTATIONS SPECIAL PROGRAMS AFFECTING ACQUISITION Acquisitions Involving Human Subjects 370.304 Contract clauses. (a...

  4. User and carer involvement in the training and education of health professionals: a review of the literature.

    PubMed

    Repper, Julie; Breeze, Jayne

    2007-03-01

    Health policy requires consumer involvement in services, research and education but little is known about how consumers are being involved in healthcare education, the effect on learning and practice, nor how involvement initiatives are being evaluated. To describe methods of involving consumers in healthcare education, discuss ways in which initiatives have been evaluated, and identify areas for development in education, practice and research. All papers reporting specific initiatives involving consumers in health care worker training and education were included. Viewpoint articles and studies of consumers training consumers were excluded. Cinahl, Medline, Assia, PsycINFO, British Nursing Index, Social Science Citation Index, citations from reference lists, relevant websites and personal communication with key people known to be working in this area. A narrative approach was taken with categorisation of data to reflect objectives of selected studies; method of involvement; process issues and evaluation. Thirty-eight papers were included; most provide small-scale qualitative studies of mental health service users and focus on process rather than outcome. Various methods of involvement are described and consumers consistently prioritise the need for training in interpersonal skills over 'technical' skills. There is little research into organisational strategies and no studies investigate the effect of consumer involvement on practice. Two studies indicated that students exposed to consumer involvement demonstrate more empathic understanding and better communication skills. There is tentative evidence that consumer involvement in training enhances workers' skills in the manner prioritised by consumers. However, if consumer involvement in training and education is to facilitate services that reflect the priorities of the people using them, it must be developed in partnership with service providers; further research is needed to explore the impact of consumer involvement and to track the development of organisational consumer involvement strategies, also systems for supporting consumers need to be established, including training for both consumers and staff.

  5. Migration strategies for service-enabling ground control stations for unmanned systems

    NASA Astrophysics Data System (ADS)

    Kroculick, Joseph B.

    2011-06-01

    Future unmanned systems will be integrated into the Global Information Grid (GIG) and support net-centric data sharing, where information in a domain is exposed to a wide variety of GIG stakeholders that can make use of the information provided. Adopting a Service-Oriented Architecture (SOA) approach to package reusable UAV control station functionality into common control services provides a number of benefits including enabling dynamic plug and play of components depending on changing mission requirements, supporting information sharing to the enterprise, and integrating information from authoritative sources such as mission planners with the UAV control stations data model. It also allows the wider enterprise community to use the services provided by unmanned systems and improve data quality to support more effective decision-making. We explore current challenges in migrating UAV control systems that manage multiple types of vehicles to a Service-Oriented Architecture (SOA). Service-oriented analysis involves reviewing legacy systems and determining which components can be made into a service. Existing UAV control stations provide audio/visual, navigation, and vehicle health and status information that are useful to C4I systems. However, many were designed to be closed systems with proprietary software and hardware implementations, message formats, and specific mission requirements. An architecture analysis can be performed that reviews legacy systems and determines which components can be made into a service. A phased SOA adoption approach can then be developed that improves system interoperability.

  6. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia

    PubMed Central

    Cyril, Sheila; Green, Julie; Nicholson, Jan M.; Agho, Kingsley; Renzaho, Andre M. N.

    2016-01-01

    Background Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers’ perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities’ participation in these services. Methods We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Results Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. Conclusion This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD communities to ensure equitable delivery of care. Collaborative approaches between health systems, immigrant services, early years’ services and community health services are urgently needed to address obesity-related disparities in Australia. PMID:27736864

  7. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia.

    PubMed

    Cyril, Sheila; Green, Julie; Nicholson, Jan M; Agho, Kingsley; Renzaho, Andre M N

    2016-01-01

    Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services. We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD communities to ensure equitable delivery of care. Collaborative approaches between health systems, immigrant services, early years' services and community health services are urgently needed to address obesity-related disparities in Australia.

  8. Optimizing care transitions: the role of the community pharmacist

    PubMed Central

    Melody, Karleen T; McCartney, Elizabeth; Sen, Sanchita; Duenas, Gladys

    2016-01-01

    Transitions of care (TOC) refer to the movement of patients across institutions, among providers, between different levels of care, and to and from home. Medication errors that occur during TOC have the potential to result in medical complications that are serious for the patient and costly to the health care system. Positive outcomes have been demonstrated when pharmacists are involved in providing TOC services, including reducing preventable adverse drug reactions, medication-related problems, and rehospitalizations, as well as improving the discharge process. This review explores TOC models involving community pharmacy practice, the current impact of pharmacist interventions in TOC, and patient satisfaction with TOC services provided by community pharmacists. Common barriers and potential solutions to TOC services provided in the community pharmacy, such as patient identification, information gathering, standardization of services, administrative support, reimbursement, and time restraints, are also discussed. PMID:29354539

  9. Iceland: health system review.

    PubMed

    Sigurgeirsdóttir, Sigurbjörg; Waagfjörð, Jónína; Maresso, Anna

    2014-01-01

    This analysis of the Icelandic health system reviews the developments in its organization and governance, health financing, health care provision, health reforms and health system performance. Life expectancy at birth is high and Icelandic men and women enjoy longer life in good health than the average European. However, Icelanders are putting on weight, more than half of adult Icelanders were overweight or obese in 2004, and total consumption of alcohol has increased considerably since 1970. The health care system is a small, state centred, publicly funded system with universal coverage, and an integrated purchaser provider relationship in which the state as payer is also the owner of most organizations providing health care services. The country's centre of clinical excellence is the University Hospital, Landspitali, in the capital Reykjavik, which alone accounts for 70 percent of the total national budget for general hospital services. However, since 1990, the health system has become increasingly characterized by a mixed economy of care and service provision, in which the number and scope of private non profit and private for profit providers has increased. While Iceland's health outcomes are some of the best among OECD countries, the health care system faces challenges involving the financial sustainability of the current system in the context of an ageing population, new public health challenges, such as obesity, and the continued impact of the country's financial collapse in 2008. The most important challenge is to change the pattern of health care utilization to steer it away from the most expensive end of the health services spectrum towards more cost efficient and effective alternatives. To a large degree, this will involve renewed attempts to prioritize primary care as the first port of call for patients, and possibly to introduce a gatekeeping function for GPs in order to moderate the use of specialist services. World Health Organization 2014 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  10. Experimental Study on the Precise Orbit Determination of the BeiDou Navigation Satellite System

    PubMed Central

    He, Lina; Ge, Maorong; Wang, Jiexian; Wickert, Jens; Schuh, Harald

    2013-01-01

    The regional service of the Chinese BeiDou satellite navigation system is now in operation with a constellation including five Geostationary Earth Orbit satellites (GEO), five Inclined Geosynchronous Orbit (IGSO) satellites and four Medium Earth Orbit (MEO) satellites. Besides the standard positioning service with positioning accuracy of about 10 m, both precise relative positioning and precise point positioning are already demonstrated. As is well known, precise orbit and clock determination is essential in enhancing precise positioning services. To improve the satellite orbits of the BeiDou regional system, we concentrate on the impact of the tracking geometry and the involvement of MEOs, and on the effect of integer ambiguity resolution as well. About seven weeks of data collected at the BeiDou Experimental Test Service (BETS) network is employed in this experimental study. Several tracking scenarios are defined, various processing schemata are designed and carried out; and then, the estimates are compared and analyzed in detail. The results show that GEO orbits, especially the along-track component, can be significantly improved by extending the tracking network in China along longitude direction, whereas IGSOs gain more improvement if the tracking network extends in latitude. The involvement of MEOs and ambiguity-fixing also make the orbits better. PMID:23529116

  11. Experimental study on the precise orbit determination of the BeiDou navigation satellite system.

    PubMed

    He, Lina; Ge, Maorong; Wang, Jiexian; Wickert, Jens; Schuh, Harald

    2013-03-01

    The regional service of the Chinese BeiDou satellite navigation system is now in operation with a constellation including five Geostationary Earth Orbit satellites (GEO), five Inclined Geosynchronous Orbit (IGSO) satellites and four Medium Earth Orbit (MEO) satellites. Besides the standard positioning service with positioning accuracy of about 10 m, both precise relative positioning and precise point positioning are already demonstrated. As is well known, precise orbit and clock determination is essential in enhancing precise positioning services. To improve the satellite orbits of the BeiDou regional system, we concentrate on the impact of the tracking geometry and the involvement of MEOs, and on the effect of integer ambiguity resolution as well. About seven weeks of data collected at the BeiDou Experimental Test Service (BETS) network is employed in this experimental study. Several tracking scenarios are defined, various processing schemata are designed and carried out; and then, the estimates are compared and analyzed in detail. The results show that GEO orbits, especially the along-track component, can be significantly improved by extending the tracking network in China along longitude direction, whereas IGSOs gain more improvement if the tracking network extends in latitude. The involvement of MEOs and ambiguity-fixing also make the orbits better.

  12. CoRes utilization for building PCK in pre-service teacher education on the digestive system topic

    NASA Astrophysics Data System (ADS)

    Nugraha, Ikmanda

    2017-05-01

    Knowledge of teachers in learning activities in the classroom has a close relationship with how well and how much students learn. Recently, a promising development in teacher education has appeared that centers on the academic construct of pedagogical content knowledge (PCK). This study was an exploratory study into a science teacher education program that seeks to build the foundations on which pre-service teachers can begin to build their pedagogical content knowledge (PCK). The program involved the use of Content Representations (CoRes), which was initially applied as component of a strategy for exploring and gaining insights into the PCK of in-service science teachers. This study involved the researcher and 20 students (third year) in a pre-service teacher education course (School Science I) in science education when the students worked to make content analysis on the digestive system topic. During the course, the students make their own CoRes through a workshop for digestive system topic individually, in pairs and whole class discussion. Data were recorded from students' CoRes, student reflective journals, interviews, and field notes recorded in the researcher's reflective journal. Pre-service teachers' comments from interviews and reflective journals were coded in relation to references about: (1) the effectiveness of variety strategies in building the knowledge bases required to design a CoRes and (2) their awareness and/or development of tentative components of future PCK for a digestive system topic as a result of CoRes construction. Observational data were examined for indications of increasing independence and competency on the part of student teachers when locating appropriate information for designing their CoRes. From this study, it is hoped that the pre-service science teachers are able to build knowledge and then transform it into a form of PCK for digestive system topic for their first classroom planning and teaching to teach digestive system contents effectively.

  13. 47 CFR 5.64 - Special provisions for satellite systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Section 5.64 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EXPERIMENTAL RADIO SERVICE... experimental satellite facilities may begin prior to Commission grant of an authorization. Such construction is..., applicants for an experimental authorization involving a satellite system must submit a description of the...

  14. An Intelligent System Proposal for Improving the Safety and Accessibility of Public Transit by Highway

    PubMed Central

    García, Carmelo R.; Quesada-Arencibia, Alexis; Cristóbal, Teresa; Padrón, Gabino; Pérez, Ricardo; Alayón, Francisco

    2015-01-01

    The development of public transit systems that are accessible and safe for everyone, including people with special needs, is an objective that is justified from the civic and economic points of view. Unfortunately, public transit services are conceived for people who do not have reduced physical or cognitive abilities. In this paper, we present an intelligent public transit system by highway with the goal of facilitating access and improving the safety of public transit for persons with special needs. The system is deployed using components that are commonly available in transport infrastructure, e.g., sensors, mobile communications systems, and positioning systems. In addition, the system can operate in non-urban transport contexts, e.g., isolated rural areas, where the availability of basic infrastructure, such as electricity and communications infrastructures, is not always guaranteed. To construct the system, the principles and techniques of Ubiquitous Computing and Ambient Intelligence have been employed. To illustrate the utility of the system, two cases of services rendered by the system are described: the first case involves a surveillance system to guarantee accessibility at bus stops; the second case involves a route assistant for blind people. PMID:26295234

  15. Involving service users in trials: developing a standard operating procedure

    PubMed Central

    2013-01-01

    Background Many funding bodies require researchers to actively involve service users in research to improve relevance, accountability and quality. Current guidance to researchers mainly discusses general principles. Formal guidance about how to involve service users operationally in the conduct of trials is lacking. We aimed to develop a standard operating procedure (SOP) to support researchers to involve service users in trials and rigorous studies. Methods Researchers with experience of involving service users and service users who were contributing to trials collaborated with the West Wales Organisation for Rigorous Trials in Health, a registered clinical trials unit, to develop the SOP. Drafts were prepared in a Task and Finish Group, reviewed by all co-authors and amendments made. Results We articulated core principles, which defined equality of service users with all other research team members and collaborative processes underpinning the SOP, plus guidance on how to achieve these. We developed a framework for involving service users in research that defined minimum levels of collaboration plus additional consultation and decision-making opportunities. We recommended service users be involved throughout the life of a trial, including planning and development, data collection, analysis and dissemination, and listed tasks for collaboration. We listed people responsible for involving service users in studies and promoting an inclusive culture. We advocate actively involving service users as early as possible in the research process, with a minimum of two on all formal trial groups and committees. We propose that researchers protect at least 1% of their total research budget as a minimum resource to involve service users and allow enough time to facilitate active involvement. Conclusions This SOP provides guidance to researchers to involve service users successfully in developing and conducting clinical trials and creating a culture of actively involving service users in research at all stages. The UK Clinical Research Collaboration should encourage clinical trials units actively to involve service users and research funders should provide sufficient funds and time for this in research grants. PMID:23866730

  16. Service user involvement in cancer care: the impact on service users

    PubMed Central

    Cotterell, Phil; Harlow, Gwen; Morris, Carolyn; Beresford, Peter; Hanley, Bec; Sargeant, Anita; Sitzia, John; Staley, Kristina

    2011-01-01

    Abstract Background  Service user involvement is embedded in the United Kingdom’s National Health Service, but knowledge about the impact of involvement on service users, such as the benefits and challenges of involvement, is scant. Our research addresses this gap. Objective  To explore the personal impact of involvement on the lives of service users affected by cancer. Design  We conducted eight focus groups with user groups supplemented by nine face‐to‐face interviews with involved individuals active at a local, regional and national level. Thematic analysis was conducted both independently and collectively. Setting and participants  Sixty‐four participants, engaged in involvement activities in cancer services, palliative care and research, were recruited across Great Britain. Results  We identified three main themes: (i) ‘Expectations and motivations for involvement’– the desire to improve services and the need for user groups to have a clear purpose, (ii) ‘Positive aspects of involvement’– support provided by user groups and assistance to live well with cancer and (iii) ‘Challenging aspects of involvement’– insensitivities and undervaluing of involvement by staff. Conclusions  This study identified that involvement has the capacity to produce varied and significant personal impacts for involved people. Involvement can be planned and implemented in ways that increase these impacts and that mediates challenges for those involved. Key aspects to increase positive impact for service users include the value service providers attach to involvement activities, the centrality with which involvement is embedded in providers’ activities, and the capacity of involvement to influence policy, planning, service delivery, research and/or practice. PMID:21029279

  17. Plans for crash-tested bridge railings for longitudinal wood decks on low-volume roads

    Treesearch

    Michael A. Ritter; Ronald K. Faller; Steve Bunnell; Paula D. Hilbrich Lee; Barry T. Rosson

    1998-01-01

    The plans for crashworthy bridge railings for low-volume roads were developed through a cooperative research program involving the USDA Forest Service, Forest Products Laboratory (FPL); the Midwest Roadside Safety Facility, University of Nebraska-Lincoln (MwRSF); and the Forest Service, National Forest System, Engineering. Three railings were developed and successfully...

  18. 47 CFR 101.81 - Future licensing in the 1850-1990 MHz, 2110-2150 MHz, and 2160-2200 MHz bands.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... two seconds); (d) Any data correction which does not involve a change in the location of an existing... COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Applications and Licenses... authorized on a secondary basis to ET systems. All other modifications will render the modified FMS license...

  19. 47 CFR 101.81 - Future licensing in the 1850-1990 MHz, 2110-2150 MHz, and 2160-2200 MHz bands.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... two seconds); (d) Any data correction which does not involve a change in the location of an existing... COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Applications and Licenses... authorized on a secondary basis to ET systems. All other modifications will render the modified FMS license...

  20. 47 CFR 101.81 - Future licensing in the 1850-1990 MHz, 2110-2150 MHz, and 2160-2200 MHz bands.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... two seconds); (d) Any data correction which does not involve a change in the location of an existing... COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Applications and Licenses... authorized on a secondary basis to ET systems. All other modifications will render the modified FMS license...

  1. 47 CFR 101.81 - Future licensing in the 1850-1990 MHz, 2110-2150 MHz, and 2160-2200 MHz bands.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... two seconds); (d) Any data correction which does not involve a change in the location of an existing... COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Applications and Licenses... authorized on a secondary basis to ET systems. All other modifications will render the modified FMS license...

  2. Development of Clinical Pharmacy in Switzerland: Involvement of Community Pharmacists in Care for Older Patients.

    PubMed

    Hersberger, Kurt E; Messerli, Markus

    2016-03-01

    The role of the community pharmacist in primary care has been undergoing change in Switzerland in parallel to international developments: it has become more clinically and patient oriented. Special services of community pharmacists to older patients taking long-term or multiple medications, discharged from hospitals or experiencing cognitive impairment or disability have been developed. These services require more clinical knowledge and skills from community pharmacists and are based on, for example, 'simple or intermediate medication reviews' focused primarily to improve medication adherence and rational drug use by a patient. Reflecting the new role of community pharmacies, this article describes the current services provided by community pharmacies in Switzerland, e.g., 'polymedication check', 'weekly pill organizer', and 'services for chronic patients', as well as new Swiss educational and reimbursement systems supporting development of these services. In the international context, involvement of community pharmacists in patient-oriented care is growing. This review summarizes positive and negative experiences from implementation of community pharmacy services in Switzerland and provides examples for the development of such services in other countries.

  3. National Observation Services at OSUG and construction of a Data Center and of a mutualized information system

    NASA Astrophysics Data System (ADS)

    Meunier, N.

    2016-12-01

    OSUG (Observatoire des Sciences de l'Univers de Grenoble) is strongly involved in more than 20 national observation services (hereafter SNO) covering the different INSU (Institut National des Sciences de l'Univers) sections, and is the PI for ten of them. This strong involvement led us to implement a data center (OSUG-DC), in order to provide the SNO and many other projects an infrastructure and common tools (software development, data monitoring, ...): the objective is to allow them to make their data available to the community in the best conditions. The OSUG-DC has been recognized as a Regional Expertise Center for the astronomy-astrophysics component in 2003 (3 SNO are concerned). This construction is also part of a larger reflexion concerning the mutualization of certain services of the information system at OSUG and at University Grenoble Alpes, some already in place for some time such as a high performance computation regional center. This paper presents the management organisation of these projects, strong points and issues.

  4. Legal, social, cultural and political developments in mental health care in the UK: the Liverpool black mental health service users' perspective.

    PubMed

    Pierre, S A

    2002-02-01

    Documentary evidence suggests that attitudes among local health and social services professionals towards the concept of user involvement in health and social care remain deeply polarized, a position characterized by commentators simultaneously as praise and damnation. Perhaps user involvement in health and social care will enhance, and it appears to resonate with the logic of, participatory democracy, in localities where the centralization of power has posed questions as to the nature and purpose of local governance in public services provision. The problems experienced by Britain's black and ethnic minorities within the mental health system have been the subject of exhaustive social inquiry. This essay attempts to explore the way in which legal, social, cultural, and political developments interface with mental health care practice in the UK, in order to assist those responsible for mental health services provision to deliver services that are in line with the Government's expectation of a modernized mental health service that is safe, sound, and supportive. An exploration of these developments within the European, national (UK), and local (Liverpool) contexts is undertaken. An appropriate local response to national priorities will ostensibly cut a swathe through the barriers confronted by the ethnic minority mental health service user in the cross-cultural context, an important prerequisite for the implementation of genuine user involvement.

  5. Healthcare reform: the role of coordinated critical care.

    PubMed

    Cerra, F B

    1993-03-01

    To evaluate and editorialize the evolving role of the discipline of critical care as a healthcare delivery system in the process of healthcare reform. The sources included material from the Federal Office of Management and Budget, Health Care Financing Review, President Bush's Office, Association of American Medical Colleges, and publications of the Society of Critical Care Medicine. Data were selected that the author felt was relevant to the healthcare reform process and its implications for the discipline of critical care. The data were extracted by the author to illustrate the forces behind healthcare reform, the implications for the practice of critical care, and role of critical care as a coordinated (managed) care system in the process of healthcare reform. Healthcare reform has been initiated because of a number of considerations that arise in evaluating the current healthcare delivery system: access, financing, cost, dissatisfactions with the mechanisms of delivery, and political issues. The reform process will occur with or without the involvement of critical care practitioners. Reforms may greatly alter the delivery of critical care services, education, training, and research in critical care. Critical care has evolved into a healthcare delivery system that provides services to patients who need and request them and provides these services in a coordinated (managed) care model. Critical care practitioners must become involved in the healthcare reform process, and critical care services that are effective must be preserved, as must the education, training, and research programs. Critical care as a healthcare delivery system utilizing a coordinated (managed) care model has the potential to provide services to all patients who need them and to deliver them in a manner that is cost effective and recognized as providing added value.

  6. Launching an EarthCube Interoperability Workbench for Constructing Workflows and Employing Service Interfaces

    NASA Astrophysics Data System (ADS)

    Fulker, D. W.; Pearlman, F.; Pearlman, J.; Arctur, D. K.; Signell, R. P.

    2016-12-01

    A major challenge for geoscientists—and a key motivation for the National Science Foundation's EarchCube initiative—is to integrate data across disciplines, as is necessary for complex Earth-system studies such as climate change. The attendant technical and social complexities have led EarthCube participants to devise a system-of-systems architectural concept. Its centerpiece is a (virtual) interoperability workbench, around which a learning community can coalesce, supported in their evolving quests to join data from diverse sources, to synthesize new forms of data depicting Earth phenomena, and to overcome immense obstacles that arise, for example, from mismatched nomenclatures, projections, mesh geometries and spatial-temporal scales. The full architectural concept will require significant time and resources to implement, but this presentation describes a (minimal) starter kit. With a keep-it-simple mantra this workbench starter kit can fulfill the following four objectives: 1) demonstrate the feasibility of an interoperability workbench by mid-2017; 2) showcase scientifically useful examples of cross-domain interoperability, drawn, e.g., from funded EarthCube projects; 3) highlight selected aspects of EarthCube's architectural concept, such as a system of systems (SoS) linked via service interfaces; 4) demonstrate how workflows can be designed and used in a manner that enables sharing, promotes collaboration and fosters learning. The outcome, despite its simplicity, will embody service interfaces sufficient to construct—from extant components—data-integration and data-synthesis workflows involving multiple geoscience domains. Tentatively, the starter kit will build on the Jupyter Notebook web application, augmented with libraries for interfacing current services (at data centers involved in EarthCube's Council of Data Facilities, e.g.) and services developed specifically for EarthCube and spanning most geoscience domains.

  7. Marketing strategies for the cosmetic practice.

    PubMed

    Austin, C J

    1994-01-01

    Appropriate marketing business systems need to be in place to attract and sustain a cosmetic dentistry patient base. Marketing for this sector is most effective when consistently patterned after businesses with high-end consumer services and products. Motivating patients of record and potential new patients to choose cosmetic dental services involves implementing both basic marketing and a series of cosmetic-specific marketing strategies. Consultants are valuable for the process of developing a strategic plan and making recommendations for developing new marketing business systems.

  8. Automated Circulation Systems in Libraries Serving the Blind and Physically Handicapped: A Reference Guide for Planning.

    ERIC Educational Resources Information Center

    Wanger, Judith; And Others

    Designed to facilitate communications in future automation projects between library and data processing personnel, especially those projects involving the use of automated systems in the service of disabled patrons, this guide identifies and describes a master set of major circulation system requirements and design considerations, and illustrates…

  9. At the Ready: Planning for Business Continuity

    ERIC Educational Resources Information Center

    Sharp, Linda

    2011-01-01

    School system leaders never know when disaster may strike. Having a plan in place to protect vital data and systems is crucial. School system leaders need to be actively involved in crisis preparedness, planned response, and recovery to ensure student and staff safety and to make certain that all important operations, services, processes, and…

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

    NASA Astrophysics Data System (ADS)

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

    2017-04-01

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

  11. A Flawed System of Law Practice and Training.

    ERIC Educational Resources Information Center

    Bok, Derek C.

    1983-01-01

    Most people find their legal rights severely compromised by the cost of legal services, the baffling complications of existing rules and procedures, and the long, frustrating delays involved in bringing proceedings to a conclusion. Some of the problems of the legal system are outlined. (MLW)

  12. [Educational guidance for families with mentally ill parents: a bridge between youth welfare services and psychiatric care system].

    PubMed

    Schrappe, Andreas

    2013-01-01

    In the last fifteen years a lot of services were established to assist children and their mentally ill parents. To improve the preventive and therapeutic interventions in favour of these families, the cooperation between all the institutions involved has to be enhanced. Family counselling centers can play an important role as a link between the psychiatric care system and the youth welfare services. By transferring the psychiatric terminology to the families' everyday language, the counsellors help the parents and the children to share their experiences with the parental illness. To implement a consultation-hour in a psychiatric clinic is an example of how educational guidance can close the gap between the two systems and strengthen the cooperation.

  13. Cross support overview and operations concept for future space missions

    NASA Technical Reports Server (NTRS)

    Stallings, William; Kaufeler, Jean-Francois

    1994-01-01

    Ground networks must respond to the requirements of future missions, which include smaller sizes, tighter budgets, increased numbers, and shorter development schedules. The Consultative Committee for Space Data Systems (CCSDS) is meeting these challenges by developing a general cross support concept, reference model, and service specifications for Space Link Extension services for space missions involving cross support among Space Agencies. This paper identifies and bounds the problem, describes the need to extend Space Link services, gives an overview of the operations concept, and introduces complimentary CCSDS work on standardizing Space Link Extension services.

  14. Urban public transit systems modeling capabilities

    DOT National Transportation Integrated Search

    1995-02-01

    Current national transportation policy places increasing emphasis on multi-modal : solutions involving public transit and high-occupancy vehicle (HOV) facilities : and services. Current traffic simulation/assignment models, however, have only : limit...

  15. The CCSDS return all frames Space Link Extension service

    NASA Technical Reports Server (NTRS)

    Uhrig, Hans; Pietras, John; Stoloff, Michael

    1994-01-01

    Existing Consultative Committee for Space Data Systems (CCSDS) Recommendations for Telemetry Channel Coding, Packet Telemetry, Advanced Orbiting Systems, and Telecommand have facilitated cross-support between Agencies by standardizing the link between spacecraft and ground terminal. CCSDS is currently defining a set of Space Link Extension (SLE) services that will enable remote science and mission operations facilities to access the ground termination of the Space Link services in a standard manner. The first SLE service to be defined is the Return All Frames (RAF) service. The RAF service delivers all CCSDS link-layer frames received on a single space link physical channel. The service provides both on-line and off-line data transfer modes to accommodate the variety of access methods typical of space mission operations. This paper describes the RAF service as of the Summer of 1994. It characterizes the behavior of the service as seen across the interface between the user and the service and gives an overview of the interactions involved in setting up and operating the service in a cross-support environment.

  16. Beyond the Bake Sale: Fundraising and Professional Experience for Students Involved in an Information Systems Student Chapter

    ERIC Educational Resources Information Center

    Snyder, Johnny; Carpenter, Don; Slauson, Gayla Jo; Skinner, Joe; Nash, Cole

    2012-01-01

    Fundraising traditionally involves selling. This paper explores the merits of selling technology services provided by a technology oriented student club to members of a campus community. This club activity puts into practice learning theories presented in the literature. Beyond fundraising, this activity yields many additional benefits to the…

  17. Involvement in the Juvenile Justice System for African American Adolescents: Examining Associations with Behavioral Health Problems

    PubMed Central

    Voisin, Dexter R.; Kim, Dongha; Takahashi, Lois; Morotta, Phillip; Bocanegra, Kathryn

    2017-01-01

    While researchers have found that African American youth experience higher levels of juvenile justice involvement at every system level (arrest, sentencing, and incarceration) relative to their other ethnic counterparts, few studies have explored how juvenile justice involvement and number of contacts might be correlated with this broad range of problems. A convenience sample of 638 African American adolescents living in predominantly low-income, urban communities participated in a survey related to juvenile justice involvement. Major findings using logistic regression models indicated that adolescents who reported juvenile justice system involvement versus no involvement were 2.3 times as likely to report mental health problems, substance abuse, and delinquent or youth offending behaviors. Additional findings documented that the higher the number of juvenile justice system contacts, the higher the rates of delinquent behaviors, alcohol and marijuana use, sex while high on drugs, and commercial sex. These findings suggest that identifying and targeting youth who have multiple juvenile justice system contacts, especially those in low-resourced communities for early intervention services, may be beneficial. Future research should examine whether peer network norms might mediate the relationships between juvenile justice involvement and youth problem behaviors. PMID:28966415

  18. Involvement in the Juvenile Justice System for African American Adolescents: Examining Associations with Behavioral Health Problems.

    PubMed

    Voisin, Dexter R; Kim, Dongha; Takahashi, Lois; Morotta, Phillip; Bocanegra, Kathryn

    2017-01-01

    While researchers have found that African American youth experience higher levels of juvenile justice involvement at every system level (arrest, sentencing, and incarceration) relative to their other ethnic counterparts, few studies have explored how juvenile justice involvement and number of contacts might be correlated with this broad range of problems. A convenience sample of 638 African American adolescents living in predominantly low-income, urban communities participated in a survey related to juvenile justice involvement. Major findings using logistic regression models indicated that adolescents who reported juvenile justice system involvement versus no involvement were 2.3 times as likely to report mental health problems, substance abuse, and delinquent or youth offending behaviors. Additional findings documented that the higher the number of juvenile justice system contacts, the higher the rates of delinquent behaviors, alcohol and marijuana use, sex while high on drugs, and commercial sex. These findings suggest that identifying and targeting youth who have multiple juvenile justice system contacts, especially those in low-resourced communities for early intervention services, may be beneficial. Future research should examine whether peer network norms might mediate the relationships between juvenile justice involvement and youth problem behaviors.

  19. State of mental healthcare systems in Eastern Europe: do we really understand what is going on?

    PubMed Central

    Winkler, Petr

    2016-01-01

    The article examines the current state of mental healthcare systems in countries of Eastern Europe and derives implications for future research and service development. Analysis of available statistics from the World Health Organization’s Mental Health Atlas suggests the need for better-quality data collection. Nonetheless, there appear to be insufficient resources allocated to mental health, lack of involvement of service users in policy-making and, to a large extent, systems continue to rely on mental hospitals. Based on the data presented, a set of directions for future reforms was drafted. PMID:29093919

  20. 48 CFR 352.270-4 - Protection of human subjects.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... regulatory requirements or ethical issues pertaining to research involving human subjects. (End of provision... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Protection of human subjects. 352.270-4 Section 352.270-4 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES...

  1. 48 CFR 352.270-4 - Protection of human subjects.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... regulatory requirements or ethical issues pertaining to research involving human subjects. (End of provision... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Protection of human subjects. 352.270-4 Section 352.270-4 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES...

  2. 48 CFR 352.270-4 - Protection of human subjects.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... regulatory requirements or ethical issues pertaining to research involving human subjects. (End of provision... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Protection of human subjects. 352.270-4 Section 352.270-4 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES...

  3. 48 CFR 352.270-4 - Protection of human subjects.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... regulatory requirements or ethical issues pertaining to research involving human subjects. (End of provision... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Protection of human subjects. 352.270-4 Section 352.270-4 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES...

  4. 48 CFR 352.270-4 - Protection of human subjects.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... regulatory requirements or ethical issues pertaining to research involving human subjects. (End of provision... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Protection of human subjects. 352.270-4 Section 352.270-4 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES...

  5. Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme--a systems approach.

    PubMed

    Agyepong, Irene A; Aryeetey, Geneieve C; Nonvignon, Justice; Asenso-Boadi, Francis; Dzikunu, Helen; Antwi, Edward; Ankrah, Daniel; Adjei-Acquah, Charles; Esena, Reuben; Aikins, Moses; Arhinful, Daniel K

    2014-08-05

    Assuring equitable universal access to essential health services without exposure to undue financial hardship requires adequate resource mobilization, efficient use of resources, and attention to quality and responsiveness of services. The way providers are paid is a critical part of this process because it can create incentives and patterns of behaviour related to supply. The objective of this work was to describe provider behaviour related to supply of health services to insured clients in Ghana and the influence of provider payment methods on incentives and behaviour. A mixed methods study involving grey and published literature reviews, as well as health management information system and primary data collection and analysis was used. Primary data collection involved in-depth interviews, observations of time spent obtaining service, prescription analysis, and exit interviews with clients. Qualitative data was analysed manually to draw out themes, commonalities, and contrasts. Quantitative data was analysed in Excel and Stata. Causal loop and cause tree diagrams were used to develop a qualitative explanatory model of provider supply incentives and behaviour related to payment method in context. There are multiple provider payment methods in the Ghanaian health system. National Health Insurance provider payment methods are the most recent additions. At the time of the study, the methods used nationwide were the Ghana Diagnostic Related Groupings payment for services and an itemized and standardized fee schedule for medicines. The influence of provider payment method on supply behaviour was sometimes intuitive and sometimes counter intuitive. It appeared to be related to context and the interaction of the methods with context and each other rather than linearly to any given method. As countries work towards Universal Health Coverage, there is a need to holistically design, implement, and manage provider payment methods reforms from systems rather than linear perspectives, since the latter fail to recognize the effects of context and the between-methods and context interactions in producing net effects.

  6. Screening for Trauma Exposure, and Posttraumatic Stress Disorder and Depression Symptoms among Mothers Receiving Child Welfare Preventive Services

    ERIC Educational Resources Information Center

    Chemtob, Claude M.; Griffing, Sascha; Tullberg, Erika; Roberts, Elizabeth; Ellis, Peggy

    2011-01-01

    The role of parental trauma exposure and related mental health symptoms as risk factors for child maltreatment for parents involved with the child welfare (CW) system has received limited attention. In particular, little is known about the extent to which mothers receiving CW services to prevent maltreatment have experienced trauma and suffered…

  7. Data and the Shift in Systems, Services, and Literacy

    ERIC Educational Resources Information Center

    Mitchell, Erik T.

    2012-01-01

    This month, the "Journal of Web Librarianship" is exploring the idea of data curation and its uses in libraries. The word "data" is as universal now as the word "cloud" was last year, and it is no accident that libraries are exploring how best to support data curation services. Data curation involves library activities in just about every way,…

  8. 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.

  9. A Best Practice for Developing Availability Guarantee Language in Photovoltaic (PV) O&M Agreements.

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

    Klise, Geoffrey Taylor; Balfour, John

    This document outlines the foundation for developing language that can be utilized in an Equipment Availability Guarantee, typically included in an O&M services agreement between a PV system or plant owner and an O&M services provider, or operator. Many of the current PV O&M service agreement Availability Guarantees are based on contracts used for traditional power generation, which create challenges for owners and operators due to the variable nature of grid-tied photovoltaic generating technologies. This report documents language used in early PV availability guarantees and presents best practices and equations that can be used to more openly communicate how themore » reliability of the PV system and plant equipment can be expressed in an availability guarantee. This work will improve the bankability of PV systems by providing greater transparency into the equipment reliability state to all parties involved in an O&M services contract.« less

  10. Decentralisation of general management within the New Zealand health system.

    PubMed

    Malcolm, L; Alp, B; Bryson, J

    1994-11-01

    The radical organisation changes implemented in the New Zealand health system in recent years are discussed and analysed in this study which is based upon a review of documents and interviews with general managers of area health boards. Service management, which involves the decentralisation of general management to programme or product groupings (medicine, child health etc) has been widely implemented in almost all boards completely replacing the traditional disciplinary hierarchies. It is also leading to a population-rather than an institutional-based system of management. General managers report positively on the achievements of service management including greater accountability and commitment of clinical staff, innovation and team building, improved performance and service quality, the integration of hospital and community-based care and a customer rather than an occupational orientation. There is an increasing trend towards the recognition of primary health care as a key service entity.

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

    PubMed

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

    2016-12-01

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

  12. Building capacity for service user and carer involvement in research: the implications and impact of best research for best health.

    PubMed

    Minogue, Virginia; Girdlestone, John

    2010-01-01

    The purpose of this paper is to examine the role of service user and carer involvement in NHS research and describe the nature of this involvement in three specialist mental health Trusts. It also aims to discuss the value of service user and carer involvement and present the perspective of the service user and research manager. The paper reviews patient and public involvement policy and practice in the NHS and NHS research. It examines the effectiveness of involvement activity and utilises a case example to demonstrate the impact of patient/service user involvement on the NHS and the individuals who take part. The paper concludes that service user involvement is essential if research is to support the development of health services that clearly reflect the needs of the service user and impact positively on service quality. Service user involvement is an established element of NHS research and development at both national and local level. The Department of Health strategy for research, Best Research for Best Health, reiterates both the importance of research that benefits the patient and the involvement of the service user in the research process. Despite this, the changes in Department of Health support funding for research, introduced by the strategy, may inadvertently lead to some NHS Trusts experiencing difficulty in resourcing this important activity. The paper illustrates the effectiveness of successful patient and public involvement in research. It also identifies how involvement has developed in a fragmented and uncoordinated way and how it is threatened by a failure to embed it more consistently in research infrastructure.

  13. Systems of care for individuals with autism spectrum disorder and serious behavioral disturbance through the lifespan.

    PubMed

    Lubetsky, Martin J; Handen, Benjamin L; Lubetsky, Michelle; McGonigle, John J

    2014-01-01

    Individuals with Autism Spectrum Disorder present with unique characteristics, and the interventions designed to address associated challenging behaviors must be highly individualized to best meet their needs and those of their families. This article reviews systems of care to support the child, adolescent, or adult with Autism Spectrum Disorder and/or Intellectual Disability. The review describes mental health/behavioral health services, Intellectual Disability and other support systems, and the systems involved in a child and adolescent's life and transition to adulthood. The types of systems and services, as well as barriers, are delineated with a brief listing of Web sites and references. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. PV systems for remote villages: Service-learning and communal sharing

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

    Duffy, J.; Soper, P.; Prasitpianchai, S.

    1999-07-01

    The remote village of Malvas in the Andes seems typical of many in Peru. The 500 descendants of the Quechua once ruled by the Inca have no electricity, no running water, one telephone, and mud adobe houses. At a 10,000-foot altitude, residents survive with subsistence farming. A group designed and installed a photovoltaic system to provide a vaccine refrigerator, lights, and a transceiver radio system in the town medical clinic last August. They installed light systems in four other town medical clinics in January. This project involves service-learning: combining service with academic subject matter, in this case solar engineering. Keymore » elements of the project also include: letting people define their needs, sustainable infrastructure development, community sharing of installation and virtual ownership (to go along with almost everything else that is shared in common).« less

  15. [Biological exposure-related injuries in workers in a health system of the health service of Galicia, Spain].

    PubMed

    Cores Calvo, Juan; Muñiz Saborido, José Ramón; González Iglesias, Marta Clara

    2013-01-01

    The objective of this study was to describe the factors involved in biological exposure-related injuries occurring in worker from a health system in Galicia, Spain. The study was conducted in a health system of the Health Service of Galicia, that included four hospitals and 72 primary care centers, with nearly 6000 workers. The study used occupational injury data available o in the injury registry of the Health Service of Galicia for the year 2011. We identified 194 biohazard-related injuries. Exposures, locations, devices, tasks and causes of these incidents were analysed. The majority of biological exposures occurred through needlestick injuries (82%). The areas where more injuries occurred were in inpatient wards (37%) and operating rooms (25%). The devices most frequently involved were suture needles (15%) and insulin needles (15%). The most frequently recorded causes were lack of training and information, together with lack of biosafety devices. Worker training and information should be promoted along with the implementation of biosafety devices, as the latter measure alone does not seem sufficient to reduce the number of injuries. Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.

  16. Challenges for a Local Service Agency to Address Domestic Violence –A Case Study From Rural Indonesia

    PubMed Central

    Hayati, Elli Nur; Emmelin, Maria; Eriksson, Malin

    2014-01-01

    Since the launch of a Zero Tolerance Policy in Indonesia, several policies to address domestic violence have been enacted. The obligation of local governments to establish service units for women survivors of domestic violence is one of them. Since domestic violence is a sensitive and complex issue in Indonesia it is important to understand how governmentally regulated services function in practice. This case study aimed to explore challenges faced by a local service agency in managing service provision for women survivors of domestic violence in rural Indonesia. Data from one focus group discussion (12 participants), four individual interviews, six short narratives, two days of participant observation, as well as archive reviews were collected. All data were analyzed using Grounded Theory Situational Analysis. The major challenge faced by the local agency was the low priority that was given them by the local authorities, mirrored also in low involvement by the assigned volunteers in the daily service. The study also identified a gap between the socio-cultural arena and the law & policy arena that needs to be bridged to avoid that the two arenas address domestic violence in a contradictory way. Budget allocation to support the sustainability of the daily routines of service agencies has to be given priority. There is also a need for careful considerations regarding the composition of personnel involved within daily management of service agencies addressing domestic violence. To bridge the gap between the legal systems and traditional cultural values, culturally adjusted alternative justice systems could be developed to increase women’s access to legal support. PMID:25363105

  17. SOA-based model for value-added ITS services delivery.

    PubMed

    Herrera-Quintero, Luis Felipe; Maciá-Pérez, Francisco; Marcos-Jorquera, Diego; Gilart-Iglesias, Virgilio

    2014-01-01

    Integration is currently a key factor in intelligent transportation systems (ITS), especially because of the ever increasing service demands originating from the ITS industry and ITS users. The current ITS landscape is made up of multiple technologies that are tightly coupled, and its interoperability is extremely low, which limits ITS services generation. Given this fact, novel information technologies (IT) based on the service-oriented architecture (SOA) paradigm have begun to introduce new ways to address this problem. The SOA paradigm allows the construction of loosely coupled distributed systems that can help to integrate the heterogeneous systems that are part of ITS. In this paper, we focus on developing an SOA-based model for integrating information technologies (IT) into ITS to achieve ITS service delivery. To develop our model, the ITS technologies and services involved were identified, catalogued, and decoupled. In doing so, we applied our SOA-based model to integrate all of the ITS technologies and services, ranging from the lowest-level technical components, such as roadside unit as a service (RSUAAS), to the most abstract ITS services that will be offered to ITS users (value-added services). To validate our model, a functionality case study that included all of the components of our model was designed.

  18. Undermining patient and public engagement and limiting its impact: the consequences of the Health and Social Care Act 2012 on collective patient and public involvement.

    PubMed

    Tritter, Jonathan Q; Koivusalo, Meri

    2013-06-01

    Patient and public involvement has been at the heart of UK health policy for more than two decades. This commitment to putting patients at the heart of the British National Health Service (NHS) has become a central principle helping to ensure equity, patient safety and effectiveness in the health system. The recent Health and Social Care Act 2012 is the most significant reform of the NHS since its foundation in 1948. More radically, this legislation undermines the principle of patient and public involvement, public accountability and returns the power for prioritisation of health services to an unaccountable medical elite. This legislation marks a sea-change in the approach to patient and public involvement in the UK and signals a shift in the commitment of the UK government to patient-centred care. © 2013 John Wiley & Sons Ltd.

  19. Approaches to child protection case management for cases involving people with disabilities.

    PubMed

    Lightfoot, Elizabeth B; LaLiberte, Traci L

    2006-04-01

    This exploratory study examines the delivery of child protection services by county child protection agencies involving cases with a family member with a disability. Telephone surveys were conducted with the directors or their designees of 89% of the child protection agencies in a Midwestern state. Respondents were asked about the policies and/or procedures for approaching cases involving a person with a disability and the barriers and strengths agencies have in serving people with disabilities. Only 6.7% of respondents reported their agency had a written policy related to serving persons with a disability. There were 18 different approaches to serving clients with a disability within child protection, with the most common being informally teaming for information, dual case assignment, and teaming with an outside consultant. Five counties had specialty workers who were experts in both child protection and disability. Barriers reported varied between rural and non-rural counties, with the most important barriers being lack of resources, lack of knowledge regarding disabilities, systems conflicts, and rural issues, such as lack of providers and lack of transportation. Strengths included accessing and coordinating services, individualizing services, good collaboration and creativity. While few county agencies had any written policies, both formal and informal collaboration is happening at the individual level. The lack of standardization in providing services indicates a need for more attention to issues regarding disability within child protection, including more training for workers, the development of models of collaborative case management and the removal of systemic barriers.

  20. Instructional System Development (ISD) in the Armed Services: Methodology and Application. Final Report, August 25, 1977 through March 19, 1979.

    ERIC Educational Resources Information Center

    Vineberg, Robert; Joyner, John N.

    Instructional System Development (ISD) methodologies and practices were examined in the Army, Navy, Marine Corps, and Air Force, each of which prescribes the ISD system involving rigorous derivation of training requirements from job requirements, selection of instructional strategies to maximize training efficiency, and revision of instruction…

  1. Proposing a Web-Based Tutorial System to Teach Malay Language Braille Code to the Sighted

    ERIC Educational Resources Information Center

    Wah, Lee Lay; Keong, Foo Kok

    2010-01-01

    The "e-KodBrailleBM Tutorial System" is a web-based tutorial system which is specially designed to teach, facilitate and support the learning of Malay Language Braille Code to individuals who are sighted. The targeted group includes special education teachers, pre-service teachers, and parents. Learning Braille code involves memorisation…

  2. A web service system supporting three-dimensional post-processing of medical images based on WADO protocol.

    PubMed

    He, Longjun; Xu, Lang; Ming, Xing; Liu, Qian

    2015-02-01

    Three-dimensional post-processing operations on the volume data generated by a series of CT or MR images had important significance on image reading and diagnosis. As a part of the DIOCM standard, WADO service defined how to access DICOM objects on the Web, but it didn't involve three-dimensional post-processing operations on the series images. This paper analyzed the technical features of three-dimensional post-processing operations on the volume data, and then designed and implemented a web service system for three-dimensional post-processing operations of medical images based on the WADO protocol. In order to improve the scalability of the proposed system, the business tasks and calculation operations were separated into two modules. As results, it was proved that the proposed system could support three-dimensional post-processing service of medical images for multiple clients at the same moment, which met the demand of accessing three-dimensional post-processing operations on the volume data on the web.

  3. An empirical typology of private child and family serving agencies.

    PubMed

    Chuang, Emmeline; Collins-Camargo, Crystal; McBeath, Bowen; Wells, Rebecca; Bunger, Alicia

    2014-03-01

    Differences in how services are organized and delivered can contribute significantly to variation in outcomes experienced by children and families. However, few comparative studies identify the strengths and limitations of alternative delivery system configurations. The current study provides the first empirical typology of private agencies involved with the formal child welfare system. Data collected in 2011 from a national sample of private agencies were used to classify agencies into five distinct groups based on internal management capacity, service diversification, integration, and policy advocacy. Findings reveal considerable heterogeneity in the population of private child and family serving agencies. Cross-group comparisons suggest that differences in agencies' strategic and structural characteristics correlated with agency directors' perceptions of different pressures in their external environment. Future research can use this typology to better understand local service systems and the extent to which different agency strategies affect performance and other outcomes. Such information has implications for public agency contracting decisions and could inform system-level assessment and planning of services for children and families.

  4. An empirical typology of private child and family serving agencies

    PubMed Central

    Collins-Camargo, Crystal; McBeath, Bowen; Wells, Rebecca; Bunger, Alicia

    2014-01-01

    Differences in how services are organized and delivered can contribute significantly to variation in outcomes experienced by children and families. However, few comparative studies identify the strengths and limitations of alternative delivery system configurations. The current study provides the first empirical typology of private agencies involved with the formal child welfare system. Data collected in 2011 from a national sample of private agencies were used to classify agencies into five distinct groups based on internal management capacity, service diversification, integration, and policy advocacy. Findings reveal considerable heterogeneity in the population of private child and family serving agencies. Cross-group comparisons suggest that differences in agencies’ strategic and structural characteristics correlated with agency directors’ perceptions of different pressures in their external environment. Future research can use this typology to better understand local service systems and the extent to which different agency strategies affect performance and other outcomes. Such information has implications for public agency contracting decisions and could inform system-level assessment and planning of services for children and families. PMID:24648603

  5. Network Communication as a Service-Oriented Capability

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

    Johnston, William; Johnston, William; Metzger, Joe

    2008-01-08

    In widely distributed systems generally, and in science-oriented Grids in particular, software, CPU time, storage, etc., are treated as"services" -- they can be allocated and used with service guarantees that allows them to be integrated into systems that perform complex tasks. Network communication is currently not a service -- it is provided, in general, as a"best effort" capability with no guarantees and only statistical predictability. In order for Grids (and most types of systems with widely distributed components) to be successful in performing the sustained, complex tasks of large-scale science -- e.g., the multi-disciplinary simulation of next generation climate modelingmore » and management and analysis of the petabytes of data that will come from the next generation of scientific instrument (which is very soon for the LHC at CERN) -- networks must provide communication capability that is service-oriented: That is it must be configurable, schedulable, predictable, and reliable. In order to accomplish this, the research and education network community is undertaking a strategy that involves changes in network architecture to support multiple classes of service; development and deployment of service-oriented communication services, and; monitoring and reporting in a form that is directly useful to the application-oriented system so that it may adapt to communications failures. In this paper we describe ESnet's approach to each of these -- an approach that is part of an international community effort to have intra-distributed system communication be based on a service-oriented capability.« less

  6. Service user involvement in mental health care: an evolutionary concept analysis.

    PubMed

    Millar, Samantha L; Chambers, Mary; Giles, Melanie

    2016-04-01

    The concept of service user involvement is an evolving concept in the mental health-care literature. This study sought to explore and analyse the concept of service user involvement as used in within the field of mental health care. An evolutionary concept analysis was conducted using a literature-based sample extracted from an electronic database search. One hundred and thirty-four papers met the inclusion criteria and were analysed to discover key attributes, antecedents and consequences of service user involvement and to produce a definition of the concept. Five key attributes of service user involvement within the context of mental health care were identified: a person-centred approach, informed decision making, advocacy, obtaining service user views and feedback and working in partnership. Clarity of the attributes and definition of the concept of service user involvement aims to promote understanding of the concept among key stakeholders including mental health professionals, service users and community and voluntary organizations. The findings of the research have utility in the areas of theory and policy development, research on service user involvement in mental health care and service user involvement in mental health practice. Directions for further research regarding the concept are identified. © 2015 John Wiley & Sons Ltd.

  7. Examining maintenance responsibilities.

    PubMed

    Lam, K C

    2001-06-01

    This paper has examined the important responsibilities of the two organisations involved in the provision of maintenance service for the vital building services in many of our highly serviced buildings. The issues raised could be put to beneficial use in both clients and maintenance providers. All in all, the clients should work closely with their maintenance providers. Engineering services in buildings will not perform satisfactorily and efficiently if both parties do not work together and understand the maintenance tasks based on a business partnering mode. Put forward is the view that the management of the activities involved in the operation and maintenance process is a "shared commitment/involvement" between the client and the maintenance provider. It is obvious that many factors can influence the continued effectiveness of a quality maintenance scheme set up by client and provider. Some of these factors are: Change in key personnel Updates in technology Amendments to engineering practice Implementation of legislative requirements Changes in operation by client or provider Change of use of building Passage of time These factors must be fully reviewed by both parties from time to time, and necessary actions taken. A cooperative team working relationship and improved communication should be fostered by the client and his provider for the best management of services maintenance. This arrangement will contribute to better building services systems with continuous improvement; improved value for clients and higher return for the maintenance provider.

  8. Development of Communication Technology in Japan: The Hi-OVIS Project.

    ERIC Educational Resources Information Center

    Murata, Toshihiko

    1981-01-01

    Describes the two-way Highly Interactive Optical Visual Information System (Hi-OVIS), involving the transmission and reception of educational, advertising, and public service programing, which has been in experimental use in Japan since 1978. Utilizing fiber optics, the system equips each house with a keyboard, television, television camera, and…

  9. Changes in Local Public Health System Performance Before and After Attainment of National Accreditation Standards.

    PubMed

    Ingram, Richard C; Mays, Glen P; Kussainov, Nurlan

    The aim of this study is to investigate the impact of Public Health Accreditation Board (PHAB) accreditation on the delivery of public health services and on participation from other sectors in the delivery of public health services in local public health systems. This study uses a longitudinal repeated measures design to identify differences between a cohort of public health systems containing PHAB-accredited local health departments and a cohort of public health systems containing unaccredited local health departments. It uses data spanning from 2006 to 2016. This study examines a cohort of local public health systems that serves large populations and contains unaccredited and PHAB-accredited local health departments. Data in this study were collected from the directors of health departments that include local public health systems followed in the National Longitudinal Study of Public Health Systems. The intervention examined is PHAB accreditation. The study focuses on 4 areas: the delivery of core public health services, local health department contribution toward these services, participation in the delivery of these services by other members of the public health system, and public health system makeup. Prior to the advent of accreditation, public health systems containing local health departments that were later accredited by PHAB appear quite similar to their unaccredited peers. Substantial differences between the 2 cohorts appear to manifest themselves after the advent of accreditation. Specifically, the accredited cohort seems to offer a broader array of public health services, involve more partners in the delivery of those services, and enjoy a higher percentage of comprehensive public health systems. The results of this study suggest that accreditation may yield significant benefits and may help public health systems develop the public health system capital necessary to protect and promote the public's health.

  10. Optimization of chassis reallocation in doublestack container transportation system

    DOT National Transportation Integrated Search

    1995-08-01

    Cost efficiencies associated with double stacking truck containers on flatbed railcars have motivated carriers to increase their involvement in intermodal freight transportation. However, container-on-flatcar (COFC) service in rail-truck environments...

  11. Systematic synthesis of barriers and facilitators to service user-led care planning.

    PubMed

    Bee, Penny; Price, Owen; Baker, John; Lovell, Karina

    2015-08-01

    Service user (patient) involvement in care planning is a principle enshrined by mental health policy yet often attracts criticism from patients and carers in practice. To examine how user-involved care planning is operationalised within mental health services and to establish where, how and why challenges to service user involvement occur. Systematic evidence synthesis. Synthesis of data from 117 studies suggests that service user involvement fails because the patients' frame of reference diverges from that of providers. Service users and carers attributed highest value to the relational aspects of care planning. Health professionals inconsistently acknowledged the quality of the care planning process, tending instead to define service user involvement in terms of quantifiable service-led outcomes. Service user-involved care planning is typically operationalised as a series of practice-based activities compliant with auditor standards. Meaningful involvement demands new patient-centred definitions of care planning quality. New organisational initiatives should validate time spent with service users and display more tangible and flexible commitments to meeting their needs. © The Royal College of Psychiatrists 2015.

  12. Systematic synthesis of barriers and facilitators to service user-led care planning

    PubMed Central

    Bee, Penny; Price, Owen; Baker, John; Lovell, Karina

    2015-01-01

    Background Service user (patient) involvement in care planning is a principle enshrined by mental health policy yet often attracts criticism from patients and carers in practice. Aims To examine how user-involved care planning is operationalised within mental health services and to establish where, how and why challenges to service user involvement occur. Method Systematic evidence synthesis. Results Synthesis of data from 117 studies suggests that service user involvement fails because the patients' frame of reference diverges from that of providers. Service users and carers attributed highest value to the relational aspects of care planning. Health professionals inconsistently acknowledged the quality of the care planning process, tending instead to define service user involvement in terms of quantifiable service-led outcomes. Conclusions Service user-involved care planning is typically operationalised as a series of practice-based activities compliant with auditor standards. Meaningful involvement demands new patient-centred definitions of care planning quality. New organisational initiatives should validate time spent with service users and display more tangible and flexible commitments to meeting their needs. PMID:26243762

  13. Collaboration, negotiation, and coalescence for interagency-collaborative teams to scale-up evidence-based practice.

    PubMed

    Aarons, Gregory A; Fettes, Danielle L; Hurlburt, Michael S; Palinkas, Lawrence A; Gunderson, Lara; Willging, Cathleen E; Chaffin, Mark J

    2014-01-01

    Implementation and scale-up of evidence-based practices (EBPs) is often portrayed as involving multiple stakeholders collaborating harmoniously in the service of a shared vision. In practice, however, collaboration is a more complex process that may involve shared and competing interests and agendas, and negotiation. The present study examined the scale-up of an EBP across an entire service system using the Interagency Collaborative Team approach. Participants were key stakeholders in a large-scale county-wide implementation of an EBP to reduce child neglect, SafeCare. Semistructured interviews and/or focus groups were conducted with 54 individuals representing diverse constituents in the service system, followed by an iterative approach to coding and analysis of transcripts. The study was conceptualized using the Exploration, Preparation, Implementation, and Sustainment framework. Although community stakeholders eventually coalesced around implementation of SafeCare, several challenges affected the implementation process. These challenges included differing organizational cultures, strategies, and approaches to collaboration; competing priorities across levels of leadership; power struggles; and role ambiguity. Each of the factors identified influenced how stakeholders approached the EBP implementation process. System-wide scale-up of EBPs involves multiple stakeholders operating in a nexus of differing agendas, priorities, leadership styles, and negotiation strategies. The term collaboration may oversimplify the multifaceted nature of the scale-up process. Implementation efforts should openly acknowledge and consider this nexus when individual stakeholders and organizations enter into EBP implementation through collaborative processes.

  14. Collaboration, Negotiation, and Coalescence for Interagency-Collaborative Teams to Scale-up Evidence-Based Practice

    PubMed Central

    Aarons, Gregory A.; Fettes, Danielle; Hurlburt, Michael; Palinkas, Lawrence; Gunderson, Lara; Willging, Cathleen; Chaffin, Mark

    2014-01-01

    Objective Implementation and scale-up of evidence-based practices (EBPs) is often portrayed as involving multiple stakeholders collaborating harmoniously in the service of a shared vision. In practice, however, collaboration is a more complex process that may involve shared and competing interests and agendas, and negotiation. The present study examined the scale-up of an EBP across an entire service system using the Interagency Collaborative Team (ICT) approach. Methods Participants were key stakeholders in a large-scale county-wide implementation of an EBP to reduce child neglect, SafeCare®. Semi-structured interviews and/or focus groups were conducted with 54 individuals representing diverse constituents in the service system, followed by an iterative approach to coding and analysis of transcripts. The study was conceptualized using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Results Although community stakeholders eventually coalesced around implementation of SafeCare, several challenges affected the implementation process. These challenges included differing organizational cultures, strategies, and approaches to collaboration, competing priorities across levels of leadership, power struggles, and role ambiguity. Each of the factors identified influenced how stakeholders approached the EBP implementation process. Conclusions System wide scale-up of EBPs involves multiple stakeholders operating in a nexus of differing agendas, priorities, leadership styles, and negotiation strategies. The term collaboration may oversimplify the multifaceted nature of the scale-up process. Implementation efforts should openly acknowledge and consider this nexus when individual stakeholders and organizations enter into EBP implementation through collaborative processes. PMID:24611580

  15. Implementation of a large-scale hospital information infrastructure for multi-unit health-care services.

    PubMed

    Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul

    2008-01-01

    With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications.

  16. Evolution of the INMARSAT aeronautical system: Service, system, and business considerations

    NASA Technical Reports Server (NTRS)

    Sengupta, Jay R.

    1995-01-01

    A market-driven approach was adopted to develop enhancements to the Inmarsat-Aeronautical system, to address the requirements of potential new market segments. An evolutionary approach and well differentiated product/service portfolio was required, to minimize system upgrade costs and market penetration, respectively. The evolved system definition serves to minimize equipment cost/size/mass for short/medium range aircraft, by reducing the antenna gain requirement and relaxing the performance requirements for non safety-related communications. A validation program involving simulation, laboratory tests, over-satellite tests and flight trials is being conducted to confirm the system definition. Extensive market research has been conducted to determine user requirements and to quantify market demand for future Inmarsat Aero-1 AES, using sophisticated computer assisted survey techniques.

  17. Security Issues in mGovernment

    NASA Astrophysics Data System (ADS)

    Kumar, Manish; Hanumanthappa, M.; Reddy, Bhavanam Lakshma

    E-government is one of the most rapidly evolving service domains in the contemporary information society. Many governments have already developed and provided e-government services to businesses and citizens. Nowadays actors in the government domain attempt to take the next step and exploit the latest wireless technologies in order to provide ubiquitous services for mobile users. However, this approach involves some hidden risks mainly due to the inherent insecurity of the air medium and the vulnerabilities of the wireless systems. Thus, in this paper we investigate the security gaps and considerations which should be taken into account for an m-government system. Finally, we provide a list of security guidelines and policies, which the users of the system should be aware of and follow in order to avoid security attacks.

  18. Posters as assessment strategies: focusing on service users.

    PubMed

    Crawley, Loretta; Frazer, Kate

    This article debates whether posters as an assessment strategy in health professionals' education programmes can benefit learners, academics, and service users. Evidence suggests that service-user involvement benefits learning by developing students' communication, partnership and advocacy skills. The authors debate the value of posters as an assessment strategy in postgraduate diploma nursing programmes delivered in an Irish School of Nursing, Midwifery and Health Systems. It is argued that assessment strategies should not only examine programme theory and practice but should also benefit the people that will be using the service. Although the assessment strategy used in these programmes aimed to benefit service users, additional work is required for assessment to be truly inclusive of service users.

  19. Integrating Substance Abuse Treatment and Child Welfare Services: Findings from the Illinois Alcohol and Other Drug Abuse Waiver Demonstration

    ERIC Educational Resources Information Center

    Ryan, Joseph P.; Marsh, Jeanne C.; Testa, Mark F.; Louderman, Richard

    2006-01-01

    Alcohol and other drug abuse is a major problem for children and families involved with public child welfare. Substance abuse compromises appropriate parenting practices and increases the risk of child maltreatment. A substantial proportion of substantiated child abuse and neglect reports involve parental substance abuse. Once in the system,…

  20. Nurse-led liaison mental health service for older adults: service development using lean thinking methodology.

    PubMed

    Atkinson, Paula; Mukaetova-Ladinska, Elizabeta B

    2012-04-01

    Liaison Psychiatric Services for Older Adults in the UK have been established over the last decade, with rather divergent team composition and involvement. The latest documents (National Dementia Strategy, Who Cares Wins) set the gold standard for liaison services for older adults in England, requiring a proactive approach to services and integrating assessment and treatment of mental disorder into routine general hospital practice. This requires a physical presence of liaison services in the hospital, with collaboration with medical colleagues. We have adopted the above strategy in a nurse-led liaison service working in a General District Hospital, and used the Toyota Production System. In the current study we reflect on the 5 day rapid progress improvement workshops event for the liaison branch of the project, and describe the process of identifying real situation problems for the care of the medically ill, the involvement of the liaison team in their clinical care, and a feedback on the change in practice. The novel approach of identifying areas for change in an ongoing nurse-led Liaison service for Older Adults resulted in improving access to mental health services for elderly medically ill inpatients and improved quality of their overall care. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Service Users' Involvement and Engagement in Interprofessional Care.

    PubMed

    Kaini, B K

    2016-01-01

    Interprofessional care is joint working between health care professionals by pooling their skills, knowledge and expertise, to make joint decisions and learn from each other for the benefits of service users and healthcare professionals. Service users involvement is considered as one of the important aspects of planning, management and decision making process in the delivery of health care to service users. Service users' involvement is not the same as public involvement and partnership arrangements in health care. The active involvement and engagement of service users in health care positively contributes to improve quality of care, to promote better health and to shape the future of health services. Service users are always at the centre of health care professionals' values, work ethics and roles. Moreover, service users centred interprofessional team collaboration is very important to deliver effective health services.

  2. Building organizational supports for knowledge sharing in county human service organizations: a cross-case analysis of works-in-progress.

    PubMed

    Lee, Chris; Austin, Michael J

    2012-01-01

    Building on the literature related to evidence-based practice, knowledge management, and learning organizations, this cross-case analysis presents twelve works-in-progress in ten local public human service organizations seeking to develop their own knowledge sharing systems. The data for this cross-case analysis can be found in the various contributions to this Special Issue. The findings feature the developmental aspects of building a learning organization that include knowledge sharing systems featuring transparency, self-assessment, and dissemination and utilization. Implications for practice focus on the structure and processes involved in building knowledge sharing teams inside public human service organizations. Copyright © Taylor & Francis Group, LLC

  3. A Research Framework for Understanding the Practical Impact of Family Involvement in the Juvenile Justice System: The Juvenile Justice Family Involvement Model.

    PubMed

    Walker, Sarah Cusworth; Bishop, Asia S; Pullmann, Michael D; Bauer, Grace

    2015-12-01

    Family involvement is recognized as a critical element of service planning for children's mental health, welfare and education. For the juvenile justice system, however, parents' roles in this system are complex due to youths' legal rights, public safety, a process which can legally position parents as plaintiffs, and a historical legacy of blaming parents for youth indiscretions. Three recent national surveys of juvenile justice-involved parents reveal that the current paradigm elicits feelings of stress, shame and distrust among parents and is likely leading to worse outcomes for youth, families and communities. While research on the impact of family involvement in the justice system is starting to emerge, the field currently has no organizing framework to guide a research agenda, interpret outcomes or translate findings for practitioners. We propose a research framework for family involvement that is informed by a comprehensive review and content analysis of current, published arguments for family involvement in juvenile justice along with a synthesis of family involvement efforts in other child-serving systems. In this model, family involvement is presented as an ascending, ordinal concept beginning with (1) exclusion, and moving toward climates characterized by (2) information-giving, (3) information-eliciting and (4) full, decision-making partnerships. Specific examples of how courts and facilities might align with these levels are described. Further, the model makes predictions for how involvement will impact outcomes at multiple levels with applications for other child-serving systems.

  4. An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan

    PubMed Central

    Chang, Hsin Hsin; Chang, Ching Sheng

    2008-01-01

    Background Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is presently the top priority for every healthcare institution. In this fast changing modern society, e-health care systems are currently the best possible way to achieve enhanced service efficiency and quality under the restraint of healthcare cost control. The electronic medical record system and the online appointment system are the core features in employing e-health care systems in the technology-based service encounters. Methods This study implemented the Service Encounters Evaluation Model, the European Customer Satisfaction Index, the Attribute Model and the Overall Affect Model for model inference. A total of 700 copies of questionnaires from two authoritative southern Taiwan medical centers providing the electronic medical record system and the online appointment system service were distributed, among which 590 valid copies were retrieved with a response rate of 84.3%. We then used SPSS 11.0 and the Linear Structural Relationship Model (LISREL 8.54) to analyze and evaluate the data. Results The findings are as follows: (1) Technology-based service encounters have a positive impact on service quality, but not patient satisfaction; (2) After experiencing technology-based service encounters, the cognition of the service quality has a positive effect on patient satisfaction; and (3) Network security contributes a positive moderating effect on service quality and patient satisfaction. Conclusion It revealed that the impact of electronic workflow (online appointment system service) on service quality was greater than electronic facilities (electronic medical record systems) in technology-based service encounters. Convenience and credibility are the most important factors of service quality in technology-based service encounters that patients demand. Due to the openness of networks, patients worry that transaction information could be intercepted; also, the credibility of the hospital involved is even a bigger concern, as patients have a strong sense of distrust. Therefore, in the operation of technology-based service encounters, along with providing network security, it is essential to build an atmosphere of psychological trust. PMID:18419820

  5. An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan.

    PubMed

    Chang, Hsin Hsin; Chang, Ching Sheng

    2008-04-17

    Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is presently the top priority for every healthcare institution. In this fast changing modern society, e-health care systems are currently the best possible way to achieve enhanced service efficiency and quality under the restraint of healthcare cost control. The electronic medical record system and the online appointment system are the core features in employing e-health care systems in the technology-based service encounters. This study implemented the Service Encounters Evaluation Model, the European Customer Satisfaction Index, the Attribute Model and the Overall Affect Model for model inference. A total of 700 copies of questionnaires from two authoritative southern Taiwan medical centers providing the electronic medical record system and the online appointment system service were distributed, among which 590 valid copies were retrieved with a response rate of 84.3%. We then used SPSS 11.0 and the Linear Structural Relationship Model (LISREL 8.54) to analyze and evaluate the data. The findings are as follows: (1) Technology-based service encounters have a positive impact on service quality, but not patient satisfaction; (2) After experiencing technology-based service encounters, the cognition of the service quality has a positive effect on patient satisfaction; and (3) Network security contributes a positive moderating effect on service quality and patient satisfaction. It revealed that the impact of electronic workflow (online appointment system service) on service quality was greater than electronic facilities (electronic medical record systems) in technology-based service encounters. Convenience and credibility are the most important factors of service quality in technology-based service encounters that patients demand. Due to the openness of networks, patients worry that transaction information could be intercepted; also, the credibility of the hospital involved is even a bigger concern, as patients have a strong sense of distrust. Therefore, in the operation of technology-based service encounters, along with providing network security, it is essential to build an atmosphere of psychological trust.

  6. Security concept in 'MyAngelWeb' a website for the individual patient at risk of emergency.

    PubMed

    Pinciroli, F; Nahaissi, D; Boschini, M; Ferrari, R; Meloni, G; Camnasio, M; Spaggiari, P; Carnerone, G

    2000-11-01

    We describe the Security Plan for the 'MyAngelWeb' service. The different actors involved in the service are subject to different security procedures. The core of the security system is implemented at the host site by means of a DBMS and standard Information Technology tools. Hardware requirements for sustainable security are needed at the web-site construction sites. They are not needed at the emergency physician's site. At the emergency physician's site, a two-way authentication system (password and test phrase method) is implemented.

  7. Security concept in 'MyAngelWeb((R))' a website for the individual patient at risk of emergency.

    PubMed

    Pinciroli; Nahaissi; Boschini; Ferrari; Meloni; Camnasio; Spaggiari; Carnerone

    2000-11-01

    We describe the Security Plan for the 'MyAngelWeb' service. The different actors involved in the service are subject to different security procedures. The core of the security system is implemented at the host site by means of a DBMS and standard Information Technology tools. Hardware requirements for sustainable security are needed at the web-site construction sites. They are not needed at the emergency physician's site. At the emergency physician's site, a two-way authentication system (password and test phrase method) is implemented.

  8. 'Calling executives and clinicians to account': user involvement in commissioning cancer services.

    PubMed

    Evans, David H; Bacon, Roger J; Greer, Elizabeth; Stagg, Angela M; Turton, Pat

    2015-08-01

    English NHS guidance emphasizes the importance of involving users in commissioning cancer services. There has been considerable previous research on involving users in service improvement, but not on involvement in commissioning cancer services. To identify how users were involved as local cancer service commissioning projects sought to implement good practice and what has been learned. Participatory evaluation with four qualitative case studies based on semi-structured interviews with project stakeholders, observation and documentary analysis. Users were involved in every stage from design to analysis and reporting. Four English cancer network user involvement in commissioning projects, with 22 stakeholders interviewed. Thematic analysis identified nine themes: initial involvement, preparation for the role, ability to exercise voice, consistency and continuity, where decisions are made, closing the feedback loop, assessing impact, value of experience and diversity. Our findings on the impact of user involvement in commissioning cancer services are consistent with other findings on user involvement in service improvement, but highlight the specific issues for involvement in commissioning. Key points include the different perspectives users and professionals may have on the impact of user involvement in commissioning, the time necessary for meaningful involvement, the importance of involving users from the beginning and the value of senior management and PPI facilitator support and training. Users can play an important role in commissioning cancer services, but their ability to do so is contingent on resources being available to support them. © 2013 John Wiley & Sons Ltd.

  9. An Examination of the Vocational Rehabilitation Needs of American Indians with Behavioral Health Diagnoses in New York State. Final Report.

    ERIC Educational Resources Information Center

    Marshall, Catherine A.; And Others

    A participatory action research project examined vocational rehabilitation (VR) services provided in New York State to American Indians with behavioral health diagnoses, including dual diagnoses involving substance abuse. In 1991, the New York public VR system had 81 American Indians apply for VR services (only 2.8 percent of American Indians with…

  10. A Case Study of the NATO Identification System (NIS) Codevelopment Program

    DTIC Science & Technology

    1988-09-01

    the otherhand are unrelated to the military equipment being purchased. These offsets include foreign investment, technology transfer, and countertrade ...manufacturer and a foreign entity. 6. Countertrade - a transaction that specifies the exchange of selected goods and services for another of equivalent...arrangements. In fact, U.S. agencies are permitted to provide advisory and marketing intelligence services to U.S. exporters involved in countertrade

  11. Measuring the impact of enhanced kinship navigator services for informal kinship caregivers using an experimental design.

    PubMed

    Feldman, Leonard H; Fertig, Amanda

    2013-01-01

    While relative care may offer significant benefits to kin children as compared to non-relative foster care, informal kinship caregivers often experience various hardships and needs without the resources of the child welfare system to aid them. They may benefit from services provided by an expanded kinship navigator program. This study, using an experimental design, adds to knowledge about the characteristics and needs of kinship caregivers and the impact of enhanced navigator services. The relative effect of this more intensive intervention was mixed. Caregivers had many of their expressed needs met. Yet, the enhanced services group did not demonstrate: an increase in perceived social support; reduction in caregiver stress; or improvement in child behavior compared to the families receiving brief, traditional navigator services. Little difference was found in post intervention involvement in the child welfare system. Further enhancements to the model are suggested.

  12. Building an HIV continuum for inmates: New York State's criminal justice initiative.

    PubMed

    Klein, Susan J; O'Connell, Daniel A; Devore, Barbara S; Wright, Lester N; Birkhead, Guthrie S

    2002-10-01

    The benefits of public health, corrections, and community-based organization (CBO) collaboration to meet HIV prevention needs of inmates are recognized. Each year over 100,000 inmates, most of whom have a history that put them at HIV risk, pass through the New York State (NYS) prison system. The NYS Department of Health AIDS Institute, the NYS Department of Correctional Services, the NYS Division of Parole, and a statewide network of CBOs collaborate to meet HIV prevention and support services needs of inmates and parolees through a continuum of interventions and services. This article describes the evolution of the prevention, supportive services, and transitional planning continuum within the NYS prison system. It identifies other agencies involved, obstacles to service delivery, describes approaches to overcome them, discusses ways to meet capacity building and technical assistance needs of CBOs, identifies challenges remaining, and provides practical advice from actual experience in NYS.

  13. A new method for E-government procurement using collaborative filtering and Bayesian approach.

    PubMed

    Zhang, Shuai; Xi, Chengyu; Wang, Yan; Zhang, Wenyu; Chen, Yanhong

    2013-01-01

    Nowadays, as the Internet services increase faster than ever before, government systems are reinvented as E-government services. Therefore, government procurement sectors have to face challenges brought by the explosion of service information. This paper presents a novel method for E-government procurement (eGP) to search for the optimal procurement scheme (OPS). Item-based collaborative filtering and Bayesian approach are used to evaluate and select the candidate services to get the top-M recommendations such that the involved computation load can be alleviated. A trapezoidal fuzzy number similarity algorithm is applied to support the item-based collaborative filtering and Bayesian approach, since some of the services' attributes can be hardly expressed as certain and static values but only be easily represented as fuzzy values. A prototype system is built and validated with an illustrative example from eGP to confirm the feasibility of our approach.

  14. A New Method for E-Government Procurement Using Collaborative Filtering and Bayesian Approach

    PubMed Central

    Wang, Yan

    2013-01-01

    Nowadays, as the Internet services increase faster than ever before, government systems are reinvented as E-government services. Therefore, government procurement sectors have to face challenges brought by the explosion of service information. This paper presents a novel method for E-government procurement (eGP) to search for the optimal procurement scheme (OPS). Item-based collaborative filtering and Bayesian approach are used to evaluate and select the candidate services to get the top-M recommendations such that the involved computation load can be alleviated. A trapezoidal fuzzy number similarity algorithm is applied to support the item-based collaborative filtering and Bayesian approach, since some of the services' attributes can be hardly expressed as certain and static values but only be easily represented as fuzzy values. A prototype system is built and validated with an illustrative example from eGP to confirm the feasibility of our approach. PMID:24385869

  15. [Adoption of new technologies by health services: the challenge of analyzing relevant factors].

    PubMed

    Trindade, Evelinda

    2008-05-01

    The exponential increase in the incorporation of health technologies has been considered a key factor in increased expenditures by the health sector. Such decisions involve multiple levels and stakeholders. Decentralization has multiplied the decision-making levels, with numerous difficult choices and limited resources. The interrelationship between stakeholders is complex, in creative systems with multiple determinants and confounders. The current review discusses the interaction between the factors influencing the decisions to incorporate technologies by health services, and proposes a structure for their analysis. The application and intensity of these factors in decision-making and the incorporation of products and programs by health services shapes the installed capacity of local and regional networks and modifies the health system. Empirical observation of decision-making and technology incorporation in Brazilian health services poses an important challenge. The structured recognition and measurement of these variables can assist proactive planning of health services.

  16. A case for increased private sector involvement in Ireland's national animal health services

    PubMed Central

    2008-01-01

    Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR) and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise) of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia). The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise) of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands). PMID:21851708

  17. A case for increased private sector involvement in Ireland's national animal health services.

    PubMed

    More, Simon J

    2008-02-01

    Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR) and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise) of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia). The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise) of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands).

  18. Paratransit Integration Workshop Proceedings, October 12-13, 1977

    DOT National Transportation Integrated Search

    1978-08-01

    Experts in the field of demand responsive transportation dealt with seven areas of concern for a proposed manual of paratransit services: planning and institutional constraints, involvement of the private operator, estimation techniques, system desig...

  19. Requirements and applications for robotic servicing of military space systems

    NASA Technical Reports Server (NTRS)

    Ledford, Otto C., Jr.; Bennett, Rodney G.

    1992-01-01

    The utility of on-orbit servicing of spacecraft has been demonstrated by NASA several times using shuttle-based astronaut EVA. There has been interest in utilizing on-orbit servicing for military space systems as well. This interest has been driven by the increasing reliance of all branches of the military upon space-based assets, the growing numbers, complexity, and cost of those assets, and a desire to normalize support policies for space-based operations. Many military satellites are placed in orbits which are unduly hostile for astronaut operations and/or cannot be reached by the shuttle. In addition, some of the projected tasks may involve hazardous operations. This has led to a focus on robotic systems, instead of astronauts, for the basis of projected servicing systems. This paper describes studies and activities which will hopefully lead to on-orbit servicing being one of the tools available to military space systems designers and operators. The utility of various forms of servicing has been evaluated for present and projected systems, critical technologies have been identified, and strategies for the development and insertion of this technology into operational systems have been developed. Many of the projected plans have been adversely affected by budgetary restrictions and evolving architectures, but the fundamental benefits and requirements are well understood. A method of introducing servicing capabilities in a manner which has a low impact on the system designer and does not require the prior development of an expensive infrastructure is discussed. This can potentially lead to an evolutionary implementation of the full technology.

  20. Semantic Repositories for eGovernment Initiatives: Integrating Knowledge and Services

    NASA Astrophysics Data System (ADS)

    Palmonari, Matteo; Viscusi, Gianluigi

    In recent years, public sector investments in eGovernment initiatives have depended on making more reliable existing governmental ICT systems and infrastructures. Furthermore, we assist at a change in the focus of public sector management, from the disaggregation, competition and performance measurements typical of the New Public Management (NPM), to new models of governance, aiming for the reintegration of services under a new perspective in bureaucracy, namely a holistic approach to policy making which exploits the extensive digitalization of administrative operations. In this scenario, major challenges are related to support effective access to information both at the front-end level, by means of highly modular and customizable content provision, and at the back-end level, by means of information integration initiatives. Repositories of information about data and services that exploit semantic models and technologies can support these goals by bridging the gap between the data-level representations and the human-level knowledge involved in accessing information and in searching for services. Moreover, semantic repository technologies can reach a new level of automation for different tasks involved in interoperability programs, both related to data integration techniques and service-oriented computing approaches. In this chapter, we discuss the above topics by referring to techniques and experiences where repositories based on conceptual models and ontologies are used at different levels in eGovernment initiatives: at the back-end level to produce a comprehensive view of the information managed in the public administrations' (PA) information systems, and at the front-end level to support effective service delivery.

  1. [Treatment of childhood injuries and violence in public emergency services].

    PubMed

    Malta, Deborah Carvalho; Mascarenhas, Márcio Denis Medeiros; Neves, Alice Cristina Medeiros das; Silva, Marta Alves da

    2015-05-01

    This study aimed to analyze the profile of treatment for accidents and violence involving children under 10 years of age in Brazil in the year 2011. This was a cross-sectional descriptive study in 71 emergency services in the Brazilian Unified National Health System (SUS), located in the national capital and 24 state capitals. Data were obtained from the Ministry of Health's system of sentinel surveillance services for Violence and Accidents (VIVA Survey). The highest proportion of injuries (67.4%) occurred inside the child's home. Among unintentional injuries, falls were the most frequent (52.4%), followed by running into objects or persons (21.8%) and traffic injuries (10.9%), especially as passengers (bicycles were an important means of transportation involved in the injuries). The vast majority of unintentional injuries are avoidable, and educational measures should be adopted, especially with parents, teachers, the community, and health workers, calling attention to the risks and the adoption of safe behaviors in the home, at school, and in leisure-time activities. Cases of violence are subject to mandatory reporting, and prompt measures should be taken to protect victims.

  2. Developing a Web-based system by integrating VGI and SDI for real estate management and marketing

    NASA Astrophysics Data System (ADS)

    Salajegheh, J.; Hakimpour, F.; Esmaeily, A.

    2014-10-01

    Property importance of various aspects, especially the impact on various sectors of the economy and the country's macroeconomic is clear. Because of the real, multi-dimensional and heterogeneous nature of housing as a commodity, the lack of an integrated system includes comprehensive information of property, the lack of awareness of some actors in this field about comprehensive information about property and the lack of clear and comprehensive rules and regulations for the trading and pricing, several problems arise for the people involved in this field. In this research implementation of a crowd-sourced Web-based real estate support system is desired. Creating a Spatial Data Infrastructure (SDI) in this system for collecting, updating and integrating all official data about property is also desired in this study. In this system a Web2.0 broker and technologies such as Web services and service composition has been used. This work aims to provide comprehensive and diverse information about property from different sources. For this purpose five-level real estate support system architecture is used. PostgreSql DBMS is used to implement the desired system. Geoserver software is also used as map server and reference implementation of OGC (Open Geospatial Consortium) standards. And Apache server is used to run web pages and user interfaces. Integration introduced methods and technologies provide a proper environment for various users to use the system and share their information. This goal is only achieved by cooperation between all involved organizations in real estate with implementation their required infrastructures in interoperability Web services format.

  3. Contextual Predictors of Mental Health Service Use Among Children Open to Child Welfare

    PubMed Central

    Leslie, Laurel K.; Landsverk, John; Barth, Richard P.; Burns, Barbara J.; Gibbons, Robert D.; Slymen, Donald J.; Zhang, Jinjin

    2006-01-01

    Background Children involved with child welfare systems are at high risk for emotional and behavioral problems. Many children with identified mental health problems do not receive care, especially ethnic/minority children. Objective To examine how patterns of specialty mental health service use among children involved with child welfare vary as a function of the degree of coordination between local child welfare and mental health agencies. Design Specialty mental health service use for 1 year after contact with child welfare was examined in a nationally representative cohort of children aged 2 to 14 years. Predictors of service use were modeled at the child/family and agency/county levels. Child- and agency-level data were collected between October 15,1999, and April 30, 2001. Setting Ninety-seven US counties. Participants A total of 2823 child welfare cases (multiple informants) from the National Survey of Child and Adolescent Well-being and agency-level key informants from the participating counties. Main Outcome Measures Specialty mental health service use during the year after contact with the child welfare system. Results Only 28.3% of children received specialty mental health services during the year, although 42.4% had clinical-level Child Behavior Checklist scores. Out-of-home placement, age, and race/ethnicity were strong predictors of service use rates, even after controlling for Child Behavior Checklist scores. Increased coordination between local child welfare and mental health agencies was associated with stronger relationships between Child Behavior Checklist scores and service use and decreased differences in rates of service use between white and African American children. Conclusions Younger children and those remaining in their homes could benefit from increased specialty mental health services. They have disproportionately low rates of service use, despite high levels of need. Increases in interagency coordination may lead to more efficient allocation of service resources to children with the greatest need and to decreased racial/ethnic disparities. PMID:15583113

  4. The CARFAX road traffic information system

    NASA Astrophysics Data System (ADS)

    Sandell, R. S.

    1984-02-01

    A description of the development work and field trials which led to the completion of the dedicated traffic information service "CARFAX' is presented. The system employs a single medium frequency channel, and involves a network of low powered transmitters that operate in time division multiplex to provide traffic announcements. A description of the network distribution, equipment test, results and future system utilization is included.

  5. [Exposure to electrocution by automotive ignition system in the work environment of car service employees].

    PubMed

    Fryśkowski, Bernard; Swiatek-Fryśkowska, Dorota

    2014-01-01

    Automotive ignition system diagnostic procedures involve a specific kind of action due to the presence of high voltage pulses rated of roughly several dozen kilovolts. Therefore, the repairers employed at car service coming into direct contact with electrical equipment of ignition systems are exposed to risk of electric shock. Typically, the electric discharge energy of automotive ignition systems is not high enough to cause fibrillation due to the electric effect on the heart. Nevertheless, there are drivers and car service employees who use electronic cardiac pacemakers susceptible to high voltage pulses. The influence of high-voltage ignition systems on the human body, especially in case of electric injury, has not been comprehensively elucidated. Therefore, relatively few scientific papers address this problem. The aim of this paper is to consider the electrical injury danger from automotive ignition systems, especially in people suffering from cardiac diseases. Some examples of the methods to reduce electric shock probability during diagnostic procedures of spark-ignition combustion engines are presented and discussed.

  6. Integrating Engineering Data Systems for NASA Spaceflight Projects

    NASA Technical Reports Server (NTRS)

    Carvalho, Robert E.; Tollinger, Irene; Bell, David G.; Berrios, Daniel C.

    2012-01-01

    NASA has a large range of custom-built and commercial data systems to support spaceflight programs. Some of the systems are re-used by many programs and projects over time. Management and systems engineering processes require integration of data across many of these systems, a difficult problem given the widely diverse nature of system interfaces and data models. This paper describes an ongoing project to use a central data model with a web services architecture to support the integration and access of linked data across engineering functions for multiple NASA programs. The work involves the implementation of a web service-based middleware system called Data Aggregator to bring together data from a variety of systems to support space exploration. Data Aggregator includes a central data model registry for storing and managing links between the data in disparate systems. Initially developed for NASA's Constellation Program needs, Data Aggregator is currently being repurposed to support the International Space Station Program and new NASA projects with processes that involve significant aggregating and linking of data. This change in user needs led to development of a more streamlined data model registry for Data Aggregator in order to simplify adding new project application data as well as standardization of the Data Aggregator query syntax to facilitate cross-application querying by client applications. This paper documents the approach from a set of stand-alone engineering systems from which data are manually retrieved and integrated, to a web of engineering data systems from which the latest data are automatically retrieved and more quickly and accurately integrated. This paper includes the lessons learned through these efforts, including the design and development of a service-oriented architecture and the evolution of the data model registry approaches as the effort continues to evolve and adapt to support multiple NASA programs and priorities.

  7. The role of community-based health planning and services strategy in involving males in the provision of family planning services: a qualitative study in Southern Ghana

    PubMed Central

    2013-01-01

    Background Reproductive health and Family Planning (FP) services have been of global concern especially in developing countries where fertility rates are high. Traditionally FP services had always targeted females with little or no attention given to males. To ensure equitable distribution of health services, Ministry of Health (MOH), Ghana adopted the Community-Based Health Planning and Services (CHPS) as a nationwide health policy with the aim of reducing obstacles to physical and geographical access to health care delivery including FP services. However, not much is known about the extent to which this policy has contributed to male involvement in FP services. This qualitative descriptive study was therefore designed to explore male involvement in FP services in communities with well functioning CHPS and those with less or no functioning CHPS structures. The study further solicited views of the community on the health status of children. Methods This was a qualitative descriptive study and adapted the design of an ongoing study to assess the impact of male involvement in FP referred to as the Navrongo experiment in Northern Ghana. Twelve focus group discussions were held with both male and female community members, six in communities with functional CHPS and six for communities with less/no-functional CHPS. In addition, fifty- nine (59) in-depth interviews were held with Community Health Officers (CHOs), Community Health Volunteers (CHVs) and Health Managers at both the districts and regional levels. The interviews and discussions were tape recorded digitally, transcribed and entered into QSR Nvivo 10© for analysis. Results The results revealed a general high perception of an improved health status of children in the last ten years in the communities. These improvements were attributed to immunization of children, exclusive breastfeeding, health education given to mothers on childcare, growth monitoring of children and accessible health care. Despite these achievements in the health of children, participants reported that malnutrition was still rife in the community. The results also revealed that spousal approval was still relevant for women in the use of contraceptives; however, the matrilineal system appears to give more autonomy to women in decision-making. The CHPS strategy was perceived as very helpful with full community participation at all levels of the implementation process. Males were more involved in FP services in communities with functioning CHPS than those without functioning CHPS. Conclusion The CHPS strategy has increased access to FP services but spousal consent was very important in the use of FP services. Involving males in reproductive health issues including FP is important to attain reproductive health targets. PMID:23890362

  8. Designing a placebo device: involving service users in clinical trial design.

    PubMed

    Gooberman-Hill, Rachael; Jinks, Clare; Bouças, Sofia Barbosa; Hislop, Kelly; Dziedzic, Krysia S; Rhodes, Carol; Burston, Amanda; Adams, Jo

    2013-12-01

    Service users are increasingly involved in the design of clinical trials and in product and device development. Service user involvement in placebo development is crucial to a credible and acceptable placebo for clinical trials, but such involvement has not yet been reported. To enhance the design of a future clinical trial of hand splints for thumb-base osteoarthritis (OA), service users were involved in splint selection and design of a placebo splint. This article describes and reflects on this process. Two fora of service users were convened in 2011. Service users who had been prescribed a thumb splint for thumb-base OA were approached about involvement by Occupational Therapy (OT) practitioners. A total of eight service users took part in the fora. Service users discussed their experience of OA and their own splints and then tried a variety of alternative splints. Through this they identified the active features of splints alongside acceptable and unacceptable design features. Service users focused on wearability and support with or without immobilization. Fora discussed whether a placebo group ('arm') was an acceptable feature of a future trial, and service users developed a potential design for a placebo splint. This is the first project that to involve service users in placebo design. Service users are increasingly involved in product and device design and are ideally placed to identify features to make a placebo credible yet lacking key active ingredients. The future trial will include research into its acceptability. © 2013 John Wiley & Sons Ltd.

  9. Requirements for Real-Time Laboratory Experimentation over the Internet.

    ERIC Educational Resources Information Center

    Salzmann, C.; Latchman, H. A.; Gillet, D.; Crisalle, O. D.

    A prototype system based on an inverted pendulum is used to study the Quality of Service and discuss requirements of remote-experimentation systems utilized for carrying out control engineering experiments over the Internet. This class of applications involves the transmission over the network of a variety of data types with their own peculiar…

  10. Private Colleges: The Federal Tax System and its Impact.

    ERIC Educational Resources Information Center

    Moran, Gerald P.

    Through its role in administering the laws pertaining to tax-exempt status, the Internal Revenue Service (IRS) is involved in regulating the activities of those organizations that claim such a special position. The interplay between the federal tax system and private colleges will intensify as the demands increase for additional financial support…

  11. The Effects of Victim-Related Contextual Factors on the Criminal Justice System

    ERIC Educational Resources Information Center

    Haynes, Stacy Hoskins

    2011-01-01

    Despite numerous reforms designed to integrate the needs and concerns of crime victims into the criminal justice system, which include expanding programs for compensation and restitution, providing counseling and other services to victims, and increasing victims' involvement in the criminal justice process, critics have argued that these reforms…

  12. Consumer participation in the planning and delivery of drug treatment services: the current arrangements.

    PubMed

    Bryant, Joanne; Saxton, Melissa; Madden, Annie; Bath, Nicky; Robinson, Suzanne

    2008-03-01

    Consumer participation in decision-making about service planning is common in certain health services in Australia but is thought to be largely underdeveloped in drug treatment services. This paper (1) describes the current practices within Australian drug treatment services that aim to include consumers in service planning and provision; and (2) determines how much consumers know about the existing opportunities for involvement. Sixty-four randomly selected service providers (representing 64 separate services) completed interviews about the current arrangements for consumer participation within their services (response rate = 82%). A total of 179 consumers completed interviews assessing their knowledge of the consumer participation activities available at the service they attended. Consumer participation activities were not uncommon in drug treatment services, although the existing activities were concerned largely with providing information to or receiving information from consumers. Activities that included consumers in higher forms of involvement, such as those in which consumers took part in decision-making, were largely uncommon. Consumers had a considerable lack of knowledge about the participation activities available to them, revealing a lack of communication between providers and consumers. While service providers were making efforts to engage consumers in service planning and provision (despite the general lack of State or Commonwealth policy directives and extra funding to do so), these appear ineffectual because of poor communication between providers and consumers. As a starting point, a critical part of any meaningful consumer participation initiative must include systems to ensure that consumers know about available opportunities.

  13. Exclusive queueing model including the choice of service windows

    NASA Astrophysics Data System (ADS)

    Tanaka, Masahiro; Yanagisawa, Daichi; Nishinari, Katsuhiro

    2018-01-01

    In a queueing system involving multiple service windows, choice behavior is a significant concern. This paper incorporates the choice of service windows into a queueing model with a floor represented by discrete cells. We contrived a logit-based choice algorithm for agents considering the numbers of agents and the distances to all service windows. Simulations were conducted with various parameters of agent choice preference for these two elements and for different floor configurations, including the floor length and the number of service windows. We investigated the model from the viewpoint of transit times and entrance block rates. The influences of the parameters on these factors were surveyed in detail and we determined that there are optimum floor lengths that minimize the transit times. In addition, we observed that the transit times were determined almost entirely by the entrance block rates. The results of the presented model are relevant to understanding queueing systems including the choice of service windows and can be employed to optimize facility design and floor management.

  14. Operational Space Weather Products at IPS

    NASA Astrophysics Data System (ADS)

    Neudegg, D.; Steward, G.; Marshall, R.; Terkildsen, M.; Kennewell, J.; Patterson, G.; Panwar, R.

    2008-12-01

    IPS Radio and Space Services operates an extensive network (IPSNET) of monitoring stations and observatories within the Australasian and Antarctic regions to gather information on the space environment. This includes ionosondes, magnetometers, GPS-ISM, oblique HF sounding, riometers, and solar radio and optical telescopes. IPS exchanges this information with similar organisations world-wide. The Regional Warning Centre (RWC) is the Australian Space Forecast Centre (ASFC) and it utilizes this data to provide products and services to support customer operations. A wide range of customers use IPS services including; defence force and emergency services using HF radio communications and surveillance systems, organisations involved in geophysical exploration and pipeline cathodic protection, GPS users in aviation. Subscriptions to the alerts, warnings, forecasts and reports regarding the solar, geophysical and ionospheric conditions are distributed by email and Special Message Service (SMS). IPS also develops and markets widely used PC software prediction tools for HF radio skywave and surface wave (ASAPS/GWPS) and provides consultancy services for system planning.

  15. Needs assessment under the Maternal and Child Health Services Block Grant: Massachusetts.

    PubMed

    Guyer, B; Schor, L; Messenger, K P; Prenney, B; Evans, F

    1984-09-01

    The Massachusetts maternal and child health (MCH) agency has developed a needs assessment process which includes four components: a statistical measure of need based on indirect, proxy health and social indicators; clinical standards for services to be provided; an advisory process which guides decision making and involves constituency groups; and a management system for implementing funds distribution, namely open competitive bidding in response to a Request for Proposals. In Fiscal Years 1982 and 1983, the process was applied statewide in the distribution of primary prenatal (MIC) and pediatric (C&Y) care services and lead poisoning prevention projects. Both processes resulted in clearer definitions of services to be provided under contract to the state as well as redistribution of funds to serve localities that had previously received no resources. Although the needs assessment process does not provide a direct measure of unmet need in a complex system of private and public services, it can be used to advocate for increased MCH funding and guide the distribution of new MCH service dollars.

  16. GlobVolcano: Earth Observation Services for Global Monitroing of Active Volcanoes

    NASA Astrophysics Data System (ADS)

    Borgstrom, S.; Bianchi, M.; Bronson, W.; Tampellini, M. L.; Ratti, R.; Seifert, F. M.; Komorowski, J. C.; Kaminski, E.; Peltier, A.; Van der Voet, P.

    2010-03-01

    The GlobVolcano project (2007-2010) is part of the Data User Element (DUE) programme of the European Space Agency (ESA).The objective of the project is to demonstrate EO-based (Earth Observation) services able to support the Volcano Observatories and other mandate users (Civil Protection, volcano scientific community) in their monitoring activities.The set of offered EO based information products is the following:- Deformation Mapping- Surface Thermal Anomalies- Volcanic Gas Emission- Volcanic Ash TrackingThe Deformation Mapping service is performed exploiting either PSInSARTM or Conventional DInSAR (EarthView® InSAR). The processing approach is selected according to the availability of SAR data and users' requests.The information services are assessed in close cooperation with the user organizations for different types of volcano, from various geographical areas in various climatic zones. Users are directly and actively involved in the validation of the Earth Observation products, by comparing them with ground data available at each site.In a first phase, the GlobVolcano Information System was designed, implemented and validated, involving a limited number of test areas and respective user organizations (Colima in Mexico, Merapi in Indonesia, Soufrière Hills in Montserrat Island, Piton de la Fournaise in La Reunion Island, Karthala in Comore Islands, Stromboli and Volcano in Italy). In particular Deformation Mapping results obtained for Piton de la Fournaise were compared with deformation rates measured by the volcano observatory using GPS stations and tiltmeters. IPGP (Institut de Physique du Globe de Paris) is responsible for the validation activities.The second phase of the project (currently on-going) concerns the service provision on pre-operational basis. Fifteen volcanic sites located in four continents are monitored and as many user organizations are involved and cooperating with the project team.In addition to the proprietary tools mentioned before, in phase two also the ROI_PAC software will be testsed for PALSAR processing on the Arenal volcano (Costa Rica).The GlobVolcano Information System includes two main elements:-The GlobVolcano Data Processing System, which consists of EO data processing subsystems located at each respective service centre.-The GlobVolcano Information Service, which is the provision infrastructure, including three elements: GlobV olcano Products Archives, GlobVolcano Metadata Catalogue, GlobVolcano User Interface (GVUI). The GlobVolcano Information System represents a significant step ahead towards the implementation of an operational, global observatory of volcanoes by a synergetic use of data from currently available Earth Observational satellites.

  17. Relationship and Involvement of the State Library Agencies with the National Program Proposed by NCLIS. Related Paper No. 1.

    ERIC Educational Resources Information Center

    Trezza, Alphonse F.

    Each of the 50 states has created a state library agency to administer state and federal library programs. Since the 1960's state library agencies have been involved in bibliographical systems and networks. In the 1970's these agencies completed long-range plans to meet each state's library service needs. Because of this experience, the state…

  18. 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.

  19. ESTRACK Support for CCSDS Space Communication Cross Support Service Management

    NASA Astrophysics Data System (ADS)

    Dreihahn, H.; Unal, M.; Hoffmann, A.

    2011-08-01

    The CCSDS Recommended Standard for Space Communication Cross Support Service Management (SCCS SM) published as Blue Book in August 2009 is intended to provide standardised interfaces to negotiate, schedule, and manage the support of space missions by ground station network operators. ESA as a member of CCSDS has actively supported the development of the SCCS SM standard and is obviously interested in adopting it. Support of SCCS SM conforming interfaces and procedures includes:• Provision of SCCS SM conforming interfaces to non ESA missions;• Use of SCCS SM interfaces provided by other ground station operators to manage cross support of ESA missions;• In longer terms potentially use of SCCS SM interfaces and procedures also internally for support of ESA missions by ESTRACK.In the recent years ESOC has automated management and scheduling of ESA Tracking Network (ESTRACK) services by the specification, development, and deployment of the ESTRACK Management System (EMS), more specifically its planning and scheduling components ESTRACK Planning System and ESTRACK Scheduling System. While full support of the SCCS SM standard will involve also other elements of the ground segment operated by ESOC such as the Flight Dynamic System, EMS is at the core of service management and it is therefore appropriate to initially focus on the question to what extent EMS can support SCCS SM. This paper presents results of the initial analysis phase. After briefly presenting the SCCS SM standard and the relevant components of the ESTRACK management system, we will discuss the initial deployment options, open issues and a tentative roadmap for the way to proceed. Obviously the adoption of a cross support standard requires and discussion and coordination of the involved parties and agencies, especially in the light of the fact that the SCCS SM standard has many optional parts.

  20. Cloud-based hospital information system as a service for grassroots healthcare institutions.

    PubMed

    Yao, Qin; Han, Xiong; Ma, Xi-Kun; Xue, Yi-Feng; Chen, Yi-Jun; Li, Jing-Song

    2014-09-01

    Grassroots healthcare institutions (GHIs) are the smallest administrative levels of medical institutions, where most patients access health services. The latest report from the National Bureau of Statistics of China showed that 96.04 % of 950,297 medical institutions in China were at the grassroots level in 2012, including county-level hospitals, township central hospitals, community health service centers, and rural clinics. In developing countries, these institutions are facing challenges involving a shortage of funds and talent, inconsistent medical standards, inefficient information sharing, and difficulties in management during the adoption of health information technologies (HIT). Because of the necessity and gravity for GHIs, our aim is to provide hospital information services for GHIs using Cloud computing technologies and service modes. In this medical scenario, the computing resources are pooled by means of a Cloud-based Virtual Desktop Infrastructure (VDI) to serve multiple GHIs, with different hospital information systems dynamically assigned and reassigned according to demand. This paper is concerned with establishing a Cloud-based Hospital Information Service Center to provide hospital information software as a service (HI-SaaS) with the aim of providing GHIs with an attractive and high-performance medical information service. Compared with individually establishing all hospital information systems, this approach is more cost-effective and affordable for GHIs and does not compromise HIT performance.

  1. Labour and Hospitals in Urban Yorkshire: Middlesbrough, Leeds and Sheffield, 1919–1938

    PubMed Central

    Doyle, Barry

    2010-01-01

    In the debates over the politics of National Health Service foundation, there has been little investigation of the attitudes of the inter-war labour movement to a state-run hospital system. In particular, there has been limited assessment of views outside parliament in provincial Labour parties and trade unions. Drawing on a case study of Middlesbrough, Leeds and Sheffield, this article examines the politics of hospital provision prior to the National Health Service (NHS). It focuses on the involvement of the labour movement in hospital provision within localities and on the extent to which the dominant form of labour politics—labourist or socialist—shaped hospital policy. It suggests that, in the heavy industrial towns of Middlesbrough and Sheffield, close involvement with voluntary hospitals through workers contributory schemes dampened the enthusiasm for a state system. However, such a policy was heavily promoted by socialists in more economically diverse Leeds.

  2. The work of commissioning: a multisite case study of healthcare commissioning in England's NHS

    PubMed Central

    Shaw, Sara E; Smith, Judith A; Porter, Alison; Rosen, Rebecca; Mays, Nicholas

    2013-01-01

    Objective To examine the work of commissioning care for people with long-term conditions and the factors inhibiting or facilitating commissioners making service change. Design Multisite mixed methods case study research, combining qualitative analysis of interviews, documents and observation of meetings. Participants Primary care trust managers and clinicians, general practice-based commissioners, National Health Service trust and foundation trust senior managers and clinicians, voluntary sector and local government representatives. Setting Three ‘commissioning communities’ (areas covered by a primary care trust) in England, 2010–2012. Results Commissioning services for people with long-term conditions was a long drawn-out process involving a range of activities and partners. Only some of the activities undertaken by commissioners, such as assessment of local health needs, coordination of healthcare planning and service specification, appeared in the official ‘commissioning cycle’ promoted by the Department of Health. Commissioners undertook a significant range of additional activities focused on reviewing and redesigning services and providing support for implementation of new services. These activities often involved partnership working with providers and other stakeholders and appeared to be largely divorced from contracting and financial negotiations. At least for long-term condition services, the time and effort involved in such work appeared to be disproportionate to the anticipated or likely service gains. Commissioners adopting an incremental approach to service change in defined and manageable areas of work appeared to be more successful in terms of delivering planned changes in service delivery than those attempting to bring about wide-scale change across complex systems. Conclusions Commissioning for long-term condition services challenges the conventional distinction between commissioners and providers with a significant amount of work focused on redesigning services in partnership with providers. Such work is labour-intensive and potentially unsustainable at a time of reduced finances. New clinical commissioning groups will need to determine how best to balance the relational and transactional elements of commissioning. PMID:24014483

  3. How do consumer leaders co-create value in mental health organisations?

    PubMed

    Scholz, Brett; Bocking, Julia; Happell, Brenda

    2017-10-01

    Objectives Contemporary mental health policies call for consumers to be involved in decision-making processes within mental health organisations. Some organisations have embraced leadership roles for consumers, but research suggests consumers remain disempowered within mental health services. Drawing on a service-dominant logic, which emphasises the co-creation of value of services, the present study provides an overview of consumer leadership within mental health organisations in the Australian Capital Territory. Methods Mental health organisations subscribing to the local peak body mailing list were invited to complete a survey about consumer leadership. Survey data were summarised using descriptive statistics and interpreted through the lens of service-dominant logic. Results Ways in which organisations may create opportunities for consumers to co-create value within their mental health services included soliciting feedback, involving consumer leaders in service design, having consumer leaders involved in hiring decisions and employing consumer leaders as staff or on boards. Strategies that organisations used to develop consumer leaders included induction, workshops and training in a variety of organisational processes and skills. Conclusions The findings of the present study extend the application of a service-dominant logic framework to consumer leadership within mental health organisations through consideration of the diverse opportunities that organisations can provide for consumer co-creation of service offerings. What is known about the topic? Policy calls for consumer involvement in all levels of mental health service planning, implementation and delivery. The extent to which service organisations have included consumer leaders varies, but research suggests that this inclusion can be tokenistic or that organisations choose to work with consumers who are less likely to challenge the status quo. Service literature has explored the way consumers can co-create value of their own health care, but is yet to explore consumers' co-creation of value at a systemic level. What does the paper add? This paper outlines ways in which mental health organisations report involving consumers in leadership positions, including having consumers on boards, having consumers on recruitment panels and providing leadership training for consumers. These initiatives are considered in terms of the potential value co-created within mental health services by consumers in leadership, suggesting that consumer leaders are a resource to mental health organisations in terms of the value brought to service offerings. What are the implications for practitioners? Research suggests that medical professionals have been resistant to increased consumer leadership within mental health services. The findings of the present study emphasise the value that can be brought to service organisations by consumer leaders, suggesting that mental health practitioners may reconsider their approach and attitudes towards consumer leadership in the sector.

  4. Commissary Services: AFSC 612XX and Civilian Equivalent

    DTIC Science & Technology

    1992-02-01

    Customer Service, Wee-Serve Operations, Storeworker, Com- missary Operation Management , and System Verification. Because of this wide dispersion across the...PERSONNEL 86% 0 0 0 STOREWORKER 0 7% 5% 0 QUALITY ASSURANCE EVALUATORS 0 * * 0 TRAINING MANAGEMENT 0 * 2% COMMISSARY OPERATION MANAGEMENT 0 7% 46% 68% WEE...skill level members work in the Commissary Operation Management job, while smaller percentages work in the Senior Management job. Continued involvement of

  5. Exploring Unsubstantiated Reports by Educational Personnel of Suspected Child Abuse and Neglect in New York State Using Geographic Information System Technology: Is There a Disproportionate Impact on African American Children?

    ERIC Educational Resources Information Center

    Krase, Kathryn S.

    2009-01-01

    "Educational personnel" serve as an important conduit for family involvement in child protective services (CPS). Educational personnel are the largest source of reports of suspected child maltreatment in the United States (United States Department of Health and Human Services, 2007). However, reports made by educational personnel are…

  6. Examining the association between suicidal behaviors and referral for mental health services among children involved in the child welfare system in Ontario, Canada.

    PubMed

    Baiden, Philip; Fallon, Barbara

    2018-05-01

    Although various studies have investigated factors associated with mental health service utilization, few studies have examined factors associated with referral for mental health services among maltreated children. The objective of this study was to examine the association between suicidal thoughts and self-harming behavior and referral for mental health services among children involved in the Child Welfare System in Ontario, Canada. Data for this study were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. An estimate 57,798 child maltreatment investigations was analyzed using binary logistic regression with referral for mental health service as the outcome variable. Of the 57,798 cases, 4709 (8.1%), were referred for mental health services. More than seven out of ten maltreated children who engaged in self-harming behavior and two out of three maltreated children who expressed suicidal thoughts were not referred for mental health services. In the multivariate logistic regression model, children who expressed suicidal thoughts had 2.39 times higher odds of being referred for mental health services compared to children with no suicidal thoughts (AOR = 2.39, 99% C.I. 2.05-2.77) and children who engaged in self-harming behavior had 1.44 times higher odds of being referred for mental health services compared to children who did not engage in self-harming behavior (AOR = 1.44, 99% C.I. 1.24-1.67), both after controlling for child demographic characteristics, maltreatment characteristics, and child functioning concerns. Given that referral is the initial step towards mental health service utilization, it is important that child welfare workers receive the necessary training so as to carefully assess and refer children in care who expressed suicidal thoughts or engaged in self-harming behavior for appropriate mental health services. The paper discusses the results and their implications for child welfare policy and practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Strengthening mental health systems in low- and middle-income countries: the Emerald programme.

    PubMed

    Semrau, Maya; Evans-Lacko, Sara; Alem, Atalay; Ayuso-Mateos, Jose Luis; Chisholm, Dan; Gureje, Oye; Hanlon, Charlotte; Jordans, Mark; Kigozi, Fred; Lempp, Heidi; Lund, Crick; Petersen, Inge; Shidhaye, Rahul; Thornicroft, Graham

    2015-04-10

    There is a large treatment gap for mental health care in low- and middle-income countries (LMICs), with the majority of people with mental, neurological, and substance use (MNS) disorders receiving no or inadequate care. Health system factors are known to play a crucial role in determining the coverage and effectiveness of health service interventions, but the study of mental health systems in LMICs has been neglected. The 'Emerging mental health systems in LMICs' (Emerald) programme aims to improve outcomes of people with MNS disorders in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda) by generating evidence and capacity to enhance health system performance in delivering mental health care. A mixed-methods approach is being applied to generate evidence on: adequate, fair, and sustainable resourcing for mental health (health system inputs); integrated provision of mental health services (health system processes); and improved coverage and goal attainment in mental health (health system outputs). Emerald has a strong focus on capacity-building of researchers, policymakers, and planners, and on increasing service user and caregiver involvement to support mental health systems strengthening. Emerald also addresses stigma and discrimination as one of the key barriers for access to and successful delivery of mental health services.

  8. Business Model Evaluation for an Advanced Multimedia Service Portfolio

    NASA Astrophysics Data System (ADS)

    Pisciella, Paolo; Zoric, Josip; Gaivoronski, Alexei A.

    In this paper we analyze quantitatively a business model for the collaborative provision of an advanced mobile data service portfolio composed of three multimedia services: Video on Demand, Internet Protocol Television and User Generated Content. We provide a description of the provision system considering the relation occurring between tecnical aspects and business aspects for each agent providing the basic multimedia service. Such a techno-business analysis is then projected into a mathematical model dealing with the problem of the definition of incentives between the different agents involved in a collaborative service provision. Through the implementation of this model we aim at shaping the behaviour of each of the contributing agents modifying the level of profitability that the Service Portfolio yields to each of them.

  9. Service Usage Typologies in a Clinical Sample of Trauma-Exposed Adolescents: A Latent Class Analysis.

    PubMed

    Choi, Kristen R; Briggs, Ernestine C; Seng, Julia S; Graham-Bermann, Sandra A; Munro-Kramer, Michelle L; Ford, Julian D

    2017-11-27

    The purpose of this study is to describe typologies of service utilization among trauma-exposed, treatment-seeking adolescents and to examine associations between trauma history, trauma-related symptoms, demographics, and service utilization. Latent class analysis was used to derive a service utilization typologies based on 10 service variables using a sample of 3,081 trauma-exposed adolescents ages 12 to 16 from the National Child Traumatic Stress Network Core Dataset. Services used 30 days prior to the initial assessment from 5 sectors were examined (health care, mental health, school, social services, and juvenile justice). A 5-class model was selected based on statistical fit indices and substantive evaluation of classes: (a) High intensity/multisystem, 9.5%; (b) Justice-involved, 7.2%; (c) Low intensity/multisystem, 19.9%; (d) Social service and mental health, 19.9%; and (e) Low service usage/reference, 43.5%. The classes could be differentiated based on cumulative trauma, maltreatment history, PTSD, externalizing and internalizing symptoms, and age, gender, race/ethnicity and place of residence. This study provides new evidence about patterns of service utilization by trauma exposed, treatment seeking adolescents. Most of these adolescents appear to be involved with at least 2 service systems prior to seeking trauma treatment. Higher cumulative exposure to multiple types of trauma was associated with greater service utilization intensity and complexity, but trauma symptomatology was not. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Security and privacy issues of personal health.

    PubMed

    Blobel, Bernd; Pharow, Peter

    2007-01-01

    While health systems in developed countries and increasingly also in developing countries are moving from organisation-centred to person-centred health service delivery, the supporting communication and information technology is faced with new risks regarding security and privacy of stakeholders involved. The comprehensively distributed environment puts special burden on guaranteeing communication security services, but even more on guaranteeing application security services dealing with privilege management, access control and audit regarding social implication and connected sensitivity of personal information recorded, processed, communicated and stored in an even internationally distributed environment.

  11. Volunteers in Specialist Palliative Care: A Survey of Adult Services in the United Kingdom

    PubMed Central

    Burbeck, Rachel; Low, Joe; Sampson, Elizabeth L.; Bravery, Ruth; Hill, Matthew; Morris, Sara; Ockenden, Nick; Payne, Sheila

    2014-01-01

    Abstract Background: Worldwide, the demand for specialist palliative care is increasing but funding is limited. The role of volunteers is underresearched, although their contribution reduces costs significantly. Understanding what volunteers do is vital to ensure services develop appropriately to meet the challenges faced by providers of palliative care. Objective: The study's objective is to describe current involvement of volunteers with direct patient/family contact in U.K. specialist palliative care. Design: An online survey was sent to 290 U.K. adult hospices and specialist palliative care services involving volunteers covering service characteristics, involvement and numbers of volunteers, settings in which they are involved, extent of involvement in care services, specific activities undertaken in each setting, and use of professional skills. Results: The survey had a 67% response rate. Volunteers were most commonly involved in day care and bereavement services. They entirely ran some complementary therapy, beauty therapy/hairdressing, and pastoral/faith-based care services, and were involved in a wide range of activities, including sitting with dying patients. Conclusions: This comprehensive survey of volunteer activity in U.K. specialist palliative care provides an up-to-date picture of volunteer involvement in direct contact with patients and their families, such as providing emotional care, and the extent of their involvement in day and bereavement services. Further research could focus on exploring their involvement in bereavement care. PMID:24475743

  12. Customer focus in breast cancer screening services.

    PubMed

    Buttimer, Andreas

    2009-01-01

    The purpose of the paper is to demonstrate how a generic value chain and customer focused system as demonstrated by the Scottish and Irish breast screening programmes can be used to provide a high quality health service. Literature relevant to aligning the entire operating model--the companies' culture, business processes, management systems to serve one value discipline, i.e. customer intimacy, is reviewed and considered in the context of the NHS Scottish Breast Screening Programme in Edinburgh and BreastCheck--the National Breast Screening Programme in Ireland. This paper demonstrates how an emphasis on customer focus and operational excellence, as used in other service industries, can help to provide a better health service. It uses the Scottish and Irish breast screening programmes as illustrative examples. The paper applies the key requirements in the delivery of a quality service including an understanding of the characteristics of a service industry, the management of discontinuities involved in its delivery and the environment in which it operates. System failure is commonly the cause of quality failure in the health system. Breast screening programmes are designed to prevent such a failure. This paper promotes and describes the use of the generic value chain by using the knowledge gained in delivering a mammography-screening programme.

  13. Promoting occupational health interventions in early return to work by implementing financial subsidies: a Swedish case study

    PubMed Central

    2013-01-01

    Background In 2010, the Swedish government introduced a system of subsidies for occupational health (OH) service interventions, as a part in a general policy promoting early return to work. The aim of this study was to analyse the implementation of these subsidies, regarding how they were used and perceived. Methods The study was carried out using a mixed-methods approach, and comprises material from six sub-studies: a register study of the use of the subsidies, one survey to OH service providers, one survey to employers, one document analysis of the documentation from interventions, interviews with stakeholders, and case interviews with actors involved in coordinated interventions. Results The subsidized services were generally perceived as positive but were modestly used. The most extensive subsidy – for coordinated interventions – was rarely used. Employers and OH service providers reported few or no effects on services and contracts. OH service providers explained the modest use in terms of already having less bureaucratic routines in place, where applying for subsidies would involve additional costs. Information about the subsidies was primarily communicated to OH service providers, while employers were not informed. Conclusions The study highlights the complexity of promoting interventions through financial incentives, since their implementation requires that they are perceived by the stakeholders involved as purposeful, manageable and cost-effective. There are inherent political challenges in influencing stakeholders who act on a free market, in that the impact of policies may be limited, unless they are enforced by law. PMID:23566064

  14. A Review of Quality Assurance Methods to Assist Professional Record Keeping: Implications for Providers of Interpersonal Violence Treatment

    PubMed Central

    Bradshaw, Kelsey M.; Donohue, Brad; Wilks, Chelsey

    2014-01-01

    Errors have been found to frequently occur in the management of case records within mental health service systems. In cases involving interpersonal violence, such errors have been found to negatively impact service implementation and lead to significant trauma and fatalities. In an effort to ensure adherence to specified standards of care, quality assurance programs (QA) have been developed to monitor and enhance service implementation. These programs have generally been successful in facilitating record management. However, these systems are rarely disseminated, and not well integrated. Therefore, within the context of interpersonal violence, we provide an extensive review of evidence supported record keeping practices, and methods to assist in assuring these practices are implemented with adherence. PMID:24976786

  15. Prevalence of Different Combinations of Antiepileptic Drugs and CNS Drugs in Elderly Home Care Service and Nursing Home Patients in Norway.

    PubMed

    Halvorsen, Kjell H; Johannessen Landmark, Cecilie; Granas, Anne Gerd

    2016-01-01

    Introduction. Antiepileptic drugs (AEDs) are used to treat different conditions in elderly patients and are among the drug classes most susceptible to be involved in drug-drug interactions (DDI). The aim of the study was to describe and compare use of AEDs between home care service and nursing home patients, as these patients are not included in nationwide databases of drug utilization. In the combined population, we investigate DDI of AEDs with other central nervous system- (CNS-) active drugs and DDIs involving AEDs in general. Materials and Methods. Point-prevalence study of Norwegian patients in home care services and nursing homes in 2009. At the patient level, we screened for different DDIs involving AEDs. Results. In total, 882 patients (7.8%) of 11,254 patients used AEDs and number of users did not differ between home care services and nursing homes (8.2% versus 7.7%). In the combined population, we identified 436 potential DDIs in 45% of the patients. Conclusions. In a large population of elderly, home care service and nursing home patients do not differ with respect to exposure of AEDs but use more AEDs as compared to the general population of similar age. The risk of DDIs with AEDs and other CNS-active drugs should be taken into consideration and individual clinical evaluations are assessed in this population.

  16. User needs for propagation data

    NASA Technical Reports Server (NTRS)

    Sullivan, Thomas M.

    1993-01-01

    New and refined models of radio signal propagation phenomena are needed to support studies of evolving satellite services and systems. Taking an engineering perspective, applications for propagation measurements and models in the context of various types of analyses that are of ongoing interest are reviewed. Problems that were encountered in the signal propagation aspects of these analyses are reviewed, and potential solutions to these problems are discussed. The focus is on propagation measurements and models needed to support design and performance analyses of systems in the Mobile-Satellite Service (MSS) operating in the 1-3 GHz range. These systems may use geostationary or non-geostationary satellites and Frequency Division Multiple Access (FDMA), Time Division Multiple Access Digital (TDMA), or Code Division Multiple Access (CDMA) techniques. Many of the propagation issues raised in relation to MSS are also pertinent to other services such as broadcasting-satellite (sound) at 2310-2360 MHz. In particular, services involving mobile terminals or terminals with low gain antennas are of concern.

  17. An Extended Petri-Net Based Approach for Supply Chain Process Enactment in Resource-Centric Web Service Environment

    NASA Astrophysics Data System (ADS)

    Wang, Xiaodong; Zhang, Xiaoyu; Cai, Hongming; Xu, Boyi

    Enacting a supply-chain process involves variant partners and different IT systems. REST receives increasing attention for distributed systems with loosely coupled resources. Nevertheless, resource model incompatibilities and conflicts prevent effective process modeling and deployment in resource-centric Web service environment. In this paper, a Petri-net based framework for supply-chain process integration is proposed. A resource meta-model is constructed to represent the basic information of resources. Then based on resource meta-model, XML schemas and documents are derived, which represent resources and their states in Petri-net. Thereafter, XML-net, a high level Petri-net, is employed for modeling control and data flow of process. From process model in XML-net, RESTful services and choreography descriptions are deduced. Therefore, unified resource representation and RESTful services description are proposed for cross-system integration in a more effective way. A case study is given to illustrate the approach and the desirable features of the approach are discussed.

  18. Realizing the potential of the CUAHSI Water Data Center to advance Earth Science

    NASA Astrophysics Data System (ADS)

    Hooper, R. P.; Seul, M.; Pollak, J.; Couch, A.

    2015-12-01

    The CUAHSI Water Data Center has developed a cloud-based system for data publication, discovery and access. Key features of this system are a semantically enabled catalog to discover data across more than 100 different services and delivery of data and metadata in a standard format. While this represents a significant technical achievement, the purpose of this system is to support data reanalysis for advancing science. A new web-based client, HydroClient, improves access to the data from previous clients. This client is envisioned as the first step in a workflow that can involve visualization and analysis using web-processing services, followed by download to local computers for further analysis. The release of the WaterML library in the R package CRAN repository is an initial attempt at linking the WDC services in a larger analysis workflow. We are seeking community input on other resources required to make the WDC services more valuable in scientific research and education.

  19. Improving public health information: a data quality intervention in KwaZulu-Natal, South Africa.

    PubMed

    Mphatswe, W; Mate, K S; Bennett, B; Ngidi, H; Reddy, J; Barker, P M; Rollins, N

    2012-03-01

    To evaluate the effect of an intervention to improve the quality of data used to monitor the prevention of mother-to-child transmission (PMTCT) of the human immunodeficiency virus in South Africa. The study involved 58 antenatal clinics and 20 delivery wards (37 urban, 21 rural and 20 semi-urban) in KwaZulu-Natal province that provided PMTCT services and reported data to the District Health Information System. The data improvement intervention, which was implemented between May 2008 and March 2009, involved training on data collection and feedback for health information personnel and programme managers, monthly data reviews and data audits at health-care facilities. Data on six data elements used to monitor PMTCT services and recorded in the information system were compared with source data from health facility registers before, during and after the intervention. Data completeness (i.e. their presence in the system) and accuracy (i.e. being within 10% of their true value) were evaluated. The level of data completeness increased from 26% before to 64% after the intervention. Similarly, the proportion of data in the information system considered accurate increased from 37% to 65% (P < 0.0001). Moreover, the correlation between data in the information system and those from facility registers rose from 0.54 to 0.92. A simple, practical data improvement intervention significantly increased the completeness and accuracy of the data used to monitor PMTCT services in South Africa.

  20. Cognitive remediation in large systems of psychiatric care.

    PubMed

    Medalia, Alice; Saperstein, Alice M; Erlich, Matthew D; Sederer, Lloyd I

    2018-05-02

    IntroductionWith the increasing enthusiasm to provide cognitive remediation (CR) as an evidence-based practice, questions arise as to what is involved in implementing CR in a large system of care. This article describes the first statewide implementation of CR in the USA, with the goal of documenting the implementation issues that care providers are likely to face when bringing CR services to their patients. In 2014, the New York State Office of Mental Health set up a Cognitive Health Service that could be implemented throughout the state-operated system of care. This service was intended to broadly address cognitive health, to assure that the cognitive deficits commonly associated with psychiatric illnesses are recognized and addressed, and that cognitive health is embedded in the vocabulary of wellness. It involved creating a mechanism to train staff to recognize how cognitive health could be prioritized in treatment planning as well as implementing CR in state-operated adult outpatient psychiatry clinics. By 2017, CR was available at clinics serving people with serious mental illness in 13 of 16 adult Psychiatric Centers, located in rural and urban settings throughout New York state. The embedded quality assurance program evaluation tools indicated that CR was acceptable, sustainable, and effective. Cognitive remediation can be feasibly implemented in large systems of care that provide a multilevel system of supports, a training program that educates broadly about cognitive health and specifically about the delivery of CR, and embedded, ongoing program evaluation that is linked to staff supervision.

  1. Effectiveness of service linkages in primary mental health care: a narrative review part 1

    PubMed Central

    2011-01-01

    Background With the move to community care and increased involvement of generalist health care providers in mental health, the need for health service partnerships has been emphasised in mental health policy. Within existing health system structures the active strategies that facilitate effective partnership linkages are not clear. The objective of this study was to examine the evidence from peer reviewed literature regarding the effectiveness of service linkages in primary mental health care. Methods A narrative and thematic review of English language papers published between 1998 and 2009. Studies of analytic, descriptive and qualitative designs from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted to examine what service linkages have been used in studies of collaboration in primary mental health care. Findings from the randomised trials were tabulated to show the proportion that demonstrated clinical, service delivery and economic benefits. Results A review of 119 studies found ten linkage types. Most studies used a combination of linkage types and so the 42 RCTs were grouped into four broad linkage categories for meaningful descriptive analysis of outcomes. Studies that used multiple linkage strategies from the suite of "direct collaborative activities" plus "agreed guidelines" plus "communication systems" showed positive clinical (81%), service (78%) and economic (75%) outcomes. Most evidence of effectiveness came from studies of depression. Long term benefits were attributed to medication concordance and the use of case managers with a professional background who received expert supervision. There were fewer randomised trials related to collaborative care of people with psychosis and there were almost none related to collaboration with the wider human service sectors. Because of the variability of study types we did not exclude on quality or attempt to weight findings according to power or effect size. Conclusion There is strong evidence to support collaborative primary mental health care for people with depression when linkages involve "direct collaborative activity", plus "agreed guidelines" and "communication systems". PMID:21481236

  2. Subjective experience or objective process: understanding the gap between values and practice for involving patients in designing patient-centred care.

    PubMed

    Lord, Laura; Gale, Nicola

    2014-01-01

    Patient-centred care and patient involvement are increasingly central concepts in health policy in the UK and elsewhere. However, there is little consensus regarding their definition or how to achieve "patient-centred" care in everyday practice or how to involve patients in service redesign initiatives. The purpose of this paper is to explore these issues from the perspective of key stakeholders within National Health Service (NHS) hospitals in the UK. Semi-structured interviews, covering a range of topics related to service redesign, were conducted with 77 key stakeholders across three NHS Trusts in the West Midlands. In total, 20 of these stakeholders were re-interviewed 18 months later. Data were managed and analysed using the Framework Method. While patient-centred care and patient involvement were regularly cited as important to the stakeholders, a gap persisted between values and reported practice. This gap is explained through close examination of the ways in which the concepts were used by stakeholders, and identifying the way in which they were adapted to fit other organizational priorities. The value placed on positive subjective experience changed to concerns about objective measurement of the patients as they move through the system. Increased awareness and reflection on the conceptual tensions between objective processes and subjective experiences could highlight reasons why patient-centred values fail to translate into improved practice. The paper describes and explains a previously unarticulated tension in health organisations between values and practice in patient centred care and patient involvement in service redesign.

  3. “The Chain Has to Be Broken”: A Qualitative Investigation of the Experiences of Young Women Following Juvenile Court Involvement

    PubMed Central

    Bright, Charlotte Lyn; Ward, Sara K.; Negi, Nalini Junko

    2012-01-01

    Whereas the number of girls involved in the juvenile justice system is on the rise, little is known about female juvenile offenders after they reach adulthood. This study aims to explore the meaning that young adult women ascribe to their juvenile court experiences and assess their perceptions of facilitators and barriers to progress in their adult lives. Data on services and support are presented from nine semistructured interviews. Findings include the commonality of mental health issues, substance abuse, and problematic relationships with intimate partners. Implications for service provision and policy, as well as future research directions, are outlined. PMID:29710878

  4. Future trends in commercial and military systems

    NASA Astrophysics Data System (ADS)

    Bond, F. E.

    Commercial and military satellite communication systems are addressed, with a review of current applications and typical communication characteristics of the space and earth segments. Drivers for the development of future commercial systems include: the pervasion of digital techniques and services, growing orbit and frequency congestion, demand for more entertainment, and the large potential market for commercial 'roof-top' service. For military systems, survivability, improved flexibility, and the need for service to small mobile terminals are the principal factors involved. Technical trends include the use of higher frequency bands, multibeam antennas and a significant increase in the application of onboard processing. Military systems will employ a variety of techniques to counter both physical and electronic threats. The use of redundant transmission paths is a particularly effective approach. Successful implementation requires transmission standards to achieve the required interoperability among the pertinent networks. For both the military and commercial sectors, the trend toward larger numbers of terminals and more complex spacecraft is still persisting.

  5. Examining Child Welfare Decisions and Services for Asian-Canadian Versus White-Canadian Children and Families in the Child Welfare System.

    PubMed

    Lee, Barbara; Fuller-Thomson, Esme; Fallon, Barbara; Black, Tara; Trocmé, Nico

    2017-05-01

    Using administrative child welfare data from the Ontario Child Abuse and Neglect Data System (OCANDS), this study compared the profiles of Asian-Canadian and White-Canadian children and families that experienced a case closure after an investigation instead of being transferred to ongoing child protection services (CPS). Child protection investigations involving Asian-Canadian and White-Canadian children and families that were transferred to ongoing CPS presented a different profile of case characteristics and caregiver and child clinical needs. Asian-Canadian children and families received ongoing CPS for over a month longer than White-Canadian children and families and were less likely (odds ratio [ OR] = 0.39) to be reinvestigated for any form of maltreatment-related concerns within 1 year after case closure. It appears that child protection investigations involving Asian-Canadian children and families are less likely to be closed prematurely than White-Canadian children and families, and the child protection system may be meeting the needs of Asian-Canadian communities. Alternatively, it is possible there is unaccounted biases that may be reflective of systemic problem of discriminative practices in the child protection system. Further research is needed to explore this phenomenon.

  6. Pathologists' roles in clinical utilization management. A financing model for managed care.

    PubMed

    Zhao, J J; Liberman, A

    2000-03-01

    In ancillary or laboratory utilization management, the roles of pathologists have not been explored fully in managed care systems. Two possible reasons may account for this: pathologists' potential contributions have not been defined clearly, and effective measurement of and reasonable compensation for the pathologist's contribution remains vague. The responsibilities of pathologists in clinical practice may include clinical pathology and laboratory services (which have long been well-defined and are compensated according to a resource-based relative value system-based coding system), laboratory administration, clinical utilization management, and clinical research. Although laboratory administration services have been compensated with mechanisms such as percentage of total service revenue or fixed salary, the involvement of pathologists seems less today than in the past, owing to increased clinical workload and time constraints in an expanding managed care environment, especially in community hospital settings. The lack of financial incentives or appropriate compensation mechanisms for the services likely accounts for the current situation. Furthermore, the importance of pathologist-driven utilization management in laboratory services lacks recognition among hospital administrators, managed care executives, and pathologists themselves, despite its potential benefits for reducing cost and enhancing quality of care. We propose a financial compensation model for such services and summarize its advantages.

  7. Resilience in young children involved with child protective services.

    PubMed

    Sattler, Kierra M P; Font, Sarah A

    2018-01-01

    Child maltreatment increases the risk of poor developmental outcomes. However, some children display resilience, meaning they are high-functioning despite their adverse experiences. To date, few research studies have examined protective factors among very young maltreated children. Yet, domains of resilience, and the protective factors that promote resilience among maltreated children, are likely to differ by developmental stage. Drawing on ecological systems theory and life course theory, we examined how protective factors at multiple ecological levels across early childhood were related to social and cognitive resilience among very young children involved with child protective services. The results demonstrated that the buffering effects of protective factors varied by social or cognitive resilience and the cumulative effects of protective factors were more consistently related to later resilience than protective factors at specific time points. In addition, the influence of specific protective factors on resilience slightly varied by initial in-home or out-of-home placement. These findings have important policy and research implications for promoting optimal development among children involved in child protective services. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Supporting the need for an integrated system of care for youth with co-occurring traumatic stress and substance abuse problems.

    PubMed

    Suarez, Liza M; Belcher, Harolyn M E; Briggs, Ernestine C; Titus, Janet C

    2012-06-01

    Adolescents are at high risk for violence exposure and initiation of drug use. Co-occurring substance use and trauma exposure are associated with increased risk of mental health disorders, school underachievement, and involvement with multiple systems of care. Coordination and integration of systems of care are of utmost importance for these vulnerable youth. This study delineates the negative sequelae and increased service utilization patterns of adolescents with a history of trauma, substance abuse, and co-occurring trauma and substance abuse to support the need for integrated mental health and substance abuse services for youth. Data from two national sources, the National Child Traumatic Stress Network and Center for Substance Abuse Treatment demonstrate the increased clinical severity (measured by reports of emotional and behavioral problems), dysfunction, and service utilization patterns for youth with co-occurring trauma exposure and substance abuse. We conclude with recommendations for an integrated system of care that includes trauma-informed mental health treatment and substance abuse services aimed at reducing the morbidity and relapse probability of this high-risk group.

  9. Exploring barriers to primary care for migrants in Greece in times of austerity: Perspectives of service providers.

    PubMed

    Papadakaki, Maria; Lionis, Christos; Saridaki, Aristoula; Dowrick, Christopher; de Brún, Tomas; O'Reilly-de Brún, Mary; O'Donnell, Catherine A; Burns, Nicola; van Weel-Baumgarten, Evelyn; van den Muijsenbergh, Maria; Spiegel, Wolfgang; MacFarlane, Anne

    2017-12-01

    Migration in Europe is increasing at an unprecedented rate. There is an urgent need to develop 'migrant-sensitive healthcare systems'. However, there are many barriers to healthcare for migrants. Despite Greece's recent, significant experiences of inward migration during a period of economic austerity, little is known about Greek primary care service providers' experiences of delivering care to migrants. To identify service providers' views on the barriers to migrant healthcare. Qualitative study involving six participatory learning and action (PLA) focus group sessions with nine service providers. Data generation was informed by normalization process theory (NPT). Thematic analysis was applied to identify barriers to efficient migrant healthcare. Three main provider and system-related barriers emerged: (a) emphasis on major challenges in healthcare provision, (b) low perceived control and effectiveness to support migrant healthcare, and (c) attention to impoverished local population. The study identified major provider and system-related barriers in the provision of primary healthcare to migrants. It is important for the healthcare system in Greece to provide appropriate supports for communication in cross-cultural consultations for its diversifying population.

  10. [Supply services at health facilities: measuring performance].

    PubMed

    Dacosta Claro, I

    2001-01-01

    Performance measurement, in their different meanings--either balance scorecard or outputs measurement--have become an essential tool in today's organizations (World-Class organizations) to improve service quality and reduce costs. This paper presents a performance measurement system for the hospital supply chain. The system is organized in different levels and groups of indicators in order to show a hierarchical, coherent and integrated vision of the processes. Thus, supply services performance is measured according to (1) financial aspects, (2) customers satisfaction aspects and (3) internal aspects of the processes performed. Since the informational needs of the managers vary within the administrative structure, the performance measurement system is defined in three hierarchical levels. Firstly, the whole supply chain, with the different interrelation of activities. Secondly, the three main processes of the chain--physical management of products, purchasing and negotiation processes and the local storage units. And finally, the performance measurement of each activity involved. The system and the indicators have been evaluated with the participation of 17 health services of Quebec (Canada), however, and due to the similarities of the operation, could be equally implemented in Spanish hospitals.

  11. Extension Educators' Perceptions of Community Readiness, Knowledge of Prevention Science, and Experience with Collaboration

    PubMed Central

    Perkins, Daniel F.; Mincemoyer, Claudia C.; Lillehoj, Catherine J.

    2011-01-01

    This investigation compared Extension educators' perceptions of community readiness, knowledge of prevention science, and experience with community collaborations with the perceptions of community human service professionals. First, Cooperative Extension System (CES) educators and human service professionals were found to hold similar perceptions of community readiness for prevention programs. Second, CES educators demonstrated less awareness of prevention programs in the community, but a greater knowledge of research-based community risk and protective factors than the human service professionals. Third, CES educators and human service professionals were similar in terms of community collaborative involvement, success, and personal effectiveness. PMID:24143063

  12. Contrasting jail diversion and in-jail services for mental illness and substance abuse: do they serve the same clients?

    PubMed

    Draine, Jeffrey; Blank, Amy; Kottsieper, Petra; Solomon, Phyllis

    2005-01-01

    Baseline data from a study of jail diversion services and in-jail behavioral health services were used to examine the differences in clients served by these two models of responding to people with co-occurring mental health and substance abuse problems in the criminal justice system. Clients of the diversion service had more acute psychiatric symptoms and were more likely to have a diagnosis of psychosis NOS. Clients of the in-jail service were more likely to have been on probation or parole in the past and to have received substance abuse treatment. Different service models may attract and serve different populations of clients. Diversion services may cast a wider net that includes clients who may not have otherwise been involved in forensic services. Copyright (c) 2005 John Wiley & Sons, Ltd.

  13. Benefit-Cost Analysis of Integrated Paratransit Systems : Volume 1. Executive Summary.

    DOT National Transportation Integrated Search

    1979-09-01

    Integrated Paratransit (IP) is a concept which involves the integration of conventional fixed-route transit with flexibly routed paratransit services to provide the most effective area-wide transit coverage. The report estimates the benefits and cost...

  14. 41 CFR 102-118.385 - What must a waiver request include?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Prepayment Audits of Transportation Services Waivers from Mandatory Prepayment Audit... a prepayment audit increases costs over a postpayment audit, decreases efficiency, involves a...

  15. 48 CFR 370.302 - Types of assurances.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....302 Section 370.302 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES HHS SUPPLEMENTATIONS SPECIAL PROGRAMS AFFECTING ACQUISITION Acquisitions Involving Human Subjects 370.302 Types of...'s current “List of Registered Institutional Review Boards (IRBs)/Independent Ethics Committees (IECs...

  16. 48 CFR 370.302 - Types of assurances.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....302 Section 370.302 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES HHS SUPPLEMENTATIONS SPECIAL PROGRAMS AFFECTING ACQUISITION Acquisitions Involving Human Subjects 370.302 Types of...'s current “List of Registered Institutional Review Boards (IRBs)/Independent Ethics Committees (IECs...

  17. 48 CFR 370.302 - Types of assurances.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....302 Section 370.302 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES HHS SUPPLEMENTATIONS SPECIAL PROGRAMS AFFECTING ACQUISITION Acquisitions Involving Human Subjects 370.302 Types of...'s current “List of Registered Institutional Review Boards (IRBs)/Independent Ethics Committees (IECs...

  18. 48 CFR 370.302 - Types of assurances.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....302 Section 370.302 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES HHS SUPPLEMENTATIONS SPECIAL PROGRAMS AFFECTING ACQUISITION Acquisitions Involving Human Subjects 370.302 Types of...'s current “List of Registered Institutional Review Boards (IRBs)/Independent Ethics Committees (IECs...

  19. 48 CFR 370.302 - Types of assurances.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....302 Section 370.302 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES HHS SUPPLEMENTATIONS SPECIAL PROGRAMS AFFECTING ACQUISITION Acquisitions Involving Human Subjects 370.302 Types of...'s current “List of Registered Institutional Review Boards (IRBs)/Independent Ethics Committees (IECs...

  20. 7 CFR 1779.27 - Lenders.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... System institution with direct lending authority authorized to make loans of the type guaranteed by this... incidental to making and servicing guaranteed loans involving community development-type projects. Lenders.... (b) Conflict of interest. When the lender's officers, stockholders, directors, or partners (including...

  1. Counseling and Wellness Services Integrated with Primary Care: A Delivery System That Works

    PubMed Central

    Van Beek, Ken; Duchemin, Steve; Gersh, Geniene; Pettigrew, Susanne; Silva, Pamela; Luskin, Barb

    2008-01-01

    Introduction: The continuity and coordination of care between medical and behavioral health services is a major issue facing our health care delivery system. Barriers to basic communication between providers of medical services and providers of behavioral health services, include: no coordination of services, and poor recognition of the relationship between medical and behavioral issues. Methods: Colocating behavioral health counselors and nutritionists alongside primary care physicians and clinicians (PCPs). Results: Grand Valley Health Plan (GVHP) established the national benchmark for patients using ambulatory services for mental health, and ranked first in Michigan on all six HEDIS “effectiveness of care” measures for behavioral health. One result was a 54% decrease in mental health hospitalization. Discussion: Up to 70% of primary care visits are driven by psychosocial factors, with 25% of patients having a diagnosable mental disorder, and comorbidity occurring in up to 80%. With colocated services, PCPs now often explain to patients that “this is just how we deliver care to you,” when introducing health coaches to patients and asking them to be involved. PMID:21339917

  2. Parental Involvement in Speech Intervention: A National Survey

    ERIC Educational Resources Information Center

    Pappas, Nicole Watts; McLeod, Sharynne; McAllister, Lindy; McKinnon, David H.

    2008-01-01

    A survey of 277 speech language pathologists (SLPs) investigated beliefs and practice regarding parents' involvement in service planning and delivery for children with speech impairment. Although the SLPs frequently involved parents in service delivery for speech intervention, parental involvement in service planning was less frequent. SLPs…

  3. Involving Fathers in Psychological Services for Children

    ERIC Educational Resources Information Center

    Carr, Alan

    2006-01-01

    This paper is a commentary of the special series on involving fathers in psychological services for children. The following themes are addressed: the effects of fathers on child development; benefits of father involvement in child psychology services; obstacles to father involvement; engaging fathers; specific interventions for fathers; and…

  4. Pilot implementation of a technologically advanced system for the optimization of pre-hospital, trauma patient care.

    PubMed

    Vagianos, Constantine E; Dimopoulou, Efi; Tsiftsis, Dimitrios; Spyropoulos, Charalambos; Spyrakopoulos, Panagiotis; Vagenas, Konstantinos

    2010-07-01

    Cooperation between medical informatics, wireless communication and pre-hospital emergency services is essential for the optimal pre-hospital patient treatment. The use of technological innovations improves medical care in the pre-hospital setting with regard to the organization of an integrated center, which coordinates all parties involved for the patient's best interest. A dispatch center was developed in the city of Patras, in southwestern Greece, equipped with a Geographic Information System (GIS), which immediately points out the location of emergency vehicles (EVs) on a digital map depicting the city plan. Additionally, three ambulances of the National Center of Immediate Aid (NCIA) were equipped with a decentralized traffic management system for the vehicle's traffic priority at signaled junctions. The system consisted of a cellular-based (GSM) telemedicine module, a Global Positioning System (GPS) and a web camera system in the vehicle cabin. The aforementioned system provided considerable assistance to the pre-hospital treatment first by selecting the ambulance closest to the accident's location and then by pinpointing the optimum route to the hospital, thus significantly reducing the overall transportation time. The project's objective to coordinate emergency hospital departments involved in the treatment of trauma patients with other emergency services by utilizing high technology was achieved within this interdisciplinary effort.

  5. Evaluation of Contribution for Voltage Control Ancillary Services Based on Social Surplus

    NASA Astrophysics Data System (ADS)

    Ueki, Yuji; Hara, Ryoichi; Kita, Hiroyuki; Hasegawa, Jun

    Reactive power supply plays an important role in active power supply with adequate system voltages. Various pricing mechanism for reactive power supply have been developed and some of them are adopted in some power systems, however they are in a trial stage. The authors also focus on development of a pricing method for reactive power ancillary services. This problem involves two technical issues: rational estimation of the cost associated with reactive power supply and fair and transparent allocation of the estimated cost among the market participants. This paper proposes methods for evaluating the contribution of generators and demands.

  6. Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme – a systems approach

    PubMed Central

    2014-01-01

    Background Assuring equitable universal access to essential health services without exposure to undue financial hardship requires adequate resource mobilization, efficient use of resources, and attention to quality and responsiveness of services. The way providers are paid is a critical part of this process because it can create incentives and patterns of behaviour related to supply. The objective of this work was to describe provider behaviour related to supply of health services to insured clients in Ghana and the influence of provider payment methods on incentives and behaviour. Methods A mixed methods study involving grey and published literature reviews, as well as health management information system and primary data collection and analysis was used. Primary data collection involved in-depth interviews, observations of time spent obtaining service, prescription analysis, and exit interviews with clients. Qualitative data was analysed manually to draw out themes, commonalities, and contrasts. Quantitative data was analysed in Excel and Stata. Causal loop and cause tree diagrams were used to develop a qualitative explanatory model of provider supply incentives and behaviour related to payment method in context. Results There are multiple provider payment methods in the Ghanaian health system. National Health Insurance provider payment methods are the most recent additions. At the time of the study, the methods used nationwide were the Ghana Diagnostic Related Groupings payment for services and an itemized and standardized fee schedule for medicines. The influence of provider payment method on supply behaviour was sometimes intuitive and sometimes counter intuitive. It appeared to be related to context and the interaction of the methods with context and each other rather than linearly to any given method. Conclusions As countries work towards Universal Health Coverage, there is a need to holistically design, implement, and manage provider payment methods reforms from systems rather than linear perspectives, since the latter fail to recognize the effects of context and the between-methods and context interactions in producing net effects. PMID:25096303

  7. Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre.

    PubMed

    Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

    2016-01-01

    This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users.

  8. 75 FR 23808 - Biweekly Notice; Applications and Amendments to Facility Operating Licenses Involving No...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ..., but should note that the NRC's E-Filing system does not support unlisted software, and the NRC Meta... support the physical fuel change. These methodologies do not use the total planar radial peaking factor (F... systems performance, operating mode and equipment out of service. The proposed change is supported by GEH...

  9. Inequities in Infancy: Addressing the Overrepresentation of African American Infants in the Child Welfare System

    ERIC Educational Resources Information Center

    Harden, Brenda Jones

    2008-01-01

    African American infants have higher rates of child welfare system involvement than any other demographic group. They are overrepresented at every point on the child welfare continuum, from reporting, to substantiation, to foster care placement, to adoption. Racial disparities have also been noted in the services these children receive. This…

  10. On the Use of e-TPCK for Situated Teacher Professional Development

    ERIC Educational Resources Information Center

    Timotheou, Maria Mama; Christodoulou, Andri; Angeli, Charoula

    2017-01-01

    The authors herein justify the need for e-TPCK, an adaptive e-learning system for teaching in-service teachers how to teach with technology. Outlining the instructional design process involved and the adaptivity feature of e-TPCK, it is explained how the system promotes and measures the development of teachers' Technological Pedagogical Content…

  11. 75 FR 43168 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-23

    ... deemed to be the most appropriate method at this stage of research on LSPs. A total of 10 states will be... is in need of filling. A qualitative study that involves a brief pre-interview questionnaire followed... LSPs, and types of management information systems and provider tracking systems at the AAA level. A...

  12. A Study of Novice Systems Analysis Problem Solving Behaviors Using Protocol Analysis

    DTIC Science & Technology

    1992-09-01

    conducted. Each subject was given the same task to perform. The task involved a case study (Appendix B) of a utility company’s customer order processing system...behavior (Ramesh, 1989). The task was to design a customer order processing system that utilized a centralized telephone answering service center...of the utility company’s customer order processing system that was developed based on information obtained by a large systems consulting firm during

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

    Wade C. Adams

    From the mid-1950s until mid-2000, the Combustion Engineering, Inc. (CE) site in Windsor, Connecticut (Figure A-1) was involved in the research, development, engineering, production, and servicing of nuclear fuels, systems, and services. The site is currently undergoing decommissioning that will lead to license termination and unrestricted release in accordance with the requirements of the License Termination Rule in 10 CFR Part 20, Subpart E. Asea Brown Boveri Incorporated (ABB) has been decommissioning the CE site since 2001.

  14. An integrated information system for the acquisition, management and sharing of environmental data aimed to decision making

    NASA Astrophysics Data System (ADS)

    La Loggia, Goffredo; Arnone, Elisa; Ciraolo, Giuseppe; Maltese, Antonino; Noto, Leonardo; Pernice, Umberto

    2012-09-01

    This paper reports the first results of the Project SESAMO - SistEma informativo integrato per l'acquisizione, geStione e condivisione di dati AMbientali per il supportO alle decisioni (Integrated Information System for the acquisition, management and sharing of environmental data aimed to decision making). The main aim of the project is to design and develop an integrated environmental information platform able to provide monitoring services for decision support, integrating data from different environmental monitoring systems (including WSN). This ICT platform, based on a service-oriented architecture (SOA), will be developed to coordinate a wide variety of data acquisition systems, based on heterogeneous technologies and communication protocols, providing different sort of environmental monitoring services. The implementation and validation of the SESAMO platform and its services will involve three specific environmental domains: 1) Urban water losses; 2) Early warning system for rainfall-induced landslides; 3) Precision irrigation planning. Services in the first domain are enabled by a low cost sensors network collecting and transmitting data, in order to allow the pipeline network managers to analyze pressure, velocity and discharge data for reducing water losses in an urban contest. This paper outlines the SESAMO functional and technological structure and then gives a concise description of the service design and development process for the second and third domain. Services in the second domain are enabled by a prototypal early warning system able to identify in near-real time high-risk zones of rainfall-induced landslides. Services in the third domain are aimed to optimize irrigation planning of vineyards depending on plant water stress.

  15. Supporting youth involved in domestic minor sex trafficking: Divergent perspectives on youth agency.

    PubMed

    Sapiro, Beth; Johnson, Laura; Postmus, Judy L; Simmel, Cassandra

    2016-08-01

    Domestic-minor sex trafficking (DMST) continues to affect youth in the United States; however, lack of empirical evidence for interventions and the complex sociopolitical discourses surrounding sex trafficking and the commercial sexual exploitation of children (CSEC) hamper delivery of effective services to this population. To explore perspectives on best practices with these young people, 20 in-depth interviews were conducted with key stakeholders whose work provides them with a unique vantage point on the needs and experiences of survivors of DMST in New Jersey. Notes from interviews were coded and analyzed for emergent themes. While key stakeholders generally agreed on best practices, there were several important areas of dispute that emerged regarding how best to serve youth involved in DMST, specifically with regard to youth running away from services, models of service provision, and the use of technology by these youth. Findings suggest that professionals from diverse backgrounds may disagree about the extent to which youth involved in DMST possess agency in their decision-making capacities as adolescents. This study explores these areas of dispute, and discusses the implications for the many different professionals and systems that must work together in providing services to this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Spacecraft servicing demonstration plan

    NASA Technical Reports Server (NTRS)

    Bergonz, F. H.; Bulboaca, M. A.; Derocher, W. L., Jr.

    1984-01-01

    A preliminary spacecraft servicing demonstration plan is prepared which leads to a fully verified operational on-orbit servicing system based on the module exchange, refueling, and resupply technologies. The resulting system can be applied at the space station, in low Earth orbit with an orbital maneuvering vehicle (OMV), or be carried with an OMV to geosynchronous orbit by an orbital transfer vehicle. The three phase plan includes ground demonstrations, cargo bay demonstrations, and free flight verifications. The plan emphasizes the exchange of multimission modular spacecraft (MMS) modules which involves space repairable satellites. Three servicer mechanism configurations are the engineering test unit, a protoflight quality unit, and two fully operational units that have been qualified and documented for use in free flight verification activity. The plan balances costs and risks by overlapping study phases, utilizing existing equipment for ground demonstrations, maximizing use of existing MMS equipment, and rental of a spacecraft bus.

  17. Families’ Experience With Seeking Treatment for Recent-Onset Psychosis

    PubMed Central

    Gerson, Ruth; Davidson, Larry; Booty, Andrew; Wong, Celine; McGlashan, Thomas; Malespina, Dolores; Pincus, Harold Alan; Corcoran, Cheryl

    2013-01-01

    Objective Qualitative research methods were used to understand the experiences of families seeking treatment for young people with recent-onset psychosis; such knowledge can inform services design. Methods The authors conducted open-ended interviews in 1999 through 2002 with family members of 13 patients with recent-onset nonaffective psychotic disorders in the New York metropolitan area, focusing on their experience in seeking treatment and engaging with mental health services. Results Family members described early lack of clarity of diagnosis and obstacles to obtaining treatment. Entry into the mental health system frequently occurred in the context of crisis, with African-American families specifically reporting police involvement. Inpatient hospitalization was depicted as traumatic yet offering relief. Aftercare was described as fragmented, and issues with third-party payers were paramount. Families expressed a desire for more education, information, and support and described their struggles with stigma. These data from families are presented in the context of more recent literature as to the efficacy of specialized treatment programs for early stages of psychotic disorder and their involvement of families. Conclusions These qualitative research data support the importance of involving and educating families about psychosis: its recognition, its treatment, and access to services. They also highlight the need to address stigma and implement structural changes in treatment that ensure continuity and coverage of care. Specialized first-episode psychosis services may address these issues, and they may minimize the traumatic experiences of involuntary hospitalization and police involvement early in treatment. PMID:19487352

  18. Families' experience with seeking treatment for recent-onset psychosis.

    PubMed

    Gerson, Ruth; Davidson, Larry; Booty, Andrew; McGlashan, Thomas; Malespina, Dolores; Pincus, Harold Alan; Corcoran, Cheryl

    2009-06-01

    Qualitative research methods were used to understand the experiences of families seeking treatment for young people with recent-onset psychosis; such knowledge can inform services design. The authors conducted open-ended interviews in 1999 through 2002 with family members of 13 patients with recent-onset nonaffective psychotic disorders in the New York metropolitan area, focusing on their experience in seeking treatment and engaging with mental health services. Family members described early lack of clarity of diagnosis and obstacles to obtaining treatment. Entry into the mental health system frequently occurred in the context of crisis, with African-American families specifically reporting police involvement. Inpatient hospitalization was depicted as traumatic yet offering relief. Aftercare was described as fragmented, and issues with third-party payers were paramount. Families expressed a desire for more education, information, and support and described their struggles with stigma. These data from families are presented in the context of more recent literature as to the efficacy of specialized treatment programs for early stages of psychotic disorder and their involvement of families. These qualitative research data support the importance of involving and educating families about psychosis: its recognition, its treatment, and access to services. They also highlight the need to address stigma and implement structural changes in treatment that ensure continuity and coverage of care. Specialized first-episode psychosis services may address these issues, and they may minimize the traumatic experiences of involuntary hospitalization and police involvement early in treatment.

  19. Service user governors in mental health foundation trusts: accountability or business as usual?

    PubMed

    MacDonald, Dee; Barnes, Marian; Crawford, Mike; Omeni, Edward; Wilson, Aaron; Rose, Diana

    2015-12-01

    National Health Foundation Trusts present opportunities for individual mental health service users to be active in the governance of trusts. This is one of a range of mechanisms for patient and public involvement and one which promotes an individual rather than collective approach to involvement. Within the context of a broader study of the impact of service user involvement in mental health services, the objective of this article was to explore the experience of service user governors in foundation trusts and their capacity to hold boards to account. The Council of Governors in three foundation trusts were observed for a year. Focus groups with service user governors were undertaken in each trust. Service users had different expectations and understandings of the role and approached it in different ways. Key themes that emerged concerned: the role of a governor, conduct and content of meetings, agenda setting, relationships and representation. The experiences of mental health service user governors need to be understood within the complex environment of patient and public involvement in general and of mental health service user involvement in particular. The dislocation of the service user governor role from other forms of service user activity and involvement result in confusion about how notions of holding a trust to account and representation of other service users can be addressed within a boundaried institutional environment. © 2014 John Wiley & Sons Ltd.

  20. EASYRIDE : Specialized Transportation Service in New York City (Phase II Report)

    DOT National Transportation Integrated Search

    1984-03-01

    The EASYRIDE demonstration involved a door-to-door specialized transportation system which served elderly and handicapped residents of the Lower East and West Sides of Manhattan. The demonstration, operated under the auspices of the non-profit Vera I...

  1. 47 CFR 76.1701 - Political file.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND... involving the discussion of a controversial issue of public importance and a corporation, committee, association or other unincorporated group, or other entity is paying for or furnishing the matter, the system...

  2. Preceiving Patterns of Reference Service: A Survey

    ERIC Educational Resources Information Center

    Blakely, Florence

    1971-01-01

    Reference librarians must, if they hope to survive, retool in preparation for becoming the interface between the patron and computer-based information systems. This involves sharpening the interview technique and understanding where to plug into the information flow process. (4 references) (Author)

  3. Mobile Location-Based Services for Trusted Information in Disaster Management

    NASA Astrophysics Data System (ADS)

    Ragia, Lemonia; Deriaz, Michel; Seigneur, Jean-Marc

    The goal of the present chapter is to provide location-based services for disaster management. The application involves services related to the safety of the people due to an unexpected event. The current prototype is implemented for a specific issue of disaster management which is road traffic control. The users can ask requests on cell phones or via Internet to the system and get an answer in a display or in textual form. The data are in a central database and every user can input data via virtual tags. The system is based on spatial messages which can be sent from any user to any other in a certain distance. In this way all the users and not a separate source provide the necessary information for a dangerous situation. To avoid any contamination problems we use trust security to check the input to the system and a trust engine model to provide information with a considerable reliability.

  4. A Content Markup Language for Data Services

    NASA Astrophysics Data System (ADS)

    Noviello, C.; Acampa, P.; Mango Furnari, M.

    Network content delivery and documents sharing is possible using a variety of technologies, such as distributed databases, service-oriented applications, and so forth. The development of such systems is a complex job, because document life cycle involves a strong cooperation between domain experts and software developers. Furthermore, the emerging software methodologies, such as the service-oriented architecture and knowledge organization (e.g., semantic web) did not really solve the problems faced in a real distributed and cooperating settlement. In this chapter the authors' efforts to design and deploy a distribute and cooperating content management system are described. The main features of the system are a user configurable document type definition and a management middleware layer. It allows CMS developers to orchestrate the composition of specialized software components around the structure of a document. In this chapter are also reported some of the experiences gained on deploying the developed framework in a cultural heritage dissemination settlement.

  5. Design Research of TIANDITU (Map Worl)-Based Geographic Information System for Travelling Service

    NASA Astrophysics Data System (ADS)

    Zhang, J.; Zhang, H.; Wang, C.

    2014-04-01

    TIANDITU (Map World) is the public version of the National Platform for Common Geospatial Information Service, and the travelling channel is TIANDITU-based geographic information platform for travelling service. With the development of tourism, traditional ways for providing travelling information cannot meet the needs of travelers. As such, the travelling channel of TIANDITU focuses on providing travel information abundantly and precisely, which integrated the geographic information data of TIANDITU Version 2.0 and the authoritative information resources from China National Tourism Administration. Furthermore, spatial positioning, category and information query of various travelling information were offered for the public in the travelling channel. This research mainly involves three important parts: the system design, key technologies of the system design and application examples. Firstly, this paper introduced the design of TIANDITU-based geographic information system for travelling service, and the general and database design were described in detail. The designs for general, database and travelling service above should consider lots of factors which illustrated in the paper in order to guarantee the efficient service. The process of system construction, the content of geographic information for travelling and system functions of geographic information for travelling are also proposed via diagram in this part. Then several key technologies were discussed, including the travelling information integration for main node and among nodes, general architecture design and management system for travelling channel, web portals and system interface. From the perspective of main technologies, this part describes how TIANDITU travelling channel can realize various functions and reach the requirements from different users. Finally, three application examples about travelling information query were listed shortly. The functions and search results are shown clearly in this part. In all, TIANDITU-based geographic information system for travelling service aimed to integrate the travelling information resources from national, provincial and municipal levels, and finally realized to provide "one stop" travelling service for users in the end.

  6. Trade in health services in the ASEAN region.

    PubMed

    Arunanondchai, Jutamas; Fink, Carsten

    2006-12-01

    Promoting quality health services to large population segments is a key ingredient to human and economic development. At its core, healthcare policymaking involves complex trade-offs between promoting equitable and affordable access to a basic set of health services, creating incentives for efficiencies in the healthcare system and managing constraints in government budgets. International trade in health services influences these trade-offs. It presents opportunities for cost savings and access to better quality care, but it also raises challenges in promoting equitable and affordable access. This paper offers a discussion of trade policy in health services for the ASEAN region. It reviews the existing patterns of trade and identifies policy measures that could further harness the benefits from trade in health services and address potential pitfalls that deeper integration may bring about.

  7. Understanding how orthopaedic surgery practices generate value for healthcare systems.

    PubMed

    Olson, Steven A; Mather, Richard C

    2013-06-01

    Orthopaedic surgery practices can provide substantial value to healthcare systems. Increasingly, healthcare administrators are speaking of the need for alignment between physicians and healthcare systems. However, physicians often do not understand what healthcare administrators value and therefore have difficulty articulating the value they create in discussions with their hospital or healthcare organization. Many health systems and hospitals use service lines as an organizational structure to track the relevant data and manage the resources associated with a particular type of care, such as musculoskeletal care. Understanding service lines and their management can be useful for orthopaedic surgeons interested in interacting with their hospital systems. We provide an overview of two basic types of value orthopaedic surgeons create for healthcare systems: financial or volume-driven benefits and nonfinancial quality or value-driven patient care benefits. We performed a search of PubMed from 1965 to 2012 using the term "service line." Of the 351 citations identified, 18 citations specifically involved the use of service lines to improve patient care in both nursing and medical journals. A service line is a structure used in healthcare organizations to enable management of a subset of activities or resources in a focused area of patient care delivery. There is not a consistent definition of what resources are managed within a service line from hospital to hospital. Physicians can positively impact patient care through engaging in service line management. There is increasing pressure for healthcare systems and hospitals to partner with orthopaedic surgeons. The peer-reviewed literature demonstrates there are limited resources for physicians to understand the value they create when attempting to negotiate with their hospital or healthcare organization. To effectively negotiate for resources to provide the best care for patients, orthopaedic surgeons need to claim and demonstrate the value they create in healthcare organizations.

  8. Recommendations for a service framework to access astronomical archives

    NASA Technical Reports Server (NTRS)

    Travisano, J. J.; Pollizzi, J.

    1992-01-01

    There are a large number of astronomical archives and catalogs on-line for network access, with many different user interfaces and features. Some systems are moving towards distributed access, supplying users with client software for their home sites which connects to servers at the archive site. Many of the issues involved in defining a standard framework of services that archive/catalog suppliers can use to achieve a basic level of interoperability are described. Such a framework would simplify the development of client and server programs to access the wide variety of astronomical archive systems. The primary services that are supplied by current systems include: catalog browsing, dataset retrieval, name resolution, and data analysis. The following issues (and probably more) need to be considered in establishing a standard set of client/server interfaces and protocols: Archive Access - dataset retrieval, delivery, file formats, data browsing, analysis, etc.; Catalog Access - database management systems, query languages, data formats, synchronous/asynchronous mode of operation, etc.; Interoperability - transaction/message protocols, distributed processing mechanisms (DCE, ONC/SunRPC, etc), networking protocols, etc.; Security - user registration, authorization/authentication mechanisms, etc.; Service Directory - service registration, lookup, port/task mapping, parameters, etc.; Software - public vs proprietary, client/server software, standard interfaces to client/server functions, software distribution, operating system portability, data portability, etc. Several archive/catalog groups, notably the Astrophysics Data System (ADS), are already working in many of these areas. In the process of developing StarView, which is the user interface to the Space Telescope Data Archive and Distribution Service (ST-DADS), these issues and the work of others were analyzed. A framework of standard interfaces for accessing services on any archive system which would benefit archive user and supplier alike is proposed.

  9. Pediatric emergency care capabilities of Indian Health Service emergency medical service agencies serving American Indians/Alaska Natives in rural and frontier areas.

    PubMed

    Genovesi, A L; Hastings, B; Edgerton, E A; Olson, L M

    2014-01-01

    In the USA, the emergency medical services (EMS) system is vital for American Indians and Alaska Natives, who are disproportionately burdened by injuries and diseases and often live in rural areas geographically far from hospitals. In rural areas, where significant health disparities exist, EMS is often a primary source of healthcare providing a safety net for uninsured individuals or families who otherwise lack access to health-related services. EMS is frequently the first entry point for children and their families into the healthcare system. The Indian Health Service (IHS) supports the federally funded, tribally operated EMS agencies to help meet the affiliated American Indian and Alaska Natives' pre-hospital needs. While periodic assessments of state EMS agencies capabilities to care for children occur, it appears a systematic assessment of IHS EMS agencies in regards to children had not been previously conducted. A consensus process, involving stakeholders, was used to identify topic areas for a survey for assessing the pediatric capabilities of IHS EMS. The survey was sent to 75 of 88 IHS EMS agency contacts. Sixty-one agencies (81%) responded. Nine agencies (15%) did not have a medical director. Agencies without a medical director were less likely to report the availability of online (p=0.1) or offline (p<0.01) pediatric medical direction. Half (51%) of the agencies had a mass casualties plan; however, 29% reported responding to a mass casualty incident, involving a large number of pediatric patients, that overwhelmed their service. Most agencies were well integrated with their state EMS system with almost all (95%) collecting EMS patient care data and 47% using national standard data elements. In some areas, IHS EMS agencies did not have the infrastructure to treat pediatric patients during day-to-day operations as well as disasters. Similar to operational challenges faced by rural EMS agencies, the IHS agencies lacked a medical director, were unable to provide pediatric continuing education, and were overwhelmed during mass casualty incidents. Moreover, the overall ratio of IHS EMS to service population is almost double that for other EMS agencies. In other areas, agencies were well integrated with their state EMS system. One possible solution to increase capabilities to care for pediatric patients is combining and sharing of common resources including medical directors with their state EMS systems and authorities.

  10. Systems of care for ST-segment-elevation myocardial infarction: a report From the American Heart Association's Mission: Lifeline.

    PubMed

    Jollis, James G; Granger, Christopher B; Henry, Timothy D; Antman, Elliott M; Berger, Peter B; Moyer, Peter H; Pratt, Franklin D; Rokos, Ivan C; Acuña, Anna R; Roettig, Mayme Lou; Jacobs, Alice K

    2012-07-01

    National guidelines call for participation in systems to rapidly diagnose and treat ST-segment-elevation myocardial infarction (STEMI). In order to characterize currently implemented STEMI reperfusion systems and identify practices common to system organization, the American Heart Association surveyed existing systems throughout the United States. A STEMI system was defined as an integrated group of separate entities focused on reperfusion therapy for STEMI within a geographic region that included at least 1 hospital that performs percutaneous coronary intervention and at least 1 emergency medical service agency. Systems meeting this definition were invited to participate in a survey of 42 questions based on expert panel opinion and knowledge of existing systems. Data were collected through the American Heart Association Mission: Lifeline website. Between April 2008 and January 2010, 381 unique systems involving 899 percutaneous coronary intervention hospitals in 47 states responded to the survey, of which 255 systems (67%) involved urban regions. The predominant funding sources for STEMI systems were percutaneous coronary intervention hospitals (n = 320, 84%) and /or cardiology practices (n = 88, 23%). Predominant system characteristics identified by the survey included: STEMI patient acceptance at percutaneous coronary intervention hospital regardless of bed availability (N = 346, 97%); single phone call activation of catheterization laboratory (N = 335, 92%); emergency department physician activation of laboratory without cardiology consultation (N = 318, 87%); data registry participation (N = 311, 84%); and prehospital activation of the laboratory through emergency department notification without cardiology notification (N = 297, 78%). The most common barriers to system implementation were hospital (n = 139, 37%) and cardiology group competition (n = 81, 21%) and emergency medical services transport and finances (n = 99, 26%). This survey broadly describes the organizational characteristics of collaborative efforts by hospitals and emergency medical services to provide timely reperfusion in the United States. These findings serve as a benchmark for existing systems and should help guide healthcare teams in the process of organizing care for patients with STEMI.

  11. The EPOS e-Infrastructure

    NASA Astrophysics Data System (ADS)

    Jeffery, Keith; Bailo, Daniele

    2014-05-01

    The European Plate Observing System (EPOS) is integrating geoscientific information concerning earth movements in Europe. We are approaching the end of the PP (Preparatory Project) phase and in October 2014 expect to continue with the full project within ESFRI (European Strategic Framework for Research Infrastructures). The key aspects of EPOS concern providing services to allow homogeneous access by end-users over heterogeneous data, software, facilities, equipment and services. The e-infrastructure of EPOS is the heart of the project since it integrates the work on organisational, legal, economic and scientific aspects. Following the creation of an inventory of relevant organisations, persons, facilities, equipment, services, datasets and software (RIDE) the scale of integration required became apparent. The EPOS e-infrastructure architecture has been developed systematically based on recorded primary (user) requirements and secondary (interoperation with other systems) requirements through Strawman, Woodman and Ironman phases with the specification - and developed confirmatory prototypes - becoming more precise and progressively moving from paper to implemented system. The EPOS architecture is based on global core services (Integrated Core Services - ICS) which access thematic nodes (domain-specific European-wide collections, called thematic Core Services - TCS), national nodes and specific institutional nodes. The key aspect is the metadata catalog. In one dimension this is described in 3 levels: (1) discovery metadata using well-known and commonly used standards such as DC (Dublin Core) to enable users (via an intelligent user interface) to search for objects within the EPOS environment relevant to their needs; (2) contextual metadata providing the context of the object described in the catalog to enable a user or the system to determine the relevance of the discovered object(s) to their requirement - the context includes projects, funding, organisations involved, persons involved, related publications, facilities, equipment and others, and utilises CERIF (Common European Research Information Format) standard (see www.eurocris.org); (3) detailed metadata which is specific to a domain or to a particular object and includes the schema describing the object to processing software. The other dimension of the metadata concerns the objects described. These are classified into users, services (including software), data and resources (computing, data storage, instruments and scientific equipment). An alternative architecture has been considered: using brokering. This technique has been used especially in North America geoscience projects to interoperate datasets. The technique involves writing software to interconvert between any two node datasets. Given n nodes this implies writing n*(n-1) convertors. EPOS Working Group 7 (e-infrastructures and virtual community) which deals with the design and implementation of a prototype of the EPOS services, chose to use an approach which endows the system with an extreme flexibility and sustainability. It is called the Metadata Catalogue approach. With the use of the catalogue the EPOS system can: 1. interoperate with software, services, users, organisations, facilities, equipment etc. as well as datasets; 2. avoid to write n*(n-1) software convertors and generate as much as possible, through the information contained in the catalogue only n convertors. This is a huge saving - especially in maintenance as the datasets (or other node resources) evolve. We are working on (semi-) automation of convertor generation by metadata mapping - this is leading-edge computer science research; 3. make large use of contextual metadata which enable a user or a machine to: (i) improve discovery of resources at nodes; (ii) improve precision and recall in search; (iii) drive the systems for identification, authentication, authorisation, security and privacy recording the relevant attributes of the node resources and of the user; (iv) manage provenance and long-term digital preservation; The linkage between the Integrated Services, which provide the integration of data and services, with the diverse Thematic Services Nodes is provided by means of a compatibility layer, which includes the aforementioned metadata catalogue. This layer provides 'connectors' to make local data, software and services available through the EPOS Integrated Services layer. In conclusion, we believe the EPOS e-infrastructure architecture is fit for purpose including long-term sustainability and pan-European access to data and services.

  12. Towards a Global Service Registry for the World-Wide LHC Computing Grid

    NASA Astrophysics Data System (ADS)

    Field, Laurence; Alandes Pradillo, Maria; Di Girolamo, Alessandro

    2014-06-01

    The World-Wide LHC Computing Grid encompasses a set of heterogeneous information systems; from central portals such as the Open Science Grid's Information Management System and the Grid Operations Centre Database, to the WLCG information system, where the information sources are the Grid services themselves. Providing a consistent view of the information, which involves synchronising all these informations systems, is a challenging activity that has lead the LHC virtual organisations to create their own configuration databases. This experience, whereby each virtual organisation's configuration database interfaces with multiple information systems, has resulted in the duplication of effort, especially relating to the use of manual checks for the handling of inconsistencies. The Global Service Registry aims to address this issue by providing a centralised service that aggregates information from multiple information systems. It shows both information on registered resources (i.e. what should be there) and available resources (i.e. what is there). The main purpose is to simplify the synchronisation of the virtual organisation's own configuration databases, which are used for job submission and data management, through the provision of a single interface for obtaining all the information. By centralising the information, automated consistency and validation checks can be performed to improve the overall quality of information provided. Although internally the GLUE 2.0 information model is used for the purpose of integration, the Global Service Registry in not dependent on any particular information model for ingestion or dissemination. The intention is to allow the virtual organisation's configuration databases to be decoupled from the underlying information systems in a transparent way and hence simplify any possible future migration due to the evolution of those systems. This paper presents the Global Service Registry architecture, its advantages compared to the current situation and how it can support the evolution of information systems.

  13. Salutogenic service user involvement in nursing research: a case study.

    PubMed

    Mjøsund, Nina Helen; Vinje, Hege Forbech; Eriksson, Monica; Haaland-Øverby, Mette; Jensen, Sven Liang; Kjus, Solveig; Norheim, Irene; Portaasen, Inger-Lill; Espnes, Geir Arild

    2018-05-12

    The aim was to explore the process of involving mental healthcare service users in a mental health promotion research project as research advisors and to articulate features of the collaboration which encouraged and empowered the advisors to make significant contributions to the research process and outcome. There is an increasing interest in evaluating aspects of service user involvement in nursing research. Few descriptions exist of features that enable meaningful service user involvement. We draw on experiences from conducting research which used the methodology interpretative phenomenological analysis to explore how persons with mental disorders perceived mental health. Aside from the participants in the project, five research advisors with service user experience were involved in the entire research process. We applied a case study design to explore the ongoing processes of service user involvement. Documents and texts produced while conducting the project (2012-2016), as well as transcripts from multistage focus group discussions with the research advisors, were analysed. The level of involvement was dynamic and varied throughout the different stages of the research process. Six features: leadership, meeting structure, role clarification, being members of a team, a focus on possibilities and being seen and treated as holistic individuals, were guiding principles for a salutogenic service user involvement. These features strengthened the advisors' perception of themselves as valuable and competent contributors. Significant contributions from research advisors were promoted by facilitating the process of involvement. A supporting structure and atmosphere were consistent with a salutogenic service user involvement. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. Flexible medical image management using service-oriented architecture.

    PubMed

    Shaham, Oded; Melament, Alex; Barak-Corren, Yuval; Kostirev, Igor; Shmueli, Noam; Peres, Yardena

    2012-01-01

    Management of medical images increasingly involves the need for integration with a variety of information systems. To address this need, we developed Content Management Offering (CMO), a platform for medical image management supporting interoperability through compliance with standards. CMO is based on the principles of service-oriented architecture, implemented with emphasis on three areas: clarity of business process definition, consolidation of service configuration management, and system scalability. Owing to the flexibility of this platform, a small team is able to accommodate requirements of customers varying in scale and in business needs. We describe two deployments of CMO, highlighting the platform's value to customers. CMO represents a flexible approach to medical image management, which can be applied to a variety of information technology challenges in healthcare and life sciences organizations.

  15. Delivering social work services in collaboration with the legal representation for individual clients: An effective, ethical and economical approach to supporting families in child abuse and neglect legal proceedings.

    PubMed

    Pott, Robbin

    2017-11-01

    This article discusses the need to improve the quality of helping relationships between families and social workers in the child protection system and the growing body of evidence that teams of social workers and lawyers are effective at improving outcomes in child protection legal proceedings. The author presents an alternative structure of delivering social work services within the child protection systems once a court gets involved with a family, proposing that social workers should focus on individual clients in collaboration with their legal representation, rather than the traditional model of a governmental agency social worker serving the family as a unit as it also determines placement of the children. Pairing the social worker to an individual client in tandem with their legal representative would help resolve the widely observed relationship problems between service users and governmental agency social workers that include the power imbalance created by the agency's authority to determine placement of children, the conflicts of interest that agency workers face when required to manage differing family members' needs, and the lack of protection of the due process right of confidentiality for parties involved in legal proceedings. This alternative structure also impacts the need to use resources more efficiently and has been demonstrated to result in substantial returns on investment. This article concludes that when a family becomes involved in child abuse and neglect legal proceedings, the child welfare agency should shift the delivery of social work services to the individual parties, away from the governmental agency and in conjunction with their legal representation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Meeting the complex needs of urban youth and their families through the 4Rs 2Ss Family Strengthening Program: The “real world” meets evidence-informed care

    PubMed Central

    Small, Latoya; Jackson, Jerrold; Gopalan, Geetha; McKay, Mary McKernan

    2014-01-01

    Youth living in poverty face compounding familial and environmental challenges in utilizing effective community mental health services. They have ongoing stressors that increase their dropout rate in mental health service use. Difficulties also exist in staying engaged in services when they are involved with the child welfare system. This study examines the 4Rs 2Ss Family Strengthening Program, developed across four broad conceptual categories related to parenting skills and family processes that form a multiple family group service delivery approach. A total of 321 families were enrolled in this randomized intervention study, assigned to either the 4Rs 2Ss Family Strengthening Program or standard care services. Caregivers and their children randomly assigned to the experimental condition received a 16 week multiple family group intervention through their respective outpatient community mental health clinic. Data was collected at baseline, midtest (8 weeks), posttest (16 weeks), and 6 month follow-up. Major findings include high engagement in the 4Rs 2Ss Family Strengthening Program, compared to standard services. Although child welfare status is not related to attendance, family stress and parental depression are also related to participant engagement in this multiple family group intervention. Involvement in the 4Rs 2Ss Family Strengthening Program resulted in improved effects for child behaviors. Lastly, no evidence of moderation effects on family stress, child welfare involvement, or parental needs were found. The 4Rs 2Ss Family Strengthening Program appeared able to engage families with more complex “real world” needs. PMID:26523115

  17. Meeting the complex needs of urban youth and their families through the 4Rs 2Ss Family Strengthening Program: The "real world" meets evidence-informed care.

    PubMed

    Small, Latoya; Jackson, Jerrold; Gopalan, Geetha; McKay, Mary McKernan

    2015-07-01

    Youth living in poverty face compounding familial and environmental challenges in utilizing effective community mental health services. They have ongoing stressors that increase their dropout rate in mental health service use. Difficulties also exist in staying engaged in services when they are involved with the child welfare system. This study examines the 4Rs 2Ss Family Strengthening Program, developed across four broad conceptual categories related to parenting skills and family processes that form a multiple family group service delivery approach. A total of 321 families were enrolled in this randomized intervention study, assigned to either the 4Rs 2Ss Family Strengthening Program or standard care services. Caregivers and their children randomly assigned to the experimental condition received a 16 week multiple family group intervention through their respective outpatient community mental health clinic. Data was collected at baseline, midtest (8 weeks), posttest (16 weeks), and 6 month follow-up. Major findings include high engagement in the 4Rs 2Ss Family Strengthening Program, compared to standard services. Although child welfare status is not related to attendance, family stress and parental depression are also related to participant engagement in this multiple family group intervention. Involvement in the 4Rs 2Ss Family Strengthening Program resulted in improved effects for child behaviors. Lastly, no evidence of moderation effects on family stress, child welfare involvement, or parental needs were found. The 4Rs 2Ss Family Strengthening Program appeared able to engage families with more complex "real world" needs.

  18. Reference Architecture Model Enabling Standards Interoperability.

    PubMed

    Blobel, Bernd

    2017-01-01

    Advanced health and social services paradigms are supported by a comprehensive set of domains managed by different scientific disciplines. Interoperability has to evolve beyond information and communication technology (ICT) concerns, including the real world business domains and their processes, but also the individual context of all actors involved. So, the system must properly reflect the environment in front and around the computer as essential and even defining part of the health system. This paper introduces an ICT-independent system-theoretical, ontology-driven reference architecture model allowing the representation and harmonization of all domains involved including the transformation into an appropriate ICT design and implementation. The entire process is completely formalized and can therefore be fully automated.

  19. Spouse Abuse, Child Abuse, and Substance Abuse Among Army Facilities: Co-Occurrence, Correlations and Service Delivery Issues

    DTIC Science & Technology

    2006-03-01

    refer spouse abuse or child abuse offenders with identified alcohol or other drug involvement to the on-base counseling center for a substance...abuse assessment. The military’s response to combat substance abuse involves a combination of education, prevention, random testing for illicit drug ...data from three Army sources: the Army Central Registry (ACR), the Drug and Alcohol Management Information System (DAMIS), and Army personnel data

  20. Values and attitudes of National Wildlife Refuge managers and biologists; Report to respondents

    USGS Publications Warehouse

    Brinson, Ayeisha A.; Benson, Delwin E.

    2002-01-01

    Analyses of data revealed that these managers and biologists did not differ substantially in terms of their environmental values. Refuge professionals were supportive of public involvement in planning and management, but hoped to maintain management authority throughout the process. Professionals were skeptical concerning the applicability of long term planning, but were generally supportive of the planning process. Attitudes toward the Service were conflicting: professionals felt that the Service needed to provide better leadership and direction, but that the Refuge System needed to assert its autonomy and independence from the rest of the Service.

  1. A toolkit for incorporating genetics into mainstream medical services: Learning from service development pilots in England

    PubMed Central

    2010-01-01

    Background As advances in genetics are becoming increasingly relevant to mainstream healthcare, a major challenge is to ensure that these are integrated appropriately into mainstream medical services. In 2003, the Department of Health for England announced the availability of start-up funding for ten 'Mainstreaming Genetics' pilot services to develop models to achieve this. Methods Multiple methods were used to explore the pilots' experiences of incorporating genetics which might inform the development of new services in the future. A workshop with project staff, an email questionnaire, interviews and a thematic analysis of pilot final reports were carried out. Results Seven themes relating to the integration of genetics into mainstream medical services were identified: planning services to incorporate genetics; the involvement of genetics departments; the establishment of roles incorporating genetic activities; identifying and involving stakeholders; the challenges of working across specialty boundaries; working with multiple healthcare organisations; and the importance of cultural awareness of genetic conditions. Pilots found that the planning phase often included the need to raise awareness of genetic conditions and services and that early consideration of organisational issues such as clinic location was essential. The formal involvement of genetics departments was crucial to success; benefits included provision of clinical and educational support for staff in new roles. Recruitment and retention for new roles outside usual career pathways sometimes proved difficult. Differences in specialties' working practices and working with multiple healthcare organisations also brought challenges such as the 'genetic approach' of working with families, incompatible record systems and different approaches to health professionals' autonomous practice. 'Practice points' have been collated into a Toolkit which includes resources from the pilots, including job descriptions and clinical tools. These can be customised for reuse by other services. Conclusions Healthcare services need to translate advances in genetics into benefits for patients. Consideration of the issues presented here when incorporating genetics into mainstream medical services will help ensure that new service developments build on the body of experience gained by the pilots, to provide high quality services for patients with or at risk of genetic conditions. PMID:20470377

  2. A toolkit for incorporating genetics into mainstream medical services: Learning from service development pilots in England.

    PubMed

    Bennett, Catherine L; Burke, Sarah E; Burton, Hilary; Farndon, Peter A

    2010-05-14

    As advances in genetics are becoming increasingly relevant to mainstream healthcare, a major challenge is to ensure that these are integrated appropriately into mainstream medical services. In 2003, the Department of Health for England announced the availability of start-up funding for ten 'Mainstreaming Genetics' pilot services to develop models to achieve this. Multiple methods were used to explore the pilots' experiences of incorporating genetics which might inform the development of new services in the future. A workshop with project staff, an email questionnaire, interviews and a thematic analysis of pilot final reports were carried out. Seven themes relating to the integration of genetics into mainstream medical services were identified: planning services to incorporate genetics; the involvement of genetics departments; the establishment of roles incorporating genetic activities; identifying and involving stakeholders; the challenges of working across specialty boundaries; working with multiple healthcare organisations; and the importance of cultural awareness of genetic conditions. Pilots found that the planning phase often included the need to raise awareness of genetic conditions and services and that early consideration of organisational issues such as clinic location was essential. The formal involvement of genetics departments was crucial to success; benefits included provision of clinical and educational support for staff in new roles. Recruitment and retention for new roles outside usual career pathways sometimes proved difficult. Differences in specialties' working practices and working with multiple healthcare organisations also brought challenges such as the 'genetic approach' of working with families, incompatible record systems and different approaches to health professionals' autonomous practice. 'Practice points' have been collated into a Toolkit which includes resources from the pilots, including job descriptions and clinical tools. These can be customised for reuse by other services. Healthcare services need to translate advances in genetics into benefits for patients. Consideration of the issues presented here when incorporating genetics into mainstream medical services will help ensure that new service developments build on the body of experience gained by the pilots, to provide high quality services for patients with or at risk of genetic conditions.

  3. Addressing the Needs of Youth with Disabilities in the Juvenile Justice System: The Current Status of Evidence-Based Research.

    ERIC Educational Resources Information Center

    Mears, Daniel P.; Aron, Laudan; Bernstein, Jenny

    This report summarizes the state of knowledge about children and youth with disabilities at risk of delinquency or already involved with the juvenile justice system. It reviews the existing research as well as perspectives of service providers, administrators, policy makers, and advocates. Following an executive summary and introductory chapter,…

  4. Education Rights for Youth with Disabilities Who Are In the Juvenile Justice System: Parent/Guardian Information Brochure

    ERIC Educational Resources Information Center

    Ohio Coalition for the Education of Children with Disabilities, 2008

    2008-01-01

    The topics addressed in this brochure for Ohio parents and guardians include whether youth with disabilities are entitled to special education services when they are in the juvenile justice system; whether parents of youth with disabilities can be involved in making decisions regarding their youth's education while the youth is in the juvenile…

  5. Potential role of dermatologists and dermatological services in developing and sustaining the leprosy control referral system in resource constrained settings.

    PubMed

    Kawuma, Herman Joseph S

    2007-03-01

    General Health Services that pay due attention to the management of skin conditions are opportune for suspecting and diagnosing early leprosy. In many developing countries, patients with dermatological conditions can only access specialist services in the larger cities and university hospitals; unaffordable costs make the services even less accessible if they can only be provided in the private sector. The high profile of dermatologists in the health services, gives them the opportunity to facilitate the development and implementation of a referral system that includes leprosy. This potential benefit for leprosy control must be initiated by current National Leprosy Programme Managers through establishing formal relationships with the dermatologists and involving them and other partners in the re-designing of leprosy control strategies to keep them in tandem with changing epidemiological patterns, national policies and on -going health sector reforms. The same health service managers should avail of the opportunities from the dermatologists (both in public and private sectors) about the current knowledge on the management and control of leprosy.

  6. Toward Equality Through Employment

    ERIC Educational Resources Information Center

    Lekachman, Robert

    1974-01-01

    An indication of the rearrangements of power, privilege, income and wealth distribution that are necessary for the establishment of full employment with price stability; involving policies of guaranteed public service jobs, income maintenance, prices and wages controls, a redistributive taxation system, and the eventual "socialization of…

  7. 48 CFR 252.239-7016 - Telecommunications security equipment, devices, techniques, and services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., record, and data communications, including management information systems and local data networks that...) Sensitive information means any information the loss, misuse, or modification of which, or unauthorized... subcontractors to transmit— (i) Classified or sensitive information; (ii) Matters involving intelligence...

  8. ESEA Title I Migrant. Final Technical Report.

    ERIC Educational Resources Information Center

    Austin Independent School District, TX. Office of Research and Evaluation.

    The 1981-82 Austin (Texas) Independent School District Title I Migrant Program consisted of seven components: three instructional components--prekindergarten, communication skills, and summer school; and four support components--health services, parental involvement, migrant student record transfer system (MSRTS), and evaluation. The major…

  9. Cape Cod National Seashore alternative transportation systems long range planning study

    DOT National Transportation Integrated Search

    2003-05-01

    This project involves the development of short-range and long-range plans for alternative transportation to, from, and within the Cape Cod National Seashore. The five-year plan notes that improved public transportation services are needed both to mit...

  10. Volunteer Services.

    ERIC Educational Resources Information Center

    Little (Arthur D.), Inc., Washington, DC.

    This report presents important issues involved in the use of volunteers in the juvenile justice system. Chapter I discusses volunteer program designs, organizational structure, potential program applications, and public relations. Chapter II reviews the volunteer: who he is, his motives for volunteering, and suggestions for recruiting, screening,…

  11. Analysis of Student Service-Learning Reflections for the Assessment of Transferable-Skills Development

    NASA Astrophysics Data System (ADS)

    Rizzo, D. M.; Dewoolkar, M.; Hayden, N.; Oka, L.; Pearce, A. R.

    2010-12-01

    The civil and environmental engineering (CEE) programs at the University of Vermont (UVM) incorporate systems thinking and a systems approach to sustainable engineering problem solving. A systems approach considers long-term social, environmental and economic factors within the context of the engineering problem solution and encompasses sustainable engineering solutions. Our goal is to prepare students to become leaders in their chosen field who can anticipate co-products associated with forecasted solutions. As a way of practicing the systems approach, we include service-learning projects in many of our undergraduate engineering courses, culminating with the senior capstone design course. We use a variety of formative and summative assessment methods to gage student understanding and attitudes including student surveys, focus groups, assessment of student projects, and student reflections. Student reflections from two courses -Modeling Environmental and Transportation Systems (31 juniors) and Senior Design Project (30 seniors) are compared. Of these, 25 students were common to both courses. The focus of the systems modeling service-learning project involved mentoring home-schooled children (11-14 yrs old) to solve problems of mobility, using the fun and inspiration of biomimicry. Students were required to invent innovative methods to move people or goods that improve associated constraints (i.e., minimize congestion, reduce pollution, increase safety), or reduce the need for transportation altogether. The capstone design project required a comprehensive engineering design involving two or more CEE sub-disciplines. Both service-learning projects were intended to enhance students’ academic learning experience, attain civic engagement and reinforce transferable skills (written and oral communication, teamwork, leadership and mentoring skills). The student course reflections were not guided; yet they provided valuable data to assess commonalities and differences in student attitudes toward their service-learning projects, specifically, the development of transferable skills. In the spirit of service-learning pedagogy, we divide the contents of students’ written reflections into three categories - academic enhancement, civic engagement and personal growth skills. The commonalities focused mostly on civic engagement. Differences are observed primarily in academic enhancement and personal growth categories. Students working on the biomimicry design project reflected on personal growth (e.g. leadership skills, mentoring, creativity, organizational skills, communication to nontechnical audience), but did not credit it with academic enhancement. In contrast, the senior design reflections concentrated on academics, specifically, students appreciated the enhancement of technical skills as a part of their engineering experience.

  12. Support of an Active Science Project by a Large Information System: Lessons for the EOS Era

    NASA Technical Reports Server (NTRS)

    Angelici, Gary L.; Skiles, J. W.; Popovici, Lidia Z.

    1993-01-01

    The ability of large information systems to support the changing data requirements of active science projects is being tested in a NASA collaborative study. This paper briefly profiles both the active science project and the large information system involved in this effort and offers some observations about the effectiveness of the project support. This is followed by lessons that are important for those participating in large information systems that need to support active science projects or that make available the valuable data produced by these projects. We learned in this work that it is difficult for a large information system focused on long term data management to satisfy the requirements of an on-going science project. For example, in order to provide the best service, it is important for all information system staff to keep focused on the needs and constraints of the scientists in the development of appropriate services. If the lessons learned in this and other science support experiences are not applied by those involved with large information systems of the EOS (Earth Observing System) era, then the final data products produced by future science projects may not be robust or of high quality, thereby making the conduct of the project science less efficacious and reducing the value of these unique suites of data for future research.

  13. Service user involvement in preregistration general nurse education: a systematic review.

    PubMed

    Scammell, Janet; Heaslip, Vanessa; Crowley, Emma

    2016-01-01

    A systematic review of published studies on service user involvement in undergraduate, preregistration general nursing education (excluding mental health-specific programmes). The objective is to examine how students are exposed to engagement with service users. The requirement of service user involvement in all nurse education is policy expectation of health professional education providers, in response to the increased public and political expectations. Previous literature reviews have focused solely on mental health. Systematic review using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines; timeframe 1997-2014; published in English. Search of CINAHL, Cochrane Review, Education Research Complete, Internurse, MEDLINE, PsychINFO, Scopus, SocINDEX and Web of Science yielded 229 citations; 11 studies met the review eligibility criteria. Seven studies used qualitative methodology, two quantitative and two mixed methods. Studies from the United Kingdom dominated (n = 9), the remainder from South Africa and Turkey. The results are described using four themes: benefits and limitations of service user involvement; nursing student selection; education delivery; practice-based learning and assessment. Most studies were small scale; nine had less than 30 participants. Overall the evidence suggests that student, lecturers and service users valued service user involvement in nurse education, to provide an authentic insight into the illness experience. Logistical considerations around support and student cohort size emerged. This is the first systematic review to focus on service user involvement in general nurse education. It reveals that service user involvement commenced later and is more limited in general programmes as compared to equivalent mental health education provision. Most of the evidence focuses on perceptions of the value of involvement. Further research is required to more clearly establish impact on learning and clinical practice. Service user involvement in nurse education is valued by stakeholders but preparation and support for those involved, including mentors is underestimated. © 2015 John Wiley & Sons Ltd.

  14. Major health service transformation and the public voice: conflict, challenge or complicity?

    PubMed

    Martin, Graham P; Carter, Pam; Dent, Mike

    2018-01-01

    Objectives Calls for major reconfigurations of health services have been accompanied by recommendations that wide ranging stakeholders be involved. In particular, patients and the wider public are seen as critical contributors as both funders and beneficiaries of public health care. But public involvement is fraught with challenges, and little research has focused on involvement in the health service transformation initiatives. This paper examines the design and function of public involvement in reconfiguration of health services within the English NHS. Methods Qualitative data including interviews, observation and documents were collected in two health service 'transformation' programmes; interviews include involved public and professional participants. Data were analysed using parallel deductive and inductive approaches. Results Public involvement in the programmes was extensive but its terms of reference, and the individuals involved, were restricted by policy pressures and programme objectives. The degree to which participants descriptively or substantively represented the wider public was limited; participants sought to 'speak for' this public but their views on what was 'acceptable' and likely to influence decision-making led them to constrain their contributions. Conclusions Public involvement in two major service reconfiguration programmes in England was seen as important and functional, and could not be characterized as tokenistic. Yet involvement in these programmes fell short of normative ideals, and could inadvertently reduce, rather than enlarge, public influence on health service reconfiguration decisions.

  15. Tritium laboratory with multiple purposes at NIPNE Magurele Romania

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

    Matei, L.; Postolache, C.

    2008-07-15

    The Tritium Laboratory from NIPNE (Romania)) is part of Radioisotope Research and Production Center. The Tritium Laboratory has been in operation since 1960, and carries out R and D activities involving tritium sources in gaseous, liquids and solid state, provides specialized service to CANDU NPP Cernavoda (Romania)), and provides tritium assay services to internal and external customers. The paper presents the activities and perspectives of Tritium Laboratory and its performances in accordance with Quality System Management. (authors)

  16. An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context.

    PubMed

    Takenga, Claude; Berndt, Rolf-Dietrich; Musongya, Olivier; Kitero, Joël; Katoke, Remi; Molo, Kakule; Kazingufu, Basile; Meni, Malikwisha; Vikandy, Mambo; Takenga, Henri

    2014-01-01

    The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which is a telemedical approach proposed for the management of long-term diseases. The system applies modern mobile and web technologies which overcome geographical barriers, and increase access to health care services. The idea of the system is to involve patients in the therapy process and motivate them for an active participation. For validation of the system in African context, a trial was conducted in the Democratic Republic of Congo. 40 Subjects with diabetes divided randomly into control and intervention groups were included in the test. Results show that Mobil Diab is suitable for African countries and presents a number of benefits for the population and public health care system. It improves clinical management and delivery of diabetes care services by enhancing access, quality, motivation, reassurance, efficiency, and cost-effectiveness.

  17. An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context

    PubMed Central

    Takenga, Claude; Berndt, Rolf-Dietrich; Musongya, Olivier; Kitero, Joël; Katoke, Remi; Molo, Kakule; Kazingufu, Basile; Meni, Malikwisha; Vikandy, Mambo; Takenga, Henri

    2014-01-01

    The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which is a telemedical approach proposed for the management of long-term diseases. The system applies modern mobile and web technologies which overcome geographical barriers, and increase access to health care services. The idea of the system is to involve patients in the therapy process and motivate them for an active participation. For validation of the system in African context, a trial was conducted in the Democratic Republic of Congo. 40 Subjects with diabetes divided randomly into control and intervention groups were included in the test. Results show that Mobil Diab is suitable for African countries and presents a number of benefits for the population and public health care system. It improves clinical management and delivery of diabetes care services by enhancing access, quality, motivation, reassurance, efficiency, and cost-effectiveness. PMID:25136358

  18. [Management control and operative budget at a radiology center].

    PubMed

    Ferrari, G; Musconi, V; Zappi, A; Cavina, A; Zanetti, M

    1996-06-01

    The laws reforming the National Health Service (SSN) (DL 30.12.92 n. 502 converted into DL 7.12.93 n.517) strongly modify the operation rules of the local sociosanitary units (USL) and imply that the rules themselves be reorganized with flexible and agile organization systems, introducing, in addition, a budget system as a tool for programming and checking the results. The essential elements for management evaluation are: -an accurate accounting system for every department, based on a detailed analysis of the productive factors directly used; -a survey of the activity data with uniform and established indices. This work deals with a radiology department as a responsible unit belonging to Imola State Administration. It is an intermediate service as its activity is for both in- and outpatients. To calculate the cost of the service provided to users and to define the use of resources, inpatients and outpatients costs were included. This involves adding the cost of the examinations requested of the intermediate service, that is, the radiology department. The operative tool used to ascribe the cost of these demands to the departments needs a transfer cost system showing the increasing value of the number of services that the intermediate service gives the final user. To evaluate the activity of the radiology department, we tried to identify an index of respective complexity for every examination: a figure which allows us to express the use of resources according to the complexity of the services given and to turn the number of examinations into significant activity.

  19. IMPRESS: medical location-aware decision making during emergencies

    NASA Astrophysics Data System (ADS)

    Gkotsis, I.; Eftychidis, G.; Leventakis, G.; Mountzouris, M.; Diagourtas, D.; Kostaridis, A.; Hedel, R.; Olunczek, A.; Hahmann, S.

    2017-09-01

    Emergency situations and mass casualties involve several agencies and public authorities, which need to gather data from the incident scene and exchange geo-referenced information to provide fast and accurate first aid to the people in need. Tracking patients on their way to the hospitals can prove critical in taking lifesaving decisions. Increased and continuous flow of information combined by vital signs and geographic location of emergency victims can greatly reduce the response time of the medical emergency chain and improve the efficiency of disaster medicine activity. Recent advances in mobile positioning systems and telecommunications are providing the technology needed for the development of location-aware medical applications. IMPRESS is an advanced ICT platform based on adequate technologies for developing location-aware medical response during emergencies. The system incorporates mobile and fixed components that collect field data from diverse sources, support medical location and situation-based services and share information on the patient's transport from the field to the hospitals. In IMPRESS platform tracking of victims, ambulances and emergency services vehicles is integrated with medical, traffic and crisis management information into a common operational picture. The Incident Management component of the system manages operational resources together with patient tracking data that contain vital sign values and patient's status evolution. Thus, it can prioritize emergency transport decisions, based on medical and location-aware information. The solution combines positioning and information gathered and owned by various public services involved in MCIs or large-scale disasters. IMPRESS solution, were validated in field and table top exercises in cooperation with emergency services and hospitals.

  20. Quality improvement: the nurse's role.

    PubMed

    Moran, M J; Johnson, J E

    1992-06-01

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

  1. Psychological Distress, Service Utilization, and Prescribed Medications among Youth with and without Histories of Involvement with Child Protective Services

    ERIC Educational Resources Information Center

    Hamilton, Hayley A.; Paglia-Boak, Angela; Wekerle, Christine; Danielson, Anna Marie; Mann, Robert E.

    2011-01-01

    The objective of this study was to examine differences in psychological distress, service utilization, and prescriptions for medications between adolescents with histories of family involvement with child protective services (CPS) and adolescents without such involvement. Data on 3,497 students were obtained from the 2009 cycle of the Ontario…

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

    Youssef, Tarek A.; El Hariri, Mohamad; Elsayed, Ahmed T.

    The smart grid is seen as a power system with realtime communication and control capabilities between the consumer and the utility. This modern platform facilitates the optimization in energy usage based on several factors including environmental, price preferences, and system technical issues. In this paper a real-time energy management system (EMS) for microgrids or nanogrids was developed. The developed system involves an online optimization scheme to adapt its parameters based on previous, current, and forecasted future system states. The communication requirements for all EMS modules were analyzed and are all integrated over a data distribution service (DDS) Ethernet network withmore » appropriate quality of service (QoS) profiles. In conclusion, the developed EMS was emulated with actual residential energy consumption and irradiance data from Miami, Florida and proved its effectiveness in reducing consumers’ bills and achieving flat peak load profiles.« less

  3. SocialRAD: an infrastructure for a secure, cooperative, asynchronous teleradiology system.

    PubMed

    Figueiredo, João Filho Matos; Motta, Gustavo Henrique Matos Bezerra

    2013-01-01

    The popularity of teleradiology services has enabled a major advance in the provision of health services to areas with difficult geographical access. However, this potential has also brought with it a number of challenges: the large volume of data, characteristic of imaging tests, and security requirements designed to ensure confidentiality and integrity. Moreover, there is also a number of ethical questions involving the dominant model on the market, whereby this service is outsourced to private companies, and is not directly undertaken by professional radiologists. Therefore, the present paper proposes a cooperative model of teleradiology, where health professionals interact directly with the hospitals providing patient care. This has involved the integration of a wide range of technologies, such as the interconnection models Peer-to-Peer, Cloud Computing, Dynamic DNS, RESTful Web Services, as well as security and interoperability standards, with the aim of promoting a secure, collaborative asynchronous environment. The developed model is currently being used on an experimental basis, providing teleradiology support to cities in the north-eastern hinterland of Brazil, and is fulfilling all expectations.

  4. Medical social work practice in child protection in China: A multiple case study in Shanghai hospitals.

    PubMed

    Zhao, Fang; Hämäläinen, Juha; Chen, Yu-Ting

    2017-01-01

    With the rapid development of the child welfare system in China over recent years, medical social work has been increasingly involved in providing child protection services in several hospitals in Shanghai. Focusing on five cases in this paper, the exploratory study aims to present a critical overview of current practices and effects of medical social work for child protection, based on a critical analysis of the multidimensional role of social work practitioners engaged in the provision of child protection services as well as potential challenges. Implications and suggestions for future improvements of China's child protection system are also discussed.

  5. Regional Approach for Managing for Resilience Linking Ecosystem Services and Livelihood Strategies for Agro-Pastoral Communities in the Mongolian Steppe Ecosystem

    NASA Astrophysics Data System (ADS)

    Ojima, D. S.; Togtohyn, C.; Qi, J.; Galvin, K.

    2011-12-01

    Dramatic changes due to climate and land use dynamics in the Mongolian Plateau are affecting ecosystem services and agro-pastoral livelihoods in Mongolia and China. Recently, evaluation of pastoral systems, where humans depend on livestock and grassland ecosystem services, have demonstrated the vulnerability of the social-ecological system to climate change. Current social-ecological changes in ecosystem services are affecting land productivity and carrying capacity, land-atmosphere interactions, water resources, and livelihood strategies. Regional dust events, changes in hydrological cycle, and land use changes contribute to changing interactions between ecosystem and landscape processes which then affect social-ecological systems. The general trend involves greater intensification of resource exploitation at the expense of traditional patterns of extensive range utilization. Thus we expect climate-land use-land cover relationships to be crucially modified by the socio-economic forces. The analysis incorporates information of the socio-economic transitions taking place in the region which affect land-use, food security, and ecosystem dynamics. The region of study extends from the Mongolian plateau in Mongolia and China to the fertile northeast China plain. Sustainability of agro-pastoral systems in the region needs to integrate the impact of climate change on ecosystem services with socio-economic changes shaping the livelihood strategies of pastoral systems in the region. Adaptation strategies which incorporate landscape management provides a potential framework to link ecosystem services across space and time more effectively to meet the needs of agro-pastoral land use, herd quality, and herder's living standards. Under appropriate adaptation strategies agro-pastoralists will have the opportunity to utilize seasonal resources and enhance their ability to process and manufacture products from the available ecosystem services in these dynamic social-ecological systems.

  6. Equity inthe use of dental services provided by the Brazilian Unified Health System (SUS) among the elderly: a population-based study.

    PubMed

    Oliveira, Renata Francine Rodrigues de; Souza, João Gabriel Silva; Haikal, Desireé Sant'Ana; Ferreira, Efigênia Ferreira E; Martins, Andréa Maria Eleutério de Barros Lima

    2016-11-01

    The scope of this study is to establish the profile of elderly users of dental services provided by the Brazilian Unified Health System(SUS) and associated factors from the standpoint of equity. It involves an analytical cross-sectional study with hierarchical modeling conducted on the basis of a complex probabilistic sample of groups of the elderly (65-74 years of age) living in a densely populated Brazilian city. Independent variables were included relating to: socio-demographic characteristics, access to information on health, behaviors/health-care system and health outcomes. Descriptive, bivariate and multiple hierarchical analysis was performed. Of the 480 elderly persons included, 138 (31.2%) used dental services from the SUS. Use of these services was greater as per capita income and level of schooling decreased. It was lower among those who had not conducted exams of their own mouths (oral self-examinations) and higher among those individuals who used dental services for non-routine procedures. In addition, people whose relationship had been affected by oral health issues and a negative perception of their appearance used the SUS more frequently. The conclusion drawn is that the use of dental services of the SUS was most prevalent among the elderly living in precarious conditions.

  7. "It's Only Right that We Get Involved": Service-User Perspectives on Involvement in Learning Disability Services

    ERIC Educational Resources Information Center

    Hoole, Lucy; Morgan, Sally

    2011-01-01

    Promotion of service-user and carer involvement is part of the mainstream policy agenda in health and social care ["Crit Soc Policy 25" (2005) 164]. Much effort has been invested into involving people with learning disabilities in decisions regarding aspects of their lives through advocacy projects and the utilisation of person-centred planning…

  8. Setting up recovery clinics and promoting service user involvement.

    PubMed

    John, Thomas

    2017-06-22

    Service user involvement in mental health has gained considerable momentum. Evidence from the literature suggests that it remains largely theoretical rather than being put into practice. The current nature of acute inpatient mental health units creates various challenges for nurses to put this concept into practice. Recovery clinics were introduced to bridge this gap and to promote service user involvement practice within the current care delivery model at Kent and Medway NHS and Social Care Partnership Trust. It has shaped new ways of working for nurses with a person-centred approach as its philosophy. Service users and nurses were involved in implementing a needs-led and bottom-up initiative using Kotter's change model. Initial results suggest that it has been successful in meeting its objectives evidenced through increased meaningful interactions and involvement in care by service users and carers. The clinics have gained wide recognition and have highlighted a need for further research into care delivery models to promote service user involvement in these units.

  9. The Complexity of Health Service Integration: A Review of Reviews.

    PubMed

    Heyeres, Marion; McCalman, Janya; Tsey, Komla; Kinchin, Irina

    2016-01-01

    The aim of health service integration is to provide a sustainable and integrated health system that better meets the needs of the end user. Yet, definitions of health service integration, methods for integrating health services, and expected outcomes are varied. This review was commissioned by Queensland Health, the government department responsible for health service delivery in Queensland, Australia, to inform efforts to integrate their mental health services. This review reports on the characteristics, reported outcomes, and design quality of studies included in systematic reviews of health service integration research. The review was developed by systematically searching nine electronic databases to find peer-reviewed Australian and international systematic reviews with a focus on health service integration. Reviews were included if they were in the English language and published between 2000 and 2015. A standardized assessment tool was used to analyze the study design quality of included reviews. Data relating to the integration types, methods, and reported outcomes of integration were synthesized. Seventeen publications met the inclusion criteria. Eleven (65%) reviews were published during the past 5 years, which may indicate a trend for increased awareness of the need for service integration. The majority of reviews were published by researchers in the UK (8/47%), USA (3/18%), and Australia (3/18%). Included reviews focused on a variety of integration types, including integrated care pathways, governance models, integration of interventions, collaborative/integrated care models, and integration of different types of health care. Most (53%) of the reviews reported on the cost-effectiveness of service integration, e.g., positive results, no effect, or inconclusive. Only one of the reviews reported on the importance of consumer involvement. The overall design of 70% of the reviews was high, 18% medium, and 12% low. There is no "one size fits all" approach to health service integration. Instead, this literature review highlighted the complexity of service integration, which in most primary studies involved a range of strategies. Rigorous assessments of cost-effectiveness and reporting on consumer involvement are required in future research.

  10. An Assessment of Service-Learning in 34 US Schools of Pharmacy Follow Up on the 2001 Professional Affairs Committee Report

    PubMed Central

    Schlesselman, Lauren; Borrego, Matthew; Mehta, Bella; Drobitch, Robert K.; Smith, Thomas

    2015-01-01

    Objective. To determine if the service-learning components used at a convenience sample of schools and colleges of pharmacy meet the intent of the 2001 AACP Professional Affairs Committee (PAC) report. Methods. An online questionnaire was used to survey faculty members or staff involved with service-learning education at their school of pharmacy. Questions addressed aspects of service-learning including types of activities used, duration of student involvement with community partners, and association of learning objectives with service-learning activities. Results. The majority (85.3%) of respondents reported their institution used service-learning. Activities reported as part of service-learning ranged from working at health fairs to involvement with pharmacy school recruitment. More than half (64.3%) of service-learning activities involved long-term interactions with one community partner, and 74.1% of respondents indicated there was always an opportunity for student reflection on the service-learning activity. Conclusion. There is increasing though inconsistent application of PAC guidelines regarding service-learning. PMID:26688584

  11. Evaluated community fire safety interventions in the United States: a review of current literature.

    PubMed

    Ta, Van M; Frattaroli, Shannon; Bergen, Gwendolyn; Gielen, Andrea Carlson

    2006-06-01

    The purpose of the study was to assess the state of fire prevention research, provide an updated synthesis of evaluated fire prevention programs, and discuss the role of fire fighters and data systems in prevention efforts. The review included all evaluations of U.S. based fire prevention interventions published between January 1998 and September 2004 and any earlier articles about U.S. fire prevention interventions not included in two prior review articles. We retrieved information from each identified study including evaluation findings, involvement of fire service personnel and use of existing data systems. We identified twelve articles: seven reported on smoke alarm interventions, three on multi-faceted programs, and two other programs. Five programs involved fire service personnel in the design, implementation, and/or evaluation, and three used existing data systems. Studies reviewed suggest that canvassing and smoke alarm installations are the most effective means of distributing alarms and increasing the functional status of distributed alarms. The functionality of smoke alarms, an issue noted in earlier reviews, remains a problem. Programs involving partnerships with fire departments have indicated success in preventing fires and deaths, improving smoke alarm ownership and functional status, and improving children's fire safety knowledge. Using existing data systems to target and to evaluate interventions was effective. In the years since prior reviews, some improvements in the rigor of evaluation designs have been made, but there is still a need for high quality evaluations that will inform fire injury prevention efforts.

  12. Intermediate Outcomes, Strategies, and Challenges of Eight Healthy Start Projects

    PubMed Central

    Walker, Deborah Klein; Hargreaves, Margaret; Rosenbach, Margo

    2008-01-01

    Site visits were conducted for the evaluation of the national Healthy Start program to gain an understanding of how projects design and implement five service components (outreach, case management, health education, depression screening and interconceptional care) and four system components (consortium, coordination/collaboration, local health system action plan and sustainability) as well as program staff’s perceptions of these components’ influence on intermediate outcomes. Interviews with project directors, case managers, local evaluators, clinicians, consortium members, outreach/lay workers and other stakeholders were conducted during 3-day in-depth site visits with eight Healthy Start grantees. Grantees reported that both services and systems components were related to self-reported service achievements (e.g. earlier entry into prenatal care) and systems achievements (e.g. consumer involvement). Outreach, case management, and health education were perceived as the service components that contributed most to their achievements while consortia was perceived as the most influential systems component in reaching their goals. Furthermore, cultural competence and community voice were overarching project components that addressed racial/ethnic disparities. Finally, there was great variability across sites regarding the challenges they faced, with poor service availability and limited funding the two most frequently reported. Service provision and systems development are both critical for successful Healthy Start projects to achieve intermediate program outcomes. Unique contextual and community issues influence Healthy Start project design, implementation and reported accomplishments. All eight projects implement the required program components yet outreach, case management, and health education are cited most frequently for contributing to their perceived achievements. PMID:19011959

  13. Re-engineering pre-employment check-up systems: a model for improving health services.

    PubMed

    Rateb, Said Abdel Hakim; El Nouman, Azza Abdel Razek; Rateb, Moshira Abdel Hakim; Asar, Mohamed Naguib; El Amin, Ayman Mohammed; Gad, Saad abdel Aziz; Mohamed, Mohamed Salah Eldin

    2011-01-01

    The purpose of this paper is to develop a model for improving health services provided by the pre-employment medical fitness check-up system affiliated to Egypt's Health Insurance Organization (HIO). Operations research, notably system re-engineering, is used in six randomly selected centers and findings before and after re-engineering are compared. The re-engineering model follows a systems approach, focusing on three areas: structure, process and outcome. The model is based on six main components: electronic booking, standardized check-up processes, protected medical documents, advanced archiving through an electronic content management (ECM) system, infrastructure development, and capacity building. The model originates mainly from customer needs and expectations. The centers' monthly customer flow increased significantly after re-engineering. The mean time spent per customer cycle improved after re-engineering--18.3 +/- 5.5 minutes as compared to 48.8 +/- 14.5 minutes before. Appointment delay was also significantly decreased from an average 18 to 6.2 days. Both beneficiaries and service providers were significantly more satisfied with the services after re-engineering. The model proves that re-engineering program costs are exceeded by increased revenue. Re-engineering in this study involved multiple structure and process elements. The literature review did not reveal similar re-engineering healthcare packages. Therefore, each element was compared separately. This model is highly recommended for improving service effectiveness and efficiency. This research is the first in Egypt to apply the re-engineering approach to public health systems. Developing user-friendly models for service improvement is an added value.

  14. New Zealand's post-2008 health system reforms: toward re-centralization of organizational arrangements.

    PubMed

    Gauld, Robin

    2012-07-01

    The election of a centre-right government in 2008 has spawned a series of ongoing reforms to the structures for governing New Zealand's health system. These mainly involve creation of a series of new national agencies designed to stimulate national coordination and centralization of some planning and service delivery functions along with performance improvements in specific areas, namely quality, information technology, service efficiency, reduction of administrative costs, and comparative-effectiveness research. This brief article provides an overview of the post-2008 reforms. It notes that, while there appears to be agreement within the health system that the reforms are moving in the right direction, the new institutional arrangements are perhaps overly complicated. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. Exploring Barriers of the Health System to Rehabilitation Services for People with Disabilities in Iran: A Qualitative Study

    PubMed Central

    Abdi, Kianoush; Arab, Mohammad; Rashidian, Arash; Kamali, Mohammad; Khankeh, Hamid Reza; Farahani, Farideh Khalajabadi

    2015-01-01

    Introduction The United Nations (UN) identified health as a basic human right, but, unfortunately, the evidence shows that people with disabilities (PWD) often have lower levels of health than the general population. This can be associated with problems in access to the services and programs. The aim of this study was to explore barriers of the health system to rehabilitation services for PWD in Iran. Methods This was a qualitative study conducted on 21 participants using semi-structured, in-depth interviews and content analysis from June 2014 to July 2015. Data analysis was performed by MAXQDA version 10. Results “Barriers” were the most prominent challenge of people with disabilities that needed access to rehabilitation services. These barriers were categorized into eight concepts of deficiency in the system that provides rehabilitation services, defect of education, deficiency in detecting and screening of people with disability, defect of stewardship in rehabilitation, ignoring socio-cultural factors, accessibility hardships, lack of identification, and financial hardships in rehabilitation. Conclusions An efficient rehabilitation plan requires a common understanding, considering the long-term complications involved in addressing the barriers. Understanding the barriers of the health system to rehabilitation services requires comprehensive management that first should be familiar with all of PWD, providers, policy makers, and other beneficiaries. It also is necessary for policy makers to consider rehabilitation services as a main part of the health plan; especially, they must change their oversight of rehabilitation services and programs. Thus, policy makers should have need comprehensive management and recommended further research. PMID:26767101

  16. Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre

    PubMed Central

    Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

    2016-01-01

    Objectives This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. Methods We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Results Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Conclusion Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users. PMID:28002491

  17. 77 FR 34387 - Proposed Information Collection Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-11

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Proposed... transportation requirement provides the requirement that each child be seated in a child restraint system while... in the best interest of the children involved. Respondents: Head Start and Early Head Start program...

  18. Information Society and the Transformation of Organizations in Finland.

    ERIC Educational Resources Information Center

    Blom, Raimo; Melin, Harri

    2003-01-01

    Case studies of three Finnish companies (involved in manufacturing, Internet catalogs, and municipal government services) were used to investigate the nature of organizational change. Significant differences among organizational types were apparent in team formation, pay systems, recruitment, and forms of control. Organization differences reflect…

  19. Cable Television Interconnection.

    ERIC Educational Resources Information Center

    Cable Television Information Center, Washington, DC.

    State and local governments have not been involved in the complexities of cable television interconnection issues in the past despite opportunities. Without their intervention, the result may well be a lack of concern for local public services. However, the entertainment and communications industries will interconnect cable systems without the…

  20. Selecting the Best Mobile Information Service with Natural Language User Input

    NASA Astrophysics Data System (ADS)

    Feng, Qiangze; Qi, Hongwei; Fukushima, Toshikazu

    Information services accessed via mobile phones provide information directly relevant to subscribers’ daily lives and are an area of dynamic market growth worldwide. Although many information services are currently offered by mobile operators, many of the existing solutions require a unique gateway for each service, and it is inconvenient for users to have to remember a large number of such gateways. Furthermore, the Short Message Service (SMS) is very popular in China and Chinese users would prefer to access these services in natural language via SMS. This chapter describes a Natural Language Based Service Selection System (NL3S) for use with a large number of mobile information services. The system can accept user queries in natural language and navigate it to the required service. Since it is difficult for existing methods to achieve high accuracy and high coverage and anticipate which other services a user might want to query, the NL3S is developed based on a Multi-service Ontology (MO) and Multi-service Query Language (MQL). The MO and MQL provide semantic and linguistic knowledge, respectively, to facilitate service selection for a user query and to provide adaptive service recommendations. Experiments show that the NL3S can achieve 75-95% accuracies and 85-95% satisfactions for processing various styles of natural language queries. A trial involving navigation of 30 different mobile services shows that the NL3S can provide a viable commercial solution for mobile operators.

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

    PubMed

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

    2011-06-30

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

  2. A Review of Opportunities to Improve the Health of People Involved in the Criminal Justice System in the United States.

    PubMed

    Freudenberg, Nicholas; Heller, Daliah

    2016-01-01

    In the past decade, many constituencies have questioned the efficacy, cost, and unintended consequences of mass incarceration in the United States. Although substantial evidence now demonstrates that US incarceration policies have had unintended adverse health consequences, we know less about the strategies and policies that can prevent or reduce these problems for justice-involved individuals and how the criminal justice system (CJS) can contribute to the Healthy People 2020 national goal of eliminating inequities in health. This review examines strategies that have been used to improve the health of people at various stages of CJS involvement, including diversion from jail and prison stays into community settings, improvements to the social and physical environments within correctional facilities, provision of health and other services to inmates, assistance for people leaving correctional facilities to make the transition back to the community, and systems coordination and integration.

  3. Climate change's impact on key ecosystem services and the human well-being they support in the US

    USGS Publications Warehouse

    Nelson, Erik J.; Kareiva, Peter; Ruckelshaus, Mary; Arkema, Katie; Geller, Gary; Girvetz, Evan; Goodrich, Dave; Matzek, Virginia; Pinsky, Malin; Reid, Walt; Saunders, Martin; Semmens, Darius J.; Tallis, Heather

    2013-01-01

    Climate change alters the functions of ecological systems. As a result, the provision of ecosystem services and the well-being of people that rely on these services are being modified. Climate models portend continued warming and more frequent extreme weather events across the US. Such weather-related disturbances will place a premium on the ecosystem services that people rely on. We discuss some of the observed and anticipated impacts of climate change on ecosystem service provision and livelihoods in the US. We also highlight promising adaptive measures. The challenge will be choosing which adaptive strategies to implement, given limited resources and time. We suggest using dynamic balance sheets or accounts of natural capital and natural assets to prioritize and evaluate national and regional adaptation strategies that involve ecosystem services.

  4. Teleconferencing: Cost optimization of satellite and ground systems for continuing progressional education and medical services

    NASA Technical Reports Server (NTRS)

    Dunn, D.; Lusignan, B.

    1972-01-01

    A set of analytical capabilities that are needed to assess the role satellite communications technology will play in public and other services was developed. It is user oriented in that it starts from descriptions of user demand and develops the ability to estimate the cost of satisfying that demand with the lowest cost communications system. To ensure that the analysis could cope with the complexities of the real users, two services were chosen as examples, continuing professional education and medical services. Telecommunications costs are effected greatly by demographic factors, involving distribution of users in urban areas and distances between towns in rural regions. For this reason the analytical tools were exercised on sample locations. San Jose, California and Denver, Colorado were used to represent an urban area and the Rocky Mountain states were used to represent a rural region. In assessing the range of satellite system costs, two example coverage areas were considered, one appropriate to cover the contiguous forty-eight states, a second appropriate to cover about one-third that area.

  5. A Real-World Community Health Worker Care Coordination Model for High-Risk Children.

    PubMed

    Martin, Molly A; Perry-Bell, Kenita; Minier, Mark; Glassgow, Anne Elizabeth; Van Voorhees, Benjamin W

    2018-04-01

    Health care systems across the United States are considering community health worker (CHW) services for high-risk patients, despite limited data on how to build and sustain effective CHW programs. We describe the process of providing CHW services to 5,289 at-risk patients within a state-run health system. The program includes 30 CHWs, six care coordinators, the Director of Care Coordination, the Medical Director, a registered nurse, mental health specialists, and legal specialists. CHWs are organized into geographic and specialized teams. All CHWs receive basic training that includes oral and mental health; some receive additional disease-specific training. CHWs develop individualized care coordination plans with patients. The implementation of these plans involves delivery of a wide range of social service and coordination support. The number of CHW contacts is determined by patient risk. CHWs spend about 60% of their time in an office setting. To deliver the program optimally, we had to develop multiple CHW job categories that allow for CHW specialization. We created new technology systems to manage operations. Field issues resulted in program changes to improve service delivery and ensure safety. Our experience serves as a model for how to integrate CHWs into clinical and community systems.

  6. Outsourcing to increase service capacity in a New Zealand hospital.

    PubMed

    Renner, C; Palmer, E

    1999-01-01

    Service firms manage variability using both demand-side tactics (levelling customer demand), and supply-side tactics (increasing available capacity). One popular way of increasing available capacity is the outsourcing of non-core services. This article uses a case study to examine the impact of an outsourced non-core service on a hospital's overall service system. Findings show that the outsourced service provides access to more sophisticated technology, increases in-house capacity and saves capital expenditure. However, the outsourcing also increases the scheduling problems that the hospital faces. These problems are largely due to communication delays from the involvement of more than one organisation. These delays decrease the response time available to match changes in demand for the outsourced service. Given the obvious benefits of such outsourcing, the article concludes that management should pay close attention to the communication pathways between organisations, in order to minimise the end effects identified in this study.

  7. Protecting Database Centric Web Services against SQL/XPath Injection Attacks

    NASA Astrophysics Data System (ADS)

    Laranjeiro, Nuno; Vieira, Marco; Madeira, Henrique

    Web services represent a powerful interface for back-end database systems and are increasingly being used in business critical applications. However, field studies show that a large number of web services are deployed with security flaws (e.g., having SQL Injection vulnerabilities). Although several techniques for the identification of security vulnerabilities have been proposed, developing non-vulnerable web services is still a difficult task. In fact, security-related concerns are hard to apply as they involve adding complexity to already complex code. This paper proposes an approach to secure web services against SQL and XPath Injection attacks, by transparently detecting and aborting service invocations that try to take advantage of potential vulnerabilities. Our mechanism was applied to secure several web services specified by the TPC-App benchmark, showing to be 100% effective in stopping attacks, non-intrusive and very easy to use.

  8. Hospital survival strategies for the 1980s.

    PubMed

    Bonney, R S

    1983-09-01

    Survival strategies for hospitals and hospital pharmacy departments are presented, and one hospital's development into a health-services system is described. Financial and competitive pressures are forcing institutions to develop new strategies for survival. The primary institutional strategy is diversification--both horizontal and vertical. Diversification can assist in the hospital's growth, increase its asset and revenue bases, and lead to the development of a health-care delivery system. Marketing to physicians and developing information systems are also critical strategies under a prospective payment system. Institutions will need to know the cost of providing care for specific diagnosis-related groups. Strategies must be employed to develop incentives to reduce inpatient acute-care services and to increase productivity. Physicians should be involved in all of the institutional strategies. Strategies for the pharmacy department are basically the same. Pharmacy departments should develop programs to reduce drug use (especially antibiotic use) and information systems that show the actual cost of providing services by diagnosis. The major corporate restructuring and diversification efforts of one hospital are described. The future of hospitals and pharmacy departments will depend on the successful application of the strategies discussed.

  9. Big Data: Implications for Health System Pharmacy

    PubMed Central

    Stokes, Laura B.; Rogers, Joseph W.; Hertig, John B.; Weber, Robert J.

    2016-01-01

    Big Data refers to datasets that are so large and complex that traditional methods and hardware for collecting, sharing, and analyzing them are not possible. Big Data that is accurate leads to more confident decision making, improved operational efficiency, and reduced costs. The rapid growth of health care information results in Big Data around health services, treatments, and outcomes, and Big Data can be used to analyze the benefit of health system pharmacy services. The goal of this article is to provide a perspective on how Big Data can be applied to health system pharmacy. It will define Big Data, describe the impact of Big Data on population health, review specific implications of Big Data in health system pharmacy, and describe an approach for pharmacy leaders to effectively use Big Data. A few strategies involved in managing Big Data in health system pharmacy include identifying potential opportunities for Big Data, prioritizing those opportunities, protecting privacy concerns, promoting data transparency, and communicating outcomes. As health care information expands in its content and becomes more integrated, Big Data can enhance the development of patient-centered pharmacy services. PMID:27559194

  10. Big Data: Implications for Health System Pharmacy.

    PubMed

    Stokes, Laura B; Rogers, Joseph W; Hertig, John B; Weber, Robert J

    2016-07-01

    Big Data refers to datasets that are so large and complex that traditional methods and hardware for collecting, sharing, and analyzing them are not possible. Big Data that is accurate leads to more confident decision making, improved operational efficiency, and reduced costs. The rapid growth of health care information results in Big Data around health services, treatments, and outcomes, and Big Data can be used to analyze the benefit of health system pharmacy services. The goal of this article is to provide a perspective on how Big Data can be applied to health system pharmacy. It will define Big Data, describe the impact of Big Data on population health, review specific implications of Big Data in health system pharmacy, and describe an approach for pharmacy leaders to effectively use Big Data. A few strategies involved in managing Big Data in health system pharmacy include identifying potential opportunities for Big Data, prioritizing those opportunities, protecting privacy concerns, promoting data transparency, and communicating outcomes. As health care information expands in its content and becomes more integrated, Big Data can enhance the development of patient-centered pharmacy services.

  11. 36 CFR 3.5 - Do I have to report an accident involving a vessel to the National Park Service?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... accident involving a vessel to the National Park Service? 3.5 Section 3.5 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR BOATING AND WATER USE ACTIVITIES § 3.5 Do I have to report an accident involving a vessel to the National Park Service? (a) The operator of a vessel...

  12. 36 CFR 3.5 - Do I have to report an accident involving a vessel to the National Park Service?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... accident involving a vessel to the National Park Service? 3.5 Section 3.5 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR BOATING AND WATER USE ACTIVITIES § 3.5 Do I have to report an accident involving a vessel to the National Park Service? (a) The operator of a vessel...

  13. 36 CFR 3.5 - Do I have to report an accident involving a vessel to the National Park Service?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... accident involving a vessel to the National Park Service? 3.5 Section 3.5 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR BOATING AND WATER USE ACTIVITIES § 3.5 Do I have to report an accident involving a vessel to the National Park Service? (a) The operator of a vessel...

  14. 36 CFR 3.5 - Do I have to report an accident involving a vessel to the National Park Service?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... accident involving a vessel to the National Park Service? 3.5 Section 3.5 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR BOATING AND WATER USE ACTIVITIES § 3.5 Do I have to report an accident involving a vessel to the National Park Service? (a) The operator of a vessel...

  15. 36 CFR 3.5 - Do I have to report an accident involving a vessel to the National Park Service?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... accident involving a vessel to the National Park Service? 3.5 Section 3.5 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR BOATING AND WATER USE ACTIVITIES § 3.5 Do I have to report an accident involving a vessel to the National Park Service? (a) The operator of a vessel...

  16. Quebec mental health services networks: models and implementation

    PubMed Central

    Fleury, Marie-Josée

    2005-01-01

    Abstract Purpose In the transformation of health care systems, the introduction of integrated service networks is considered to be one of the main solutions for enhancing efficiency. In the last few years, a wealth of literature has emerged on the topic of services integration. However, the question of how integrated service networks should be modelled to suit different implementation contexts has barely been touched. To fill that gap, this article presents four models for the organization of mental health integrated networks. Data sources The proposed models are drawn from three recently published studies on mental health integrated services in the province of Quebec (Canada) with the author as principal investigator. Description Following an explanation of the concept of integrated service network and a description of the Quebec context for mental health networks, the models, applicable in all settings: rural, urban or semi-urban, and metropolitan, and summarized in four figures, are presented. Discussion and conclusion To apply the models successfully, the necessity of rallying all the actors of a system, from the strategic, tactical and operational levels, according to the type of integration involved: functional/administrative, clinical and physician-system is highlighted. The importance of formalizing activities among organizations and actors in a network and reinforcing the governing mechanisms at the local level is also underlined. Finally, a number of integration strategies and key conditions of success to operationalize integrated service networks are suggested. PMID:16773157

  17. The selling of mental health services: some ethical reflections.

    PubMed

    Neumann, M

    1993-01-01

    Since the introduction of public mental health services in Israel, the main principle of our work has been to provide equal and free of charge health services to all patients. We were proud of our ability to provide optimal treatment to all patients in all our facilities, regardless of cost or status of insurance. During the last decade, the cost of providing good quality public health services, including mental health services, has constantly increased, and the system has reached a state of financial distress resulting in insufficiency and inability to perform properly. In order to maintain the level of mental health services, the health authorities started planning a system of payment for various mental health services which, until now, were supplied free of charge. This change of policy and attitude towards the population in need poses severe ethical and practical questions and problems. It is questionable that the amount of income ensuing from the sale of mental health services and whether a relatively small financial profit justify possible injury of the population in need of these services, especially the sicker and weaker members of it. This article raises some ethical doubts involved in charging money for psychiatric services that are given to this special group of the mentally ill, and claims that the feasibility of selling services in this area of public health should be reinvestigated.

  18. Problem reporting management system performance simulation

    NASA Technical Reports Server (NTRS)

    Vannatta, David S.

    1993-01-01

    This paper proposes the Problem Reporting Management System (PRMS) model as an effective discrete simulation tool that determines the risks involved during the development phase of a Trouble Tracking Reporting Data Base replacement system. The model considers the type of equipment and networks which will be used in the replacement system as well as varying user loads, size of the database, and expected operational availability. The paper discusses the dynamics, stability, and application of the PRMS and addresses suggested concepts to enhance the service performance and enrich them.

  19. Use of negotiated rulemaking in developing technical rules for low-Earth orbit mobile satellite systems

    NASA Technical Reports Server (NTRS)

    Taylor, Leslie A.

    1993-01-01

    Technical innovations have converged with the exploding market demand for mobile telecommunications to create the impetus for low-earth orbit (LEO) communications satellite systems. The so-called 'Little LEO's' propose use of VHF and UHF spectrum to provide position - location and data messaging services. The so-called 'Big LEO's' propose to utilize the RDSS bands to provide voice and data services. In the United States, several applications were filed with the U.S. Federal Communications Commission (FCC) to construct and operate these mobile satellite systems. To enable the prompt introduction of such new technology services, the FCC is using innovative approaches to process the applications. Traditionally, when the FCC is faced with 'mutually exclusive' applications, e.g. a grant of one would preclude a grant of the others, it uses selection mechanisms such as comparative hearings or lotteries. In the case of the LEO systems, the FCC has sought to avoid these time-consuming approaches by using negotiated rulemakings. The FCC's objective is to enable the multiple applicants and other interested parties to agree on technical and service rules which will enable the grant of all qualified applications. With regard to the VHF/UHF systems, the Advisory Committee submitted a consensus report to the FCC. The process for the systems operating in the bands above 1 GHz involved more parties and more issues but still provided the FCC useful technical information to guide the adoption of rules for the new mobile satellite service.

  20. Use of negotiated rulemaking in developing technical rules for low-Earth orbit mobile satellite systems

    NASA Astrophysics Data System (ADS)

    Taylor, Leslie A.

    Technical innovations have converged with the exploding market demand for mobile telecommunications to create the impetus for low-earth orbit (LEO) communications satellite systems. The so-called 'Little LEO's' propose use of VHF and UHF spectrum to provide position - location and data messaging services. The so-called 'Big LEO's' propose to utilize the RDSS bands to provide voice and data services. In the United States, several applications were filed with the U.S. Federal Communications Commission (FCC) to construct and operate these mobile satellite systems. To enable the prompt introduction of such new technology services, the FCC is using innovative approaches to process the applications. Traditionally, when the FCC is faced with 'mutually exclusive' applications, e.g. a grant of one would preclude a grant of the others, it uses selection mechanisms such as comparative hearings or lotteries. In the case of the LEO systems, the FCC has sought to avoid these time-consuming approaches by using negotiated rulemakings. The FCC's objective is to enable the multiple applicants and other interested parties to agree on technical and service rules which will enable the grant of all qualified applications. With regard to the VHF/UHF systems, the Advisory Committee submitted a consensus report to the FCC. The process for the systems operating in the bands above 1 GHz involved more parties and more issues but still provided the FCC useful technical information to guide the adoption of rules for the new mobile satellite service.

  1. 78 FR 27339 - Private Attorney Involvement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ... LEGAL SERVICES CORPORATION 45 CFR Part 1614 Private Attorney Involvement AGENCY: Legal Services... in the rulemaking workshops. SUMMARY: The Legal Services Corporation (LSC) is conducting two... to Mark Freedman, Senior Assistant General Counsel, Legal Services Corporation, 3333 K St NW...

  2. Integrating into the Mental Health System from the Criminal Justice System: Jail Aftercare Services for Persons with a Severe Mental Illness

    ERIC Educational Resources Information Center

    Davis, Kristin; Fallon, John; Vogel, Sue; Teachout, Alexandra

    2008-01-01

    This article describes a mental health evidence based practice, Assertive Community Treatment (ACT). While ACT has scientific support, it has not been rigorously tested for persons with a severe mental illness and repeated forensic involvement. This article provides preliminary evidence that ACT is best suited for reentry into the mental health…

  3. Adolescents' Faith Commitments as Correlates of Their Involvement in Christian Service

    ERIC Educational Resources Information Center

    Nagy, Andrea; Ostrander, Raymond; Kijai, Jimmy; Matthews, John

    2017-01-01

    This study sought to determine the relationship between adolescents' involvement in service to others and their commitment to religious values and Seventh-day Adventist beliefs. Canonical correlation indicated that adolescents' involvement in service to others is significantly related to their commitment to religious values and beliefs. Results…

  4. “When You’re Sitting on the Fence, Hope’s the Hardest Part”: Challenges and Experiences of Heterosexual and Same-Sex Couples Adopting Through the Child Welfare System

    PubMed Central

    Moyer, April M.; Kinkler, Lori A.; Richardson, Hannah B.

    2012-01-01

    Foster-to-adopt families can be viewed as systems that are influenced by many other systems (e.g., the legal system, the social service agency, and the birth family). The current qualitative study of 84 foster-to-adopt parents (members of 42 lesbian, gay, and heterosexual couples) examined the types of challenges that parents faced as they navigated multiple systems during the initial post-placement period. Some participants described the legal insecurity associated with their role as foster-to-adopt parents as impacting their personal well-being and their attachment to their children. Lack of support services and disorganization within social service agencies, as well as strained relationships with birth parents, were also identified as stressors for foster-to-adopt parents. Importantly, lesbian and gay participants faced additional concerns regarding the security of their placement, due to the possibility for discrimination within the various systems involved with the foster-to-adopt process. Participants as a whole also identified positive aspects of their experiences within various systems; for example, they appreciated child care subsidies, state-provided health insurance, and supportive social workers. Our findings provide insights into foster-to-adopt parents’ experiences during the initial post-placement period, and have implications for adoption services aimed to improve placement stability and enhance family functioning in foster-to-adopt families. PMID:23226935

  5. Lean management systems: creating a culture of continuous quality improvement.

    PubMed

    Clark, David M; Silvester, Kate; Knowles, Simon

    2013-08-01

    This is the first in a series of articles describing the application of Lean management systems to Laboratory Medicine. Lean is the term used to describe a principle-based continuous quality improvement (CQI) management system based on the Toyota production system (TPS) that has been evolving for over 70 years. Its origins go back much further and are heavily influenced by the work of W Edwards Deming and the scientific method that forms the basis of most quality management systems. Lean has two fundamental elements--a systematic approach to process improvement by removing waste in order to maximise value for the end-user of the service and a commitment to respect, challenge and develop the people who work within the service to create a culture of continuous improvement. Lean principles have been applied to a growing number of Healthcare systems throughout the world to improve the quality and cost-effectiveness of services for patients and a number of laboratories from all the pathology disciplines have used Lean to shorten turnaround times, improve quality (reduce errors) and improve productivity. Increasingly, models used to plan and implement large scale change in healthcare systems, including the National Health Service (NHS) change model, have evidence-based improvement methodologies (such as Lean CQI) as a core component. Consequently, a working knowledge of improvement methodology will be a core skill for Pathologists involved in leadership and management.

  6. "The study on surgical services for the United States": a valid prescription for American surgery?

    PubMed

    Hughes, E F; Lewit, E M; Pauly, M V

    1977-01-01

    The overall approach of SOSSUS to the study of surgical services, the interpretation of findings, and policy recommendations are rightly called into question. But singular concern with the consequences of monopolistic control by the profession is no substitute for analysis of the dynamics among demand, production, and supply of surgery. Any delivery system--and many models are feasible--involving consumers, providers, and payers is a market in which multidimensional behavior must be anticipated.

  7. Public service communications satellite. [health, education, safety and information transfer applications

    NASA Technical Reports Server (NTRS)

    Wolff, E. A.

    1978-01-01

    Health, education, public safety, and information transfer applications of public service communications satellites are discussed with particular attention to the use of communications satellites to improve rural health delivery. Health-care communications requirements are summarized. The communications system concept involves small inexpensive stationary, portable, and moving ground terminals which will provide communications between any two points in the U.S. with both fixed and moving terminals on a continuous 24-hour basis. User requirements, wavebands, and privacy techniques are surveyed.

  8. Staffing Systems of Care for Children and Families: A Report of the Southern Human Resource Development Consortium for Mental Health on Workforce Issues Related to Community-Based Service Delivery for Children and Adolescents with Serious Emotional Disturbance/Mental Illness and Their Families.

    ERIC Educational Resources Information Center

    Pires, Sheila A.

    This report describes the results of a regional needs assessment of workforce issues related to the delivery of community-based services for children and adolescents with serious emotional disturbance or mental illness and their families in a region comprising 12 southern states. The assessment involved a survey of key stakeholders, principally…

  9. Public service satellite communications

    NASA Technical Reports Server (NTRS)

    Wolff, E. A.

    1978-01-01

    It is suggested that the high effective isotropic radiated power provided by high-power satellite transmitters and high-gain antennas could be used in conjunction with economical ground receivers to furnish public services in remote areas of the U.S. Applications to health care, education and public safety are mentioned. A system concept involving a communications satellite operating in the Ku-band (12-GHz down, 14-GHz up) and either 100/30 watt stationary earth terminals with 1-1.8 m antennas or mobile terminals with omnidirectional antennas is presented.

  10. The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China.

    PubMed

    Tang, Liyang

    2012-09-14

    Patient's satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient's life satisfaction in China's health delivery system/in various kinds of hospitals.The aim of this study was to test whether and to what extent patient's satisfaction with medical service delivery/patient's assessments of various major aspects of medical service/various major aspects of patient's trust in health delivery system influenced patient's life satisfaction in China's health delivery system/in various kinds of hospitals. This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. The key considerations in generating patient's life satisfaction involved patient's overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient's life satisfaction were different among low level public hospital, high level public hospital, and private hospital. The promotion of patient's overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient's trust in prescription, the promotion of patient's trust in doctor, and the promotion of patient's trust in recommended medical examination could all help promote patient's life satisfaction. But their promotion effects were different among low level public hospital, high level public hospital, and private hospital.

  11. Involving older people in intermediate care.

    PubMed

    Andrews, JoyAnn; Manthorpe, Jill; Watson, Roger

    2004-05-01

    Intermediate care has become a crucial part of the United Kingdom government's programme for improving services for older people. Older people comprise a substantial part of the user base for these services, and it is increasingly recognized that there is a need for greater user involvement in service development for intermediate care. National initiatives undertaken in intermediate care have sought to widen and deepen the remit of such services, and in this way promote greater independence and improved quality of care for older people. In particular, the government has set out clear plans for reshaping services for older people in the National Health Service Plan and the rationale for greater involvement of older people in service development. This article considers ways in which these national and local objectives may be achieved and considers some of the implications for nursing. This paper aims to explore the concept of intermediate care and to identify trends and existing evidence of user involvement in care. In this way it charts a possible way forward for the development of a more 'user sensitive' approach. The following databases were searched: Medline, Cochrane Library, the Social Science Citation Index and CINAHL. Key words were 'intermediate care', 'older people', 'formal care', 'primary care', 'social services' and 'geriatrics', used in combination. The findings from this study indicate that there is considerable scope for increased user involvement in service development for intermediate care. Such challenges may be more effectively met through greater clarity of the concept of intermediate care, and a bridging of user involvement at the practice and policy levels. Nurses are key providers of intermediate care in the community. The involvement of older people in intermediate care service development must be premised on a shared comprehension of the purpose and function of intermediate care. Nurses must be involved in shifting intermediate care from being service-focused to patient-centred. Effective participation eschews the application of global constructs for older people, while supporting greater participation at all levels and robust implementation processes.

  12. Weight management in community pharmacy: what do the experts think?

    PubMed

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

    2013-06-01

    The increasing prevalence of obesity and overweight adults creates a significant public health burden and there is great potential for pharmacists to be involved in the provision of weight management services, other than the mundane supply of commercial products. In order to provide optimal services that can be integrated into the healthcare system, a best practice model for weight management services in community pharmacy should be in place. We sought experts' and key stakeholders' opinions on this matter. (1) To identify components of a best practice model of a weight management service feasible in Australian community pharmacy. (2) To identify the role of pharmacists and the training requirements to up-skill pharmacists to competently provide weight management services. (3) To elicit any practical suggestions that would contribute to successful implementation of weight management services in pharmacy. Australian primary care sector. Semi-structured interviews were conducted with a purposive sample of 12 participants including Australian experts in obesity and representatives of main Australian professional organisations in pharmacy. Interviews were digitally recorded, transcribed verbatim and thematically analysed using the framework approach. Recommended components of pharmacy-based weight management services and training requirements. Participants perceived two potential roles for pharmacists involved in weight management: health promotion and individualised service. Multi-component interventions targeting all three areas: diet, physical activity and behaviour change were emphasised. Physical assessment (e.g. weight, waist circumference measurements), goal setting, referral to allied healthcare professionals and on-going support for weight maintenance were also proposed. Participants suggested pharmacists should undergo formal training and identified various training topics to improve pharmacists' knowledge, attributes and skills to acquire competencies necessary for delivery of this service. Some physical and financial barriers in providing these services were also identified including infrastructure, pharmacists' time and cost-effectiveness. Pharmacists are well-positioned to promote healthy weight and/or implement weight management interventions. Furthering pharmacists' role would involve training and up-skilling; and addressing key practice change facilitators such as pharmacy layout and remuneration. This study provides some insight into the design and implementation of a best practice model for pharmacy-based weight management services in Australia.

  13. INTRODUCTION OF UNIVERSAL HEALTH PROGRAM IN GEORGIA: PROBLEMS AND PERSPECTIVES.

    PubMed

    Verulava, T; Jorbenadze, R; Barkalaia, T

    2017-01-01

    Since 2013, Georgia enacted Universal Healthcare (UHC) program. Inclusion of uninsured population in the UHC program will have a positive impact on their financial accessibility to the health services. The study aims to analyze the referral rate of the beneficiaries to the health service providers before introduction and after application of the UHC program, particularly, how much it increased the recently uninsured population referral to primary health care units, and also to study the level of satisfaction with the UHC program. Research was conducted by qualitative and quantitative methods. The target groups' (program beneficiaries, physicians, personnel of the Social Service Agency) opinions were identified by means of face-to-face interviews. Enactment of the UHC programs significantly raised the population refferal to the family physicians, and the specialists. Insignificantly, but also increased the frequency of laboratory and diagnostic services. Despite the serious positive changes caused by UHC program implementation there still remain the problems in the primary healthcare system. Also, it is desirable to raise the financial availability of those medical services, which may cause catastrophic costs. In this respect, such medical services must be involved in the universal healthcare program and been expanded their scale. For the purpose of effective usage of the limited funds allocated for health care services provision, the private health insurance companies should be involved in UHC programs. This, together with the reduction of health care costs will increase a competition in the medical market, and enhance the quality of health service.

  14. Case management of persons with acquired immunodeficiency syndrome in San Francisco

    PubMed Central

    Benjamin, A. E.; Lee, Philip R.; Solkowitz, Sharon N.

    1988-01-01

    The acquired immunodeficiency syndrome (AIDS) epidemic represents a growing challenge for the health care system and for case management models applied to persons with AIDS. The experience of San Francisco highlights some of the issues involved in developing a case management system appropriate to the needs of persons with AIDS, as well as providers, and payers. Dramatic growth in the size and complexity of the AIDS caseload and the involvement of public, health maintenance organization, and community providers has required the increasing formalization and centralization of case management roles. Persistent questions about the definition and goals of case management complicate development of these services. PMID:10312974

  15. 5 CFR 6801.109 - Prior approval for compensated outside employment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... SYSTEM SUPPLEMENTAL STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE BOARD OF GOVERNORS OF THE FEDERAL... designee) and the concurrence of the Board's Designated Agency Ethics Official before engaging in... employment or business relationship involving the provision of personal services by the employee. It includes...

  16. 48 CFR 1335.006 - Contracting methods and contract type.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  17. Employment Priorities for the '90s for People with Disabilities.

    ERIC Educational Resources Information Center

    President's Committee on Employment of People with Disabilities, Washington, DC.

    This report resulted from a project designed to involve people with disabilities in the development of employment policies and rehabilitation services. The report presents recommendations addressing employment preparation, placement, postemployment, and support systems. The project, titled "National Agenda for the Employment of People with…

  18. 77 FR 46762 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-06

    ... children involved. Respondents: Head Start and Early Head Start program grants recipients. Annual Burden... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Submission for... requirement that each child be seated in a child restraint system while the vehicle is in motion, and the...

  19. How states, tribes and localities are re-defining systems of care.

    PubMed

    Pires, Sheila A

    2010-02-01

    The original definition of system of care was developed 20 years ago largely in response to the fragmented services experienced by children with serious emotional disorders and their families, who, typically, were involved in multiple systems and/or receiving services from different providers. Over time, in response to national funders' pursuing system of care for different populations and their own experience, states, tribes and localities have applied system of care principles, values and operational characteristics to other populations (children and adults). The definition offered by Hodges et al., has an unintended effect of constraining the properties (and potential) of system of care in its limitation to a single population. This paper argues that the adaptations made to the original Stroul and Friedman definition in the training curriculum Building Systems of Care: A Primer adequately encompass properties that reflect state, tribal and local implementation experience and are specific to planning, implementing and evaluating a system of care, without limiting system of care to any one population.

  20. An operational, multistate, earth observation data management system

    NASA Technical Reports Server (NTRS)

    Eastwood, L. F., Jr.; Hill, C. T.; Morgan, R. P.; Gohagan, J. K.; Hays, T. R.; Ballard, R. J.; Crnkovich, G. G.; Schaeffer, M. A.

    1977-01-01

    State, local, and regional agencies involved in natural resources management were investigated as potential users of satellite remotely sensed data. This group's needs are assessed and alternative data management systems serving some of those needs are outlined. It is concluded that an operational earth observation data management system will be of most use to these user agencies if it provides a full range of information services -- from raw data acquisition to interpretation and dissemination of final information products.

  1. Best kept secrets ... First Coast Systems, Inc. (FCS).

    PubMed

    Andrew, W F

    1991-04-01

    The FCS/APaCS system is a viable option for small-to medium-size hospitals (up to 400 beds). The table-driven system takes full advantage of IBM AS/400 computer architecture. A comprehensive application set, provided in an integrated database environment, is adaptable to multi-facility environments. Price/performance appears to be competitive. Commitment to IBM AS/400 environment assures cost-effective hardware platforms backed by IBM support and resources. As an IBM Health Industry Business Partner, FCS (and its clients) benefits from IBM's well-known commitment to quality and service. Corporate emphasis on user involvement and satisfaction, along with a commitment to quality and service for the APaCS systems, assures clients of "leading edge" capabilities in this evolutionary healthcare delivery environment. FCS/APaCS will be a strong contender in selected marketing environments.

  2. The Use of Smartphones in Norwegian Social Care Services.

    PubMed

    Hansen, Linda Iren Mihaila; Fruhling, Ann; Fossum, Mariann

    2016-01-01

    This study aims to understand how smartphone technology was perceived by social workers responsible for piloting social services software and the experiences of involving end-users as co-developers. The pilot resulted in an improved match between the smartphone software and workflow as well as mutual learning experiences among the social workers, clients, and the vendor. The pilot study revealed several graphical user interface (GUI) and functionality challenges. Implementing an ICT social service smartphone application may further improve efficiencies for social workers serving citizens, however; this study validates the importance to study end-users' experiences with communication and the real-time use of the system in order reap the anticipated benefits of ICT capabilities for smart phone social service applications.

  3. 26 CFR 54.4975-6 - Statutory exemptions for office space or services and certain transactions involving financial...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... services and certain transactions involving financial institutions. 54.4975-6 Section 54.4975-6 Internal... transactions involving financial institutions. (a) Exemption for office space or services—(1) In general... imposed by section 4975 the provision of certain ancillary services by a bank or similar financial...

  4. 47 CFR 80.302 - Notice of discontinuance, reduction, or impairment of service involving a distress watch.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Notice of discontinuance, reduction, or impairment of service involving a distress watch. 80.302 Section 80.302 Telecommunication FEDERAL..., reduction, or impairment of service involving a distress watch. (a) When changes occur in the operation of a...

  5. Ethical Tensions Related to Systemic Constraints: Occupational Alienation in Occupational Therapy Practice.

    PubMed

    Durocher, Evelyne; Kinsella, Elizabeth Anne; McCorquodale, Lisa; Phelan, Shanon

    2016-09-03

    Ethical tensions arise daily in health care practice and are frequently related to health care system structures or policies. Collective case study methodology was adopted to examine ethical tensions reported by occupational therapists practicing in different settings in Southwestern Ontario, Canada. Inductive analysis involving multiple layers of coding was conducted. This article focuses on tensions related to systemic constraints. Participants reported ethical tensions related to balancing client priorities with those of health care services. Four themes related to systemic constraints were identified including imposed practices, ineffective processes, resource limitations, and lack of services. Therapists' aims could be seen to align with an "ethic of care" and were seen to be in tension in light of systemic constraints. The findings raise issues related to occupational justice, particularly related to occupational alienation in occupational therapy practice, and open conversations related to neoliberalist health care agendas. © The Author(s) 2016.

  6. A DDS-Based Energy Management Framework for Small Microgrid Operation and Control

    DOE PAGES

    Youssef, Tarek A.; El Hariri, Mohamad; Elsayed, Ahmed T.; ...

    2017-09-26

    The smart grid is seen as a power system with realtime communication and control capabilities between the consumer and the utility. This modern platform facilitates the optimization in energy usage based on several factors including environmental, price preferences, and system technical issues. In this paper a real-time energy management system (EMS) for microgrids or nanogrids was developed. The developed system involves an online optimization scheme to adapt its parameters based on previous, current, and forecasted future system states. The communication requirements for all EMS modules were analyzed and are all integrated over a data distribution service (DDS) Ethernet network withmore » appropriate quality of service (QoS) profiles. In conclusion, the developed EMS was emulated with actual residential energy consumption and irradiance data from Miami, Florida and proved its effectiveness in reducing consumers’ bills and achieving flat peak load profiles.« less

  7. Neglected populations: safeguarding the health of street-involved children in Ghana.

    PubMed

    Osei-Twum, Jo-Ann; Wasan, Kishor M

    2012-10-01

    Ensuring the health of street-involved children is a growing public health challenge. These children are vulnerable, neglected, and rarely a priority for basic service providers and governments. Sizable populations of street-involved children are present in major urban areas worldwide and current trends in urbanization suggest these populations will grow in the coming years. Although migration offers employment and training opportunities, the health and wellbeing of children is negatively impacted by their interactions with the streets. However, systemic barriers may also prevent these children from achieving an adequate health status. The situation of street-involved children in Ghana, West Africa will be discussed. Copyright © 2012 Wiley Periodicals, Inc.

  8. Factors and Strategies That Influence Faculty Involvement in Public Service

    ERIC Educational Resources Information Center

    Holland, Barbara A.

    2016-01-01

    Data from several national research and evaluation projects involving 32 diverse institutions offer insights into what motivates college-faculty involvement in public service and outreach efforts, what faculty find to be obstacles to involvement, and what institutions can do to facilitate involvement. One salient policy supporting faculty…

  9. Wireless telemedicine for the delivery of specialist paediatric services to the bedside.

    PubMed

    Smith, Anthony C; Coulthard, Mark; Clark, Ron; Armfield, Nigel; Taylor, Shauna; Goff, Robyn; Mottarelly, Ian; Youngberry, Karen; Isles, Alan; McCrossin, Robert; Wootton, Richard

    2005-01-01

    A mobile interactive online health system was used to conduct virtual ward rounds at a regional hospital which had no specialist paediatrician. The system was wireless, which allowed telepaediatric services to be delivered direct to the bedside. Between December 2004 and May 2005, 43 virtual ward rounds were coordinated between specialists based in Brisbane and local staff at the Gladstone Hospital. Eighty-six consultations were provided for 64 patients. The most common conditions included asthma (27%), chest infections (12%), gastroenteritis (10%) and urinary tract infections (10%). In the majority of cases, there were partial (67%) or complete changes (11%) in the clinical management of patients. Specialist services were offered by a team of 13 clinicians at the Royal Children's Hospital: 10 general paediatricians, two physiotherapists and one registered nurse. Feedback from all consultants involved in the service and local staff in Gladstone was extremely positive. In 43 videoconference calls there were three technical problems, probably due to an intermittent mains power supply at the regional hospital. There appears to be potential for other rural and regional hospitals to adopt this model of service delivery.

  10. Rural health service planning: the need for a comprehensive approach to costing.

    PubMed

    Kornelsen, Jude A; Barclay, Lesley; Grzybowski, Stefan; Gao, Yu

    2016-01-01

    The precipitous closure of rural maternity services in industrialized countries over the past two decades is underscored in part by assumptions of efficiencies of scale leading to cost-effectiveness. However, there is scant evidence to support this and the costing evidence that exists lacks comprehensiveness. To clearly understand the cost-effectiveness of rural services we must take the broadest societal perspective to include not only health system costs, but also those costs incurred at the family and community levels. We must consider manifest costs (hard, easily quantifiable costs, both direct and indirect) and latent costs (understood as what is sacrificed or lost), and take into account cost shifting (reallocating costs to different parts of the system) and cost downloading (passing costs on to women and families). Further, we must compare the costs of having a rural maternity service to those incurred by not having a service, a comparison that is seldom made. This approach will require determining a methodological framework for weighing all costs, one which will likely involve attention to the rich descriptions of those experiencing loss.

  11. Bridging the gap from values to actions: a family systems framework for family-centered AAC services.

    PubMed

    Mandak, Kelsey; O'Neill, Tara; Light, Janice; Fosco, Gregory M

    2017-03-01

    Despite the growing recognition of the importance of family involvement in augmentative and alternative communication (AAC) intervention, little guidance exists on how professionals can establish successful collaborative relationships with families. In this paper, we discuss family systems theory and ecological systems theory as a framework to guide family-centered AAC practice, review family-focused research in AAC, consider how AAC may impact the family system, and provide examples of the clinical implications of using the proposed family systems framework to improve family-centered AAC practice.

  12. Health information system linkage and coordination are critical for increasing access to secondary prevention in Aboriginal health: a qualitative study.

    PubMed

    Digiacomo, Michelle; Davidson, Patricia M; Taylor, Kate P; Smith, Julie S; Dimer, Lyn; Ali, Mohammed; Wood, Marianne M; Leahy, Timothy G; Thompson, Sandra C

    2010-01-01

    Aboriginal Australians have low rates of participation in cardiac rehabilitation (CR), despite having high rates of cardiovascular disease. Barriers to CR participation reflect multiple patient-related issues. However, an examination of the broader context of health service delivery design and implementation is needed. To identify health professionals' perspectives of systems related barriers to implementation of the National Health and Medical Research Council (NHMRC) guidelines Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples. Semi-structured interviews were conducted with health professionals involved in CR within mainstream and Aboriginal Community Controlled Health Services in Western Australia (WA). Thirty-eight health professionals from 17 services (ten rural, seven metropolitan) listed in the WA Directory of CR services and seven Aboriginal Medical Services in WA were interviewed. Respondents reported barriers encountered in health information management and the impact of access to CR services for Aboriginal people. Crucial issues identified by participants were: poor communication across the health care sector and between providers, inconsistent and insufficient data collection processes (particularly relating to Aboriginal ethnicity identification), and challenges resulting from multiple clinical information systems and incompatible technologies. This study has demonstrated that inadequate information systems and communication strategies, particularly those representing the interface between primary and secondary care, contribute to the low participation rates of Aboriginal Australians in CR. Although these challenges are shared by non-Aboriginal Australians, the needs are greater for Aboriginal Australians and innovative solutions are required.

  13. End-to-end simulation and verification of GNC and robotic systems considering both space segment and ground segment

    NASA Astrophysics Data System (ADS)

    Benninghoff, Heike; Rems, Florian; Risse, Eicke; Brunner, Bernhard; Stelzer, Martin; Krenn, Rainer; Reiner, Matthias; Stangl, Christian; Gnat, Marcin

    2018-01-01

    In the framework of a project called on-orbit servicing end-to-end simulation, the final approach and capture of a tumbling client satellite in an on-orbit servicing mission are simulated. The necessary components are developed and the entire end-to-end chain is tested and verified. This involves both on-board and on-ground systems. The space segment comprises a passive client satellite, and an active service satellite with its rendezvous and berthing payload. The space segment is simulated using a software satellite simulator and two robotic, hardware-in-the-loop test beds, the European Proximity Operations Simulator (EPOS) 2.0 and the OOS-Sim. The ground segment is established as for a real servicing mission, such that realistic operations can be performed from the different consoles in the control room. During the simulation of the telerobotic operation, it is important to provide a realistic communication environment with different parameters like they occur in the real world (realistic delay and jitter, for example).

  14. The 2017 International Joint Working Group White Paper by INDUSEM, the Emergency Medicine Association and the Academic College of Emergency Experts on Establishing Standardized Regulations, Operational Mechanisms, and Accreditation Pathways for Education and Care Provided by the Prehospital Emergency Medical Service Systems in India

    PubMed Central

    Sikka, Veronica; Gautam, V.; Galwankar, Sagar; Guleria, Randeep; Stawicki, Stanislaw P.; Paladino, Lorenzo; Chauhan, Vivek; Menon, Geetha; Shah, Vijay; Srivastava, R. P.; Rana, B. K.; Batra, Bipin; Kalra, OP.; Aggarwal, P.; Bhoi, Sanjeev; Krishnan, S. Vimal

    2017-01-01

    The government of India has done remarkable work on commissioning a government funded prehospital emergency ambulance service in India. This has both public health implications and an economic impact on the nation. With the establishment of these services, there is an acute need for standardization of education and quality assurance regarding prehospital care provided. The International Joint Working Group has been actively involved in designing guidelines and establishing a comprehensive framework for ensuring high-quality education and clinical standards of care for prehospital services in India. This paper provides an independent expert opinion and a proposed framework for general operations and administration of a standardized, national prehospital emergency medical systems program. Program implementation, operational details, and regulations will require close collaboration between key stakeholders, including local, regional, and national governmental agencies of India. PMID:28855780

  15. The relationship between access to and use of dental services following expansion of a primary care service to embrace dental team training.

    PubMed

    Wanyonyi, K L; Radford, D R; Gallagher, J E

    2013-11-01

    To investigate changes in the patient population and treatment case-mix within an expanded primary care dental training facility in Southern England. Cross-sectional analysis of patient management system data. Electronic data for patients with a closed/completed treatment plan in the 12-month period prior to, and following, dental service expansion were extracted for analysis (n = 4343). Descriptive analysis involved age, sex, payment status, deprivation status and treatment activity. Logistic regression was used to model the likelihood of treatment involving laboratory constructed devices (crowns, bridges, dentures), in relation to demography and deprivation in each time period. The volume of patients using the service increased by 48.3% (1749 cf 2594). The average age increased from 31.97 (95%CI: 30.8, 32.5) to 36.4 years (95%CI: 35.6, 37.1); greatest increase was in the over 75 years age-group (96%). The patient base became less deprived: patients exempt from payment reduced from 43.2% (n = 755) to 28.6% (n = 741) (P = 0.001) and the mean population deprivation score (IMD) reduced from 24.5 (95%CI: 23.8, 25.2) to 22.3 (95%CI: 21.7, 22.8). The volume and proportion of care involving laboratory constructed devices increased from 8.3% (n = 145) to 15.8% (n = 411) whilst assessments without interventive care decreased (34.5%-26.3%). On a logistic regression, the odds of having treatment involving laboratory constructed devices, increased with increasing age in both time periods 7% (95% CI: 1.06-1.08) and 6% (95% CI: 1.05-1.07) respectively. Furthermore, the odds increased by 38% OR: 1.38 (95% CI: 1.01-1.89) in period 2, for white patients. After adjusting for these effects, the odds of having care that involved laboratory constructed devices were less in period 2 than period 1 (100% cf 43%) for those who were technically exempt from payment (OR = 2.0; 95% CI 1.34 to 2.90 cf, OR = 1.43; 95% CI 1.13-1.81). The patient population altered in relation to age and socio-economic status. The expanded service had greater uptake by older people while users were less likely to be deprived. The expanded service, free at the point of delivery, attracted a higher proportion of patients who would normally have to pay health service charges. The service also showed an increase in treatment case-mix that involved laboratory constructed dental devices. © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  16. Resilient actions in the diagnostic process and system performance.

    PubMed

    Smith, Michael W; Davis Giardina, Traber; Murphy, Daniel R; Laxmisan, Archana; Singh, Hardeep

    2013-12-01

    Systemic issues can adversely affect the diagnostic process. Many system-related barriers can be masked by 'resilient' actions of frontline providers (ie, actions supporting the safe delivery of care in the presence of pressures that the system cannot readily adapt to). We explored system barriers and resilient actions of primary care providers (PCPs) in the diagnostic evaluation of cancer. We conducted a secondary data analysis of interviews of PCPs involved in diagnostic evaluation of 29 lung and colorectal cancer cases. Cases covered a range of diagnostic timeliness and were analysed to identify barriers for rapid diagnostic evaluation, and PCPs' actions involving elements of resilience addressing those barriers. We rated these actions according to whether they were usual or extraordinary for typical PCP work. Resilient actions and associated barriers were found in 59% of the cases, in all ranges of timeliness, with 40% involving actions rated as beyond typical. Most of the barriers were related to access to specialty services and coordination with patients. Many of the resilient actions involved using additional communication channels to solicit cooperation from other participants in the diagnostic process. Diagnostic evaluation of cancer involves several resilient actions by PCPs targeted at system deficiencies. PCPs' actions can sometimes mitigate system barriers to diagnosis, and thereby impact the sensitivity of 'downstream' measures (eg, delays) in detecting barriers. While resilient actions might enable providers to mitigate system deficiencies in the short run, they can be resource intensive and potentially unsustainable. They complement, rather than substitute for, structural remedies to improve system performance. Measures to detect and fix system performance issues targeted by these resilient actions could facilitate diagnostic safety.

  17. Care and Service at Home for Persons With Dementia in Europe.

    PubMed

    Bökberg, Christina; Ahlström, Gerd; Leino-Kilpi, Helena; Soto-Martin, Maria E; Cabrera, Esther; Verbeek, Hilde; Saks, Kai; Stephan, Astrid; Sutcliffe, Caroline; Karlsson, Staffan

    2015-09-01

    To describe available and utilized formal care and service at home for persons with dementia, from diagnosis to end-of-life stage, in eight European countries. A descriptive cross-country design concerning eight European countries as a part of the European research project RightTimePlaceCare. The research team in each country used a mapping system to collect country-specific information concerning dementia care and service system. The mapping system consists of 50 types of care and service activities. Sixteen of the 50 predefined activities concerning care and service at home were selected for this study and subdivided into three categories, following the stages of dementia. Availability was reported to be higher than utilization, and the findings indicated more similarities than differences among the eight countries involved. Even though there were several available activities of "basic care and services" and "healthcare interventions," they were utilized by few in most countries. Furthermore, "specialized dementia care and services" were sparsely available and even more sparsely utilized in the participating countries. The findings indicated that persons with dementia in Europe received formal care and service on a general, basic level but seldom adjusted to their specific needs. This study describes the gap between service provision and utilization enabling nurses to develop individually adjusted care plans for persons with dementia during the progress of the disease. The findings do not include matters of quality of care or how to best organize effective care and services. However, the activities of care and services presented here should shed light on what room there is for improvement when it comes to enabling persons with dementia to go on living at home. © 2015 Sigma Theta Tau International.

  18. Diagnosis-related group (DRG)-based case-mix funding system, a promising alternative for fee for service payment in China.

    PubMed

    Zhao, Cuirong; Wang, Chao; Shen, Chengwu; Wang, Qian

    2018-05-13

    Fee for services (FFS) is the prevailing method of payment in most Chinese public hospitals. Under this retrospective payment system, medical care providers are paid based on medical services and tend to over-treat to maximize their income, thereby contributing to rising medical costs and uncontrollable health expenditures to a large extent. Payment reform needs to be promptly implemented to move to a prospective payment plan. The diagnosis-related group (DRG)-based case-mix payment system, with its superior efficiency and containment of costs, has garnered increased attention and it represents a promising alternative. This article briefly describes the DRG-based case-mix payment system, it comparatively analyzes differences between FFS and case-mix funding systems, and it describes the implementation of DRGs in China. China's social and economic conditions differ across regions, so establishment of a national payment standard will take time and involve difficulties. No single method of provider payment is perfect. Measures to monitor and minimize the negative ethical implications and unintended effects of a DRG-based case-mix payment system are essential to ensuring the lasting social benefits of payment reform in Chinese public hospitals.

  19. Quality management in home care: models for today's practice.

    PubMed

    Verhey, M P

    1996-01-01

    In less than a decade, home care providers have been a part of two major transitions in health care delivery. First, because of the advent of managed care and a shift from inpatient to community-based services, home care service delivery systems have experienced tremendous growth. Second, the principles and practices of total quality management and continuous quality improvement have permeated the organization, administration, and practice of home health care. Based on the work of Deming, Juran, and Crosby, the basic tenets of the new quality management philosophy involve a focus on the following five key areas: (1) systems and processes rather than individual performance; (2) involvement, collaboration, and empowerment; (3) internal and external "customers"; (4) data and measurement; and (5) standards, guidelines, and outcomes of care. Home care providers are among those in the forefront who are developing and implementing programs that integrate these foci into the delivery of quality home care services. This article provides a summary of current home care programs that address these five key areas of quality management philosophy and provide models for innovative quality management practice in home care. For further information about each program, readers are referred to the original reports in the home care and quality management journal literature, as cited herein.

  20. Instruments for measuring mental health recovery: a systematic review.

    PubMed

    Sklar, Marisa; Groessl, Erik J; O'Connell, Maria; Davidson, Larry; Aarons, Gregory A

    2013-12-01

    Persons in recovery, providers, and policymakers alike are advocating for recovery-oriented mental health care, with the promotion of recovery becoming a prominent feature of mental health policy in the United States and internationally. One step toward creating a recovery-oriented system of care is to use recovery-oriented outcome measures. Numerous instruments have been developed to assess progress towards mental health recovery. This review identifies instruments of mental health recovery and evaluates the appropriateness of their use including their psychometric properties, ease of administration, and service-user involvement in their development. A literature search using the Medline and Psych-INFO databases was conducted, identifying 21 instruments for potential inclusion in this review, of which thirteen met inclusion criteria. Results suggest only three instruments (25%) have had their psychometric properties assessed in three or more unique samples of participants. Ease of administration varied between instruments, and for the majority of instruments, development included service user involvement. This review updates and expands previous reviews of instruments to assess mental health recovery. As mental health care continues to transform to a recovery-oriented model of service delivery, this review may facilitate selection of appropriate assessments of mental health recovery for systems to use in evaluating and improving the care they provide. © 2013.

  1. Housing and Child Well Being: Implications for Research, Policy, and Practice.

    PubMed

    Fowler, Patrick J; Farrell, Anne F

    2017-09-01

    Inadequate housing and homelessness represent significant barriers to family stability and child development. An accumulating body of evidence documents the relatively high risk of family separation among families experiencing housing instability and homelessness, the extent of housing problems experienced by families involved in the child welfare system, and the disproportionately high rates of homelessness among youth aging out of foster care. Vulnerable youth and families interact frequently with various social service programs intended to mitigate multifaceted and multilevel risks, however, systems efforts and resources are rarely coordinated and results to date are mixed. We introduce 13 papers that are part of a burgeoning, increasingly sophisticated body of scholarship that inform coordinated responses to inadequate housing experienced by families involved in child welfare and related interventions. We note emergent themes and state a pressing need for research that accounts for ecological and contextual influences, examines the differential impact of housing and service interventions, identifies critical ingredients of effective housing and service interventions, and positions for scale-up. We distill findings into a set of observations and recommendations that align with best intentions to improve quality of life and promote well being among some of society's most vulnerable individuals. © Society for Community Research and Action 2017.

  2. Forensic issues in intellectual disability.

    PubMed

    Søndenaa, Erik; Rasmussen, Kirsten; Nøttestad, Jim Aage

    2008-09-01

    The present paper reviews some of the most significant findings in the field of forensic issues related to intellectual disability over the last 2 years. Recent publications have explored the prevalence and assessment of intellectual disabilities in the criminal justice system, as well as individual characteristics of intellectual disabled offenders. Service by the criminal justice system and treatment of intellectual disabled offenders have also been explored. New insights into violence and sexual offences have been achieved, however identification and evidence-based treatment of intellectual disabled offenders are not widely explored issues. Progress in treatment studies, studies of the function of the criminal justice system and risk assessments have resulted in improvements in these aspects during recent years. The wide range of services involved in successful initiatives has been addressed, but some crucial aspects still receive too little attention. Differences between countries and cultures have not been emphasized, and the progress that has been achieved seems to be confined to countries with a clear policy and organized services for offenders with intellectual disabilities.

  3. A community engaged curriculum for public service psychiatry fellowship training.

    PubMed

    Sowers, Wesley; Marin, Robert

    2014-01-01

    Transforming the mental health system into a recovery oriented, integrated system of care requires a psychiatric work force that understands the relationship between recovery processes and community living. Fellowship programs in public and community psychiatry contribute to this transformation by educating psychiatrists about recovery, system dynamics, leadership, effective administration and community involvement. This paper describes a novel approach to fellowship programming that accomplishes these aims through an organizational strategy that emphasizes community engagement. After describing the administrative background for the program, we describe how the content curriculum and teaching process focus on the engagement of community members-both service users and service providers-as participating faculty. The faculty includes over 100 consumers, family members, advocacy group representatives, clinicians, and administrators. We present evaluation data obtained from 45 of the 100 community and university faculty who participated in the first 2 years' of the fellowship and conclude with a critique and recommendations for further progress in community engaged fellowship training.

  4. Accidents involving Brazilian indigenous treated at urgent and emergency services of the Unified Health System.

    PubMed

    Souza, Edinilsa Ramos de; Njaine, Kathie; Mascarenhas, Márcio Dênis Medeiros; Oliveira, Maria Conceição de

    2016-12-01

    Abstract We analyzed the accidents with Brazilian indigenous treated at urgent and emergency services of the Unified Health System (SUS). Data were obtained from the 2014 Viva Survey, which included 86 services from 24 capitals and the Federal District. The demographic profile of the indigenous, the event and the attendance were characterized. Most of the attended people were male in the 20-39 years age group. Falls and traffic accidents were the main reasons for attendance. Alcohol use was informed by 5.6% of the attended people, a figure that increases to 19.1% in traffic accidents, 26.1% among drivers and 22.8% among motorcyclists. There was a statistical difference between genders in relation to age, disability, place of occurrence of the event, work-related event and victim's condition in the traffic accident. We emphasize the importance of providing visibility to accidents with indigenous and engage them in the prevention of such events. Data reliability depends on the adequate completion in indigenous health information systems.

  5. A system dynamics model to evaluate effects of source separation of municipal solid waste management: A case of Bangkok, Thailand.

    PubMed

    Sukholthaman, Pitchayanin; Sharp, Alice

    2016-06-01

    Municipal solid waste has been considered as one of the most immediate and serious problems confronting urban government in most developing and transitional economies. Providing solid waste performance highly depends on the effectiveness of waste collection and transportation process. Generally, this process involves a large amount of expenditures and has very complex and dynamic operational problems. Source separation has a major impact on effectiveness of waste management system as it causes significant changes in quantity and quality of waste reaching final disposal. To evaluate the impact of effective source separation on waste collection and transportation, this study adopts a decision support tool to comprehend cause-and-effect interactions of different variables in waste management system. A system dynamics model that envisages the relationships of source separation and effectiveness of waste management in Bangkok, Thailand is presented. Influential factors that affect waste separation attitudes are addressed; and the result of change in perception on waste separation is explained. The impacts of different separation rates on effectiveness of provided collection service are compared in six scenarios. 'Scenario 5' gives the most promising opportunities as 40% of residents are willing to conduct organic and recyclable waste separation. The results show that better service of waste collection and transportation, less monthly expense, extended landfill life, and satisfactory efficiency of the provided service at 60.48% will be achieved at the end of the simulation period. Implications of how to get public involved and conducted source separation are proposed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. A Multi-organisational Approach to Service Delivery

    NASA Astrophysics Data System (ADS)

    Purchase, Valerie; Mills, John; Parry, Glenn

    Who is involved in delivering a service? There has been growing recognition in a wide variety of contexts that service is increasingly being delivered by multi-rather than single-organisational entities. Such recognition is evident not only in our experience but in a number of areas of literature including strategy development, core competence analysis, operations and supply chain management, and is reflected in and further facilitated by ICT developments. Customers have always been involved in some degree in the process of value delivery and such involvement is increasing to include complex co-creation of value. Such interactions are challenging when they involve individual customers, however, this becomes ever more challenging when the 'customer' is another organisation or when there are multiple 'customers'. Within this chapter we will consider some of the key drivers for a multi-organisational approach to service delivery; examine the ways in which the parties involved in service co-creation have expanded to include multiple service providers and customers; and finally, identify some of the challenges created by a multi-organisational approach to service delivery.

  7. Inclusive Education: A Servant-Leadership Perspective

    ERIC Educational Resources Information Center

    Crippen, Carolyn

    2005-01-01

    The concept of inclusive education is common to the Canadian educational system and involves service to the students. According to Young and Levin, "The provision of appropriate education to meet the needs of each student is increasingly accepted as a right in Canadian education." Bloom, Perlmutter and Burnell define inclusion as "a…

  8. TIPS: Trends for Inclusive Pediatric Services.

    ERIC Educational Resources Information Center

    Connecticut Univ. Health Center, Farmington.

    This guide was developed as part of a project to provide practicing physicians with training to enhance their understanding of and involvement with early intervention and the special education system in Connecticut. The introductory section notes that best practices in both primary medical care and early intervention promote care that is family…

  9. Sewer Maintenance Manual.

    ERIC Educational Resources Information Center

    Ontario Ministry of the Environment, Toronto.

    Outlined are practices and procedures that should be followed in order to protect and fully realize the benefits of sewer systems and also to maximize service and minimize inconveniences to the public. Written in practical terms, the manual is designed to be of immediate use to municipal employees and others involved in sewer maintenance…

  10. The Perceptions of Professionals toward Siblings of Individuals with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Burke, Meghan M.; Lee, Chung eun; Arnold, Catherine K.; Owen, Aleksa

    2017-01-01

    Adult siblings of individuals with intellectual and developmental disabilities (IDD) report struggling to navigate the adult disability service delivery system and collaborate with professionals. To date, though, it is unclear how professionals encourage sibling involvement and, accordingly, the facilitators and challenges in working with…

  11. NASA Pathways: Intern Employment Program Work Report Summer 2014

    NASA Technical Reports Server (NTRS)

    Davidson, Kyle B.

    2014-01-01

    This report documents the work experience and project involvement of Kyle Davidson during his tenure at Kennedy Space Center for the summer of 2014. Projects include the Nitrogen Oxygen Recharge System (NORS), Restore satellite servicing program, and mechanical handling operations for the SAGE III and Rapidscat payloads.

  12. Preparation for Employment: Programs at Illinois Public Community Colleges.

    ERIC Educational Resources Information Center

    Illinois Community Coll. Board, Springfield.

    This report highlights the involvement of Illinois public community colleges in preparing individuals for employment, including instruction and services offered to students and businesses. After providing an overview of the state's community college system, the report describes the following components and aspects of employment preparation: (1)…

  13. Traumatisation and Long-Term Stress Cascades: Case Report--Jan M.

    ERIC Educational Resources Information Center

    Herz, Birgit

    2011-01-01

    Numerous services in the field of social, emotional and behavioural difficulties (SEBD) are active, with different qualities and outcomes in their work. Different professions are also involved in this field between regular and special schools, the children and young people welfare system, the psychiatric ward, the police, therapeutically services…

  14. Data Sharing to Inform School-Based Asthma Services

    ERIC Educational Resources Information Center

    Portwood, Sharon G.; Nelson, Elissa B.

    2013-01-01

    Background: This article examines results and lessons learned from a collaborative project involving a large urban school district, its county health department, multiple community partners, and the local university to establish an effective system for data sharing to inform monitoring and evaluation of the Charlotte Mecklenburg Schools (CMS)…

  15. Job Analysis, Job Descriptions, and Performance Appraisal Systems.

    ERIC Educational Resources Information Center

    Sims, Johnnie M.; Foxley, Cecelia H.

    1980-01-01

    Job analysis, job descriptions, and performance appraisal can benefit student services administration in many ways. Involving staff members in the development and implementation of these techniques can increase commitment to and understanding of the overall objectives of the office, as well as communication and cooperation among colleagues.…

  16. The Language of Biotechnology: A Dictionary of Terms.

    ERIC Educational Resources Information Center

    Walker, John M.; Cox, Michael

    This dictionary attempts to define routinely used specialized language in the various areas of biotechnology, and remain suitable for use by scientists involved in unrelated disciplines. Viewing biotechnology as the practical application of biological systems to the manufacturing and service industries, and to the management of the environment,…

  17. COMPENDEX/TEXT-PAC: RETROSPECTIVE SEARCH.

    ERIC Educational Resources Information Center

    Standera, Oldrich

    The Text-Pac System is capable of generating indexes and bulletins to provide a current information service without the selectivity feature. Indexes of the accumulated data base may also be used as a basis for manual retrospective searching. The manual search involves searching computer-prepared indexes from a machine readable data base produced…

  18. Recycling Buildings for Libraries: A Moving Account.

    ERIC Educational Resources Information Center

    Shields, Gerald R.

    1994-01-01

    Described a project that moved a retired Carnegie library four blocks and back into service as an annex to the Mexico-Audrain Library System (Missouri). Insights are provided into the practicality of recycling buildings as public library facilities and the effects that such efforts can have on community pride and involvement. (SLW)

  19. Communications Satellite Receiver Systems for Public Schools: A Technical Primer.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    Designed to aid school districts contemplating use of some of the telecommunications services now available by satellite, this document contains information on home satellite receiving dishes (Television Receive-Only--TVROs), which can receive radio signals carrying television, sound, and data. This information includes: some factors involved in…

  20. Pharmaceutical Technology Clerkship: A Professional Elective Course at the University of Kentucky

    ERIC Educational Resources Information Center

    Im, Sophann; DeLuca, Patrick P.

    1978-01-01

    Three objectives are described: (1) teach methods for applying the principles of pharmaceutical technology to institutional services involving drug safety, efficacy, and administration; (2) develop student skills in drug-delivery systems within hospitals; and (3) encourage technology application within a clinical setting for better patient care.…

  1. Black-White Differences in Child Maltreatment Reports and Foster Care Placements: A Statistical Decomposition Using Linked Administrative Data.

    PubMed

    Maloney, Tim; Jiang, Nan; Putnam-Hornstein, Emily; Dalton, Erin; Vaithianathan, Rhema

    2017-03-01

    Introduction Official statistics have confirmed that relative to their presence in the population and relative to white children, black children have consistently higher rates of contact with child protective services (CPS). We used linked administrative data and statistical decomposition techniques to generate new insights into black and white differences in child maltreatment reports and foster care placements. Methods Birth records for all children born in Allegheny County, Pennsylvania, between 2008 and 2010 were linked to administrative service records originating in multiple county data systems. Differences in rates of involvement with child protective services between black and white children by age 4 were decomposed using nonlinear regression techniques. Results Black children had rates of CPS involvement that were 3 times higher than white children. Racial differences were explained solely by parental marital status (i.e., being unmarried) and age at birth (i.e., predominantly teenage mothers). Adding other covariates did not capture any further racial differences in maltreatment reporting or foster care placement rates, they simply shifted differences already explained by marital status and age to these other variables. Discussion Racial differences in rates of maltreatment reports and foster care placements can be explained by a basic model that adjusts only for parental marital status and age at the time of birth. Increasing access to early prevention services for vulnerable families may reduce disparities in child protective service involvement. Using birth records linked to other administrative data sources provides an important means to developing population-based research.

  2. Service user involvement in preregistration child nursing programmes.

    PubMed

    Barnley, Rebecca

    2017-12-05

    Service user involvement is a fundamental part of preregistration nursing education programmes, however achieving this for child nursing students is challenging. Service user involvement can be achieved through online forums but this method can lack the emotional interaction and opportunity for deep reflection. This article reviews the background and challenges of service user involvement in preregistration child nursing programmes, further exploring the evaluation of a group of final year child nursing students' experience of appreciating the journey of two service users. The input from service users provided the opportunity for reflection, empathy and improved student self-awareness in nursing practice. Students gained perspective of the holistic needs of the service user, which empowered them to have confidence in their communication skills to ensure the voice of the child is heard and their rights are upheld. This article concludes that service user involvement is crucial in preregistration nursing programmes for the development of child nursing students, not only affecting their training but also the future workforce. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  3. Health Correlates of Criminal Justice Involvement in 4,793 Transgender Veterans.

    PubMed

    Brown, George R; Jones, Kenneth T

    2015-12-01

    Transgender (TG) persons are overrepresented in prison settings and in the U.S. veteran population. Health disparities studies of large populations of transgender people involved with the criminal justice system have not been published to date. We studied a large cohort of TG veterans who received care in Veterans Health Administration (VHA) facilities during 2007-2013 (n = 4,793) and a 3:1 matched control group of veterans without known TG identification (n = 13,625). Three hundred twenty six (n = 138 TG, 188 non-TG) had received VHA services in programs designed to address the needs of justice involved (JI) veterans. We linked patients in each of the three groups to their medical and administrative data. TG veterans were more likely to be justice involved than controls (2.88% vs. 1.38%; P < .0001). Compared to non-TG JI veterans, TG JI veterans were more likely to have a history of homelessness (80% vs. 67%; P < .05) and to have reported sexual trauma while serving in the military (23% vs. 12%; P < .01). Significant health disparities were noted for TG JI veterans for depression, hypertension, obesity, posttraumatic stress disorder, serious mental illness, and suicidal ideation/attempts. These data suggest that TG veterans experience a number of health risks compared to non-TG veterans, including an increased likelihood of justice involvement. TG veterans involved with the criminal justice system are a particularly vulnerable group and services designed to address the health care needs of this population, both while incarcerated and when in the community, should take these findings into account in the development of health screenings and treatment plans.

  4. Review of serious events in cases of (suspected) child abuse and/or neglect: A RoSE by any other name?

    PubMed

    Raman, Shanti; Maiese, Michelle; Vasquez, Viviana; Gordon, Paola; Jones, Jennifer M

    2017-08-01

    Child abuse and neglect (CAN) cases presenting to health-services may be complex; when things go seriously wrong such as a child death or near miss, cases are reviewed and health-services and professionals subject to intense scrutiny. While there are a variety of mechanisms to review critical incidents in health-services no formal process for the review of cases where child protection is the primary concern exists in Australia. We aimed to develop a systematic process to review serious events in cases of suspected CAN across two health districts in Sydney, so that shared learnings could fuel system change. Drawing upon mapping, case review, literature findings and using quality improvement methodology, we developed a model named Review of Serious Events (RoSE), in suspected cases of CAN. The RoSE model has the key features of: being child focused; seeking to examine care over a period of time; using child protection staff as lead reviewers; involving health professionals/services in the review who have been involved with the child; and actioning systems change at local levels. The RoSE model was trialled through 2014-2015. Eight cases were reviewed using RoSE; cases were similar to those reviewed prior to having a model. Participant feedback from RoSE group processes was overwhelmingly positive; outputs were transparent and accessible to key stakeholders, there was mixed progress with implementation. The RoSE model is a serious case review process that is strongly child-focused, is both investigative and reflective, led by child protection experts; and can be adapted to other settings and systems. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  5. Frozen section evaluation via dynamic real-time non-robotic Telepathology system in a university Cancer center by resident / faculty cooperation team.

    PubMed

    Vosoughi, Aram; Smith, Paul Taylor; Zeitouni, Joseph A; Sodeman, Gregori M; Jorda, Merce; Gomez-Fernandez, Carmen; Garcia-Buitrago, Monica; Petito, Carol K; Chapman, Jennifer R; Campuzano-Zuluaga, German; Rosenberg, Andrew E; Kryvenko, Oleksandr N

    2018-04-30

    Frozen section telepathology interpretation experience has been largely limited to practices with locations significantly distant from one another with sporadic need for frozen section diagnosis. In 2010 we established a real-time non-robotic telepathology system in a very active cancer center for daily frozen section service. Herein, we evaluate its accuracy compared to direct microscopic interpretation performed in the main hospital by the same faculty and its cost-efficiency over a 1-year period. From 643 (1416 parts) cases requiring intraoperative consultation, 333 cases (690 parts) were examined by telepathology and 310 cases (726 parts) by direct microscopy. Corresponding discrepancy rates were 2.6% (18 cases: 6 (0.9%) sampling and 12 (1.7%) diagnostic errors) and 3.2% (23 cases: 8 (1.1%) sampling and 15 (2.1%) diagnostic errors), P=.63. The sensitivity and specificity of intraoperative frozen diagnosis were 0.92 and 0.99, respectively, in telepathology, and 0.90 and 0.99, respectively, in direct microscopy. There was no correlation of error incidence with post graduate year level of residents involved in the telepathology service. Cost analysis indicated that the time saved by telepathology was $19691 over one year of the study period while the capital cost for establishing the system was $8924. Thus, real-time non-robotic telepathology is a reliable and easy to use tool for frozen section evaluation in busy clinical settings, especially when frozen section service involves more than one hospital, and it is cost efficient when travel is a component of the service. Copyright © 2018. Published by Elsevier Inc.

  6. Contribution of student involvement in production/service unit and experience of industry practices to entrepreneurial attitude and the impact entrepeneurship readiness of vocational high school students of great Malang

    NASA Astrophysics Data System (ADS)

    Mukminna, Halimahtus; Isnandar, Muladi

    2017-09-01

    Purpose of this research was to determine the contribution of student involvement in production/ service unit (X1), experience of industry practices (X2), and entrepreneurial attitude (Y) towards readiness entrepreneurship (Z) of vocational student regional Malang. The design of the study using a quantitative approach. The samples used as many as 130 respondents. Instruments used for collecting data in the form of questionnaires. Data analysis included descriptive and test of hypothesis. The result showed: that the description of data on the level of student involvement in production/ service unit, experience of industry practices, entrepreneurial attitude and entrepreneurship readiness in the high category. The contribution student involvement in production/ service unit of entrepreneurial attitude of 10.6%. The contribution experience of industry practices of entrepreneurial attitude of 17.4%. The contribution student involvement in production/ service unit and experience of industry practices simultaneously to entrepreneurial attitude of 44.1%. The contribution student involvement in production/ service unit of readiness entrepreneurship of 4%. The contribution experience of industry practices of readiness entrepreneurship of 5%. The contribution entrepreneurial attitude of readiness entrepreneurship of 16%. Finally, the contribution student involvement in production/ service unit, experience of industry practices, and entrepreneurial attitude simultaneously to readiness entrepreneurship of 50.3%.

  7. Research on the Application of Persona in Book Recommendation System

    NASA Astrophysics Data System (ADS)

    Gao, Baozhong; Du, Shouyan; Li, Xinzhi; Liu, Fangai

    2017-10-01

    Currently, there still exists a host of problems in the book recommendation system, such as low accuracy, weak correlation and poor pertinence. Aiming to unravel these problems, this paper based on the theory of big data and data mining technology, through analyzing internet user behavior and the “5C” model of personal credit evaluation, combined with joint impact weight calculation method, which involves user grade, borrowing credit, book friend recommendation degree, book friend recommended adoption degree, borrowing frequency, borrowing number, and borrowing time interval. User activity and credit are also taken into account in the process of establishing user tagging system so as to build classified book recommendation service. This method is of universal meaning to the book recommendation service of smart campus with user as the core under big data environment.

  8. Using a systems orientation and foundational theory to enhance theory-driven human service program evaluations.

    PubMed

    Wasserman, Deborah L

    2010-05-01

    This paper offers a framework for using a systems orientation and "foundational theory" to enhance theory-driven evaluations and logic models. The framework guides the process of identifying and explaining operative relationships and perspectives within human service program systems. Self-Determination Theory exemplifies how a foundational theory can be used to support the framework in a wide range of program evaluations. Two examples illustrate how applications of the framework have improved the evaluators' abilities to observe and explain program effect. In both exemplars improvements involved addressing and organizing into a single logic model heretofore seemingly disparate evaluation issues regarding valuing (by whose values); the role of organizational and program context; and evaluation anxiety and utilization. Copyright 2009 Elsevier Ltd. All rights reserved.

  9. Strategic planning for clinical services: St. Joseph Hospital and Health Care Center.

    PubMed

    Linggi, A; Pelham, L D

    1986-09-01

    A pharmacy department at a 340-bed community hospital based its strategic plan for developing patient-oriented services on a sound drug distribution system, a credible work-measurement program, and fiscal responsibility. In 1982 the department of pharmacy and i.v. therapy implemented a strategic plan for improving pharmaceutical services. The plan involved developing goals and objectives for the department; marketing the department's services and fiscal management to hospital administrators, medical staff, and nursing staff; building teamwork among the pharmacy staff; and improving the drug distribution system before instituting clinical services. Hiring of additional pharmacy staff was justified on the basis of work-measurement data. By adjusting staffing levels every two weeks based on work-measurement data, the department increased the efficiency of drug distribution activities; the pharmacy also implemented cost-saving programs like selection of therapeutic alternates and formulary restrictions. The savings were then reinvested in labor-intensive patient-oriented pharmaceutical services. A staff development program using staff pharmacists as preceptors expanded the breadth and depth of pharmacists' clinical skills. The planning efforts were successful because the needs of hospital administrators, the pharmacy department, and staff members were addressed.

  10. Improving the seniors' transition from hospital to the community: a case for intensive geriatric service workers.

    PubMed

    McAiney, Carrie A; Hillier, Loretta M; Paul, Janice; McKinnon Wilson, Jane; Tersigni Phelan, Anna; Wagner, Fred; O'Connor, Sheli

    2017-01-01

    Limited continuity of care, poor communication between healthcare providers, and ineffective self-management are barriers to recovery as seniors transition back to the community following an Emergency Department (ED) visit or hospitalization. The intensive geriatric service worker (IGSW) role is a new service developed in southern Ontario, Canada to address gaps for seniors transitioning home from acute care to prevent rehospitalization and premature institutionalization through the provision of intensive support and follow-up to ensure adherence to care plans, facilitate communication with care providers, and promote self-management. This study describes the IGSW role and provides preliminary evidence of its impact on clients, caregivers and the broader health system. This mixed methods evaluation included a chart audit of all clients served, tracking of the achievement of goals for IGSW involvement, and interviews with clients and caregivers and other key informants. During the study period, 632 clients were served. Rates of goal achievement ranged from 25%-87% and in cases where achieved, the extent of IGSW involvement mostly exceeded recommendations. IGSWs were credited with improving adherence with treatment recommendations, increasing awareness and use of community services, and improving self-management, which potentially reduced ED visits and hospitalizations and delayed institutionalization. The IGSW role has the potential to improve supports for seniors and facilitate more appropriate use of health system resources, and represents a promising mechanism for improving the integration and coordination of care across health sectors.

  11. [Introduction of rapid syphilis and HIV testing in prenatal care in Colombia: qualitative analysis].

    PubMed

    Ochoa-Manjarrés, María Teresa; Gaitán-Duarte, Hernando Guillermo; Caicedo, Sidia; Gómez, Berta; Pérez, Freddy

    2016-12-01

    Interpret perceptions of Colombian health professionals concerning factors that obstruct and facilitate the introduction of rapid syphilis and HIV testing in prenatal care services. A qualitative study based on semi-structured interviews was carried out. A convenience sample was selected with 37 participants, who included health professionals involved in prenatal care services, programs for pregnant women, clinical laboratories, and directors of health care units or centers, as well as representatives from regional departments and the Ministry of Health. Colombia does not do widespread screening with rapid syphilis and HIV tests in prenatal care. The professionals interviewed stated they did not have prior experience in the use of rapid tests-except for laboratory staff-or in the course of action in response to a positive result. The insurance system hinders access to timely diagnosis and treatment. Health authorities perceive a need to review existing standards, strengthen the first level of care, and promote comprehensive prenatal care starting with contracts between insurers and health service institutional providers. Participants recommended staff training and integration between health-policymaking and academic entities for updating training programs. The market approach and the characteristics of the Colombian health system constitute the main barriers to implementation of rapid testing as a strategy for elimination of mother-to-child transmission of syphilis and HIV. Measures identified include making changes in contracts between insurers and health service institutional providers, adapting the timing and duration of prenatal care procedures, and training physicians and nurses involved in prenatal care.

  12. Multiple Service System Involvement and Later Offending Behavior: Implications for Prevention and Early Intervention.

    PubMed

    Bright, Charlotte Lyn; Jonson-Reid, Melissa

    2015-07-01

    We investigated patterns of childhood and adolescent experiences that correspond to later justice system entry, including persistence into adulthood, and explored whether timing of potential supports to the child or onset of family poverty, according to developmental periods and gender, would distinguish among latent classes. We constructed a database containing records for 8587 youths from a Midwestern metropolitan region, born between 1982 and 1991, with outcomes. We used data from multiple publicly funded systems (child welfare, income maintenance, juvenile and criminal justice, mental health, Medicaid, vital statistics). We applied a latent class analysis and interpreted a 7-class model. Classes with higher rates of offending persisting into adulthood were characterized by involvement with multiple publicly funded systems in childhood and adolescence, with the exception of 1 less-urban, predominantly female class that had similarly high system involvement coupled with lower rates of offending. Poverty and maltreatment appear to play a critical role in offending trajectories. Identifying risk factors that cluster together may help program and intervention staff best target those most in need of more intensive intervention.

  13. A physical layer perspective on access network sharing

    NASA Astrophysics Data System (ADS)

    Pfeiffer, Thomas

    2015-12-01

    Unlike in copper or wireless networks, there is no sharing of resources in fiber access networks yet, other than bit stream access or cable sharing, in which the fibers of a cable are let to one or multiple operators. Sharing optical resources on a single fiber among multiple operators or different services has not yet been applied. While this would allow for a better exploitation of installed infrastructures, there are operational issues which still need to be resolved, before this sharing model can be implemented in networks. Operating multiple optical systems and services over a common fiber plant, autonomously and independently from each other, can result in mutual distortions on the physical layer. These distortions will degrade the performance of the involved systems, unless precautions are taken in the infrastructure hardware to eliminate or to reduce them to an acceptable level. Moreover, the infrastructure needs to be designed such as to support different system technologies and to ensure a guaranteed quality of the end-to-end connections. In this paper, suitable means are proposed to be introduced in fiber access infrastructures that will allow for shared utilization of the fibers while safeguarding the operational needs and business interests of the involved parties.

  14. On estimating the economic value of insectivorous bats: Prospects and priorities for biologists

    USGS Publications Warehouse

    Boyles, Justin G.; Sole, Catherine L.; Cryan, Paul M.; McCracken, Gary F.

    2013-01-01

    Bats are among the most economically important nondomesticated mammals in the world. They are well-known pollinators and seed dispersers, but crop pest suppression is probably the most valuable ecosystem service provided by bats. Scientific literature and popular media often include reports of crop pests in the diet of bats and anecdotal or extrapolated estimates of how many insects are eaten by bats. However, quantitative estimates of the ecosystem services provided by bats in agricultural systems are rare, and the few estimates that are available are limited to a single cotton-dominated system in Texas. Despite the tremendous value for conservation and economic security of such information, surprisingly few scientific efforts have been dedicated to quantifying the economic value of bats. Here, we outline the types of information needed to better quantify the value of bats in agricultural ecosystems. Because of the complexity of the ecosystems involved, creative experimental design and innovative new methods will help advance our knowledge in this area. Experiments involving bats in agricultural systems may be needed sooner than later, before population declines associated with white-nose syndrome and wind turbines potentially render them impossible.

  15. Integrated Care to Address the Physical Health Needs of People with Severe Mental Illness: A Mapping Review of the Recent Evidence on Barriers, Facilitators and Evaluations.

    PubMed

    Rodgers, Mark; Dalton, Jane; Harden, Melissa; Street, Andrew; Parker, Gillian; Eastwood, Alison

    2018-01-25

    People with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests this is due to a combination of clinical risk factors, socioeconomic factors, and health system factors, notably a lack of integration when care is required across service settings. Several recent reports have looked at ways to better integrate physical and mental health care for people with severe mental illness (SMI). We built on these by conducting a mapping review that looked for the most recent evidence and service models in this area. This involved searching the published literature and speaking to people involved in providing or using current services. Few of the identified service models were described adequately and fewer still were evaluated, raising questions about the replicability and generalisability of much of the existing evidence. However, some common themes did emerge. Efforts to improve the physical health care of people with SMI should empower staff and service users and help remove everyday barriers to delivering and accessing integrated care. In particular, there is a need for improved communication among professionals and better information technology to support them, greater clarity about who is responsible and accountable for physical health care, and greater awareness of the effects of stigmatisation on the wider culture and environment in which services are delivered.

  16. A review of international pharmacy-based minor ailment services and proposed service design model.

    PubMed

    Aly, Mariyam; García-Cárdenas, Victoria; Williams, Kylie; Benrimoj, Shalom I

    2018-01-05

    The need to consider sustainable healthcare solutions is essential. An innovative strategy used to promote minor ailment care is the utilisation of community pharmacists to deliver minor ailment services (MASs). Promoting higher levels of self-care can potentially reduce the strain on existing resources. To explore the features of international MASs, including their similarities and differences, and consider the essential elements to design a MAS model. A grey literature search strategy was completed in June 2017 to comply with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standard. This included (1) Google/Yahoo! search engines, (2) targeted websites, and (3) contact with commissioning organisations. Executive summaries, table of contents and title pages of documents were reviewed. Key characteristics of MASs were extracted and a MAS model was developed. A total of 147 publications were included in the review. Key service elements identified included eligibility, accessibility, staff involvement, reimbursement systems. Several factors need to be considered when designing a MAS model; including contextualisation of MAS to the market. Stakeholder engagement, service planning, governance, implementation and review have emerged as key aspects involved with a design model. MASs differ in their structural parameters. Consideration of these parameters is necessary when devising MAS aims and assessing outcomes to promote sustainability and success of the service. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Computer-Based Instruction for TRIDENT FBM Training

    DTIC Science & Technology

    1976-06-01

    remote voice feedback to an operator. In this case it is possible to display text which represents the voice messages required during sequential ...provides two main services: (a) the preparation of missiles for sequential launching with self-guidance after launch, and (b) the coordination of...monitor- ing the status of the guidance system in each missile. FCS SWS coordina- tion consists of monitoring systems involved in sequential functions at

  18. Space Shuttle Familiarization

    NASA Technical Reports Server (NTRS)

    Mellett, Kevin

    2006-01-01

    This slide presentation visualizes the NASA space center and research facility sites, as well as the geography, launching sites, launching pads, rocket launching, pre-flight activities, and space shuttle ground operations located at NASA Kennedy Space Center. Additionally, highlights the international involvement behind the International Space Station and the space station mobile servicing system. Extraterrestrial landings, surface habitats and habitation systems, outposts, extravehicular activity, and spacecraft rendezvous with the Earth return vehicle are also covered.

  19. A national survey of U.S. juvenile mental health courts.

    PubMed

    Callahan, Lisa; Cocozza, Joseph; Steadman, Henry J; Tillman, Sheila

    2012-02-01

    The authors surveyed U.S. juvenile mental health courts (JMHCs). Forty-one were identified in 15 states, and 34 returned surveys; one was completed on the basis of published information. Topics included the court's history, youths served, inclusion and exclusion criteria, the court process, and services provided. Half (51%) reported that the juvenile court was responsible for the program; for 11% the probation agency had the responsibility, and 17% reported shared responsibility by these entities. Fifty-one percent reported that all youths with any mental disorder diagnosis are eligible. The most commonly reported participant diagnoses are bipolar disorder (27%), depression (23%), and attention-deficit hyperactivity disorder (16%). Seventy percent currently include participants with felony offenses, and 91% with misdemeanors; 67% exclude status offenses, and 21% exclude violent offenses. A guilty plea was required by 63%. Incentives to participate included dismissal of charges (40%), reduction in court hearings (43%), praise by the judge and probation officer (60%), reduction in curfew restrictions (23%), and gift cards or gifts (71%). Sanctions for not participating included increased supervision or hearings (60%), performing community service (54%), and placement in residential detention (60%). Most JMHCs reported use of a multidisciplinary team to coordinate community-based services to prevent protracted justice system involvement. JMHCs are being developed in the absence of systematically collected outcome data. Although they resemble adult mental health courts, they have unique features that are specific to addressing the complex needs of youths with mental disorders involved in the justice system. These include diagnostic and treatment challenges and issues related to involving families and schools.

  20. Belarus: health system review.

    PubMed

    Richardson, Erica; Malakhova, Irina; Novik, Irina; Famenka, Andrei

    2013-01-01

    This analysis of the Belarusian health system reviews the developments in organization and governance, health financing, healthcare provision, health reforms and health system performance since 2008. Despite considerable change since independence, Belarus retains a commitment to the principle of universal access to health care, provided free at the point of use through predominantly state-owned facilities, organized hierarchically on a territorial basis. Incremental change, rather than radical reform, has also been the hallmark of health-care policy, although capitation funding has been introduced in some areas and there have been consistent efforts to strengthen the role of primary care. Issues of high costs in the hospital sector and of weaknesses in public health demonstrate the necessity of moving forward with the reform programme. The focus for future reform is on strengthening preventive services and improving the quality and efficiency of specialist services. The key challenges in achieving this involve reducing excess hospital capacity, strengthening health-care management, use of evidence-based treatment and diagnostic procedures, and the development of more efficient financing mechanisms. Involving all stakeholders in the development of further reform planning and achieving consensus among them will be key to its success. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  1. The space station assembly phase: System design trade-offs for the flight telerobotic servicer

    NASA Technical Reports Server (NTRS)

    Smith, Jeffrey H.; Gyamfi, Max; Volkmer, Kent; Zimmerman, Wayne

    1988-01-01

    The effects of a recent study aimed at identifying key issues and trade-offs associated with using a Flight Telerobotic Servicer (FTS) to aid in Space Station assembly-phase tasks is described. The use of automation and robotic (A and R) technologies for large space systems often involves a substitution of automation capabilities for human EVA or IVA activities. A methodology is presented that incorporates assessment of candidate assembly-phase tasks, telerobotic performance capabilities, development costs, and effects of operational constaints. Changes in the region of cost-effectiveness are examined under a variety of system design assumptions. A discussion of issues is presented with focus on three roles the FTS might serve: as a research-oriented test bed to learn more about space usage of telerobotics; as a research based test bed having an experimental demonstration orientation with limited assembly and servicing applications; or as an operational system to augment EVA and to aid construction of the Space Station and to reduce the program (schedule) risk by increasing the flexibility of mission operations.

  2. Does recyclable separation reduce the cost of municipal waste management in Japan?

    PubMed

    Chifari, Rosaria; Lo Piano, Samuele; Matsumoto, Shigeru; Tasaki, Tomohiro

    2017-02-01

    Municipal solid waste (MSW) management is a system involving multiple sub-systems that typically require demanding inputs, materials and resources to properly process generated waste throughput. For this reason, MSW management is generally one of the most expensive services provided by municipalities. In this paper, we analyze the Japanese MSW management system and estimate the cost elasticity with respect to the waste volumes at three treatment stages: collection, processing, and disposal. Although we observe economies of scale at all three stages, the collection cost is less elastic than the disposal cost. We also examine whether source separation at home affects the cost of MSW management. The empirical results show that the separate collection of the recyclable fraction leads to reduced processing costs at intermediate treatment facilities, but does not change the overall waste management cost. Our analysis also reveals that the cost of waste management systems decreases when the service is provided by private companies through a public tender. The cost decreases even more when the service is performed under the coordination of adjacent municipalities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Health services reforms in revolutionary Nicaragua.

    PubMed Central

    Garfield, R M; Taboada, E

    1984-01-01

    Before the Nicaraguan revolution of 1979, access to health services was largely limited to the affluent sectors of the urban population and the minority of workers with social security coverage. Repeated attempts at reform by organized medicine were ineffective. Since the revolution, a tremendous expansion in health services has occurred. The national health system receives approximately one-third of its funds from the social security system. Steadily increasing equity in access is a result of the promotion of primary care, health campaigns involving up to 10 per cent of the general population as volunteers, the use of paramedical aides, and foreign assistance. Private practice nevertheless remains strong. In the coming years, several complex issues must be examined, including: a balance in the number of nurses and doctors trained, the role of private practice, and the relationship of the Ministry of Health to the social security system. Further progress in health reforms may be delayed by the defensive war which Nicaragua is fighting on its northern and southern borders. Despite emergent health problems in the war zones, most of the innovative aspects of the health system remain intact as of this writing. PMID:6476169

  4. Service Management Database for DSN Equipment

    NASA Technical Reports Server (NTRS)

    Zendejas, Silvino; Bui, Tung; Bui, Bach; Malhotra, Shantanu; Chen, Fannie; Wolgast, Paul; Allen, Christopher; Luong, Ivy; Chang, George; Sadaqathulla, Syed

    2009-01-01

    This data- and event-driven persistent storage system leverages the use of commercial software provided by Oracle for portability, ease of maintenance, scalability, and ease of integration with embedded, client-server, and multi-tiered applications. In this role, the Service Management Database (SMDB) is a key component of the overall end-to-end process involved in the scheduling, preparation, and configuration of the Deep Space Network (DSN) equipment needed to perform the various telecommunication services the DSN provides to its customers worldwide. SMDB makes efficient use of triggers, stored procedures, queuing functions, e-mail capabilities, data management, and Java integration features provided by the Oracle relational database management system. SMDB uses a third normal form schema design that allows for simple data maintenance procedures and thin layers of integration with client applications. The software provides an integrated event logging system with ability to publish events to a JMS messaging system for synchronous and asynchronous delivery to subscribed applications. It provides a structured classification of events and application-level messages stored in database tables that are accessible by monitoring applications for real-time monitoring or for troubleshooting and analysis over historical archives.

  5. Racial differences in the mental health needs and service utilization of youth in the juvenile justice system.

    PubMed

    Rawal, Purva; Romansky, Jill; Jenuwine, Michael; Lyons, John S

    2004-01-01

    Mental health placement rates by the juvenile justice system differ by race. However, it is unknown whether mental health needs differ by race. This study attempted to investigate potential differences in mental health needs and service utilization among Caucasian, African American, and Hispanic juvenile justice involved youth. A stratified random sample of 473 youth petitioned, adjudicated, and incarcerated from 1995-1996 was examined using a standard chart review protocol and the Childhood Severity of Psychiatric Illness measure for mental health needs. Significant and unique mental health needs were demonstrated for all racial groups. African American youth demonstrated the greatest level of needs. Minority status indicated significantly lower rates of mental health service utilization. Minority youth in the juvenile justice system are most at risk for underserved mental health needs. Based on the current data, it can be inferred that the first contact with the state's child and adolescent serving system, which includes the juvenile justice and mental health sectors, appears to be through the juvenile justice sector for many minority youth with delinquency problems.

  6. "The View from Inside": Understanding Service User Involvement in Health and Social Care Education

    ERIC Educational Resources Information Center

    Fox, Joanna

    2011-01-01

    Service users are increasingly involved in health and social care education, whilst the government is committed to increasing access to employment for people with mental health needs. The benefits of involving service users in social work education have been identified, including increasing skills, confidence, and building capacity; yet there is…

  7. 50 CFR 222.309 - Permits for listed species of sea turtles involving the Fish and Wildlife Service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Permits for listed species of sea turtles involving the Fish and Wildlife Service. 222.309 Section 222.309 Wildlife and Fisheries NATIONAL MARINE... species of sea turtles involving the Fish and Wildlife Service. (a) This section establishes specific...

  8. 50 CFR 222.309 - Permits for listed species of sea turtles involving the Fish and Wildlife Service.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 10 2013-10-01 2013-10-01 false Permits for listed species of sea turtles involving the Fish and Wildlife Service. 222.309 Section 222.309 Wildlife and Fisheries NATIONAL MARINE... species of sea turtles involving the Fish and Wildlife Service. (a) This section establishes specific...

  9. 50 CFR 222.309 - Permits for listed species of sea turtles involving the Fish and Wildlife Service.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Permits for listed species of sea turtles involving the Fish and Wildlife Service. 222.309 Section 222.309 Wildlife and Fisheries NATIONAL MARINE... species of sea turtles involving the Fish and Wildlife Service. (a) This section establishes specific...

  10. 50 CFR 222.309 - Permits for listed species of sea turtles involving the Fish and Wildlife Service.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 10 2012-10-01 2012-10-01 false Permits for listed species of sea turtles involving the Fish and Wildlife Service. 222.309 Section 222.309 Wildlife and Fisheries NATIONAL MARINE... species of sea turtles involving the Fish and Wildlife Service. (a) This section establishes specific...

  11. 50 CFR 222.309 - Permits for listed species of sea turtles involving the Fish and Wildlife Service.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 10 2014-10-01 2014-10-01 false Permits for listed species of sea turtles involving the Fish and Wildlife Service. 222.309 Section 222.309 Wildlife and Fisheries NATIONAL MARINE... species of sea turtles involving the Fish and Wildlife Service. (a) This section establishes specific...

  12. Experience and meaning of user involvement: some explorations from a community mental health project.

    PubMed

    Truman, Carole; Raine, Pamela

    2002-05-01

    With an increased interest in and policy commitment to involving service users in the planning and delivery of health service provision, there is a clear need to explore both the rhetoric and realities of what user involvement entails. In the present paper, by drawing upon an evaluation of a community-based exercise facility for people with mental health problems, the authors explore ways in which the reality of user involvement is subject to a range of configurations within health services. The paper describes a piece of qualitative research that was undertaken within a participatory framework to explore the nature of user involvement within the facility. The data have been analysed using a grounded theory approach to provide insights into: the organisational context in which user involvement takes place; factors which encourage meaningful participation on the part of service users; perceived barriers to user involvement; and issues of sustainability and continuity. This research approach has enabled the authors to explore the views and experiences of users, service providers and referral agencies in relation to the nature and potential for user involvement. The findings illustrate ways in which user involvement may take place under both flexible and formal arrangements across a variety of activities. The present paper provides an account of some of the meanings and experiences of what 'successful' user participation may involve and the conditions which underpin 'success'. The authors conclude that successful and meaningful user involvement should enable and support users to recognise their existing skills, and to develop new ones, at a pace that suits their particular circumstances and personal resources. This process may require adaptation not only by organisations, but also by service providers and non-involved users.

  13. Involving older people in a multi-centre randomised trial of a complex intervention in pre-hospital emergency care: implementation of a collaborative model.

    PubMed

    Koniotou, Marina; Evans, Bridie Angela; Chatters, Robin; Fothergill, Rachael; Garnsworthy, Christopher; Gaze, Sarah; Halter, Mary; Mason, Suzanne; Peconi, Julie; Porter, Alison; Siriwardena, A Niroshan; Toghill, Alun; Snooks, Helen

    2015-07-10

    Health services research is expected to involve service users as active partners in the research process, but few examples report how this has been achieved in practice in trials. We implemented a model to involve service users in a multi-centre randomised controlled trial in pre-hospital emergency care. We used the generic Standard Operating Procedure (SOP) from our Clinical Trials Unit (CTU) as the basis for creating a model to fit the context and population of the SAFER 2 trial. In our model, we planned to involve service users at all stages in the trial through decision-making forums at 3 levels: 1) strategic; 2) site (e.g. Wales; London; East Midlands); 3) local. We linked with charities and community groups to recruit people with experience of our study population. We collected notes of meetings alongside other documentary evidence such as attendance records and study documentation to track how we implemented our model. We involved service users at strategic, site and local level. We also added additional strategic level forums (Task and Finish Groups and Writing Days) where we included service users. Service user involvement varied in frequency and type across meetings, research stages and locations but stabilised and increased as the trial progressed. Involving service users in the SAFER 2 trial showed how it is feasible and achievable for patients, carers and potential patients sharing the demographic characteristics of our study population to collaborate in a multi-centre trial at the level which suited their health, location, skills and expertise. A standard model of involvement can be tailored by adopting a flexible approach to take account of the context and complexities of a multi-site trial. Current Controlled Trials ISRCTN60481756. Registered: 13 March 2009.

  14. Nationwide validation of ensemble streamflow forecasts from the Hydrologic Ensemble Forecast Service (HEFS) of the U.S. National Weather Service

    NASA Astrophysics Data System (ADS)

    Lee, H. S.; Liu, Y.; Ward, J.; Brown, J.; Maestre, A.; Herr, H.; Fresch, M. A.; Wells, E.; Reed, S. M.; Jones, E.

    2017-12-01

    The National Weather Service's (NWS) Office of Water Prediction (OWP) recently launched a nationwide effort to verify streamflow forecasts from the Hydrologic Ensemble Forecast Service (HEFS) for a majority of forecast locations across the 13 River Forecast Centers (RFCs). Known as the HEFS Baseline Validation (BV), the project involves a joint effort between the OWP and the RFCs. It aims to provide a geographically consistent, statistically robust validation, and a benchmark to guide the operational implementation of the HEFS, inform practical applications, such as impact-based decision support services, and to provide an objective framework for evaluating strategic investments in the HEFS. For the BV, HEFS hindcasts are issued once per day on a 12Z cycle for the period of 1985-2015 with a forecast horizon of 30 days. For the first two weeks, the hindcasts are forced with precipitation and temperature ensemble forecasts from the Global Ensemble Forecast System of the National Centers for Environmental Prediction, and by resampled climatology for the remaining period. The HEFS-generated ensemble streamflow hindcasts are verified using the Ensemble Verification System. Skill is assessed relative to streamflow hindcasts generated from NWS' current operational system, namely climatology-based Ensemble Streamflow Prediction. In this presentation, we summarize the results and findings to date.

  15. Towards sustainable infrastructure management: knowledge-based service-oriented computing framework for visual analytics

    NASA Astrophysics Data System (ADS)

    Vatcha, Rashna; Lee, Seok-Won; Murty, Ajeet; Tolone, William; Wang, Xiaoyu; Dou, Wenwen; Chang, Remco; Ribarsky, William; Liu, Wanqiu; Chen, Shen-en; Hauser, Edd

    2009-05-01

    Infrastructure management (and its associated processes) is complex to understand, perform and thus, hard to make efficient and effective informed decisions. The management involves a multi-faceted operation that requires the most robust data fusion, visualization and decision making. In order to protect and build sustainable critical assets, we present our on-going multi-disciplinary large-scale project that establishes the Integrated Remote Sensing and Visualization (IRSV) system with a focus on supporting bridge structure inspection and management. This project involves specific expertise from civil engineers, computer scientists, geographers, and real-world practitioners from industry, local and federal government agencies. IRSV is being designed to accommodate the essential needs from the following aspects: 1) Better understanding and enforcement of complex inspection process that can bridge the gap between evidence gathering and decision making through the implementation of ontological knowledge engineering system; 2) Aggregation, representation and fusion of complex multi-layered heterogeneous data (i.e. infrared imaging, aerial photos and ground-mounted LIDAR etc.) with domain application knowledge to support machine understandable recommendation system; 3) Robust visualization techniques with large-scale analytical and interactive visualizations that support users' decision making; and 4) Integration of these needs through the flexible Service-oriented Architecture (SOA) framework to compose and provide services on-demand. IRSV is expected to serve as a management and data visualization tool for construction deliverable assurance and infrastructure monitoring both periodically (annually, monthly, even daily if needed) as well as after extreme events.

  16. Integrating Emotion and Cognition in Successful Service Learning: A Complex System Approach (Invited)

    NASA Astrophysics Data System (ADS)

    Raia, F.

    2010-12-01

    Service-learning (S-L) has evolved as valuable pedagogic concept during the last two decades, based on the hypothesis that learning can best be accomplished when placed in the context of real-life social settings, e.g. schools, production, research, healthcare etc. What students learn in the academic course/context must be elaborated in the context of the S-L experience. In return for the authentic learning experience, the learner provides the service-provider with a "free" service. This reciprocality makes service-learning an appealing concept. Because of its attractive "win-win" design, the field of service-learning is continuously expanding. At a major public university CCNY with a very diverse student population, we were interested in developing and participating in S-L experience in the field of Earth System Science. We designed an upper level undergraduate course - Environmental Soil Science for Urban Sustainability - specifically targeted to students of Earth Science, Engineering, Economics and, Political Sciences to support environmental entrepreneurship. Specifically, we integrated S-L activities in the exploration of soil studies and urban agriculture. Students worked together in small groups both in class and for their S-L experience (30 hours) with urban garden and agriculture organizations. Students were required to apply the content learned in the academic course providing soil testing and soil evaluation to the partners, generate reports through a series of homework assignments and journal entries connecting three major components: Community Service, Personal Experience and Course Content. Our experience with this course shows the following results: S-L must be considered a complex system characterized by the continually changing interactions among the above mentioned three major components and three social and academic diverse groups of people involved: Students, Service-Providers and Academic Instructors. Because experience alone does not produce learning, this system requires participants to elaborate and connect the three major components and continually update, modify and build on the learning experience and personal growth. Critical reflection activities are considered to be a powerful tool to bridge community service activities and the educational content. Reflection activities gauge students’ expectations, thoughts and understanding and, by making these evident to the students, can reveal less obvious aspects of the experience and support different interpretations of an event. However, in the form of critical reflection, they tend to exclude the role emotion may play throughout the learning process specifically for one of the three components -Personal Growth. Moreover, in the last decade neuroscience and psychology research shows that emotion is indispensable for conceiving rational thoughts, understanding and memory development and that a purely cognitive view on learning is not working. In our course we strove to design reflections that involve emotion and cognition and their interdependence in connecting the three components of S-L. A complex system approach is fundamental when challenges of integrating emotion and cognition in Service Learning need to be addressed.

  17. A strategy for human factors/ergonomics: developing the discipline and profession.

    PubMed

    Dul, Jan; Bruder, Ralph; Buckle, Peter; Carayon, Pascale; Falzon, Pierre; Marras, William S; Wilson, John R; van der Doelen, Bas

    2012-01-01

    Human factors/ergonomics (HFE) has great potential to contribute to the design of all kinds of systems with people (work systems, product/service systems), but faces challenges in the readiness of its market and in the supply of high-quality applications. HFE has a unique combination of three fundamental characteristics: (1) it takes a systems approach (2) it is design driven and (3) it focuses on two closely related outcomes: performance and well-being. In order to contribute to future system design, HFE must demonstrate its value more successfully to the main stakeholders of system design. HFE already has a strong value proposition (mainly well-being) and interactivity with the stakeholder group of 'system actors' (employees and product/service users). However, the value proposition (mainly performance) and relationships with the stakeholder groups of 'system experts' (experts fromtechnical and social sciences involved in system design), and 'system decision makers' (managers and other decision makers involved in system design, purchase, implementation and use), who have a strong power to influence system design, need to be developed. Therefore, the first main strategic direction is to strengthen the demand for high-quality HFE by increasing awareness among powerful stakeholders of the value of high-quality HFE by communicating with stakeholders, by building partnerships and by educating stakeholders. The second main strategic direction is to strengthen the application of high-quality HFE by promoting the education of HFE specialists, by ensuring high-quality standards of HFE applications and HFE specialists, and by promoting HFE research excellence at universities and other organisations. This strategy requires cooperation between the HFE community at large, consisting of the International Ergonomics Association (IEA), local (national and regional) HFE societies, and HFE specialists. We propose a joint world-wide HFE development plan, in which the IEA takes a leadership role. Human factors/ergonomics (HFE) has much to offer by addressing major business and societal challenges regarding work and product/service systems. HFE potential, however, is underexploited. This paper presents a strategy for the HFE community to strengthen demand and application of high-quality HFE, emphasising its key elements: systems approach, design driven, and performance and well-being goals.

  18. Telematics and smart cards in integrated health information system.

    PubMed

    Sicurello, F; Nicolosi, A

    1997-01-01

    Telematics and information technology are the base on which it will be possible to build an integrated health information system to support population and improve their quality of life. This system should be based on record linkage of all data based on the interactions of the patients with the health structures, such as general practitioners, specialists, health institutes and hospitals, pharmacies, etc. The record linkage can provide the connection and integration of various records, thanks to the use of telematic technology (either urban or geographical local networks, such as the Internet) and electronic data cards. Particular emphasis should be placed on the introduction of smart cards, such as portable health cards, which will contain a standardized data set and will be sufficient to access different databases found in various health services. The inter-operability of the social-health records (including multimedia types) and the smart cards (which are one of the most important prerequisites for the homogenization and wide diffusion of these cards at an European level) should be strongly taken into consideration. In this framework a project is going to be developed aiming towards the integration of various data bases distributed territorially, from the reading of the software and the updating of the smart cards to the complete management of the patients' evaluation records, to the quality of the services offered and to the health planning. The applications developed will support epidemiological investigation software and data analysis. The inter-connection of all the databases of the various structures involved will take place through a coordination center, the most important system of which we will call "record linkage" or "integrated database". Smart cards will be distributed to a sample group of possible users and the necessary smart card management tools will be installed in all the structures involved. All the final users (the patients) in the whole network of services involved will be monitored for the duration of the project. The system users will also include general practitioners, social workers, physicians, health operators, pharmacists, laboratory workers and administrative personnel of the municipality and of the health structures concerned.

  19. Designing a Safer Interactive Healthcare System - The Impact of Authentic User Participation

    NASA Astrophysics Data System (ADS)

    Went, Kathryn L.; Gregor, Peter; Ricketts, Ian W.

    Information technology has been widely promoted in the healthcare sector to improve current practice and patient safety. However, end users are seldom involved extensively in the design and development of healthcare systems, with lip service often paid to the idea of true user involvement. In this case study the impact of sustained authentic user participation was explored using an interdisciplinary team, consisting of experts both in interaction and healthcare design and consultant anaesthetists, nurses, and pharmacists, to create an electronic prescribing and administration system. This paper details the interface that was created and provides examples of the way in which the design evolved in response to the sustained authentic user participation methods. The working prototype both reduced the opportunity for user error and was preferred by its users to the existing manual system.

  20. A total design and implementation of an intelligent mobile chemotherapy medication administration.

    PubMed

    Kuo, Ming-Chuan; Chang, Polun

    2014-01-01

    The chemotherapy medication administration is a process involved many stakeholders and efforts. Therefore, the information support system cannot be well designed if the entire process was not carefully examined and reengineered first. We, from a 805-teaching medical center, did a process reengineering and involved physicians, pharmacists and IT engineers to work together to design a mobile support solution. System was implemented in March to July, 2013. A 6" android handheld device with 1D BCR was used as the main hardware. 18 nurses were invited to evaluate their perceived acceptance of system based on Technology Acceptance Model for Mobile Service Model. Time saved was also calculated to measure the effectiveness of system. The results showed positive support from nurses. The estimated time saved every year was about 288 nursing days. We believe our mobile chemotherapy medication administration support system is successful in terms of acceptance and real impacts.

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