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

Bishop, J.

This paper reports on site assessment services in support of real estate transactions which appear to be an answer to marketing managers' dreams. It is a service that sells itself. Although the consensus among assessment consultants is that lenders and property developers currently are only dimly aware and somewhat resentful of the need for site assessments, the potential market for these services, they say, seems nearly boundless.

A multi-site randomised controlled trial of evidence-based supported employment for adults with severe and persistent mental illness.

PubMed

Waghorn, Geoffrey; Dias, Shannon; Gladman, Beverley; Harris, Meredith; Saha, Sukanta

2014-12-01

The Individual Placement and Support (IPS) approach is an evidence-based form of supported employment for people with severe and persistent mental illness. This approach is not yet widely available in Australia even though there is mounting evidence of its generalisability outside the USA. One previous Australian randomised controlled trial found that IPS is effective for young people with first episode psychosis. The aim of the current trial was to assess the effectiveness of evidence-based supported employment when implemented for Australian adult consumers of public mental health services by utilising existing service systems. A four-site randomised control trial design (n = 208) was conducted in Brisbane (two sites), Townsville and Cairns. The intervention consisted of an IPS supported employment service hosted by a community mental health team. The control condition was delivered at each site by mental health teams referring consumers to other disability employment services in the local area. At 12 months, those in the IPS condition had 2.4 times greater odds of commencing employment than those in the control condition (42.5% vs. 23.5%). The conditions did not differ on secondary employment outcomes including job duration, hours worked, or job diversity. Attrition was higher than expected in both conditions with 28.4% completing the baseline interview but taking no further part in the study. The results support previous international findings that IPS-supported employment is more effective than non-integrated supported employment. IPS can be successfully implemented this way in Australia, but with a loss of effect strength compared to previous USA trials. © 2014 Occupational Therapy Australia.

Impact of chiropractic services at an on-site health center.

PubMed

Kindermann, Sylvia L; Hou, Qingjiang; Miller, Ross M

2014-09-01

To compare the influence of employer-sponsored, on-site chiropractic care against community-obtained care on health care utilization. This was a retrospective claims analysis of members of a single employee health plan receiving chiropractic care on-site or off-site from 2010 to 2012. Utilization differences were evaluated by having 1 health care event or more, including radiology or clinical visits. There were 876 on-site and 759 off-site participants. The off-site group received more radiology services overall (55.5% vs 38.2%; P < 0.001) including magnetic resonance imaging, ultrasound, and radiograph (all P < 0.0001); had higher outpatient (P < 0.0001) and emergency department (P = 0.022) utilization; and demonstrated greater use of chiropractic care and physical therapy (both P < 0.0001). Compared with off-site care, on-site chiropractic services are associated with lower health care utilization. These results support the value of chiropractic services offered at on-site health centers.

Organisational space for partnership and sustainability: lessons from the implementation of the National Dementia Strategy for England.

PubMed

Clarke, Charlotte Laura; Keyes, Sarah Elizabeth; Wilkinson, Heather; Alexjuk, Joanna; Wilcockson, Jane; Robinson, Louise; Corner, Lynne; Cattan, Mima

2014-11-01

National policy initiatives are faced with challenges in their partnership development and sustainability. The National Dementia Strategy for England recommended Dementia Adviser (DA) and Peer Support Network (PSN) services and 40 demonstration sites were established. In this paper, we report on the national evaluation of these demonstration sites, with specific reference to aspects of organisational development. The research used a mixed-methods design with three main strands: (i) activity and outcome monitoring; (ii) organisational surveys and collaborative discussion; (iii) in-depth case studies in eight of the 40 sites. This paper focuses primarily on three rounds of organisational surveys distributed to all 40 demonstration sites over a period of 21 months and interviews in the case studies. Data identify the significance of infrastructure within immediate services as well as the position of services within the external infrastructure of the wider health and social care landscape. Partnership - both internally and externally - was key to establishing and sustaining services that flourished. When working well, DAs and PSNs acted as a link between services and people with dementia at the same time as filling gaps in existing support, providing information, advice and interpersonal support that was tailored to individual needs and circumstances. In conclusion, to achieve the full potential and sustainability of services requires them to be in an organisational space that allows them to work in partnership and collaboration with other services, and that values their distinct knowledge of their communities. © 2014 John Wiley & Sons Ltd.

Better and more efficient care through ICT-enabled integration of social care and healthcare services: experiences from two European projects

PubMed Central

Müller, Sonja; Meyer, Ingo; Kubitschke, Lutz; Delaney, Sarah

2012-01-01

Unsynchronised social and health care service delivery leads to inefficiencies, duplication of resources and reduced levels of quality of care. Older people are particularly affected by this situation. They often need both types of services, such as support with daily living activities and chronic disease management. ICT has the potential to support integrated service delivery to achieve high quality independent living and wellbeing for older people across Europe and elsewhere. Against this background, the presentation will demonstrate experiences and results derived from the development and piloting of ICT-supported integrated care services in eight sites across Europe, namely Dublin, Hull, Milton Keynes, Malaga, Veldhoven, Geldrop, Eindhoven and Bielefeld. Through innovative usage of ICT, current ‘silos’ in service delivery are broken up to allow for cooperation across relevant care sectors and participation of family members. The integrated services are to support the effective management of chronic diseases, and to address issues which affect independence, such as reduced agility, vision or hearing, in order to significantly improve the quality of life for older people and their carers. A dedicated programme of service process innovation complemented by adaptation of technology is being pursued in order to develop an integrated digital support infrastructure and related services: using appropriate existing technology to provide as many older people as possible with digital access to support services they needaugmenting and opening sectoral care platforms to enable coordinated cross-sector support deliveryadopting a clearly demand-driven inclusive approach and avoiding a technology ‘push’. Wider deployment of the services is supported by a dedicated programme of socio-economic service evaluation. The evaluation framework utilises a multi-method and multi-perspective approach, involving end users, family carers, service provider staff and key informants at corporate level. Triangulation is used to cross-reference data from different sources in order to maximize the reliability and robustness of conclusions drawn from the evaluation. Based on an overall framework taking into account themes such as integration, user outcomes, staff impact, organisational impact, technology, implementation and overall satisfaction, the specifics of each site are taken into account in operationally applying the overall framework in each case. The designs to be employed at each site have been developed to be as robust as possible, taking into account the constraints of the realities of the interventions. The evaluation is accompanied by a business case modelling approach that builds largely on a cost-benefit analysis covering the service development and implementation activities as well as the pilots and modelling the further deployment of services in each of the pilot sites. The presentation builds upon experiences gained within the framework of two European projects, CommonWell and INDEPENDENT. They are both co-funded under the EU’s Competitiveness and Innovation Framework Programme (CIP) focus on better joining-up of formal social/healthcare services and strengthening participation of the so-called ‘third sector’.

An Experimental Study of the Effects of Employer-Sponsored Child Care Services on Selected Employee Behaviors. Executive Summary.

ERIC Educational Resources Information Center

Dawson, Ann Gilman; And Others

This executive summary describes a study conducted to determine whether different kinds of employer-supported child care services had differing effects on service users. Turnover and attendance data on 891 randomly selected female employees were gathered from 39 companies and hospitals offering on-site or off-site child care, information and…

The Mind-Body Building Equation.

ERIC Educational Resources Information Center

Dryfoos, Joy

2000-01-01

Full-service community schools combine three concepts--mind, body, and building--into an integrated approach placing quality education and comprehensive support services at one site. The DeWitt Wallace-Reader's Digest Fund is helping schools and communities replicate 4 such programs at 60 sites in 20 U.S. cities. (MLH)

IsoWAN: A NASA Science and Engineering Information and Services Framework

NASA Technical Reports Server (NTRS)

Korsmeyer, David J.; Chow, Edward T.; Conroy, Michael P.; Swanson, Keith (Technical Monitor)

2000-01-01

We believe that the next evolutionary step in supporting wide-area application and services delivery to customers is a network framework that provides for collocation of applications and services at distinct sites in the network, an interconnection between these sites that is performance optimized for these applications, and value-added services for applications. We use the term IsoWAN to describe an advanced, isolated network interconnect services framework that will enable applications to be more secure, and able to access and be in use in both local and remote environments. The main functions of an IsoWAN are virtual localization of application services, an application service interface, coordinated delivery of applications and associated data to the customer, and supporting collaborative application development for customers. An initial pilot network between three NASA Centers: Ames Research Center, the Jet Propulsion Laboratory, and Marshall Space Flight Center, has been built and its properties will be discussed.

SWS: accessing SRS sites contents through Web Services.

PubMed

Romano, Paolo; Marra, Domenico

2008-03-26

Web Services and Workflow Management Systems can support creation and deployment of network systems, able to automate data analysis and retrieval processes in biomedical research. Web Services have been implemented at bioinformatics centres and workflow systems have been proposed for biological data analysis. New databanks are often developed by taking into account these technologies, but many existing databases do not allow a programmatic access. Only a fraction of available databanks can thus be queried through programmatic interfaces. SRS is a well know indexing and search engine for biomedical databanks offering public access to many databanks and analysis tools. Unfortunately, these data are not easily and efficiently accessible through Web Services. We have developed 'SRS by WS' (SWS), a tool that makes information available in SRS sites accessible through Web Services. Information on known sites is maintained in a database, srsdb. SWS consists in a suite of WS that can query both srsdb, for information on sites and databases, and SRS sites. SWS returns results in a text-only format and can be accessed through a WSDL compliant client. SWS enables interoperability between workflow systems and SRS implementations, by also managing access to alternative sites, in order to cope with network and maintenance problems, and selecting the most up-to-date among available systems. Development and implementation of Web Services, allowing to make a programmatic access to an exhaustive set of biomedical databases can significantly improve automation of in-silico analysis. SWS supports this activity by making biological databanks that are managed in public SRS sites available through a programmatic interface.

Combining ecosystem services assessment with structured decision making to support ecological restoration planning.

PubMed

Martin, David M; Mazzotta, Marisa; Bousquin, Justin

2018-04-10

Accounting for ecosystem services in environmental decision making is an emerging research topic. Modern frameworks for ecosystem services assessment emphasize evaluating the social benefits of ecosystems, in terms of who benefits and by how much, to aid in comparing multiple courses of action. Structured methods that use decision analytic-approaches are emerging for the practice of ecological restoration. In this article, we combine ecosystem services assessment with structured decision making to estimate and evaluate measures of the potential benefits of ecological restoration with a case study in the Woonasquatucket River watershed, Rhode Island, USA. We partnered with a local watershed management organization to analyze dozens of candidate wetland restoration sites for their abilities to supply five ecosystem services-flood water retention, scenic landscapes, learning opportunities, recreational opportunities, and birds. We developed 22 benefit indicators related to the ecosystem services as well as indicators for social equity and reliability that benefits will sustain in the future. We applied conceptual modeling and spatial analysis to estimate indicator values for each candidate restoration site. Lastly, we developed a decision support tool to score and aggregate the values for the organization to screen the restoration sites. Results show that restoration sites in urban areas can provide greater social benefits than sites in less urban areas. Our research approach is general and can be used to investigate other restoration planning studies that perform ecosystem services assessment and fit into a decision-making process.

The On-Site, Programmatic Approach to Staff Development.

ERIC Educational Resources Information Center

Collins, Charles C.; Case, Chester H.

At present, community college in-service professional development programs are not top quality. Little, if any, budgetary support is allocated for them, and responsibility for planning and carrying them out is allocated to no one in particular. The few on-site in-service professional development programs now in operation exhibit common elements…

Cost Analysis in Telemedicine: Empirical Evidence From Sites in Arizona

ERIC Educational Resources Information Center

de la Torre, Adela; Hernandez-Rodriguez, Clemente; Garcia, Lorena

2004-01-01

Support of telemedicine for largely rural and ethnically diverse populations is premised on expectations that it increases opportunities for appropriate and timely medical services, and that it improves cost-effective service delivery. To understand the cost-effectiveness of telemedicine in 8 small and/or rural sites in Arizona. A cost analysis…

FermiGrid—experience and future plans

NASA Astrophysics Data System (ADS)

Chadwick, K.; Berman, E.; Canal, P.; Hesselroth, T.; Garzoglio, G.; Levshina, T.; Sergeev, V.; Sfiligoi, I.; Sharma, N.; Timm, S.; Yocum, D. R.

2008-07-01

Fermilab supports a scientific program that includes experiments and scientists located across the globe. In order to better serve this community, Fermilab has placed its production computer resources in a Campus Grid infrastructure called 'FermiGrid'. The FermiGrid infrastructure allows the large experiments at Fermilab to have priority access to their own resources, enables sharing of these resources in an opportunistic fashion, and movement of work (jobs, data) between the Campus Grid and National Grids such as Open Science Grid (OSG) and the Worldwide LHC Computing Grid Collaboration (WLCG). FermiGrid resources support multiple Virtual Organizations (VOs), including VOs from the OSG, EGEE, and the WLCG. Fermilab also makes leading contributions to the Open Science Grid in the areas of accounting, batch computing, grid security, job management, resource selection, site infrastructure, storage management, and VO services. Through the FermiGrid interfaces, authenticated and authorized VOs and individuals may access our core grid services, the 10,000+ Fermilab resident CPUs, near-petabyte (including CMS) online disk pools and the multi-petabyte Fermilab Mass Storage System. These core grid services include a site wide Globus gatekeeper, VO management services for several VOs, Fermilab site authorization services, grid user mapping services, as well as job accounting and monitoring, resource selection and data movement services. Access to these services is via standard and well-supported grid interfaces. We will report on the user experience of using the FermiGrid campus infrastructure interfaced to a national cyberinfrastructure - the successes and the problems.

FermiGrid - experience and future plans

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

Chadwick, K.; Berman, E.; Canal, P.

2007-09-01

Fermilab supports a scientific program that includes experiments and scientists located across the globe. In order to better serve this community, Fermilab has placed its production computer resources in a Campus Grid infrastructure called 'FermiGrid'. The FermiGrid infrastructure allows the large experiments at Fermilab to have priority access to their own resources, enables sharing of these resources in an opportunistic fashion, and movement of work (jobs, data) between the Campus Grid and National Grids such as Open Science Grid and the WLCG. FermiGrid resources support multiple Virtual Organizations (VOs), including VOs from the Open Science Grid (OSG), EGEE and themore » Worldwide LHC Computing Grid Collaboration (WLCG). Fermilab also makes leading contributions to the Open Science Grid in the areas of accounting, batch computing, grid security, job management, resource selection, site infrastructure, storage management, and VO services. Through the FermiGrid interfaces, authenticated and authorized VOs and individuals may access our core grid services, the 10,000+ Fermilab resident CPUs, near-petabyte (including CMS) online disk pools and the multi-petabyte Fermilab Mass Storage System. These core grid services include a site wide Globus gatekeeper, VO management services for several VOs, Fermilab site authorization services, grid user mapping services, as well as job accounting and monitoring, resource selection and data movement services. Access to these services is via standard and well-supported grid interfaces. We will report on the user experience of using the FermiGrid campus infrastructure interfaced to a national cyberinfrastructure--the successes and the problems.« less

EPIC'S PRODUCTS AND SERVICES

EPA Science Inventory

EPIC completes approximately 150 site characterizations annually using current and historical aerial photographs. This work is done in support of EPA Regional and Program
offices. Site characterization provides detailed information about a site and its history, often going ba...

Improving the healthcare response to domestic violence and abuse in sexual health clinics: feasibility study of a training, support and referral intervention

PubMed Central

Sohal, Alex Hardip; Pathak, Neha; Blake, Sarah; Apea, Vanessa; Berry, Judith; Bailey, Jayne; Griffiths, Chris; Feder, Gene

2018-01-01

Objectives Sexual health and gynaecological problems are the most consistent and largest physical health differences between abused and non-abused female populations. Sexual health services are well placed to identify and support patients experiencing domestic violence and abuse (DVA). Most sexual health professionals have had minimal DVA training despite English National Institute for Health and Care Excellence recommendations. We sought to determine the feasibility of an evidence-based complex DVA training intervention in female sexual health walk-in services (IRIS ADViSE: Identification and Referral to Improve Safety whilst Assessing Domestic Violence in Sexual Health Environments). Methods An adaptive mixed method pilot study in the female walk-in service of two sexual health clinics. Following implementation and evaluation at site 1, the intervention was refined before implementation at site 2. The intervention comprised electronic prompts, multidisciplinary training sessions, clinic materials and simple referral pathways to IRIS ADViSE advocate-educators (AEs). The pilot lasted 7 weeks at site 1 and 12 weeks at site 2. Feasibility outcomes were to assign a supportive DVA clinical lead, an IRIS ADViSE AE employed by a local DVA service provider, adapt electronic records, develop local referral pathways, assess whether enquiry, identification and referral rates were measurable. Results Both sites achieved all feasibility outcomes: appointing a supportive DVA clinical lead and IRIS ADViSE AE, establishing links with a local DVA provider, adapting electronic records, developing local referral pathways and rates of enquiry, identification and referral were found to be measurable. Site 1: 10% enquiry rate (n=267), 4% identification rate (n=16) and eight AE referrals. Site 2: 61% enquiry rate (n=1090), a 7% identification rate (n=79) and eight AE referrals. Conclusions IRIS ADViSE can be successfully developed and implemented in sexual health clinics. It fulfils the unmet need for DVA training. Longer-term evaluation is recommended. PMID:28724743

Key components of a service model providing early childhood support for women attending opioid treatment clinics: an Australian state health service review.

PubMed

Harvey, Susan R; Schmied, Virginia; Nicholls, Daniel; Dahlen, Hannah

2012-09-01

To report the findings of a service review--specifically the strategy to provide early childhood services 'on site' at opioid treatment clinics to address access difficulties. Child and family health nurses are skilled in the assessment and support of families during early childhood. However, women with a history of substance abuse are often cautious when engaging with universal and other health services, with the result that the infant may miss recommended developmental screening and early referral to improve health outcomes. In 2006, an internal review was undertaken of the integration of early childhood and parenting services at opioid treatment clinics in a large Area Health Service of New South Wales, Australia. A qualitative study design, using semi-structured interview questions was used. Data were collected via six focus groups (4-15 participants in each group) and individual interview of child and family health nurses, nurse unit managers and clinical staff (n=58). Three key components of a model for providing early childhood support in collaboration with opioid treatment services were identified. First, the importance of building a trusting relationship between the woman and the child and family health nurses, second, maintaining continuity of care and a multidisciplinary/multiagency approach, and finally the importance of staff education, support and professional development. The provision of early childhood and parenting services on site, as part of a multidisciplinary 'one stop shop' approach to service delivery was a clear recommendation of the review. Reduction of access difficulties to specialised early childhood support is of benefit to clients, community health services attempting to provide a service to this difficult to reach population and to drug and alcohol services seeking to provide a high level of holistic care for clients. © 2012 Blackwell Publishing Ltd.

Visitor Expectations, Satisfactions, and Views Toward Financial Support for Selected New Hampshire Historic Sites

Treesearch

Ronald J. Glass; Nancy Gustke; Nancy Gustke

1987-01-01

Although the number of visitors to New Hampshire stateowned historic sites has declined during the last 20 years, the results of a survey indicate that most respondents are satisfied with the level of services provided. The majority of visitors indicated that historic sites need not be "self-supporting"; they were willing to pay an entry fee and did not...

Monitoring and Modeling Carbon Dynamics at a Network of Intensive Sites in the USA and Mexico

NASA Astrophysics Data System (ADS)

Birdsey, R.; Wayson, C.; Johnson, K. D.; Pan, Y.; Angeles, G.; De Jong, B. H.; Andrade, J. L.; Dai, Z.

2013-05-01

The Forest Services of the USA and Mexico, supported by NASA and USAID, have begun to establish a network of intensive forest carbon monitoring sites. These sites are used for research and teaching, developing forest management practices, and forging links to the needs of communities. Several of the sites have installed eddy flux towers to basic meteorology data and daily estimates of forest carbon uptake and release, the processes that determine forest growth. Field sampling locations at each site provide estimates of forest biomass and carbon stocks, and monitor forest dynamic processes such as growth and mortality rates. Remote sensing facilitates scaling up to the surrounding landscapes. The sites support information requirements for implementing programs such as Reducing Emissions from Deforestation and Forest Degradation (REDD+), enabling communities to receive payments for ecosystem services such as reduced carbon emissions or improved forest management. In addition to providing benchmark data for REDD+ projects, the sites are valuable for validating state and national estimates from satellite remote sensing and the national forest inventory. Data from the sites provide parameters for forest models that support strategic management analysis, and support student training and graduate projects. The intensive monitoring sites may be a model for other countries in Latin America. Coordination among sites in the USA, Mexico and other Latin American countries can ensure harmonization of approaches and data, and share experiences and knowledge among countries with emerging opportunities for implementing REDD+ and other conservation programs.

Marshall Space Flight Center Telescience Resource Kit

NASA Technical Reports Server (NTRS)

Wade, Gina

2016-01-01

Telescience Resource Kit (TReK) is a suite of software applications that can be used to monitor and control assets in space or on the ground. The Telescience Resource Kit was originally developed for the International Space Station program. Since then it has been used to support a variety of NASA programs and projects including the WB-57 Ascent Vehicle Experiment (WAVE) project, the Fast Affordable Science and Technology Satellite (FASTSAT) project, and the Constellation Program. The Payloads Operations Center (POC), also known as the Payload Operations Integration Center (POIC), provides the capability for payload users to operate their payloads at their home sites. In this environment, TReK provides local ground support system services and an interface to utilize remote services provided by the POC. TReK provides ground system services for local and remote payload user sites including International Partner sites, Telescience Support Centers, and U.S. Investigator sites in over 40 locations worldwide. General Capabilities: Support for various data interfaces such as User Datagram Protocol, Transmission Control Protocol, and Serial interfaces. Data Services - retrieve, process, record, playback, forward, and display data (ground based data or telemetry data). Command - create, modify, send, and track commands. Command Management - Configure one TReK system to serve as a command server/filter for other TReK systems. Database - databases are used to store telemetry and command definition information. Application Programming Interface (API) - ANSI C interface compatible with commercial products such as Visual C++, Visual Basic, LabVIEW, Borland C++, etc. The TReK API provides a bridge for users to develop software to access and extend TReK services. Environments - development, test, simulations, training, and flight. Includes standalone training simulators.

Multiperspective analysis of workforce challenges and their effects on consumer and family quality of life.

PubMed

Larson, Sheryl A; Hewitt, Amy S; Lakin, K Charlie

2004-11-01

The impacts of direct support professional turnover, wages, and vacancy rates as reported in interviews with 372 adult service recipients and 20 county managers and surveys of 183 families, 520 service coordinators, 228 direct support professionals, and 184 residential and 82 vocational managers were examined. Direct support professional turnover, wages, and vacancy rates were reported to be barriers to high quality supports, serving people waiting for services, and providing in-home or respite services. Higher direct support professional turnover was associated with lower wages and supports in urban counties. Multivariate analyses of covariance revealed a complex pattern of significant associations between quality of life outcomes; level of mental retardation, medical status, site size (for vocational settings); and direct support professional vacancy rates, average wage, and turnover rates.

Integrated care services: lessons learned from the deployment of the NEXES project.

PubMed

Hernández, Carme; Alonso, Albert; Garcia-Aymerich, Judith; Grimsmo, Anders; Vontetsianos, Theodore; García Cuyàs, Francesc; Altes, Anna Garcia; Vogiatzis, Ioannis; Garåsen, Helge; Pellise, Laura; Wienhofen, Leendert; Cano, Isaac; Meya, Montserrat; Moharra, Montserrat; Martinez, Joan Ignasi; Escarrabill, Juan; Roca, Josep

2015-01-01

To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus. One health care sector in Spain (Barcelona) (n = 11.382); six municipalities in Norway (Trondheim) (n = 450); and one hospital in Greece (Athens) (n = 388). The four services were: (i) Home-based long-term maintenance of rehabilitation effects (n = 337); (ii) Enhanced Care for frail patients, n = 1340); (iii) Home Hospitalization and Early Discharge (n = 2404); and Support for remote diagnosis (forced spirometry testing) in primary care (Support) (n = 8139). Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted. The project demonstrated: (i) Sustainability of training effects over time in chronic patients with obstructive pulmonary disease (p < 0.01); (ii) Enhanced care and fewer hospitalizations in chronic respiratory patients (p < 0.05); (iii) Reduced in-hospital days for all types of patients (p < 0.001) in Home Hospitalization/Early Discharge; and (iv) Increased quality of testing (p < 0.01) for patients with respiratory symptoms in Support, with marked differences among sites. The four integrated care services showed high potential to enhance health outcomes with cost-containment. Change management, technological approach and legal issues were major factors modulating the success of the deployment. The project generated a business plan to foster service sustainability and health innovation. Deployment strategies require site-specific adaptations.

One-Stop Shop

ERIC Educational Resources Information Center

Protheroe, Nancy

2010-01-01

Full-service community schools do more than educate; they partner with the community to provide the supports and services that students and families need through one comprehensive, coordinated effort. By offering services on-site, full-service schools can help eliminate some barriers that families face such as problems with transportation, lack of…

Models for Access to Maternal Smoking cessation Support (MAMSS): a study protocol of a quasi-experiment to increase the engagement of pregnant women who smoke in NHS Stop Smoking Services.

PubMed

Bennett, Lorna; Grant, Aimee; Jones, Siobhan; Bowley, Mererid; Heathcote-Elliott, Christian; Ford, Catrin; Jones, Angela; Lewis, Rachel; Munkley, Margaret; Owen, Carol; Petherick, Annie; Paranjothy, Shantini

2014-10-06

Maternal smoking is a key cause of poor outcomes for mothers, babies and children and Wales has higher rates of smoking in pregnancy than any other UK country. Despite various improvements within the NHS Stop Smoking Service to strengthen the intervention for pregnant women, referrals and successful quit attempts for this group have continued to remain extremely low. A key element of UK national guidance for smoking cessation during pregnancy is to provide a flexible and tailored service to help increase levels of engagement. This study aims to test the effectiveness of three different models of service delivery to address the gap in the evidence base about how to deliver a flexible, tailored smoking cessation service to pregnant women. This study will adopt a quasi-experimental design over a 12 month period. The setting is four of Wales' seven Health Boards using an integrated approach between maternity services, local public health teams and the NHS Stop Smoking Service. Core recommendations from UK public health guidance are being implemented across intervention and usual care sites. Stop smoking support for pregnant women in intervention sites is being delivered more flexibly than in usual care sites. Both qualitative and quantitative approaches will be adopted to capture important contextual information and consider multiple perspectives. A health economic analysis will be undertaken using a cost-consequences analysis approach. The primary outcome measure is engagement with stop smoking services (defined as having at least one face-to-face therapeutic contact with a clinician). Supporting pregnant women to stop smoking is a challenging area of public health. The proposed study will address several areas where there are key evidence gaps relating to smoking cessation interventions for pregnant women. Specifically, how best to encourage pregnant women to attend a specialist stop smoking support service, how to deliver the service and who should provide it.

Developing Cost Accounting and Decision Support Software for Comprehensive Community-Based Support Systems: An Analysis of Needs, Interest, and Readiness in the Field.

ERIC Educational Resources Information Center

Harrington, Robert; Jenkins, Peter; Marzke, Carolyn; Cohen, Carol

Prominent among the new models of social service delivery are organizations providing comprehensive, community-based supports and services (CCBSS) to children and their families. A needs analysis explored CCBSS sites' interest in and readiness to use a software tool designed to help them make more effective internal resource allocation decisions…

34 CFR 491.21 - What selection criteria does the Secretary use?

Code of Federal Regulations, 2010 CFR

2010-07-01

... and group mental health counseling; (iv) Health care; (v) Child care; (vi) Case management; (vii) Job... support services to address the most pressing needs of the target group at, or through, the project site. Support services must be designed to bring members of the target group to a state of readiness for...

Improving the Quality of Voluntary Medical Male Circumcision through Use of the Continuous Quality Improvement Approach: A Pilot in 30 PEPFAR-Supported Sites in Uganda

PubMed Central

Opio, Alex; Calnan, Jacqueline; Njeuhmeli, Emmanuel

2015-01-01

Background Uganda adopted voluntary medical male circumcision (VMMC) (also called Safe Male Circumcision in Uganda), as part of its HIV prevention strategy in 2010. Since then, the Ministry of Health (MOH) has implemented VMMC mostly with support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through its partners. In 2012, two PEPFAR-led external quality assessments evaluated compliance of service delivery sites with minimum quality standards. Quality gaps were identified, including lack of standardized forms or registers, lack of documentation of client consent, poor preparedness for emergencies and use of untrained service providers. In response, PEPFAR, through a USAID-supported technical assistance project, provided support in quality improvement to the MOH and implementing partners to improve quality and safety in VMMC services and build capacity of MOH staff to continuously improve VMMC service quality. Methods and Findings Sites were supported to identify barriers in achieving national standards, identify possible solutions to overcome the barriers and carry out improvement plans to test these changes, while collecting performance data to objectively measure whether they had bridged gaps. A 53-indicator quality assessment tool was used by teams as a management tool to measure progress; teams also measured client-level indicators through self-assessment of client records. At baseline (February-March 2013), less than 20 percent of sites scored in the “good” range (>80%) for supplies and equipment, patient counseling and surgical procedure; by November 2013, the proportion of sites scoring “good” rose to 67 percent, 93 percent and 90 percent, respectively. Significant improvement was noted in post-operative follow-up at 48 hours, sexually transmitted infection assessment, informed consent and use of local anesthesia but not rate of adverse events. Conclusion Public sector providers can be engaged to address the quality of VMMC using a continuous quality improvement approach. PMID:26207986

Organisation and features of hospital, intermediate care and social services in English sites with low rates of delayed discharge.

PubMed

Baumann, Matt; Evans, Sherrill; Perkins, Margaret; Curtis, Lesley; Netten, Ann; Fernandez, Jose-Luis; Huxley, Peter

2007-07-01

In recent years, there has been significant concern, and policy activity, in relation to the problem of delayed discharges from hospital. Key elements of policy to tackle delays include new investment, the establishment of the Health and Social Care Change Agent Team, and the implementation of the Community Care (Delayed Discharge) Act 2003. Whilst the problem of delays has been widespread, some authorities have managed to tackle delays successfully. The aim of the qualitative study reported here was to investigate discharge practice and the organisation of services at sites with consistently low rates of delay, in order to identify factors supporting such good performance. Six 'high performing' English sites (each including a hospital trust, a local authority, and a primary care trust) were identified using a statistical model, and 42 interviews were undertaken with health and social services staff involved in discharge arrangements. Additionally, the authors set out to investigate the experiences of patients in the sites to examine whether there was a cost to patient care and outcomes of discharge arrangements in these sites, but unfortunately, it was not possible to secure sufficient patient participation. Whilst acknowledging the lack of patient experience and outcome data, a range of service elements was identified at the sites that contribute to the avoidance of delays, either through supporting efficiency within individual agencies or enabling more efficient joint working. Sites still struggling with delays should benefit from knowledge of this range. The government's reimbursement scheme appears to have been largely helpful in the study sites, prompting efficiency-driven changes to the organisation of services and discharge systems, but further focused research is required to provide clear evidence of its impact nationally, and in particular, how it impacts on staff, and patients and their families.

Implementation of evidence-based supported employment in regional Australia.

PubMed

Morris, Adrienne; Waghorn, Geoffrey; Robson, Emma; Moore, Lyndell; Edwards, Emma

2014-06-01

To implement the Individual Placement and Support (IPS) approach at 4 locations in regional New South Wales, Australia. Outcomes attained were compared with a national non-IPS program and with international trials of IPS within and outside the United States. Four IPS programs were established through formal partnerships between mental health services and disability employment services. Ninety-five mental health service clients commenced employment assistance and were tracked for a minimum of 12 months. Two sites achieved good fidelity to IPS principles, and 2 sites achieved fair fidelity. IPS clients had 3.5 times greater odds of attaining 13 weeks' employment than those receiving assistance in the national network of disability employment services. Implementing IPS is challenging in the Australian service delivery context. Factors other than program fidelity appear to contribute to excellent employment outcomes. Further research is needed to identify these factors.

Accessibility

MedlinePlus

... MedlinePlus GO GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español ... using our site, please let us know. Contact Customer Service or phone us at (888) FIND-NLM ( ...

Obtaining Technical Support for Superfund, RCRA and Brownfields Site Issues Fact Sheet

EPA Pesticide Factsheets

EPA’s Technical Support Centers (TSCs) and other technical support services are available to Regional RemedialProject Managers, Corrective Action Staff, and On-Scene Coordinators needing specialized technical expertisefor specific tasks or projects.

The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs.

PubMed

McGurk, Susan R; Mueser, Kim T; Watkins, Melanie A; Dalton, Carline M; Deutsch, Heather

2017-03-01

Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing psychiatric rehabilitation, and suggest that ease of access to vocational services may influence work outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

CAP: Mobile App

Science.gov Websites

Interpreting Services Training Non-DoD Employees Partner Agencies A - L Partner Agencies M - Z Training Service Service Members Site Map + CAP Customers DoD Employees DoD Agencies Support Services Training Non-DoD Employees Partner Agencies A - L Partner Agencies M - Z Training Service Members Military Treatment

Service use and financial performance in a replication program on adult day centers.

PubMed

Reifler, B V; Cox, N J; Jones, B N; Rushing, J; Yates, K

1999-01-01

The authors describe results from Partners in Caregiving: The Dementia Services Program, and present information on service utilization and financial performance among a group of 48 adult day centers across the United States from 1992 to 1996. Centers, with nonrandom assignment, received either grant support (average value: $93,000) or intensive technical assistance (average value: $39,000). Sites reported baseline data and submitted utilization information (enrollment and census) and financial data (revenue and expenses) quarterly. Overall, there were significant increases in enrollment, census, and financial performance (percent of cash expenses met through operating revenue) over the 4-year period. The grant-supported and technical-assistance sites had similar rates of improvement. Results provide data on service utilization and financial performance and demonstrate gains that can be achieved in these areas through improved marketing and financial management.

Integrated care services: lessons learned from the deployment of the NEXES project

PubMed Central

Hernández, Carme; Alonso, Albert; Garcia-Aymerich, Judith; Grimsmo, Anders; Vontetsianos, Theodore; García Cuyàs, Francesc; Altes, Anna Garcia; Vogiatzis, Ioannis; Garåsen, Helge; Pellise, Laura; Wienhofen, Leendert; Cano, Isaac; Meya, Montserrat; Moharra, Montserrat; Martinez, Joan Ignasi; Escarrabill, Juan; Roca, Josep

2015-01-01

Objectives To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus. Setting One health care sector in Spain (Barcelona) (n = 11.382); six municipalities in Norway (Trondheim) (n = 450); and one hospital in Greece (Athens) (n = 388). Method The four services were: (i) Home-based long-term maintenance of rehabilitation effects (n = 337); (ii) Enhanced Care for frail patients, n = 1340); (iii) Home Hospitalization and Early Discharge (n = 2404); and Support for remote diagnosis (forced spirometry testing) in primary care (Support) (n = 8139). Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted. Results The project demonstrated: (i) Sustainability of training effects over time in chronic patients with obstructive pulmonary disease (p < 0.01); (ii) Enhanced care and fewer hospitalizations in chronic respiratory patients (p < 0.05); (iii) Reduced in-hospital days for all types of patients (p < 0.001) in Home Hospitalization/Early Discharge; and (iv) Increased quality of testing (p < 0.01) for patients with respiratory symptoms in Support, with marked differences among sites. Conclusions The four integrated care services showed high potential to enhance health outcomes with cost-containment. Change management, technological approach and legal issues were major factors modulating the success of the deployment. The project generated a business plan to foster service sustainability and health innovation. Deployment strategies require site-specific adaptations. PMID:26034465

Improving the healthcare response to domestic violence and abuse in sexual health clinics: feasibility study of a training, support and referral intervention.

PubMed

Sohal, Alex Hardip; Pathak, Neha; Blake, Sarah; Apea, Vanessa; Berry, Judith; Bailey, Jayne; Griffiths, Chris; Feder, Gene

2018-03-01

Sexual health and gynaecological problems are the most consistent and largest physical health differences between abused and non-abused female populations. Sexual health services are well placed to identify and support patients experiencing domestic violence and abuse (DVA). Most sexual health professionals have had minimal DVA training despite English National Institute for Health and Care Excellence recommendations. We sought to determine the feasibility of an evidence-based complex DVA training intervention in female sexual health walk-in services (IRIS ADViSE: Identification and Referral to Improve Safety whilst Assessing Domestic Violence in Sexual Health Environments). An adaptive mixed method pilot study in the female walk-in service of two sexual health clinics. Following implementation and evaluation at site 1, the intervention was refined before implementation at site 2. The intervention comprised electronic prompts, multidisciplinary training sessions, clinic materials and simple referral pathways to IRIS ADViSE advocate-educators (AEs). The pilot lasted 7 weeks at site 1 and 12 weeks at site 2. Feasibility outcomes were to assign a supportive DVA clinical lead, an IRIS ADViSE AE employed by a local DVA service provider, adapt electronic records, develop local referral pathways, assess whether enquiry, identification and referral rates were measurable. Both sites achieved all feasibility outcomes: appointing a supportive DVA clinical lead and IRIS ADViSE AE, establishing links with a local DVA provider, adapting electronic records, developing local referral pathways and rates of enquiry, identification and referral were found to be measurable. Site 1: 10% enquiry rate (n=267), 4% identification rate (n=16) and eight AE referrals. Site 2: 61% enquiry rate (n=1090), a 7% identification rate (n=79) and eight AE referrals. IRIS ADViSE can be successfully developed and implemented in sexual health clinics. It fulfils the unmet need for DVA training. Longer-term evaluation is recommended. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration

PubMed Central

Duda, Stephany N; Farr, Amanda M; Lindegren, Mary Lou; Blevins, Meridith; Wester, C William; Wools-Kaloustian, Kara; Ekouevi, Didier K; Egger, Matthias; Hemingway-Foday, Jennifer; Cooper, David A; Moore, Richard D; McGowan, Catherine C; Nash, Denis

2014-01-01

Introduction HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. Methods Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. Results Most sites reported serving urban (61%; region range (rr): 33–100%) and both adult and paediatric populations (77%; rr: 29–96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services – nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) – were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services. Conclusions This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care. PMID:25516092

Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration.

PubMed

Duda, Stephany N; Farr, Amanda M; Lindegren, Mary Lou; Blevins, Meridith; Wester, C William; Wools-Kaloustian, Kara; Ekouevi, Didier K; Egger, Matthias; Hemingway-Foday, Jennifer; Cooper, David A; Moore, Richard D; McGowan, Catherine C; Nash, Denis

2014-01-01

HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. Most sites reported serving urban (61%; region range (rr): 33-100%) and both adult and paediatric populations (77%; rr: 29-96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services - nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) - were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services. This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.

Emergent Family Support Practices in a Context of Policy Churn: An Example from the Children's Fund

ERIC Educational Resources Information Center

Warren, Simon; Apostolov, Apostol; Broughton, Kevin; Evans, Ruth; MacNab, Natasha; Smith, Penny

2006-01-01

What might family support services look like in the reconfigured children and family services after the Children Act? This is the question this article attempts to explore by drawing on evidence from the National Evaluation of the Children's Fund in England. The article describes common features in two case-study sites that might indicate the…

75 FR 9189 - Office of Special Education and Rehabilitative Services; Overview Information; Assistive...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-01

... Public Internet Site; Notice Inviting Applications for New Awards for Fiscal Year (FY) 2010 Catalog of... assistive technology public Internet site to improve awareness of and access to assistive technology (AT...: National Assistive Technology Public Internet Site. Under this priority, the Department will support an...

Facility Systems, Ground Support Systems, and Ground Support Equipment General Design Requirements

NASA Technical Reports Server (NTRS)

Thaxton, Eric A.

2014-01-01

KSC-DE-512-SM establishes overall requirements and best design practices to be used at the John F. Kennedy Space Center (KSC) for the development of ground systems (GS) in support of operations at launch, landing, and retrieval sites. These requirements apply to the design and development of hardware and software for ground support equipment (GSE), ground support systems (GSS), and facility ground support systems (F-GSS) used to support the KSC mission for transportation, receiving, handling, assembly, test, checkout, servicing, and launch of space vehicles and payloads and selected flight hardware items for retrieval. This standards manual supplements NASA-STD-5005 by including KSC-site-specific and local environment requirements. These requirements and practices are optional for equipment used at manufacturing, development, and test sites.

Attitudes to, and experience of, pooled sampling for sexually transmitted infection testing: a web-based survey of English sexual health services.

PubMed

Shaw, Jonathan; Saunders, John Michael; Hughes, Gwenda

2018-05-01

Chlamydia trachomatis and Neisseria gonorrhoeae testing guidance recommends extragenital screening with locally validated nucleic acid amplification tests, with anatomical sites tested separately. Evidence supports multi-patient combined aliquot pooled sampling (PS) for population screening; evidence for within-patient PS is sparse. Within-patient PS could be more cost-effective for triple-site testing, but requires distinct clinical pathways and consideration over loss of information to guide risk assessments and treatment. We explored PS attitudes and practices amongst clinicians in England. A cross-sectional web-based survey was distributed to clinical leads of sexual health services throughout England in February 2016. Fifty-two (52/216, 23%) services responded. One service reported current within-patient PS and two were awaiting implementation. Of the 49 services not pooling, five were considering implementation. Concerns raised included the inability to distinguish infection site(s) (36/52, 69%), absence of national guidance (34/52, 65%) and reduced assay performance (18/52, 34%). Only 8/52 (15%) considered the current level of evidence sufficient to support PS, with 40/52 (77%) requesting further validation studies and 39/52 (77%) national guidance. PS was rarely used by respondents to this survey, although the response rate was low. The clinical challenges presented by PS need to be addressed through further development of the evidence base.

A Grid job monitoring system

NASA Astrophysics Data System (ADS)

Dumitrescu, Catalin; Nowack, Andreas; Padhi, Sanjay; Sarkar, Subir

2010-04-01

This paper presents a web-based Job Monitoring framework for individual Grid sites that allows users to follow in detail their jobs in quasi-real time. The framework consists of several independent components : (a) a set of sensors that run on the site CE and worker nodes and update a database, (b) a simple yet extensible web services framework and (c) an Ajax powered web interface having a look-and-feel and control similar to a desktop application. The monitoring framework supports LSF, Condor and PBS-like batch systems. This is one of the first monitoring systems where an X.509 authenticated web interface can be seamlessly accessed by both end-users and site administrators. While a site administrator has access to all the possible information, a user can only view the jobs for the Virtual Organizations (VO) he/she is a part of. The monitoring framework design supports several possible deployment scenarios. For a site running a supported batch system, the system may be deployed as a whole, or existing site sensors can be adapted and reused with the web services components. A site may even prefer to build the web server independently and choose to use only the Ajax powered web interface. Finally, the system is being used to monitor a glideinWMS instance. This broadens the scope significantly, allowing it to monitor jobs over multiple sites.

Online Student Services: An Overview of the Provision.

ERIC Educational Resources Information Center

McNickle, Cathy

This paper presents an overview of online student services being used by 19 vocational education and training (VET) and higher education institutions in Australia. Information was gathered though site visits between July and September 2000 about online support services for prospective students, enrolling students, enrolled students, and graduating…

75 FR 58416 - Statement of Organization, Functions and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

..., customer service and system and analytical support. Chapter RU--Bureau of Clinician Recruitment and Service..., coordinates and evaluates Bureau-wide management activities; (3) maintains effective relationships within HRSA... including but not limited to the Bureau Web site, BCRS Call Center and customer service portal, and...

Servicing capability for the evolutionary Space Station

NASA Technical Reports Server (NTRS)

Thomas, Edward F.; Grems, Edward G., III; Corbo, James E.

1990-01-01

Since the beginning of the Space Station Freedom (SSF) program the concept of on-orbit servicing of user hardware has been an integral part of the program implementation. The user servicing system architecture has been divided into a baseline and a growth phase. The baseline system consists of the following hardware elements that will support user servicing - flight telerobotic servicer, crew and equipment translation aid, crew intravehicular and extravehicular servicing support, logistics supply system, mobile servicing center, and the special purpose dextrous manipulator. The growth phase incorporates a customer servicing facility (CSF), a station-based orbital maneuvering vehicle and an orbital spacecraft consumables resupply system. The requirements for user servicing were derived from the necessity to service attached payloads, free flyers and coorbiting platforms. These requirements include: orbital replacement units (ORU) and instrument changeout, National Space Transportation System cargo bay loading and unloading, contamination control and monitoring, thermal protection, payload berthing, storage, access to SSF distributed systems, functional checkout, and fluid replenishment. The baseline user servicing capabilities accommodate ORU and instrument changeout. However, this service is limited to attached payloads, either in situ or at a locally adjacent site. The growth phase satisfies all identified user servicing requirements by expanding servicing capabilities to include complex servicing tasks for attached payloads, free-flyers and coorbiting platforms at a dedicated, protected Servicing site. To provide a smooth evolution of user servicing the SSF interfaces that are necessary to accommodate the growth phase have been identified. The interface requirements on SSF have been greatly simplified by accommodating the growth servicing support elements within the CSF. This results in a single SSF interface: SSF to the CSF.

Health information technology interventions enhance care completion, engagement in HIV care and treatment, and viral suppression among HIV-infected patients in publicly funded settings.

PubMed

Shade, Starley B; Steward, Wayne T; Koester, Kimberly A; Chakravarty, Deepalika; Myers, Janet J

2015-04-01

The National HIV/AIDS Strategy (NHAS) emphasizes the use of technology to facilitate coordination of comprehensive care for people with HIV. We examined the effect of six health information technology (HIT) interventions in a Ryan White-funded Special Projects of National Significance (SPNS) on care completion services, engagement in HIV care, and viral suppression. Interventions included use of surveillance data to identify out-of-care individuals, extending access to electronic health records to support service providers, use of electronic laboratory ordering and prescribing, and development of a patient portal. Data from a sample of electronic patient records from each site were analyzed to assess changes in utilization of comprehensive care (prevention screening, support service utilization), engagement in primary HIV medical care (receipt of services and use of antiretroviral therapy), and viral suppression. We used weighted generalized estimating equations to estimate outcomes while accounting for the unequal contribution of data and differences in the distribution of patient characteristics across sites and over time. We observed statistically significant changes in the desired direction in comprehensive care utilization and engagement in primary care outcomes targeted by each site. Five of six sites experienced statistically significant increases in viral suppression. These results provide additional support for the use of HIT as a valuable tool for achieving the NHAS goal of providing comprehensive care for all people living with HIV. HIT has the potential to increase utilization of services, improve health outcomes for people with HIV, and reduce community viral load and subsequent transmission of HIV. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com For affiliation see end of article.

Weaving Silos--A Leadership Challenge: A Cross-Functional Team Approach to Supporting Web-Based Student Services

ERIC Educational Resources Information Center

Kleemann, Gary L.

2005-01-01

The author reviews the evolution of Web services--from information sharing to transactional to relationship building--and the progression from first-generation to fourth-generation Web sites. (Contains 3 figures.)

76 FR 56295 - Schools and Libraries Universal Service Support Mechanism and a National Broadband Plan for Our...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-13

... other individuals on social networking Web sites and in chat rooms, and regarding cyberbullying... appropriate online behavior, including interacting with other individuals on social networking Web sites and... behavior, including interacting with other individuals on social networking Web sites and in chat rooms and...

Distributed user services for supercomputers

NASA Technical Reports Server (NTRS)

Sowizral, Henry A.

1989-01-01

User-service operations at supercomputer facilities are examined. The question is whether a single, possibly distributed, user-services organization could be shared by NASA's supercomputer sites in support of a diverse, geographically dispersed, user community. A possible structure for such an organization is identified as well as some of the technologies needed in operating such an organization.

Developing Web Services for Technology Education. The Graphic Communication Electronic Publishing Project.

ERIC Educational Resources Information Center

Sanders, Mark

1999-01-01

Graphic Communication Electronic Publishing Project supports a Web site (http://TechEd.vt.edu/gcc/) for graphic communication teachers and students, providing links to Web materials, conversion of print materials to electronic formats, and electronic products and services including job listings, resume posting service, and a listserv. (SK)

An Integrated Approach to Student Services.

ERIC Educational Resources Information Center

Kelly, Rob

2001-01-01

Describes the comprehensive, coordinated approach to student support services at the University of Wisconsin Learning Innovations, an electronic learning consultation utility that develops online programs for distance learning. Topics include the Learner Relationship Management System, advising opportunities, help desk, administrative Web site,…

Minimizing impacts of land use change on ecosystem services using multi-criteria heuristic analysis.

PubMed

Keller, Arturo A; Fournier, Eric; Fox, Jessica

2015-06-01

Development of natural landscapes to support human activities impacts the capacity of the landscape to provide ecosystem services. Typically, several ecosystem services are impacted at a single development site and various footprint scenarios are possible, thus a multi-criteria analysis is needed. Restoration potential should also be considered for the area surrounding the permanent impact site. The primary objective of this research was to develop a heuristic approach to analyze multiple criteria (e.g. impacts to various ecosystem services) in a spatial configuration with many potential development sites. The approach was to: (1) quantify the magnitude of terrestrial ecosystem service (biodiversity, carbon sequestration, nutrient and sediment retention, and pollination) impacts associated with a suite of land use change scenarios using the InVEST model; (2) normalize results across categories of ecosystem services to allow cross-service comparison; (3) apply the multi-criteria heuristic algorithm to select sites with the least impact to ecosystem services, including a spatial criterion (separation between sites). As a case study, the multi-criteria impact minimization algorithm was applied to InVEST output to select 25 potential development sites out of 204 possible locations (selected by other criteria) within a 24,000 ha property. This study advanced a generally applicable spatial multi-criteria approach for 1) considering many land use footprint scenarios, 2) balancing impact decisions across a suite of ecosystem services, and 3) determining the restoration potential of ecosystem services after impacts. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Evaluation of trained volunteer doula services for disadvantaged women in five areas in England: women's experiences.

PubMed

Darwin, Zoe; Green, Josephine; McLeish, Jenny; Willmot, Helen; Spiby, Helen

2017-03-01

Disadvantaged childbearing women experience barriers to accessing health and social care services and face greater risk of adverse medical, social and emotional outcomes. Support from doulas (trained lay women) has been identified as a way to improve outcomes; however, in the UK doula support is usually paid-for privately by the individual, limiting access among disadvantaged groups. As part of an independent multi-site evaluation of a volunteer doula service, this study examined women's experiences of one-to-one support from a trained volunteer doula during pregnancy, labour and the post-natal period among women living in five low-income communities in England. A mixed methods multi-site evaluation was conducted with women (total n = 137) who received the service before December 2012, using a combination of questionnaires (n = 136), and individual or group interviews (n = 12). Topics explored with women included the timing and nature of support, its impact, the relationship with the doula and negative experiences. Most women valued volunteer support, describing positive impacts for emotional health and well-being, and their relationships with their partners. Such impacts did not depend upon the volunteer's presence during labour and birth. Indeed, only half (75/137; 54.7%) had a doula attend their birth. Many experienced volunteer support as a friendship, distinct from the relationships offered by healthcare professionals and family. This led to potential feelings of loss in these often isolated women when the relationship ended. Volunteer doula support that supplements routine maternity services is potentially beneficial for disadvantaged women in the UK even when it does not involve birth support. However, the distress experienced by some women at the conclusion of their relationship with their volunteer doula may compromise the service's impact. Greater consideration is needed for managing the ending of a one-to-one relationship with a volunteer, particularly given the likelihood of it coinciding with a period of heightened emotional vulnerability. © 2016 John Wiley & Sons Ltd.

How supportive supervision influences immunization session site practices: a quasi-experimental study in Odisha, India.

PubMed

Panda, Bhuputra; Pati, Sanghamitra; Nallala, Srinivas; Chauhan, Abhimanyu S; Anasuya, Anita; Som, Meena; Zodpey, Sanjay

2015-01-01

Routine immunization (RI) is a key child survival intervention. Ensuring acceptable standards of RI service delivery is critical for optimal outcomes. Accumulated evidences suggest that 'supportive supervision' improves the quality of health care services in general. During 2009-2010, the Government of Odisha and UNICEF jointly piloted this strategy in four districts to improve RI program outcomes. The present study aims to assess the effect of this strategy on improvement of skills and practices at immunization session sites. A quasi-experimental 'post-test only' study design was adopted to compare the opinion and practices of frontline health workers and their supervisors in four intervention districts (IDs) with two control districts (CDs). Altogether, we interviewed 111 supervisor-supervisee (health worker) pairs using semi-structured interview schedules and case vignettes. We also directly observed health workers' practices during immunization sessions at 111 sites. Data were analyzed with SPSS version 16.0. The mean knowledge score of supervisors in CDs was significantly higher than in intervention groups. Variegated responses were obtained on case vignettes. The control group performed better in solving certain hypothetically asked problems, whereas the intervention group scored better in others. Health workers in IDs gave a lower rating to their respective supervisors' knowledge, skill, and frequency of supervision. Logistics and vaccine availability were better in CDs. Notwithstanding other limitations, supportive supervision may not have independent effects on improving the quality of immunization services. Addressing systemic issues, such as the availability of essential logistics, supply chain management, timely indenting, and financial resources, could complement the supportive supervision strategy in improving immunization service delivery.

The StratusLab cloud distribution: Use-cases and support for scientific applications

NASA Astrophysics Data System (ADS)

Floros, E.

2012-04-01

The StratusLab project is integrating an open cloud software distribution that enables organizations to setup and provide their own private or public IaaS (Infrastructure as a Service) computing clouds. StratusLab distribution capitalizes on popular infrastructure virtualization solutions like KVM, the OpenNebula virtual machine manager, Claudia service manager and SlipStream deployment platform, which are further enhanced and expanded with additional components developed within the project. The StratusLab distribution covers the core aspects of a cloud IaaS architecture, namely Computing (life-cycle management of virtual machines), Storage, Appliance management and Networking. The resulting software stack provides a packaged turn-key solution for deploying cloud computing services. The cloud computing infrastructures deployed using StratusLab can support a wide range of scientific and business use cases. Grid computing has been the primary use case pursued by the project and for this reason the initial priority has been the support for the deployment and operation of fully virtualized production-level grid sites; a goal that has already been achieved by operating such a site as part of EGI's (European Grid Initiative) pan-european grid infrastructure. In this area the project is currently working to provide non-trivial capabilities like elastic and autonomic management of grid site resources. Although grid computing has been the motivating paradigm, StratusLab's cloud distribution can support a wider range of use cases. Towards this direction, we have developed and currently provide support for setting up general purpose computing solutions like Hadoop, MPI and Torque clusters. For what concerns scientific applications the project is collaborating closely with the Bioinformatics community in order to prepare VM appliances and deploy optimized services for bioinformatics applications. In a similar manner additional scientific disciplines like Earth Science can take advantage of StratusLab cloud solutions. Interested users are welcomed to join StratusLab's user community by getting access to the reference cloud services deployed by the project and offered to the public.

Remote Excavation of Heavily Contaminated UXO Sites

DTIC Science & Technology

2007-12-01

detonation RF radio frequency RPM revolutions per minute Shaw Shaw Environmental Services SUXOS senior UXO supervisor Timberline Timberline ... Timberline Environmental Services, Inc. ( Timberline ). Timberline , and most notably Mr. Terry Northcutt, was the heart and soul of this project...the prime contractor responsible for project management and UXO support; and Timberline Environmental Services, 2 Inc. ( Timberline ) is responsible

Supporting pre-service science teachers in developing culturally relevant pedagogy

NASA Astrophysics Data System (ADS)

Krajeski, Stephen

This study employed a case study methodology to investigate a near-authentic intervention program designed to support the development of culturally relevant pedagogy and its impact on pre-service science teachers' notions of culturally relevant pedagogy. The unit of analysis for this study was the discourse of pre-service science teachers enrolled in a second semester science methods course, which was the site of the intervention program. Data for this study was collected from videos of classroom observations, audio recordings of personal interviews, and artifacts created by the pre-service science teachers during the class. To determine how effective science teacher certification programs are at supporting the development of culturally relevant pedagogy without an immersion aspect, two research questions were investigated: 1) How do pre-service science teachers view and design pedagogy while participating in an intervention designed to support the development of culturally relevant pedagogy? 2) How do pre-service science teachers view the importance of culturally relevant pedagogy for supporting student learning? How do their practices in the field change these initial views?

Supported employment: cost-effectiveness across six European sites

PubMed Central

Knapp, Martin; Patel, Anita; Curran, Claire; Latimer, Eric; Catty, Jocelyn; Becker, Thomas; Drake, Robert E; Fioritti, Angelo; Kilian, Reinhold; Lauber, Christoph; Rössler, Wulf; Tomov, Toma; van Busschbach, Jooske; Comas-Herrera, Adelina; White, Sarah; Wiersma, Durk; Burns, Tom

2013-01-01

A high proportion of people with severe mental health problems are unemployed but would like to work. Individual Placement and Support (IPS) offers a promising approach to establishing people in paid employment. In a randomized controlled trial across six European countries, we investigated the economic case for IPS for people with severe mental health problems compared to standard vocational rehabilitation. Individuals (n=312) were randomized to receive either IPS or standard vocational services and followed for 18 months. Service use and outcome data were collected. Cost-effectiveness analysis was conducted with two primary outcomes: additional days worked in competitive settings and additional percentage of individuals who worked at least 1 day. Analyses distinguished country effects. A partial cost-benefit analysis was also conducted. IPS produced better outcomes than alternative vocational services at lower cost overall to the health and social care systems. This pattern also held in disaggregated analyses for five of the six European sites. The inclusion of imputed values for missing cost data supported these findings. IPS would be viewed as more cost-effective than standard vocational services. Further analysis demonstrated cost-benefit arguments for IPS. Compared to standard vocational rehabilitation services, IPS is, therefore, probably cost-saving and almost certainly more cost-effective as a way to help people with severe mental health problems into competitive employment. PMID:23471803

76 FR 13664 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-14

... International, Manpower, Acro Service Corp., Adecco, Inc., Aerotek, Inc., CDI Corporation, Emergent Systems Corp... Manpower, Van Buren Township, Michigan. The workers are engaged in the manufacturing of automotive systems. The Visteon Headquarter sites provide support services including research, engineering, manufacturing...

Barriers and Facilitators to Integrating Health Service Responses to Intimate Partner Violence in Low- and Middle-Income Countries: A Comparative Health Systems and Service Analysis.

PubMed

Colombini, Manuela; Dockerty, Colleen; Mayhew, Susannah H

2017-06-01

This systematic review synthesizes 11 studies of health-sector responses to intimate partner violence (IPV) in low- and middle-income countries. The services that were most comprehensive and integrated in their responsiveness to IPV were primarily in primary health and antenatal care settings. Findings suggest that the following facilitators are important: availability of clear guidelines, policies, or protocols; management support; intersectoral coordination with clear, accessible on-site and off-site referral options; adequate and trained staff with accepting and empathetic attitudes toward survivors of IPV; initial and ongoing training for health workers; and a supportive and supervised environment in which to enact new IPV protocols. A key characteristic of the most integrated responses was the connection or "linkages" between different individual factors. Irrespective of their service entry point, what emerged as crucial was a connected systems-level response, with all elements implemented in a coordinated manner. © 2017 The Population Council, Inc.

Barriers and Facilitators to Integrating Health Service Responses to Intimate Partner Violence in Low‐ and Middle‐Income Countries: A Comparative Health Systems and Service Analysis

PubMed Central

Colombini, Manuela; Dockerty, Colleen; Mayhew, Susannah H.

2017-01-01

This systematic review synthesizes 11 studies of health‐sector responses to intimate partner violence (IPV) in low‐ and middle‐income countries. The services that were most comprehensive and integrated in their responsiveness to IPV were primarily in primary health and antenatal care settings. Findings suggest that the following facilitators are important: availability of clear guidelines, policies, or protocols; management support; intersectoral coordination with clear, accessible on‐site and off‐site referral options; adequate and trained staff with accepting and empathetic attitudes toward survivors of IPV; initial and ongoing training for health workers; and a supportive and supervised environment in which to enact new IPV protocols. A key characteristic of the most integrated responses was the connection or “linkages” between different individual factors. Irrespective of their service entry point, what emerged as crucial was a connected systems‐level response, with all elements implemented in a coordinated manner. PMID:28422291

Self-efficacy, social support and service integration at medical cannabis facilities in the San Francisco Bay area of California.

PubMed

Reiman, Amanda E

2008-01-01

In an effort to examine and possibly utilise the community-based, bottom-up service design of medical cannabis facilities in the San Francisco Bay area of California, 130 adults who had received medical cannabis recommendations from a physician were surveyed at seven facilities to describe the social service aspects of these unique, community-based programmes. This study used an unselected consecutive sample and cross-sectional survey design that included primary data collection at the medical cannabis facilities themselves. In this exploratory study, individual level data were collected on patient demographics and reported patient satisfaction as gathered by the Patient Satisfaction Questionnaire III. Surveys were filled out on site. In the case of a refusal, the next person was asked. The refusal rate varied depending on the study site and ranged between 25% and 60%, depending on the facility and the day of sampling. Organisational-level data, such as operating characteristics and products offered, created a backdrop for further examination into the social services offered by these facilities and the attempts made by this largely unregulated healthcare system to create a community-based environment of social support for chronically ill people. Informal assessment suggests that chronic pain is the most common malady for which medical cannabis is used. Descriptive statistics were generated to examine sample- and site-related differences. Results show that medical cannabis patients have created a system of dispensing medical cannabis that also includes services such as counselling, entertainment and support groups - all important components of coping with chronic illness. Furthermore, patients tend to be male, over 35, identify with more than one ethnicity, and earn less than US$20 000 annually. Levels of satisfaction with facility care were fairly high, and higher than nationally reported satisfaction with health care in the USA. Facilities tended to follow a social model of cannabis care, including allowing patients to use medicine on site and offering social services. This approach has implications for the creation and maintenance of a continuum of care among bottom-up social and health services agencies.

Group purchasing of workplace health promotion services for small employers.

PubMed

Harris, Jeffrey R; Hammerback, Kristen R; Hannon, Peggy A; McDowell, Julie; Katzman, Avi; Clegg-Thorp, Catherine; Gallagher, John

2014-07-01

Small employers are underserved with workplace health promotion services, so we explored the potential for group purchasing of these services. We conducted semistructured telephone interviews of member organizations serving small employers, as well as workplace health promotion vendors, in Washington State. We interviewed 22 employer organizations (chambers of commerce, trade associations, and an insurance trust) and vendors (of fitness facilities, healthy vending machines, fresh produce delivery, weight management services, and tobacco cessation quitlines). Both cautiously supported the idea of group purchasing but felt that small employers' workplace health promotion demand must increase first. Vendors providing off-site services, for example, quitline, found group purchasing more feasible than vendors providing on-site services, for example, produce delivery. Employer member organizations are well-positioned to group purchase workplace health promotion services; vendors are receptive if there is potential profit.

Linking Course Web Sites to Library Collections and Services

ERIC Educational Resources Information Center

Rieger, Oya Y.; Horne, Angela K.; Revels, Ira

2004-01-01

A five-month research study at Cornell University Library (CUL) confirmed the strategic importance of a library presence in faculty-created course Web sites. It sparked specific recommendations to support the seamless integration of the CUL digital library within the virtual learning environments created by faculty.

Civil engineering support for the traffic monitoring program : final report, January 2010.

DOT National Transportation Integrated Search

2010-01-01

This project was aimed at providing various civil engineering support services for the telemetered traffic monitoring sites operated by the Statistics Office of the Florida Department of Transportation. This was a companion project to the one that pr...

The Cost of Providing Comprehensive HIV Treatment in PEPFAR-Supported Programs

PubMed Central

Menzies, Nicolas A; Berruti, Andres A; Berzon, Richard; Filler, Scott; Ferris, Robert; Ellerbrock, Tedd V; Blandford, John M

2011-01-01

PEPFAR, national governments, and other stakeholders are investing unprecedented resources to provide HIV treatment in developing countries. This study reports empirical data on costs and cost trends in a large sample of HIV treatment sites. In 2006–2007, we conducted cost analyses at 43 PEPFAR-supported outpatient clinics providing free comprehensive HIV treatment in Botswana, Ethiopia, Nigeria, Uganda, and Vietnam. We collected data on HIV treatment costs over consecutive 6-month periods from scale-up of dedicated HIV treatment services at each site. The study included all patients receiving HIV treatment and care at study sites (62,512 ART and 44,394 pre-ART patients). Outcomes were costs per-patient and total program costs, subdivided by major cost categories. Median annual economic costs were $202 (2009 USD) for pre-ART patients and $880 for ART patients. Excluding ARVs, per-patient ART costs were $298. Care for newly initiated ART patients cost 15–20% more than for established patients. Per-patient costs dropped rapidly as sites matured, with per-patient ART costs dropping 46.8% between first and second 6-month periods after the beginning of scale-up, and an additional 29.5% the following year. PEPFAR provided 79.4% of funding for service delivery, and national governments provided 15.2%. Treatment costs vary widely between sites, and high early costs drop rapidly as sites mature. Treatment costs vary between countries and respond to changes in ARV regimen costs and the package of services. While cost reductions may allow near-term program growth, programs need to weigh the trade-off between improving services for current patients and expanding coverage to new patients. PMID:21412127

National dissemination of supported housing in the VA: model adherence versus model modification.

PubMed

O'Connell, Maria; Kasprow, Wesley; Rosenheck, Robert A

2010-01-01

The continuing development and dissemination of emerging evidence-based practices may be facilitated by the availability of descriptive information on the actual delivery of the service, and its variability, across sites. This paper presents data on the participation of 2,925 homeless veterans in the Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program at 36 sites across the country, for up to five years. While most conceptual models emphasize rapid placement, sustained intensive case management, rehabilitation services, and "permanent" housing, no program has yet presented empirical data on the actual delivery of such services over an extended period of time. Using extensive longitudinal data from the VA's national homeless outreach program, the Health Care for Homeless Veterans (HCHV) program, a quantitative portrait presents what happens in supported housing in a large real-world dissemination effort. Program entry to HUD-VASH was generally slow with 108 days (sd = 92 days) on average passing between program entry and housing placement. Total program participation lasted 2.6 years on average (sd = 1.6 years)-just half of the possible 5 years. Service delivery became substantially less intensive over time by several measures, and three-fourths of the veterans terminated within five years, although the vast majority (82%) were housed at the time. Few veterans received rehabilitation services (6%) or employment assistance (17%) and most service delivery focused on obtaining housing. These data suggest that real-world supported housing programs may not adhere to the prevalent model descriptions either because of implementation failure or because veteran needs and preferences differ from those suggested by that model.

Care for Child Development: an intervention in support of responsive caregiving and early child development.

PubMed

Lucas, J E; Richter, L M; Daelmans, B

2018-01-01

An estimated 43% of children younger than 5 years of age are at elevated risk of failing to achieve their human potential. In response, the World Health Organization and UNICEF developed Care for Child Development (CCD), based on the science of child development, to improve sensitive and responsive caregiving and promote the psychosocial development of young children. In 2015, the World Health Organization and UNICEF identified sites where CCD has been implemented and sustained. The sites were surveyed, and responses were followed up by phone interviews. Project reports provided information on additional sites, and a review of published studies was undertaken to document the effectiveness of CCD for improving child and family outcomes, as well as its feasibility for implementation in resource-constrained communities. The inventory found that CCD had been integrated into existing services in diverse sectors in 19 countries and 23 sites, including child survival, health, nutrition, infant day care, early education, family and child protection and services for children with disabilities. Published and unpublished evaluations have found that CCD interventions can improve child development, growth and health, as well as responsive caregiving. It has also been reported to reduce maternal depression, a known risk factor for poor pregnancy outcomes and poor child health, growth and development. Although CCD has expanded beyond initial implementation sites, only three countries reported having national policy support for integrating CCD into health or other services. Strong interest exists in many countries to move beyond child survival to protect and support optimal child development. The United Nations Sustainable Development Goals depend on children realizing their potential to build healthy and emotionally, cognitively and socially competent future generations. More studies are needed to guide the integration of the CCD approach under different conditions. Nevertheless, the time is right to provide for the scale-up of CCD as part of services for families and children. © 2017 The Authors. Child: Care, Health and Development Published by John Wiley & Sons Ltd.

An Evaluation of Videoconferencing as a Supportive Technology for Practicum Supervision

ERIC Educational Resources Information Center

Dymond, Stacy K.; Renzaglia, Adelle; Halle, James W.; Chadsey, Janis; Bentz, Johnell L.

2008-01-01

In this study, the authors determine the efficacy of videoconferencing to supervise pre-service special education teachers. Efficacy is determined by (a) assessing interobserver reliability between on-site and off-site observers and (b) evaluating the feasibility and practicality of the videoconferencing technology. Data are collected in two…

The Influences of Gender and Religiousness on Alzheimer Disease Caregivers’ Use of Informal Support and Formal Services

PubMed Central

Sun, Fei; Roff, Lucinda Lee; Klemmack, David; Burgio, Louis D.

2010-01-01

Objective This study explored how male and female family caregivers of Alzheimer’s disease (AD) patients differ in their use of formal services and informal support and how religiousness may affect such differences. Methods Data were from a sample of 720 family caregivers of AD patients who participated in the Resources for Enhancing Alzheimer’s Caregiver Heath (REACH I) study sites in Birmingham, Boston, Memphis, and Philadelphia. Results Female caregivers were less likely to use in-home services than males (M = 0.83 vs. M = 1.06, p < .01) but reported more use of transportation services (21.6% vs. 12.7%, p < .01) and more use of informal support (M = 13.9 vs. M = 10.7, p < .01). Mediation tests suggested that three measures of religiousness helped explain the relationship between gender and use of formal services and informal support. Discussion These findings highlight the necessity to assess AD caregivers’ religiousness to better understand their circumstances. PMID:18936242

Differential Exposure to Early Childhood Education Services and Mother-Toddler Interaction

ERIC Educational Resources Information Center

Klebanov, P.K.; Brooks-Gunn, J.

2008-01-01

This study examined the associations of exposure to early childhood education (ECE) services upon 2.5-year-old children's task persistence and enthusiasm and their mothers' authoritative and authoritarian behavior and support stimulation. Families participated in the Infant Health and Development Program, an eight-site randomized comprehensive ECE…

75 FR 75953 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-07

... it displays a currently valid OMB control number. Agricultural Marketing Service Title: Reporting and... Equitable Tobacco Reform Act of 2004 (7 U.S.C. 518) eliminated price supports and marketing quotas for all.... Agricultural Marketing Service Title: USDA Food Connect Web site. OMB Control Number: 0581-0224. Summary of...

INCAS—Interactive Teleconsultation Network for Worldwide Healthcare Services

PubMed Central

Castelli, A.; Colombo, C.; Garlaschelli, A.; Pepe, G.

2001-01-01

The INCAS Project arises from the needs of an Italian oil company in order to support the doctors responsible for the healthcare in remote drilling sites. The INCAS telemedicine1 system implements a prototype of teleconsultation medical service allowing for the interactive on-line connection with Italian healthcare reference centres in order to: • provide support to the expatriate doctor with the diagnoses and treatment of routine complaints; • contribute to the general improvement of healthcare in remote areas.

Big Outcrops and Big Ideas in Earth Science K-8 Professional Development

NASA Astrophysics Data System (ADS)

Baldwin, K. A.; Cooper, C. M.; Cavagnetto, A.; Morrison, J.; Adesope, O.

2014-12-01

Washington State has recently adopted the Next Generation Science Standards (NGSS) and state leaders are now working toward supporting teachers' implementation of the new standards and the pedagogical practices that support them. This poster encompasses one of one such professional development (PD) effort. The Enhancing Understanding of Concepts and Processes of Science (EUCAPS) project serves 31 K-8 in-service teachers in two southeast Washington school districts. In year two of this three year PD project, in-service teachers explored the Earth sciences and pedagogical approaches such as the Science Writing Heuristic, concept mapping, and activities which emphasized the epistemic nature of science. The goals of the EUCAPS PD project are to increase in-service teachers' big ideas in science and to provide support to in-service teachers as they transition to the NGSS. Teachers used concepts maps to document their knowledge of Earth science processes before and after visiting a local field site in Lewiston, Idaho. In the context of immersive inquiries, teachers collected field-based evidence to support their claims about the geological history of the field site. Teachers presented their claims and evidence to their peers in the form a story about the local geologic history. This poster will present an overview of the PD as well as provide examples of teacher's work and alignment with the NGSS.

Family Supports for Children with Severe Disabilities and Chronic Illnesses in Maryland.

ERIC Educational Resources Information Center

Walker, Pam

This report focuses on positive practices in providing support services to families of children with severe disabilities and chronic illnesses, based on visits to three sites in Maryland: the Family Support Program at the Kennedy Institute in Baltimore, the Coordinating Center for Home and Community Care, and Sick Kids Need Involved People (SKIP).…

Selling a service: experiences of peer supporters while promoting exclusive infant feeding in three sites in South Africa.

PubMed

Nkonki, Lungiswa L; Daniels, Karen L

2010-10-26

Even though it has been shown that peer support to mothers at home helps to increase exclusive breastfeeding, little is known about the experiences of peer supporters themselves and what is required of them to fulfil their day-to-day tasks. Therefore, a community-based randomised control trial using trained "lay" women to support exclusive infant feeding at home was implemented in three different sites across South Africa. The aim of this paper is to describe the experiences of peer supporters who promote exclusive infant feeding. Three focus group discussions were held, in a language of their choice, with peer supporters. These meetings focused on how the peer educators utilised their time in the process of delivering the intervention. Data from the discussions were transcribed, with both verbatim and translated transcripts being used in the analysis. Unlike the services provided by mainstream health care, peer supporters had to market their services. They had to negotiate entry into the mother's home and then her life. Furthermore, they had to demonstrate competence and come across as professional and trustworthy. An HIV-positive mother's fear of being stigmatised posed an added burden - subsequent disclosure of her positive status would lead to an increased workload and emotional distress. Peer supporters spent most of their time in the field and had to learn the skill of self-management. Their support-base was enhanced when supervision focused on their working conditions as well as the delivery of their tasks. Despite this, they faced other insurmountable issues, such as mothers being compelled to offer their infants mixed feeding simultaneously due to normative practices and working in the fields postpartum. Designers of peer support interventions should consider the skills required for delivering health messages and the skills required for selling a service. Supportive supervision should be responsive both to the health care task and the challenges faced in the process of delivering it. NCT00297150.

Deployment of IPv6-only CPU resources at WLCG sites

NASA Astrophysics Data System (ADS)

Babik, M.; Chudoba, J.; Dewhurst, A.; Finnern, T.; Froy, T.; Grigoras, C.; Hafeez, K.; Hoeft, B.; Idiculla, T.; Kelsey, D. P.; López Muñoz, F.; Martelli, E.; Nandakumar, R.; Ohrenberg, K.; Prelz, F.; Rand, D.; Sciabà, A.; Tigerstedt, U.; Traynor, D.

2017-10-01

The fraction of Internet traffic carried over IPv6 continues to grow rapidly. IPv6 support from network hardware vendors and carriers is pervasive and becoming mature. A network infrastructure upgrade often offers sites an excellent window of opportunity to configure and enable IPv6. There is a significant overhead when setting up and maintaining dual-stack machines, so where possible sites would like to upgrade their services directly to IPv6 only. In doing so, they are also expediting the transition process towards its desired completion. While the LHC experiments accept there is a need to move to IPv6, it is currently not directly affecting their work. Sites are unwilling to upgrade if they will be unable to run LHC experiment workflows. This has resulted in a very slow uptake of IPv6 from WLCG sites. For several years the HEPiX IPv6 Working Group has been testing a range of WLCG services to ensure they are IPv6 compliant. Several sites are now running many of their services as dual-stack. The working group, driven by the requirements of the LHC VOs to be able to use IPv6-only opportunistic resources, continues to encourage wider deployment of dual-stack services to make the use of such IPv6-only clients viable. This paper presents the working group’s plan and progress so far to allow sites to deploy IPv6-only CPU resources. This includes making experiment central services dual-stack as well as a number of storage services. The monitoring, accounting and information services that are used by jobs also need to be upgraded. Finally the VO testing that has taken place on hosts connected via IPv6-only is reported.

Implementation of Evidence-Based Employment Services in Specialty Mental Health

PubMed Central

Hamilton, Alison B; Cohen, Amy N; Glover, Dawn L; Whelan, Fiona; Chemerinski, Eran; McNagny, Kirk P; Mullins, Deborah; Reist, Christopher; Schubert, Max; Young, Alexander S

2013-01-01

Objective. Study a quality improvement approach for implementing evidence-based employment services at specialty mental health clinics. Data Sources/Study Setting. Semistructured interviews with clinicians and administrators before, during, and after implementation. Qualitative field notes, structured baseline and follow-up interviews with patients, semistructured interviews with patients after implementation, and administrative data. Study Design. Site-level controlled trial at four implementation and four control sites. Hybrid implementation–effectiveness study with mixed methods intervention evaluation design. Data Collection/Extraction Methods. Site visits, in-person and telephone interviews, patient surveys, patient self-assessment. A total of 801 patients completed baseline surveys and 53 clinicians and other clinical key stakeholders completed longitudinal qualitative interviews. Principal Findings. At baseline, sites varied in the availability, utilization, and quality of supported employment. Each site needed quality improvement for this service, though for differing reasons, with some needing development of the service itself and others needing increased service capacity. Improvements in knowledge, attitudes, beliefs, and referral behaviors were evident in mid- and postimplementation interviews, though some barriers persisted. Half of patients expressed an interest in working at baseline. Patients at implementation sites were 2.3 times more likely to receive employment services during the study year. Those who had a service visit were more likely to be employed at follow-up than those who did not. Conclusions. Studies of implementation and effectiveness require mixed methods to both enhance implementation in real time and provide context for interpretation of complex results. In this study, a quality improvement approach resulted in superior patient-level outcomes and improved clinician knowledge, attitudes, and behaviors, in the context of substantial variation among sites. PMID:24138608

Impact of the Macmillan specialist Care at Home service: a mixed methods evaluation across six sites.

PubMed

Johnston, Bridget; Patterson, Anne; Bird, Lydia; Wilson, Eleanor; Almack, Kathryn; Mathews, Gillian; Seymour, Jane

2018-02-23

The Midhurst Macmillan Specialist Palliative Care at Home Service was founded in 2006 to improve community-based palliative care provision. Principal components include; early referral; home-based clinical interventions; close partnership working; and flexible teamwork. Following a successful introduction, the model was implemented in six further sites across England. This article reports a mixed methods evaluation of the implementation across these 'Innovation Centres'. The evaluation aimed to assess the process and impact on staff, patients and carers of providing Macmillan Specialist Care at Home services across the six sites. The study was set within a Realist Evaluation framework and used a longitudinal, mixed methods research design. Data collection over 15 months (2014-2016) included: Quantitative outcome measures - Palliative Performance Scale [PPS] and Palliative Prognostic Index [PPI] (n = 2711); Integrated Palliative Outcome Scales [IPOS] (n = 1157); Carers Support Needs Assessment Tool [CSNAT] (n = 241); Views of Informal Carers -Evaluation of Services [VOICES-SF] (n = 102); a custom-designed Service Data Tool [SDT] that gathered prospective data from each site (n = 88). Qualitative data methods included: focus groups with project team and staff (n = 32 groups with n = 190 participants), and, volunteers (n = 6 groups with n = 32 participants). Quantitative data were analysed using SPPS Vs. 21 and qualitative data was examined via thematic analysis. Comparison of findings across the six sites revealed the impact of their unique configurations on outcomes, compounded by variations in stage and mode of implementation. PPS, PPI and IPOS data revealed disparity in early referral criteria, complicated by contrasting interpretations of palliative care. The qualitative analysis, CSNAT and VOICES-SF data confirmed the value of the Macmillan model of care but uptake of specialist home-based clinical interventions was limited. The Macmillan brand engendered patient and carer confidence, bringing added value to existing services. Significant findings included better co-ordination of palliative care through project management and a single referral point and multi-disciplinary teamwork including leadership from consultants in palliative medicine, the role of health care assistants in rapid referral, and volunteer support. Macmillan Specialist Care at Home increases patient choice about place of death and enhances the quality of end of life experience. Clarification of key components is advocated to aid consistency of implementation across different sites and support future evaluative work.

A standards-based approach to quality improvement for HIV services at Zambia Defence Force facilities: results and lessons learned.

PubMed

Kols, Adrienne; Kim, Young-Mi; Bazant, Eva; Necochea, Edgar; Banda, Joseph; Stender, Stacie

2015-07-01

The Zambia Defence Force adopted the Standards-Based Management and Recognition approach to improve the quality of the HIV-related services at its health facilities. This quality improvement intervention relies on comprehensive, detailed assessment tools to communicate and verify adherence to national standards of care, and to test and implement changes to improve performance. A quasi-experimental evaluation of the intervention was conducted at eight Zambia Defence Force primary health facilities (four facilities implemented the intervention and four did not). Data from three previous analyses are combined to assess the effect of Standards-Based Management and Recognition on three domains: facility readiness to provide services; observed provider performance during antiretroviral therapy (ART) and antenatal care consultations; and provider perceptions of the work environment. Facility readiness scores for ART improved on four of the eight standards at intervention sites, and one standard at comparison sites. Facility readiness scores for prevention of mother-to-child transmission (PMTCT) of HIV increased by 15 percentage points at intervention sites and 7 percentage points at comparison sites. Provider performance improved significantly at intervention sites for both ART services (from 58 to 84%; P < 0.01) and PMTCT services (from 58 to 73%; P = 0.003); there was no significant change at comparison sites. Providers' perceptions of the work environment generally improved at intervention sites and declined at comparison sites; differences in trends between study groups were significant for eight items. A standards-based approach to quality improvement proved effective in supporting healthcare managers and providers to deliver ART and PMTCT services in accordance with evidence-based standards in a health system suffering from staff shortages.

The Global GNSS, SLR, VLBI, and DORIS Networks and their Support of GGOS: IGS+ILRS+IVS+IDS

NASA Technical Reports Server (NTRS)

Noll, Carey

2008-01-01

The global network of the International GNSS Service (IGS), the International Laser Ranging Service (ILRS), the International VLBI Service for Geodesy and Astrometry (IVS), and the International DORIS Service (IDS) are part of the ground-based infrastructure for GGOS. The observations obtained from these global networks provide for the determination and maintenance of the International Terrestrial Reference Frame (ITRF), an accurate set of positions and velocities that provides a stable coordinate system allowing scientists ts to link measurements over space and time. Many of these sites offer co-location of two or more techniques. Co-location provides integration of technique-specific networks into the ITRF as well as an assessment/validation of the quality and accuracy of the resulting measurements. As of fall 2008, these networks consisted of 410 GNSS sites, 42 laser ranging sites, 45 VLBI sites, and 58 DORIS sites. This poster will illustrate the global coverage of these networks, highlighting inter-technique co-locations, and show the importance of these networks 60 the underlying goals of GGOS including providing the observational basis to maintain a stable, accurate, global reference frame.

Service system integration, access to services, and housing outcomes in a program for homeless persons with severe mental illness.

PubMed

Rosenheck, R; Morrissey, J; Lam, J; Calloway, M; Johnsen, M; Goldman, H; Randolph, F; Blasinsky, M; Fontana, A; Calsyn, R; Teague, G

1998-11-01

This study evaluated the hypothesis that greater integration and coordination between agencies within service systems is associated with greater accessibility of services and improved client housing outcomes. As part of the Access to Community Care and Effective Services and Supports program, data were obtained on baseline client characteristics, service use, and 3-month and 12-month outcomes from 1832 clients seen at 18 sites during the first year of program operation. Data on interorganizational relationships were obtained from structured interviews with key informants from relevant organizations in each community (n = 32-82 at each site). Complete follow-up data were obtained from 1340 clients (73%). After control for baseline characteristics, service system integration was associated with superior housing outcomes at 12 months, and this relationship was mediated through greater access to housing agencies. Service system integration is related to improved access to housing services and better housing outcomes among homeless people with mental illness.

Resources for Math and Reading Tutoring Programs.

ERIC Educational Resources Information Center

Corporation for National Service, Washington, DC.

This updated and expanded resource on the mathematics and reading tutoring programs list of national service and Federal Work-Study tutoring programs includes publications, videos, and Web sites that have been developed by the Corporation for National Service or the U.S. Department of Education and their partners in support of work in literacy,…

Commercial Space Port Planning in Texas

NASA Astrophysics Data System (ADS)

Bell, L.; Looke, B.

2002-01-01

The Texas Legislature is providing funding to support research and planning activities aimed at creating a commercial spaceport in the state. These monies have been allocated to regional Spaceport Development Corporations that have been established in three countries containing candidate site locations: Willacy County (in South Texas); Brazoria County (East Texas); and Pecos County (West Texas). This program is being sponsored and coordinated by the Texas Aerospace Commission (TAC). The Sasakawa International Center for Space Architecture (SICSA) at the University of Houston is providing research, planning and design support to TAC and is a member of each of the three regional development teams. Planning must carefully consider special support requirements and operational characteristics of all prospective launch systems along with geographic, infrastructure and environmental factors at each site. Two of the candidate sites are in coastal areas; a priority for certain launch service providers; whereas the third inland site is more attractive to others. Candidate launch systems include winged horizontal takeoff air-launch vehicles, vertical multi-stage reusable launch vehicles, and expendable sub-orbital surrounding rockets. Important research and planning activities include environmental impact assessments, analyses of overflight hazards, investigations of economic impacts and business plan development. The results of these activities will guide master plan development for each site, including: a physical plan (site layout, infrastructure improvements and facility construction); and a strategic plan (user agreements, licenses, finance sources and participants). Commercial spaceport development demands compliance with stringent FAA regulations established by the Office of Commercial Space Transportation (OCST) which exceed minimum standards allowed for U.S. Government spaceport facilities. Key among these requirements are 15,000 ft. radius on-site clear zones separating launch areas form inhabited facilities, and extremely conservative flight risk restrictions associated with launch trajectories over populated areas. Unless modified, the flight risk criteria currently mandated will prevent virtually all new U.S. commercial spaceport operating license proposals from being approved. Commercial spaceport development also presents significant financing challenges. New launch service companies typically lack substantial economic resources needed for infrastructure construction such as long horizontal runways, launch platforms and vehicle assembly and payload integration facilities. Outside investment sources much be identified, with supplementary revenues potentially derived from space tourism and ancillary public service uses. Texas spaceport planning sponsors, participants and advocates recognize that such a development warrants the necessary investment. It will support the advancement and services of new generations of launch systems vitally needed to reduce the high costs of space access. It will afford new state-wide, regional and local economic development opportunities that promote business investments, create jobs and expand infrastructure resources. It will also support a wide spectrum of educational objectives by including and serving academic programs at all levels. Regardless which site is ultimately selected, all Texas regions and public interests in general will benefit.

A new information architecture, website and services for the CMS experiment

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

Taylor, Lucas; Rusack, Eleanor; Zemleris, Vidmantas

2012-01-01

The age and size of the CMS collaboration at the LHC means it now has many hundreds of inhomogeneous web sites and services, and hundreds of thousands of documents. We describe a major initiative to create a single coherent CMS internal and public web site. This uses the Drupal web Content Management System (now supported by CERN/IT) on top of a standard LAMP stack (Linux, Apache, MySQL, and php/perl). The new navigation, content and search services are coherently integrated with numerous existing CERN services (CDS, EDMS, Indico, phonebook, Twiki) as well as many CMS internal Web services. We describe themore » information architecture, the system design, implementation and monitoring, the document and content database, security aspects, and our deployment strategy, which ensured continual smooth operation of all systems at all times.« less

A new Information Architecture, Website and Services for the CMS Experiment

NASA Astrophysics Data System (ADS)

Taylor, Lucas; Rusack, Eleanor; Zemleris, Vidmantas

2012-12-01

The age and size of the CMS collaboration at the LHC means it now has many hundreds of inhomogeneous web sites and services, and hundreds of thousands of documents. We describe a major initiative to create a single coherent CMS internal and public web site. This uses the Drupal web Content Management System (now supported by CERN/IT) on top of a standard LAMP stack (Linux, Apache, MySQL, and php/perl). The new navigation, content and search services are coherently integrated with numerous existing CERN services (CDS, EDMS, Indico, phonebook, Twiki) as well as many CMS internal Web services. We describe the information architecture; the system design, implementation and monitoring; the document and content database; security aspects; and our deployment strategy, which ensured continual smooth operation of all systems at all times.

Arctic Research Mapping Application (ARMAP): 2D Maps and 3D Globes Support Arctic Science

NASA Astrophysics Data System (ADS)

Johnson, G.; Gaylord, A. G.; Brady, J. J.; Cody, R. P.; Aguilar, J. A.; Dover, M.; Garcia-Lavigne, D.; Manley, W.; Score, R.; Tweedie, C. E.

2007-12-01

The Arctic Research Mapping Application (ARMAP) is a suite of online services to provide support of Arctic science. These services include: a text based online search utility, 2D Internet Map Server (IMS); 3D globes and Open Geospatial Consortium (OGC) Web Map Services (WMS). With ARMAP's 2D maps and 3D globes, users can navigate to areas of interest, view a variety of map layers, and explore U.S. Federally funded research projects. Projects can be queried by location, year, funding program, discipline, and keyword. Links take you to specific information and other web sites associated with a particular research project. The Arctic Research Logistics Support Service (ARLSS) database is the foundation of ARMAP including US research funded by the National Science Foundation, National Aeronautics and Space Administration, National Oceanic and Atmospheric Administration, and the United States Geological Survey. Avoiding a duplication of effort has been a primary objective of the ARMAP project which incorporates best practices (e.g. Spatial Data Infrastructure and OGC standard web services and metadata) and off the shelf technologies where appropriate. The ARMAP suite provides tools for users of various levels of technical ability to interact with the data by importing the web services directly into their own GIS applications and virtual globes; performing advanced GIS queries; simply printing maps from a set of predefined images in the map gallery; browsing the layers in an IMS; or by choosing to "fly to" sites using a 3D globe. With special emphasis on the International Polar Year (IPY), ARMAP has targeted science planners, scientists, educators, and the general public. In sum, ARMAP goes beyond a simple map display to enable analysis, synthesis, and coordination of Arctic research. ARMAP may be accessed via the gateway web site at http://www.armap.org.

Fiscal Year 2009 Revegetation Assessment

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

Michael Lewis

2009-10-01

This report summarizes the Fiscal Year 2009 Revegetation Assessment by Battelle Energy Alliance, LLC. This assessment was conducted to supplement documentation related to the Storm Water Pollution Prevention Plan for Construction Activities and to ensure that disturbed vegetation and soil at various locations are being restored. This report provides the following information for each site being monitored by the Idaho National Laboratory Environmental Support and Services: • Summary of each site • Assessment of vegetation status and site stabilization at each location • Recommendation(s) for each site.

Fiscal Year 2010 Revegetation Assessment

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

Jenifer Nordstrom; Mike Lewis

2010-11-01

This report summarizes the Fiscal Year 2010 Revegetation Assessment by Battelle Energy Alliance, LLC. This assessment was conducted to supplement documentation related to the Storm Water Pollution Prevention Plan for Construction Activities and to ensure that disturbed vegetation and soil at various locations are being restored. This report provides the following information for each site being monitored by the Idaho National Laboratory Environmental Support and Services: • Summary of each site • Assessment of vegetation status and site stabilization at each location • Recommendation(s) for each site.

More than a device: today's medical technology companies provide value through service.

PubMed

McCoy, Fred

2003-01-01

When physicians implant cardiac rhythm management devices, they establish a long-term relationship with those devices and with the manufacturers of those devices. The therapeutic value that each device will provide to its patient is enhanced throughout the life of the device by the services that the manufacturer provides. Services are provided prior to, during and long after implantation. Services include physician and allied health professional training, quality assurance programs, therapy outreach initiatives, on site technical support during device implantation and follow-up, technical service expertise and customer service support. The costs of these services are substantial. When assessed on a per device basis, the service costs may actually exceed the costs of manufacture. Further, the costs of these services are rising. Over the past five years, the number of implanted cardiac rhythm management devices has doubled. Industry field forces have tripled in size. Clearly, industry is dedicated to providing service as a critical element in achieving excellent patient outcomes.

Exploring the Real Thing: A Guide to Educational Programs at National Park Sites in Massachusetts.

ERIC Educational Resources Information Center

Emerson, Rae; Hoermann, Elizabeth; Stearns, Liza

As the steward of the nation's premier historic, natural, and recreational resources, the National Park Service manages 15 unique areas within the Commonwealth of Massachusetts. Each of these sites offers hands-on programs specifically geared to meet the needs of teachers and students. The programs support the Massachusetts Curriculum Frameworks…

Using model analyses and surface-atmosphere exchange measurements from the Howland AmeriFlux Site in Maine, USA, to improve understanding of forest ecosystem C cycling

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

Hollinger, David Y.; Davidson, Eric A.; Richardson, Andrew D.

2013-03-25

Summary of research carried out under Interagency Agreement DE-AI02-07ER64355 with the USDA Forest Service at the Howland Forest AmeriFlux site in central Maine. Includes a list of publications resulting in part or whole from this support.

Illinois Community College System. Workforce Development Grant Report Business and Industry Services, Fiscal Year 2009

ERIC Educational Resources Information Center

Illinois Community College Board, 2009

2009-01-01

The Illinois Community College Board provided more than $3.3 million to community colleges during fiscal year 2009 to support local workforce and economic development services through their Business and Industry Centers. The workforce development activities conducted under this grant include customized job training on campus or on-site at a…

Service on demand for ISS users

NASA Astrophysics Data System (ADS)

Hüser, Detlev; Berg, Marco; Körtge, Nicole; Mildner, Wolfgang; Salmen, Frank; Strauch, Karsten

2002-07-01

Since the ISS started its operational phase, the need of logistics scenarios and solutions, supporting the utilisation of the station and its facilities, becomes increasingly important. Our contribution to this challenge is a SERVICE On DEMAND for ISS users, which offers a business friendly engineering and logistics support for the resupply of the station. Especially the utilisation by commercial and industrial users is supported and simplified by this service. Our industrial team, consisting of OHB-System and BEOS, provides experience and development support for space dedicated hard- and software elements, their transportation and operation. Furthermore, we operate as the interface between customer and the envisaged space authorities. Due to a variety of tailored service elements and the ongoing servicing, customers can concentrate on their payload content or mission objectives and don't have to deal with space-specific techniques and regulations. The SERVICE On DEMAND includes the following elements: ITR is our in-orbit platform service. ITR is a transport rack, used in the SPACEHAB logistics double module, for active and passive payloads on subrack- and drawer level of different standards. Due to its unique late access and early retrieval capability, ITR increases the flexibility concerning transport capabilities to and from the ISS. RIST is our multi-functional test facility for ISPR-based experiment drawer and locker payloads. The test program concentrates on physical and functional interface and performance testing at the payload developers site prior to the shipment to the integration and launch. The RIST service program comprises consulting, planning and engineering as well. The RIST test suitcase is planned to be available for lease or rent to users, too. AMTSS is an advanced multimedia terminal consulting service for communication with the space station scientific facilities, as part of the user home-base. This unique ISS multimedia kit combines communication technologies, software tools and hardware to provide a simple and cost-efficient access to data from the station, using the interconnection ground subnetwork. BEOLOG is our efficient ground logistics service for the transportation of payload hardware and support equipment from the user location to the launch/landing sites for the ISS service flights and back home. The main function of this service is the planning and organisation of all packaging, handling, storage & transportation tasks according to international rules. In conclusion, we offer novel service elements for logistics ground- and flight-infrastructure, dedicated for ISS users. These services can be easily adapted to the needs of users and are suitable for other μg- platforms as well.

A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy

PubMed Central

2011-01-01

Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at-risk" citizens, and a ferry. Conclusions The results proved the functionality and utilization of the platform in various rural places in Greece, Cyprus and Italy. However, further actions are needed to enable the local healthcare systems and the different population groups to be familiarized with, and use in their everyday lives, mature technological solutions for the provision of healthcare services. PMID:21649924

An Investigation into the Use of 3G Mobile Communications to Provide Telehealth Services in Rural KwaZulu-Natal

PubMed Central

Mars, Maurice

2015-01-01

Abstract Background: We investigated the use of third-generation (3G) mobile communications to provide telehealth services in remote health clinics in rural KwaZulu-Natal, South Africa. Materials and Methods: We specified a minimal set of services as our use case that would be representative of typical activity and to provide a baseline for analysis of network performance. Services included database access to manage chronic disease, local support and management of patients (to reduce unnecessary travel to the hospital), emergency care (up to 8 h for an ambulance to arrive), e-mail, access to up-to-date information (Web), and teleclinics. We made site measurements at a representative set of health clinics to determine the type of coverage (general packet radio service [GPRS]/3G), its capabilities to support videoconferencing (H323 and Skype™ [Microsoft, Redmond, WA]) and audio (Skype), and throughput for transmission control protocol (TCP) to gain a measure of application performance. Results: We found that none of the remote health clinics had 3G service. The GPRS service provided typical upload speed of 44 kilobits per second (Kbps) and download speed of 64 Kbps. This was not sufficient to support any form of videoconferencing. We also observed that GPRS had significant round trip time (RTT), in some cases in excess of 750 ms, and this led to slow start-up for TCP applications. Conclusions: We found audio was always so broken as to be unusable and further observed that many applications such as Web access would fail under conditions of very high RTT. We found some health clinics were so remote that they had no mobile service. 3G, where available, had measured upload speed of 331 Kbps and download speed of 446 Kbps and supported videoconferencing and audio at all sites, but we frequently experienced 3G changing to GPRS. We conclude that mobile communications currently provide insufficient coverage and capability to provide reliable clinical services and would advocate dedicated wireless services where reliable communication is essential and use of store and forward for mobile applications. PMID:24926731

An investigation into the use of 3G mobile communications to provide telehealth services in rural KwaZulu-Natal.

PubMed

Clarke, Malcolm; Mars, Maurice

2015-02-01

We investigated the use of third-generation (3G) mobile communications to provide telehealth services in remote health clinics in rural KwaZulu-Natal, South Africa. We specified a minimal set of services as our use case that would be representative of typical activity and to provide a baseline for analysis of network performance. Services included database access to manage chronic disease, local support and management of patients (to reduce unnecessary travel to the hospital), emergency care (up to 8 h for an ambulance to arrive), e-mail, access to up-to-date information (Web), and teleclinics. We made site measurements at a representative set of health clinics to determine the type of coverage (general packet radio service [GPRS]/3G), its capabilities to support videoconferencing (H323 and Skype™ [Microsoft, Redmond, WA]) and audio (Skype), and throughput for transmission control protocol (TCP) to gain a measure of application performance. We found that none of the remote health clinics had 3G service. The GPRS service provided typical upload speed of 44 kilobits per second (Kbps) and download speed of 64 Kbps. This was not sufficient to support any form of videoconferencing. We also observed that GPRS had significant round trip time (RTT), in some cases in excess of 750 ms, and this led to slow start-up for TCP applications. We found audio was always so broken as to be unusable and further observed that many applications such as Web access would fail under conditions of very high RTT. We found some health clinics were so remote that they had no mobile service. 3G, where available, had measured upload speed of 331 Kbps and download speed of 446 Kbps and supported videoconferencing and audio at all sites, but we frequently experienced 3G changing to GPRS. We conclude that mobile communications currently provide insufficient coverage and capability to provide reliable clinical services and would advocate dedicated wireless services where reliable communication is essential and use of store and forward for mobile applications.

Professionals' Perspectives on Organizational Factors that Support or Hinder the Successful Implementation of Family-Centered Practice

ERIC Educational Resources Information Center

Wright, Alexandra; Hiebert-Murphy, Diane; Trute, Barry

2010-01-01

This article presents findings from an exploratory, qualitative study whose objective was to identify professionals' perceptions of organizational factors that support or hinder the implementation of family-centered practice (FCP). Two disability services organizations in Manitoba, Canada, were selected as the research sites. In 2002, all staff…

Independent Living Functions for the Elderly (IN-LIFE): Supporting Communication in Dementia.

PubMed

Smith, Sarah K; Astell, Arlene J

2017-01-01

Independent Living Functions for the Elderly (IN-LIFE) is a 3 year multidisciplinary, multisite European project that aims to prolong and support independent living for people with cognitive impairments, through (ICT) services. Sheffield is one of six research sites and is focused on enhancing communication and conversations using touch screen computers.

Heart and vascular services

MedlinePlus

... using x-rays and injected contrast dye to evaluate blood vessels) Angioplasty (using a small balloon to ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

Sexually Transmitted Disease Program Evolution in Response to Changes in the Public Health Environment: A Massachusetts Example.

PubMed

Carter, Marion W; Hsu, Katherine K; Loosier, Penny S; Maddox, Brandy L Peterson; Doshi, Sonal R; Kroeger, Karen; Cranston, Kevin

2016-11-01

In 2008, the line item supporting sexually transmitted disease (STD) services in the Massachusetts state budget was cut as a result of budget shortfalls. Shortly thereafter, direct provision of STD clinical services supported by the Massachusetts Department of Public Health (MDPH) was suspended. Massachusetts Department of Public Health requested an initial assessment of its internal response and impact in 2010. A follow-up assessment occurred in September 2013. In 2010 and 2013, 39 and 46 staff, respectively, from MDPH and from clinical partner agencies, were interviewed about changes in the role of the MDPH, partnerships, STD services, challenges, and recommendations. Interview notes were summarized, analyzed, and synthesized by coauthors using qualitative analysis techniques and NVivo software. The withdrawal of state funding for STD services, and the subsequent reduction in clinical service hours, erected numerous barriers for Disease Intervention Specialists (DIS) seeking to ensure timely STD treatment for index cases and their partners. After initial instability, MDPH operations stabilized due partly to strong management, new staff, and intensified integration with human immunodeficiency virus services. Existing contracts with human immunodeficiency virus providers were leveraged to support alternative STD testing and care sites. Massachusetts Department of Public Health strengthened its clinical and epidemiologic expertise. The DIS expanded their scope of work and were outposted to select new sites. Challenges remained, however, such as a shortage of DIS staff to meet the needs. Although unique in many ways, MA offers experiences and lessons for how a state STD program can adapt to a changing public health context.

Remaining Sites Verification Package for the 100-B-20, 1716-B Maintenance Garage Underground Tank, Waste Site Reclassification Form 2006-019

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

L. M. Dittmer

2006-09-27

The 100-B-20 waste site, located in the 100-BC-1 Operable Unit of the Hanford Site, consisted of an underground oil tank that once serviced the 1716-B Maintenance Garage. The selected action for the 100-B-20 waste site involved removal of the oil tanks and their contents and demonstrating through confirmatory sampling that all cleanup goals have been met. In accordance with this evaluation, a reclassification status of interim closed out has been determined. The results demonstrate that the site will support future unrestricted land uses that can be represented by a rural-residential scenario. These results also show that residual concentrations support unrestrictedmore » future use of shallow zone soil and that contaminant levels remaining in the soil are protective of groundwater and the Columbia River.« less

Health services received by individuals with duchenne/becker muscular dystrophy.

PubMed

Pandya, Shree K; Campbell, Kim A; Andrews, Jennifer G; Meaney, F John; Ciafaloni, Emma

2016-02-01

Anecdotal reports from families and care providers suggest a wide variation in services received by individuals with Duchenne/Becker muscular dystrophy (DBMD). We documented the type and frequency of health services received by individuals with DBMD using the Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet) interview data released in June 2012. Interviews with eligible caregivers from 5 sites (Arizona, Colorado, Georgia, Iowa, and western New York) were conducted from April 2007 to March 2012. Two hundred ninety-six caregivers (66% of those contactable) participated in the interview. There were significant differences among sites in the specialists seen and services received. Concurrence with cardiac recommendations was higher than that with respiratory recommendations. The results of this survey support and quantify the anecdotal reports from families and care providers regarding the disparities in services received by individuals with DBMD. It remains to be determined whether these differences affect outcomes. © 2015 Wiley Periodicals, Inc.

Use of a remote clinical decision support service for a multicenter trial to implement prediction rules for children with minor blunt head trauma.

PubMed

Goldberg, Howard S; Paterno, Marilyn D; Grundmeier, Robert W; Rocha, Beatriz H; Hoffman, Jeffrey M; Tham, Eric; Swietlik, Marguerite; Schaeffer, Molly H; Pabbathi, Deepika; Deakyne, Sara J; Kuppermann, Nathan; Dayan, Peter S

2016-03-01

To evaluate the architecture, integration requirements, and execution characteristics of a remote clinical decision support (CDS) service used in a multicenter clinical trial. The trial tested the efficacy of implementing brain injury prediction rules for children with minor blunt head trauma. We integrated the Epic(®) electronic health record (EHR) with the Enterprise Clinical Rules Service (ECRS), a web-based CDS service, at two emergency departments. Patterns of CDS review included either a delayed, near-real-time review, where the physician viewed CDS recommendations generated by the nursing assessment, or a real-time review, where the physician viewed recommendations generated by their own documentation. A backstopping, vendor-based CDS triggered with zero delay when no recommendation was available in the EHR from the web-service. We assessed the execution characteristics of the integrated system and the source of the generated recommendations viewed by physicians. The ECRS mean execution time was 0.74 ±0.72 s. Overall execution time was substantially different at the two sites, with mean total transaction times of 19.67 and 3.99 s. Of 1930 analyzed transactions from the two sites, 60% (310/521) of all physician documentation-initiated recommendations and 99% (1390/1409) of all nurse documentation-initiated recommendations originated from the remote web service. The remote CDS system was the source of recommendations in more than half of the real-time cases and virtually all the near-real-time cases. Comparisons are limited by allowable variation in user workflow and resolution of the EHR clock. With maturation and adoption of standards for CDS services, remote CDS shows promise to decrease time-to-trial for multicenter evaluations of candidate decision support interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Impact of service delivery model on health care access among HIV-positive women in New York City.

PubMed

Pillai, Nandini V; Kupprat, Sandra A; Halkitis, Perry N

2009-01-01

As the New York City HIV=AIDS epidemic began generalizing beyond traditionally high-risk groups in the early 1990s, AIDS Service Organizations (ASO) sought to increase access to medical care and broaden service offerings to incorporate the needs of low-income women and their families. Strategies to achieve entry into and retention in medical care included the development of integrated care facilities, case management, and a myriad of supportive service offerings. This study examines a nonrandom sample of 60 HIV-positive women receiving case management and supportive services at New York City ASOs. Over 55% of the women interviewed reported high access to care, 43% reported the ability to access urgent care all of the time and 94% reported high satisfaction with obstetrics=gynecology (OB=GYN) care. This held true across race=ethnicity, income level, medical coverage, and service delivery model.Women who accessed services at integrated care facilities offering onsite medical care and case management=supportive services perceived lower access to medical specialists as compared to those who received services at nonintegrated sites. Data from this analysis indicate that supportive services increase access to and satisfaction with both HIV and non-HIV-related health care. Additionally, women who received services at a medical model agency were more likely to report accessing non-HIV care at a clinic compared to those receiving services at a nonmedical model agencies, these women were more likely to report receiving non-HIV care at a hospital.

Workplace Lactation Programs in Small WIC Service Sites: A Potential Model.

PubMed

Angeletti, Michelle A; Llossas, Jose R

2018-03-01

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has an opportunity to protect, promote, and support breastfeeding by implementing and modeling workplace lactation programs in small WIC agencies that may have barriers regarding the lack of both human and financial resources. The goal of this article was to describe effective strategies for agency administrators in small WIC service sites so that they can reduce barriers, successfully implement workplace lactation policies and programs, and model successful strategies for other small employers. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

2014-01-01

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

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

PubMed

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

2014-07-28

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

Blowing in the wind: evaluating wind energy projects on the national forests

Treesearch

Kerry Schlichting; Evan Mercer

2011-01-01

The 650 million ac of federal lands are facing increased scrutiny for wind energy development. As a result, the US Forest Service has been directed to develop policies and procedures for siting wind energy projects. We incorporate geospatial site suitability analysis with applicable policy and management principles to illustrate the use of a Spatial Decision Support...

Realizing ecosystem services: wetland hydrologic function along a gradient of ecosystem condition.

PubMed

McLaughlin, Daniel L; Cohen, Matthew J

2013-10-01

Wetlands provide numerous ecosystem services, from habitat provision to pollutant removal, floodwater storage, and microclimate regulation. Delivery of particular services relies on specific ecological functions, and thus to varying degree on wetland ecological condition, commonly quantified as departure from minimally impacted reference sites. Condition assessments are widely adopted as regulatory indicators of ecosystem function, and for some services (e.g., habitat) links between condition and function are often direct. For others, however, links are more tenuous, and using condition alone to enumerate ecosystem value (e.g., for compensatory mitigation) may underestimate important services. Hydrologic function affects many services cited in support of wetland protection both directly (floodwater retention, microclimate regulation) and indirectly (biogeochemical cycling, pollutant removal). We investigated links between condition and hydrologic function to test the hypothesis, embedded in regulatory assessment of wetland value, that condition predicts function. Condition was assessed using rapid and intensive approaches, including Florida's official wetland assessment tool, in 11 isolated forested wetlands in north Florida (USA) spanning a land use intensity gradient. Hydrologic function was assessed using hydrologic regime (mean, variance, and rates of change of water depth), and measurements of groundwater exchange and evapotranspiration (ET). Despite a wide range in condition, no systematic variation in hydrologic regime was observed; indeed reference sites spanned the full range of variation. In contrast, ET was affected by land use, with higher rates in intensive (agriculture and urban) landscapes in response to higher leaf area. ET determines latent heat exchange, which regulates microclimate, a valuable service in urban heat islands. Higher ET also indicates higher productivity and thus carbon cycling. Groundwater exchange regularly reversed flow direction at all sites in response to rainfall. This buffering effect on regional aquifer levels, an underappreciated service of isolated wetlands, was provided regardless of condition. Intensive landscapes may benefit most from the hydrologic services that wetlands provide because that is where certain services (floodwater storage, microclimate regulation) are realized. While the portfolio of wetland services clearly changes with disturbance, our results support a revised approach to wetland valuation that recognizes the services that accrue from sustained or enhanced functions in these "working wetlands."

A survey of National Cancer Institute-designated comprehensive cancer centers' oral health supportive care practices and resources in the USA.

PubMed

Epstein, Joel B; Parker, Ira R; Epstein, Matthew S; Gupta, Anurag; Kutis, Susan; Witkowski, Daniela M

2007-04-01

The oral complications and morbidity resulting from overall cancer therapy utilizing radiation, chemotherapy, and/or stem cell transplantation can have significant impact on a patient's health, quality of life, cost of care, and cancer management. There has been minimal health services research focusing on the status of medically necessary, oral supportive services at US cancer centers. A pre-tested, survey questionnaire was distributed to the directors of National Cancer Institute (NCI)-designated comprehensive cancer centers to assess each institution's resource availability and clinical practices, as it relates to the prevention and management of oral complications during cancer treatment. Sixteen of the 39 comprehensive cancer centers responded to the survey. Of the respondents, 56% of the centers did not have a dental department. The sites of delivery of oral supportive care services range from the provision of in-house dental care to community-based, private practice sites. No standard protocols were in place for either oral preventive care or for supportive services for oral complications during or after cancer therapy. Fifty percent of the responding comprehensive cancer centers reported orally focused research and/or clinical trial activities. Comprehensive cancer care must include an oral care component, particularly for those cancer patients who are at high risk for oral complications. This requires a functional team of oral care providers collaborating closely within the oncology team. Considering the number of cancer patients receiving aggressive oncologic treatment that may result in oral toxicity, the impact of oral conditions on a compromised host, and the potential lack of appropriate resources and healthcare personnel to manage these complications, future research efforts are needed to identify the strengths and weaknesses of present oral supportive care delivery systems at both NCI-designated cancer centers and community-based oncology practices.

Project A.B.C. Bronx Academic Bilingual Career Program, 1982-1983. O.E.E. Evaluation Report.

ERIC Educational Resources Information Center

DiMartino, Vincent James; Schulman, Robert

This multi-site program, in its final year of a two-year funding cycle, provided special resources and supportive services to approximately 200 recently arrived students of limited English proficiency in grades 9-12 at three Bronx (New York) high schools. The project served Vietnamese (Chinese ethnics), Italians, and Hispanics. Services provided…

Standards for Data Exchange and Case Management Information Systems in Support of Comprehensive Integrated School-Linked Services. Version 2.0.

ERIC Educational Resources Information Center

Far West Lab. for Educational Research and Development, San Francisco, CA.

This report is intended as a guide for local comprehensive integrated school-linked services sites and software vendors in developing and implementing case management information systems for the exchange and management of client data. The report is also intended to influence new development and future revisions of data systems, databases, and…

Using a telehealth service delivery approach to working with an undergraduate student with a traumatic brain injury: A case study.

PubMed

Quaco, Carrie

2017-09-14

Project Career is a five year NIDILRR-funded interprofessional demonstration project aimed to improve the academic and career success of undergraduate students who have a traumatic brain injury (TBI). The information for this case study was collected and synthesized by an occupational therapy graduate student intern for one of the Project Career sites in collaboration with the Technology and Employment Coordinator for the site, the co-PI for Project Career, and the student participant. A case study is presented to provide an understanding of one of the Project Career participant's experience using a telehealth service delivery approach to working with Project Career for academic and career support. The participant's case notes, direct communication with the intern, and outcome assessments were used to perform a qualitative analysis. The participant reported that he believed Project Career was an effective support service for him. However, the participant's initial and 6-month outcome assessment scores are inconclusive regarding improvements in his academic abilities and satisfaction with academic and career attainment. Further research on the effectiveness of using a telehealth service delivery approach to working with undergraduate students with a TBI is needed.

Can Health Trainers Make a Difference With Difficult-to-Engage Clients? A Multisite Case Study.

PubMed

Bailey, Di; Kerlin, Lianne

2015-09-01

A political attempt in the United Kingdom to address health inequalities in the past decade has been the government's initiative to employ local health trainers (HTs) or health trainer champions (HTCs) to support disadvantaged individuals with aspects of their health-related behaviors. HT/HTCs provide health-related information and support to individuals with healthy eating, physical activity, and smoking cessation. They undertake community engagement and direct individuals to relevant health services. They differ in that HTs are trained to provide health interventions to individuals or groups and to make referrals to specialist health care services when necessary. This article provides an evaluation of HT/HTCs interventions across three sites, including one prison, one probation service (three teams), and one mental health center. An evaluation framework combining process and outcome measures was employed that used mixed methods to capture data relating to the implementation of the service, including the context of the HT/HTCs interventions, the reactions of their clients, and the outcomes reported. It was found that HT/HTCs interventions were more effective in the prison and mental health center compared with the probation site largely as a result of contextual factors. © 2015 Society for Public Health Education.

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Intimate partner violence victims' acceptance and refusal of on-site counseling in emergency departments: Predictors of help-seeking behavior explored through a 5-year medical chart review.

PubMed

Choi, Anna Wai-Man; Wong, Janet Yuen-Ha; Lo, Ruby Tsz-Fung; Chan, Pik-Ying; Wong, John Kit-Shing; Lau, Chu-Leung; Kam, Chak-Wah

2018-03-01

Healthcare services constitute the first formal support that many intimate partner violence (IPV) victims receive and a link to formal welfare and psychological support. The help-seeking behavior for psychosocial support, e.g., Accident and Emergency Departments (AED) onsite counseling, is key to developing effective support for IPV victims. This study aimed to strengthen the health-welfare support link to aid IPV prevention in AEDs by investigating the acceptance and refusal of on-site counseling by IPV victims. A retrospective cohort study retrieved and reviewed all records of IPV victims presenting at the AEDs of two Hong Kong hospitals between 2010 and 2014. A total of 157 male and 823 female IPV victims were identified, 295 of whom refused on-site counseling. Bivariate and multivariate analyses were performed to examine the association between help-seeking and demographic and violent injury-related factors. The odds of help-seeking via on-site counseling were significantly lower for victims with mental illness (aOR=0.49; 95% CI=0.27, 0.88). After controlling for all demographic characteristics, mental illness, and drug abuse information, sex remained an independent predictor of help-seeking (aOR=2.62; 95% CI=1.45, 4.74); victims who had experienced >2 abuse incidents were more likely to seek help than those who had experienced ≤2 abuse incidents (aOR=1.90; 95% CI=1.11, 3.26). The factors associated with help-seeking from on-site services by IPV victims reflect the need for multidisciplinary collaborative work aimed at IPV prevention. Healthcare professionals require training on how to promote help-seeking behavior targeted specifically for male and female IPV victims according to their needs and preferences. Copyright © 2018 Elsevier Inc. All rights reserved.

"The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs": Correction to McGurk et al. (2017).

PubMed

2017-06-01

Reports an error in "The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs" by Susan R. McGurk, Kim T. Mueser, Melanie A. Watkins, Carline M. Dalton and Heather Deutsch ( Psychiatric Rehabilitation Journal , 2017[Mar], Vol 40[1], 79-86). In the article, the author order was incorrect due to a printer error. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2017-13255-004.) Objective: Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing psychiatric rehabilitation, and suggest that ease of access to vocational services may influence work outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Rural Palliative Care in North India: Rapid Evaluation of a Program Using a Realist Mixed Method Approach.

PubMed

Munday, Daniel F; Haraldsdottir, Erna; Manak, Manju; Thyle, Ann; Ratcliff, Cathy M

2018-01-01

Palliative care has not developed widely in rural North India. Since 2010, the Emmanuel Hospitals Association (EHA) has been developing a model of palliative care appropriate for this setting, based on teams undertaking home visits with the backup of outpatient and inpatient services. A project to further develop the model operated from 2012 to 2015 supported by funding from the UK. This study aims to evaluate the EHA palliative care project. Rapid evaluation method using a mixed method realist approach at the five project hospital sites. An overview of the project was obtained by analyzing project documents and key informant interviews. Questionnaire data from each hospital were collected, followed by interviews with staff, patients, and relatives and observations of home visits and other activities at each site. Descriptive analysis of quantitative and thematic analysis of qualitative data was undertaken. Each site was measured against the Indian Minimum Standards Tool for Palliative Care (IMSTPC). Each team followed the EHA model, with local modifications. Services were nurse led with medical support. Eighty percent of patients had cancer. Staff demonstrated good palliative care skills and patients and families appreciated the care. Most essential IMSTPC markers were achieved but morphine licenses were available to only two teams. Remarkable synergy was emerging between palliative care and community health. Hospitals planned to fund palliative care through income from surgical services. Excellent palliative care appropriate for rural north India is delivered through the EHA model. It could be extended to other similar sites.

Cost of Screening, Brief Intervention, and Referral to Treatment in Health Care Settings.

PubMed

Barbosa, Carolina; Cowell, Alexander J; Landwehr, Justin; Dowd, William; Bray, Jeremy W

2016-01-01

This study analyzed service unit and annual costs of substance abuse screening, brief intervention, and referral to treatment (SBIRT) programs implemented in emergency department (ED), inpatient, and outpatient medical settings in three U.S. states and one tribal organization. Unit costs and annual costs were estimated from the perspective of service providers. Data for unit costs came from 26 performance sites, and data for annual costs came from 10 programs. A bottom-up approach was used to derive unit costs and included labor, space, and materials used in each SBIRT activity. Activities included direct SBIRT services and activities that support direct service delivery. Labor time spent in each activity was collected by trained observers using a time-and-motion approach. A top-down approach used cost questionnaires completed by program administrators to calculate annual costs and included labor, space, contracted services, overhead, training, travel, equipment, and supplies and materials. Costs were estimated in 2012 U.S. dollars. Average unit costs for prescreening, screening, brief intervention, brief treatment, and referral to treatment were $0.61, $6.59, $10.48, $22.63, and $12.06 in ED; $0.86, $6.33, $9.07, $27.61, and $8.03 in inpatient; and $0.84, $3.98, $7.81, $27.94, and $9.23 in outpatient settings, respectively; over half of the costs were attributable to support activities. Across all settings, the average cost to provide SBIRT per positive screen, for 1year, was about $400. Support activities comprise a large proportion of costs. Health administrators can use the results to budget and compare how much sites are reimbursed for SBIRT to how much services actually cost. Copyright © 2015 Elsevier Inc. All rights reserved.

Genetics Home Reference: Pallister-Killian mosaic syndrome

MedlinePlus

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Implementing new models of care: Lessons from the new care models programme in England.

PubMed

Starling, Anna

2018-06-01

In 2014, the body that leads the National Health Service in England published a new strategic vision for the National Health Service. A major part of this strategy was a three-year-long national programme to develop new care models to coordinate care across primary care, community services and hospitals that could be replicated across the country. Local 'vanguard sites' were selected to develop five types of new care model with support from a national team. The new care models programme provided support for local leaders to enable them to collaborate to improve care for their local populations. We interviewed leaders in the vanguard sites to better understand how they made changes to care locally. Drawing on the insights from these interviews and the literature on cross-organisational change and improvement we devised a framework of 10 lessons for health and care leaders seeking to develop and implement new models of care. The framework emphasises the importance of developing relationships and building capability locally to enable areas to continuously develop and test new ideas.

Enablers of and barriers to abortion training.

PubMed

Guiahi, Maryam; Lim, Sahnah; Westover, Corey; Gold, Marji; Westhoff, Carolyn L

2013-06-01

Since the legalization of abortion services in the United States, provision of abortions has remained a controversial issue of high political interest. Routine abortion training is not offered at all obstetrics and gynecology (Ob-Gyn) training programs, despite a specific training requirement by the Accreditation Council for Graduate Medical Education. Previous studies that described Ob-Gyn programs with routine abortion training either examined associations by using national surveys of program directors or described the experience of a single program. We set out to identify enablers of and barriers to Ob-Gyn abortion training in the context of a New York City political initiative, in order to better understand how to improve abortion training at other sites. We conducted in-depth qualitative interviews with 22 stakeholders from 7 New York City public hospitals and focus group interviews with 62 current residents at 6 sites. Enablers of abortion training included program location, high-capacity services, faculty commitment to abortion training, external programmatic support, and resident interest. Barriers to abortion training included lack of leadership continuity, leadership conflict, lack of second-trimester abortion services, difficulty obtaining mifepristone, optional rather than routine training, and antiabortion values of hospital personnel. Supportive leadership, faculty commitment, and external programmatic support appear to be key elements for establishing routine abortion training at Ob-Gyn residency training programs.

What did the public think of health services reform in Bangladesh? Three national community-based surveys 1999–2003

PubMed Central

Cockcroft, Anne; Andersson, Neil; Milne, Deborah; Hossain, Md Zakir; Karim, Enamul

2007-01-01

Background Supported by development partners, the Government of Bangladesh carried out a comprehensive reform of health services in Bangladesh between 1998 and 2003, intended to make services more responsive to public needs: the Health and Population Sector Programme (HPSP). They commissioned a series of surveys of the public, as part of evaluation of the HPSP. This article uses the survey findings to examine the changes in public opinions, use and experience of health services in the period of the HPSP. Methods We carried out three household surveys (1999, 2000 and 2003) of a stratified random sample of 217 rural sites and 30 urban sites. Each site comprised 100–120 contiguous households. Each survey included interviews with 25,000 household respondents and managers of health facilities serving the sites, and gender-stratified focus groups in each site. We measured: household ratings of government health services; reported use of services in the preceding month; unmet need for health care; user reports of waiting times, payments, explanations of condition, availability of prescribed medicines, and satisfaction with service providers. Results Public rating of government health services as "good" fell from 37% to 10% and the proportion using government treatment services fell from 13% to 10%. Unmet need increased from 3% to 9% of households. The proportion of visits to government facilities fell from 17% to 13%, while the proportion to unqualified practitioners rose from 52% to 60%. Satisfaction with service providers' behaviour dropped from 66% to 56%. Users were more satisfied when waiting time was shorter, prescribed medicines were available, and they received explanations of their condition. Conclusion Services have retracted despite increased investment and the public now prefer unqualified practitioners over government services. Public opinion of government health services has deteriorated and the reforms have not specifically helped the poorest people. User satisfaction could be increased if government doctors improved their interaction with patients and if waiting times were reduced by better management of facilities. PMID:17324263

P.L. 89-313 Supplementary Services for Previously Non-Public-School Institutionalized Students, 1982-1983. O.E.E. Evaluation Report.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Office of Educational Evaluation.

The Supplementary Services for Previously Non-Public-School Institutionalized Students in New York City was designed to assist students who were formerly educated at state-operated or state-supported schools to adapt to public school education. The 1982-83 program served 1054 students in 367 sites, which included community schools, high schools, a…

Could Practicum Placements in Contrasting Contexts Support the Preparation of Pre-Service Teachers for an Envisaged Inclusive Education System? A South African Study

ERIC Educational Resources Information Center

Rusznyak, Lee; Walton, Elizabeth

2017-01-01

In contexts where inclusive education is nascent, teacher educators face the challenge of preparing pre-service teachers for a system that does not yet exist. While this might be possible through university-based coursework, difficulties arise when so few sites that model inclusive pedagogies are available for practicum placements. This article…

Network and computing infrastructure for scientific applications in Georgia

NASA Astrophysics Data System (ADS)

Kvatadze, R.; Modebadze, Z.

2016-09-01

Status of network and computing infrastructure and available services for research and education community of Georgia are presented. Research and Educational Networking Association - GRENA provides the following network services: Internet connectivity, network services, cyber security, technical support, etc. Computing resources used by the research teams are located at GRENA and at major state universities. GE-01-GRENA site is included in European Grid infrastructure. Paper also contains information about programs of Learning Center and research and development projects in which GRENA is participating.

Gender differences in living with schizophrenia. A cross-sectional European multi-site study.

PubMed

Thornicroft, Graham; Leese, Morven; Tansella, Michele; Howard, Louise; Toulmin, Hilary; Herran, Andres; Schene, Aart

2002-10-01

The EPSILON project (European Psychistric Services: Inputs Linked to Outcomes and Needs) is a cross-sectional study of the clinical and social characteristics, needs, satisfaction with services, quality of life, and service utilisation and costs for people with schizophrenia in five European sites (Amsterdam, Copenhagen, London, Santander, and Verona). This study examined five hypotheses: (1) Men will have more total needs and more unmet needs for: 'accommodation', 'substance misuse', 'psychotic symptoms', 'harm to others', and 'sexual expression', whereas women will have more total needs and more unmet needs in the domains of 'childcare' and 'harm to self'. (2) Caregivers of male patients will show higher rates of psychological distress, and higher scores for 'supervision' and 'urging' than caregivers of female patients. (3) Male and female patients will show similar levels of satisfaction with services, both in total scores and subscores. (4) Male patients will show lower objective quality of life, but similar subjective quality of life compared with women. (5) Service utilization for men and women will differ, and patterns will vary by site. The results confirmed hypotheses 1 (in part) and 3, but failed to support hypotheses 2, 4 and 5. Graphical models were used to generate hypotheses for future research. The implications for planning separate services for male and female schizophrenic patients are discussed.

Hanford analytical sample projections FY 1998--FY 2002

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

Joyce, S.M.

1998-02-12

Analytical Services projections are compiled for the Hanford site based on inputs from the major programs for the years 1998 through 2002. Projections are categorized by radiation level, protocol, sample matrix and program. Analyses requirements are also presented. This document summarizes the Hanford sample projections for fiscal years 1998 to 2002. Sample projections are based on inputs submitted to Analytical Services covering Environmental Restoration, Tank Waste Remediation Systems (TWRS), Solid Waste, Liquid Effluents, Spent Nuclear Fuels, Transition Projects, Site Monitoring, Industrial Hygiene, Analytical Services and miscellaneous Hanford support activities. In addition, details on laboratory scale technology (development) work, Sample Management,more » and Data Management activities are included. This information will be used by Hanford Analytical Services (HAS) and the Sample Management Working Group (SMWG) to assure that laboratories and resources are available and effectively utilized to meet these documented needs.« less

Contribution of the voluntary sector to mental health crisis care in England: protocol for a multimethod study.

PubMed

Newbigging, Karen; Mohan, John; Rees, James; Harlock, Jenny; Davis, Alex

2017-11-08

Timely access to the right kind of support for people experiencing a mental health crisis can be problematic. The voluntary sector (VS) plays a key role in providing support and enabling access, but there is a knowledge gap concerning its contribution and interface with public services in mental health crisis care. This study aims to address this. The study has three empirical elements: (1) a national survey of voluntary sector organisations (VSOs) in England and national stakeholder interviews to develop a typology of organisations and interventions provided by VSOs; (2) detailed mapping of VS services in two regions through interviews and extending the national survey; (3) four case studies, identified from the regional mapping, of VS mental health crisis services and their interface with National Health Service (NHS) and local authority services, at both a system and individual level. Data collection will involve interviews with commissioners; VSO and NHS or local authority providers; and focus groups with people who have experience of VSO crisis support, both service users and carers; and mapping the crisis trajectory of 10 service users in each study site through narrative interviews with service users and informal carers to understand the experience of VSO crisis care and its impact. The University of Birmingham Humanities and Social Sciences Ethical Review Committee granted ethical approval (reference ERN_16-1183) for the national and regional elements of the study. Ethical review by the Health Research Authority will be required for the case study research once the sites have been identified from the first two elements of the study. A range of methods including a policy seminar, publication in academic journals and a tool kit for commissioners and practitioners will be produced to maximise the impact of the findings on policy and practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Contribution of the voluntary sector to mental health crisis care in England: protocol for a multimethod study

PubMed Central

Newbigging, Karen; Mohan, John; Rees, James; Harlock, Jenny; Davis, Alex

2017-01-01

Introduction Timely access to the right kind of support for people experiencing a mental health crisis can be problematic. The voluntary sector (VS) plays a key role in providing support and enabling access, but there is a knowledge gap concerning its contribution and interface with public services in mental health crisis care. This study aims to address this. Methods and analysis The study has three empirical elements: (1) a national survey of voluntary sector organisations (VSOs) in England and national stakeholder interviews to develop a typology of organisations and interventions provided by VSOs; (2) detailed mapping of VS services in two regions through interviews and extending the national survey; (3) four case studies, identified from the regional mapping, of VS mental health crisis services and their interface with National Health Service (NHS) and local authority services, at both a system and individual level. Data collection will involve interviews with commissioners; VSO and NHS or local authority providers; and focus groups with people who have experience of VSO crisis support, both service users and carers; and mapping the crisis trajectory of 10 service users in each study site through narrative interviews with service users and informal carers to understand the experience of VSO crisis care and its impact. Ethics and dissemination The University of Birmingham Humanities and Social Sciences Ethical Review Committee granted ethical approval (reference ERN_16–1183) for the national and regional elements of the study. Ethical review by the Health Research Authority will be required for the case study research once the sites have been identified from the first two elements of the study. A range of methods including a policy seminar, publication in academic journals and a tool kit for commissioners and practitioners will be produced to maximise the impact of the findings on policy and practice. PMID:29122807

MATES in Construction: Impact of a Multimodal, Community-Based Program for Suicide Prevention in the Construction Industry

PubMed Central

Gullestrup, Jorgen; Lequertier, Belinda; Martin, Graham

2011-01-01

A large-scale workplace-based suicide prevention and early intervention program was delivered to over 9,000 construction workers on building sites across Queensland. Intervention components included universal General Awareness Training (GAT; general mental health with a focus on suicide prevention); gatekeeper training provided to construction worker volunteer ‘Connectors’; Suicide First Aid (ASIST) training offered to key workers; outreach support provided by trained and supervised MIC staff; state-wide suicide prevention hotline; case management service; and postvention support provided in the event of a suicide. Findings from over 7,000 workers (April 2008 to November 2010) are reported, indicating strong construction industry support, with 67% building sites and employers approached agreeing to participate in MIC. GAT participants demonstrated significantly increased suicide prevention awareness compared with a comparison group. Connector training participants rated MIC as helpful and effective, felt prepared to intervene with a suicidal person, and knew where to seek help for a suicidal individual following the training. Workers engaged positively with the after-hours crisis support phone line and case management. MIC provided postvention support to 10 non-MIC sites and sites engaged with MIC, but not yet MIC-compliant. Current findings support the potential effectiveness and social validity of MIC for preventing suicide in construction workers. PMID:22163201

Shuttle abort landing site emergency medical services

NASA Technical Reports Server (NTRS)

Mckenas, David K.; Jennings, Richard T.

1991-01-01

NASA and DOD studies of medical-planning and logistical problems are reviewed as applicable to providing emergency medical care at remote transoceanic abort landing (TAL) sites. Two options are analyzed including a modified surgical response team and a combination physician/medical technician team. The two concepts are examined in terms of cost-effectiveness, specific types of medical support such as blood procurement, and search-and-rescue requirements. It is found that the physician/technician team is more economically efficient, and the description of the concept permits the development of an effective TAL-site astronaut medical-support system. A balance is struck between the competing problems of cost and medical capability by planning for on-scene medical stabilization and air evacuation to DOD tertiary medical centers.

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration

PubMed Central

Sullivan, Jennifer L.; Adjognon, Omonyêlé L.; Engle, Ryann L.; Shin, Marlena H.; Afable, Melissa K.; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

2018-01-01

Background: From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. Purpose: The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Methodology: Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. Results: The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. Discussion: This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Implications: Anticipating potential pitfalls of program implementation for future noninstitutional LTSS programs can improve implementation efficiency and program sustainability. Staff at multiple levels in the organization must fully support noninstitutional LTSS programs to address these challenges. PMID:28125459

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration.

PubMed

Sullivan, Jennifer L; Adjognon, Omonyêlé L; Engle, Ryann L; Shin, Marlena H; Afable, Melissa K; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Anticipating potential pitfalls of program implementation for future noninstitutional LTSS programs can improve implementation efficiency and program sustainability. Staff at multiple levels in the organization must fully support noninstitutional LTSS programs to address these challenges.

The uses and gratifications of online care pages: a study of CaringBridge.

PubMed

Anderson, Isolde K

2011-09-01

This study investigated how online care pages help people connect with others and gain social support during a health care event. It reports the results of a survey of 1035 CaringBridge authors who set up personalized web pages because of hospitalization, serious illness, or other reasons, regarding the uses and gratifications obtained from their sites. Four primary benefits were found to be important to all authors of CaringBridge sites: providing information, receiving encouragement from messages, convenience, and psychological support. Hierarchical multiple regression revealed significant effects for six demographic and health-related variables: gender, age, religiosity, Internet usage, the purpose for which the site was set up, and sufficiency of information received from health care providers. Support was obtained for the perspective that online care pages provide new media gratifications for authors, and that health-related antecedents of media use may affect media selection and gratifications. The implications of this study for communication researchers and support services like CaringBridge are also discussed.

Genetics Home Reference: dilated cardiomyopathy with ataxia syndrome

MedlinePlus

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7 CFR 249.17 - Management evaluations and reviews.

Code of Federal Regulations, 2010 CFR

2010-01-01

....17 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SENIOR FARMERS' MARKET NUTRITION PROGRAM (SFMNP..., and on-site reviews of selected farmers, farmers' markets, roadside stands, and community supported...

Evaluation of How Integrative Oncology Services Are Valued between Hematology/Oncology Patients and Hematologists/Oncologists at a Tertiary Care Center.

PubMed

Hansra, D M; McIntyre, K; Ramdial, J; Sacks, S; Patrick, C S; Cutler, J; McIntyre, B; Feister, K; Miller, M; Taylor, A K; Farooq, F; de Mayolo, J Antunez; Ahn, E

2018-01-01

Evidence regarding opinions on integrative modalities by patients and physicians is lacking. Methods . A survey study was conducted assessing how integrative modalities were valued among hematology/oncology patients and hematologists and oncologists at a major tertiary medical center. Results. 1008 patients and 55 physicians were surveyed. With the exception of support groups, patients valued nutrition services, exercise therapy, spiritual/religious counseling, supplement/herbal advice, support groups, music therapy, and other complimentary medicine services significantly more than physicians ( P ≤ 0.05). Conclusion . With the exception of support groups, patients value integrative modalities more than physicians. Perhaps with increasing education, awareness, and acceptance by providers and traditional institutions, integrative modalities could be equally valued between patients and providers. It is possible that increased availability and utilization of integrative oncology modalities at tertiary hospital sites could improve patient satisfaction, quality of life, and other clinical endpoints.

Outcomes of a nurse-managed service for stable HIV-positive patients in a large South African public sector antiretroviral therapy programme.

PubMed

Grimsrud, Anna; Kaplan, Richard; Bekker, Linda-Gail; Myer, Landon

2014-09-01

Models of care utilizing task shifting and decentralization are needed to support growing ART programmes. We compared patient outcomes between a doctor-managed clinic and a nurse-managed down-referral site in Cape Town, South Africa. Analysis included all adults who initiated ART between 2002 and 2011 within a large public sector ART service. Stable patients were eligible for down-referral. Outcomes [mortality, loss to follow-up (LTFU), virologic failure] were compared under different models of care using proportional hazards models with time-dependent covariates. Five thousand seven hundred and forty-six patients initiated ART and over 5 years 41% (n = 2341) were down-referred; the median time on ART before down-referral was 1.6 years (interquartile range, 0.9-2.6). The nurse-managed down-referral site reported lower crude rates of mortality, LTFU and virologic failure compared with the doctor-managed clinic. After adjustment, there was no difference in the risk of mortality or virologic failure by model of care. However, patients who were down-referred were more likely to be LTFU than those retained at the doctor-managed site (adjusted hazard ratio, 1.36; 95% CI, 1.09-1.69). Increased levels of LTFU in the nurse-managed vs. doctor-managed service were observed in subgroups of male patients, those with advanced disease at initiation and those who started ART in the early years of the programme. Reorganization of ART maintenance by down-referral to nurse-managed services is associated with programme outcomes similar to those achieved using doctor-driven primary care services. Further research is necessary to identify optimal models of care to support long-term retention of patients on ART in resource-limited settings. © 2014 John Wiley & Sons Ltd.

Enabling Interoperable and Selective Data Sharing among Social Networking Sites

NASA Astrophysics Data System (ADS)

Shin, Dongwan; Lopes, Rodrigo

With the widespread use of social networking (SN) sites and even introduction of a social component in non-social oriented services, there is a growing concern over user privacy in general, how to handle and share user profiles across SN sites in particular. Although there have been several proprietary or open source-based approaches to unifying the creation of third party applications, the availability and retrieval of user profile information are still limited to the site where the third party application is run, mostly devoid of the support for data interoperability. In this paper we propose an approach to enabling interopearable and selective data sharing among SN sites. To support selective data sharing, we discuss an authenticated dictionary (ADT)-based credential which enables a user to share only a subset of her information certified by external SN sites with applications running on an SN site. For interoperable data sharing, we propose an extension to the OpenSocial API so that it can provide an open source-based framework for allowing the ADT-based credential to be used seamlessly among different SN sites.

Development/Testing of a Monitoring System Assisting MCI Patients: The European Project INLIFE.

PubMed

Kaimakamis, Evangelos; Karavidopoulou, Vaia; Kilintzis, Vassilios; Stefanopoulos, Leandros; Papageorgiou, Valentini

2017-01-01

INLIFE is a project cofounded from the European Union aiming in prolonging independent living of elderly people with cognitive impairment based on open, seamless ICT services supporting communication, daily activities, providing health services and professional care to the elderly. The main innovation stems from ICT solutions offering 19 different services adapted on specific characteristics elderly people with mild cognitive impairment, early and later stages of Dementia, cognitive impairment and co-morbid condition, as well as their formal and informal caregivers. All services have different focus areas and are incorporated into a unified system based on cloud architecture implemented in patients of 6 European countries, including Greece. More than 1200 patients, caregivers and healthcare providers participate in the pilot testing of the project. Primary parameter for assessing the effectiveness of the interventions is their impact on the quality of life of the elderly patients and their caregivers, contributing to prolonging independent living of the affected. A special digital platform has been developed in the Greek pilot site aiming to adapt and monitor all the implemented applications. This includes a medical decision support system that receives biosignals from patients and interaction interfaces in which all participants are involved. Recruitment and patients' participation has already started in the pilot site of Thessaloniki for the services that are to be tested in Greece.

Service, training, mentorship: first report of an innovative education-support program to revitalize primary care social service in Chiapas, Mexico.

PubMed

Van Wieren, Andrew; Palazuelos, Lindsay; Elliott, Patrick F; Arrieta, Jafet; Flores, Hugo; Palazuelos, Daniel

2014-01-01

The Mexican mandatory year of social service following medical school, or pasantía, is designed to provide a safety net for the underserved. However, social service physicians (pasantes) are typically unpracticed, unsupervised, and unsupported. Significant demotivation, absenteeism, and underperformance typically plague the social service year. Compañeros en Salud (CES) aimed to create an education-support package to turn the pasantía into a transformative learning experience. CES recruited pasantes to complete their pasantía in CES-supported Ministry of Health clinics in rural Chiapas. The program aims to: 1) train pasantes to more effectively deliver primary care, 2) expose pasantes to central concepts of global health and social medicine, and 3) foster career development of pasantes. Program components include supportive supervision, on-site mentorship, clinical information resources, monthly interactive seminars, and improved clinic function. We report quantitative and qualitative pasante survey data collected from February 2012 to August 2013 to discuss strengths and weaknesses of this program and its implications for the pasante workforce in Mexico. Pasantes reported that their medical knowledge, and clinical and leadership skills all improved during the CES education-support program. Most pasantes felt the program had an overall positive effect on their career goals and plans, although their self-report of preparedness for the Mexican residency entrance exam (ENARM) decreased during the social service year. One hundred percent reported they were satisfied with the CES-supported pasantía experience and wished to help the poor and underserved in their careers. Education-support programs similar to the CES program may encourage graduating medical students to complete their social service in underserved areas, improve the quality of care provided by pasantes, and address many of the known shortcomings of the pasantía. Additional efforts should focus on developing a strategy to expand this education-support model so that more pasantes throughout Mexico can experience a transformative, career-building, social service year.

The IPS supported employment learning collaborative.

PubMed

Becker, Deborah R; Drake, Robert E; Bond, Gary R

2014-06-01

Learning collaboratives aim to improve the quality and outcomes of health care. This paper updates the Johnson & Johnson-Dartmouth Community Mental Health Program, a 12-year learning collaborative on supported employment for people with mental illness. We gathered data from quarterly employment reports, monthly Individual Placement and Support (IPS) meetings, and presentations at the 2013 annual meeting of the learning collaborative. The number of participant states or regions (and sites within these jurisdictions) was expanded to 16 jurisdictions in the United States and 3 in European countries. The quarterly rate of competitive employment has averaged 43% over 11 years in the U.S. sites. The collaborative has spawned numerous interactions, trainings, innovations, and research projects. Long-term learning collaboratives can produce high quality services, good outcomes, sustainability, and innovation.

75 FR 30064 - Autosplice, Inc. Including On-Site Leased Workers From Select Temporary Services and Payrolling...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-28

... separation has occurred involving an employee in support of the San Diego, California location of Autosplice, Inc., working out of Farmingdale, New York. Ms. Pamela J. Sokol provided sales and marketing functions...

Area 3 Support Buildings (A3SB) H5-0992, H5-0996 PRL 218 Confirmatory Sampling Report

NASA Technical Reports Server (NTRS)

Mrdjenovich, Timothy

2015-01-01

The Area 3 Support Buildings site (A3SB) consists of two separate areas located on the north side of Beach Road in the northern portion of Kennedy Space Center, Florida (KSC), outside the secured perimeter of KSC. The A3SB areas are approximately 0.6 miles apart, and were developed as Shiffler's Grocery Store and Service Station (west site) and as a residence (east site) prior to acquisition by the National Aeronautics and Space Administration (NASA) in 1963. Both areas were used by the Bendix Company in support of NASA as chemical laboratories from 1963 through 1969. Both of the buildings were demolished by 1987. The west portion of the site was used by the US Fish & Wildlife Service (F&W) in support of the Merritt Island National Wildlife Refuge (MINWR) for parking at the entrance to the Hammock Trails from 1969 to the present. The east portion of the site was used for intermittent suspect materials staging in the early 1990s and is still used as an apiary location, but is otherwise no longer active. In support of the NASA HSWA permit requirements, this site was identified as Potential Release Location (PRL) 218 and a Solid Waste Management Unit (SWMU) Assessment (SA) was conducted in 2013. Confirmatory Sampling (CS) was recommended and approved by the KSC Remediation Team (KSCRT). Three locations of concern (LOCs) were identified and sampled at the site. The LOCs include two former chemical labs and a former suspect staging area. The CS was conducted in March of 2015 at three locations by means of Direct Push Technology (DPT) groundwater sampling and at one location for soil sampling. The samples were collected and analyzed in accordance with the approved CS Work Plan. There were no exceedances of criteria detected in any of the samples from the three LOCs. The results of this investigation indicate that past and/or present operations have not negatively impacted environmental media at the A3SB. Based upon no confirmed groundwater detections above GCTLs and no soil impacts above applicable screening criteria no further investigation is warranted at the A3SB. A No Further Action (NFA) status for all locations was approved by the KSCRT at the June 2015 meeting.

A Soil Service Index: a method for quantifying the value, vulnerability, and status of soil resources

NASA Astrophysics Data System (ADS)

Harden, J. W.; Loisel, J.; Hugelius, G.; Sulman, B. N.; Bond-Lamberty, B. P.; Abramoff, R. Z.; Malhotra, A.; Gill, A. L.

2017-12-01

Soils support ecological and human systems by providing a physical and biogeochemical basis for plant growth, ecological functions, water quality, and water storage, and by providing services and functions needed for economic development, human well-being, and conservation of natural resources. Quantitative evaluation of soil services, however, is inconsistent and poorly communicated, in part because we lack a scientific, unified basis for evaluating soils and their potential for serving our needs. We introduce an index of soil service (SSI) in which multiple services are numerically or quantitatively assessed, normalized to a unit-less scale for purposes of intercomparability, and evaluated for a given site or region. Services include organic matter and/or organic carbon storage; plant productivity; CO2 or GHG exchange with the atmosphere; water storage capacity; and nutrient storage and/or availability. The status of SSI can be evaluated by individual services or by a composite index that combines multiple services. The status can be monitored over time; and key services that are more highly valued for a given soil can be weighted accordingly in comparison to other services. As a first step, existing data for each service are captured from a literature and data review in order to establish the full range of values. A site value establishes the ranking relative to the full range. Key services are weighted according to local values. A final index is the sum of the normalized, weighted products. Metrics can be updated and adapted as new data or services are discovered or recognized. Metrics can be used to compare among sites, regions, or time periods.

"The Bad People Go and Speak to Her": Young People's Choice and Agency when Accessing Mental Health Support in School

ERIC Educational Resources Information Center

Spratt, Jennifer; Shucksmith, Janet; Philip, Kate; Watson, Cate

2010-01-01

Concerns about the mental health and well-being of children and young people have been articulated in health and education policy fields as a call for closer working between schools and providers of mental health support services. Drawing from a Scottish study, this article explores issues of access, when mental health initiatives are sited in…

Service Based Internship Training to Prepare Workers to Support the Recovery of People with Co-Occurring Substance Abuse and Mental Health Disorders

ERIC Educational Resources Information Center

Crowe, Trevor P.; Kelly, Peter; Pepper, James; McLennan, Ross; Deane, Frank P.; Buckingham, Mark

2013-01-01

A repeated measures design was used to evaluate a 12 month on-site counsellor internship programme aimed at training staff to support the recovery needs of people with co-occurring substance use and mental health disorders. Fifty-four interns completed measures of recovery knowledge, attitudes, confidence/competence, as well as identifying…

Program planning for a community pharmacy residency support service using the nominal group technique.

PubMed

Rupp, Michael T

2002-01-01

To define programmatic objectives and initial operational priorities for CommuniRes, a university-based education and support service designed to help community pharmacists successfully implement and sustain community pharmacy residency programs (CPRPs). Advisory committee of nationally recognized experts in CPRPs in a small-group planning session. CPRPs are postgraduate clinical training experiences conducted in chain and independent community pharmacies. The nominal group technique (NGT), a structured approach to group planning and decision making, was used to identify and prioritize the needs of CPRPs. Results of the NGT exercise were used as input to a brainstorming session that defined specific CommuniRes services and resources that must be developed to meet high priority needs of CPRPs. Group consensus on the priority needs of CPRPs was determined through rank order voting. The advisory committee identified 20 separate CPRP needs that it believed must be met to ensure that CPRPs will be successful and sustainable. Group voting resulted in the selection of six needs that were considered to be consensus priorities for services and resources provided through CommuniRes: image parity for CPRPs; CPRP marketing materials; attractive postresidency employment opportunities; well-defined goals, objectives, and residency job descriptions; return on investment and sources of ongoing funding for the residency; and opportunities and mechanisms for communicating/networking with other residents and preceptors. The needs-based programmatic priorities defined by the advisory committee are now being implemented through a tripartite program consisting of live training seminars for CPRP preceptors and directors, an Internet site (www.communires.com), and a host of continuing support services available to affiliated CPRP sites. Future programmatic planning will increasingly involve CPRP preceptors, directors, and former residents to determine the ongoing needs of CPRPs.

38 CFR 39.26 - Forms.

Code of Federal Regulations, 2010 CFR

2010-07-01

... roads shall be generally 24 feet wide. (4) Pavement design. The pavement section of all roads, service... planning standards. 39.62 Space criteria for support facilities. 39.63 Architectural design standards... this part: (a) Establishment means the process of site selection, land acquisition, design and planning...

BITNET: Past, Present, and Future.

ERIC Educational Resources Information Center

Oberst, Daniel J.; Smith, Sheldon B.

1986-01-01

Discusses history and development of the academic computer network BITNET, including BITNET Network Support Center's growth and services, and international expansion. Network users, reasons for growth, and future developments are reviewed. A BITNET applications sampler and listings of compatible computers and operating systems, sites, and…

Emergency medical services

NASA Technical Reports Server (NTRS)

Billica, Roger; Chandler, Michael

1994-01-01

When NASA was established in 1958, it was known that space flight would require efforts beyond those of NASA to ensure the health and safety of our astronauts. On 10 Aug. 1958, a Secretary of Defense memorandum was signed that assigned the first Department of Defense (DOD) Manager to provide support to NASA for Project Mercury. This established a chain of command through the Joint Chiefs of Staff to the Secretary of Defense. The current charter is dated 19 Mar. 1986 and assigns the DOD Manager responsibilities to the Commander and Chief, US Space Command. The DOD Managers charter has many support areas and among them are recovery of astronauts and medical support. Today these efforts support the Space Shuttle and Space Station Programs. Briefly, the program works with each organization tasking the other through a requirements document. Level of care, communications, and recovery requirements are established; NASA and the DOD provide the capability to meet them. NASA is also responsible for the specialized training and equipment needed to meet these requirements. A Shuttle launch a KSC requires an Emergency Medical Services (EMS) coordinator on console to facilitate communications, ensure proper coverage, and coordinate with area hospitals. A contingent of NASA medical personnel are assembled to provide triage and medical support capabilities. The DOD provides medical evacuation (MEDEVAC) helicopters with surgeons and pararescue specialists (PJ's) or emergency medical technicians (EMT's). Each helicopter is equipped with at least one doctor and one PJ/EMT per astronaut crew member. Transoceanic abort landing (TAL) sites and end of mission (EOM) sites have similar structures, with TAL sites utilizing fixed wingg aircraft for MEDEVAC. The DOD also supports contingency planning for the support and return of crew members from the Space Station Freedom. Much of this support has been directed at the recovery of crew members following the landing of an Assured Crew Return Vehicle.

Potential barriers to veterinary student access to counselling and other support systems: perceptions of staff and students at a UK veterinary school.

PubMed

Pickles, K J; Rhind, S M; Miller, R; Jackson, S; Allister, R; Philp, J; Waterhouse, L; Mellanby, R J

2012-02-04

Considerable evidence suggests that veterinary surgeons' mental health is often poorer than comparable populations and that the incidence of suicide is higher among veterinary surgeons than the general public. Veterinary students also appear to suffer from high levels of anxiety and stress, and may possess inadequate coping strategies when faced with adversity. Veterinary students may find it difficult to access central university support systems due to their heavy workload and geographical isolation on some veterinary campuses. A previous study of University of Edinburgh fourth-year veterinary students found that support services located several miles from the main veterinary campus was a barrier to students accessing counselling services. Consequently, a pilot project was initiated, which provided a counselling service at the University of Edinburgh's rural Easter Bush veterinary campus one afternoon a week during 2010. As part of the evaluation of this service, web-based questionnaires were delivered via e-mail to all veterinary staff and students towards the end of the 12-month pilot period to evaluate perceptions of barriers to student counselling and to investigate student-valued support services. Questionnaire responses were received from 35 per cent of veterinary students and 52 per cent of staff. Stigmatisation of being unable to cope was a potent inhibitor of seeking support within the veterinary environment, but counselling was perceived as valuable by the majority of staff and students. Provision of an on-site counselling service was considered important for increasing ease of access; however, students viewed friends and family as their most important support mechanism. Workload was cited as the main cause of veterinary student stress. The majority of staff and student respondents perceived veterinary students as having an increased need for counselling support compared with other students.

Supporting Collaborative Model and Data Service Development and Deployment with DevOps

NASA Astrophysics Data System (ADS)

David, O.

2016-12-01

Adopting DevOps practices for model service development and deployment enables a community to engage in service-oriented modeling and data management. The Cloud Services Integration Platform (CSIP) developed the last 5 years at Colorado State University provides for collaborative integration of environmental models into scalable model and data services as a micro-services platform with API and deployment infrastructure. Originally developed to support USDA natural resource applications, it proved suitable for a wider range of applications in the environmental modeling domain. While extending its scope and visibility it became apparent community integration and adequate work flow support through the full model development and application cycle drove successful outcomes.DevOps provide best practices, tools, and organizational structures to optimize the transition from model service development to deployment by minimizing the (i) operational burden and (ii) turnaround time for modelers. We have developed and implemented a methodology to fully automate a suite of applications for application lifecycle management, version control, continuous integration, container management, and container scaling to enable model and data service developers in various institutions to collaboratively build, run, deploy, test, and scale services within minutes.To date more than 160 model and data services are available for applications in hydrology (PRMS, Hydrotools, CFA, ESP), water and wind erosion prediction (WEPP, WEPS, RUSLE2), soil quality trends (SCI, STIR), water quality analysis (SWAT-CP, WQM, CFA, AgES-W), stream degradation assessment (SWAT-DEG), hydraulics (cross-section), and grazing management (GRAS). In addition, supporting data services include soil (SSURGO), ecological site (ESIS), climate (CLIGEN, WINDGEN), land management and crop rotations (LMOD), and pesticides (WQM), developed using this workflow automation and decentralized governance.

Occupational and environmental health nursing in the era of consumer-directed health care.

PubMed

Sherman, Bruce; Click, Elizabeth

2007-05-01

Consumer-directed health care plans (CDHPs) present an opportunity to control health care costs. Health savings accounts (HSAs) and health reimbursement arrangements (HRAs) are two different approaches to providing pre-tax funding for CDHP enrollees. Each has a significant impact on the nature and business aspects of worksite health care. Worksite clinics can provide support via on-site education, expanded acute care services, and referral to other health-related benefits and resources for all CDHP enrollees. With attention to the type of employee health benefits funding support (HSA or HRA), occupational health nurses can maximize the effectiveness and value of worksite clinic services for CDHP enrollees.

Strengthening health-related rehabilitation services at national levels.

PubMed

Gutenbrunner, Christoph; Bickenbach, Jerome; Melvin, John; Lains, Jorge; Nugraha, Boya

2018-04-18

One of the aims of the World Health Organization's Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up) rehabilitation services. This paper describes the measures required and how (advisory) missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

The Role of Publicly Funded Family Planning Sites In Health Insurance Enrollment.

PubMed

Yarger, Jennifer; Daniel, Sara; Biggs, M Antonia; Malvin, Jan; Brindis, Claire D

2017-06-01

Publicly funded family planning providers are well positioned to help uninsured individuals learn about health insurance coverage options and effectively navigate the enrollment process. Understanding how these providers are engaged in enrollment assistance and the challenges they face in providing assistance is important for maximizing their role in health insurance outreach and enrollment. In 2014, some 684 sites participating in California's family planning program were surveyed about their involvement in helping clients enroll in health insurance. Weighted univariate and bivariate analyses were conducted to examine enrollment activities and perceived barriers to facilitating enrollment by site characteristics. Most family planning program sites provided eligibility screening (68%), enrollment education (77%), on-site enrollment assistance (55%) and referrals for off-site enrollment support (91%). The proportion of sites offering each type of assistance was highest among community clinics (83-96%), primary care and multispecialty sites (65-95%), Title X-funded sites (72-98%), sites with contracts to provide primary care services (64-93%) and sites using only electronic health records (66-94%). Commonly identified barriers to providing assistance were lack of staff time (reported by 52% of sites), lack of funding (47%), lack of physical space (34%) and lack of staff knowledge (33%); only 20% of sites received funding to support enrollment activities. Although there were significant variations among them, publicly funded family planning providers in California are actively engaged in health insurance enrollment. Supporting their vital role in enrollment could help in the achievement of universal health insurance coverage. Copyright © 2017 by the Guttmacher Institute.

Quarterly Performance/Technical Report of the National Marrow Donor Program

DTIC Science & Technology

2010-11-05

care. IIBA. Task 1: Period 8 Activity: Expand Network Co=unications Extended the Business to Business ( B2B ) Services to support the new alleles...exterior glass. • Site visit was conducted at the NMDP operated donor center in Philadelphia (August 12,2010) 0 At these site visits the Business ...Continuity Planner reviews the Business Continuity Action Guide with staff to better prepare each location for responding to incidents that interrupt

The Role of Education in a System of Care: Effectively Serving Children with Emotional or Behavioral Disorders. Systems of Care: Promising Practices in Children's Mental Health 1998 Series. Volume III.

ERIC Educational Resources Information Center

Woodruff, Darren W.; Osher, David; Hoffman, Catherine C.; Gruner, Allison; King, Mark A.; Snow, Stephanie T.; McIntire, Jonathan C.

This is the third volume in a series of monographs from the Comprehensive Community Mental Health Service for Children and Their Families Program, which currently supports 41 comprehensive system of care sites to meet the needs of children with serious emotional disturbances (SED). This volume explores sites that are overcoming obstacles to…

Using an ecosystem service decision support tool to support ridge to reef management: An example of sediment reduction in west Maui, Hawaii

NASA Astrophysics Data System (ADS)

Falinski, K. A.; Oleson, K.; Htun, H.; Kappel, C.; Lecky, J.; Rowe, C.; Selkoe, K.; White, C.

2016-12-01

Faced with anthropogenic stressors and declining coral reef states, managers concerned with restoration and resilience of coral reefs are increasingly recognizing the need to take a ridge-to-reef, ecosystem-based approach. An ecosystem services framing can help managers move towards these goals, helping to illustrate trade-offs and opportunities of management actions in terms of their impacts on society. We describe a research program building a spatial ecosystem services-based decision-support tool, and being applied to guide ridge-to-reef management in a NOAA priority site in West Maui. We use multiple modeling methods to link biophysical processes to ecosystem services and their spatial flows and social values in an integrating platform. Modeled services include water availability, sediment retention, nutrient retention and carbon sequestration on land. A coral reef ecosystem service model is under development to capture the linkages between terrestrial and coastal ecosystem services. Valuation studies are underway to quantify the implications for human well-being. The tool integrates techniques from decision science to facilitate decision making. We use the sediment retention model to illustrate the types of analyses the tool can support. The case study explores the tradeoffs between road rehabilitation costs and sediment export avoided. We couple the sediment and cost models with trade-off analysis to identify optimal distributed solutions that are most cost-effective in reducing erosion, and then use those models to estimate sediment exposure to coral reefs. We find that cooperation between land owners reveals opportunities for maximizing the benefits of fixing roads and minimizes costs. This research forms the building blocks of an ecosystem service decision support tool that we intend to continue to test and apply in other Pacific Island settings.

Tailoring family planning services to the special needs of adolescents.

PubMed

Winter, L; Breckenmaker, L C

1991-01-01

Experimental service protocols tailored to the needs of teenage family planning patients were developed that emphasized indepth counseling, education geared to an adolescent's level of development, and the provision of reassurance and social support. These protocols were tested against usual service delivery practices in a study involving 1,261 patients under 18 years of age at six nonmetropolitan family planning clinics. A comparison with teenagers obtaining services at control sites found that six months after their first clinic visit, patients at the experimental sites were more likely to be using a method, were less likely to experience difficulty in dealing with problems, were more likely to continue using their method despite problems and had learned more during the educational session. Teenage patients at the experimental clinics were also less likely to have become pregnant within one year than those who went to control clinics. Attrition during the year following the first study visit was similar among both groups; patient satisfaction was very high, and equivalent at experimental and control sites. The data show that the extra time and effort required to meet the special needs of teenagers is justified by their improved contraceptive use, greater knowledge and lower pregnancy rates.

Navigating identity, territorial stigma, and HIV care services in Vancouver, Canada: A qualitative study.

PubMed

Collins, Alexandra B; Parashar, Surita; Closson, Kalysha; Turje, Rosalind Baltzer; Strike, Carol; McNeil, Ryan

2016-07-01

This study examines the influence of territorial stigma on access to HIV care and other support services. Qualitative interviews were conducted with thirty people living with HIV (PLHIV) who use drugs recruited from the Dr. Peter Centre (DPC), an HIV care facility located in Vancouver, Canada's West End neighbourhood that operates under a harm reduction approach. Findings demonstrated that territorial stigma can undermine access to critical support services and resources in spatially stigmatized neighbourhoods among PLHIV who use drugs who have relocated elsewhere. Furthermore, PLHIV moving from spatially stigmatized neighbourhoods - in this case, Vancouver's Downtown Eastside - to access HIV care services experienced tension with different groups at the DPC (e.g., men who have sex with me, people who use drugs), as these groups sought to define who constituted a'normative' client. Collectively, these findings demonstrate the urgent need to consider the siting of HIV care services as the epidemic evolves. Copyright © 2016 Elsevier Ltd. All rights reserved.

Fiscal Year 2012 Revegetation Assessment

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

Jenifer Nordstrom

2012-11-01

This report summarizes the Fiscal Year 2012 Revegetation Assessment by Battelle Energy Alliance, LLC. This assessment was conducted to supplement documentation related to the Storm Water Pollution Prevention Plan for Construction Activities and to ensure that disturbed vegetation and soil at various locations are being restored. This report provides the following information for each site being monitored by the Idaho National Laboratory Environmental Support and Services: • Summary of each site • Assessment of vegetation status and site stabilization at each location • Actions and Resolutions for each site. Ten disturbed sites were evaluated for this assessment. Six have achievedmore » final stabilization. The remaining four sites not meeting the criteria for final stabilization will be evaluated again in the next fiscal year.« less

Ideas Exchange: How Do You Use NASPE's Teacher Toolbox to Enhance Professional Activities with Students, Sport or Physical Education Lessons, Faculty Wellness Classes or Community Programs?

ERIC Educational Resources Information Center

Simpkins, Mary Ann; McNeill, Shane; Dieckman, Dale; Sissom, Mark; LoBianco, Judy; Lund, Jackie; Barney, David C.; Manson, Mara; Silva, Betsy

2009-01-01

NASPE's Teacher Toolbox is an instructional resource site which provides educators with a wide variety of teaching tools that focus on physical activity. This service is provided by NASPE to support instructional activities as well as promote quality programs. New monthly issues support NASPE's mission to enhance knowledge, improve professional…

49 CFR 835.11 - Obtaining Board accident reports, factual accident reports, and supporting information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... rules at parts 801 and 837 of this chapter explain our procedures, as will our web site, at www.ntsb.gov... witnesses at depositions, nor will copying services be provided by deponents. [63 FR 71608, Dec. 29, 1998] ...

A Planning Guide for Instructional Networks, Part II.

ERIC Educational Resources Information Center

Daly, Kevin F.

1994-01-01

This second in a series of articles on planning for instructional computer networks focuses on site preparation, installation, service, and support. Highlights include an implementation schedule; classroom and computer lab layouts; electrical power needs; workstations; network cable; telephones; furniture; climate control; and security. (LRW)

Information Security and the Internet.

ERIC Educational Resources Information Center

Doddrell, Gregory R.

1996-01-01

As business relies less on "fortress" style central computers and more on distributed systems, the risk of disruption increases because of inadequate physical security, support services, and site monitoring. This article discusses information security and why protection is required on the Internet, presents a best practice firewall, and…

Satisfaction and sustainability: a realist review of decentralized models of perinatal surgery for rural women.

PubMed

Kornelsen, Jude; McCartney, Kevin; Williams, Kim

2016-01-01

This article was developed as part of a larger realist review investigating the viability and efficacy of decentralized models of perinatal surgical services for rural women in the context of recent and ongoing service centralization witnessed in many developed nations. The larger realist review was commissioned by the British Columbia Ministry of Health and Perinatal Services of British Columbia, Canada. Findings from that review are addressed in this article specific to the sustainability of rural perinatal surgical sites and the satisfaction of providers that underpins their recruitment to and retention at such sites. A realist method was used in the selection and analysis of literature with the intention to iteratively develop a sophisticated understanding of how perinatal surgical services can best meet the needs of women who live in rural and remote environments. The goal of a realist review is to examine what works for whom under what circumstances and why. The high sensitivity search used language (English) and year (since 1990) limiters in keeping with both a realist and rapid review tradition of using reasoned contextual boundaries. No exclusions were made based on methodology or methodological approach in keeping with a realist review. Databases searched included MEDLINE, PubMed, EBSCO, CINAHL, EBM Reviews, NHS Economic Evaluation Database and PAIS International for literature in December 2013. Database searching produced 103 included academic articles. A further 59 resources were added through pearling and 13 grey literature reports were added on recommendation from the commissioner. A total of 42 of these 175 articles were included in this article as specific to provider satisfaction and service sustainability. Operative perinatal practice was found to be a lynchpin of sustainable primary and surgical services in rural communities. Rural shortages of providers, including challenges with recruitment and retention, were found to be a complex issue, with scope of practice and contextual support as the key factors. Targeted educational programs, exposure to rural practice and living environments, accessible and appropriate continuing medical education, and strong clinical support (including locum coverage and sustainable on-call schedules) were all found to be areas of important consideration in rural service sustainability. Rural practice was found to be a site to actualize personal goals and values for providers. A broad and challenging scope of practice and the opportunity to participate in community level health improvements were seen as critical to the retention of providers. Without proper support, however, providers reported a feeling of being 'in too deep'. Common themes were a lack of health human resource redundancies, compromised access to specialist support and technology, and a lack of work-life balance. Burnout and attrition in perinatal surgical services threaten to destabilize other aspects of rural community health services, making the need to address sustainability of rural providers urgent.

Remaining Sites Verification Package for the 100-F-26:10, 1607-F3 Sanitary Sewer Pipelines (182-F, 183-F, and 151-F Sanitary Sewer Lines), Waste Site Reclassification Form 2007-028

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

L. M. Dittmer

2007-12-03

The 100-F-26:10 waste site includes sanitary sewer lines that serviced the former 182-F, 183-F, and 151-F Buildings. In accordance with this evaluation, the verification sampling results support a reclassification of this site to Interim Closed Out. The results of verification sampling show that residual contaminant concentrations do not preclude any future uses and allow for unrestricted use of shallow zone soils. The results also demonstrate that residual contaminant concentrations are protective of groundwater and the Columbia River.

Supporting Shared Resource Usage for a Diverse User Community: the OSG Experience and Lessons Learned

NASA Astrophysics Data System (ADS)

Garzoglio, Gabriele; Levshina, Tanya; Rynge, Mats; Sehgal, Chander; Slyz, Marko

2012-12-01

The Open Science Grid (OSG) supports a diverse community of new and existing users in adopting and making effective use of the Distributed High Throughput Computing (DHTC) model. The LHC user community has deep local support within the experiments. For other smaller communities and individual users the OSG provides consulting and technical services through the User Support area. We describe these sometimes successful and sometimes not so successful experiences and analyze lessons learned that are helping us improve our services. The services offered include forums to enable shared learning and mutual support, tutorials and documentation for new technology, and troubleshooting of problematic or systemic failure modes. For new communities and users, we bootstrap their use of the distributed high throughput computing technologies and resources available on the OSG by following a phased approach. We first adapt the application and run a small production campaign on a subset of “friendly” sites. Only then do we move the user to run full production campaigns across the many remote sites on the OSG, adding to the community resources up to hundreds of thousands of CPU hours per day. This scaling up generates new challenges - like no determinism in the time to job completion, and diverse errors due to the heterogeneity of the configurations and environments - so some attention is needed to get good results. We cover recent experiences with image simulation for the Large Synoptic Survey Telescope (LSST), small-file large volume data movement for the Dark Energy Survey (DES), civil engineering simulation with the Network for Earthquake Engineering Simulation (NEES), and accelerator modeling with the Electron Ion Collider group at BNL. We will categorize and analyze the use cases and describe how our processes are evolving based on lessons learned.

Data management integration for biomedical core facilities

NASA Astrophysics Data System (ADS)

Zhang, Guo-Qiang; Szymanski, Jacek; Wilson, David

2007-03-01

We present the design, development, and pilot-deployment experiences of MIMI, a web-based, Multi-modality Multi-Resource Information Integration environment for biomedical core facilities. This is an easily customizable, web-based software tool that integrates scientific and administrative support for a biomedical core facility involving a common set of entities: researchers; projects; equipments and devices; support staff; services; samples and materials; experimental workflow; large and complex data. With this software, one can: register users; manage projects; schedule resources; bill services; perform site-wide search; archive, back-up, and share data. With its customizable, expandable, and scalable characteristics, MIMI not only provides a cost-effective solution to the overarching data management problem of biomedical core facilities unavailable in the market place, but also lays a foundation for data federation to facilitate and support discovery-driven research.

78 FR 20355 - Notice of Availability of Funds and Solicitation for Grant Applications for Face Forward-Serving...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

...The U.S. Department of Labor (we, the Department or DOL) Employment and Training Administration (ETA), announces the availability of approximately $26 million in grant funds authorized by the Workforce Investment Act. Under this solicitation, DOL expects to award 26 grants for up to $1,000,000 each to cover a 39-month period of performance, which includes a planning period of up to six months, program operation period of 24 months, and a minimum of nine months of post program support and follow-up services provided to each participant. Any non- profit organization with IRS 501(c)(3) status, unit of state or local government, or any Indian and Native American entity eligible for grants under WIA Section 166, may apply for these grants to provide services to eligible participants in areas with high-poverty and high- crime rates. These services will include diversion and/or expungement (required for all participants), case management, mentoring, education, training leading to industry-recognized credentials for in demand industries and occupations in the State or local area, service- learning, workforce activities, and post-program support and follow-up services. The complete SGA and any subsequent SGA amendments in connection with this solicitation are described in further detail on ETA's Web site at http://www.doleta.gov/grants/ or on http://www.grants.gov. The Web sites provide application information, eligibility requirements, review and selection procedures, and other program requirements governing this solicitation.

Increasing the vocational focus of the community mental health team.

PubMed

Seebohm, Patience; Secker, Jenny

2003-08-01

Despite increasing interest in the UK in enabling community mental health teams to support clients' vocational aspirations, surveys suggest that progress to date has been slow. This study aimed to identify factors that facilitate or create barriers to teams engaging in vocational work by exploring experiences and perceptions at three sites where progress had been made. Semi-structured interviews were carried out with on-site and off-site vocational specialists, care coordinators and other professionals identified locally as supportive of vocational work. Participants' accounts were compared with a framework derived from previous research into effective vocational services. The framework encompassed partnership working, attention to clients' needs, choices and mental health, and enabling clients to access and retain employment. Interprofessional partnership working emerged as particularly strong at one site and in turn was key to facilitating attention to the other elements of the framework. Conversely, at the other two sites less well-developed partnership working could create barriers to addressing these elements. Across all three sites access to expert welfare benefits advice was problematic, with evidence of widespread ignorance about the crucial issues involved.

[Geographic distribution of supportive care for disabled young people].

PubMed

Bourgarel, Sophie; Piteau-Delord, Monique

2013-01-01

To analyse the logic for the distribution of home care services for disabled children (SESSAD) in a context of under-equipment. Questionnaire-based survey of 75 units (82% of the region's SESSAD units) concerning patient transport. Equipment and transport mapping. Support units for disabled children are often set up in the housing facilities that contributed to their creation. These sites are sometimes situated a long way from densely populated regions, thereby generating unnecessary travel times and expenses. Chronic under-equipment makes these sites viable, as the various units are always full, despite their distance from the children for whom they provide support. Mapping illustrates the extensive recruitment zones overlapping several units managing similar patients. The major revision of accreditation of these units, planned for 2017, could lead to redefinition of geographical zones of accreditations. New unit opening procedures based on ARS calls for tenders may help to improve the geographical distribution of this supportive care.

Designing and implementing E-health Applications in the UK's National Health Service.

PubMed

Bower, D Jane; Barry, Nessa; Reid, Margaret; Norrie, John

2005-12-01

Telemedicine/e-health applications have the potential to play an important role in Britain's National Health Service (NHS), including the NHS in Scotland. The Scottish Telemedicine Action Forum (STAF) was established by the Scottish Executive Department of Health in 1999 to take a range of applications, targeted on national priorities, into routine service. In the process it has provided insights into how advanced information and communication technologies (ICTs) can be moved from the research stage into routine service. In this article four of the projects are described and analysed focusing on the key issues that have emerged as critical for carrying projects successfully through to implementation in service as follows: 1. A multisite videoconferencing network linking 15 minor injury units to the main accident and emergency (A&E) centre. 2. A single-site neonatal intensive care "cotside" laptop system to assist communication between parents and clinical staff. 3. A single-site outpatient chronic disease management system. 4. A multisite software audit tool to support the care of cleft lip and palate patients from birth onward.

Support groups for older victims of domestic violence.

PubMed

Wolf, R S

2001-01-01

A 1997 nationwide (US and Canada) search to identify support groups for older victims of domestic violence located 16 sponsored by domestic violence programs and 14 sponsored by aging services. Interviews with group leaders indicated more similarities than differences between the two types of sponsorship in group purpose, leadership, numbers served, content of support group sessions, and success in accomplishing goals. Resistance of elders to participate in a group experience was cited by leaders as a major barrier. Recommendations for future groups include insuring accessibility of meeting site; using a leader and co-leader, at least one of whom is older or familiar with aging issues; allocating resources for recruitment; and seeking a steady source of funding. A policy of collaboration among the state's domestic violence coalition, state unit on aging, adult protective services, and victim assistance program may help in promoting support group development and utilization.

Evaluation of an online partner notification program.

PubMed

Rietmeijer, Cornelis A; Westergaard, Benton; Mickiewicz, Theresa A; Richardson, Doug; Ling, Sarah; Sapp, Terri; Jordan, Rebecca; Wilmoth, Ralph; Kachur, Rachel; McFarlane, Mary

2011-05-01

Internet-based programs for sexually transmitted infections (STI)/HIV partner notification have generated considerable interest as public health interventions; yet data are lacking to support widespread dissemination. We report on a clinic-based and web-based evaluation of the Colorado inSPOT online partner notification program. Clinic-based surveys were conducted at a large urban STI clinic before and after the implementation of feasible clinic interventions as well as nonclinic campaigns to promote the use of inSPOT Colorado. Questions assessed recognition and use of the site. Website statistics were provided by the inSPOT service, including the number of site hits, e-cards sent, and specific STI exposures identified on the card. Recognition and use of the service among STI clinic patients remained low (<6%) despite the interventions. Site statistics demonstrated an immediate but quickly diminishing response after placement of a banner ad on a popular gay website. Newspaper advertisements and radio public service announcements showed small increases in website use. Analysis of STIs specified on the e-cards, showed scabies and pediculosis as the most-identified STIs, accounting for nearly 30% of all e-cards sent. Clinic survey data indicated that when respondents were faced with the hypothetical situation of being diagnosed with an STI, more than 90% would notify partners in person; only 5% would use e-mail or the Internet. Our data did not support the effectiveness of the inSPOT intervention among a predominantly heterosexual population in a large urban STI clinic.

7 CFR 1794.21 - Categorically excluded proposals without an ER.

Code of Federal Regulations, 2010 CFR

2010-01-01

... an emergency situation to return to service damaged facilities of an applicant's system. (b) Electric... electric generating or fuel processing facilities and related support structures where there is negligible... boundaries of an existing electric generating facility site. A description of the facilities to be...

Managing Mission-Critical Infrastructure

ERIC Educational Resources Information Center

Breeding, Marshall

2012-01-01

In the library context, they depend on sophisticated business applications specifically designed to support their work. This infrastructure consists of such components as integrated library systems, their associated online catalogs or discovery services, and self-check equipment, as well as a Web site and the various online tools and services…

16 CFR 312.12 - Voluntary Commission Approval Processes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CONGRESS CHILDREN'S ONLINE PRIVACY PROTECTION RULE § 312.12 Voluntary Commission Approval Processes. (a...; and (b) Support for internal operations of the Web site or online service. An interested party may... potential effects on children's online privacy. The request shall be filed with the Commission's Office of...

Genetics Home Reference: pseudoachondroplasia

MedlinePlus

... of Kansas Medical Center Patient Support and Advocacy Resources (4 links) Human Growth Foundation Little People of America National Organization ... Reviewed : January 2013 Published : June 26, 2018 The resources on this site should not be used as a substitute ... Department of Health & Human Services National Institutes of Health National Library of ...

EUDAT: A New Cross-Disciplinary Data Infrastructure For Science

NASA Astrophysics Data System (ADS)

Lecarpentier, Damien; Michelini, Alberto; Wittenburg, Peter

2013-04-01

In recent years significant investments have been made by the European Commission and European member states to create a pan-European e-Infrastructure supporting multiple research communities. As a result, a European e-Infrastructure ecosystem is currently taking shape, with communication networks, distributed grids and HPC facilities providing European researchers from all fields with state-of-the-art instruments and services that support the deployment of new research facilities on a pan-European level. However, the accelerated proliferation of data - newly available from powerful new scientific instruments, simulations and the digitization of existing resources - has created a new impetus for increasing efforts and investments in order to tackle the specific challenges of data management, and to ensure a coherent approach to research data access and preservation. EUDAT is a pan-European initiative that started in October 2011 and which aims to help overcome these challenges by laying out the foundations of a Collaborative Data Infrastructure (CDI) in which centres offering community-specific support services to their users could rely on a set of common data services shared between different research communities. Although research communities from different disciplines have different ambitions and approaches - particularly with respect to data organization and content - they also share many basic service requirements. This commonality makes it possible for EUDAT to establish common data services, designed to support multiple research communities, as part of this CDI. During the first year, EUDAT has been reviewing the approaches and requirements of a first subset of communities from linguistics (CLARIN), solid earth sciences (EPOS), climate sciences (ENES), environmental sciences (LIFEWATCH), and biological and medical sciences (VPH), and shortlisted four generic services to be deployed as shared services on the EUDAT infrastructure. These services are data replication from site to site, data staging to compute facilities, metadata, and easy storage. A number of enabling services such as distributed authentication and authorization, persistent identifiers, hosting of services, workspaces and centre registry were also discussed. The services being designed in EUDAT will thus be of interest to a broad range of communities that lack their own robust data infrastructures, or that are simply looking for additional storage and/or computing capacities to better access, use, re-use, and preserve their data. The first pilots were completed in 2012 and a pre-production ready operational infrastructure, comprised of five sites (RZG, CINECA, SARA, CSC, FZJ), offering 480TB of online storage and 4PB of near-line (tape) storage, initially serving four user communities (ENES, EPOS, CLARIN, VPH) was established. These services shall be available to all communities in a production environment by 2014. Although EUDAT has initially focused on a subset of research communities, it aims to engage with other communities interested in adapting their solutions or contributing to the design of the infrastructure. Discussions with other research communities - belonging to the fields of environmental sciences, biomedical science, physics, social sciences and humanities - have already begun and are following a pattern similar to the one we adopted with the initial communities. The next step will consist of integrating representatives from these communities into the existing pilots and task forces so as to include them in the process of designing the services and, ultimately, shaping the future CDI.

Protocol for the End-of-Life Social Action Study (ELSA): a randomised wait-list controlled trial and embedded qualitative case study evaluation assessing the causal impact of social action befriending services on end of life experience.

PubMed

Walshe, Catherine; Algorta, Guillermo Perez; Dodd, Steven; Hill, Matthew; Ockenden, Nick; Payne, Sheila; Preston, Nancy

2016-07-13

Compassionate support at the end of life should not be the responsibility of health and social care professionals alone and requires a response from the wider community. Volunteers, as community members, are a critical part of many end-of-life care services. The impact of their services on important outcomes such as quality of life is currently poorly understood. The purpose of this study is to evaluate a series of social action initiatives which use volunteers to deliver befriending services to people anticipated to be in their last year of life. The aim is to determine if receiving care from a social action volunteer befriending service plus usual care significantly improves quality of life in the last year of life. The research questions will be addressed through a wait-list randomised controlled trial (WLRCT) and qualitative case study evaluation across 12 sites in England. Participants will be randomly allocated to either receive the social action volunteer befriending service straight away or receive the intervention after a four week wait (wait-list arm). The impact of the intervention on end-of-life experience (quality of life as primary outcome, loneliness, social support) will be measured. Repeated assessments will be carried out at baseline and weeks 4 and 8 for the intervention arm and weeks 4, 8 and 12 for the wait-list arm. For selected sites case study evaluation will include interviews, observation and documentary analysis to understand the mechanisms underpinning any found impact. This study will address the need to both provide services which use social action models to support end-of-life care in community settings, and to robustly evaluate these models to determine if they influence the experience of end-of-life care. Such services could work to reduce isolation, help meet emotional needs and maintain a sense of connectedness to the community. ISRCTN 12929812 Registered 20.5.15.

Software-supported USER cloning strategies for site-directed mutagenesis and DNA assembly.

PubMed

Genee, Hans Jasper; Bonde, Mads Tvillinggaard; Bagger, Frederik Otzen; Jespersen, Jakob Berg; Sommer, Morten O A; Wernersson, Rasmus; Olsen, Lars Rønn

2015-03-20

USER cloning is a fast and versatile method for engineering of plasmid DNA. We have developed a user friendly Web server tool that automates the design of optimal PCR primers for several distinct USER cloning-based applications. Our Web server, named AMUSER (Automated DNA Modifications with USER cloning), facilitates DNA assembly and introduction of virtually any type of site-directed mutagenesis by designing optimal PCR primers for the desired genetic changes. To demonstrate the utility, we designed primers for a simultaneous two-position site-directed mutagenesis of green fluorescent protein (GFP) to yellow fluorescent protein (YFP), which in a single step reaction resulted in a 94% cloning efficiency. AMUSER also supports degenerate nucleotide primers, single insert combinatorial assembly, and flexible parameters for PCR amplification. AMUSER is freely available online at http://www.cbs.dtu.dk/services/AMUSER/.

VHA mental health information system: applying health information technology to monitor and facilitate implementation of VHA Uniform Mental Health Services Handbook requirements.

PubMed

Trafton, Jodie A; Greenberg, Greg; Harris, Alex H S; Tavakoli, Sara; Kearney, Lisa; McCarthy, John; Blow, Fredric; Hoff, Rani; Schohn, Mary

2013-03-01

To describe the design and deployment of health information technology to support implementation of mental health services policy requirements in the Veterans Health Administration (VHA). Using administrative and self-report survey data, we developed and fielded metrics regarding implementation of the requirements delineated in the VHA Uniform Mental Health Services Handbook. Finalized metrics were incorporated into 2 external facilitation-based quality improvement programs led by the VHA Mental Health Operations. To support these programs, tailored site-specific reports were generated. Metric development required close collaboration between program evaluators, policy makers and clinical leadership, and consideration of policy language and intent. Electronic reports supporting different purposes required distinct formatting and presentation features, despite their having similar general goals and using the same metrics. Health information technology can facilitate mental health policy implementation but must be integrated into a process of consensus building and close collaboration with policy makers, evaluators, and practitioners.

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

PubMed

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

2017-07-01

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

Psychosocial service use and unmet need among recently diagnosed adolescent and young adult cancer patients.

PubMed

Zebrack, Brad J; Block, Rebecca; Hayes-Lattin, Brandon; Embry, Leanne; Aguilar, Christine; Meeske, Kathleen A; Li, Yun; Butler, Melissa; Cole, Steven

2013-01-01

Adolescents and young adults (AYAs) with cancer demonstrate biomedical risks and psychosocial issues distinct from those of children or older adults. In this study, the authors examined and compared the extent to which AYAs treated in pediatric or adult oncology settings reported use of, and unmet need for, psychosocial support services. Within 4 months of initial cancer diagnosis, 215 AYAs ages 14 to 39 years (99 from pediatric care settings and 116 from adult care settings; 75% response rate) were assessed for reporting use of information resources, emotional support services, and practical support services. Statistical analyses derived odds ratios and 95% confidence intervals for service use and unmet needs after controlling for race, employment/school status, sex, relationship status, severity of cancer, treatment, and treatment-related side effects. AYAs ages 20 to 29 years were significantly less likely than teens and older patients ages 30 to 39 years to report using professional mental health services and were significantly more likely to report an unmet need with regard to cancer information, infertility information, and diet/nutrition information. Compared with teens who were treated in pediatric facilities, AYAs who were treated in adult facilities were more likely to report an unmet need for age-appropriate Internet sites, professional mental health services, camp/retreats programs, transportation assistance, and complementary and alternative health services. Substantial proportions of AYAs are not getting their psychosocial care needs met. Bolstering psychosocial support staff and patient referral to community-based social service agencies and reputable Internet resources may enhance care and improve quality of life for AYAs. Copyright © 2012 American Cancer Society.

A qualitative study of innovations implemented to improve transition of care from maternity to child and family health (CFH) services in Australia.

PubMed

Psaila, Kim; Fowler, Cathrine; Kruske, Sue; Schmied, Virginia

2014-12-01

The transition of care (ToC) from maternity services, particularly from midwifery care to child and family health (CFH) nursing services, is a critical time in the support of women as they transition into early parenting. However significant issues in service provision exist, particularly meeting the needs of women with social and emotional health risk factors. These include insufficient resources, poor communication and information transfer, limited interface between private and public health systems and tension around role boundaries. In response some services are implementing strategies to improve the transition of care from maternity to CFH services. This paper describes a range of innovations developed to improve transition of care between maternity and child and family health services and identifies the characteristics common to all innovations. Data reported were collected in phase three of a mixed methods study investigating the feasibility of implementing a national approach to child and family health services in Australia (CHoRUS study). Data were collected from 33 professionals including midwives, child and family health nurses, allied health staff and managers, at seven sites across four Australian states. Data were analysed thematically, guided by Braun and Clarke's six-step process of thematic analysis. The range of innovations implemented included those which addressed; information sharing, the efficient use of funding and resources, development of new roles to improve co-ordination of care, the co-location of services and working together. Four of the seven sites implemented innovations that specifically targeted families with additional needs. Successful implementation was dependent on the preliminary work undertaken which required professionals and/or organisations to work collaboratively. Improving the transition of care requires co-ordination and collaboration to ensure families are adequately supported. Collaboration between professionals and services facilitated innovative practice and was core to successful change. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Brentwood Lessons Learned Project Report

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

Rivkin, Carl H.; Caton, Melanie C.; Ainscough, Christopher D.

The purpose of this report is to document lessons learned in the installation of the hydrogen fueling station at the National Park Service Brentwood site in Washington, D.C., to help further the deployment of hydrogen infrastructure required to support hydrogen and other fuel cell technologies. Hydrogen fueling is the most difficult infrastructure component to build and permit. Hydrogen fueling can include augmenting hydrogen fueling capability to existing conventional fuel fueling stations as well as building brand new hydrogen fueling stations. This report was produced as part of the Brentwood Lessons Learned project. The project consisted of transplanting an existing modularmore » hydrogen fueling station from Connecticut to the National Park Service Brentwood site. This relocation required design and construction at the Brentwood site to accommodate the existing station design as well as installation and validation of the updated station. One of the most important lessons learned was that simply moving an existing modular station to an operating site was not necessarily straight-forward - performing the relocation required significant effort and cost. The station has to function at the selected operating site and this functionality requires a power supply, building supports connecting to an existing alarm system, electrical grounding and lighting, providing nitrogen for purging, and providing deionized water if an electrolyzer is part of the station package. Most importantly, the station has to fit into the existing site both spatially and operationally and not disrupt existing operations at the site. All of this coordination and integration requires logistical planning and project management. The idea that a hydrogen fueling station can be simply dropped onto a site and made immediately operational is generally not realistic. Other important lessons learned include that delineating the boundaries of the multiple jurisdictions that have authority over a project for all parties involved in the project are key to an efficient approval process; and site investigation is necessary when integrating a new station design onto an existing site, particularly an older existing site that may have limited documentation on the site history and operations. The lessons learned for permitting and subcontracting construction work can be applied to other similar sites and to commercial sites.« less

Sexual and Gender Minority Health Curricula and Institutional Support Services at U.S. Schools of Public Health.

PubMed

Talan, Ali J; Drake, Carolyn B; Glick, Jennifer L; Claiborn, Camilla Scott; Seal, David

2017-01-01

Limited research has examined the ways in which public health training programs equip students to address health disparities affecting the lesbian, gay, bisexual, and transgender (LGBT) community and other sexual and gender minority (SGM) populations. This study outlines the availability of public health curricula on SGM health topics, and the prevalence of LGBT and SGM-inclusive institutional support services across CEPH-accredited U.S. schools of public health. Content analysis of all course offerings related to gender and sexuality revealed a limited focus on sexual and gender minority health: just 4.7% of courses contained keywords indicating that LGBT or SGM health topics were covered. Similar analysis of institutional support services available at U.S. schools of public health found that only 25% of schools had LGBT student organizations, and just 19% had an office of diversity that specifically advertised LGBT or SGM-inclusive programming or services on the institution's Web site. Finally, only two of 52 schools offered an educational certificate centered on LGBT health. These findings illustrate a significant need for enhanced curricular content and institutional support services that equip public health students to address SGM health disparities. Improvement in this area may encourage future health care professionals to work to reduce these disparities, to improve SGM persons' experiences in health care settings, and to generate further research in this area.

Experience of Primary Care among Homeless Individuals with Mental Health Conditions

PubMed Central

Chrystal, Joya G.; Glover, Dawn L.; Young, Alexander S.; Whelan, Fiona; Austin, Erika L.; Johnson, Nancy K.; Pollio, David E.; Holt, Cheryl L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa A.; Daigle, Shanette G.; Steward, Jocelyn L.; Kertesz, Stefan G

2015-01-01

The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons’ needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers. PMID:25659142

Experience of primary care among homeless individuals with mental health conditions.

PubMed

Chrystal, Joya G; Glover, Dawn L; Young, Alexander S; Whelan, Fiona; Austin, Erika L; Johnson, Nancy K; Pollio, David E; Holt, Cheryl L; Stringfellow, Erin; Gordon, Adam J; Kim, Theresa A; Daigle, Shanette G; Steward, Jocelyn L; Kertesz, Stefan G

2015-01-01

The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons' needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers.

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.

Model for collaboration: a rural medicine and academic health center teleradiology project

NASA Astrophysics Data System (ADS)

Van Slyke, Mark A.; Eggli, Douglas F.; Prior, Fred W.; Salmon, William; Pappas, Gregory; Vanatta, Fred; Goldfetter, Warren; Hashem, Said

1996-05-01

A pilot project was developed to explore the role of subspecialty radiology support to rural medicine sites over a long-distance network. A collaborative relationship between 2 rural radiology practices and an academic health was established. Project objectives included: (1) Does the subspecialty consultation significantly change diagnosis patterns at the rural site? (2) Is there value added as measured by improved clinical care or an overall decreased cost of care? (3) Can a collaborative model be economically self-supportive? (4) Does the collaborative model encourage and support education and collegial relationships? Two rural hospitals were selected based on the level of imaging technology and willingness to cooperate. Image capture and network technology was chosen to make the network process transparent to the users. DICOM standard interfaces were incorporated into existing CT and MRI scanners and a film digitizer. Nuclear medicine images were transferred and viewed using a proprietary vendor protocol. Relevant clinical data was managed by a custom designed PC based Lotus Notes application (Patient Study Tracking System: PaSTS) (Pennsylvania Blue Shield Institute). All data was transferred over a Frame Relay network and managed by the Pennsylvania Commonwealth sponsored PA Health Net. Images, other than nuclear medicine, were viewed on a GE Advantage viewing station using a pair of 2 X 2.5 K gray scale monitors. Patient text data was managed by the PaSTS PC and displayed on a separate 15' color monitor. A total of 476 radiology studies were networked into the AHC. Randomly chosen research studies comprised 82% of the case work. Consultative and primary read cases comprised 17% and 1% respectively. The exercise was judged effective by both rural sites. Significant findings and diagnoses were confirmed in 73% of cases with discrepant findings in only 4%. One site benefited by adopting more advanced imaging techniques increasing the sophistication of radiology services. The primary value for the referring sites was the added confidence provided by the subspecialty overreads. An educational value was recognized by all. In conclusion, the networking of rural health care sites to an AHC subspecialty radiology practice was successful primarily in increasing the diagnostic confidence at the rural site. Other benefits included: education; increased rural imaging and an opportunity to provide primary interpretation when the rural radiologist is not available. However, the rate of rural generated consultation was low (17%) and is unlikely to support the costs of a high speed network. To support, rather than replace, rural radiology requires a lower cost network and a mechanism for payment for these services.

Design and Recruitment for a Randomized Controlled Trial of Problem-Solving Therapy to Prevent Depression among Older Adults with Need for Supportive Services.

PubMed

Albert, Steven M; King, Jennifer; Dew, Mary Amanda; Begley, Amy; Anderson, Stewart; Karp, Jordan; Gildengers, Ari; Butters, Meryl; Reynolds, Charles F

2016-01-01

Addressing subthreshold depression (indicated prevention) and vulnerabilities that increase the risk of major depression or anxiety disorders (selective prevention) is important for protecting mental health in old age. The Depression-Agency Based Collaborative (Dep-ABC) is a prevention trial involving older adults recruited from aging services sites (home care agencies, senior housing, senior centers) who meet criteria for subthreshold depression and disability. Therefore, the authors examine the effectiveness of partnerships with aging services sites for recruiting at-risk older adults, the quality of recruitment and acceptability of the Dep-ABC assessment and intervention, and the baseline status of participants. Dep-ABC is a single-blind randomized controlled prevention trial set in aging services settings but with centralized screening, randomization, in-home assessments, and follow-up. Its intervention arm involves six to eight sessions of problem-solving therapy, in which older adults aged 60+ learn to break down problems that affect well-being and develop strategies to address them. We examined participation rates to assess quality of recruitment across sites and level of disability according to service use. Dep-ABC randomized 104 participants, 68.4% of eligible older adults. Screening using self-reported disability successfully netted a sample in which 74% received home care agency services, with remaining participants similarly impaired in structured self-reports of impairment and on observed performance tests. Direct outreach to aging services providers is an effective way to identify older adults with service needs at high risk of major depression. Problem-solving therapy is acceptable to this population and can be added to current services. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Design and Recruitment for a Randomized Controlled Trial of Problem Solving Therapy to Prevent Depression among Older Adults with Need for Supportive Services

PubMed Central

Albert, Steven M.; King, Jennifer; Dew, Mary Amanda; Begley, Amy; Anderson, Stewart; Karp, Jordan; Gildengers, Ari; Butters, Meryl; Reynolds, Charles F.

2015-01-01

Background Addressing subthreshold depression (indicated prevention) as well as vulnerabilities that increase the risk of major depression or anxiety disorders (selective prevention) is important for protecting mental health in old age. The Depression-Agency Based Collaborative is a prevention trial involving older adults recruited from aging services sites (home care agencies, senior housing senior centers) who meet criteria for subthreshold depression and disability. Objective To examine (i) the effectiveness of partnerships with aging services sites for recruiting at-risk older adults, (ii) the quality of recruitment and acceptability of the Dep-ABC assessment and intervention, and (iii) the baseline status of participants. Methods Dep-ABC is a single-blind randomized controlled prevention trial set in aging services settings but with centralized screening, randomization, in-home assessments, and follow-up. Its intervention arm involves 6–8 sessions of problem-solving therapy, in which older adults aged 60+ learn to break down problems that affect wellbeing and develop strategies to address them. We examined participation rates to assess quality of recruitment across sites and level of disability according to service use. Results Dep-ABC randomized 104 participants, 68.4% of eligible older adults. Screening using self-reported disability successfully netted a sample in which 74% received home care agency services, with remaining participants similarly impaired in structured self-reports of impairment and on observed performance tests. Conclusions Direct outreach to aging services providers is an effective way to identify older adults with service needs at high risk of major depression. Problem solving therapy is acceptable to this population and can be added to current services. PMID:26706911

77 FR 40693 - Bureau of Political-Military Affairs: Directorate of Defense Trade Controls; Notifications to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-10

..., including technical data, and defense services for the design, development, manufacture, production... support the design, manufacturing and delivery phases of the SES-8 Commercial Communications Satellite... design, manufacture, test, on-ground launch-site delivery, completion of in-orbit testing and long-term...

Study of short haul high-density V/STOL transportation systems. Volume 2: Appendices

NASA Technical Reports Server (NTRS)

Solomon, H. L.

1972-01-01

Essential supporting data to the short haul transportation study are presented. The specific appendices are arena characteristics, aerospace transportation analysis computer program, economics, model calibration, STOLport siting and services path selection, STOL schedule definition, tabulated California corridor results, and tabulated Midwest arena results.

75 FR 2836 - Schools and Libraries Universal Service Support Mechanism

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-19

... networking websites and in chat rooms and cyberbullying awareness and response, as required by the Protecting... interacting with other individuals on social networking Web sites and in chat rooms and cyberbullying... networking websites and in chat rooms and cyberbullying awareness and response. We seek comment on this...

77 FR 21587 - Bayer Cropscience, LP, Including On-Site Leased Workers From Jacobs PSG, Middough Associates, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

...., Digital Management Group, Mercury Air Group, Inc., Greenwood, and Professional Maintenance of Charleston... Solutions, Becht Engineering, Engineering Support Systems, Manufacturing Management Services, US Securities, WB Wells, Belcan, American Engineers, CH2M Hill Engineers, Inc., Digital Management Group, Mercury...

48 CFR 1837.110-70 - NASA solicitation provision and contract clauses.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false NASA solicitation... Contracts-General 1837.110-70 NASA solicitation provision and contract clauses. (a) The contracting officer... for on-site support services where emergency evacuations of the NASA installation may occur, e.g...

48 CFR 1837.110-70 - NASA solicitation provision and contract clauses.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false NASA solicitation... Contracts-General 1837.110-70 NASA solicitation provision and contract clauses. (a) The contracting officer... for on-site support services where emergency evacuations of the NASA installation may occur, e.g...

48 CFR 1837.110-70 - NASA solicitation provision and contract clauses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false NASA solicitation... Contracts-General 1837.110-70 NASA solicitation provision and contract clauses. (a) The contracting officer... for on-site support services where emergency evacuations of the NASA installation may occur, e.g...

48 CFR 1837.110-70 - NASA solicitation provision and contract clauses.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false NASA solicitation... Contracts-General 1837.110-70 NASA solicitation provision and contract clauses. (a) The contracting officer... for on-site support services where emergency evacuations of the NASA installation may occur, e.g...

48 CFR 1837.110-70 - NASA solicitation provision and contract clauses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true NASA solicitation provision...-General 1837.110-70 NASA solicitation provision and contract clauses. (a) The contracting officer shall...-site support services where emergency evacuations of the NASA installation may occur, e.g., snow...

An "Information Ecosystem" to meet the data requirements of the Long-Term Agroecosystem Research (LTAR)

USDA-ARS?s Scientific Manuscript database

USDA’s Long-Term Agroecosystem Research (LTAR) Network consists of 18 locations across the continental United States comprised of government, university and NGO supported sites. LTAR research on the sustainability of agricultural production and associated provision of ecosystem services relies upon ...

A Methodology for Enhancing Mobile Learning through Content Semantics

ERIC Educational Resources Information Center

Dimitrios, Glaroudis; Athanasios, Manitsaris; Isabella, Kotini

2013-01-01

Mobile learning is becoming increasingly popular. Educational web sites can be used as supporting learning tools for students who wish to supplement their knowledge without restrictions of time and place. The continuously increasing demand for enhanced remote and mobile services, as well as the difficulty in easily incorporating current learning…

Health Services Management Education On-Site at a Military Medical Center

ERIC Educational Resources Information Center

Williams, Stephen J.; Poss, W. Bradley; Cupp, Craig L.

2014-01-01

A cooperative educational program with the U.S. military is described to illustrate a unique opportunity that confronted a graduate healthcare management program. The resulting degree program supported the military's operational medical mission but also presented interesting and unexpected challenges resulting from the wars in Iraq and…

RNGR: A national resource for reforestation, restoration, and nursery professionals

Treesearch

Diane L. Haase; Jeremiah R. Pinto; R. Kasten Dumroese; George Hernandez; Bob Karrfalt; Ron Overton

2011-01-01

The Forest Service developed the national Reforestation, Nurseries, and Genetics Resources (RNGR) program to provide expert support to State, industrial, and private forest and conservation nurseries throughout the country. The RNGR program includes technical assistance to nurseries, research projects (to address seedling and field issues), and Internet sites. RNGR...

Genetics Home Reference: isolated growth hormone deficiency

MedlinePlus

... hormone deficiency type III Patient Support and Advocacy Resources (3 links) Human Growth Foundation Little People UK The MAGIC Foundation ... Reviewed : February 2012 Published : June 26, 2018 The resources on this site should not be used as a substitute ... Department of Health & Human Services National Institutes of Health National Library of ...

An Effective Risk Minimization Strategy Applied to an Outdoor Music Festival: A Multi-Agency Approach.

PubMed

Luther, Matt; Gardiner, Fergus; Lenson, Shane; Caldicott, David; Harris, Ryan; Sabet, Ryan; Malloy, Mark; Perkins, Jo

2018-04-01

Specific Event Identifiers a. Event type: Outdoor music festival. b. Event onset date: December 3, 2016. c. Location of event: Regatta Point, Commonwealth Park. d. Geographical coordinates: Canberra, Australian Capital Territory (ACT), Australia (-35.289002, 149.131957, 600m). e. Dates and times of observation in latitude, longitude, and elevation: December 3, 2016, 11:00-23:00. f. Response type: Event medical support. Abstract Introduction Young adult patrons are vulnerable to risk-taking behavior, including drug taking, at outdoor music festivals. Therefore, the aim of this field report is to discuss the on-site medical response during a music festival, and subsequently highlight observed strategies aimed at minimizing substance abuse harm. The observed outdoor music festival was held in Canberra (Australian Capital Territory [ACT], Australia) during the early summer of 2016, with an attendance of 23,008 patrons. First aid and on-site medical treatment data were gained from the relevant treatment area and service. The integrated first aid service provided support to 292 patients. Final analysis consisted of 286 patients' records, with 119 (41.6%) males and 167 (58.4%) females. Results from this report indicated that drug intoxication was an observed event issue, with 15 (5.1%) treated on site and 13 emergency department (ED) presentations, primarily related to trauma or medical conditions requiring further diagnostics. This report details an important public health need, which could be met by providing a coordinated approach, including a robust on-site medical service, accepting intrinsic risk-taking behavior. This may include on-site drug-checking, providing reliable information on drug content with associated education. Luther M , Gardiner F , Lenson S , Caldicott D , Harris R , Sabet R , Malloy M , Perkins J . An effective risk minimization strategy applied to an outdoor music festival: a multi-agency approach. Prehosp Disaster Med. 2018;33(2):220-224.

Federal Emergency Management Information System (FEMIS) system administration guide, version 1.4.5

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

Arp, J.A.; Burnett, R.A.; Carter, R.J.

The Federal Emergency Management Information Systems (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the US Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local areamore » network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication, data distribution, and notification functionality necessary to operate FEMIS in a networked, client/server environment. The UNIX server provides an Oracle relational database management system (RDBMS) services, ARC/INFO GIS (optional) capabilities, and basic file management services. PNNL developed utilities that reside on the server include the Notification Service, the Command Service that executes the evacuation model, and AutoRecovery. To operate FEMIS, the Application Software must have access to a site specific FEMIS emergency management database. Data that pertains to an individual EOC`s jurisdiction is stored on the EOC`s local server. Information that needs to be accessible to all EOCs is automatically distributed by the FEMIS database to the other EOCs at the site.« less

On-site fuel cell field test support program

NASA Astrophysics Data System (ADS)

Staniunas, J. W.; Merten, G. P.

1982-01-01

In order to assess the impact of grid connection on the potential market for fuel cell service, applications studies were conducted to identify the fuel cell operating modes and corresponding fuel cell sizing criteria which offer the most potential for initial commercial service. The market for grid-connected fuel cell service was quantified using United's market analysis program and computerized building data base. Electric and gas consumption data for 268 buildings was added to our surveyed building data file, bringing the total to 407 buildings. These buildings were analyzed for grid-isolated and grid-connected fuel cell service. The results of the analyses indicated that the nursing home, restaurant and health club building sectors offer significant potential for fuel cell service.

MilitaryKidsConnect: Web-based prevention services for military children.

PubMed

Blasko, Kelly A

2015-08-01

Military children often present with psychological health concerns related to their experience of deployments, reintegration, and frequent moves common in military life. MilitaryKidsConnect is a Department of Defense (DoD) Web site designed to enhance the coping of military children in the context of their military life experience. The purpose of this paper is to describe the development of the Web site as a resource that provides psychoeducation, coping strategies, and peer support to military children. (c) 2015 APA, all rights reserved).

Application service provider (ASP) financial models for off-site PACS archiving

NASA Astrophysics Data System (ADS)

Ratib, Osman M.; Liu, Brent J.; McCoy, J. Michael; Enzmann, Dieter R.

2003-05-01

For the replacement of its legacy Picture Archiving and Communication Systems (approx. annual workload of 300,000 procedures), UCLA Medical Center has evaluated and adopted an off-site data-warehousing solution based on an ASP financial with a one-time single payment per study archived. Different financial models for long-term data archive services were compared to the traditional capital/operational costs of on-site digital archives. Total cost of ownership (TCO), including direct and indirect expenses and savings, were compared for each model. Financial parameters were considered: logistic/operational advantages and disadvantages of ASP models versus traditional archiving systems. Our initial analysis demonstrated that the traditional linear ASP business model for data storage was unsuitable for large institutions. The overall cost markedly exceeds the TCO of an in-house archive infrastructure (when support and maintenance costs are included.) We demonstrated, however, that non-linear ASP pricing models can be cost-effective alternatives for large-scale data storage, particularly if they are based on a scalable off-site data-warehousing service and the prices are adapted to the specific size of a given institution. The added value of ASP is that it does not require iterative data migrations from legacy media to new storage media at regular intervals.

Strategies for more effective monitoring and evaluation systems in HIV programmatic scale-up in resource-limited settings: Implications for health systems strengthening.

PubMed

Nash, Denis; Elul, Batya; Rabkin, Miriam; Tun, May; Saito, Suzue; Becker, Mark; Nuwagaba-Biribonwoha, Harriet

2009-11-01

Program monitoring and evaluation (M&E) has the potential to be a cornerstone of health systems strengthening and of evidence-informed implementation and scale-up of HIV-related services in resource-limited settings. We discuss common challenges to M&E systems used in the rapid scale-up of HIV services as well as innovations that may have relevance to systems used to monitor, evaluate, and inform health systems strengthening. These include (1) Web-based applications with decentralized data entry and real-time access to summary reporting; (2) timely feedback of information to site and district staff; (3) site-level integration of traditionally siloed program area indicators; (4) longitudinal tracking of program and site characteristics; (5) geographic information systems; and (6) use of routinely collected aggregate data for epidemiologic analysis and operations research. Although conventionally used in the context of vertical programs, these approaches can form a foundation on which data relevant to other health services and systems can be layered, including prevention services, primary care, maternal-child health, and chronic disease management. Guiding principles for sustainable national M&E systems include country-led development and ownership, support for national programs and policies, interoperability, and employment of an open-source approach to software development.

Design of RCSS

PubMed Central

Strum, David P.; Vargas, Luis G.; May, Jerrold H.

1997-01-01

Abstract The plans for Resource Coordination for Surgical Services system (RCSS) incorporate a distributed objectbase with a coordinating server. User-centered information screens are customized for each geographic location in surgical services. User interfaces are designed to mimic paper lists and worksheets used by health care providers. Patient-specific and site-specific data will be entered and maintained by providers at each geographic location, but also rebroadcast and displayed for all providers. Although RCSS is primarily a communications system, it will also support review of surgical utilization and operative scheduling. PMID:9067878

Decision-making experiences of family members of older adults with moderate dementia towards community and residential care home services: a grounded theory study protocol.

PubMed

Le Low, Lisa Pau; Lam, Lai Wah; Fan, Kim Pong

2017-06-05

Caring and supporting older people with dementia have become a major public health priority. Recent reports have also revealed a diminishing number of family carers to provide dementia care in the future. Carers who are engaged in the caring role are known to bear significant psychological, practical and economic challenges as the disease advances over time. Seemingly, evidence indicates that the burden of care can be relieved by formal services. This study aims to explore decision-making experiences of family members of older adults with moderate dementia towards the use of community support (CS) and residential care home (RCH) services. A large multi-site constructivist grounded theory in a range of non-government organizations and a private aged home will frame this Hong Kong study. Purposive sampling will begin the recruitment of family members, followed by theoretical sampling. It is estimated that more than 100 family members using CS and RCH services will participate in an interview. The process of successive constant comparative analysis will be undertaken. The final product, a theory, will generate an integrated and comprehensive conceptual understanding which will explain the processes associated with decision-making of family members for dementia sufferers. Deeper understanding of issues including, but not exclusive to, service needs, expectations and hopes among family carers for improving service support to serve dementia sufferers in CS and RCH services will also be revealed. Importantly, this study seeks to illustrate the practical and strategic aspects of the theory and how it may be useful to transfer its applicability to various service settings to better support those who deliver formal and informal care to the dementia population.

Interoperable Data Access Services for NOAA IOOS

NASA Astrophysics Data System (ADS)

de La Beaujardiere, J.

2008-12-01

The Integrated Ocean Observing System (IOOS) is intended to enhance our ability to collect, deliver, and use ocean information. The goal is to support research and decision-making by providing data on our open oceans, coastal waters, and Great Lakes in the formats, rates, and scales required by scientists, managers, businesses, governments, and the public. The US National Oceanic and Atmospheric Administration (NOAA) is the lead agency for IOOS. NOAA's IOOS office supports the development of regional coastal observing capability and promotes data management efforts to increase data accessibility. Geospatial web services have been established at NOAA data providers including the National Data Buoy Center (NDBC), the Center for Operational Oceanographic Products and Services (CO-OPS), and CoastWatch, and at regional data provider sites. Services established include Open-source Project for a Network Data Access Protocol (OpenDAP), Open Geospatial Consortium (OGC) Sensor Observation Service (SOS), and OGC Web Coverage Service (WCS). These services provide integrated access to data holdings that have been aggregated at each center from multiple sources. We wish to collaborate with other groups to improve our service offerings to maximize interoperability and enhance cross-provider data integration, and to share common service components such as registries, catalogs, data conversion, and gateways. This paper will discuss the current status of NOAA's IOOS efforts and possible next steps.

Coral identity underpins architectural complexity on Caribbean reefs.

PubMed

Alvarez-Filip, Lorenzo; Dulvy, Nicholas K; Côte, Isabelle M; Watkinson, Andrew R; Gill, Jennifer A

2011-09-01

The architectural complexity of ecosystems can greatly influence their capacity to support biodiversity and deliver ecosystem services. Understanding the components underlying this complexity can aid the development of effective strategies for ecosystem conservation. Caribbean coral reefs support and protect millions of livelihoods, but recent anthropogenic change is shifting communities toward reefs dominated by stress-resistant coral species, which are often less architecturally complex. With the regionwide decline in reef fish abundance, it is becoming increasingly important to understand changes in coral reef community structure and function. We quantify the influence of coral composition, diversity, and morpho-functional traits on the architectural complexity of reefs across 91 sites at Cozumel, Mexico. Although reef architectural complexity increases with coral cover and species richness, it is highest on sites that are low in taxonomic evenness and dominated by morpho-functionally important, reef-building coral genera, particularly Montastraea. Sites with similar coral community composition also tend to occur on reefs with very similar architectural complexity, suggesting that reef structure tends to be determined by the same key species across sites. Our findings provide support for prioritizing and protecting particular reef types, especially those dominated by key reef-building corals, in order to enhance reef complexity.

Providing smoking cessation programs to homeless youth: the perspective of service providers.

PubMed

Shadel, William G; Tucker, Joan S; Mullins, Leslie; Staplefoote, Lynette

2014-10-01

There is almost no information available on cigarette smoking among homeless youth, whether they are currently receiving services for smoking cessation, and how to best help them quit. This paper presents data collected from a series of semi-structured telephone interviews with service providers from 23 shelters and drop-in centers serving homeless youth in Los Angeles County about their current smoking cessation programming, interest in providing smoking cessation services to their clients, potential barriers to providing this service, and ways to overcome these barriers. Results indicated that 84% of facilities did not offer smoking cessation services, although nearly all (91%) were interested in doing so. Barriers to implementing formal smoking cessation programs on site included lack of resources (e.g., money, personnel) to support the programs, staff training, and concern that smoking cessation may not be a high priority for homeless youth themselves. Overall, service providers seemed to prefer a less intensive smoking cessation program that could be delivered at their site by existing staff. Data from this formative needs assessment will be useful for developing and evaluating a smoking cessation treatment that could be integrated into the busy, complex environment that characterizes agencies that serve homeless youth. Copyright © 2014 Elsevier Inc. All rights reserved.

A Wide Area Risk Assessment Framework for Underwater Military Munitions Response

NASA Astrophysics Data System (ADS)

Holland, K. T.; Calantoni, J.

2017-12-01

Our objective was to develop a prototype statistical framework supporting Wide Area Assessment and Remedial Investigation decisions relating to the risk of unexploded ordnance and other military munitions concentrated in underwater environments. Decision making involving underwater munitions is inherently complex due to the high degree of uncertainty in the environmental conditions that force munitions responses (burial, decay, migration, etc.) and associated risks to the public. The prototype framework provides a consistent approach to accurately delineating contaminated areas at underwater munitions sites through the estimation of most probable concentrations. We adapted existing deterministic models and environmental data services for use within statistical modules that allowed the estimation of munition concentration given historic site information and environmental attributes. Ultimately this risk surface can be used to evaluate costs associated with various remediation approaches (e.g. removal, monitoring, etc.). Unfortunately, evaluation of the assessment framework was limited due to the lack of enduser data services from munition site managers. Of the 450 U.S. sites identified as having potential contamination with underwater munitions, assessment of available munitions information (including historic firing or disposal records, and recent ground-truth munitions samples) indicated very limited information in the databases. Example data types include the most probable munition types, approximate firing / disposal dates and locations, and any supportive munition survey or sampling results. However the overall technical goal to integrate trained statistical belief networks with detailed geophysical knowledge of sites, of sensors and of the underwater environment was demonstrated and should allow probabilistic estimates of the most likely outcomes and tradeoffs while managing uncertainty associated with military munitions response.

Medical Education in Decentralized Settings: How Medical Students Contribute to Health Care in 10 Sub-Saharan African Countries.

PubMed

Talib, Zohray; van Schalkwyk, Susan; Couper, Ian; Pattanaik, Swaha; Turay, Khadija; Sagay, Atiene S; Baingana, Rhona; Baird, Sarah; Gaede, Bernhard; Iputo, Jehu; Kibore, Minnie; Manongi, Rachel; Matsika, Antony; Mogodi, Mpho; Ramucesse, Jeremais; Ross, Heather; Simuyeba, Moses; Haile-Mariam, Damen

2017-12-01

African medical schools are expanding, straining resources at tertiary health facilities. Decentralizing clinical training can alleviate this tension. This study assessed the impact of decentralized training and contribution of undergraduate medical students at health facilities. Participants were from 11 Medical Education Partnership Initiative-funded medical schools in 10 African countries. Each school identified two clinical training sites-one rural and the other either peri-urban or urban. Qualitative and quantitative data collection tools were used to gather information about the sites, student activities, and staff perspectives between March 2015 and February 2016. Interviews with site staff were analyzed using a collaborative directed approach to content analysis, and frequencies were generated to describe site characteristics and student experiences. The clinical sites varied in level of care but were similar in scope of clinical services and types of clinical and nonclinical student activities. Staff indicated that students have a positive effect on job satisfaction and workload. Respondents reported that students improved the work environment, institutional reputation, and introduced evidence-based approaches. Students also contributed to perceived improvements in quality of care, patient experience, and community outreach. Staff highlighted the need for resources to support students. Students were seen as valuable resources for health facilities. They strengthened health care quality by supporting overburdened staff and by bringing rigor and accountability into the work environment. As medical schools expand, especially in low-resource settings, mobilizing new and existing resources for decentralized clinical training could transform health facilities into vibrant service and learning environments.

Emergency care provision at the 2009 Special Olympics Great Britain.

PubMed

Williamson, Timothy; Wheeler, Patrick; Stephens, Catherine; Ferguson, Mike

2013-05-01

The Special Olympics Great Britain (SOLGB) summer games 2009 were held in Leicester between 25 and 31 July. They involved 2413 athletes that were engaged in 21 different sports across 19 different locations. The onsite healthcare was provided by a specialist medical team. The hospital services available were at the local emergency department (ED) and the co-located urgent care centre (UCC). To assess the on-site provision required to support a large multisport event for people with learning disabilities and to ascertain the impact on the local hospital services. On-site consultations were documented on SOLGB medical record forms. Referrals to the local ED and UCC were identified from the SOLGB medical notes or from the ED/UCC attendance codes, as a specific code was applied to all patients related to the games. 581 on-site consultations were documented at SOLGB 2009, of which 95% of these were for athletes. 477 treatments were completed in total, of which 444 were undertaken on-site (93%). 20 people attended the ED; there were no documented attendances at the UCC. 17 of the 20 attendances at the ED were athletes competing. Allocation of the healthcare team was appropriate, with the exception of one sport, where a doctor was moved from a nearby event to consult on 13 occasions. Attendances to the local ED and UCC were minimal. Therefore, the model of on-site medical care that was used, which led to minimal impact on NHS resources, will support the arrangements of medical requirements at future SOLGB games.

Family Planning Supply Environment in Kinshasa, DRC: Survey Findings and Their Value in Advancing Family Planning Programming.

PubMed

Kayembe, Patrick; Babazadeh, Saleh; Dikamba, Nelly; Akilimali, Pierre; Hernandez, Julie; Binanga, Arsene; Bertrand, Jane T

2015-12-01

Modern contraceptive prevalence was 14.1% in 2007 in Kinshasa, the capital city of the Democratic Republic of the Congo (DRC). Yet virtually nothing was known about the family planning supply environment. Three surveys of health facilities were conducted in 2012, 2013, and 2014 to determine the number, spatial distribution, and attributes of sites providing family planning services. The 2012 and 2013 surveys aimed to identify the universe of family planning facilities while obtaining a limited set of data on "readiness" to provide family planning services (defined as having at least 3 modern methods, at least 1 person training in family planning in the last 3 years, and an information system to track distribution of products to clients) and output (measured by couple-years of protection, or CYP). In contrast, the 2014 survey, conducted under the umbrella of the Performance Monitoring and Accountability 2020 (PMA2020) project, was based on 2-stage cluster sampling. This article provides detailed analysis of the 2012 and 2013 surveys, including bivariate and multivariate analysis of correlates of readiness to provide services and of output. We identified 184 health facilities that reported providing at least 1 contraceptive method in 2012 and 395 facilities in 2013. The percentage of sites defined as "ready" to provide services increased from 44.1% in 2012 to 63.3% in 2013. For the 3-month period between January and March 2013, facilities distributed between 0 and 879.2 CYP (mean, 39.7). Nearly half (49%) of the CYP was attributable to implants, followed by IUDs (24%), CycleBeads (11%), and injectables (8%). In 2013, facilities supported by PEPFAR (n = 121) were more likely than other facilities to be rated as ready to provide services (P<.0001); however, PEPFAR-supported sites generated less CYP on average than sites supported by family planning implementing agencies (P<.0001). Multivariate analysis showed 3 variables were associated with CYP: type of health facility, length of time in operation, and number of contraceptive methods available. Clinics generated higher (3-month) CYP than hospitals and health centers by 65.3 and 61.5 units, respectively (P<.01). The mean CYP for facilities in operation for 4-6 years was 26.9 units higher (P<.05), and 50.2 units higher for those operating 7+ years (P<.01), than the reference group of facilities in operation for 1 year or less. For each additional method available at a facility, CYP increased by almost 8 units (P<.01). Findings from these surveys suggest that lack of physical access is not the defining reason for low contraceptive use in Kinshasa, although it is highly likely that other service-related factors contribute to low service utilization. The results contributed to increasing the momentum for family planning in the DRC in many ways, including mobilizing partners to increase contraceptive access and increasing donor investment in family planning in the DRC. © Kayembe et al.

Network Resources and Training Site at Elizabeth City State University

NASA Technical Reports Server (NTRS)

Hayden, Linda Bailey

1996-01-01

The format of the annual report follows the same format as the quarterly report. In the annual report Elizabeth City State University (ECSU) has included responses to the items listed in the 'Critique of Quarterly Report Summary, and the 'Technical Recommendations for Consideration to NRTS/ECSU'. A budget for FY96-97 is included requesting $500,000.00 to cover the operating expenses of the Network Resources Training Site (NRTS) and its current partners as outlined in the original grant. The final attachment is a proposal to expand the partnerships and services of the NRTS at ECSU. This proposal would increase the number of predominantly minority attended secondary schools that this NRTS services and to support participation of these secondary schools in the GLOBE, ATLAS and Skymath projects. The proposal would also make Bennett College a full partner in the NRTS and it would increase the networking funds available to Virginia State University (HBCU/MI partner). Funds to increase the NRTS staff size to support the new partners and extended services is included in the extension budget. The NRTS Office Staff provides training and technical expertise to all its partners. In the appendix of the report, you will find technical soundness questionnaires and campus LAN Diagrams for the HBCU/MI Partners.

Framework for experimenting with QoS for multimedia services

NASA Astrophysics Data System (ADS)

Chen, Deming; Colwell, Regis; Gelman, Herschel; Chrysanthis, Panos K.; Mosse, Daniel

1996-03-01

It has been recognized that an effective support for multimedia applications must provide Quality of Service (QoS) guarantees. Current methods propose to provide such QoS guarantees through coordinated network resource reservations. In our approach, we extend this idea providing system-wide QoS guarantees that consider the data manipulation and transformations needed in the intermediate and end sites of the network. Given a user's QoS requirements, multisegment virtual channels are established with the necessary communication and computation resources reserved for the timely, synchronized, and reliable delivery of the different datatypes. Such data originate in several distributed data repositories, are transformed at intermediate service stations into suitable formats for transportation and presentation, and are delivered to a viewing unit. In this paper, we first review NETWORLD, an architecture that provides such QoS guarantees and an interface for the specification and negotiation of user-level QoS requirements. Our user interface supports both expert and non- expert modes. We then describe how to map user-level QoS requirements into low-level system parameters, leading into a contract between the application and the network. The mapping considers various characteristics of the architectures (such as the hardware and software available at each source, destination, or intermediate site) as well as cost constraints.

Strategic plan for infrastructure optimization

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

Donley, C.D.

This document represents Fluor Daniel Hanford`s and DynCorp`s Tri-Cities Strategic Plan for Fiscal Years 1998--2002, the road map that will guide them into the next century and their sixth year of providing safe and cost effective infrastructure services and support to the Department of Energy (DOE) and the Hanford Site. The Plan responds directly to the issues raised in the FDH/DOE Critical Self Assessment specifically: (1) a strategy in place to give DOE the management (systems) and physical infrastructure for the future; (2) dealing with the barriers that exist to making change; and (3) a plan to right-size the infrastructuremore » and services, and reduce the cost of providing services. The Plan incorporates initiatives from several studies conducted in Fiscal Year 1997 to include: the Systems Functional Analysis, 200 Area Water Commercial Practices Plan, $ million Originated Cost Budget Achievement Plan, the 1OO Area Vacate Plan, the Railroad Shutdown Plan, as well as recommendations from the recently completed Review of Hanford Electrical Utility. These and other initiatives identified over the next five years will result in significant improvements in efficiency, allowing a greater portion of the infrastructure budget to be applied to Site cleanup. The Plan outlines a planning and management process that defines infrastructure services and structure by linking site technical base line data and customer requirements to work scope and resources. The Plan also provides a vision of where Site infrastructure is going and specific initiatives to get there.« less

The GMOS cyber(e)-infrastructure: advanced services for supporting science and policy.

PubMed

Cinnirella, S; D'Amore, F; Bencardino, M; Sprovieri, F; Pirrone, N

2014-03-01

The need for coordinated, systematized and catalogued databases on mercury in the environment is of paramount importance as improved information can help the assessment of the effectiveness of measures established to phase out and ban mercury. Long-term monitoring sites have been established in a number of regions and countries for the measurement of mercury in ambient air and wet deposition. Long term measurements of mercury concentration in biota also produced a huge amount of information, but such initiatives are far from being within a global, systematic and interoperable approach. To address these weaknesses the on-going Global Mercury Observation System (GMOS) project ( www.gmos.eu ) established a coordinated global observation system for mercury as well it retrieved historical data ( www.gmos.eu/sdi ). To manage such large amount of information a technological infrastructure was planned. This high-performance back-end resource associated with sophisticated client applications enables data storage, computing services, telecommunications networks and all services necessary to support the activity. This paper reports the architecture definition of the GMOS Cyber(e)-Infrastructure and the services developed to support science and policy, including the United Nation Environmental Program. It finally describes new possibilities in data analysis and data management through client applications.

A qualitative description of service providers' experiences of ethical issues in HIV care.

PubMed

Sabone, Motshedisi B; Mogobe, Keitshokile Dintle; Matshediso, Ellah; Shaibu, Sheila; Ntsayagae, Esther I; Corless, Inge B; Cuca, Yvette P; Holzemer, William L; Dawson-Rose, Carol; Baez, Solymar S Soliz; Rivero-Mendz, Marta; Webel, Allison R; Eller, Lucille Sanzero; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Wantland, Dean; Nicholas, Patrice K; Lingren, Teri; Portillo, Carmen J; Sefcik, Elizabeth; Long-Middleton, Ellen

2018-01-01

Managing HIV treatment is a complex multi-dimensional task because of a combination of factors such as stigma and discrimination of some populations who frequently get infected with HIV. In addition, patient-provider encounters have become increasingly multicultural, making effective communication and provision of ethically sound care a challenge. This article explores ethical issues that health service providers in the United States and Botswana encountered in their interaction with patients in HIV care. A descriptive qualitative design was used to collect data from health service providers and patients using focused group discussions. This article is based on responses from health service providers only. Participants and context: This article is based on 11 focused group discussions with a total sample of 71 service providers in seven US sites and one Botswana site. Ethical considerations: Ethical review boards at all the study sites reviewed the study protocol and approved it. Ethical review boards of the study's coordinating centers, Rutgers University and the University of California at San Francisco, also approved it. The study participants provided a written informed consent to participate. HIV service providers encountered ethical challenges in all the four Beauchamp and Childress' biomedical ethics of respect for patients' autonomy, beneficence, justice, and nonmaleficence. The finding that HIV service providers encounter ethical challenges in their interaction with patients is supported by prior studies. The ethical challenges are particularly prominent in multicultural care and resource-constrained care environments. Provision of HIV care is fraught with ethical challenges that tend to pose different issues depending on a given care environment. It is important that strong partnerships are developed among key stakeholders in HIV care. In addition, health service providers need to be provided with resources so they can provide quality and ethically sound care.

Improvement of force health protection through preventive medicine oversight of contractor support.

PubMed

Mower, Scott A

2009-01-01

Unprecedented numbers of contractors are used throughout the Iraq theater of operations to alleviate military manpower shortages. At virtually every major forward operating base, US-based contractors perform the preponderance of essential life support services. At more remote sites, local national contractors are increasingly relied upon to maintain chemical latrines, remove trash, deliver bulk water, and execute other janitorial functions. Vigorous oversight of contractor performance is essential to ensure services are delivered according to specified standards. Poor oversight can increase the risk of criminal activities, permit substandard performance, elevate disease and nonbattle injury rates, degrade morale, and diminish Soldier readiness. As the principal force health protection proponents in the Department of Defense, preventive medicine units must be tightly integrated into the oversight processes. This article defines the force health protection implications associated with service contracts and provide recommendations for strengthening preventive medicine's oversight role.

Breaking down barriers to eye care for Indigenous people: a new scheme for delivery of eye care in Victoria.

PubMed

Napper, Genevieve; Fricke, Tim; Anjou, Mitchell D; Jackson, A Jonathan

2015-09-01

This report describes the implementation of and outcomes from a new spectacle subsidy scheme and de-centralised care options for Aboriginal and Torres Strait Islander peoples in Victoria, Australia. The Victorian Aboriginal Spectacle Subsidy Scheme (VASSS) commenced in 2010, as an additional subsidy to the long-established Victorian Eyecare Service (VES). The Victorian Aboriginal Spectacle Subsidy Scheme aimed to improve access to and uptake of affordable spectacles and eye examinations by Indigenous Victorians. The scheme is overseen by a committee convened by the Victorian Government's Department of Health and Human Services and includes eye-health stakeholders from the Aboriginal community and government, not-for-profit, university and Aboriginal communities. Key features of the Victorian Aboriginal Spectacle Subsidy Scheme include reduced and certain patient co-payments of $10, expanded spectacle frame range, broadened eligibility and community participation in service design and implementation. We describe the services implemented by the Australian College of Optometry (ACO) in Victoria and their impact on access to eye-care services. In 2014, optometric services were available at 36 service sites across Victoria, including 21 Aboriginal Health Services (AHS) sites. Patient services have increased from 400 services per year in 2009, to 1,800 services provided in 2014. During the first three years of the Victorian Aboriginal Spectacle Subsidy Scheme program (2010 to 2013), 4,200 pairs of glasses (1,400 pairs per year) were provided. Further funding to 2016/17 will lift the number of glasses to be delivered to 6,600 pairs (1,650 per year). This compares to population projected needs of 2,400 pairs per year. Overcoming the barriers to using eye-care services by Indigenous people can be difficult and resource intensive; however the Victorian Aboriginal Spectacle Subsidy Scheme provides an example of positive outcomes achieved through carefully designed and targeted approaches that engender sector and stakeholder support. Sustained support for the Victorian Aboriginal Spectacle Subsidy Scheme at a level that meets population needs is an ongoing challenge. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

A time and motion study of Screening, Brief Intervention, and Referral to Treatment implementation in health-care settings.

PubMed

Cowell, Alexander J; Dowd, William N; Landwehr, Justin; Barbosa, Carolina; Bray, Jeremy W

2017-02-01

Screening and brief intervention for harmful substance use in medical settings is being promoted heavily in the United States. To justify service provision fiscally, the field needs accurate estimates of the number and type of staff required to provide services, and thus the time taken to perform activities used to deliver services. This study analyzed the time spent in activities for the component services of the substance misuse Screening, Brief Intervention and Referral to Treatment (SBIRT) program implemented in emergency departments, in-patient units and ambulatory clinics. Observers timed activities according to 18 distinct codes among SBIRT practitioners. Twenty-six US sites within four grantees. Five hundred and one practitioner-patient interactions; 63 SBIRT practitioners. Timing of practitioner activities. Delivery of component services of SBIRT. The mean (standard error) time to deliver services was 1:19 (0:06) for a pre-screen (n = 210), 4:28 (0:24) for a screen (n = 97) and 6:51 (0:38) for a brief intervention (n = 66). Estimates of service duration varied by setting. Overall, practitioners spent 40% of their time supporting SBIRT delivery to patients and 13% of their time delivering services. In the United States, support activities (e.g. reviewing the patient's chart, locating the patient, writing case-notes) for substance abuse Screening, Brief Intervention and Referral to Treatment require more staff time than delivery of services. Support time for screens and brief interventions in the emergency department/trauma setting was high compared with the out-patient setting. © 2017 Society for the Study of Addiction.

Are integrated HIV services less stigmatizing than stand-alone models of care? A comparative case study from Swaziland

PubMed Central

Church, Kathryn; Wringe, Alison; Fakudze, Phelele; Kikuvi, Joshua; Simelane, Dudu; Mayhew, Susannah H

2013-01-01

Introduction Integrating HIV with primary health services has the potential to reduce HIV-related stigma through delivering care in settings disassociated with HIV. This study investigated the relationship between integrated care and felt stigma. The study design was a comparative case study of four models of HIV care in Swaziland, ranging from fully integrated to fully stand-alone HIV care. Methods An exit survey (N=602) measured differences in felt stigma across model of care; the primary outcome “perception of HIV status exposure through clinic attendance” was analyzed using multivariable logistic regression. In-depth interviews (N=22) explored whether and how measured differences in stigma experiences were related to service integration. Results There were significant differences in perceived status exposure across models of care. After adjustment for potential confounding between sites, those at a partially integrated site and a partially stand-alone site had greater odds of perceived status exposure than those at the fully stand-alone site (aOR 3.33, 95% CI 1.98–5.60; and aOR 11.84, 95% CI 6.89–20.36, respectively). There was no difference between the fully stand-alone and the fully integrated clinic. Qualitative data suggested that many clients at HIV-only sites felt greater confidentiality knowing that those around them were positive, and support was gained from other HIV care clients. Confidentiality was maintained in various ways, even in stand-alone sites, through separate waiting areas for HIV testing and HIV treatment, and careful clinic and room labelling. Conclusions The relationship between model of care and stigma was complex, and the hypothesis that stigma is higher at stand-alone sites did not hold true in this high prevalence setting. Policy-makers should ensure that service integration does not increase stigma, in particular within partially integrated models of care. PMID:23336726

Tailoring Care to Vulnerable Populations by Incorporating Social Determinants of Health: the Veterans Health Administration's "Homeless Patient Aligned Care Team" Program.

PubMed

O'Toole, Thomas P; Johnson, Erin E; Aiello, Riccardo; Kane, Vincent; Pape, Lisa

2016-03-31

Although the clinical consequences of homelessness are well described, less is known about the role for health care systems in improving clinical and social outcomes for the homeless. We described the national implementation of a "homeless medical home" initiative in the Veterans Health Administration (VHA) and correlated patient health outcomes with characteristics of high-performing sites. We conducted an observational study of 33 VHA facilities with homeless medical homes and patient- aligned care teams that served more than 14,000 patients. We correlated site-specific health care performance data for the 3,543 homeless veterans enrolled in the program from October 2013 through March 2014, including those receiving ambulatory or acute health care services during the 6 months prior to enrollment in our study and 6 months post-enrollment with corresponding survey data on the Homeless Patient Aligned Care Team (H-PACT) program implementation. We defined high performance as high rates of ambulatory care and reduced use of acute care services. More than 96% of VHA patients enrolled in these programs were concurrently receiving VHA homeless services. Of the 33 sites studied, 82% provided hygiene care (on-site showers, hygiene kits, and laundry), 76% provided transportation, and 55% had an on-site clothes pantry; 42% had a food pantry and provided on-site meals or other food assistance. Six-month patterns of acute-care use pre-enrollment and post-enrollment for 3,543 consecutively enrolled patients showed a 19.0% reduction in emergency department use and a 34.7% reduction in hospitalizations. Three features were significantly associated with high performance: 1) higher staffing ratios than other sites, 1) integration of social supports and social services into clinical care, and 3) outreach to and integration with community agencies. Integrating social determinants of health into clinical care can be effective for high-risk homeless veterans.

Tailoring Care to Vulnerable Populations by Incorporating Social Determinants of Health: the Veterans Health Administration’s “Homeless Patient Aligned Care Team” Program

PubMed Central

Johnson, Erin E.; Aiello, Riccardo; Kane, Vincent; Pape, Lisa

2016-01-01

Introduction Although the clinical consequences of homelessness are well described, less is known about the role for health care systems in improving clinical and social outcomes for the homeless. We described the national implementation of a “homeless medical home” initiative in the Veterans Health Administration (VHA) and correlated patient health outcomes with characteristics of high-performing sites. Methods We conducted an observational study of 33 VHA facilities with homeless medical homes and patient- aligned care teams that served more than 14,000 patients. We correlated site-specific health care performance data for the 3,543 homeless veterans enrolled in the program from October 2013 through March 2014, including those receiving ambulatory or acute health care services during the 6 months prior to enrollment in our study and 6 months post-enrollment with corresponding survey data on the Homeless Patient Aligned Care Team (H-PACT) program implementation. We defined high performance as high rates of ambulatory care and reduced use of acute care services. Results More than 96% of VHA patients enrolled in these programs were concurrently receiving VHA homeless services. Of the 33 sites studied, 82% provided hygiene care (on-site showers, hygiene kits, and laundry), 76% provided transportation, and 55% had an on-site clothes pantry; 42% had a food pantry and provided on-site meals or other food assistance. Six-month patterns of acute-care use pre-enrollment and post-enrollment for 3,543 consecutively enrolled patients showed a 19.0% reduction in emergency department use and a 34.7% reduction in hospitalizations. Three features were significantly associated with high performance: 1) higher staffing ratios than other sites, 1) integration of social supports and social services into clinical care, and 3) outreach to and integration with community agencies. Conclusion Integrating social determinants of health into clinical care can be effective for high-risk homeless veterans. PMID:27032987

A landscape character assessment of three terraced areas in Campania region, Italy

NASA Astrophysics Data System (ADS)

Gravagnuolo, Antonia; Ronza, Maria; Di Martino, Ferdinando; De Rosa, Fortuna

2017-04-01

Agricultural terraces represent the territorial structure of many cultural landscapes in the Campania region, Italy. Historic urban/rural settlements and hydraulic-agrarian systems have been developed on mountains and hills, producing diverse cultural landscapes depending on the specific geological, pedological and geomorphological characteristics, which influenced the character and functions of terraces. These unique landscapes are multi-functional and provide many ecosystem services: provisioning (food, water retention, building materials); regulating and maintenance (hydrogeological stability, soil fertility, protection from soil erosion, maintenance of genetic diversity, habitat); cultural services (heritage and traditional knowledge conservation, tourism and recreation, spiritual experience, education, aesthetic quality). Three terraced landscapes in Campania are analysed, which present a rich diversity in the geological structure and formal/functional characteristics: the Roccamonfina vulcanic area, a highly fertile and lapillous soil; the Monte di Bulgheria, a clay-rich area; and finally the well-known UNESCO World Heritage site of the Amalfi Coast, a calcareous, steep rock faced area. A landscape character assessment of the three sites is processed, identifying the biophysical structure of the sites, natural systems and land use, and cultural and anthropic elements. Terraced landscapes in Campania can be regenerated, taking again an active social and economic role for the society, enhancing their multifunctionality as a key source of wellbeing. Ecosystem services are mapped and evaluated to assess benefits and costs in a multidimensional framework. Spatial analysis in GIS environment supports this process, providing a decision-support tool for mapping and assessment of terraced landscapes, to convert their actual and potential value into a resource of economic sustainable development.

Five years' experience in a (really) rural teleradiology practice. Was it worth it? The successes and the failures

NASA Astrophysics Data System (ADS)

Telepak, Robert J.; Freede, Emily; Jaramillo, Richard E.; Alverson, Dale C.

1998-07-01

During the past 5 years (1992 - 1997) the Department of Radiology of the University of New Mexico Health Sciences Center has developed an active teleradiology program. Contracts are in place to provide both routine and emergency image interpretations 24 hours per day, every day of the year. Several rural hospitals are served as well as the Navajo Indian Health Service. Areas of success: include significantly improved radiologic service to the rural sites, specialty consultations to general radiologists, successful teaching of teleradiology practice to radiology residents and staff, good diagnostic quality images, a small but real profit, improved quality assurance for the rural sites, and no significant medical-legal problems. Failures include: significant telecommunications problems, lack of acceptance and utilization by some of the rural sites, poor QA compliance by some sites, a long period of disappointing technical support by equipment vendors, and slow acceptance of DICOM by equipment manufacturers. The successes outweigh the failures. We would do it again -- but somewhat differently. We offer advice to institutions developing a new rural teleradiology operation.

A science-based, watershed strategy to support effective remediation of abandoned mine lands

USGS Publications Warehouse

Buxton, Herbert T.; Nimick, David A.; Von Guerard, Paul; Church, Stan E.; Frazier, Ann G.; Gray, John R.; Lipin, Bruce R.; Marsh, Sherman P.; Woodward, Daniel F.; Kimball, Briant A.; Finger, Susan E.; Ischinger, Lee S.; Fordham, John C.; Power, Martha S.; Bunch, Christine M.; Jones, John W.

1997-01-01

A U.S. Geological Survey Abandoned Mine Lands Initiative will develop a strategy for gathering and communicating the scientific information needed to formulate effective and cost-efficient remediation of abandoned mine lands. A watershed approach will identify, characterize, and remediate contaminated sites that have the most profound effect on water and ecosystem quality within a watershed. The Initiative will be conducted during 1997 through 2001 in two pilot watersheds, the Upper Animas River watershed in Colorado and the Boulder River watershed in Montana. Initiative efforts are being coordinated with the U.S. Forest Service, Bureau of Land Management, National Park Service, and other stakeholders which are using the resulting scientific information to design and implement remediation activities. The Initiative has the following eight objective-oriented components: estimate background (pre-mining) conditions; define baseline (current) conditions; identify target sites (major contaminant sources); characterize target sites and processes affecting contaminant dispersal; characterize ecosystem health and controlling processes at target sites; develop remediation goals and monitoring network; provide an integrated, quality-assured and accessible data network; and document lessons learned for future applications of the watershed approach.

Supporting Children's Mental Health in Schools: Teacher Views

ERIC Educational Resources Information Center

Graham, Anne; Phelps, Renata; Maddison, Carrie; Fitzgerald, Robyn

2011-01-01

Schools have increasingly been targeted as appropriate sites for mental health promotion and teachers are considered well placed to identify issues concerning students' social and emotional well-being. Whilst teachers are now expected to be responsive to a wide range of student needs and circumstances, they receive little in their pre-service and…

Federal IPM Programs - National Site for the Regional IPM Centers

Science.gov Websites

2012 Symposium 2015 Symposium USDA/NIFA NIFA advances knowledge for agriculture, the environment, human strengthen the Department's support for agriculture by helping to develop alternative pest management tools timely, accurate, and useful statistics in service to U. S. agriculture. NASS publications cover a wide

75 FR 1814 - Solicitation for a Cooperative Agreement-Curriculum Development: Training for Correctional...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-13

... services and programming that support the offenders' long term attachment to the labor force. DATES... Instructional Theory Into Practice (ITIP) model, to be written based on occupational documentation that includes... using NIC's Instructional Theory Into Practice (ITIP) model. This model can be found on NIC's Web site...

MAST

Science.gov Websites

Guide Related Sites submenu NASA Datacenters ADS HEASARC IRSA LAMBDA NED NSSDC MAST Services submenu Archive for Space Telescopes (MAST) is a NASA funded project to support and provide to the astronomical : STScI may provide links to Web pages that are not part of the STScI, AURA, NASA, or ESA domain. These

Project COMPUOCC.LEP, 1988-89. Evaluation Section Report [and] Executive Summary. OREA Report.

ERIC Educational Resources Information Center

Berney, Tomi D.; Velasquez, Clara

Project COMPUOCC.LEP, a Title VII-funded program of instructional and support services, served 400 Hispanic students of limited English proficiency with special handicapping conditions. It also served 36 special education teachers at 14 Bronx (New York) intermediate and junior high schools, offering on-site technical assistance in curriculum…

Sanford Maine Public Schools National Workplace Literacy Program. Performance Report. External Evaluator Report.

ERIC Educational Resources Information Center

Sanford Public Schools, ME.

A joint enterprise by Sanford Public Schools of Sanford, Maine, and five partners established and operated a program of literacy, math, and reasoning/problem-solving skills instruction and support services at five work sites. The business partners were Sprague Electric Company; The Baker Company; Jagger Brothers, Inc.; Greenwood Center; and…

Educational Scenarios with Smartphones in Cultural Heritage Sites and Environments

ERIC Educational Resources Information Center

Styliaras, Georgios; Koukopoulos, Dimitrios

2012-01-01

The needs of everyday life for communication and interactivity anywhere and at anytime have led to the tremendous development of mobile devices and applications. Nowadays, we want to have access to enhanced services with high quality at indoor and outdoor environments. Smartphone is a clever new media that supports interactivity and communication…

AERO: A decision support tool for wind erosion assessment in rangelands and croplands

USDA-ARS?s Scientific Manuscript database

Wind erosion is a key driver of global land degradation, with on- and off-site impacts on agricultural production, air quality, ecosystem services and climate. Measuring rates of wind erosion and dust emission across land use and land cover types is important for quantifying the impacts and identify...

Genetics Home Reference: short stature, hyperextensibility, hernia, ocular depression, Rieger anomaly, and teething ...

MedlinePlus

... syndrome Orphanet: SHORT syndrome Patient Support and Advocacy Resources (5 links) Human Growth Foundation Little People of America Little People ... Reviewed : December 2013 Published : June 26, 2018 The resources on this site should not be used as a ... Department of Health & Human Services National Institutes of Health National Library of ...

Observed Benefits to On-site Medical Services during an Annual 5-day Electronic Dance Music Event with Harm Reduction Services.

PubMed

Munn, Matthew Brendan; Lund, Adam; Golby, Riley; Turris, Sheila A

2016-04-01

With increasing attendance and media attention, large-scale electronic dance music events (EDMEs) are a subset of mass gatherings that have a unique risk profile for attendees and promoters. Shambhala Music Festival (Canada) is a multi-day event in a rural setting with a recognized history of providing harm reduction (HR) services alongside medical care. Study/Objective This manuscript describes the medical response at a multi-day electronic music festival where on-site HR interventions and dedicated medical care are delivered as parallel public health measures. This study was a descriptive case report. Medical encounters and event-related data were documented prospectively using an established event registry database. In 2014, Shambhala Music Festival had 67,120 cumulative attendees over a 7-day period, with a peak daily attendance of 15,380 people. There were 1,393 patient encounters and the patient presentation rate (PPR) was 20.8 per one thousand. The majority of these (90.9%) were for non-urgent complaints. The ambulance transfer rate (ATR) was 0.194 per one thousand and 0.93% of patient encounters were transferred by ambulance. No patients required intubation and there were no fatalities. Harm reduction services included mobile outreach teams, distribution of educational materials, pill checking facilities, a dedicated women's space, and a "Sanctuary" area that provided non-medical peer support for overwhelmed guests. More than 10,000 encounters were recorded by mobile and booth-based preventive and educational services, and 2,786 pills were checked on-site with a seven percent discard rate. Dedicated medical and HR services represent two complementary public health strategies to minimize risk at a multi-day electronic music festival. The specific extent to which HR strategies reduce the need for medical care is not well understood. Incorporation of HR practices when planning on-site medical care has the potential to inform patient management, reduce presentation rates and acuity, and decrease utilization and cost for local, community-based health services.

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

PubMed

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

2017-07-01

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

Transforming youth mental health services and supports in Ireland.

PubMed

Illback, Robert J; Bates, Tony

2011-02-01

Young people in the Republic of Ireland do not have access to appropriate mental health services and supports, necessitating transformational change in delivery systems. Describe ongoing development and change efforts facilitated by Headstrong--The National Centre for Youth Mental Health. Discusses findings from a national needs assessment, core strategies within the change initiative, progress in system-building, and preliminary descriptive and outcome data. Five demonstration sites comprised of four counties and a city neighbourhood are operational and preliminary data are promising with respect to implementation and outcomes. Effective change initiatives require vision and leadership, competence- and capacity-building, participative planning and engagement, adequate and thoughtfully deployed resources, and a comprehensive change management approach. © 2011 Blackwell Publishing Asia Pty Ltd.

Healthy Families America state systems development: an emerging practice to ensure program growth and sustainability.

PubMed

Friedman, Lori; Schreiber, Lisa

2007-01-01

In an era of fiscal constraints and increased accountability for social service programs, having a centralized and efficient infrastructure is critical. A well-functioning infrastructure helps a state reduce duplication of services, creates economies of scale, coordinates resources, supports high-quality site development and promotes the self-sufficiency and growth of community-based programs. Throughout the Healthy Families America home visitation network, both program growth and contraction have been managed by in-state collaborations, referred to as "state systems." This article explores the research base that supports the rationale for implementing state systems, describes the evolution of state systems for Healthy Families America, and discusses the benefits, challenges and lessons learned of utilizing a systems approach.

Consumer Health Informatics Aspects of Direct-to-Consumer Personal Genomic Testing.

PubMed

Gray, Kathleen; Stephen, Remya; Terrill, Bronwyn; Wilson, Brenda; Middleton, Anna; Tytherleigh, Rigan; Turbitt, Erin; Gaff, Clara; Savard, Jacqueline; Hickerton, Chriselle; Newson, Ainsley; Metcalfe, Sylvia

2017-01-01

This paper uses consumer health informatics as a framework to explore whether and how direct-to-consumer personal genomic testing can be regarded as a form of information which assists consumers to manage their health. It presents findings from qualitative content analysis of web sites that offer testing services, and of transcripts from focus groups conducted as part a study of the Australian public's expectations of personal genomics. Content analysis showed that service offerings have some features of consumer health information but lack consistency. Focus group participants were mostly unfamiliar with the specifics of test reports and related information services. Some of their ideas about aids to knowledge were in line with the benefits described on provider web sites, but some expectations were inflated. People were ambivalent about whether these services would address consumers' health needs, interests and contexts and whether they would support consumers' health self-management decisions and outcomes. There is scope for consumer health informatics approaches to refine the usage and the utility of direct-to-consumer personal genomic testing. Further research may focus on how uptake is affected by consumers' health literacy or by services' engagement with consumers about what they really want.

Factors shaping intersectoral action in primary health care services.

PubMed

Anaf, Julia; Baum, Fran; Freeman, Toby; Labonte, Ron; Javanparast, Sara; Jolley, Gwyn; Lawless, Angela; Bentley, Michael

2014-12-01

To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory. Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners. The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care. While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action. © 2014 Public Health Association of Australia.

The Hawke's Bay Condom Card Scheme: a qualitative study of the views of service providers on increased, discreet access for youth to free condoms.

PubMed

Ryder, Hollie; Aspden, Trudi; Sheridan, Janie

2015-12-01

The incidence of sexually transmitted infections and unplanned pregnancies in adolescence is of concern. The Hawke's Bay District Health Board, New Zealand, set up a pilot condom card scheme ('the Scheme') to allow 13- to 24-year-olds, deemed suitable for the Scheme, to access free condoms from pharmacies on presentation of a Condom Card. Our study explored the views of service providers of a pilot Condom Card Scheme. Qualitative interviews were conducted with 17 service providers (nurses, pharmacists, pharmacy staff) between February and April 2013. Our findings showed that the Scheme was viewed positively by service providers, who indicated almost universal support for the Scheme to continue. However, participants noted a perceived lack of advertising, low number of sites for collection of condoms, lack of flexibility of the Scheme's criteria relating to who could access the scheme and issues with some pharmacy service providers, all of which led to a number of recommendations for improving the Scheme. The views of service providers indicate broad support for the continuation of the Scheme. Canvassing young people's suggestions for improving the Scheme is also essential. © 2015 Royal Pharmaceutical Society.

Implementation of a DOD ELAP Conforming Quality System at a FUSRAP Site Field Temporary Radiological Screening Laboratory - 13500

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

Winters, M.S.; McElheny, G.; Houston, L.M.

2013-07-01

A case study is presented on specific program elements that supported the transition of a temporary field radiological screening lab to an accredited operation capable of meeting client quality objectives for definitive results data. The temporary field lab is located at the Formerly Utilized Sites Remedial Action Program Linde Site in Tonawanda, NY. The site is undergoing remediation under the direction of the United States Army Corps of Engineers - Buffalo District, with Cabrera Services Inc. as the remediation contractor and operator of the on-site lab. Analysis methods employed in the on-site lab include gross counting of alpha and betamore » particle activity on swipes and air filters and gamma spectroscopy of soils and other solid samples. A discussion of key program elements and lessons learned may help other organizations considering pursuit of accreditation for on-site screening laboratories. (authors)« less

Exercise training characteristics in cardiac rehabilitation programmes: a cross-sectional survey of Australian practice.

PubMed

Abell, Bridget; Glasziou, Paul; Briffa, Tom; Hoffmann, Tammy

2016-01-01

Exercise training is a core component of cardiac rehabilitation (CR), however, little information exists regarding the specific exercise interventions currently provided for coronary heart disease in Australian practice. We aimed to analyse the current status of exercise-based CR services across Australia. Cross-sectional survey. Australian sites offering exercise-based CR were identified from publically available directories. All sites were invited by email to participate in an online Survey Monkey questionnaire between October 2014 and March 2015, with reminders via email and phone follow-up. Questions investigated the demographics and format of individual programmes, as well as specific exercise training characteristics. 297 eligible programmes were identified, with an 82% response rate. Most sites (82%) were based at hospital or outpatient centres, with home (15%), community (18%) or gym-based options (5%) less common. While CR was most often offered in a comprehensive format (72% of sites), the level of exercise intervention varied greatly among programmes. Most frequently, exercise was prescribed 1-2 times per week for 60 min over 7 weeks. Almost one-quarter (24%) had a sole practitioner supervising exercise, although the majority used a nurse/physiotherapist combination. Low to moderate exercise intensities were used in 60% of programmes, however, higher intensity prescriptions were not uncommon. Few sites (<6%) made use of technology, such as mobile phones or the internet, to deliver or support exercise training. While advances have been made towards providing flexible and accessible exercise-based CR, much of Australia's service remains within traditional models of care. A continuing focus on service improvement and evidence-based care should, therefore, be considered a core aim of those providing exercise for CR in order to improve health service delivery and optimise outcomes for patients.

Improving older people's life satisfaction via social networking site use: Evidence from China.

PubMed

Zhou, Junjie

2018-03-01

This study aimed to examine the pathways by which social networking sites (SNSs) can improve older people's life satisfaction. We conducted an online survey in China that lasted eight weeks. Respondents were required to report their demographic characteristics and feelings regarding SNS use. Data were analysed using SPSS 20 and Amos 21. We collected 596 valid samples. The empirical results show that SNS use improves older people's life satisfaction by reducing their loneliness and improving their self-efficacy. Social support alleviates the negative effect of loneliness and enhances the positive effect of self-efficacy on life satisfaction. Sex differences and education differences were significant. Men and less educated people had higher levels of life satisfaction. Policymakers should offer support to SNSs targeting older people and encourage them to provide more useful services. SNS operators should encourage social support among older users and pay attention to sex differences and education differences. © 2018 AJA Inc.

The Launch Processing System for Space Shuttle.

NASA Technical Reports Server (NTRS)

Springer, D. A.

1973-01-01

In order to reduce costs and accelerate vehicle turnaround, a single automated system will be developed to support shuttle launch site operations, replacing a multiplicity of systems used in previous programs. The Launch Processing System will provide real-time control, data analysis, and information display for the checkout, servicing, launch, landing, and refurbishment of the launch vehicles, payloads, and all ground support systems. It will also provide real-time and historical data retrieval for management and sustaining engineering (test records and procedures, logistics, configuration control, scheduling, etc.).

Cabana Multi-User Spaceport Tour of KSC

NASA Image and Video Library

2017-02-17

Nancy Bray, director of Spaceport Integration and Services at NASA's Kennedy Space Center, speaks to members of the news media on the balcony of Operations Support Building II describing the site's transition from a primarily government-only facility to a premier, multi-user spaceport. In the background is the Vehicle Assembly Building (VAB). Modifications were recently completed in the VAB where new work platforms were installed to support processing of NASA's Space Launch System rocket designed to send the Orion spacecraft on missions beyond low-Earth orbit.

Ethics Review for a Multi-Site Project Involving Tribal Nations in the Northern Plains.

PubMed

Angal, Jyoti; Petersen, Julie M; Tobacco, Deborah; Elliott, Amy J

2016-04-01

Increasingly, Tribal Nations are forming ethics review panels, which function separately from institutional review boards (IRBs). The emergence of strong community representation coincides with a widespread effort supported by the U.S. Department of Health & Human Services and other federal agencies to establish a single IRB for all multi-site research. This article underscores the value of a tribal ethics review board and describes the tribal oversight for the Safe Passage Study-a multi-site, community-based project in the Northern Plains. Our experience demonstrates the benefits of tribal ethics review and makes a strong argument for including tribal oversight in future regulatory guidance for multi-site, community-based research. © The Author(s) 2016.

Assessing the quality of infertility resources on the World Wide Web: tools to guide clients through the maze of fact and fiction.

PubMed

Okamura, Kyoko; Bernstein, Judith; Fidler, Anne T

2002-01-01

The Internet has become a major source of health information for women, but information placed on the World Wide Web does not routinely undergo a peer review process before dissemination. In this study, we present an analysis of 197 infertility-related Web sites for quality and accountability, using JAMA's minimal core standards for responsible print. Only 2% of the web sites analyzed met all four recommended standards, and 50.8% failed to report any of the four. Commercial web sites were more likely to fail to meet minimum standards (71.2%) than those with educational (46.8%) or supportive (29.8%) elements. Web sites with educational and informational components were most common (70.6%), followed by commercial sites (52.8%) and sites that offered a forum for infertility support and activism (28.9%). Internet resources available to infertile patients are at best variable. The current state of infertility-related materials on the World Wide Web offers unprecedented opportunities to improve services to a growing number of e-health users. Because of variations in quality of site content, women's health clinicians must assume responsibility for a new role as information monitor. This study provides assessment tools clinicians can apply and share with clients.

Overview for Attached Payload Accommodations and Environments

NASA Technical Reports Server (NTRS)

Schaffer, Craig; Cook, Gene; Nabizadeh, Rodney; Phillion, James

2007-01-01

External payload accommodations are provided at attach sites on the U.S provided ELC, U.S. Truss, the Japanese Experiment Module Exposed Facility (JEM EF) and the Columbus EPF (External Payload Facilities). The Integrated Truss Segment (ITS) provides the backbone structure for the ISS. It attaches the solar and thermal control arrays to the rest of the complex, and houses cable distribution trays Extravehicular Activity (EVA) support equipment such as handholds and lighting; and providing for Extravehicular Robotic (EVR) accommodations using the Mobile Servicing System (MSS). It also provides logistics and maintenance, and payload attachment sites. The attachment sites accommodate logistics and maintenance and payloads carriers, zenith and nadir. The JEM-EF, a back porch-like attachment to the JEM Pressurized Module, accommodates up to eight payloads, which can be serviced by the crew via the JEM PM's airlock and dedicated robotic arm. The Columbus-EPF is another porch-like platform that can accommodate two zenith and two nadir looking payloads.

Estimating the Economic Value of National Parks with Count Data Models Using On-Site, Secondary Data: The Case of the Great Sand Dunes National Park and Preserve

NASA Astrophysics Data System (ADS)

Heberling, Matthew T.; Templeton, Joshua J.

2009-04-01

We estimate an individual travel cost model for Great Sand Dunes National Park and Preserve (GSD) in Colorado using on-site, secondary data. The purpose of the on-site survey was to help the National Park Service better understand the visitors of GSD; it was not intended for a travel cost model. Variables such as travel cost and income were estimated based on respondents’ Zip Codes. Following approaches found in the literature, a negative binomial model corrected for truncation and endogenous stratification fit the data the best. We estimate a recreational benefit of U.S. 89/visitor/year or U.S. 54/visitor/24-h recreational day (in 2002 U.S. ). Based on the approach presented here, there are other data sets for national parks, preserves, and battlefields where travel cost models could be estimated and used to support National Park Service management decisions.

NASA Integrated Space Communications Network

NASA Technical Reports Server (NTRS)

Tai, Wallace; Wright, Nate; Prior, Mike; Bhasin, Kul

2012-01-01

The NASA Integrated Network for Space Communications and Navigation (SCaN) has been in the definition phase since 2010. It is intended to integrate NASA s three existing network elements, i.e., the Space Network, Near Earth Network, and Deep Space Network, into a single network. In addition to the technical merits, the primary purpose of the Integrated Network is to achieve a level of operating cost efficiency significantly higher than it is today. Salient features of the Integrated Network include (a) a central system element that performs service management functions and user mission interfaces for service requests; (b) a set of common service execution equipment deployed at the all stations that provides return, forward, and radiometric data processing and delivery capabilities; (c) the network monitor and control operations for the entire integrated network are conducted remotely and centrally at a prime-shift site and rotating among three sites globally (a follow-the-sun approach); (d) the common network monitor and control software deployed at all three network elements that supports the follow-the-sun operations.

Outcomes and Cost-Effectiveness of Integrating HIV and Nutrition Service Delivery: Pilots in Malawi and Mozambique.

PubMed

Bergmann, Julie N; Legins, Kenneth; Sint, Tin Tin; Snidal, Sarah; Amor, Yanis Ben; McCord, Gordon C

2017-03-01

This paper provides the first estimates of impact and cost-effectiveness for integrated HIV and nutrition service delivery in sub-Saharan Africa. HIV and undernutrition are synergistic co-epidemics impacting millions of children throughout the region. To alleviate this co-epidemic, UNICEF supported small-scale pilot programs in Malawi and Mozambique that integrated HIV and nutrition service delivery. We use trends from integration sites and comparison sites to estimate the number of lives saved, infections averted and/or undernutrition cases cured due to programmatic activities, and to estimate cost-effectiveness. Results suggest that Malawi's program had a cost-effectiveness of $11-29/DALY, while Mozambique's was $16-59/DALY. Some components were more effective than others ($1-4/DALY for Malawi's Male motivators vs. $179/DALY for Mozambique's One stop shops). These results suggest that integrating HIV and nutrition programming leads to a positive impact on health outcomes and should motivate additional work to evaluate impact and determine cost-effectiveness using an appropriate research design.

Paediatric International Nursing Study: using person-centred key performance indicators to benchmark children's services.

PubMed

McCance, Tanya; Wilson, Val; Kornman, Kelly

2016-07-01

The aim of the Paediatric International Nursing Study was to explore the utility of key performance indicators in developing person-centred practice across a range of services provided to sick children. The objective addressed in this paper was evaluating the use of these indicators to benchmark services internationally. This study builds on primary research, which produced indicators that were considered novel both in terms of their positive orientation and use in generating data that privileges the patient voice. This study extends this research through wider testing on an international platform within paediatrics. The overall methodological approach was a realistic evaluation used to evaluate the implementation of the key performance indicators, which combined an integrated development and evaluation methodology. The study involved children's wards/hospitals in Australia (six sites across three states) and Europe (seven sites across four countries). Qualitative and quantitative methods were used during the implementation process, however, this paper reports the quantitative data only, which used survey, observations and documentary review. The findings demonstrate the quality of care being delivered to children and their families across different international sites. The benchmarking does, however, highlight some differences between paediatric and general hospitals, and between the different key performance indicators across all the sites. The findings support the use of the key performance indicators as a novel method to benchmark services internationally. Whilst the data collected across 20 paediatric sites suggest services are more similar than different, benchmarking illuminates variations that encourage a critical dialogue about what works and why. The transferability of the key performance indicators and measurement framework across different settings has significant implications for practice. The findings offer an approach to benchmarking and celebrating the successes within practice, while learning from partners across the globe in further developing person-centred cultures. © 2016 John Wiley & Sons Ltd.

The National Wind Erosion Research Network: Building a standardized long-term data resource for aeolian research, modeling and land management

USGS Publications Warehouse

Webb, Nicholas P.; Herrick, Jeffrey E.; Van Zee, Justin W; Courtright, Ericha M; Hugenholtz, Ted M; Zobeck, Ted M; Okin, Gregory S.; Barchyn, Thomas E; Billings, Benjamin J; Boyd, Robert A.; Clingan, Scott D; Cooper, Brad F; Duniway, Michael C.; Derner, Justin D.; Fox, Fred A; Havstad, Kris M.; Heilman, Philip; LaPlante, Valerie; Ludwig, Noel A; Metz, Loretta J; Nearing, Mark A; Norfleet, M Lee; Pierson, Frederick B; Sanderson, Matt A; Sharrat, Brenton S; Steiner, Jean L; Tatarko, John; Tedela, Negussie H; Todelo, David; Unnasch, Robert S; Van Pelt, R Scott; Wagner, Larry

2016-01-01

The National Wind Erosion Research Network was established in 2014 as a collaborative effort led by the United States Department of Agriculture’s Agricultural Research Service and Natural Resources Conservation Service, and the United States Department of the Interior’s Bureau of Land Management, to address the need for a long-term research program to meet critical challenges in wind erosion research and management in the United States. The Network has three aims: (1) provide data to support understanding of basic aeolian processes across land use types, land cover types, and management practices, (2) support development and application of models to assess wind erosion and dust emission and their impacts on human and environmental systems, and (3) encourage collaboration among the aeolian research community and resource managers for the transfer of wind erosion technologies. The Network currently consists of thirteen intensively instrumented sites providing measurements of aeolian sediment transport rates, meteorological conditions, and soil and vegetation properties that influence wind erosion. Network sites are located across rangelands, croplands, and deserts of the western US. In support of Network activities, http://winderosionnetwork.org was developed as a portal for information about the Network, providing site descriptions, measurement protocols, and data visualization tools to facilitate collaboration with scientists and managers interested in the Network and accessing Network products. The Network provides a mechanism for engaging national and international partners in a wind erosion research program that addresses the need for improved understanding and prediction of aeolian processes across complex and diverse land use types and management practices.

Professional and collegiate team assistance programs: services and utilization patterns.

PubMed

McDuff, David R; Morse, Eric D; White, Robert K

2005-10-01

Elite professional and collegiate athletes underuse stress control, mental health, and substance abuse treatment services. Behavioral health services use can be increased by establishing on-site, sports-specific services. Like Employee Assistance Programs of industry and government, Team Assistance Programs (TAPs) address critical issues such as substance abuse prevention, tobacco cessation, stress recognition, mental illness management, injury rehabilitation, performance enhancement, and cultural support. Strong links with the team's medical and conditioning staff can ensure a steady stream of TAP referrals and build trust with players and team staff. This article describes nine years of operation for two professional TAPs and three years for one college TAP. Use patterns and linkage strategies with team physicians, trainers, strength staff, chiropractors, and nutritionists are discussed.

Economic, Labor, and Regulatory Moderators of the Effect of Individual Placement and Support Among People With Severe Mental Illness: A Systematic Review and Meta-analysis.

PubMed

Metcalfe, Justin D; Drake, Robert E; Bond, Gary R

2018-01-13

As Individual Placement and Support (IPS) has become the international standard for vocational rehabilitation of adults with serious mental illness, researchers must consider the relationship between IPS and local environments. This meta-analysis used mixed-effects meta-regressions to assess the impact of site-level moderators on the likelihood that IPS recipients, compared with recipients of alternative vocational services, achieved competitive employment. Potential moderators included change in gross domestic product (GDP), local unemployment and unionization rates, and indices describing employment protection regulations, level of disability benefits compensation, and efforts to integrate people with disabilities into the workforce. Regulatory moderators represent facilitators and barriers to employment that may reinforce or detract from the effectiveness of IPS. Across 30 sites drawn from 21 randomized controlled trials in 12 countries (33% in the United States), IPS recipients were 2.31 (95% CI 1.99-2.69) times more likely to find competitive employment than recipients of alternative vocational rehabilitation services. The significant competitive-employment rate advantage of IPS over control services increased in the presence of weaker employment protection legislation and integration efforts, and less generous disability benefits. Policy makers should recognize and account for the fact that labor and disability regulations can create an arrangement of incentives that reduces the relative efficacy of supported employment. © The Author(s) 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Shielding and Activation Analyses for BTF Facility at SNS

NASA Astrophysics Data System (ADS)

Popova, Irina; Gallmeier, Franz X.

2017-09-01

The beam test facility (BTF), which simulates front end of the Spallation Neutron Source (SNS), has been built at the SNS, and is preparing for commissioning. The BTF has been assembled and will operate in one of service buildings at the site. The 2.5 MeV proton beam, produced in the facility, will be stopped in the beam dump. In order to support BTF project from radiation protection site, neutronics simulations and activation analyses were performed to evaluate the necessary shielding around the facility and radionuclide inventory of the beam stop.

Improving the management and care of refugees in Australian hospitals: a descriptive study.

PubMed

Ross, Lindsey; Harding, Catherine; Seal, Alexa; Duncan, Geraldine

2016-01-01

Objectives The aim of the present study was to investigate healthcare provider perceptions of the impact of refugee patients at two public hospitals, one rural and one urban, in designated refugee resettlement areas. Healthcare professionals' views regarding improvements that could be made in this area were also sought. Methods Two-page anonymous questionnaires containing demographic, quantitative and open-ended questions were distributed to 150 healthcare providers at each research site. Results Response rates at the rural and urban sites were 50% and 49%, respectively. Refugees were seen at least monthly by 40% of respondents. Additional support was requested by 70% of respondents. Confidence was associated with being born overseas (P=0.029) and increased time working with refugees (r s =0.418, P<0.001). Only 47% of respondents felt confident managing social and psychological needs of refugees. Midwives saw refugees more than nursing and allied healthcare staff combined, and this was significant at the rural hospital (P<0.001). Rural respondents reported that working with refugees enhanced their practice (P=0.025), although felt significantly less confident (P<0.001) than urban respondents. Themes that arose regarding barriers to care included language and cultural barriers, paucity of knowledge and issues accessing available services, including appropriate interpreters, Medicare eligibility and patient factors, including lack of patient trust in government systems. Desire for support was more pronounced in the rural setting (P=0.001). Conclusions Refugees were seen frequently in both settings and most respondents requested additional support, highlighting that caring for refugees in Australian hospitals is a significant challenge. Additional support and education should be targeted to those caring for refugees most frequently, particularly midwifery services, to reduce barriers to care. What is known about the topic? Refugees are a vulnerable group, often with complex health needs. These needs are often unmet because of issues including language and cultural barriers. What does this paper add? Refugees were seen frequently in the two public hospital settings involved in the present study and most often by midwifery services. Healthcare professionals require more support, more information about available services and better access to interpreter services. These issues were more pronounced in the rural setting where very limited research exists. What are the implications for practitioners? Implementing additional support and education regarding refugee health needs could increase knowledge and confidence when managing refugees, reducing barriers to care and improving quality of care.

Providers' and Administrators' Perceptions of Complementary and Integrative Health Practices Across the Veterans Health Administration

PubMed Central

Mitchinson, Allison R.; Trumble, Erika; Hinshaw, Daniel B.; Dusek, Jeffery A.

2017-01-01

Abstract Objectives: Use of complementary and integrative health (CIH) therapies is being promoted by the Veterans Health Administration (VA), but promotion may not equate to adoption. The purpose of this study was to explore whether perceptions regarding CIH at one VA medical center (VAMC) were similar to perceptions from a sample of other VAMCs. Design: This article reports a subset of qualitative findings from a mixed-methods study. Setting/Participants: Sites were recruited through a VA-wide CIH listserver. On the basis of site description (e.g., therapies offered, interest in CIH), sustained site interest, and geographic location, recorded interviews of 22 persons were conducted at 6 sites across the country. Outcome measures: Interviewees were asked the same questions as the single-site VAMC study respondents. Results: Variable access to CIH services across the VA created the need for workarounds. Multiple barriers (e.g., limited space and challenging credentialing) and facilitators (e.g., strong champion and high veteran demand) were cited. Respondents described nonpharmacologic pain control, the usefulness in treating mental health and/or post-traumatic stress disorder issues, and improvement of staff morale as additional reasons to promote CIH. Findings confirmed those from the earlier single-site VAMC phase of the study. Even the highest-performing sites reported struggling to meet veterans' demands for delivery of CIH. Conclusions: Almost half of active-duty military personnel report the use of at least one type of CIH therapy. As active-duty personnel transition to veteran status, both their physical and mental healthcare needs can potentially benefit from CIH therapies. The VA must actively support local enthusiastic CIH proponents and receive congressional support if it is to actually meet its stated goal of providing personalized, proactive, patient-driven healthcare through the promotion of comprehensive CIH services to veterans. PMID:27925776

Nutrition in primary health care: using a Delphi process to design new interdisciplinary services.

PubMed

Brauer, Paula; Dietrich, Linda; Davidson, Bridget

2006-01-01

A modified Delphi process was used to identify key features of interdisciplinary nutrition services, including provider roles and responsibilities for Ontario Family Health Networks (FHNs), a family physician-based type of primary care. Twenty-three representatives from interested professional organizations, including three FHN demonstration sites, completed a modified Delphi process. Participants reviewed evidence from a systematic literature review, a patient survey, a costing analysis, and key informant interview results before undertaking the Delphi process. Statements describing various options for services were developed at an in-person meeting, which was followed by two rounds of e-mail questionnaires. Teleconference discussions were held between rounds. An interdisciplinary model with differing and complementary roles for health care providers emerged from the process. Additional key features addressing screening for nutrition problems, health promotion and disease prevention, team collaboration, planning and evaluation, administrative support, access to care, and medical directives/delegated acts were identified. Under the proposed model, the registered dietitian is the team member responsible for managing all aspects of nutrition services, from needs assessment to program delivery, as well as for supporting all providers' nutrition services. The proposed interdisciplinary nutrition services model merits evaluation of cost, effectiveness, applicability, and sustainability in team-based primary care service settings.

Comprehensive Calibration and Validation Site for Information Remote Sensing

NASA Astrophysics Data System (ADS)

Li, C. R.; Tang, L. L.; Ma, L. L.; Zhou, Y. S.; Gao, C. X.; Wang, N.; Li, X. H.; Wang, X. H.; Zhu, X. H.

2015-04-01

As a naturally part of information technology, Remote Sensing (RS) is strongly required to provide very precise and accurate information product to serve industry, academy and the public at this information economic era. To meet the needs of high quality RS product, building a fully functional and advanced calibration system, including measuring instruments, measuring approaches and target site become extremely important. Supported by MOST of China via national plan, great progress has been made to construct a comprehensive calibration and validation (Cal&Val) site, which integrates most functions of RS sensor aviation testing, EO satellite on-orbit caration and performance assessment and RS product validation at this site located in Baotou, 600km west of Beijing. The site is equipped with various artificial standard targets, including portable and permanent targets, which supports for long-term calibration and validation. A number of fine-designed ground measuring instruments and airborne standard sensors are developed for realizing high-accuracy stepwise validation, an approach in avoiding or reducing uncertainties caused from nonsynchronized measurement. As part of contribution to worldwide Cal&Val study coordinated by CEOS-WGCV, Baotou site is offering its support to Radiometric Calibration Network of Automated Instruments (RadCalNet), with an aim of providing demonstrated global standard automated radiometric calibration service in cooperation with ESA, NASA, CNES and NPL. Furthermore, several Cal&Val campaigns have been performed during the past years to calibrate and validate the spaceborne/airborne optical and SAR sensors, and the results of some typical demonstration are discussed in this study.

Developing a Virtual Network of Research Observatories

NASA Astrophysics Data System (ADS)

Hooper, R. P.; Kirschtl, D.

2008-12-01

The hydrologic community has been discussing the concept of a network of observatories for the advancement of hydrologic science in areas of scaling processes, in testing generality of hypotheses, and in examining non-linear couplings between hydrologic, biotic, and human systems. The Consortium of Universities for the Advancement of Hydrologic Science, Inc. (CUAHSI) is exploring the formation of a virtual network of observatories, formed from existing field studies without regard to funding source. Such a network would encourage sharing of data, metadata, field methods, and data analysis techniques to enable multidisciplinary synthesis, meta-analysis, and scientific collaboration in hydrologic and environmental science and engineering. The virtual network would strive to provide both the data and the environmental context of the data through advanced cyberinfrastructure support. The foundation for this virtual network is Water Data Services that enable the publication of time-series data collected at fixed points using a services-oriented architecture. These publication services, developed in the CUAHSI Hydrologic Information Systems project, permit the discovery of data from both academic and government sources through a single portal. Additional services under consideration are publication of geospatial data sets, immersive environments based upon site digital elevation models, and a common web portal to member sites populated with structured data about the site (such as land use history and geologic setting) to permit understanding the environmental context of the data being shared.

7 CFR 1924.115 - Single Family Housing site evaluation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Single Family Housing site evaluation. 1924.115... SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT... Work § 1924.115 Single Family Housing site evaluation. (a) Site review. The site approval official will...

Generic, Extensible, Configurable Push-Pull Framework for Large-Scale Science Missions

NASA Technical Reports Server (NTRS)

Foster, Brian M.; Chang, Albert Y.; Freeborn, Dana J.; Crichton, Daniel J.; Woollard, David M.; Mattmann, Chris A.

2011-01-01

The push-pull framework was developed in hopes that an infrastructure would be created that could literally connect to any given remote site, and (given a set of restrictions) download files from that remote site based on those restrictions. The Cataloging and Archiving Service (CAS) has recently been re-architected and re-factored in its canonical services, including file management, workflow management, and resource management. Additionally, a generic CAS Crawling Framework was built based on motivation from Apache s open-source search engine project called Nutch. Nutch is an Apache effort to provide search engine services (akin to Google), including crawling, parsing, content analysis, and indexing. It has produced several stable software releases, and is currently used in production services at companies such as Yahoo, and at NASA's Planetary Data System. The CAS Crawling Framework supports many of the Nutch Crawler's generic services, including metadata extraction, crawling, and ingestion. However, one service that was not ported over from Nutch is a generic protocol layer service that allows the Nutch crawler to obtain content using protocol plug-ins that download content using implementations of remote protocols, such as HTTP, FTP, WinNT file system, HTTPS, etc. Such a generic protocol layer would greatly aid in the CAS Crawling Framework, as the layer would allow the framework to generically obtain content (i.e., data products) from remote sites using protocols such as FTP and others. Augmented with this capability, the Orbiting Carbon Observatory (OCO) and NPP (NPOESS Preparatory Project) Sounder PEATE (Product Evaluation and Analysis Tools Elements) would be provided with an infrastructure to support generic FTP-based pull access to remote data products, obviating the need for any specialized software outside of the context of their existing process control systems. This extensible configurable framework was created in Java, and allows the use of different underlying communication middleware (at present, both XMLRPC, and RMI). In addition, the framework is entirely suitable in a multi-mission environment and is supporting both NPP Sounder PEATE and the OCO Mission. Both systems involve tasks such as high-throughput job processing, terabyte-scale data management, and science computing facilities. NPP Sounder PEATE is already using the push-pull framework to accept hundreds of gigabytes of IASI (infrared atmospheric sounding interferometer) data, and is in preparation to accept CRIMS (Cross-track Infrared Microwave Sounding Suite) data. OCO will leverage the framework to download MODIS, CloudSat, and other ancillary data products for use in the high-performance Level 2 Science Algorithm. The National Cancer Institute is also evaluating the framework for use in sharing and disseminating cancer research data through its Early Detection Research Network (EDRN).

78 FR 23983 - Endangered and Threatened Wildlife and Plants; Threatened Status for Eriogonum codium

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-23

... substrates that support these and other rare endemic plants (see Species Information sections) within the... large-scale rare plant surveys on the Hanford Site that were initiated in 1994 by TNC and the DOE, as... Service 50 CFR Part 17 Endangered and Threatened Wildlife and Plants; Threatened Status for Eriogonum...

National Information Clearinghouse on Children Who Are Deaf-Blind (DB-LINK). National Resource Directory.

ERIC Educational Resources Information Center

National Information Clearinghouse on Children Who Are Deaf-Blind, Monmouth, OR.

This resource guide, consisting of pages downloaded from the DB-LINK Web site, is designed to assist parents, professionals, and others in identifying services that hold the potential for supporting and improving the lives of children and youth who experience combined vision and hearing loss. Information is provided on: (1) the American…

Project EXCEL. Final Performance Report, March 1, 1991-October 31, 1992.

ERIC Educational Resources Information Center

Career Resources Development Center, Inc., San Francisco, CA.

Project EXCEL is a workplace literacy project involving four small business enterprises in San Francisco. Over a 19-month period, the project focused on literacy and basic skills training for 271 limited-English-proficient (LEP) workers. All training was conducted at the work sites, and a variety of support services were provided, including…

Logistics Support for U.S. Perimeter and Portal Monitoring Sites in the Soviet Union

DTIC Science & Technology

1990-09-01

Interaction of Components. .................. 40 The U.S. National Defense Transportation System.......................52 DTS Description...53 Pros and Cons of Air, Motor Transport 54 Military Airlift Command ............ 56 iii Page Cost/Service Tradeoffs ... .......... . 59 Military...Traffic Management Command . . 59 The Soviet National Transportation System . 61 Transportation and the Economy ....... .. 63 Intermodal Comparison

Native Language Reading Approach Program, 1982-1983. O.E.E. Final Evaluation Report.

ERIC Educational Resources Information Center

Keyes, Jose Luis; And Others

The Native Language Reading Approach Program in New York City was designed as an exemplary approach to on-site training of classroom teachers and their assistants in how to help students transfer reading skills from their native language to English. Program components included support services, teacher training, material/curriculum development,…

Scaling the CERN OpenStack cloud

NASA Astrophysics Data System (ADS)

Bell, T.; Bompastor, B.; Bukowiec, S.; Castro Leon, J.; Denis, M. K.; van Eldik, J.; Fermin Lobo, M.; Fernandez Alvarez, L.; Fernandez Rodriguez, D.; Marino, A.; Moreira, B.; Noel, B.; Oulevey, T.; Takase, W.; Wiebalck, A.; Zilli, S.

2015-12-01

CERN has been running a production OpenStack cloud since July 2013 to support physics computing and infrastructure services for the site. In the past year, CERN Cloud Infrastructure has seen a constant increase in nodes, virtual machines, users and projects. This paper will present what has been done in order to make the CERN cloud infrastructure scale out.

Prioritizing preferable locations for increasing urban tree canopy in New York City

Treesearch

Dexter Locke; J. Morgan Grove; Jacqueline W.T. Lu; Austin Troy; Jarlath P.M. O' Neil-Dunne; Brian Beck

2010-01-01

This paper presents a set of Geographic Information System (GIS) methods for identifying and prioritizing tree planting sites in urban environments. It uses an analytical approach created by a University of Vermont service-learning class called "GIS Analysis of New York City's Ecology" that was designed to provide research support to the MillionTreesNYC...

Making Choices in the Virtual World: The New Model at United Technologies Information Network.

ERIC Educational Resources Information Center

Gulliford, Bradley

1998-01-01

Describes changes in services of the United Technologies Corporation Information Network from a traditional library system to a virtual system of World Wide Web sites, a document-delivery unit, telephone and e-mail reference, and desktop technical support to provide remote access. Staff time, security, and licensing issues are addressed.…

78 FR 47779 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-06

...., Brunswick R & D Center. 82,792 BASF Corporation, AZO Louisville, KY June 5, 2012. Organics Plant, On- Site..., Corporate Claims Support. 82,847 Tyco Electronics, Mt. Joy, PA June 24, 2012. Aerospace, Defense and Marine Division, Kelly Services. 82,847A Tyco Electronics, Manheim, PA June 24, 2012. Aerospace, Defense and...

Day Care in Alberta, Canada: Overcoming the Barriers for Children with Disabilities. Working Paper Series, No. 231.

ERIC Educational Resources Information Center

Fink, Dale Borman

This study of integrated day care in the province of Alberta, Canada, involved observations and interviews at preschool sites in Calgary and Edmonton. The discussion resulting from the Calgary visits considers: combining funding from a provincial agency with the availability of hospital-sponsored mobile clinical services to support integration in…

Pollution Abatement and Prevention Analysis (PAPA) Study.

DTIC Science & Technology

1994-07-01

of information. Including suggestions for reducing this burden, to Washington Headquarters Services , Directorate for information Operations and Reports...areas include solid and hazardous waste management, wastewater discharge, noise abatement, endangered species, wetlands, air quality attainment, and...support this study. The Environmental Quality Office of HQ AMC provided policy and program guidance while the sites provided the specific pollution

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

PubMed

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

2004-04-01

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

Decentralization Does Not Assure Optimal Delivery of PMTCT and HIV-Exposed Infant Services in a Low Prevalence Setting

PubMed Central

Edmonds, Andrew; Feinstein, Lydia; Okitolonda, Vitus; Thompson, Deidre; Kawende, Bienvenu; Behets, Frieda

2016-01-01

Background The consequences of decentralizing prevention of mother-to-child HIV transmission and HIV-exposed infant services to antenatal care (ANC)/labor and delivery (L&D) sites from dedicated HIV care and treatment (C&T) centers remain unknown, particularly in low prevalence settings. Methods In a cohort of mother–infant pairs, we compared delivery of routine services at ANC/L&D and C&T facilities in Kinshasa, Democratic Republic of Congo from 2010–2013, using methods accounting for competing risks (eg, death). Women could opt to receive interventions at 90 decentralized ANC/L&D sites, or 2 affiliated C&T centers. Additionally, we assessed decentralization’s population-level impacts by comparing proportions of women and infants receiving interventions before (2009–2010) and after (2011–2013) decentralization. Results Among newly HIV-diagnosed women (N = 1482), the 14-week cumulative incidence of receiving the package of CD4 testing and zidovudine or antiretroviral therapy was less at ANC/L&D [66%; 95% confidence interval (CI): 63% to 69%] than at C&T (88%; 95% CI: 83% to 92%) sites (subdistribution hazard ratio, 0.62; 95% CI: 0.55 to 0.69). Delivery of cotrimoxazole and DNA polymerase chain reaction testing to HIV-exposed infants (N = 1182) was inferior at ANC/L&D sites (subdistribution hazard ratio, 0.84; 95% CI: 0.76 to 0.92); the 10-month cumulative incidence of the package at ANC/L&D sites was 89% (95% CI: 82% to 93%) versus 97% (95% CI: 93% to 99%) at C&T centers. Receipt of the pregnancy (20% of 1518, to 64% of 1405) and infant (16%–31%) packages improved post decentralization. Conclusions Services were delivered less efficiently at ANC/L&D sites than C&T centers. Although access improved with decentralization, its potential cannot be realized without sufficient and sustained support. PMID:26262776

Promon's participation in the Brasilsat program: first & second generations

NASA Astrophysics Data System (ADS)

Depaiva, Ricardo N.

This paper presents an overview of the Brasilsat program, space and ground segments, developed by Hughes and Promon. Promon is a Brazilian engineering company that has been actively participating in the Brasilsat Satellite Telecommunications Program since its beginning. During the first generation, as subcontractor of the Spar/Hughes/SED consortium, Promon had a significant participation in the site installation of the Ground Segment, including the antennas. During the second generation, as partner of a consortium with Hughes, Promon participated in the upgrade of Brasilsat's Ground Segment systems: the TT&C (TCR1, TCR2, and SCC) and the COCC (Communications and Operations Control Center). This upgrade consisted of the design and development of hardware and software to support the second generation requirements, followed by integration and tests, factory acceptance tests, transport to site, site installation, site acceptance tests and warranty support. The upgraded systems are distributed over four sites with remote access to the main ground station. The solutions adopted provide a high level of automation, and easy operator interaction. The hardware and software technologies were selected to provide the flexibility to incorporate new technologies and services from the demanding satellite telecommunications market.

Family Planning Supply Environment in Kinshasa, DRC: Survey Findings and Their Value in Advancing Family Planning Programming

PubMed Central

Kayembe, Patrick; Babazadeh, Saleh; Dikamba, Nelly; Akilimali, Pierre; Hernandez, Julie; Binanga, Arsene; Bertrand, Jane T

2015-01-01

Background: Modern contraceptive prevalence was 14.1% in 2007 in Kinshasa, the capital city of the Democratic Republic of the Congo (DRC). Yet virtually nothing was known about the family planning supply environment. Methods: Three surveys of health facilities were conducted in 2012, 2013, and 2014 to determine the number, spatial distribution, and attributes of sites providing family planning services. The 2012 and 2013 surveys aimed to identify the universe of family planning facilities while obtaining a limited set of data on “readiness” to provide family planning services (defined as having at least 3 modern methods, at least 1 person training in family planning in the last 3 years, and an information system to track distribution of products to clients) and output (measured by couple-years of protection, or CYP). In contrast, the 2014 survey, conducted under the umbrella of the Performance Monitoring and Accountability 2020 (PMA2020) project, was based on 2-stage cluster sampling. This article provides detailed analysis of the 2012 and 2013 surveys, including bivariate and multivariate analysis of correlates of readiness to provide services and of output. Results: We identified 184 health facilities that reported providing at least 1 contraceptive method in 2012 and 395 facilities in 2013. The percentage of sites defined as “ready” to provide services increased from 44.1% in 2012 to 63.3% in 2013. For the 3-month period between January and March 2013, facilities distributed between 0 and 879.2 CYP (mean, 39.7). Nearly half (49%) of the CYP was attributable to implants, followed by IUDs (24%), CycleBeads (11%), and injectables (8%). In 2013, facilities supported by PEPFAR (n = 121) were more likely than other facilities to be rated as ready to provide services (P<.0001); however, PEPFAR-supported sites generated less CYP on average than sites supported by family planning implementing agencies (P<.0001). Multivariate analysis showed 3 variables were associated with CYP: type of health facility, length of time in operation, and number of contraceptive methods available. Clinics generated higher (3-month) CYP than hospitals and health centers by 65.3 and 61.5 units, respectively (P<.01). The mean CYP for facilities in operation for 4–6 years was 26.9 units higher (P<.05), and 50.2 units higher for those operating 7+ years (P<.01), than the reference group of facilities in operation for 1 year or less. For each additional method available at a facility, CYP increased by almost 8 units (P<.01). Conclusions: Findings from these surveys suggest that lack of physical access is not the defining reason for low contraceptive use in Kinshasa, although it is highly likely that other service-related factors contribute to low service utilization. The results contributed to increasing the momentum for family planning in the DRC in many ways, including mobilizing partners to increase contraceptive access and increasing donor investment in family planning in the DRC. PMID:26681709

The development of a dynamic software for the user interaction from the geographic information system environment with the database of the calibration site of the satellite remote electro-optic sensors

NASA Astrophysics Data System (ADS)

Zyelyk, Ya. I.; Semeniv, O. V.

2015-12-01

The state of the problem of the post-launch calibration of the satellite electro-optic remote sensors and its solutions in Ukraine is analyzed. The database is improved and dynamic services for user interaction with database from the environment of open geographical information system Quantum GIS for information support of calibration activities are created. A dynamic application under QGIS is developed, implementing these services in the direction of the possibility of data entering, editing and extraction from the database, using the technology of object-oriented programming and of modern complex program design patterns. The functional and algorithmic support of this dynamic software and its interface are developed.

Data Service: Distributed Data Capture and Replication

NASA Astrophysics Data System (ADS)

Warner, P. B.; Pietrowicz, S. R.

2007-10-01

Data Service is a critical component of the NOAO Data Management and Science Support (DMaSS) Solutions Platform, which is based on a service-oriented architecture, and is to replace the current NOAO Data Transport System. Its responsibilities include capturing data from NOAO and partner telescopes and instruments and replicating the data across multiple (currently six) storage sites. Java 5 was chosen as the implementation language, and Java EE as the underlying enterprise framework. Application metadata persistence is performed using EJB and Hibernate on the JBoss Application Server, with PostgreSQL as the persistence back-end. Although potentially any underlying mass storage system may be used as the Data Service file persistence technology, DTS deployments and Data Service test deployments currently use the Storage Resource Broker from SDSC. This paper presents an overview and high-level design of the Data Service, including aspects of deployment, e.g., for the LSST Data Challenge at the NCSA computing facilities.

Cost savings associated with an alternative payment model for integrating behavioral health in primary care.

PubMed

Ross, Kaile M; Gilchrist, Emma C; Melek, Stephen P; Gordon, Patrick D; Ruland, Sandra L; Miller, Benjamin F

2018-05-23

Financially supporting and sustaining behavioral health services integrated into primary care settings remains a major barrier to widespread implementation. Sustaining Healthcare Across Integrated Primary Care Efforts (SHAPE) was a demonstration project designed to prospectively examine the cost savings associated with utilizing an alternative payment methodology to support behavioral health services in primary care practices with integrated behavioral health services. Six primary care practices in Colorado participated in this project. Each practice had at least one on-site behavioral health clinician providing integrated behavioral health services. Three practices received non-fee-for-service payments (i.e., SHAPE payment) to support provision of behavioral health services for 18 months. Three practices did not receive the SHAPE payment and served as control practices for comparison purposes. Assignment to condition was nonrandom. Patient claims data were collected for 9 months before the start of the SHAPE demonstration project (pre-period) and for 18 months during the SHAPE project (post-period) to evaluate cost savings. During the 18-month post-period, analysis of the practices' claims data demonstrated that practices receiving the SHAPE payment generated approximately $1.08 million in net cost savings for their public payer population (i.e., Medicare, Medicaid, and Dual Eligible; N = 9,042). The cost savings were primarily achieved through reduction in downstream utilization (e.g., hospitalizations). The SHAPE demonstration project found that non-fee-for-service payments for behavioral health integrated into primary care may be associated with significant cost savings for public payers, which could have implications on future delivery and payment work in public programs (e.g., Medicaid).

Implementation of nutrition risk screening using the Malnutrition Universal Screening Tool across a large metropolitan health service.

PubMed

Cooper, P L; Raja, R; Golder, J; Stewart, A J; Shaikh, R F; Apostolides, M; Savva, J; Sequeira, J L; Silvers, M A

2016-12-01

A standardised nutrition risk screening (NRS) programme with ongoing education is recommended for the successful implementation of NRS. This project aimed to develop and implement a standardised NRS and education process across the adult bed-based services of a large metropolitan health service and to achieve a 75% NRS compliance at 12 months post-implementation. A working party of Monash Health (MH) dietitians and a nutrition technician revised an existing NRS medical record form consisting of the Malnutrition Universal Screening Tool and nutrition management guidelines. Nursing staff across six MH hospital sites were educated in the use of this revised form and there was a formalised implementation process. Support from Executive Management, nurse educators and the Nutrition Risk Committee ensured the incorporation of NRS into nursing practice. Compliance audits were conducted pre- and post-implementation. At 12 months post-implementation, organisation-wide NRS compliance reached 34.3%. For those wards that had pre-implementation NRS performed by nursing staff, compliance increased from 7.1% to 37.9% at 12 months (P < 0.001). The improved NRS form is now incorporated into standard nursing practice and NRS is embedded in the organisation's 'Point of Care Audit', which is reported 6-monthly to the Nutrition Risk Committee and site Quality and Safety Committees. NRS compliance improved at MH with strong governance support and formalised implementation; however, the overall compliance achieved appears to have been affected by the complexity and diversity of multiple healthcare sites. Ongoing education, regular auditing and establishment of NRS routines and ward practices is recommended to further improve compliance. © 2016 The British Dietetic Association Ltd.

Social media and patient self-management: not all sites are created equal.

PubMed

Ellis, Leonie; Showell, Chris; Turner, Paul

2013-01-01

This paper compares two social media sites that aim to support patients to enhance self-management. The first site, PatientsLikeMe is a well established global site designed to allow peer-to-peer communication between people with similar conditions. The second, HealthShare, is a recently developed site for Australians described as "Australia's Social Health Network". The comparison conducted examines the purpose, ownership, and design of both sites as well as how the data they collect is used. Analysis highlights that PatientsLikeMe actively facilitates patient self-management, while HealthShare is revealed to be a professionally moderated health information portal presented as a social networking site. While the impetus for the development of PatientsLikeMe is clear, the motives underpinning HealthShare are less obvious. With increasing patient interest in connecting with, and sharing information with one another, awareness of the nature and motivations underpinning sites that provide these services is of increasing relevance.

Latent homeless risk profiles of a national sample of homeless veterans and their relation to program referral and admission patterns.

PubMed

Tsai, Jack; Kasprow, Wesley J; Rosenheck, Robert A

2013-12-01

We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. We examined data from the VA's new Homeless Operations Management and Evaluation System on 120,852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class solution compared both referral and admission to VA homeless services. We identified 4 latent classes: relatively few problems, dual diagnosis, poverty-substance abuse-incarceration, and disabling medical problems. Homeless veterans in the first group were more likely to be admitted to the VA's permanent supportive housing program, whereas those in the second group were more likely to be admitted to more restrictive VA residential treatment. Homeless veterans in the third group were more likely to be admitted to the VA's prisoner re-entry program, and those in the fourth group were more likely to be directed to VA medical services. The heterogeneous risk and need profiles of homeless veterans supported the diversity of VA homeless services and encouraged the development of specialized services to meet their diverse needs.

Establishing a regional, multisite database for quality improvement and service planning in community-based palliative care and hospice.

PubMed

Bull, Janet; Zafar, S Yousuf; Wheeler, Jane L; Harker, Matthew; Gblokpor, Agbessi; Hanson, Laura; Hulihan, Deirdre; Nugent, Rikki; Morris, John; Abernethy, Amy P

2010-08-01

Outpatient palliative care, an evolving delivery model, seeks to improve continuity of care across settings and to increase access to services in hospice and palliative medicine (HPM). It can provide a critical bridge between inpatient palliative care and hospice, filling the gap in community-based supportive care for patients with advanced life-limiting illness. Low capacities for data collection and quantitative research in HPM have impeded assessment of the impact of outpatient palliative care. In North Carolina, a regional database for community-based palliative care has been created through a unique partnership between a HPM organization and academic medical center. This database flexibly uses information technology to collect patient data, entered at the point of care (e.g., home, inpatient hospice, assisted living facility, nursing home). HPM physicians and nurse practitioners collect data; data are transferred to an academic site that assists with analyses and data management. Reports to community-based sites, based on data they provide, create a better understanding of local care quality. The data system was developed and implemented over a 2-year period, starting with one community-based HPM site and expanding to four. Data collection methods were collaboratively created and refined. The database continues to grow. Analyses presented herein examine data from one site and encompass 2572 visits from 970 new patients, characterizing the population, symptom profiles, and change in symptoms after intervention. A collaborative regional approach to HPM data can support evaluation and improvement of palliative care quality at the local, aggregated, and statewide levels.

Development and evaluation of SOA-based AAL services in real-life environments: a case study and lessons learned.

PubMed

Stav, Erlend; Walderhaug, Ståle; Mikalsen, Marius; Hanke, Sten; Benc, Ivan

2013-11-01

The proper use of ICT services can support seniors in living independently longer. While such services are starting to emerge, current proprietary solutions are often expensive, covering only isolated parts of seniors' needs, and lack support for sharing information between services and between users. For developers, the challenge is that it is complex and time consuming to develop high quality, interoperable services, and new techniques are needed to simplify the development and reduce the development costs. This paper provides the complete view of the experiences gained in the MPOWER project with respect to using model-driven development (MDD) techniques for Service Oriented Architecture (SOA) system development in the Ambient Assisted Living (AAL) domain. To address this challenge, the approach of the European research project MPOWER (2006-2009) was to investigate and record the user needs, define a set of reusable software services based on these needs, and then implement pilot systems using these services. Further, a model-driven toolchain covering key development phases was developed to support software developers through this process. Evaluations were conducted both on the technical artefacts (methodology and tools), and on end user experience from using the pilot systems in trial sites. The outcome of the work on the user needs is a knowledge base recorded as a Unified Modeling Language (UML) model. This comprehensive model describes actors, use cases, and features derived from these. The model further includes the design of a set of software services, including full trace information back to the features and use cases motivating their design. Based on the model, the services were implemented for use in Service Oriented Architecture (SOA) systems, and are publicly available as open source software. The services were successfully used in the realization of two pilot applications. There is therefore a direct and traceable link from the user needs of the elderly, through the service design knowledge base, to the service and pilot implementations. The evaluation of the SOA approach on the developers in the project revealed that SOA is useful with respect to job performance and quality. Furthermore, they think SOA is easy to use and support development of AAL applications. An important finding is that the developers clearly report that they intend to use SOA in the future, but not for all type of projects. With respect to using model-driven development in web services design and implementation, the developers reported that it was useful. However, it is important that the code generated from the models is correct if the full potential of MDD should be achieved. The pilots and their evaluation in the trial sites showed that the services of the platform are sufficient to create suitable systems for end users in the domain. A SOA platform with a set of reusable domain services is a suitable foundation for more rapid development and tailoring of assisted living systems covering reoccurring needs among elderly users. It is feasible to realize a tool-chain for model-driven development of SOA applications in the AAL domain, and such a tool-chain can be accepted and found useful by software developers. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

41 CFR 102-76.20 - What issues must Federal agencies consider in providing site planning and landscape design services?

Code of Federal Regulations, 2012 CFR

2012-01-01

... agencies consider in providing site planning and landscape design services? 102-76.20 Section 102-76.20... What issues must Federal agencies consider in providing site planning and landscape design services? In providing site planning and design services, Federal agencies must— (a) Make the site planning and landscape...

41 CFR 102-76.20 - What issues must Federal agencies consider in providing site planning and landscape design services?

Code of Federal Regulations, 2011 CFR

2011-01-01

... agencies consider in providing site planning and landscape design services? 102-76.20 Section 102-76.20... What issues must Federal agencies consider in providing site planning and landscape design services? In providing site planning and design services, Federal agencies must— (a) Make the site planning and landscape...

41 CFR 102-76.20 - What issues must Federal agencies consider in providing site planning and landscape design services?

Code of Federal Regulations, 2014 CFR

2014-01-01

... agencies consider in providing site planning and landscape design services? 102-76.20 Section 102-76.20... What issues must Federal agencies consider in providing site planning and landscape design services? In providing site planning and design services, Federal agencies must— (a) Make the site planning and landscape...

41 CFR 102-76.20 - What issues must Federal agencies consider in providing site planning and landscape design services?

Code of Federal Regulations, 2013 CFR

2013-07-01

... agencies consider in providing site planning and landscape design services? 102-76.20 Section 102-76.20... What issues must Federal agencies consider in providing site planning and landscape design services? In providing site planning and design services, Federal agencies must— (a) Make the site planning and landscape...

76 FR 44912 - Callaway and Son Drum Service Superfund Site; Lake Alfred, Polk County, FL; Notice of Settlement

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-27

... Service Superfund Site; Lake Alfred, Polk County, FL; Notice of Settlement AGENCY: Environmental... Callaway and son Drum Service Superfund Site located in Lake Alfred, Polk County, Florida for publication... by Site name Callaway and Son Drum Service Superfund Site by one of the following methods: http://www...

Assessing missed opportunities for the prevention of mother-to-child HIV transmission in an Eastern Cape local service area.

PubMed

Rispel, L C; Peltzer, K; Phaswana-Mafuya, N; Metcalf, C A; Treger, L

2009-03-01

Prevention of new HIV infections is a critical imperative for South Africa; the prevention of mother-to-child transmission (PMTCT) is one of the most efficacious HIV prevention interventions. Assessment of a PMTCT programme to determine missed opportunities. The Kouga local service area (LSA), bordering Nelson Mandela Bay Municipality (Port Elizabeth) in the Eastern Cape. An assessment was conducted in 2007 before implementing technical support for strengthening the PMTCT programme, including: interviews with 20 PMTCT managers, 4 maternity staff and 27 other health workers on service provision, management, infrastructure, human resources and the health information system; 296 antenatal clinic users on their service perceptions; 70 HIV-positive women on HIV knowledge, infant feeding, coping, support and service perceptions; 8 representatives from community organisations and 101 traditional health practitioners (THPs). Observations were conducted during site visits to health facilities, and the District Health Information System (DHIS) data were reviewed. Staff had high levels of awareness of HIV policies and most had received some relevant training. Nevirapine uptake varied by clinic, with an average of 56%. There were many missed opportunities for PMTCT, with 67% of pregnant women tested for HIV and only 43% of antenatal care attendees tested during a previous pregnancy. Only 6% of HIV-positive women reported support group participation. Reducing missed opportunities for PMTCT requires strengthening of the formal health sector, intersectoral liaison, and greater community support. Priority areas that require strengthening in the formal health sector include HIV counselling and testing; family planning and nutrition counselling; infant follow-up; human resources; and monitoring and evaluation.

Change In Length of Stay and Readmissions among Hospitalized Medical Patients after Inpatient Medicine Service Adoption of Mobile Secure Text Messaging.

PubMed

Patel, Mitesh S; Patel, Neha; Small, Dylan S; Rosin, Roy; Rohrbach, Jeffrey I; Stromberg, Nathaniel; Hanson, C William; Asch, David A

2016-08-01

Changes in the medium of communication from paging to mobile secure text messaging may change clinical care, but the effects of these changes on patient outcomes have not been well examined. To evaluate the association between inpatient medicine service adoption of mobile secure text messaging and patient length of stay and readmissions. Observational study. Patients admitted to medicine services at the Hospital of the University of Pennsylvania (intervention site; n = 8995 admissions of 6484 patients) and Penn Presbyterian Medical Center (control site; n = 6799 admissions of 4977 patients) between May 1, 2012, and April 30, 2014. Mobile secure text messaging. Change in length of stay and 30-day readmissions, comparing patients at the intervention site to the control site before (May 1, 2012 to April 30, 2013) and after (May 1, 2013 to April 30, 2014) the intervention, adjusting for time trends and patient demographics, comorbidities, insurance, and disposition. During the pre-intervention period, the mean length of stay ranged from 4.0 to 5.0 days at the control site and from 5.2 to 6.7 days at the intervention site, but trends were similar. In the first month after the intervention, the mean length of stay was unchanged at the control site (4.7 to 4.7 days) but declined at the intervention site (6.0 to 5.4 days). Trends were mostly similar during the rest of the post-intervention period, ranging from 4.4 to 5.6 days at the control site and from 5.4 to 6.5 days at the intervention site. Readmission rates varied significantly within sites before and after the intervention, but overall trends were similar. In adjusted analyses, there was a significant decrease in length of stay for the intervention site relative to the control site during the post-intervention period compared to the pre-intervention period (-0.77 days ; 95 % CI, -1.14, -0.40; P < 0.001). There was no significant difference in the odds of readmission (OR, 0.97; 95 % CI: 0.81, 1.17; P = 0.77). These findings were supported by multiple sensitivity analyses. Compared to a control group over time, hospitalized medical patients on inpatient services whose care providers and staff were offered mobile secure text messaging showed a relative decrease in length of stay and no change in readmissions.

Grid Computing and Collaboration Technology in Support of Fusion Energy Sciences

NASA Astrophysics Data System (ADS)

Schissel, D. P.

2004-11-01

The SciDAC Initiative is creating a computational grid designed to advance scientific understanding in fusion research by facilitating collaborations, enabling more effective integration of experiments, theory and modeling, and allowing more efficient use of experimental facilities. The philosophy is that data, codes, analysis routines, visualization tools, and communication tools should be thought of as easy to use network available services. Access to services is stressed rather than portability. Services share the same basic security infrastructure so that stakeholders can control their own resources and helps ensure fair use of resources. The collaborative control room is being developed using the open-source Access Grid software that enables secure group-to-group collaboration with capabilities beyond teleconferencing including application sharing and control. The ability to effectively integrate off-site scientists into a dynamic control room will be critical to the success of future international projects like ITER. Grid computing, the secure integration of computer systems over high-speed networks to provide on-demand access to data analysis capabilities and related functions, is being deployed as an alternative to traditional resource sharing among institutions. The first grid computational service deployed was the transport code TRANSP and included tools for run preparation, submission, monitoring and management. This approach saves user sites from the laborious effort of maintaining a complex code while at the same time reducing the burden on developers by avoiding the support of a large number of heterogeneous installations. This tutorial will present the philosophy behind an advanced collaborative environment, give specific examples, and discuss its usage beyond FES.

Referral patterns and service utilization in a pediatric hospital-wide intimate partner violence program.

PubMed

Cruz, Mario; Cruz, Patricia B; Weirich, Christine; McGorty, Ryan; McColgan, Maria D

2013-08-01

To describe the referral patterns and utilization of on-site intimate partner violence (IPV) services in both inpatient and outpatient settings at a large urban children's hospital. Retrospective review of case records from IPV victims referred to an on-site IPV counselor between September 2005 and February 2010. Descriptive statistics were used to examine IPV victim demographics, number of referrals per hospital department, referral source (type of staff member), time spent by IPV counselor for initial consultation, and services provided to IPV victims. A total of 453 unique referrals were made to the IPV counselor: 81% were identified by universal screening and 19% by risk-based screening. Thirty-six percent of IPV victims were referred from primary care clinics; 26% from inpatient units; 13% from outpatient subspecialty clinics; 12.5% from the emergency department; 5% from the Child Protection Program; and 4% were employee self-referrals. Social workers generated the most referrals (55%), followed by attending physicians (17%), residents (13%), nurses (7%), and other individuals (self-referrals) (4%). The median initial IPV intervention required 42 minutes. Supportive counseling and safety planning were the services most often utilized by IPV victims. IPV screening can be successfully integrated in both inpatient and outpatient settings by a multidisciplinary group of hospital staff. Most referrals were generated by universal screening outside of the primary care setting. IPV victims generally desired supportive counseling and safety planning over immediate housing relocation. Many IPV screening opportunities were missed by using verbal screening alone. Copyright © 2013 Elsevier Ltd. All rights reserved.

An innovative partnership in service.

PubMed

Lazarus, Cathy J; Krane, N Kevin; Bowdish, Bruce

2002-07-01

Stimulated by the need for better alignment of educational content and goals with evolving societal needs, practice patterns, and scientific developments, many medical schools are implementing new and creative educational experiences for students. Tulane University School of Medicine and Apple Computers have established an innovative partnership in which Apple laptop computers support and enhance students' service learning projects. The partnership also provides a unique opportunity to meet the Medical School Objectives Project (MSOP) objectives in Medical Informatics and Population Health, as outlined in Report II.(1) Apple Computers has a commitment to the New Orleans community as part of its corporate strategic plan to support educational programs at all levels; Tulane has a longstanding commitment to and experience with student-led service learning as part of the Foundations in Medicine Course.(2) Senior administrative personnel from Tulane and Apple discussed these common interests, resulting in a partnership to enhance the potential impact on the community served. Apple agreed to donate 20 G3 Powerbooks and a complete set of the Apple Learning series of software to support new and ongoing service-learning projects. A committee of Tulane faculty and students, information technology staff, and an Apple representative developed the project. To maximize students' access to the laptops while managing the administration's liability, the laptops were identically configured with standardized software packages (database development and maintenance, Web access, word processing, presentation development and execution, automated backup, and individual project access to protected server space). To maximize the use of the laptops, students from the service-learning organizations can check out the laptops on a just-in-time basis, because the projects have different needs over time. Student-service leaders are currently defining and developing the exact uses for the laptops. We anticipate that this project will enhance the administrative management of service-learning programs (e.g., schedules, directions to sites), the presentation of educational programs (e.g., teaching in schools), the creation of new media to support programs (e.g., our restaurant choking program has a partnership with the American Heart Association to create a video and training manual to be used nationwide), and data tracking (e.g., sites and clients served, outcomes achieved). Students' use of the laptops should support the achievement of several of the MSOP Report II Medical Informatics objectives. To assess that, all first-year medical students are completing a pre- and post-project survey based on those objectives. The availability of laptops and software should significantly enhance the service-learning programs. The students participating should gain important skills in the use of computer technology related to their roles as lifelong learners, educators and communicators, researchers, and managers.(1) We plan to report the results of the pre- and post-project surveys once they have been completed. Students' feedback on the project has been very positive, and we hope it can serve as a model for other medical school, corporate, and community partnerships.

An analysis of the costs of implementing the National Newborn Hearing Screening Programme in England.

PubMed

Uus, K; Bamford, J; Taylor, R

2006-01-01

The primary aim of this analysis was to prospectively assess the full economic costs associated with implementing Newborn Hearing Screening Programme (NHSP) based on a two-stage screen, transient evoked otoacoustic emissions followed, if there is no clear response, by automated auditory brainstem response. Economic data were also collected from the Infant Distraction Test Screening (IDTS) service performed by health visitors at around eight months of age, which was being phased out. A comparison of costs and outcomes associated with NHSP and IDTS was conducted. 20 NHSP sites were invited to provide detailed cost data on NHSP implementation and 14 of these sites were selected to provide costs on the IDTS service that was being supplanted. There was marked variability in the costs. Given the higher yield of NHSP sites, the average cost per case detected across NHSP sites (31,410 pounds/case) was approximately half that of IDTS sites (69,919 pounds/case). Including family costs, the average total cost per case of NHSP (34,826 pounds/case) was almost a quarter of IDTS (117,942 pounds/case). Family costs and cost per case associated with NHSP are considerably less than that with IDTS. These findings support the policy of implementation of NHSP and the phasing out of the IDTS.

Analysing biodiversity and conservation knowledge products to support regional environmental assessments.

PubMed

Brooks, Thomas M; Akçakaya, H Resit; Burgess, Neil D; Butchart, Stuart H M; Hilton-Taylor, Craig; Hoffmann, Michael; Juffe-Bignoli, Diego; Kingston, Naomi; MacSharry, Brian; Parr, Mike; Perianin, Laurence; Regan, Eugenie C; Rodrigues, Ana S L; Rondinini, Carlo; Shennan-Farpon, Yara; Young, Bruce E

2016-02-16

Two processes for regional environmental assessment are currently underway: the Global Environment Outlook (GEO) and Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES). Both face constraints of data, time, capacity, and resources. To support these assessments, we disaggregate three global knowledge products according to their regions and subregions. These products are: The IUCN Red List of Threatened Species, Key Biodiversity Areas (specifically Important Bird &Biodiversity Areas [IBAs], and Alliance for Zero Extinction [AZE] sites), and Protected Planet. We present fourteen Data citations: numbers of species occurring and percentages threatened; numbers of endemics and percentages threatened; downscaled Red List Indices for mammals, birds, and amphibians; numbers, mean sizes, and percentage coverages of IBAs and AZE sites; percentage coverage of land and sea by protected areas; and trends in percentages of IBAs and AZE sites wholly covered by protected areas. These data will inform the regional/subregional assessment chapters on the status of biodiversity, drivers of its decline, and institutional responses, and greatly facilitate comparability and consistency between the different regional/subregional assessments.

The Recovery of a Clinical Database Management System after Destruction by Fire *

PubMed Central

Covvey, H.D.; McAlister, N.H.; Greene, J.; Wigle, E.D.

1981-01-01

In August 1980 a fire in the Cardiovascular Unit at Toronto General Hospital severely damaged the physical plant and rendered all on-site equipment unrecoverable. Among the hardware items in the fire was the computer which supports our cardiovascular database system. Within hours after the fire it was determined that the computer was no longer serviceable. Beyond off-site back-up tapes, there was the possibility that recent records on the computer had suffered a similar fate. Immediate procedures were instituted to obtain a replacement computer system and to clean media to permit data recovery. Within 2 months a partial system was supporting all users, and all data was recovered and being used. The destructive potential of a fire is rarely seriously considered relative to computer equipment in our clinical environments. Full-replacement value insurance; an excellent equipment supplier with the capacity to respond to an emergency; backup and recovery procedures with off-site storage; and dedicated staff are key hedges against disaster.

A cloud computing based 12-lead ECG telemedicine service

PubMed Central

2012-01-01

Background Due to the great variability of 12-lead ECG instruments and medical specialists’ interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists’ decision making support in emergency telecardiology. Methods We create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG) service to realize ubiquitous 12-lead ECG tele-diagnosis. Results This developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive. Conclusions This cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan. PMID:22838382

A cloud computing based 12-lead ECG telemedicine service.

PubMed

Hsieh, Jui-Chien; Hsu, Meng-Wei

2012-07-28

Due to the great variability of 12-lead ECG instruments and medical specialists' interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists' decision making support in emergency telecardiology. We create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG) service to realize ubiquitous 12-lead ECG tele-diagnosis. This developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive. This cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan.

Data federation strategies for ATLAS using XRootD

NASA Astrophysics Data System (ADS)

Gardner, Robert; Campana, Simone; Duckeck, Guenter; Elmsheuser, Johannes; Hanushevsky, Andrew; Hönig, Friedrich G.; Iven, Jan; Legger, Federica; Vukotic, Ilija; Yang, Wei; Atlas Collaboration

2014-06-01

In the past year the ATLAS Collaboration accelerated its program to federate data storage resources using an architecture based on XRootD with its attendant redirection and storage integration services. The main goal of the federation is an improvement in the data access experience for the end user while allowing more efficient and intelligent use of computing resources. Along with these advances come integration with existing ATLAS production services (PanDA and its pilot services) and data management services (DQ2, and in the next generation, Rucio). Functional testing of the federation has been integrated into the standard ATLAS and WLCG monitoring frameworks and a dedicated set of tools provides high granularity information on its current and historical usage. We use a federation topology designed to search from the site's local storage outward to its region and to globally distributed storage resources. We describe programmatic testing of various federation access modes including direct access over the wide area network and staging of remote data files to local disk. To support job-brokering decisions, a time-dependent cost-of-data-access matrix is made taking into account network performance and key site performance factors. The system's response to production-scale physics analysis workloads, either from individual end-users or ATLAS analysis services, is discussed.

Supported education for individuals with psychiatric disabilities: State of the practice and policy implications.

PubMed

Ringeisen, Heather; Langer Ellison, Marsha; Ryder-Burge, Amy; Biebel, Kathleen; Alikhan, Shums; Jones, Emily

2017-06-01

Supported education (SEd) is a promising practice that supports and encourages educational goals and attainment among individuals with psychiatric disabilities. This paper provides insights into how SEd objectives are pursued in different settings, assesses the evidence base, and discusses policy implications. Insights from 3 data sources were synthesized: published literature, an environmental scan, and 3 site visits to programs that support the education goals of individuals with psychiatric disabilities. While setting, target populations, level of coordination with supported employment, and financing strategies varied, common SEd components emerged: specialized and dedicated staffing, one-on-one and group skill-building activities, assistance with navigating the academic setting and coordinating different services, and linkages with mental health counseling. The evidence base is growing; however, many published studies to date do not employ rigorous methodology. Conclusions and Implications for Policy and Practice: Continued specification, operationalization, and testing of SEd core components are needed. The components of the evolving SEd model would benefit from rigorous testing to evaluate impact on degree completion and other key impacts such as employment; health, mental health, or recovery; and community participation. In addition to funding streams from special education and Medicaid, new opportunities for increasing the availability of SEd include the Workforce Innovation and Opportunities Act (WIOA) reauthorization, which requires state vocational rehabilitation agencies to fund preemployment services for transition-age individuals. New "set-aside" requirements for the Mental Health Services Block Grant will increase funding for early intervention services for individuals with serious mental illness, potentially including SEd. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Current status of palliative care services in Indonesia: a literature review.

PubMed

Rochmawati, Erna; Wiechula, Rick; Cameron, Kate

2016-06-01

To review healthcare literature in relation to the provision of palliative care in Indonesia and to identify factors that may impact on palliative care development. People living with life-limiting illness benefit from access to palliative care services to optimize quality of life. Palliative care services are being expanded in developing countries but in Indonesia such services are in their infancy with many patients with life-limiting illnesses having access to appropriate health care compromised. Relevant healthcare databases including CINAHL, PubMed, Science Direct and Scopus were searched using the combinations of search terms: palliative care, terminal care, end-of-life care, Indonesia and nursing. A search of grey literature including Internet sites was also carried out. Nine articles were included in the review. Facilitating factors supporting the provision of palliative care included: a culture of strong familial support, government policy support, volunteering and support from regional organizations. Identified barriers to palliative care provision were a limited understanding of palliative care among healthcare professionals, the challenging geography of Indonesia and limited access to opioid medications. There are facilitators and barriers that currently impact on the development of palliative care in Indonesia. Strategies that can be implemented to improve palliative care include training of nurses and doctors in the primary care sector, integrating palliative care in undergraduate medical and nursing curriculum and educating family and community about basic care. Nurses and doctors who work in primary care can potentially play a role in supporting and educating family members providing direct care to patients with palliative needs. © 2016 International Council of Nurses.

Labouring Together: collaborative alliances in maternity care in Victoria, Australia-protocol of a mixed-methods study.

PubMed

Watkins, Vanessa; Nagle, Cate; Kent, Bridie; Hutchinson, Alison M

2017-03-07

For over a decade, enquiries into adverse perinatal outcomes have led to reports that poor collaboration has been detrimental to the safety and experience of maternity care. Despite efforts to improve collaboration, investigations into maternity care at Morecambe Bay (UK) and Djerriwarrh Health Services (Australia) have revealed that poor collaboration and decision-making remain a threat to perinatal safety. The Labouring Together study will investigate how elements hypothesised to influence the effectiveness of collaboration are reflected in perceptions and experiences of clinicians and childbearing women in Victoria, Australia. The study will explore conditions that assist clinicians and women to work collaboratively to support positive maternity outcomes. Results of the study will provide a platform for consumers, clinician groups, organisations and policymakers to work together to improve the quality, safety and experience of maternity care. 4 case study sites have been selected to represent a range of models of maternity care in metropolitan and regional Victoria, Australia. A mixed-methods approach including cross-sectional surveys and interviews will be used in each case study site, involving both clinicians and consumers. Quantitative data analysis will include descriptive statistics, 2-way multivariate analysis of variance for the dependent and independent variables, and χ 2 analysis to identify the degree of congruence between consumer preferences and experiences. Interview data will be analysed for emerging themes and concepts. Data will then be analysed for convergent lines of enquiry supported by triangulation of data to draw conclusions. Organisational ethics approval has been received from the case study sites and Deakin University Human Research Ethics Committee (2014-238). Dissemination of the results of the Labouring Together study will be via peer-reviewed publications and conference presentations, and in written reports for each case study site to support organisational change. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Ecosystem services-based SWOT analysis of protected areas for conservation strategies.

PubMed

Scolozzi, Rocco; Schirpke, Uta; Morri, Elisa; D'Amato, Dalia; Santolini, Riccardo

2014-12-15

An ecosystem services-based SWOT analysis is proposed in order to identify and quantify internal and external factors supporting or threatening the conservation effectiveness of protected areas. The proposed approach concerns both the ecological and the social perspective. Strengths and weaknesses, opportunities and threats were evaluated based on 12 selected environmental and socio-economic indicators for all terrestrial Italian protected areas, belonging to the Natura 2000 network, and for their 5-km buffer area. The indicators, used as criteria within a multi-criteria assessment, include: core area, cost-distance between protected areas, changes in ecosystem services values, intensification of land use, and urbanization. The results were aggregated for three biogeographical regions, Alpine, Continental, and Mediterranean, indicating that Alpine sites have more opportunities and strengths than Continental and Mediterranean sites. The results call attention to where connectivity and land-use changes may have stronger influence on protected areas, in particular, whereas urbanization or intensification of agriculture may hamper conservation goals of protected areas. The proposed SWOT analysis provides helpful information for a multiple scale perspective and for identifying conservation priorities and for defining management strategies to assure biodiversity conservation and ecosystem services provision. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluating the capacity of California's publicly funded universities to provide medication abortion.

PubMed

Raifman, Sarah; Anderson, Patricia; Kaller, Shelly; Tober, Diane; Grossman, Daniel

2018-05-18

To explore capacity of University of California (UC) and California State University (CSU) student health centers (SHCs) to provide medication abortion (MA) and SHC staff perspectives on providing MA. SHC staff completed an online survey; we conducted site visits and conference calls with a subset of SHCs. The survey focused on barriers to abortion, resources needed for MA, and potential benefits and challenges. 11 UCs (100%) and 20 CSUs (87%) completed surveys. All facilities provided basic primary care, including sexual and reproductive health services and some contraceptive services, but not abortion. All sites had adequate staffing and physical plant, but most would require training, access to ultrasound when needed, 24-hour hotlines (CSUs), and back-up care to provide MA. It would be feasible to provide MA at SHCs, but investment is needed to support staff training, equipment, 24-hour hotlines, back-up care, and minimal security upgrades, in order to implement MA services. If SB320 is passed, provision of MA services at student health centers could improve access to early abortion for students in California. This model may be scaled up at other universities around the country. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Service Providers’ Experiences and Perspectives on Recovery-Oriented Mental Health System Reform

PubMed Central

Piat, Myra; Lal, Shalini

2016-01-01

Objective With the use of a qualitative approach, this study focuses on service providers’ experiences and perspectives on recovery-oriented reform. Methods Nine focus groups were conducted with a sample of 68 service providers recruited from three Canadian sites. Results Three major themes were identified: 1) positive attitudes towards recovery-oriented reform; 2) skepticism towards recovery-oriented reform; and 3) challenges associated with implementing recovery-oriented practice. These challenges pertained to conceptual uncertainty and consistency around the meanings of recovery; application of recovery-oriented practice with certain populations and in certain contexts; bureaucratization of recovery-oriented tools; limited leadership support; and, societal stigma and social exclusion of persons with mental illnesses. Conclusions and Implications for Practice The findings point towards challenges that might arise as system planners move ahead in their efforts toward implementing recovery within the mental health system. In this regard, we offer several recommendations for the planning of organizational and educational practices that support the implementation of recovery-oriented practice. PMID:22491368

A Web-based assessment of bioinformatics end-user support services at US universities.

PubMed

Messersmith, Donna J; Benson, Dennis A; Geer, Renata C

2006-07-01

This study was conducted to gauge the availability of bioinformatics end-user support services at US universities and to identify the providers of those services. The study primarily focused on the availability of short-term workshops that introduce users to molecular biology databases and analysis software. Websites of selected US universities were reviewed to determine if bioinformatics educational workshops were offered, and, if so, what organizational units in the universities provided them. Of 239 reviewed universities, 72 (30%) offered bioinformatics educational workshops. These workshops were located at libraries (N = 15), bioinformatics centers (N = 38), or other facilities (N = 35). No such training was noted on the sites of 167 universities (70%). Of the 115 bioinformatics centers identified, two-thirds did not offer workshops. This analysis of university Websites indicates that a gap may exist in the availability of workshops and related training to assist researchers in the use of bioinformatics resources, representing a potential opportunity for libraries and other facilities to provide training and assistance for this growing user group.

Identifying User Needs and the Participative Design Process

NASA Astrophysics Data System (ADS)

Meiland, Franka; Dröes, Rose-Marie; Sävenstedt, Stefan; Bergvall-Kåreborn, Birgitta; Andersson, Anna-Lena

As the number of persons with dementia increases and also the demands on care and support at home, additional solutions to support persons with dementia are needed. The COGKNOW project aims to develop an integrated, user-driven cognitive prosthetic device to help persons with dementia. The project focuses on support in the areas of memory, social contact, daily living activities and feelings of safety. The design process is user-participatory and consists of iterative cycles at three test sites across Europe. In the first cycle persons with dementia and their carers (n = 17) actively participated in the developmental process. Based on their priorities of needs and solutions, on their disabilities and after discussion between the team, a top four list of Information and Communication Technology (ICT) solutions was made and now serves as the basis for development: in the area of remembering - day and time orientation support, find mobile service and reminding service, in the area of social contact - telephone support by picture dialling, in the area of daily activities - media control support through a music playback and radio function, and finally, in the area of safety - a warning service to indicate when the front door is open and an emergency contact service to enhance feelings of safety. The results of this first project phase show that, in general, the people with mild dementia as well as their carers were able to express and prioritize their (unmet) needs, and the kind of technological assistance they preferred in the selected areas. In next phases it will be tested if the user-participatory design and multidisciplinary approach employed in the COGKNOW project result in a user-friendly, useful device that positively impacts the autonomy and quality of life of persons with dementia and their carers.

NDE investigation of the timber foundation in the historic Kennecott Mine Concentration Mill Building

Treesearch

James P. Wacker; Xiping Wang; Douglas R. Rammer; Bessie M. Woodward

2011-01-01

The U.S. National Park Service acquired the National Historic Copper Mine at Kennecott, Alaska, in 1998. There was uncertainty about the condition of the timber-cribbing foundation supporting the concentration mill, the largest building in the mine complex. A comprehensive on-site evaluation of the timber cribbing foundation was performed in summer 2009. The inspection...

Dune Management Challenges on Developed Coasts

DTIC Science & Technology

2016-10-01

provide essential ecosys- tem services, including habitat for en- dangered species such as piping plovers, sites of high tourism value, groundwater...maintaining the physical environment’s ability to support urban, commercial, and tourism uses, can lead to management approaches which do not...Beach nourishment and restoration is also valued by many stakeholders who recognize that tourism can decline where beach widths have decreased

A bill to authorize the Secretary of the Interior to make improvements to support facilities for National Historic Sites operated by the National Park Service, and for other purposes.

THOMAS, 113th Congress

Sen. Udall, Mark [D-CO

2013-05-23

Senate - 07/31/2013 Committee on Energy and Natural Resources Subcommittee on National Parks. Hearings held. With printed Hearing: S.Hrg. 113-93. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Harmony in Career Learning and Scholastic System (Project HI-CLASS). Final Evaluation Report 1992-93. OREA Report.

ERIC Educational Resources Information Center

Duque, Diana L.

Harmony in Career Learning and Scholastic System (Project HI-CLASS) was a Transitional Bilingual Education Title VII-funded program in its fifth and final year in 1992-93. The project offered instructional and support services to 641 students of limited English proficiency (LEP) at three sites, all of which had many immigrant students, in…

Developing Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT): protocol for a pilot randomized controlled trial.

PubMed

Watson, Dennis P; Ray, Bradley; Robison, Lisa; Xu, Huiping; Edwards, Rhiannon; Salyers, Michelle P; Hill, James; Shue, Sarah

2017-01-01

There is a lack of evidence-based substance use disorder treatment and services targeting returning inmates. Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT) is a community-driven, recovery-oriented approach to substance abuse care which has the potential to address this service gap. SUPPORT is modeled after Indiana's Access to Recovery program, which was closed due to lack of federal support despite positive improvements in clients' recovery outcomes. SUPPORT builds on noted limitations of Indiana's Access to Recovery program. The ultimate goal of this project is to establish SUPPORT as an effective and scalable recovery-oriented system of care. A necessary step we must take before launching a large clinical trial is pilot testing the SUPPORT intervention. The pilot will take place at Public Advocates in Community Re-Entry (PACE), nonprofit serving individuals with felony convictions who are located in Marion County, Indiana (Indianapolis). The pilot will follow a basic parallel randomized design to compare clients receiving SUPPORT with clients receiving standard services. A total of 80 clients within 3 months of prison release will be recruited to participate and randomly assigned to one of the two intervention arms. Quantitative measures will be collected at multiple time points to understand SUPPORT's impact on recovery capital and outcomes. We will also collect qualitative data from SUPPORT clients to better understand their program and post-discharge experiences. Successful completion of this pilot will prepare us to conduct a multi-site clinical trial. The ultimate goal of this future work is to develop an evidence-based and scalable approach to treating substance use disorder among persons returning to society after incarceration. ClinicalTrials.gov (Clinical Trials ID: NCT03132753 and Protocol Number: 1511731907). Registered 28 April 2017.

Meteorological support to the West German-United States Barium Ion Cloud Project.

NASA Technical Reports Server (NTRS)

Westfall, R. R.; Chamberlain, L. W.

1972-01-01

The objective of the Barium Ion Cloud Project was to study a barium ionized cloud released at an altitude of 5 earth radii. Accurate forecasting of weather conditions to prevail during the experiment period was critical to the project success. Good seeing conditions were required at all optical sites during the experiment. All meteorological support was the responsibility of the National Weather Service at Wallops Station, Virginia. Preliminary results confirm the scientists' theories of the magnetic fields and the existence of electric fields in the magnetosphere.

Skylab Rescue Space Vehicle OAT No. 1 Plugs in Test

NASA Technical Reports Server (NTRS)

Jevitt, S. J.

1973-01-01

A test is described which demonstrates the compatibility of the Skylab Rescue Space Vehicle systems, the ground support equipment, and off-site support facilities by proceeding through a simulated launch countdown, liftoff, and flight. The functions of propellant loading, umbilical ejection, holddown arm release, service arm retraction, liftoff, and inflight separation are simulated. An external power source supplies transfer power to internal, and instrument unit commands are simulated by the digital command system. The test outline is presented along with a list of references, intercommunications information, radio frequency matrix, and interface control chart.

Development by a Large Integrated Health Care System of an Objective Methodology for Evaluation of Medical Oncology Service Sites.

PubMed

Bjegovich-Weidman, Marija; Kahabka, Jill; Bock, Amy; Frick, Jacob; Kowalski, Helga; Mirro, Joseph

2012-03-01

Aurora Health Care (AHC) is the largest health care system in Wisconsin, with 14 acute care hospitals. In early 2010, a group of 18 medical oncologists became affiliated with AHC. This affiliation added 13 medical oncology infusion clinics to our existing 12 sites. In the era of health care reform and declining reimbursement, we need an objective method and criteria to evaluate our 25 outpatient medical oncology sites. We developed financial, clinical, and strategic tools for the evaluation and management of our cancer subservice lines and outpatient sites. The key to our success has been the direct involvement of stakeholders with a vested interest in the services in the selection of the criteria and evaluation process. We developed our objective metrics for evaluation based on strategic, financial, operational, and patient experience criteria. Strategic criteria included: population trends, full-time equivalent (FTE) medical oncologists/primary care physicians, FTE radiation oncologists, FTE oncologic surgeons, new annual cases of patients with cancer, and market share trends. Financial criteria per site included: physician work relative value units, staff FTE by type, staff salaries, and profit and loss. Operational criteria included: facility by type (clinic v hospital based), hours of operation, and facility detail (eg, No. of chairs, No. of procedure and examination rooms, square footage). Patient experience criteria included: nursing model primary/nurse navigators, multidisciplinary support at site, Press Ganey (South Bend, IN; health care performance improvement company) results, and employee engagement score. The outcome of our data analysis has resulted in the development of recommendations for AHC senior leadership and geographic market leadership to consider the consolidation of four sites (phase one, four sites; phase two, two sites) and priority strategic sites to address capacity issues that limit growth. The recommendations if implemented would result in significant cost savings, currently being quantified as a result of consolidation and improved efficiency. A reinvestment of these cost savings would be required to address facility expansion and program enhancement to maximize patient-centered expert care consistently across all of our remaining sites of service.

UK-based, multisite, prospective cohort study of small bowel obstruction in acute surgical services: National Audit of Small Bowel Obstruction (NASBO) protocol

PubMed Central

Sayers, Adele E; Drake, Thomas M; Hollyman, Marianne; Bradburn, Mike; Hind, Daniel; Wilson, Timothy R; Fearnhead, Nicola S; Abercrombie, John

2017-01-01

Introduction Small bowel obstruction (SBO) is a common indication for emergency laparotomy in the UK, which is associated with a 90-day mortality rate of 13%. There are currently no UK clinical guidelines for the management of this condition. The aim of this multicentre prospective cohort study is to describe the burden, variation in management and associated outcomes of SBO in the UK adult population. Methods and analysis UK hospitals providing emergency general surgery are eligible to participate. This study has three components: (1) a clinical preference questionnaire to be completed by consultants providing emergency general surgical care to assesses preferences in diagnostics and therapeutic approaches, including laparoscopy and nutritional interventions; (2) site resource profile questionnaire to indicate ease of access to diagnostic services, operating theatres, nutritional support teams and postoperative support including intensive care; (3) prospective cohort study of all cases of SBO admitted during an 8-week period at participating trusts. Data on diagnostics, operative and nutritional interventions, and in-hospital mortality and morbidity will be captured, followed by data validation. Ethics and dissemination This will be conducted as a national audit of practice in conjunction with trainee research collaboratives, with support from patient representatives, surgeons, anaesthetists, gastroenterologists and a clinical trials unit. Site-specific reports will be provided to each participant site as well as an overall report to be disseminated through specialist societies. Results will be published in a formal project report endorsed by stakeholders, and in peer-reviewed scientific reports. Key findings will be debated at a focused national meeting with a view to quality improvement initiatives. PMID:28982819

UK-based, multisite, prospective cohort study of small bowel obstruction in acute surgical services: National Audit of Small Bowel Obstruction (NASBO) protocol.

PubMed

Lee, Matthew J; Sayers, Adele E; Drake, Thomas M; Hollyman, Marianne; Bradburn, Mike; Hind, Daniel; Wilson, Timothy R; Fearnhead, Nicola S

2017-10-05

Small bowel obstruction (SBO) is a common indication for emergency laparotomy in the UK, which is associated with a 90-day mortality rate of 13%. There are currently no UK clinical guidelines for the management of this condition. The aim of this multicentre prospective cohort study is to describe the burden, variation in management and associated outcomes of SBO in the UK adult population. UK hospitals providing emergency general surgery are eligible to participate. This study has three components: (1) a clinical preference questionnaire to be completed by consultants providing emergency general surgical care to assesses preferences in diagnostics and therapeutic approaches, including laparoscopy and nutritional interventions; (2) site resource profile questionnaire to indicate ease of access to diagnostic services, operating theatres, nutritional support teams and postoperative support including intensive care; (3) prospective cohort study of all cases of SBO admitted during an 8-week period at participating trusts. Data on diagnostics, operative and nutritional interventions, and in-hospital mortality and morbidity will be captured, followed by data validation. This will be conducted as a national audit of practice in conjunction with trainee research collaboratives, with support from patient representatives, surgeons, anaesthetists, gastroenterologists and a clinical trials unit. Site-specific reports will be provided to each participant site as well as an overall report to be disseminated through specialist societies. Results will be published in a formal project report endorsed by stakeholders, and in peer-reviewed scientific reports. Key findings will be debated at a focused national meeting with a view to quality improvement initiatives. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluation of a quality improvement intervention to prevent mother-to-child transmission of HIV (PMTCT) at Zambia defence force facilities.

PubMed

Kim, Young Mi; Chilila, Maureen; Shasulwe, Hildah; Banda, Joseph; Kanjipite, Webby; Sarkar, Supriya; Bazant, Eva; Hiner, Cyndi; Tholandi, Maya; Reinhardt, Stephanie; Mulilo, Joyce Chongo; Kols, Adrienne

2013-09-08

The Zambian Defence Force (ZDF) is working to improve the quality of services to prevent mother-to-child transmission of HIV (PMTCT) at its health facilities. This study evaluates the impact of an intervention that included provider training, supportive supervision, detailed performance standards, repeated assessments of service quality, and task shifting of group education to lay workers. Four ZDF facilities implementing the intervention were matched with four comparison sites. Assessors visited the sites before and after the intervention and completed checklists while observing 387 antenatal care (ANC) consultations and 41 group education sessions. A checklist was used to observe facilities' infrastructure and support systems. Bivariate and multivariate analyses were conducted of findings on provider performance during consultations. Among 137 women observed during their initial ANC visit, 52% came during the first 20 weeks of pregnancy, but 19% waited until the 28th week or later. Overall scores for providers' PMTCT skills rose from 58% at baseline to 73% at endline (p=0.003) at intervention sites, but remained stable at 52% at comparison sites. Especially large gains were seen at intervention sites in family planning counseling (34% to 75%, p=0.026), HIV testing during return visits (13% to 48%, p=0.034), and HIV/AIDS management during visits that did not include an HIV test (1% to 34%, p=0.004). Overall scores for providers' ANC skills rose from 67% to 74% at intervention sites, but declined from 65% to 59% at comparison sites; neither change was significant in the multivariate analysis. Overall scores for group education rose from 87% to 91% at intervention sites and declined from 78% to 57% at comparison sites. The overall facility readiness score rose from 73% to 88% at intervention sites and from 75% to 82% at comparison sites. These findings are relevant to civilian as well as military health systems in Zambia because the two are closely coordinated. Lessons learned include: the ability of detailed performance standards to draw attention to and strengthen areas of weakness; the benefits of training lay workers to take over non-clinical PMTCT tasks; and the need to encourage pregnant women to seek ANC early.

Strengthening pharmaceutical systems for palliative care services in resource limited settings: piloting a mHealth application across a rural and urban setting in Uganda.

PubMed

Namisango, Eve; Ntege, Chris; Luyirika, Emmanuel B K; Kiyange, Fatia; Allsop, Matthew J

2016-02-19

Medicine availability is improving in sub-Saharan Africa for palliative care services. There is a need to develop strong and sustainable pharmaceutical systems to enhance the proper management of palliative care medicines, some of which are controlled. One approach to addressing these needs is the use of mobile technology to support data capture, storage and retrieval. Utilizing mobile technology in healthcare (mHealth) has recently been highlighted as an approach to enhancing palliative care services but development is at an early stage. An electronic application was implemented as part of palliative care services at two settings in Uganda; a rural hospital and an urban hospice. Measures of the completeness of data capture, time efficiency of activities and medicines stock and waste management were taken pre- and post-implementation to identify changes to practice arising from the introduction of the application. Improvements in all measures were identified at both sites. The application supported the registration and management of 455 patients and a total of 565 consultations. Improvements in both time efficiency and medicines management were noted. Time taken to collect and report pharmaceuticals data was reduced from 7 days to 30 min and 10 days to 1 h at the urban hospice and rural hospital respectively. Stock expiration reduced from 3 to 0.5% at the urban hospice and from 58 to 0% at the rural hospital. Additional observations relating to the use of the application across the two sites are reported. A mHealth approach adopted in this study was shown to improve existing processes for patient record management, pharmacy forecasting and supply planning, procurement, and distribution of essential health commodities for palliative care services. An important next step will be to identify where and how such mHealth approaches can be implemented more widely to improve pharmaceutical systems for palliative care services in resource limited settings.

Health diplomacy the adaptation of global health interventions to local needs in sub-Saharan Africa and Thailand: Evaluating findings from Project Accept (HPTN 043)

PubMed Central

2012-01-01

Background Study-based global health interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1) respond to socio-cultural differences in risk determinants, (2) to make interventions more relevant to target population needs, and (3) in recognition of ‘global health diplomacy' issues. We report on the adaptations development, approval and implementation process from the Project Accept voluntary counseling and testing, community mobilization and post-test support services intervention. Methods We reviewed all relevant documentation collected during the study intervention period (e.g. monthly progress reports; bi-annual steering committee presentations) and conducted a series of semi-structured interviews with project directors and between 12 and 23 field staff at each study site in South Africa, Zimbabwe, Thailand and Tanzania during 2009. Respondents were asked to describe (1) the adaptations development and approval process and (2) the most successful site-specific adaptations from the perspective of facilitating intervention implementation. Results Across sites, proposed adaptations were identified by field staff and submitted to project directors for review on a formally planned basis. The cross-site intervention sub-committee then ensured fidelity to the study protocol before approval. Successfully-implemented adaptations included: intervention delivery adaptations (e.g. development of tailored counseling messages for immigrant labour groups in South Africa) political, environmental and infrastructural adaptations (e.g. use of local community centers as VCT venues in Zimbabwe); religious adaptations (e.g. dividing clients by gender in Muslim areas of Tanzania); economic adaptations (e.g. co-provision of income generating skills classes in Zimbabwe); epidemiological adaptations (e.g. provision of ‘youth-friendly’ services in South Africa, Zimbabwe and Tanzania), and social adaptations (e.g. modification of terminology to local dialects in Thailand: and adjustment of service delivery schedules to suit seasonal and daily work schedules across sites). Conclusions Adaptation selection, development and approval during multi-site global health research studies should be a planned process that maintains fidelity to the study protocol. The successful implementation of appropriate site-specific adaptations may have important implications for intervention implementation, from both a service uptake and a global health diplomacy perspective. PMID:22716131

Microgravity

NASA Image and Video Library

1998-10-21

The Glenn Research Center (GRC) Telescience Support Center (TSC) is a NASA telescience ground facility that provides the capability to execute ground support operations of on-orbit International Space Station (ISS) and Space Shuttle payloads. This capability is provided with the coordination with the Marshall Space Flight Center (MSFC) Huntsville Operations Support Center (HOSC), the Johnson Space Center (JSC) Mission Control Center in Houston (MCC-H) and other remote ground control facilities. The concept of telescience is a result of NASA's vision to provide worldwide distributed ISS ground operations that will enable payload developers and scientists to control and monitor their on-board payloads from any location -- not necessarily a NASA site. This concept enhances the quality of scientific and technological data while decreasing operation costs of long-term support activities by providing ground operation services to a Principal Investigator and Engineering Team at their home site. The TSC acts as a hub in which users can either locate their operations staff within the walls of the TSC or request the TSC operation capabilities be extended to a location more convenient such as a university.

Three years experience with forward-site mass casualty triage-, evacuation-, operating room-, ICU-, and radiography-enabled disaster vehicles: development of usage strategies from drills and deployments.

PubMed

Griffiths, Jane L; Kirby, Neil R; Waterson, James A

2014-01-01

Delineation of the advantages and problems related to the use of forward-site operating room-, Intensive Care Unit (ICU)-, radiography-, and mass casualty-enabled disaster vehicles for site evacuation, patient stabilization, and triage. The vehicles discussed have six ventilated ICU spaces, two ORs, on-site radiography, 21 intermediate acuity spaces with stretchers, and 54 seated minor acuity spaces. Each space has piped oxygen with an independent vehicle-loaded supply. The vehicles are operated by the Dubai Corporate Ambulance Services. Their support hospital is the main trauma center for the Emirate of Dubai and provides the vehicles' surgical, intensivist, anesthesia, and nursing staff. The disaster vehicles have been deployed 264 times in the last 5 years (these figures do not include deployments for drills). Introducing this new service required extensive initial planning and ongoing analysis of the performance of the disaster vehicles that offer ambulance services and receiving hospitals a large array of possibilities in terms of triage, stabilization of priority I and II patients, and management of priority III patients. In both drills and in disasters, the vehicles were valuable in forward triage and stabilization and in the transport of large numbers of priority III patients. This has avoided the depletion of emergency transport available for priority I and II patients. The successful utilization of disaster vehicles requires seamless cooperation between the hospital staffing the vehicles and the ambulance service deploying them. They are particularly effective during preplanned deployments to high-risk situations. These vehicles also potentially provide self-sufficient refuges for forward teams in hostile environments.

Addressing the impact that workshop site coordinators and administrators have on the teaching of science in the classroom

NASA Astrophysics Data System (ADS)

McKenna, Valerie E.

This dissertation studied the beliefs and practices of principals, workshop site coordinators, and science support personnel in two Central Florida school districts and compared those beliefs and practices to the literature on effective science in-service education. It is important to understand these beliefs and practices because they directly affect the content and pedagogical knowledge of classroom teachers, yet this aspect of instructional practices has been ignored in the science education literature. This study used a grounded theory methodology using open-ended individual interviews, participants observation, and documented analysis. Constant comparisons were built through analyzing the data. The research shows that in-service providers' and administrators' beliefs are aligned with the effective science education in-service literature. The conditions and context are ripe for changes because principals and workshop site coordinators' beliefs are aligned with the literature and changes are already beginning to take place. The intervening conditions may lead to improved teacher knowledge, teaching, and learning because standardized testing is expanding to incorporate the content area of science. Also workshop site coordinators are trying to set up a variety of opportunities to attend workshops on the same topic throughout the school year. Budgets are being restructured at the school level and district level to incorporate more science content professional development. However, it is too early to show how much improvement there will be in standardized test scores or whether teachers' have a deeper understanding of science content knowledge or effective science instruction.

Hanford radiological protection support services annual report for 1994

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

Lyon, M.; Bihl, D.E.; Fix, J.J.

1995-06-01

Various Hanford Site radiation protection services provided by the Pacific Northwest Laboratory for the US Department of Energy Richland Operations Office and Hanford contractors are described in this annual report for the calendar year 1994. These activities include external dosimetry measurements and evaluations, internal dosimetry measurements and evaluations, in vivo measurements, radiological record keeping, radiation source calibration, and instrument calibration and evaluation. For each of these activities, the routine program and any program changes or enhancements are described, as well as associated tasks, investigations, and studies. Program- related publications, presentations, and other staff professional activities are also described.

Hanford radiological protection support services. Annual report for 1995

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

Lyon, M.; Bihl, D.E.; Carbaugh, E.H.

1996-05-01

Various Hanford Site radiation protection services provided by the Pacific Northwest National Laboratory for the U.S. Department of Energy Richland Operations Office and Hanford contractors are described in this annual report for calendar year 1995. These activities include external dosimetry measurements and evaluations, internal dosimetry measurements and evaluations, in vivo measurements, radiological record keeping, radiation source calibration, and instrument calibration and evaluation. For each of these activities, the routine program and any program changes or enhancements are described, as well as associated tasks, investigations, and studies. Program-related publications, presentations, and other staff professional activities are also described.

Impact of care management processes and integration of care on blood pressure control in diabetes.

PubMed

Wong, Ken; Boulanger, Luke; Smalarz, Amy; Wu, Ning; Fraser, Kimberly; Wogen, Jenifer

2013-02-27

Fragmentation within health care systems may negatively impact the quality of chronic disease patient care. We sought to evaluate the relationship between care management processes (CMP), integration of services, and blood pressure (BP) control among diabetic patients. Retrospective chart reviews were performed for a random sample of adult diabetic hypertensive patients (n = 2,162) from 28 physician organizations in the United States (US). A modified version of the Physician Practice Connection Readiness Survey (PPC-RS) was completed by the chief medical officer at each site. The PPC-RS measured health system organization, delivery system redesign, decision support, clinical information systems, and self-management support, and an integration scale measured structure, functions, and financial risk. Correlations between PPC and integration scores and BP outcomes were assessed using Spearman correlation coefficients. Approximately 39.9% of diabetic patients had controlled BP. Mean total PPC score across sites was 55, with highest mean scores for health system organization (81), followed by design support (60), clinical information systems (57), self-management support (39), and delivery system redesign (39). Mean integration score was 46 (SD 27, range 4-93), and means of subscores were 64 for structure, 33 for financial risk, and 42 for function. Clinical information systems subscore was correlated with uncontrolled BP (r = -0.38, p < 0.05), while association with total PPC score was strong but not significant at p < 0.05 (r = -0.32). Total integration score and the structure subscore were significantly correlated with BP control (r = 0.38, p < 0.05, and r = 0.49, p < 0.01). This study suggests that CMP and service integration may be associated with better outcomes in diabetes, though results were mixed and limited by a small number of participating sites. Primary care implementation of integrated electronic medical records may have a beneficial effect on patient outcomes for diabetes and other chronic diseases.

Impact of droughts on water provision in managed alpine grasslands in two climatically different regions of the Alps.

PubMed

Leitinger, Georg; Ruggenthaler, Romed; Hammerle, Albin; Lavorel, Sandra; Schirpke, Uta; Clement, Jean-Christophe; Lamarque, Pénélope; Obojes, Nikolaus; Tappeiner, Ulrike

2015-12-01

This study analyzes the impact of droughts, compared with average climatic conditions, on the supporting ecosystem service water provision in sub-watersheds in managed alpine grasslands in two climatically different regions of the Alps, Lautaret (French Alps) and Stubai (Austrian Alps). Soil moisture was modelled in the range of 0-0.3 m. At both sites, current patterns showed that the mean seasonal soil moisture was (1) near field capacity for grasslands with low management intensity and (2) below field capacity for grasslands with higher land-use intensity. Soil moisture was significantly reduced by drought at both sites, with lower reductions at the drier Lautaret site. At the sub-watershed scale, soil moisture spatial heterogeneity was reduced by drought. Under drought conditions, the evapotranspiration to precipitation ratios at Stubai was slightly higher than those at Lautaret, indicating a dominant 'water spending' strategy of plant communities. Regarding catchment water balance, deep seepage was reduced by drought at Stubai more strongly than at Lautaret. Hence, the observed 'water spending' strategy at Stubai might have negative consequences for downstream water users. Assessing the water provision service for alpine grasslands provided evidence that, under drought conditions, evapotranspiration was influenced not only by abiotic factors but also by the water-use strategy of established vegetation. These results highlight the importance of 'water-use' strategies in existing plant communities as predictors of the impacts of drought on water provision services and related ecosystem services at both the field and catchment scale.

Foreign aid or foreign investments: call for a paradigm shift in mentality and nomenclature

PubMed Central

Oleribe, Obinna Ositadimma; Nwanwanyu, Okey

2015-01-01

Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems. PMID:26113945

Foreign aid or foreign investments: call for a paradigm shift in mentality and nomenclature.

PubMed

Oleribe, Obinna Ositadimma; Nwanwanyu, Okey

2015-01-01

Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems.

Giving parents a voice: A qualitative study of the challenges experienced by parents of children with disabilities.

PubMed

Resch, J Aaron; Mireles, Gerardo; Benz, Michael R; Grenwelge, Cheryl; Peterson, Rick; Zhang, Dalun

2010-05-01

This study sought to examine the specific sources of challenges as identified by parents of children with disabilities. Focus groups were conducted with 40 parent caregivers. Data gathered were coded into themes which were then analyzed through an intentional process of data reduction that resulted in the cross site validation of four superordinate themes. Four themes emerged as the most prominent barriers to positive parent wellbeing: (a) access to information and services, (b) financial barriers, (c) school and community inclusion, and (d) family support. These four themes are indicative of problems associated with a lack of match between caregiver needs and services, resources, or support available in the community to meet those needs. Caring for a child with a disability can be challenging, but many of these challenges are likely due to a lack of necessary environmental supports. Future research should expand on these findings and policy makers, scientists and providers should give particular attention to the environmental support needs of parents in order to create policies and interventions that are more family-centered.

Capabilities of NASA's Space Physics Data Facility as Resources to Enable the Heliophysics Virtual discipline Observatories (VxOs)

NASA Technical Reports Server (NTRS)

McGuire, Robert E.; Candey, Robert M.

2007-01-01

SPDF now supports a broad range of data, user services and other activities. These include: CDAWeb current multi-mission data graphics, listings, file subsetting and supersetting by time and parameters; SSCWeb and 3-D Java client orbit graphics, listings and conjunction queries; OMNIWeb 1/5/60 minute interplanetary parameters at Earth; product-level SPASE descriptions of data including holdings of nssdcftp; VSPO SPASE-based heliophysics-wide product site finding and data use;, standard Data format Translation Webservices (DTWS); metrics software and others. These data and services are available through standard user and application webservices interfaces, so middleware services such as the Heliophysics VxOs, and externally-developed clients or services, can readily leverage our data and capabilities. Beyond a short summary of the above, we will then conduct the talk as a conversation to evolving VxO needs and planned approach to leverage such existing and ongoing services.

Telemedicine and electronic health information for clinical continuity in a mobile surgery program.

PubMed

Mora, Francisco; Cone, Stephen; Rodas, Edgar; Merrell, Ronald C

2006-06-01

An intermittent surgical services program in rural Ecuador was able to benefit from close collaboration between surgeons and primary care physicians through the use of telemedicine technologies. Inexpensive telemedicine workstations capable of patient documentation, imaging, and video-conferencing at extremely low bandwidth were established in collaborative primary care sites in rural Ecuador. Patients were screened for intermittent surgical services by primary caregivers according to the surgeons' guidelines. Real-time and store-and-forward telemedicine allowed appropriate collaborative, informed decision-making. Surgery was performed, and postoperative care was similarly handled by on-site, familiar primary caregivers. To date, this system has been used in more than 124 patient encounters (74 preoperative and 50 postoperative visits). The system allowed advance screening of patients on the part of the surgeons, leading to cancellations for 9 patients. Postoperatively, the system allowed 100% concurrence in postoperative diagnoses between the primary caregivers and the surgeons. Inexpensive, low-bandwidth telemedicine solutions can support intermittent surgical services by providing patients to have contact with specialist care through their familiar, local primary caregivers.

Commercial products that convey personal health information in emergencies.

PubMed

Potini, Vishnu C; Weerasuriya, Dilani N; Lowery-North, Douglas W; Kellermann, Arthur L

2011-12-01

Describe commercially available products and services designed to convey personal health information in emergencies. The search engine Google®, supplemented by print ads, was used to identify companies and organizations that offer relevant products and services to the general market. Disease-specific, health system, and health plan-specific offerings were excluded. Vendor web sites were the primary sources of information, supplemented by telephone and e-mail queries to sales representatives. Perfect inter-rater agreement was achieved. Thirty-nine unique vendors were identified. Eight sell engraved jewelry. Three offer an embossed card or pamphlet. Twelve supply USB drives with various features. Eleven support password-protected web sites. Five maintain national call centers. Available media differed markedly with respect to capacity and accessibility. Quoted prices ranged from a one-time expenditure of $3.50 to an annual fee of $200. Associated features and annual fees varied widely. A wide range of products and services exist to help patients convey personal health information. Health care providers should be familiar with their features, so they can access the information in a disaster or emergency.

The cost of HIV medication adherence support interventions: results of a cross-site evaluation.

PubMed

Schackman, B R; Finkelstein, R; Neukermans, C P; Lewis, L; Eldred, L

2005-11-01

The objective of this study was to determine the direct cost of HIV adherence support programmes participating in a cross-site evaluation in the US. Data on the frequency, type, and setting of adherence encounters; providers' professions; and adherence tools provided were collected for 1,122 patients enrolled in 13 interventions at 9 sites. The site staff estimated the average duration of each type of encounter and national wage rates were used for labour costs. The median (range) adherence encounters/year among interventions was 16.5 (4.3-104.6) per patient; encounters lasted 24.6 (8.9-40.9) minutes. Intervention direct cost was correlated with the average frequency of encounters (r = 0.57), but not with encounter duration or providers' professions. The median direct cost/month was 35 dollars(5 dollars-58 dollars) per patient, and included direct provider costs (66%); incentives (17%); reminders and other tools (8%); and direct administrative time, provider transportation, training, and home delivery (9%). The median direct cost/month from a societal perspective, which includes patient time and travel costs, was 47 dollars(24 dollars-114 dollars) per patient. Adherence interventions with moderate efficacy costing < or =100 dollars/month have been estimated to meet a cost-effectiveness threshold that is generally accepted in the US. Payers should consider enhanced reimbursement for adherence support services.

Strengthening primary eye care in South Africa: An assessment of services and prospective evaluation of a health systems support package

PubMed Central

Lilian, Rivka R.; Railton, Jean; Schaftenaar, Erik; Mabitsi, Moyahabo; Grobbelaar, Cornelis J.; Khosa, N. Sellina; Maluleke, Babra H.; Struthers, Helen E.; McIntyre, James A.

2018-01-01

Visual impairment is a significant public health concern, particularly in low- and middle-income countries where eye care is predominantly provided at the primary healthcare (PHC) level, known as primary eye care. This study aimed to perform an evaluation of primary eye care services in three districts of South Africa and to assess whether an ophthalmic health system strengthening (HSS) package could improve these services. Baseline surveys were conducted in Cape Winelands District, Johannesburg Health District and Mopani District at 14, 25 and 36 PHC facilities, respectively. Thereafter, the HSS package, comprising group training, individual mentoring, stakeholder engagement and resource provision, was implemented in 20 intervention sites in Mopani District, with the remaining 16 Mopani facilities serving as control sites. At baseline, less than half the facilities in Johannesburg and Mopani had dedicated eye care personnel or sufficient space to measure visual acuity. Although visual acuity charts were available in most facilities, <50% assessed patients at the correct distance. Median score for availability of nine essential drugs was <70%. Referral criteria knowledge was highest in Cape Winelands and Johannesburg, with poor clinical knowledge across all districts. Several HSS interventions produced successful outcomes: compared to control sites there was a significant increase in the proportion of intervention sites with eye care personnel and resources such as visual acuity charts (p = 0.02 and <0.01, respectively). However, engaging with district pharmacists did not improve availability of essential drugs (p = 0.47). Referral criteria knowledge improved significantly in intervention sites (p<0.01) but there was no improvement in clinical knowledge (p = 0.76). Primary eye care in South Africa faces multiple challenges with regard to organisation of care, resource availability and clinical competence. The HSS package successfully improved some aspects of this care, but further development is warranted together with debate regarding the positioning of eye services at PHC level. PMID:29758069

The effects of housing stability on service use among homeless adults with mental illness in a randomized controlled trial of housing first.

PubMed

Kerman, Nick; Sylvestre, John; Aubry, Tim; Distasio, Jino

2018-03-20

Housing First is an effective intervention to stably house and alter service use patterns in a large proportion of homeless people with mental illness. However, it is unknown whether there are differences in the patterns of service use over time among those who do or do not become stably housed and what effect, if any, Housing First has on these differing service use patterns. This study explored changes in the service use of people with mental illness who received Housing First compared to standard care, and how patterns of use differed among people who did and did not become stably housed. The study design was a multi-site randomized controlled trial of Housing First, a supported housing intervention. 2039 participants (Housing First: n = 1131; standard care: n = 908) were included in this study. Outcome variables include nine types of self-reported service use over 24 months. Linear mixed models examined what effects the intervention and housing stability had on service use. Participants who achieved housing stability, across the two groups, had decreased use of inpatient psychiatric hospitals and increased use of food banks. Within the Housing First group, unstably housed participants spent more time in prison over the study period. The Housing First and standard care groups both had decreased use of emergency departments and homeless shelters. The temporal service use changes that occurred as homeless people with mental illness became stably housed are similar for those receiving Housing First or standard care, with the exception of time in prison. Service use patterns, particularly with regard to psychiatric hospitalizations and time in prison, may signify persons who are at-risk of recurrent homelessness. Housing support teams should be alert to the impacts of stay-based services, such as hospitalizations and incarcerations, on housing stability and offer an increased level of support to tenants during critical periods, such as discharges. ISRCTN. ISRCTN42520374 . Registered 18 August 2009.

Ecosystem services - from assessements of estimations to quantitative, validated, high-resolution, continental-scale mapping via airborne LIDAR

NASA Astrophysics Data System (ADS)

Zlinszky, András; Pfeifer, Norbert

2016-04-01

"Ecosystem services" defined vaguely as "nature's benefits to people" are a trending concept in ecology and conservation. Quantifying and mapping these services is a longtime demand of both ecosystems science and environmental policy. The current state of the art is to use existing maps of land cover, and assign certain average ecosystem service values to their unit areas. This approach has some major weaknesses: the concept of "ecosystem services", the input land cover maps and the value indicators. Such assessments often aim at valueing services in terms of human currency as a basis for decision-making, although this approach remains contested. Land cover maps used for ecosystem service assessments (typically the CORINE land cover product) are generated from continental-scale satellite imagery, with resolution in the range of hundreds of meters. In some rare cases, airborne sensors are used, with higher resolution but less covered area. Typically, general land cover classes are used instead of categories defined specifically for the purpose of ecosystem service assessment. The value indicators are developed for and tested on small study sites, but widely applied and adapted to other sites far away (a process called benefit transfer) where local information may not be available. Upscaling is always problematic since such measurements investigate areas much smaller than the output map unit. Nevertheless, remote sensing is still expected to play a major role in conceptualization and assessment of ecosystem services. We propose that an improvement of several orders of magnitude in resolution and accuracy is possible through the application of airborne LIDAR, a measurement technique now routinely used for collection of countrywide three-dimensional datasets with typically sub-meter resolution. However, this requires a clear definition of the concept of ecosystem services and the variables in focus: remote sensing can measure variables closely related to "ecosystem service potential" which is the ability of the local ecosystem to deliver various functions (water retention, carbon storage etc.), but can't quantify how much of these are actually used by humans or what the estimated monetary value is. Due to its ability to measure both terrain relief and vegetation structure in high resolution, airborne LIDAR supports direct quantification of the properties of an ecosystem that lead to it delivering a given service (such as biomass, water retention, micro-climate regulation or habitat diversity). In addition, its high resolution allows direct calibration with field measurements: routine harvesting-based ecological measurements, local biodiversity indicator surveys or microclimate recordings all take place at the human scale and can be directly linked to the local value of LIDAR-based indicators at meter resolution. Therefore, if some field measurements with standard ecological methods are performed on site, the accuracy of LIDAR-based ecosystem service indicators can be rigorously validated. With this conceptual and technical approach high resolution ecosystem service assessments can be made with well established credibility. These would consolidate the concept of ecosystem services and support both scientific research and evidence-based environmental policy at local and - as data coverage is continually increasing - continental scale.

Update on the activities of the GGOS Bureau of Networks and Observations

NASA Technical Reports Server (NTRS)

Pearlman, Michael R.; Pavlis, Erricos C.; Ma, Chopo; Noll, Carey; Thaller, Daniela; Richter, Bernd; Gross, Richard; Neilan, Ruth; Mueller, Juergen; Barzaghi, Ricardo;

External Performance Evaluation Program Participation at Fluor Hanford (FH) 222S Lab

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

CLARK, G.A.

2002-06-01

Fluor Hanford operates the U. S. Department of Energy's (DOE) 2224 Laboratory on the Hanford Site in Southeastern Washington State. 222-S Laboratory recently celebrated its 50th anniversary of providing laboratory services to DOE and DOE contractors on the Hanford Site. The laboratory operated for many years as a production support analytical laboratory, but in the last two decades has supported the Hanford Site cleanup mission. The laboratory performs radioanalytical, inorganic, and organic characterization analyses on highly radioactive liquid and solid tank waste that will eventually be vitrified for long-term storage and or disposal. It is essential that the laboratory reportmore » defensible, highly credible data in its role as a service provider to DOE and DOE contractors. Among other things, the participation in a number of performance evaluation (PE) programs helps to ensure the credibility of the laboratory. The laboratory currently participates in Environmental Resource Associates' Water Pollution (WP) Studies and the DOE Environmental Management Laboratory (EML) Quality Assessment Program (QAP). DOE has mandated participation of the laboratory in the EML QAP. This EML program evaluates the competence of laboratories performing environmental radioanalytical measurements for DOE, and is the most comprehensive and well-established PE program in the DOE community for radiochemical laboratories. Samples are received and analyzed for radionuclides in air filter, soil, vegetation, and water matrices on a semiannual basis. The 222-S Laboratory has performed well in this program over the years as evidenced by the scores in the chart below.« less

Field Tested Service Oriented Robotic Architecture: Case Study

NASA Technical Reports Server (NTRS)

Flueckiger, Lorenzo; Utz, Hanz

2012-01-01

This paper presents the lessons learned from six years of experiments with planetary rover prototypes running the Service Oriented Robotic Architecture (SORA) developed by the Intelligent Robotics Group (IRG) at NASA Ames Research Center. SORA relies on proven software methods and technologies applied to the robotic world. Based on a Service Oriented Architecture and robust middleware, SORA extends its reach beyond the on-board robot controller and supports the full suite of software tools used during mission scenarios from ground control to remote robotic sites. SORA has been field tested in numerous scenarios of robotic lunar and planetary exploration. The results of these high fidelity experiments are illustrated through concrete examples that have shown the benefits of using SORA as well as its limitations.

WLCG Monitoring Consolidation and further evolution

NASA Astrophysics Data System (ADS)

Saiz, P.; Aimar, A.; Andreeva, J.; Babik, M.; Cons, L.; Dzhunov, I.; Forti, A.; di Girolamo, A.; Karavakis, E.; Litmaath, M.; Magini, N.; Magnoni, L.; de los Rios, H. Martin; Roiser, S.; Sciaba, A.; Schulz, M.; Tarragon, J.; Tuckett, D.

2015-12-01

The WLCG monitoring system solves a challenging task of keeping track of the LHC computing activities on the WLCG infrastructure, ensuring health and performance of the distributed services at more than 170 sites. The challenge consists of decreasing the effort needed to operate the monitoring service and to satisfy the constantly growing requirements for its scalability and performance. This contribution describes the recent consolidation work aimed to reduce the complexity of the system, and to ensure more effective operations, support and service management. This was done by unifying where possible the implementation of the monitoring components. The contribution also covers further steps like the evaluation of the new technologies for data storage, processing and visualization and migration to a new technology stack.

Defense Energy Support Center Fact Book FY 2007

DTIC Science & Technology

2008-03-21

3 M 21 years Fort Monmouth, NJ Lighting Upgrade, HVAC Renovation , UESC Implementation, GHP, Cogeneration System Site Preparation/Feasibility Ameresco...behalf of Navy Installations in the Sicily, Sardinia and Campania regions of Italy . Awards were made to two companies, ENEL Energia and Energia y...funded $333 million for SRM projects to maintain and renovate military Services owned fuels facilities worldwide . This amount was nearly double the

An Assessment of the Support Service Needs of Career and Technical Education Teachers and Their Students with Limited English Proficiency in Selected Pennsylvania AVTS's

ERIC Educational Resources Information Center

Wichowski, Chester P.; Nunez, Frances

2005-01-01

A survey was conducted among a population of 350 Career and Technical Education, CTE, teachers from 12 Career Technical Education Centers, CTC, sites in seven counties throughout Pennsylvania (return rate = 64%). The participating schools demographic settings, which were selected by the respondents, were closely divided between rural (37.9%) and…

Towards Gathering Initial Requirements of Developing a Mobile Service to Support Informal Learning at Cultural Heritage Sites

ERIC Educational Resources Information Center

Alkhafaji, Alaa; Fallahkhair, Sanaz; Cocea, Mihaela

2015-01-01

Informal learning allows learners to be in charge of their own learning process instead of being a content consumer. Harnessing mobile technology in informal learning field could help learners in taking a learning opportunity whenever they need either individually or in a group. This paper presents a small-scale study to investigate how people may…

Reentry Vehicle On-Site Inspection Technology Study

DTIC Science & Technology

1994-11-01

masking Image Additional required* generated information required/wquied Pasive radiation Neutron scanning Neutron dose rate PNS Yes No SRS/BMO Yes...considerations for RVOSI techbologles. Inspection methods Instrument Setup Data Host support proximity time collection (m) (hr) time (hir) Pasive radiation...The unwillingness of our own services to allow equipment in close proximity to missile front ends is a matter which will have to be considered if a

A national survey of health service infrastructure and policy impacts on access to computerised CBT in Scotland

PubMed Central

2012-01-01

Background NICE recommends computerised cognitive behavioural therapy (cCBT) for the treatment of several mental health problems such as anxiety and depression. cCBT may be one way that services can reduce waiting lists and improve capacity and efficiency. However, there is some doubt about the extent to which the National Health Service (NHS) in the UK is embracing this new health technology in practice. This study aimed to investigate Scottish health service infrastructure and policies that promote or impede the implementation of cCBT in the NHS. Methods A telephone survey of lead IT staff at all health board areas across Scotland to systematically enquire about the ability of local IT infrastructure and IT policies to support delivery of cCBT. Results Overall, most of the health boards possess the required software to use cCBT programmes. However, the majority of NHS health boards reported that they lack dedicated computers for patient use, hence access to cCBT at NHS sites is limited. Additionally, local policy in the majority of boards prevent staff from routinely contacting patients via email, skype or instant messenger, making the delivery of short, efficient support sessions difficult. Conclusions Conclusions: Overall most of the infrastructure is in place but is not utilised in ways that allow effective delivery. For cCBT to be successfully delivered within a guided support model, as recommended by national guidelines, dedicated patient computers should be provided to allow access to online interventions. Additionally, policy should allow staff to support patients in convenient ways such as via email or live chat. These measures would increase the likelihood of achieving Scottish health service targets to reduce waiting time for psychological therapies to 18 weeks. PMID:22958309

Rapid decision support tool based on novel ecosystem service variables for retrofitting of permeable pavement systems in the presence of trees.

PubMed

Scholz, Miklas; Uzomah, Vincent C

2013-08-01

The retrofitting of sustainable drainage systems (SuDS) such as permeable pavements is currently undertaken ad hoc using expert experience supported by minimal guidance based predominantly on hard engineering variables. There is a lack of practical decision support tools useful for a rapid assessment of the potential of ecosystem services when retrofitting permeable pavements in urban areas that either feature existing trees or should be planted with trees in the near future. Thus the aim of this paper is to develop an innovative rapid decision support tool based on novel ecosystem service variables for retrofitting of permeable pavement systems close to trees. This unique tool proposes the retrofitting of permeable pavements that obtained the highest ecosystem service score for a specific urban site enhanced by the presence of trees. This approach is based on a novel ecosystem service philosophy adapted to permeable pavements rather than on traditional engineering judgement associated with variables based on quick community and environment assessments. For an example case study area such as Greater Manchester, which was dominated by Sycamore and Common Lime, a comparison with the traditional approach of determining community and environment variables indicates that permeable pavements are generally a preferred SuDS option. Permeable pavements combined with urban trees received relatively high scores, because of their great potential impact in terms of water and air quality improvement, and flood control, respectively. The outcomes of this paper are likely to lead to more combined permeable pavement and tree systems in the urban landscape, which are beneficial for humans and the environment. Copyright © 2013 Elsevier B.V. All rights reserved.

75 FR 66795 - TTM Technologies, Including On-Site Leased Workers From Kelly Services, Aerotek, and an On-Site...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... follows: ``All workers TTM Technologies, including on-site leased workers from Kelly Services and Aerotek... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-64,993] TTM Technologies, Including On-Site Leased Workers From Kelly Services, Aerotek, and an On-Site Leased Worker From Orbotech...

SU-F-T-237: The Imaging and Radiation Oncology Core (IROC) Cooperatives Activities Supporting the NCI’s National Clinical Trial Network

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

Followill, D; Galvin, J; Michalski, J

Purpose: The Imaging and Radiation Oncology Core (IROC) Cooperative has been active for the past two years supporting the National Clinical Trial Network and the details of that support are reported. Methods: There are six QA centers (Houston, Ohio, Philadelphia-RT, Philadelphia-DI, Rhode Island, St. Louis) providing an integrated RT and DI quality control program in support of the NCI’s clinical trials. The QA Center’s efforts are focused on assuring high quality data for clinical trials designed to improve the clinical outcomes for cancer patients worldwide. This program is administered through five core services: site qualification, trial design support, credentialing, datamore » management, and case review. Results: IROC currently provides core support for 172 NCTN trials with RT, DI and RT/DI components. Many of these trials were legacy trial from the previous cooperative group program. IROC monitors nearly 1800 RT photon and 20 proton institutions. Over 28,000 beams outputs were monitored with 8% of the sites requiring repeat audits due to beam out of criteria. As part of credentialing, 950 QA phantoms have been irradiated, 515 imaging modalities evaluated and almost 4000 credentialing letters have been issued. In just year 2, 5290 RT and 4934 DI patient datasets were received (many using TRIAD) by IROC QA Centers to be prepared for review. During the past 2 years, a total of 6300 RT cases and 19,000 DI image sets were reviewed by IROC technical staff. To date, IROC has published 36 manuscripts. Conclusion: The QA services provided by IROC are numerous and are continually being evaluated for effectiveness, harmonized across all NCTN Groups and administered in an efficient and timely manner to enhance accurate and per protocol trial data submission. These efforts increase each NCTN Group’s ability to derive meaningful outcomes from their clinical trials. This work was supported by DHHS NIH grant 5U24CA180803.« less

Intensive Group Learning and On-Site Services to Improve Sexual and Reproductive Health Among Young Adults in Liberia: A Randomized Evaluation of HealthyActions.

PubMed

Firestone, Rebecca; Moorsmith, Reid; James, Simon; Urey, Marilyn; Greifinger, Rena; Lloyd, Danielle; Hartenberger-Toby, Lisa; Gausman, Jewel; Sanoe, Musa

2016-09-28

Young Liberians, particularly undereducated young adults, face substantial sexual and reproductive health (SRH) challenges, with low uptake of contraceptive methods, high rates of unintended pregnancy, and low levels of knowledge about HIV status. The purpose of this study was to assess the impact of a 6-day intensive group learning intervention combined with on-site SRH services (called HealthyActions) among out-of-school young adults, implemented through an existing alternative education program, on uptake of contraception and HIV testing and counseling (HTC). The intervention was implemented among young women and men ages 15-35 who were enrolled in alternative basic education learning sites in 5 counties of Liberia. We conducted a randomized evaluation to assess program impact. Baseline data were collected in January-March 2014, and endline data in June-July 2014. Key outcomes of condom use, contraceptive use, and HTC were estimated with difference-in-difference models using fixed effects. All analyses were conducted in Stata 13. We assessed outcomes for 1,157 learners at baseline and 1,052 learners at endline, across 29 treatment and 26 control sites. After adjusting for potential confounders, learners in the HealthyActions intervention group were 12% less likely to report never using a condom with a regular partner over the last month compared with the control group (P = .02). Female learners who received HealthyActions were 13% more likely to use any form of modern contraception compared with learners in control sites (P<.001), with the greatest increase in the use of contraceptive implants. Learners in HealthyActions sites were 45% more likely to have received HTC (P<.001). Providing intensive group learning in a supportive environment coupled with on-site health services improved SRH outcomes among participating learners. The focus of HealthyActions on participatory learning for low-literacy populations presents an adaptable solution for health programming across Liberia and the region. © Firestone et al.

Effects of climate change on tidal marshes along a latitudinal gradient in California

USGS Publications Warehouse

Thorne, Karen M.; MacDonald, Glen M.; Ambrose, Rich F.; Buffington, Kevin J.; Freeman, Chase M.; Janousek, Christopher N.; Brown, Lauren N.; Holmquist, James R.; Guntenspergen, Glenn R.; Powelson, Katherine W.; Barnard, Patrick L.; Takekawa, John Y.

2016-08-05

Public SummaryThe coastal region of California supports a wealth of ecosystem services including habitat provision for wildlife and fisheries. Tidal marshes, mudflats, and shallow bays within coastal estuaries link marine, freshwater and terrestrial habitats, and provide economic and recreational benefits to local communities. Climate change effects such as sea-level rise (SLR) are altering these habitats, but we know little about how these areas will change over the next 50–100 years. Our study examined the projected effects of three recent SLR scenarios produced for the West Coast of North America on tidal marshes in California. We compiled physical and biological data, including coastal topography, tidal inundation, plant composition, and sediment accretion to project how SLR may alter these ecosystems in the future. The goal of our research was to provide results that support coastal management and conservation efforts across California. Under a low SLR scenario, all study sites remained vegetated tidal wetlands, with most sites showing little elevation and vegetation change relative to sea level. At most sites, mid SLR projections led to increases in low marsh habitat at the expense of middle and high marsh habitat. Marshes at Morro Bay and Tijuana River Estuary were the most vulnerable to mid SLR with many areas becoming intertidal mudflat. Under a high SLR scenario, most sites were projected to lose vegetated habitat, eventually converting to intertidal mudflats. Our results suggest that California marshes are vulnerable to major habitat shifts under mid or high rates of SLR, especially in the latter part of the century. Loss of vegetated tidal marshes in California due to SLR is expected to impact ecosystem services that are dependent on coastal wetlands such as wildlife habitat, carbon sequestration, improved water quality, and coastal protection from storms.

Successful Proof of Concept of Family Planning and Immunization Integration in Liberia

PubMed Central

Cooper, Chelsea M; Fields, Rebecca; Mazzeo, Corinne I; Taylor, Nyapu; Pfitzer, Anne; Momolu, Mary; Jabbeh-Howe, Cuallau

2015-01-01

ABSTRACT Globally, unmet need for postpartum family planning remains high, while immunization services are among the most wide-reaching and equitable interventions. Given overlapping time frames, integrating these services provides an opportunity to leverage existing health visits to offer women more comprehensive services. From March through November 2012, Liberia's government, with support from the Maternal and Child Health Integrated Program (MCHIP), piloted an integrated family planning and immunization model at 10 health facilities in Bong and Lofa counties. Vaccinators provided mothers bringing infants for routine immunization with targeted family planning and immunization messages and same-day referrals to co-located family planning services. In February 2013, we compared service statistics for family planning and immunization during the pilot against the previous year's statistics. We also conducted in-depth interviews with service providers and other personnel and focus group discussions with clients. Results showed that referral acceptance across the facilities varied from 10% to 45% per month, on average. Over 80% of referral acceptors completed the family planning visit that day, of whom over 90% accepted a contraceptive method that day. The total number of new contraceptive users at participating facilities increased by 73% in Bong and by 90% in Lofa. Women referred from immunization who accepted family planning that day accounted for 44% and 34% of total new contraceptive users in Bong and Lofa, respectively. In Lofa, pilot sites administered 35% more Penta 1 and 21% more Penta 3 doses during the pilot period compared with the same period of the previous year, while Penta 1 and Penta 3 administration decreased in non-pilot facilities. In Bong, there was little difference in the number of Penta 1 and Penta 3 doses administered between pilot and non-pilot facilities. In both counties, Penta 1 to Penta 3 dropout rates increased at pilot sites but not in non-pilot facilities, possibly due to higher than average background dropout rates at pilot sites prior to the intervention in Lofa and the disproportionate effect of data from 1 large facility in Bong. The project provided considerable basic support to assess this proof of concept. However, results suggest that introducing a simple model that is minimally disruptive to existing immunization service delivery can facilitate integration. The model is currently being scaled-up to other counties in Liberia, which could potentially contribute to increased postpartum contraceptive uptake, leading to longer birth intervals and improved health outcomes for children and mothers. PMID:25745121

Strengths of the Northwell Health Laboratory Service Line

PubMed Central

Balfour, Erika; Stallone, Robert; Castagnaro, Joseph; Poczter, Hannah; Schron, Deborah; Martone, James; Breining, Dwayne; Simpkins, Henry; Neglia, Tom; Kalish, Paul

2016-01-01

From 2009 to 2015, the laboratories of the 19-hospital North Shore-LIJ Health System experienced 5 threatened interruptions in service and supported 2 regional health-care providers with threatened interruptions in their laboratory service. We report our strategies to maintain laboratory performance during these events, drawing upon the strengths of our integrated laboratory service line. Established in 2009, the laboratory service line has unified medical and administrative leadership and system-wide divisional structure, quality management, and standardization of operations and procedures. Among many benefits, this governance structure enabled the laboratories to respond to a series of unexpected events. Specifically, at our various service sites, the laboratories dealt with pandemic (2009), 2 floods (2010, 2012), 2 fires (2010, 2015), and laboratory floor subsidence (2013). We were also asked to provide support for a regional physician network facing abrupt loss of testing services from closure of another regional clinical laboratory (2010) and to intervene for a non-health system hospital threatened with closure owing to noncompliance of laboratory operations (2012). In all but a single instance, patient care was served without interruption in service. In the last instance, fire interrupted laboratory services for 30 minutes. We conclude that in a large integrated health system, threats to continuous laboratory operations are not infrequent when measured on an annual basis. While most threats are from external physical circumstances, some emanate from unexpected administrative events. A strong laboratory governance mechanism that includes unified medical and administrative leadership across the entirety of the laboratory service line enables successful responses to these threats. PMID:28725768

The Swedish Research Infrastructure for Ecosystem Science - SITES

NASA Astrophysics Data System (ADS)

Lindroth, A.; Ahlström, M.; Augner, M.; Erefur, C.; Jansson, G.; Steen Jensen, E.; Klemedtsson, L.; Langenheder, S.; Rosqvist, G. N.; Viklund, J.

2017-12-01

The vision of SITES is to promote long-term field-based ecosystem research at a world class level by offering an infrastructure with excellent technical and scientific support and services attracting both national and international researchers. In addition, SITES will make data freely and easily available through an advanced data portal which will add value to the research. During the first funding period, three innovative joint integrating facilities were established through a researcher-driven procedure: SITES Water, SITES Spectral, and SITES AquaNet. These new facilities make it possible to study terrestrial and limnic ecosystem processes across a range of ecosystem types and climatic gradients, with common protocols and similar equipment. In addition, user-driven development at the nine individual stations has resulted in e.g. design of a long-term agricultural systems experiment, and installation of weather stations, flux systems, etc. at various stations. SITES, with its integrative approach and broad coverage of climate and ecosystem types across Sweden, constitutes an excellent platform for state-of-the-art research projects. SITES' support the development of: A better understanding of the way in which key ecosystems function and interact with each other at the landscape level and with the climate system in terms of mass and energy exchanges. A better understanding of the role of different organisms in controlling different processes and ultimately the functioning of ecosystems. New strategies for forest management to better meet the many and varied requirements from nature conservation, climate and wood, fibre, and energy supply points of view. Agricultural systems that better utilize resources and minimize adverse impacts on the environment. Collaboration with other similar infrastructures and networks is a high priority for SITES. This will enable us to make use of each others' experiences, harmonize metadata for easier exchange of data, and support each other to widen the user community.

Remaining Sites Verification Package for the 1607-B1 Septic System, Waste Site Reclassification Form 2007-015

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

L. M. Dittmer

2007-08-30

The 1607-B1 Septic System includes a septic tank, drain field, and associated connecting pipelines and influent sanitary sewer lines. This septic system serviced the former 1701-B Badgehouse, 1720-B Patrol Building/Change Room, and the 1709-B Fire Headquarters. The 1607-B1 waste site received unknown amounts of nonhazardous, nonradioactive sanitary sewage from these facilities during its operational history from 1944 to approximately 1970. In accordance with this evaluation, the confirmatory sampling results support a reclassification of this site to No Action. The current site conditions achieve the remedial action objectives and the corresponding remedial action goals established in the Remaining Sites ROD. Themore » results of confirmatory sampling show that residual contaminant concentrations do not preclude any future uses and allow for unrestricted use of shallow zone soils. The results also demonstrate that residual contaminant concentrations are protective of groundwater and the Columbia River.« less

An evaluation of National Health Service England's Care Maker Programme: A mixed-methods analysis.

PubMed

Zubairu, Kate; Christiansen, Angela; Kirkcaldy, Andrew; Kirton, Jennifer A; Kelly, Carol A; Simpson, Paul; Gillespie, Andrea; Brown, Jeremy M

2017-12-01

To investigate the impact and sustainability of the Care Maker programme across England from the perspective of those involved in its delivery. The Care Maker programme was launched in England in 2013. It aims to support the "Compassion in Practice" strategy, with particular emphasis on the 6Cs of care, compassion, competence, communication, courage and commitment. Care Makers were recruited in an ambassadorial role. The intention was to inspire individuals throughout the National Health Service in England to bridge national policy with those delivering care. A mixed methods design was chosen, but this article focuses on two of the four distinct empirical data collection phases undertaken as part of this evaluation: a questionnaire with Care Makers; and two case studies of separate National Health Service trust sites. Data were collected for this evaluation in 2015. An online questionnaire was distributed to the total population of Care Makers across the National Health Service in England. It included a combination of open and closed questions. The case studies involved semistructured telephone interviews with a range of professionals engaged with the Care Maker programme across the trust sites. Care Makers reported that participation in the programme had offered opportunities in terms of improving the quality-of-care provision in the workplace as well as contributing towards their own professional development. The Care Maker programme has supported and helped underpin the nursing, midwifery and care strategy "Compassion in Practice". This model of using volunteers to embed strategy and policy could potentially be used in other areas of clinical practice and indeed in other countries. © 2017 John Wiley & Sons Ltd.

Fire Promotes Pollinator Visitation: Implications for Ameliorating Declines of Pollination Services

PubMed Central

Van Nuland, Michael E.; Haag, Elliot N.; Bryant, Jessica A. M.; Read, Quentin D.; Klein, Robert N.; Douglas, Morgan J.; Gorman, Courtney E.; Greenwell, Trey D.; Busby, Mark W.; Collins, Jonathan; LeRoy, Joseph T.; Schuchmann, George; Schweitzer, Jennifer A.; Bailey, Joseph K.

2013-01-01

Pollinators serve critical roles for the functioning of terrestrial ecosystems, and have an estimated annual value of over $150 billion for global agriculture. Mounting evidence from agricultural systems reveals that pollinators are declining in many regions of the world, and with a lack of information on whether pollinator communities in natural systems are following similar trends, identifying factors which support pollinator visitation and services are important for ameliorating the effects of the current global pollinator crisis. We investigated how fire affects resource structure and how that variation influences floral pollinator communities by comparing burn versus control treatments in a southeastern USA old-field system. We hypothesized and found a positive relationship between fire and plant density of a native forb, Verbesina alternifolia, as well as a significant difference in floral visitation of V. alternifolia between burn and control treatments. V. alternifolia density was 44% greater and floral visitation was 54% greater in burned treatments relative to control sites. When the density of V. alternifolia was experimentally reduced in the burn sites to equivalent densities observed in control sites, floral visitation in burned sites declined to rates found in control sites. Our results indicate that plant density is a proximal mechanism by which an imposed fire regime can indirectly impact floral visitation, suggesting its usefulness as a tool for management of pollination services. Although concerns surround the negative impacts of management, indirect positive effects may provide an important direction to explore for managing future ecological and conservation issues. Studies examining the interaction among resource concentration, plant apparency, and how fire affects the evolutionary consequences of altered patterns of floral visitation are overdue. PMID:24265787

Latent Homeless Risk Profiles of a National Sample of Homeless Veterans and Their Relation to Program Referral and Admission Patterns

PubMed Central

Kasprow, Wesley J.; Rosenheck, Robert A.

2013-01-01

Objectives. We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. Methods. We examined data from the VA’s new Homeless Operations Management and Evaluation System on 120 852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class solution compared both referral and admission to VA homeless services. Results. We identified 4 latent classes: relatively few problems, dual diagnosis, poverty–substance abuse–incarceration, and disabling medical problems. Homeless veterans in the first group were more likely to be admitted to the VA’s permanent supportive housing program, whereas those in the second group were more likely to be admitted to more restrictive VA residential treatment. Homeless veterans in the third group were more likely to be admitted to the VA’s prisoner re-entry program, and those in the fourth group were more likely to be directed to VA medical services. Conclusions. The heterogeneous risk and need profiles of homeless veterans supported the diversity of VA homeless services and encouraged the development of specialized services to meet their diverse needs. PMID:24148048

Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study.

PubMed

Westbrook, Johanna I; Braithwaite, Jeffrey; Gibson, Kathryn; Paoloni, Richard; Callen, Joanne; Georgiou, Andrew; Creswick, Nerida; Robertson, Louise

2009-11-08

Widespread adoption of information and communication technologies (ICT) is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care. A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care. A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care delivery. Such views have stifled debate as well as wider explorations of ICT's potential benefits, yet firm evidence of the effects of role changes on health service outcomes is limited. This project will provide important evidence about the role of ICT in supporting new models of care delivery across multiple healthcare organizations and about the ways in which innovative work practice change is diffused.

Microlearning mApp raises health competence: hybrid service design.

PubMed

Simons, Luuk P A; Foerster, Florian; Bruck, Peter A; Motiwalla, Luvai; Jonker, Catholijn M

Work place health support interventions can help support our aging work force, with mApps offering cost-effectiveness opportunities. Previous research shows that health support apps should offer users enough newness and relevance each time they are used. Otherwise the 'eHealth law of attrition' applies: 90 % of users are lost prematurely. Our research study builds on this prior research with further investigation on whether a mobile health quiz provides added value for users within a hybrid service mix and whether it promotes long term health? We developed a hybrid health support intervention solution that uses a mix of electronic and physical support services for improving health behaviours, including a mobile micro-learning health quiz. This solution was evaluated in a multiple-case study at three work sites with 86 users. We find that both our mobile health quiz and the overall hybrid solution contributed to improvements in health readiness, -behaviour and -competence. Users indicated that the micro-learning health quiz courses provided new and relevant information. Relatively high utilization rates of the health quiz were observed. Participants indicated that health insights were given that directly influenced every day health perceptions, -choices, coping and goal achievement strategies, plus motivation and self-norms. This points to increased user health self-management competence. Moreover, even after 10 months they indicated to still have improved health awareness, -motivation and -behaviours (food, physical activity, mental recuperation). A design analysis was conducted regarding service mix efficacy; the mobile micro-learning health quiz helped fulfil a set of key requirements that exist for designing ICT-enabled lifestyle interventions, largely in the way it was anticipated.

The faces of breastfeeding support: Experiences of mothers seeking breastfeeding support online.

PubMed

Bridges, Nicole

2016-03-01

The aim of this study was to advance understanding of the experiences of mothers using closed Facebook groups attached to the Australian Breastfeeding Association (ABA) and how these mothers find and share breastfeeding support and information using this forum. The study involved members of three closed Facebook groups that were chosen as interesting cases for study, based on the volume and nature of their posts. Members of these three groups then participated in online depth interviews and online semi-structured focus groups. The overarching theme identified was support, with four sub-themes that describe the nature of online breastfeeding support within the Facebook environment. These sub-themes are: community, complementary, immediate and information. It was found that social networking sites (SNSs) provide support from the trusted community. It is immediate, it complements existing support or services that ABA provides and also provides practical and valuable information for its users.

Unifying Access to National Hydrologic Data Repositories via Web Services

NASA Astrophysics Data System (ADS)

Valentine, D. W.; Jennings, B.; Zaslavsky, I.; Maidment, D. R.

2006-12-01

The CUAHSI hydrologic information system (HIS) is designed to be a live, multiscale web portal system for accessing, querying, visualizing, and publishing distributed hydrologic observation data and models for any location or region in the United States. The HIS design follows the principles of open service oriented architecture, i.e. system components are represented as web services with well defined standard service APIs. WaterOneFlow web services are the main component of the design. The currently available services have been completely re-written compared to the previous version, and provide programmatic access to USGS NWIS. (steam flow, groundwater and water quality repositories), DAYMET daily observations, NASA MODIS, and Unidata NAM streams, with several additional web service wrappers being added (EPA STORET, NCDC and others.). Different repositories of hydrologic data use different vocabularies, and support different types of query access. Resolving semantic and structural heterogeneities across different hydrologic observation archives and distilling a generic set of service signatures is one of the main scalability challenges in this project, and a requirement in our web service design. To accomplish the uniformity of the web services API, data repositories are modeled following the CUAHSI Observation Data Model. The web service responses are document-based, and use an XML schema to express the semantics in a standard format. Access to station metadata is provided via web service methods, GetSites, GetSiteInfo and GetVariableInfo. The methdods form the foundation of CUAHSI HIS discovery interface and may execute over locally-stored metadata or request the information from remote repositories directly. Observation values are retrieved via a generic GetValues method which is executed against national data repositories. The service is implemented in ASP.Net, and other providers are implementing WaterOneFlow services in java. Reference implementation of WaterOneFlow web services is available. More information about the ongoing development of CUAHSI HIS is available from http://www.cuahsi.org/his/.

Safe and Effective Deactivation of Metallic Sodium Filled Scrap and Cold Traps From Sodium-cooled Nuclear Reactor D and D - 12176

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

Nester, Dean; Crocker, Ben; Smart, Bill

2012-07-01

As part of the Plateau Remediation Project at US Department of Energy's Hanford, Washington site, CH2M Hill Plateau Remediation Company (CHPRC) contracted with IMPACT Services, LLC to receive and deactivate approximately 28 cubic meters of sodium metal contaminated debris from two sodium-cooled research reactors (Enrico Fermi Unit 1 and the Fast Flux Test Facility) which had been stored at Hanford for over 25 years. CHPRC found an off-site team composed of IMPACT Services and Commodore Advanced Sciences, Inc., with the facilities and technological capabilities to safely and effectively perform deactivation of this sodium metal contaminated debris. IMPACT Services provided themore » licensed fixed facility and the logistical support required to receive, store, and manage the waste materials before treatment, and the characterization, manifesting, and return shipping of the cleaned material after treatment. They also provided a recycle outlet for the liquid sodium hydroxide byproduct resulting from removal of the sodium from reactor parts. Commodore Advanced Sciences, Inc. mobilized their patented AMANDA unit to the IMPACT Services site and operated the unit to perform the sodium removal process. Approximately 816 Kg of metallic sodium were removed and converted to sodium hydroxide, and the project was accomplished in 107 days, from receipt of the first shipment at the IMPACT Services facility to the last outgoing shipment of deactivated scrap metal. There were no safety incidents of any kind during the performance of this project. The AMANDA process has been demonstrated in this project to be both safe and effective for deactivation of sodium and NaK. It has also been used in other venues to treat other highly reactive alkali metals, such as lithium (Li), potassium (K), NaK and Cesium (Cs). (authors)« less

'Drug adherence levels are falling down again': health worker perceptions of women's service utilization before and after integration of HIV/AIDS services into general care in India.

PubMed

Shukla, Shrivridhi; Muchomba, Felix M; McCoyd, Judith L M

2018-06-01

Integrated models of HIV/AIDS service delivery are believed to have advantages over stand-alone models of care from health planners' and providers' perspectives. Integration models differ, yet there is little information about the influence of differing models on workers' beliefs about models' efficacy. Here, we examine the effect of integration of HIV care into the general health system in India. In 2014, India replaced its stand-alone model of HIV service delivery-Community Care Centers (CCCs)-with a purported integrated model that delivers HIV medical services at general hospitals and HIV psychosocial services at nearby Care and Support Centers (CSCs). We examine 15 health workers' perceptions of how change from the earlier stand-alone model to the current model impacted women's care in a district in Uttar Pradesh, India. Results indicate that (1) Women's antiretroviral (ART) adherence and utilization of psychosocial support service for HIV/AIDS suffered when services were not provided at one site; (2) Provision of inpatient care in the CCC model offered women living in poverty personal safety in accessing HIV health services and promoted chances of competent ART usage and repeat service utilization; and (3) Although integration of HIV services with the general health system was perceived to improve patient anonymity and decrease chances of HIV-related stigma and discrimination, resource shortages continued to plague the integrated system while shifting costs of time and money to the patients. Findings suggest that integration efforts need to consider the context of service provision and the gendered nature of access to HIV care.

The Mobile Reference Service: a case study of an onsite reference service program at the School of Public Health.

PubMed

Tao, Donghua; McCarthy, Patrick G; Krieger, Mary M; Webb, Annie B

2009-01-01

The School of Public Health at Saint Louis University is located at a greater distance from the library than other programs on the main medical center campus. Physical distance diminishes the ease of access to direct reference services for public health users. To bridge the gap, the library developed the Mobile Reference Service to deliver on-site information assistance with regular office hours each week. Between September 2006 and April 2007, a total of 57 in-depth reference transactions took place over 25 weeks, averaging 2 transactions per week in a 2-hour period. Overall reference transactions from public health users went up 28%, while liaison contacts with public health users doubled compared to the same period the year before. The Mobile Reference Service program has improved library support for research and scholarship, cultivated and strengthened liaison relationships, and enhanced marketing and delivery of library resources and services to the Saint Louis University School of Public Health.

Main-streaming NFP into the Department of Health of the Philippines: opportunities and challenges.

PubMed

Infantado, R B

1997-01-01

In 1994, the Department of Health (DOH) of the Philippines issued a circular which reaffirmed natural family planning (NFP) as one of the basic services to be offered in all government family planning service sites and urged family planning workers to develop competence in teaching NFP methods. Although the circular represented a major policy breakthrough for the main-streaming of NFP it found the department without the capability or experience to directly provide NFP services. The two approaches the department is taking to respond to this new policy initiative are described in this paper. The selection of these approaches was influenced by the devolution of central government authority to local government units. The approaches include developing department capability in NFP training, service provision and service installation and creating a supportive program and policy environment. DOH partnership with an NFP non-government organization (NGO) has been critical in developing NFP capability within the government sector, particularly in NFP training and service installation.

A survey of nurse staffing levels in interventional radiology units throughout the UK.

PubMed

Christie, A; Robertson, I

2016-07-01

To supplement previous surveys analysing provision of interventional radiology (IR), in-hours (IH) and out-of-hours (OOH), by specifically surveying the level of nursing support provided. A web-based questionnaire was distributed to all British Society of Interventional Radiology (BSIR) members. This addressed several aspects of radiology nursing support for IR procedures, both IH and OOH. Sixty percent of respondents indicated that they have a formal OOH service. Of these, all have a dedicated nursing rota, with the vast majority operating with one nurse. IH, 77% of respondents always have a scrubbed nurse assistant, but this reduces to 40% OOH. IH, 4% never have a scrubbed radiology nurse assistant, which rises to 25% OOH. IH, 75% of respondents always have a radiology nurse dedicated to patient monitoring, but this reduces to 20% OOH. IH, 3% never have a radiology nurse dedicated to patient monitoring, which rises to 42% OOH. A significant disparity exists in the level of IR nursing support between IH and OOH. The majority of sites provide a single nurse with ad hoc additional support. This is potentially putting patients at increased risk. Radiology nurses are integral to the safe and sustainable provision of IR OOH services and a greater focus is required to ensure adequate and safe staffing levels for 24/7 IR services. Copyright © 2016. Published by Elsevier Ltd.

Effects of a demand-led evidence briefing service on the uptake and use of research evidence by commissioners of health services: protocol for a controlled before and after study.

PubMed

Wilson, Paul M; Farley, Kate; Thompson, Carl; Chambers, Duncan; Bickerdike, Liz; Watt, Ian S; Lambert, Mark; Turner, Rhiannon

2015-01-09

Clinical Commissioning Groups (CCGs) are mandated to use research evidence effectively to ensure optimum use of resources by the National Health Service (NHS), both in accelerating innovation and in stopping the use of less effective practices and models of service delivery. We intend to evaluate whether access to a demand-led evidence service improves uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. This is a controlled before and after study involving CCGs in the North of England. Participating CCGs will receive one of three interventions to support the use of research evidence in their decision-making: 1) consulting plus responsive push of tailored evidence; 2) consulting plus an unsolicited push of non-tailored evidence; or 3) standard service unsolicited push of non-tailored evidence. Our primary outcome will be changed at 12 months from baseline of a CCGs ability to acquire, assess, adapt and apply research evidence to support decision-making. Secondary outcomes will measure individual clinical leads and managers' intentions to use research evidence in decision making. Documentary evidence of the use of the outputs of the service will be sought. A process evaluation will evaluate the nature and success of the interactions both within the sites and between commissioners and researchers delivering the service. The proposed research will generate new knowledge of direct relevance and value to the NHS. The findings will help to clarify which elements of the service are of value in promoting the use of research evidence. Those involved in NHS commissioning will be able to use the results to inform how best to build the infrastructure they need to acquire, assess, adapt and apply research evidence to support decision-making and to fulfil their statutory duties under the Health and Social Care Act.

78 FR 16871 - Notice of Availability of Funds and Solicitation for Grant Applications for Training to Work...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-19

...The Employment and Training Administration (ETA) U.S. Department of Labor (DOL), announces the availability of approximately $20 million in grant funds authorized by the Workforce Investment Act and the Second Chance Act of 2007 to serve adult offenders enrolled in state and/or local work-release programs. Under this solicitation, DOL expects to award 15 grants for up to $1,400,000 each to cover a 39-month period of performance, which includes a planning period of up to six months, program operation period of 24 months, and follow-up services of at least nine months provided to each participant. Any non-profit organization with Internal Revenue Service 501(c)(3) status may apply for these grants to provide services to eligible participants in areas of high-poverty and high- crime rates. These services will include case management; mentoring to support reintegration; education and/or training leading to industry- recognized credentials for in demand industries and occupations in the state or local area; integrated workforce activities to reduce recidivism; and follow-up services. The complete SGA and any subsequent SGA amendments in connection with this solicitation are described in further detail on ETA's Web site at http://www.doleta.gov/grants/ or on http://www.grants.gov. The Web sites provide application information, eligibility requirements, review and selection procedures, and other program requirements governing this solicitation.

'Halfway people': refugee views of reproductive health services.

PubMed

Whelan, A; Blogg, J

2007-01-01

The objective of this study was to identify factors that facilitate or hinder access to, use of, and satisfaction with reproductive health services in refugee settings, from the perspective of beneficiaries. Rapid appraisal methods included 46 focus group discussions and interviews with over 800 refugees, audits of 14 health facilities, referral hospital reviews, exit interviews with clients, and interviews with health workers. The study was conducted between February and April 2004 in 11 sites in Uganda, Republic of Congo, and Yemen. Reproductive health was clearly on the policy agenda in all countries with stable refugee sites, but problems with implementation and resources were identified. The quality of services was variable, with high staff turnover in some areas affecting relationships with refugee clients. Referral hospitals in host countries were not all equipped to deal with obstetric and other emergencies of either local or refugee populations, including deficiencies in safe blood supplies and antibiotics. Diagnosis and treatment of STIs and HIV/AIDS was frequently inadequate. Gender based violence was the least well addressed aspect of reproductive health. Interest and knowledge about family planning was high, but acceptance was low. It was concluded that progress has been made in reproductive health services for refugees since 1994, however, urgent advocacy and action is required to sustain and improve the situation. Local implementing partners need more support and supervision to develop appropriate service models and to maintain an acceptable standard of care.

Impact of Resource-Based Practice Expenses on the Medicare Physician Volume

PubMed Central

Maxwell, Stephanie; Zuckerman, Stephen

2007-01-01

In 1999, Medicare implemented a resource-based relative value unit (RVU) system for physician practice expense payments, and increased the number of services for which practice expense payments differ by site. Using 1998-2004 data, we examined RVU growth and decomposed that growth into resource-based RVUs, site of service, and service quantity and mix. We found that the number services with site of service differentials doubled, and that shifts in site of service and introduction of resource-based practice expenses (RBPE) were important sources of change in practice expense RVU volume. Service quantity and mix remained the largest source of growth in total RVU volume. PMID:18435224

Measuring economic value for tourism destination using contingent valuation method: The Sangiran Sites, Central Java Province, Indonesia

NASA Astrophysics Data System (ADS)

Subanti, S.; Zukhronah, E.; Handajani, S. S.; Irawan, BRM B.; Hakim, A. R.

2018-03-01

This purpose of study aims to estimate the economic value for quality improvement in Sangiran, Indonesia. This paper used contingent valuation method. The study was found significant factors affecting the probability of individuals to be willing to pay for quality improvement are the nominal amount bid, gender, and income. The economic value of Sangiran sites tourism was estimated between Rp 2.219 billion per year until Rp 2.756 billion per year. This value can be a guidance for management of the Sangiran as a basic reason for Sangiran’s improvement. The improvement includes to add the collection, to build supporting infrastructure in Sangiran, to increase services, to arrange training for Sangiran staff, and others. The suggestion from this paper, we must support the local government for Sangiran improvement, because it can be profitable and it can give benefits from many aspects includes economic, historical, and education.

Landlord project multi-year program plan, fiscal year 1999, WBS 1.5

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

Dallas, M.D.

The MYWP technical baseline describes the work to be accomplished by the Project and the technical standards which govern that work. The mission of Landlord Project is to provide more maintenance replacement of general infrastructure facilities and systems to facilitate the Hanford Site cleanup mission. Also, once an infrastructure facility or system is no longer needed the Landlord Project transitions the facility to final closure/removal through excess, salvage or demolition. Landlord Project activities will be performed in an environmentally sound, safe, economical, prudent, and reliable manner. The Landlord Project consists of the following facilities systems: steam, water, liquid sanitary waste,more » electrical distribution, telecommunication, sanitary landfill, emergency services, general purpose offices, general purpose shops, general purpose warehouses, environmental supports facilities, roads, railroad, and the site land. The objectives for general infrastructure support are reflected in two specific areas, (1) Core Infrastructure Maintenance, and (2) Infrastructure Risk Mitigation.« less

The psychosocial experience of parents receiving care closer to home for their ill child.

PubMed

Spiers, Gemma; Parker, Gillian; Gridley, Kate; Atkin, Karl

2011-11-01

Current health policy in England regarding the management of childhood illness advocates for care to be delivered as close to home as possible. The aim of this article is to report findings from a qualitative component of a larger study evaluating models of care closer to home (CCTH) for children and young people who are ill. The focus is on parents' psychosocial experience of receiving CCTH for their ill child. A qualitative case study design was used, with four Primary Care Trusts in England as the case study sites. In-depth, semi-structured interviews were conducted with 27 parents and one extended family caregiver of children using CCTH services within the case study sites. Interviews were conducted face-to-face and audio-recorded with permission. Data were collected in 2009. There was an overall preference for CCTH over hospital-based care where possible. The parents in this study experienced differing levels of responsibility as part of this care, and responded to this in different ways. Being supported emotionally and socially by practitioners was an important part of receiving CCTH for parents, especially when they had increased responsibility as part of this care. Developing relationships with practitioners appeared to be a medium through which parents received support. If the provision of CCTH continues to expand in line with current policy, provision of support for parents should be considered a fundamental aspect of service development. © 2011 Blackwell Publishing Ltd.

39 CFR 3001.12 - Service of documents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... or presiding officer has determined is unable to receive service through the Commission's Web site... presiding officer has determined is unable to receive service through the Commission Web site shall be by... service list for each current proceeding will be available on the Commission's Web site http://www.prc.gov...

The evolution of the CUAHSI Water Markup Language (WaterML)

NASA Astrophysics Data System (ADS)

Zaslavsky, I.; Valentine, D.; Maidment, D.; Tarboton, D. G.; Whiteaker, T.; Hooper, R.; Kirschtel, D.; Rodriguez, M.

2009-04-01

The CUAHSI Hydrologic Information System (HIS, his.cuahsi.org) uses web services as the core data exchange mechanism which provides programmatic connection between many heterogeneous sources of hydrologic data and a variety of online and desktop client applications. The service message schema follows the CUAHSI Water Markup Language (WaterML) 1.x specification (see OGC Discussion Paper 07-041r1). Data sources that can be queried via WaterML-compliant water data services include national and international repositories such as USGS NWIS (National Water Information System), USEPA STORET (Storage & Retrieval), USDA SNOTEL (Snowpack Telemetry), NCDC ISH and ISD(Integrated Surface Hourly and Daily Data), MODIS (Moderate Resolution Imaging Spectroradiometer), and DAYMET (Daily Surface Weather Data and Climatological Summaries). Besides government data sources, CUAHSI HIS provides access to a growing number of academic hydrologic observation networks. These networks are registered by researchers associated with 11 hydrologic observatory testbeds around the US, and other research, government and commercial groups wishing to join the emerging CUAHSI Water Data Federation. The Hydrologic Information Server (HIS Server) software stack deployed at NSF-supported hydrologic observatory sites and other universities around the country, supports a hydrologic data publication workflow which includes the following steps: (1) observational data are loaded from static files or streamed from sensors into a local instance of an Observations Data Model (ODM) database; (2) a generic web service template is configured for the new ODM instance to expose the data as a WaterML-compliant water data service, and (3) the new water data service is registered at the HISCentral registry (hiscentral.cuahsi.org), its metadata are harvested and semantically tagged using concepts from a hydrologic ontology. As a result, the new service is indexed in the CUAHSI central metadata catalog, and becomes available for spatial and semantics-based queries. The main component of interoperability across hydrologic data repositories in CUAHSI HIS is mapping different repository schemas and semantics to a shared community information model for observations made at stationary points. This information model has been implemented as both a relational schema (ODM) and an XML schema (WaterML). Its main design drivers have been data storage and data interchange needs of hydrology researchers, a series of community reviews of the ODM, and the practices of hydrologic data modeling and presentation adopted by federal agencies as observed in agency online data access applications, such as NWISWeb and USEPA STORET. The goal of the first version of WaterML was to encode the semantics of hydrologic observations discovery and retrieval and implement water data services in a way that is generic across different data providers. In particular, this implied maintaining a single common representation for the key constructs returned to web service calls, related to observations, features of interest, observation procedures, observation series, etc. Another WaterML design consideration was to create (in version 1 of CUAHSI HIS in particular) a fairly rigid, compact, and simple XML schema which was easy to generate and parse, thus creating the least barrier for adoption by hydrologists. Each of the three main request methods in the water data web services - GetSiteInfo, GetVariableInfo, and GetValues - has a corresponding response element in WaterML: SiteResponse, VariableResponse, and TimeSeriesResponse. The strictness and compactness of the first version of WaterML supported its community adoption. Over the last two years, several ODM and WaterML implementations for various platforms have emerged, and several Water Data Services client applications have been created by outside groups in both industry and academia. In a significant development, the WaterML specification has been adopted by federal agencies. The experimental USGS NWIS Daily Values web service returns WaterML-compliant TimeSeriesResponse. NCDC is also prototyping WaterML for data delivery, and has developed a REST-based service that generates WaterML- compliant output for its integrated station network. These agency-supported web services provide a much more efficient way to deliver agency data compared to the web site scraper services that the CUAHSI HIS project developed initially. Adoption of WaterML by the US Geological Survey is particularly significant because the USGS maintains by far the largest water data repository in the United States. For version 1.1, WaterML has evolved to reflect the deployment experience at hydrologic observatory testbeds, as well as feedback from hydrologic data repository managers at federal and state agencies. Further development of WaterML and enhancement of the underlying information model is the focus of the recently established OGC Hydrology Domain Working Group, whose mission is to profile OGC standards (GML, O&M, SOS, WCS, WFS) for the water resources domain and thus ensure WaterML's wider applicability and easier implementation. WaterML 2.0 is envisioned as an OGC-compliant application schema that supports OGC features, can express different types of observations and various groupings of observations, and allows researchers to define custom metadata elements. This presentation will discuss the information model underlying WaterML and describe the rationale, design drivers and evolution of WaterML and the water data services, illustrating their recent application in the context of CUAHSI HIS and the hydrologic observatory testbeds.

Contrasting and not-so-contrasting perspectives between local stakeholders and scientists and across dryland sites in participatory assessment of land management

NASA Astrophysics Data System (ADS)

Bautista, Susana; Zucca, Claudio; Urghege, Anna M.; Ramón Vallejo, V.

2015-04-01

The participation of stakeholders and the integration of scientific and local knowledge in the assessment of environmental problems and potential solutions have been increasingly demanded by international institutions. Participatory assessment has the potential to engender social learning among all stakeholders, including scientists, which then has the potential to increase collaboration and the probability for adoption of good practices. Using PRACTICE participatory assessment tool, IAPro, a number of assessment criteria were identified, selected and weighted by local stakeholder platforms (SHPs) and scientists in 18 dryland sites distributed across 11 countries. These criteria were then applied to the assessment of a variety of local land management actions. In total, around 50 criteria were proposed by the SHPs, ranging from 6 to 14 per platform. The proposed criteria represented a wide variety of social, economic, cultural, and environmental aspects. Many of them were proposed by many of the SHPs, stressing their potential as universal assessment criteria across drylands. In most cases, these repeatedly proposed criteria were the same criteria proposed by the scientific panel. The relative importance given to the variety of criteria by each SHP was evenly distributed among the economic wealth criterion and each of the main categories of ecosystem services (provisioning, supporting & regulating, and cultural). In general, African and American sites where local people economies heavily rely on natural lands gave higher weights than European sites to "economic-wealth", "provision of goods", and "supporting and regulating services" criteria, and also to "socio-cultural services". All European SHPs selected and gave great importance to criteria that are related to security, such hydrogeological hazard, flood prevention, and fire risk. The participatory assessment process in IAPro facilitated social learning among the stakeholders, including scientists, and promoted knowledge exchange at multiple levels. The change between the initial and final perspectives on the assessment criteria and the quality of the management actions assessed was considered to be a metric of the learning gained through the IAPro process. A decrease in the variability of weights and rates given by the stakeholders to each criteria and management action reflects the consensus building process that takes place during the discussion sessions.

Challenges encountered in the conduct of Optimal Health: A patient-centered comparative effectiveness study of interventions for adults with serious mental illness.

PubMed

Kogan, Jane N; Schuster, James; Nikolajski, Cara; Schake, Patricia; Carney, Tracy; Morton, Sally C; Kang, Chaeryon; Reynolds, Charles F

2017-02-01

The aim of patient-centered comparative effectiveness research is to conduct stakeholder-driven investigations that identify which interventions are most effective for which patients under specific circumstances. Conducting this research in real-world settings comes with unique experiences and challenges. We provide the study design, challenges confronted, and the solutions we devised for Optimal Health, a stakeholder-informed patient-centered comparative effectiveness study focused on the needs of seriously mentally ill individuals receiving case management services in community mental health centers across Pennsylvania. Optimal Health, supported by the Patient-Centered Outcomes Research Institute, is a cluster-randomized trial of two evidence-based interventions for improving health and wellness across 11 provider sites. Participants were followed for 18-24 months, with repeated measurements of self-reported health status and activation in care and administrative measurements of primary and specialty health service utilization. Health-related quality of life, engagement in care, and service utilization are to be compared via random effects mixed models. Stakeholders were, and continue to be, engaged via focus groups, interviews, and stakeholder advisory board meetings. A learning collaborative model was used to support shared learning and implementation fidelity across provider sites. From 1 November 2013 through 15 July 2014, we recruited 1229 adults with serious mental illness, representing 85.1% of those eligible for study participation. Of these, 713 are in the Provider-Supported arm of the study and 516 in Patient Self-Directed Care. Across five data collection time points, we retained 86% and 83% of the participants in the Provider-Supported and Self-Directed arms, respectively. Lessons learned relate to estimation of the size of our study population, the value of multiple data sources, and intervention training and implementation. The use of historical claims data can lead to an overestimation of eligible participants and, subsequently, a reduced study sample and an imbalance between intervention arms. Disruptions in continuity of care in real-world settings can pose challenges to on-site self-report data collection, although the inclusion of multiple data sources in study design can improve data completeness. Geographic dispersion of rural provider sites and staff turnover can lead to training and intervention fidelity challenges that can be overcome with the use of a "train-the-trainer" model, "wellness champions," and the use of a Learning Collaborative approach. Stakeholder engagement in mitigating these challenges proved to be critical to study progress. Conducting real-world patient-centered comparative effectiveness research in healthcare systems that care for seriously mentally ill persons is an important yet challenging undertaking, one which requires flexibility in identifying potential adaptations within all major study phases. Advice from a wide range of stakeholders is critical in development of successful strategies.

Analysing biodiversity and conservation knowledge products to support regional environmental assessments

PubMed Central

Brooks, Thomas M.; Akçakaya, H. Resit; Burgess, Neil D.; Butchart, Stuart H.M.; Hilton-Taylor, Craig; Hoffmann, Michael; Juffe-Bignoli, Diego; Kingston, Naomi; MacSharry, Brian; Parr, Mike; Perianin, Laurence; Regan, Eugenie C.; Rodrigues, Ana S.L.; Rondinini, Carlo; Shennan-Farpon, Yara; Young, Bruce E.

2016-01-01

Two processes for regional environmental assessment are currently underway: the Global Environment Outlook (GEO) and Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES). Both face constraints of data, time, capacity, and resources. To support these assessments, we disaggregate three global knowledge products according to their regions and subregions. These products are: The IUCN Red List of Threatened Species, Key Biodiversity Areas (specifically Important Bird & Biodiversity Areas [IBAs], and Alliance for Zero Extinction [AZE] sites), and Protected Planet. We present fourteen Data citations: numbers of species occurring and percentages threatened; numbers of endemics and percentages threatened; downscaled Red List Indices for mammals, birds, and amphibians; numbers, mean sizes, and percentage coverages of IBAs and AZE sites; percentage coverage of land and sea by protected areas; and trends in percentages of IBAs and AZE sites wholly covered by protected areas. These data will inform the regional/subregional assessment chapters on the status of biodiversity, drivers of its decline, and institutional responses, and greatly facilitate comparability and consistency between the different regional/subregional assessments. PMID:26881749

SecureMA: protecting participant privacy in genetic association meta-analysis.

PubMed

Xie, Wei; Kantarcioglu, Murat; Bush, William S; Crawford, Dana; Denny, Joshua C; Heatherly, Raymond; Malin, Bradley A

2014-12-01

Sharing genomic data is crucial to support scientific investigation such as genome-wide association studies. However, recent investigations suggest the privacy of the individual participants in these studies can be compromised, leading to serious concerns and consequences, such as overly restricted access to data. We introduce a novel cryptographic strategy to securely perform meta-analysis for genetic association studies in large consortia. Our methodology is useful for supporting joint studies among disparate data sites, where privacy or confidentiality is of concern. We validate our method using three multisite association studies. Our research shows that genetic associations can be analyzed efficiently and accurately across substudy sites, without leaking information on individual participants and site-level association summaries. Our software for secure meta-analysis of genetic association studies, SecureMA, is publicly available at http://github.com/XieConnect/SecureMA. Our customized secure computation framework is also publicly available at http://github.com/XieConnect/CircuitService. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Expansion of Safe Abortion Services in Nepal Through Auxiliary Nurse‐Midwife Provision of Medical Abortion, 2011‐2013

PubMed Central

Basnett, Indira; Shrestha, Dirgha Raj; Shrestha, Meena Kumari; Shah, Mukta; Aryal, Shilu

2016-01-01

Introduction The termination of unwanted pregnancies up to 12 weeks’ gestation became legal in Nepal in 2002. Many interventions have taken place to expand access to comprehensive abortion care services. However, comprehensive abortion care services remain out of reach for women in rural and remote areas. This article describes a training and support strategy to train auxiliary nurse‐midwives (ANMs), already certified as skilled birth attendants, as medical abortion providers and expand geographic access to safe abortion care to the community level in Nepal. Methods This was a descriptive program evaluation. Sites and trainees were selected using standardized assessment tools to determine minimum facility requirements and willingness to provide medical abortion after training. Training was evaluated via posttests and observational checklists. Service statistics were collected through the government's facility logbook for safe abortion services (HMIS‐11). Results By the end of June 2014, medical abortion service had been expanded to 25 districts through 463 listed ANMs at 290 listed primary‐level facilities and served 25,187 women. Providers report a high level of confidence in their medical abortion skills and considerable clinical knowledge and capacity in medical abortion. Discussion The Nepali experience demonstrates that safe induced abortion care can be provided by ANMs, even in remote primary‐level health facilities. Post‐training support for providers is critical in helping ANMs handle potential barriers to medical abortion service provision and build lasting capacity in medical abortion. PMID:26860072

Clinical operations generation next… The age of technology and outsourcing

PubMed Central

Temkar, Priya

2015-01-01

Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT) industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA) guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations. PMID:26623386

Clinical operations generation next… The age of technology and outsourcing.

PubMed

Temkar, Priya

2015-01-01

Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT) industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA) guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations.

Supporting Military Families with Young Children throughout the Deployment Lifecycle

DTIC Science & Technology

2017-10-01

military service since the September 11th, 2001 terrorist attacks has placed tremendous demands on families. Approximately 43% of the Total Forces are...Parents program on the primary outcomes of interest including parental reflective capacity, parent-child relationship quality, and parenting stress...Hire and train SFSF2 staff at BU and UTHSCSA (for Ft. Hood site) 4a) Provide intensive training on home-based intervention (Strong Families

Great 3 - Cultural Resource Inventory. Volume 1

DTIC Science & Technology

1982-05-01

Transportation, the Corps of Engineers, the U. S. D. A. Forest Service, the Federal Aviation Administration, and the Economic Development Administration among...more permanent occupation sites (Ford 1974). This form of socio- economic structure would in theory have supported a larger population base than did the...result of postulated socio- economic and demographic factors, this increase should occur. As can be noted in Figure 6,i complexes, aggregates, assemblages

Joint Information Environment: DOD Needs to Strengthen Governance and Management

DTIC Science & Technology

2016-07-01

provide fast and secure connections to any application or service from any authorized network at any time Software application rationalization and...deployment at all sites. DOD further defines an automated information system as a system of computer hardware, computer software , data or telecommunications ...Why GAO Did This Study For fiscal year 2017, DOD plans to spend more than $38 billion on information technology to support thousands of networks and

Joint Doctrine for Operations in Nuclear, Biological, and Chemical (NBC) Environments

DTIC Science & Technology

2000-07-11

groups may have or be able to acquire military, civilian, and dual-use technologies and methods that provide adequate reliability for selective...procedures, and methods . •• Patient decontamination reduces the threat of contamination-related injury to health service support (HSS) personnel and...passing warnings to workers and units throughout their sites. •• Because of the variety of delivery methods for NBC weapons and the limitations of

Wind Powering America State Outreach. Final Technical Report: Washington State

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

Stearns, Tim

2013-09-30

The Washington Department of Commerce, via a U.S. Department of Energy grant, supported research into siting and permitting processes for wind projects by Skagit County, Washington. The goal was to help a local government understand key issues, consider how other areas have addressed wind siting, and establish a basis for enacting permitting and zoning ordinances that provided a more predictable permitting path and process for landowners, citizens, government and developers of small and community wind projects. The County?s contractor developed a report that looked at various approaches to wind siting, interviewed stakeholders, and examined technology options. The contractor outlined keymore » issues and recommended the adoption of a siting process. The Skagit County Commission considered the report and directed the Skagit County Planning & Development Services Department to add development of wind guidelines to its work plan for potential changes to development codes.« less

The Geodetic Seamless Archive Centers Service Layer: A System Architecture for Federating Geodesy Data Repositories

NASA Astrophysics Data System (ADS)

McWhirter, J.; Boler, F. M.; Bock, Y.; Jamason, P.; Squibb, M. B.; Noll, C. E.; Blewitt, G.; Kreemer, C. W.

2010-12-01

Three geodesy Archive Centers, Scripps Orbit and Permanent Array Center (SOPAC), NASA's Crustal Dynamics Data Information System (CDDIS) and UNAVCO are engaged in a joint effort to define and develop a common Web Service Application Programming Interface (API) for accessing geodetic data holdings. This effort is funded by the NASA ROSES ACCESS Program to modernize the original GPS Seamless Archive Centers (GSAC) technology which was developed in the 1990s. A new web service interface, the GSAC-WS, is being developed to provide uniform and expanded mechanisms through which users can access our data repositories. In total, our respective archives hold tens of millions of files and contain a rich collection of site/station metadata. Though we serve similar user communities, we currently provide a range of different access methods, query services and metadata formats. This leads to a lack of consistency in the userís experience and a duplication of engineering efforts. The GSAC-WS API and its reference implementation in an underlying Java-based GSAC Service Layer (GSL) supports metadata and data queries into site/station oriented data archives. The general nature of this API makes it applicable to a broad range of data systems. The overall goals of this project include providing consistent and rich query interfaces for end users and client programs, the development of enabling technology to facilitate third party repositories in developing these web service capabilities and to enable the ability to perform data queries across a collection of federated GSAC-WS enabled repositories. A fundamental challenge faced in this project is to provide a common suite of query services across a heterogeneous collection of data yet enabling each repository to expose their specific metadata holdings. To address this challenge we are developing a "capabilities" based service where a repository can describe its specific query and metadata capabilities. Furthermore, the architecture of the GSL is based on a model-view paradigm that decouples the underlying data model semantics from particular representations of the data model. This will allow for the GSAC-WS enabled repositories to evolve their service offerings to incorporate new metadata definition formats (e.g., ISO-19115, FGDC, JSON, etc.) and new techniques for accessing their holdings. Building on the core GSAC-WS implementations the project is also developing a federated/distributed query service. This service will seamlessly integrate with the GSAC Service Layer and will support data and metadata queries across a collection of federated GSAC repositories.

The Crustal Dynamics Data Information System: A Resource to Support Scientific Analysis Using Space Geodesy

NASA Technical Reports Server (NTRS)

Noll. Carey E.

2010-01-01

Since 1982. the Crustal Dynamics Data Information System (CDDIS) has supported the archive and distribution of geodetic data products acquired by the National Aeronautics and Space Administration (NASA) as well as national and international programs. The CDDIS provides easy, timely, and reliable access to a variety of data sets, products, and information about these data. These measurements. obtained from a global network of nearly 650 instruments at more than 400 distinct sites, include DORIS (Doppler Orbitography and Radiopositioning Integrated by Satellite), GNSS (Global Navigation Satellite System), SLR and LLR (Satellite and Lunar Laser Ranging), and VLBI (Very Long Baseline Interferometry). The CDDIS data system and its archive have become increasingly important to many national and international science communities, particularly several of the operational services within the International Association of Geodesy (IAG) and its observing system the Global Geodetic Observing System (GGOS), including the International DORIS Service (IDS), the International GNSS Service (IGS). the International Laser Ranging Service (ILRS), the International VLBI Service for Geodesy and Astrometry (IVS). and the International Earth rotation and Reference frame Service (IERS), Investigations resulting from the data and products available through the CDDIS support research in many aspects of Earth system science and global change. Each month, the CDDIS archives more than one million data and derived product files totaling over 90 Gbytes in volume. In turn. the global user community downloads nearly 1.2 TBytes (over 10.5 million files) of data and products from the CDDIS each month. The requirements of analysts have evolved since the start of the CDDIS; the specialized nature of the system accommodates the enhancements required to support diverse data sets and user needs. This paper discusses the CDDIS. including background information about the system and its. user communities. archive contents. available metadata, and future plans.

Social media use by patients with glaucoma: what can we learn?

PubMed

McGregor, Freia; Somner, John E A; Bourne, Rupert R; Munn-Giddings, Carol; Shah, Peter; Cross, Vinette

2014-01-01

Much health-related information is available on the internet but its quality is known to be variable. This research aimed to analyse the ophthalmic content of social media platforms which has yet to be formally assessed. Five online social media platforms were selected, the International Glaucoma Association (IGA) forum, Facebook, Twitter, YouTube and Patient Opinion.org.uk. A total of 3785 items were scraped from the sites, collated and analysed using simple thematic analysis by two coders. Fourteen themes were identified. The most commonly discussed topics included treatments, care experiences, promotions and support. Un-moderated sites contain more misleading information. Complementary therapies and treatments with a poor evidence base are presented more positively than established, evidence-based treatments. Online forums give patients a space to air questions, grievances, suggestions and to provide mutual support. The information they contain may be of use to physicians by flagging adverse drug reactions, areas for service improvement or topics about which patients require more information. There is a risk of exposure to misleading content which is heightened in un-moderated sites. Social media platforms may be an adjunct to current care models by providing a supportive and educational online community if these risks are understood. © 2013 The Authors Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

The potential for multi-disciplinary primary health care services to take action on the social determinants of health: actions and constraints.

PubMed

Baum, Frances E; Legge, David G; Freeman, Toby; Lawless, Angela; Labonté, Ronald; Jolley, Gwyneth M

2013-05-10

The Commission on the Social Determinants of Health and the World Health Organization have called for action to address the social determinants of health. This paper considers the extent to which primary health care services in Australia are able to respond to this call. We report on interview data from an empirical study of primary health care centres in Adelaide and Alice Springs, Australia. Sixty-eight interviews were held with staff and managers at six case study primary health care services, regional health executives, and departmental funders to explore how their work responded to the social determinants of health and the dilemmas in doing so. The six case study sites included an Aboriginal Community Controlled Organisation, a sexual health non-government organisation, and four services funded and managed by the South Australian government. While respondents varied in the extent to which they exhibited an understanding of social determinants most were reflexive about the constraints on their ability to take action. Services' responses to social determinants included delivering services in a way that takes account of the limitations individuals face from their life circumstances, and physical spaces in the primary health care services being designed to do more than simply deliver services to individuals. The services also undertake advocacy for policies that create healthier communities but note barriers to them doing this work. Our findings suggest that primary health care workers are required to transverse "dilemmatic space" in their work. The absence of systematic supportive policy, frameworks and structure means that it is hard for PHC services to act on the Commission on the Social Determinants of Health's recommendations. Our study does, however, provide evidence of the potential for PHC services to be more responsive to social determinants given more support and by building alliances with communities and social movements. Further research on the value of community control of PHC services and the types of policy, resource and managerial environments that support action on social determinants is warranted by this study's findings.

Lung cancer, caring for the caregivers. A qualitative study of providing pro-active social support targeted to the carers of patients with lung cancer.

PubMed

Ryan, P J; Howell, V; Jones, J; Hardy, E J

2008-04-01

Carers of patients with lung cancer often have a short time to access the support they require. The Macmillan Carers Project (MCP) was set up to provide non-clinical social support targeted in the community to the carers of patients with lung cancer and this study describes its evaluation. Prospective case study using interviews with the carers, project workers and health and social care professionals to obtain qualitative data for thematic analysis. 81 patients' carers received support from the MCP; 20 carers, 2 MCP workers and their manager and 10 other professionals (chest consultant physician, lung cancer clinical nurse specialist, GP, four Macmillan nurses, hospice social worker and two community social workers) were interviewed. Patients were predominantly male (62%), mean age 71 years and carers were predominantly female (70%) mean age 63 years. Carers identified the MCP as providing emotional support, more time, practical help, financial advice, information and back-up for a myriad of problems. Although there was some overlap with other services, the MCP was valued by carers and professionals as filling a gap in social care. The unique aspect of this study was support targeted to the carers of a single cancer site (lung) rather than generic cancer support. As lung cancer may progress rapidly, patients and their carers have a short time to gather new information, access services and adjust to their new circumstances and roles. By focusing on the needs of carers from the time of lung cancer diagnosis, we have shown that the MCP was a valued additional service, well received by carers, patients and professionals.

What is the role of clinical ethics support in the era of e-medicine?

PubMed

Parker, M; Gray, J A

2001-04-01

The internet is becoming increasingly important in health care practice. The number of health-related web sites is rising exponentially as people seek health-related information and services to supplement traditional sources, such as their local doctor, friends, or family. The development of e-medicine poses important ethical challenges, both for health professionals and for those who provide clinical ethics support for them. This paper describes some of these challenges and explores some of the ways in which those who provide clinical ethics support might respond creatively to them. By offering ways of responding to such challenges, both electronically and face-to-face, the providers of clinical ethics support can show themselves to be an indispensable part of good quality health care provision.

A Web-based assessment of bioinformatics end-user support services at US universities

PubMed Central

Messersmith, Donna J.; Benson, Dennis A.; Geer, Renata C.

2006-01-01

Objectives: This study was conducted to gauge the availability of bioinformatics end-user support services at US universities and to identify the providers of those services. The study primarily focused on the availability of short-term workshops that introduce users to molecular biology databases and analysis software. Methods: Websites of selected US universities were reviewed to determine if bioinformatics educational workshops were offered, and, if so, what organizational units in the universities provided them. Results: Of 239 reviewed universities, 72 (30%) offered bioinformatics educational workshops. These workshops were located at libraries (N = 15), bioinformatics centers (N = 38), or other facilities (N = 35). No such training was noted on the sites of 167 universities (70%). Of the 115 bioinformatics centers identified, two-thirds did not offer workshops. Conclusions: This analysis of university Websites indicates that a gap may exist in the availability of workshops and related training to assist researchers in the use of bioinformatics resources, representing a potential opportunity for libraries and other facilities to provide training and assistance for this growing user group. PMID:16888663

An Integrated and Collaborative Approach for NASA Earth Science Data

NASA Technical Reports Server (NTRS)

Murphy, K.; Lowe, D.; Behnke, J.; Ramapriyan, H.; Behnke, J.; Sofinowski, E.

2012-01-01

Earth science research requires coordination and collaboration across multiple disparate science domains. Data systems that support this research are often as disparate as the disciplines that they support. These distinctions can create barriers limiting access to measurements, which could otherwise enable cross-discipline Earth science. NASA's Earth Observing System Data and Information System (EOSDIS) is continuing to bridge the gap between discipline-centric data systems with a coherent and transparent system of systems that offers up to date and engaging science related content, creates an active and immersive science user experience, and encourages the use of EOSDIS earth data and services. The new Earthdata Coherent Web (ECW) project encourages cohesiveness by combining existing websites, data and services into a unified website with a common look and feel, common tools and common processes. It includes cross-linking and cross-referencing across the Earthdata site and NASA's Distributed Active Archive Centers (DAAC), and by leveraging existing EOSDIS Cyber-infrastructure and Web Service technologies to foster re-use and to reduce barriers to discovering Earth science data (http://earthdata.nasa.gov).

An Ecosystem Service Evaluation Tool to Support Ridge-to-Reef Management and Conservation in Hawaii

NASA Astrophysics Data System (ADS)

Oleson, K.; Callender, T.; Delevaux, J. M. S.; Falinski, K. A.; Htun, H.; Jin, G.

2014-12-01

Faced with increasing anthropogenic stressors and diverse stakeholders, local managers are adopting a ridge-to-reef and multi-objective management approach to restore declining coral reef health state. An ecosystem services framework, which integrates ecological indicators and stakeholder values, can foster more applied and integrated research, data collection, and modeling, and thus better inform the decision-making process and realize decision outcomes grounded in stakeholders' values. Here, we describe a research program that (i) leverages remotely sensed and empirical data to build an ecosystem services-based decision-support tool geared towards ridge-to-reef management; and (ii) applies it as part of a structured, value-based decision-making process to inform management in west Maui, a NOAA coral reef conservation priority site. The tool links terrestrial and marine biophysical models in a spatially explicit manner to quantify and map changes in ecosystem services delivery resulting from management actions, projected climate change impacts, and adaptive responses. We couple model outputs with localized valuation studies to translate ecosystem service outcomes into benefits and their associated socio-cultural and/or economic values. Managers can use this tool to run scenarios during their deliberations to evaluate trade-offs, cost-effectiveness, and equity implications of proposed policies. Ultimately, this research program aims at improving the effectiveness, efficiency, and equity outcomes of ecosystem-based management. This presentation will describe our approach, summarize initial results from the terrestrial modeling and economic valuations for west Maui, and highlight how this decision support tool benefits managers in west Maui.

76 FR 38651 - Sikes Oil Service; Arcade, Jackson County, GA; Notice of Settlement

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-01

... ENVIRONMENTAL PROTECTION AGENCY [Docket EPA-RO4-SFUND-2011-0557, FRL-9427-7] Sikes Oil Service... settlement for reimbursement of past response costs concerning the Sikes Oil Service Superfund Site located...- SFUND-2011-0557 or Site name Sikes Oil Service Superfund Site by one of the following methods: http...

76 FR 66328 - Callaway Golf Ball Operations, Inc., Including On-Site Leased Workers From Reliable Temp Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-26

... Operations, Inc., Including On-Site Leased Workers From Reliable Temp Services, Inc., Johnson & Hill Staffing... Golf Ball Operations, Inc., including on-site leased workers from Reliable Temp Services, Inc., and... Reliable Temp Services, Inc., Johnson & Hill Staffing and Apollo Security, Chicopee, Massachusetts, who...

44 CFR 354.5 - Description of site-specific, plume pathway EPZ biennial exercise-related component services and...

Code of Federal Regulations, 2012 CFR

2012-10-01

..., plume pathway EPZ biennial exercise-related component services and other services. 354.5 Section 354.5... Description of site-specific, plume pathway EPZ biennial exercise-related component services and other... will assess fees on licensees include the following: (a) Site-specific, plume pathway EPZ biennial...

Design and performance of mobile terminal for North American MSAT network

NASA Technical Reports Server (NTRS)

Fuji, Tsuyoshi; Tsuchiya, Makio; Isota, Yoji; Aoki, Katsuhiko

1995-01-01

The mobile terminal (MT), which can be selected for various applications, i.e. land mobile, transportable, fixed site, and maritime use, has been developed. Medium gain and high gain antennas are available. The MT can support circuit switched voice and data service. Additionally, cellular roaming service, net radio, and Group 3 facsimile services are optionally provided. A Mitsubishi handheld portable phone can be used as a stand-alone portable cellular-only phone or it can provide MSAT voice service when connected to MT. The MT which operates in L-band (1.5 GHz/1.6 GHz) satisfies equivalent isotropically radiated power (EIRP) of 12.5 dBW minimum and G/T of -16 dB/K minimum for medium gain system and -12 dB/K for high gain system. The excellent performance of transmit phase noise and bit error rate is achieved by using new technologies.

Impact of a broadband interactive televisit/teleconsultation service for residential and working environments.

PubMed Central

Valero, M. A.; Arredondo, M. T.; Guillén, S.; Traver, V.; Fernández, C.; Basagoiti, I.; del Nogal, F.; Gallar, P.; Insausti, J.

2001-01-01

The availability of health care attention at the point of need is one of the key benefits of telemedicine. Home environment and working place are the two scenarios selected in this article to evaluate the impact of a televisit and teleconsultation service. 31 users from four different medical and patient groups participated in this study supported by European Commission ATTRACT project. The experiences, carried out in Madrid and Valencia Spanish sites, benefited from interactive broadband access networks to provide cost-effective telecare services. Key areas analyzed encompass systems usability, clinical outcomes, patients quality of care and infoethic issues. Services advantages were verified and compared both from patients and medical staff points of view. Main benefits pointed out refer to displacement reduction, better communication doctor/patient, provision of comfort or friendliness, more precise therapy follow-up and increases in patients sense of well being. PMID:11825280

Impact of a broadband interactive televisit/teleconsultation service for residential and working environments.

PubMed

Valero, M A; Arredondo, M T; Guillén, S; Traver, V; Fernández, C; Basagoiti, I; del Nogal, F; Gallar, P; Insausti, J

2001-01-01

The availability of health care attention at the point of need is one of the key benefits of telemedicine. Home environment and working place are the two scenarios selected in this article to evaluate the impact of a televisit and teleconsultation service. 31 users from four different medical and patient groups participated in this study supported by European Commission ATTRACT project. The experiences, carried out in Madrid and Valencia Spanish sites, benefited from interactive broadband access networks to provide cost-effective telecare services. Key areas analyzed encompass systems usability, clinical outcomes, patients quality of care and infoethic issues. Services advantages were verified and compared both from patients and medical staff points of view. Main benefits pointed out refer to displacement reduction, better communication doctor/patient, provision of comfort or friendliness, more precise therapy follow-up and increases in patients sense of well being.

Enhancing the AliEn Web Service Authentication

NASA Astrophysics Data System (ADS)

Zhu, Jianlin; Saiz, Pablo; Carminati, Federico; Betev, Latchezar; Zhou, Daicui; Mendez Lorenzo, Patricia; Grigoras, Alina Gabriela; Grigoras, Costin; Furano, Fabrizio; Schreiner, Steffen; Vladimirovna Datskova, Olga; Sankar Banerjee, Subho; Zhang, Guoping

2011-12-01

Web Services are an XML based technology that allow applications to communicate with each other across disparate systems. Web Services are becoming the de facto standard that enable inter operability between heterogeneous processes and systems. AliEn2 is a grid environment based on web services. The AliEn2 services can be divided in three categories: Central services, deployed once per organization; Site services, deployed on each of the participating centers; Job Agents running on the worker nodes automatically. A security model to protect these services is essential for the whole system. Current implementations of web server, such as Apache, are not suitable to be used within the grid environment. Apache with the mod_ssl and OpenSSL only supports the X.509 certificates. But in the grid environment, the common credential is the proxy certificate for the purpose of providing restricted proxy and delegation. An Authentication framework was taken for AliEn2 web services to add the ability to accept X.509 certificates and proxy certificates from client-side to Apache Web Server. The authentication framework could also allow the generation of access control policies to limit access to the AliEn2 web services.

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

PubMed

Rambarran, D D

2013-10-01

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

Using a public health approach to improve end-of-life care: results and discussion of a health needs assessment undertaken in a large city in northern England.

PubMed

Ingold, Kathryn; Hicks, Fiona

2015-06-01

A detailed health needs assessment (HNA) for end-of-life care (EoLC) services was led by public health in Leeds to inform a commissioning strategy. To answer the question: are we delivering the best possible EoLC services within the resources available? Mixed methods were used with three approaches: epidemiological, corporate and comparative. More people from deprived communities die in hospital. 18% of people who die each year are on a palliative care register, reflecting a lack of recognition and planning for EoLC given that 75% of people who die need EoLC. Over 100 staff, patients and carers were interviewed and over 200 staff returned questionnaires. Staff highlighted concerns about capacity of services; pressure on out-of-hospital care; problems at physical and electronic interfaces between services; suboptimal hospital discharge; need for earlier recognition of the EoL stage for patients. Patients and carers stressed the importance of communication, coordination and continuity of care; full involvement in care planning; honesty and support for the bereaved; an advocate for patients and families; accessible information; improved urgent care; integrated team working; pain relief, dignity and respect. Issues from comparator sites included the need for sustainable leadership for change, lack of interoperability between IT systems; building advance care planning into working culture; gaps in psychological services, bereavement and pastoral support; integration within all clinical areas; lack of district nurses; few investment opportunities; getting home care support right; concerns about 111; incentives for general practitioners to deliver EoLC; variability in service and the Liverpool Care Pathway controversy. Ethical approval was not sought as the HNA was undertaken as a service evaluation. Local policy is that ethical approval is not required for service evaluation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Early abortion services in the United States: a provider survey.

PubMed

Benson, Janie; Clark, Kathryn Andersen; Gerhardt, Ann; Randall, Lynne; Dudley, Susan

2003-04-01

The objective of this study was to describe the availability of early surgical and medical abortion among members of the National Abortion Federation (NAF) and to identify factors affecting the integration of early abortion services into current services. Telephone interviews were conducted with staff at 113 Planned Parenthood affiliates and independent abortion providers between February and April 2000, prior to FDA approval of mifepristone. Early abortion services were available at 59% of sites, and establishing services was less difficult than or about what was anticipated. Sites generally found it easier to begin offering early surgical abortion than early medical abortion. Physician participation was found to be critical to implementing early services. At sites where some but not all providers offered early abortion, variations in service availability resulted. Given the option of reconsidering early services, virtually all sites would make the same decision again. These data suggest that developing mentoring relationships between experienced early abortion providers/sites and those not offering early services, and training physicians and other staff, are likely to be effective approaches to expanding service availability.

caCORE: a common infrastructure for cancer informatics.

PubMed

Covitz, Peter A; Hartel, Frank; Schaefer, Carl; De Coronado, Sherri; Fragoso, Gilberto; Sahni, Himanso; Gustafson, Scott; Buetow, Kenneth H

2003-12-12

Sites with substantive bioinformatics operations are challenged to build data processing and delivery infrastructure that provides reliable access and enables data integration. Locally generated data must be processed and stored such that relationships to external data sources can be presented. Consistency and comparability across data sets requires annotation with controlled vocabularies and, further, metadata standards for data representation. Programmatic access to the processed data should be supported to ensure the maximum possible value is extracted. Confronted with these challenges at the National Cancer Institute Center for Bioinformatics, we decided to develop a robust infrastructure for data management and integration that supports advanced biomedical applications. We have developed an interconnected set of software and services called caCORE. Enterprise Vocabulary Services (EVS) provide controlled vocabulary, dictionary and thesaurus services. The Cancer Data Standards Repository (caDSR) provides a metadata registry for common data elements. Cancer Bioinformatics Infrastructure Objects (caBIO) implements an object-oriented model of the biomedical domain and provides Java, Simple Object Access Protocol and HTTP-XML application programming interfaces. caCORE has been used to develop scientific applications that bring together data from distinct genomic and clinical science sources. caCORE downloads and web interfaces can be accessed from links on the caCORE web site (http://ncicb.nci.nih.gov/core). caBIO software is distributed under an open source license that permits unrestricted academic and commercial use. Vocabulary and metadata content in the EVS and caDSR, respectively, is similarly unrestricted, and is available through web applications and FTP downloads. http://ncicb.nci.nih.gov/core/publications contains links to the caBIO 1.0 class diagram and the caCORE 1.0 Technical Guide, which provide detailed information on the present caCORE architecture, data sources and APIs. Updated information appears on a regular basis on the caCORE web site (http://ncicb.nci.nih.gov/core).

Challenges and Opportunities for Implementing Integrated Mental Health Care: A District Level Situation Analysis from Five Low- and Middle-Income Countries

PubMed Central

Hanlon, Charlotte; Luitel, Nagendra P.; Kathree, Tasneem; Murhar, Vaibhav; Shrivasta, Sanjay; Medhin, Girmay; Ssebunnya, Joshua; Fekadu, Abebaw; Shidhaye, Rahul; Petersen, Inge; Jordans, Mark; Kigozi, Fred; Thornicroft, Graham; Patel, Vikram; Tomlinson, Mark; Lund, Crick; Breuer, Erica; De Silva, Mary; Prince, Martin

2014-01-01

Background Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs) to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda) participating in the PRogramme for Improving Mental health carE (PRIME). The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care. Methods A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts. Results The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care. Conclusions The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential for sustainable delivery of quality mental health care integrated into primary care. PMID:24558389

Development of a diabetes care management curriculum in a family practice residency program.

PubMed

Nuovo, Jim; Balsbaugh, Thomas; Barton, Sue; Davidson, Ellen; Fox-Garcia, Jane; Gandolfo, Angela; Levich, Bridget; Seibles, Joann

2004-01-01

Improving the quality of care for patients with chronic illness has become a high priority. Implementing training programs in disease management (DM) so the next generation of physicians can manage chronic illness more effectively is challenging. Residency training programs have no specific mandate to implement DM training. Additional barriers at the training facility include: 1) lack of a population-based perspective for service delivery; 2) weak support for self-management of illness; 3) incomplete implementation due to physician resistance or inertia; and 4) few incentives to change practices and behaviors. In order to overcome these barriers, training programs must take the initiative to implement DM training that addresses each of these issues. We report the implementation of a chronic illness management curriculum based on the Improving Chronic Illness Care (ICIC) Model. Features of this process included both patient care and learner objectives. These were: development of a multidisciplinary diabetes DM team; development of a patient registry; development of diabetes teaching clinics in the family practice center (nutrition, general management classes, and one-on-one teaching); development of a group visit model; and training the residents in the elements of the ICIC Model, ie, the community, the health system, self-management support, delivery system design, decision support, and clinical information systems. Barriers to implementing these curricular changes were: the development of a patient registry; buy-in from faculty, residents, clinic leadership, staff, and patients for the chronic care model; the ability to bill for services and maintain clinical productivity; and support from the health system key stakeholders for sustainability. Unique features of each training site will dictate differences in emphasis and structure; however, the core principles of the ICIC Model in enhancing self-management may be generalized to all sites.

The CREAM-CE: First experiences, results and requirements of the four LHC experiments

NASA Astrophysics Data System (ADS)

Mendez Lorenzo, Patricia; Santinelli, Roberto; Sciaba, Andrea; Thackray, Nick; Shiers, Jamie; Renshall, Harry; Sgaravatto, Massimo; Padhi, Sanjay

2010-04-01

In terms of the gLite middleware, the current LCG-CE used by the four LHC experiments is about to be deprecated. The new CREAM-CE service (Computing Resource Execution And Management) has been approved to replace the previous service. CREAM-CE is a lightweight service created to handle job management operations at the CE level. It is able to accept requests both via the gLite WMS service and also via direct submission for transmission to the local batch system. This flexible duality provides the experiments with a large level of freedom to adapt the service to their own computing models, but at the same time it requires a careful follow up of the requirements and tests of the experiments to ensure that their needs are fulfilled before real data taking. In this paper we present the current testing results of the four LHC experiments concerning this new service. The operations procedures, which have been elaborated together with the experiment support teams will be discussed. Finally, the experiments requirements and the expectations for both the sites and the service itself are exposed in detail.

Identifying Variability in Permanent Supportive Housing: A comparative effectiveness approach to measuring health outcomes

PubMed Central

Dickson-Gomez, Julia; Quinn, Katherine; Bendixen, Arturo; Johnson, Amy; Nowicki, Kelly; Ko, Thant Ko; Galletly, Carol

2017-01-01

Supportive housing has become the dominant model in the United States to provide housing to chronically homeless and to improve their housing stability and health. Most supportive housing programs follow a “housing first” paradigm modeled after the Pathways to Housing program in New York City. However, components of housing first supportive housing models were poorly defined and supportive models have varied considerably in their dissemination and implementation to other parts of the country. Recently, research has been conducted to determine the fidelity by which specific housing programs adhere to the Pathways Housing First model. However, evidence regarding which combination of components leads to better health outcomes for particular subpopulations is lacking. This paper presents results from qualitative interviews with supportive housing providers in the Chicago Metropolitan area. Supportive housing varied according to housing configuration (scattered-site versus project-based) and service provision model (low-intensity case management, intensive case management and behavioral health) resulting in six basic types. Supportive housing programs also differed in services they provided in addition to case management and the extent to which they followed harm reduction versus abstinence policies. Results showed advantages and disadvantages to each of the six basic types. Comparative effectiveness research may help identify which program components lead to better health outcomes among different subpopulations of homeless. Future longitudinal research will use the identified typology and other factors to compare the housing stability and health outcomes of supportive housing residents in programs that differ along these dimensions. PMID:28301175

Factors limiting immunization coverage in urban Dili, Timor-Leste

PubMed Central

Amin, Ruhul; De Oliveira, Telma Joana Corte Real; Da Cunha, Mateus; Brown, Tanya Wells; Favin, Michael; Cappelier, Kelli

2013-01-01

ABSTRACT Background: Timor-Leste's immunization coverage is among the poorest in Asia. The 2009/2010 Demographic and Health Survey found that complete vaccination coverage in urban areas, at 47.7%, was lower than in rural areas, at 54.1%. The city of Dili, the capital of Timor-Leste, had even lower coverage (43.4%) than the national urban average. Objective: To better understand the service- and user-related factors that account for low vaccination coverage in urban Dili, despite high literacy rates and relatively good access to immunization services and communication media. Methods: A mixed-methods (mainly qualitative) study, conducted in 5 urban sub-districts of Dili, involved in-depth interviews with18 Ministry of Health staff and 6 community leaders, 83 observations of immunization encounters, 37 exit interviews with infants' caregivers at 11 vaccination sites, and 11 focus group discussions with 70 caregivers of vaccination-eligible children ages 6 to 23 months. Results: The main reasons for low vaccination rates in urban Dili included caregivers' knowledge, attitudes, and perceptions as well as barriers at immunization service sites. Other important factors were access to services and information, particularly in the city periphery, health workers' attitudes and practices, caregivers' fears of side effects, conflicting priorities, large family size, lack of support from husbands and paternal grandmothers, and seasonal migration. Conclusion: Good access to health facilities or health services does not necessarily translate into uptake of immunization services. The reasons are complex and multifaceted but in general relate to the health services' insufficient understanding of and attention to their clients' needs. Almost all families in Dili would be motivated to have their children immunized if services were convenient, reliable, friendly, and informative. PMID:25276554

INSA Scientific Activities in the Space Astronomy Area

NASA Astrophysics Data System (ADS)

Pérez Martínez, Ricardo; Sánchez Portal, Miguel

Support to astronomy operations is an important and long-lived activity within INSA. Probably the best known (and traditional) INSA activities are those related with real-time spacecraft operations: ground station maintenance and operation (ground station engineers and operators); spacecraft and payload real-time operation (spacecraft and instruments controllers); computing infrastructure maintenance (operators, analysts), and general site services. In this paper, we’ll show a different perspective, probably not so well-known, presenting some INSA recent activities at the European Space Astronomy Centre (ESAC) and NASA Madrid Deep Space Communication Complex (MDSCC) directly related to scientific operations. Basic lines of activity involved include: operations support for science operations; system and software support for real time systems; technical administration and IT support; R&D activities, radioastronomy (at MDSCC and ESAC), and scientific research projects. This paper is structured as follows: first, INSA activities in two ESA cornerstone astrophysics missions, XMM-Newton and Herschel, will be outlined. Then, our activities related to scientific infrastructure services, represented by the Virtual Observatory (VO) framework and the Science Archives development facilities, are briefly shown. Radio astronomy activities will be described afterwards, and, finally, a few research topics in which INSA scientists are involved will also be described.

The potential for multi-disciplinary primary health care services to take action on the social determinants of health: actions and constraints

PubMed Central

2013-01-01

Background The Commission on the Social Determinants of Health and the World Health Organization have called for action to address the social determinants of health. This paper considers the extent to which primary health care services in Australia are able to respond to this call. We report on interview data from an empirical study of primary health care centres in Adelaide and Alice Springs, Australia. Methods Sixty-eight interviews were held with staff and managers at six case study primary health care services, regional health executives, and departmental funders to explore how their work responded to the social determinants of health and the dilemmas in doing so. The six case study sites included an Aboriginal Community Controlled Organisation, a sexual health non-government organisation, and four services funded and managed by the South Australian government. Results While respondents varied in the extent to which they exhibited an understanding of social determinants most were reflexive about the constraints on their ability to take action. Services’ responses to social determinants included delivering services in a way that takes account of the limitations individuals face from their life circumstances, and physical spaces in the primary health care services being designed to do more than simply deliver services to individuals. The services also undertake advocacy for policies that create healthier communities but note barriers to them doing this work. Our findings suggest that primary health care workers are required to transverse “dilemmatic space” in their work. Conclusions The absence of systematic supportive policy, frameworks and structure means that it is hard for PHC services to act on the Commission on the Social Determinants of Health’s recommendations. Our study does, however, provide evidence of the potential for PHC services to be more responsive to social determinants given more support and by building alliances with communities and social movements. Further research on the value of community control of PHC services and the types of policy, resource and managerial environments that support action on social determinants is warranted by this study’s findings. PMID:23663304

Global Health Diplomacy, Monitoring & Evaluation, and the Importance of Quality Assurance & Control: Findings from NIMH Project Accept (HPTN 043): A Phase III Randomized Controlled Trial of Community Mobilization, Mobile Testing, Same-Day Results, and Post-Test Support for HIV in Sub-Saharan Africa and Thailand.

PubMed

Kevany, Sebastian; Khumalo-Sakutukwa, Gertrude; Singh, Basant; Chingono, Alfred; Morin, Stephen

2016-01-01

Provision and scale-up of high quality, evidence-based services is essential for successful international HIV prevention interventions in order to generate and maintain intervention uptake, study integrity and participant trust, from both health service delivery and diplomatic perspectives. We developed quality assurance (QAC) procedures to evaluate staff fidelity to a cluster-randomized trial of the NIMH Project Accept (HPTN 043) assessing the effectiveness of a community-based voluntary counseling and testing strategy. The intervention was comprised of three components-Mobile Voluntary Counseling and Testing (MVCT), Community Mobilization (CM) and Post-Test Support Services (PTSS). QAC procedures were based on standardized criteria, and were designed to assess both provider skills and adherence to the intervention protocol. Supervisors observed a random sample of 5% to 10% of sessions each month and evaluated staff against multiple criteria on scales of 1-5. A score of 5 indicated 100% adherence, 4 indicated 95% adherence, and 3 indicated 90% adherence. Scores below 3 were considered unsatisfactory, and protocol deviations were discussed with the respective staff. During the first year of the intervention, the mean scores of MVCT and CM staff across the 5 study sites were 4 (95% adherence) or greater and continued to improve over time. Mean QAC scores for the PTSS component were lower and displayed greater fluctuations. Challenges to PTSS staff were identified as coping with the wide range of activities in the PTSS component and the novelty of the PTSS process. QAC fluctuations for PTSS were also associated with new staff hires or changes in staff responsibilities. Through constant staff monitoring and support, by Year 2, QAC scores for PTSS activities had reached those of MVCT and CM. The implementation of a large-sale, evidence based HIV intervention requires extensive QAC to ensure implementation effectiveness. Ongoing appraisal of study staff across sites ensures consistent and high quality delivery of all intervention components, in keeping with the goals of the study protocol, while also providing a forum for corrective feedback, additional supervision and retraining of staff. QAC ensures staff fidelity to study procedures and is critical to the successful delivery of multi-site HIV prevention interventions, as well as the delivery of services scaled up in programmatic situations.

The Healthnet project: extending online information resources to end users in rural hospitals.

PubMed

Holtum, E; Zollo, S A

1998-10-01

The importance of easily available, high quality, and current biomedical literature within the clinical enterprise is now widely documented and accepted. Access to this information has been shown to have a direct bearing on diagnosis, choices of tests, choices of drugs, and length of hospital stay. However, many health professionals do not have adequate access to current health information, particularly those practicing in rural, isolated, or underserved hospitals. Thanks to a three-year telemedicine award from the National Library of Medicine, The University of Iowa (UI) has developed a high-speed, point-to-point telecommunications network to deliver clinical and educational applications to ten community-based Iowa hospitals. One of the services offered over the network allows health professionals from the site hospitals to access online health databases and order articles via an online document delivery service. Installation, training, and troubleshooting support are provided to the remote sites by UI project staff. To date, 1,339 health professionals from the ten networked hospitals have registered to use the Healthnet program. Despite the friendly interface on the computer workstations installed at the sites, training emerged as the key issue in maximizing health professional utilization of these programs.

The Healthnet project: extending online information resources to end users in rural hospitals.

PubMed Central

Holtum, E; Zollo, S A

1998-01-01

The importance of easily available, high quality, and current biomedical literature within the clinical enterprise is now widely documented and accepted. Access to this information has been shown to have a direct bearing on diagnosis, choices of tests, choices of drugs, and length of hospital stay. However, many health professionals do not have adequate access to current health information, particularly those practicing in rural, isolated, or underserved hospitals. Thanks to a three-year telemedicine award from the National Library of Medicine, The University of Iowa (UI) has developed a high-speed, point-to-point telecommunications network to deliver clinical and educational applications to ten community-based Iowa hospitals. One of the services offered over the network allows health professionals from the site hospitals to access online health databases and order articles via an online document delivery service. Installation, training, and troubleshooting support are provided to the remote sites by UI project staff. To date, 1,339 health professionals from the ten networked hospitals have registered to use the Healthnet program. Despite the friendly interface on the computer workstations installed at the sites, training emerged as the key issue in maximizing health professional utilization of these programs. PMID:9803302

Transforming an EPA QA/R-2 quality management plan into an ISO 9002 quality management system.

PubMed

Kell, R A; Hedin, C M; Kassakhian, G H; Reynolds, E S

2001-01-01

The Environmental Protection Agency's (EPA) Office of Emergency and Remedial Response (OERR) requires environmental data of known quality to support Superfund hazardous waste site projects. The Quality Assurance Technical Support (QATS) Program is operated by Shaw Environmental and Infrastructure, Inc. to provide EPA's Analytical Operations Center (AOC) with performance evaluation samples, reference materials, on-site laboratory auditing capabilities, data audits (including electronic media data audits), methods development, and other support services. The new QATS contract awarded in November 2000 required that the QATS Program become ISO 9000 certified. In a first for an EPA contractor, the QATS staff and management successfully transformed EPA's QA/R-2 type Quality Management Plan into a Quality Management System (QMS) that complies with the requirements of the internationally recognized ISO 9002 standard and achieved certification in the United States, Canada, and throughout Europe. The presentation describes how quality system elements of ISO 9002 were implemented on an already existing quality system. The psychological and organizational challenges of the culture change in QATS' day-to-day operations will be discussed for the benefit of other ISO 9000 aspirants.

Identifying barriers and facilitators to ambulance service assessment and treatment of acute asthma: a focus group study.

PubMed

Shaw, Deborah; Siriwardena, Aloysius Niroshan

2014-08-03

Acute asthma is a common reason for patients to seek care from ambulance services. Although better care of acute asthma can prevent avoidable morbidity and deaths, there has been little research into ambulance clinicians' adherence to national guidelines for asthma assessment and management and how this might be improved. Our research aim was to explore paramedics' attitudes, perceptions and beliefs about prehospital management of asthma, to identify barriers and facilitators to guideline adherence. We conducted three focus group interviews of paramedics in a regional UK ambulance trust. We used framework analysis supported by NVivo 8 to code and analyse the data. Seventeen participants, including paramedics, advanced paramedics or paramedic operational managers at three geographical sites, contributed to the interviews. Analysis led to five themes: (1) guidelines should be made more relevant to ambulance service care; (2) there were barriers to assessment; (3) the approach needed to address conflicts between clinicians' and patients' expectations; (4) the complexity of ambulance service processes and equipment needed to be taken into account; (5) and finally there were opportunities for improved prehospital education, information, communication, support and care pathways for asthma. This qualitative study provides insight into paramedics' perceptions of the assessment and management of asthma, including why paramedics may not always follow guidelines for assessment or management of asthma. These findings provide opportunities to strengthen clinical support, patient communication, information transfer between professionals and pathways for prehospital care of patients with asthma.

Commercial Experiment Transporter: COMET

NASA Astrophysics Data System (ADS)

Wessling, Francis C.; Robinson, Michael; Martinez, Ramiro S.; Gallimore, Thomas; Combs, Nick

1994-09-01

A launch system consisting of ground-support equipment, a four-stage rocket, a service module, a recovery system and a recovery site, and an orbital operations center is being assembled. The system is designed to launch 818 kg (1800 lb) to a 552-km (300-n.mi.) low earth orbit at a 40-deg inclination. Experiment space exists in both the service module and the recovery system. The service module provides space for 68 kg (150 lb) of experiments plus telemetry services, attitude control, and power and uses no consumables to maintain attitude. Consequently, the service module can maintain orbit attitude for years. Power of 400 W is supplied by solar cells and batteries for both experiment operation and housekeeping. The recovery system houses an experiment carrier for 136 kg (300 lb) of experiments, a retro rocket, a heat shield, and a parachute. An orbital operations control center provides tracking, telemetry, and commanding for the satellite. The payloads are also briefly described. The first launch was scheduled for 1995.

Ionospheric research for space weather service support

NASA Astrophysics Data System (ADS)

Stanislawska, Iwona; Gulyaeva, Tamara; Dziak-Jankowska, Beata

2016-07-01

Knowledge of the behavior of the ionosphere is very important for space weather services. A wide variety of ground based and satellite existing and future systems (communications, radar, surveillance, intelligence gathering, satellite operation, etc) is affected by the ionosphere. There are the needs for reliable and efficient support for such systems against natural hazard and minimalization of the risk failure. The joint research Project on the 'Ionospheric Weather' of IZMIRAN and SRC PAS is aimed to provide on-line the ionospheric parameters characterizing the space weather in the ionosphere. It is devoted to science, techniques and to more application oriented areas of ionospheric investigation in order to support space weather services. The studies based on data mining philosophy increasing the knowledge of ionospheric physical properties, modelling capabilities and gain applications of various procedures in ionospheric monitoring and forecasting were concerned. In the framework of the joint Project the novel techniques for data analysis, the original system of the ionospheric disturbance indices and their implementation for the ionosphere and the ionospheric radio wave propagation are developed since 1997. Data of ionosonde measurements and results of their forecasting for the ionospheric observatories network, the regional maps and global ionospheric maps of total electron content from the navigational satellite system (GNSS) observations, the global maps of the F2 layer peak parameters (foF2, hmF2) and W-index of the ionospheric variability are provided at the web pages of SRC PAS and IZMIRAN. The data processing systems include analysis and forecast of geomagnetic indices ap and kp and new eta index applied for the ionosphere forecasting. For the first time in the world the new products of the W-index maps analysis are provided in Catalogues of the ionospheric storms and sub-storms and their association with the global geomagnetic Dst storms is investigated. The products of the Project web sites at http://www.cbk.waw.pl/rwc and http://www.izmiran.ru/services/iweather are widely used in scientific investigations and numerous applications by the telecommunication and navigation operators and users whose number at the web sites is growing substantially from month to month.

Service failures and challenges in responding to people bereaved through drugs and alcohol: An interprofessional analysis.

PubMed

Valentine, Christine; McKell, Jennifer; Ford, Allison

2018-05-01

This article reports findings from the first two stages of a three-stage qualitative study which considered the role of services, including public, private and charitable organisations, in responding to the needs of adults bereaved following the drug and/or alcohol-related death of someone close. The study, the first of its kind to explore the landscape and role of services in substance use deaths, was conducted over two sites: south west England and Scotland. In stage 1 of the research, adopting both convenience and purposive sampling, data were collected via semi-structured interviews on experiences and support needs of bereaved individuals (n = 106). In stage 2, six focus groups were conducted with a purposive sample of practitioners (n = 40), including those working for the police, coroner's service, procurator fiscal depute (Scotland), health service, funeral service, press, clergy, Public Health England, Drugs Policy Unit, bereavement counselling/support and alcohol and drug treatment services, to investigate how services may better respond to this bereavement. Thematic analysis from both data-sets identified two overarching themes. The first, focusing on practitioner responses, captures how these bereaved people may meet with inadequate, unkind, and discriminatory responses from services. Having to navigate unfamiliar, fragmented, and time-consuming procedures compounds the bereaved's distress at an already difficult time, illustrated by a 'mapping' of relevant services. The second relates to challenges and opportunities for those responding. Service failures reflect practitioners' poor understanding of both substance use bereavement and the range of other practitioners and services involved. Those bereaved are a poorly understood, neglected and stigmatised group of service users. There is a need for services to respond without judgement or insensitive language, and provide information about, communicate and work closely with, other services despite differences in working practices and cultures. These recommendations could positively affect bereaved peoples' experiences, alleviating stress and overwhelm at a particularly vulnerable time.

How university students with reading difficulties are supported in achieving their goals.

PubMed

Stack-Cutler, Holly L; Parrila, Rauno K; Jokisaari, Markku; Nurmi, Jari-Erik

2015-01-01

We examine (a) what social ties university students with a history of reading difficulty (RD) report assisting them to achieve their goals, (b) outlets available for developing social ties, (c) resources mobilized within these relationships, and (d) the impact of social ties' status on academic achievement. Participants were 107 university students with RD who were currently completing or had recently completed a university degree. Results showed that university students with RD named friends, parents, and significant others (e.g., boy/girlfriend, spouse) as social ties most often. Personal social ties were developed through social media networking sites and within close relationships, and institutional social ties through academic centers and university general services, among others. Resources mobilized among personal and institutional social ties included emotional and social support, advice and planning, writing and studying help, and goal setting. Institutional social ties also afforded job search assistance, accommodations, skill development, financial support, and mental health services. Finally, the status of employed, but not student, social ties explained academic achievement. © Hammill Institute on Disabilities 2013.

Towards Dynamic Service Level Agreement Negotiation:An Approach Based on WS-Agreement

NASA Astrophysics Data System (ADS)

Pichot, Antoine; Wäldrich, Oliver; Ziegler, Wolfgang; Wieder, Philipp

In Grid, e-Science and e-Business environments, Service Level Agreements are often used to establish frameworks for the delivery of services between service providers and the organisations hosting the researchers. While this high level SLAs define the overall quality of the services, it is desirable for the end-user to have dedicated service quality also for individual services like the orchestration of resources necessary for composed services. Grid level scheduling services typically are responsible for the orchestration and co-ordination of resources in the Grid. Co-allocation e.g. requires the Grid level scheduler to co-ordinate resource management systems located in different domains. As the site autonomy has to be respected negotiation is the only way to achieve the intended co-ordination. SLAs emerged as a new way to negotiate and manage usage of resources in the Grid and are already adopted by a number of management systems. Therefore, it is natural to look for ways to adopt SLAs for Grid level scheduling. In order to do this, efficient and flexible protocols are needed, which support dynamic negotiation and creation of SLAs. In this paper we propose and discuss extensions to the WS-Agreement protocol addressing these issues.

A Process Analysis of the Uniform Chart of Accounts Personnel Utilization System

DTIC Science & Technology

2002-04-23

business practices is evolving rapidly. The ever- changing health care environment requires all providers to be familiar with the costs of each...advised the standardization of the data used to develop them as well as the formulas for calculating them. These changes mostly related to workload...can also be used to determine site-specific capabilities and to identify potential areas for inter - service support of workload through sharing of

Crew systems and architectural considerations for first lunar surface return missions

NASA Astrophysics Data System (ADS)

Winisdoerffer, F.; Ximenes, S.

1992-08-01

The design requirements for the habitability of the pressurized volumes of a typical first manned lander are presented. Attention is given to providing dual habitation/exploration services (EVA/IVA), supporting the separation of the surface/flight functions, allowing growth potential based on site characteristics, and in situ resources utilization. Lunar lander conceptual diagrams are provided for the basic system architecture, automatic cargo delivery, the piloted crew module, and the pressurized volumes.

39 CFR 242.2 - Change of site-fourth-class offices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Change of site-fourth-class offices. 242.2 Section 242.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION CHANGE OF SITE § 242.2 Change of site—fourth-class offices. Report by memorandum to chief, organization and management branch, when change in site is necessary....

Informing the design of clinical decision support services for evaluation of children with minor blunt head trauma in the emergency department: a sociotechnical analysis.

PubMed

Sheehan, Barbara; Nigrovic, Lise E; Dayan, Peter S; Kuppermann, Nathan; Ballard, Dustin W; Alessandrini, Evaline; Bajaj, Lalit; Goldberg, Howard; Hoffman, Jeffrey; Offerman, Steven R; Mark, Dustin G; Swietlik, Marguerite; Tham, Eric; Tzimenatos, Leah; Vinson, David R; Jones, Grant S; Bakken, Suzanne

2013-10-01

Integration of clinical decision support services (CDSS) into electronic health records (EHRs) may be integral to widespread dissemination and use of clinical prediction rules in the emergency department (ED). However, the best way to design such services to maximize their usefulness in such a complex setting is poorly understood. We conducted a multi-site cross-sectional qualitative study whose aim was to describe the sociotechnical environment in the ED to inform the design of a CDSS intervention to implement the Pediatric Emergency Care Applied Research Network (PECARN) clinical prediction rules for children with minor blunt head trauma. Informed by a sociotechnical model consisting of eight dimensions, we conducted focus groups, individual interviews and workflow observations in 11 EDs, of which 5 were located in academic medical centers and 6 were in community hospitals. A total of 126 ED clinicians, information technology specialists, and administrators participated. We clustered data into 19 categories of sociotechnical factors through a process of thematic analysis and subsequently organized the categories into a sociotechnical matrix consisting of three high-level sociotechnical dimensions (workflow and communication, organizational factors, human factors) and three themes (interdisciplinary assessment processes, clinical practices related to prediction rules, EHR as a decision support tool). Design challenges that emerged from the analysis included the need to use structured data fields to support data capture and re-use while maintaining efficient care processes, supporting interdisciplinary communication, and facilitating family-clinician interaction for decision-making. Copyright © 2013 Elsevier Inc. All rights reserved.

The cost structure of routine infant immunization services: a systematic analysis of six countries

PubMed Central

Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

2017-01-01

Abstract Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77–93% of national routine infant immunization costs. Labour and vaccine costs comprised 14–69% and 13–69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48–78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. PMID:28575193

The cost structure of routine infant immunization services: a systematic analysis of six countries.

PubMed

Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

2017-10-01

Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77-93% of national routine infant immunization costs. Labour and vaccine costs comprised 14-69% and 13-69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48-78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Effectiveness and Advantages of On-Site Pathology Services in the Care of Patients With Nonmelanoma Skin Cancer.

PubMed

Machan, Mac; Zitelli, John; Brodland, David

2016-01-01

On-site pathology services are an integral part of many dermatology and surgical dermatology practices in the United States. Assess the effectiveness and advantages of on-site pathology services. Biopsy data from 7 practices with on-site pathology services were reviewed to determine the diagnostic accuracy of malignancies from all lesional biopsies. Patient preference and convenience were queried and measured with satisfaction surveys. Of note, 1,052/1,379 (76.3%) of biopsies demonstrated a malignancy. Most patients underwent treatment of malignant lesions on a different day than the biopsy. Of the patients who scheduled a return visit for surgery on a later date, 42/246 (17.1%) reported incurring additional costs and 44/249 (17.7%) had a relative/friend who was inconvenienced. On-site pathology services provide efficient, effective, and convenient care for skin cancer patients. Fellowship-trained dermatologic surgeons use on-site pathology services to diagnose and treat clinically relevant nonmelanoma skin cancer.

Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique.

PubMed

Manders, Eric-Jan; José, Eurico; Solis, Manuel; Burlison, Janeen; Nhampossa, José Leopoldo; Moon, Troy

2010-01-01

We have adopted the Open Medical Record System (OpenMRS) framework to implement an electronic patient monitoring system for an HIV care and treatment program in Mozambique. The program provides technical assistance to the Ministry of Health supporting the scale up of integrated HIV care and support services in health facilities in rural resource limited settings. The implementation is in use for adult and pediatric programs, with ongoing roll-out to cover all supported sites. We describe early experiences in adapting the system to the program needs, addressing infrastructure challenges, creating a regional support team, training data entry staff, migrating a legacy database, deployment, and current use. We find that OpenMRS offers excellent prospects for in-country development of health information systems, even in severely resource limited settings. However, it also requires considerable organizational infrastructure investment and technical capacity building to ensure continued local support.

Factors associated with antenatal care adequacy in rural and urban contexts-results from two health and demographic surveillance sites in Vietnam

PubMed Central

2012-01-01

Background Antenatal Care (ANC) is universally considered important for women and children. This study aims to identify factors, demographic, social and economic, possibly associated with three ANC indicators: number of visits, timing of visits and content of services. The aim is also to compare the patterns of association of such factors between one rural and one urban context in northern Vietnam. Methods Totally 2,132 pregnant women were followed from identification of pregnancy until birth in two Health and Demographic Surveillance Sites (HDSS). Information was obtained through quarterly face to face interviews. Results Living in the rural area was significantly associated with lower adequate use of ANC compared to living in the urban area, both regarding quantity (number and timing of visits) and content. Low education, living in poor households and exclusively using private sector ANC in both sites and self employment, becoming pregnant before 25 years of age and living in poor communities in the rural area turned out to increase the risk for overall inadequate ANC. High risk pregnancy could not be demonstrated to be associated with ANC adequacy in either site. The medical content of services offered was often inadequate, in relation to the national recommendations, especially in the private sector. Conclusion Low education, low economic status, exclusive use of private ANC and living in rural areas were main factors associated with risk for overall inadequate ANC use as related to the national recommendations. Therefore, interventions focussing on poor and less educated women, especially in rural areas should be prioritized. They should focus the importance of early attendance of ANC and sufficient use of core services. Financial support for poor and near poor women should be considered. Providers of ANC should be educated and otherwise influenced to provide sufficient core services. Adherence to ANC content guidelines must be improved through enhanced supervision, particularly in the private sector. PMID:22335834

An evaluation of a multi-site community pharmacy-based chronic obstructive pulmonary disease support service.

PubMed

Wright, David; Twigg, Michael; Barton, Garry; Thornley, Tracey; Kerr, Clare

2015-02-01

Chronic obstructive pulmonary disease (COPD) is a progressive chronic condition that can be effectively managed by smoking-cessation, optimising prescribed therapy and providing treatment to prevent chest infections from causing hospitalisation. The government agenda in the UK is for community pharmacists to become involved in chronic disease management, and COPD is one area where they are ideally located to provide a comprehensive service. This study aims to evaluate the effect of a community pharmacy-based COPD service on patient outcomes. Patients in one UK location were recruited over a 10-week period to receive a community pharmacy-based COPD support service consisting of signposting to or provision of smoking-cessation service, therapy optimisation and recommendation to obtain a rescue pack containing steroid and antibiotic to prevent hospitalisation as a result of chest infection. Data were collected over a 6-month period for all recruited patients. Appropriate clinical outcomes, patient reported medication adherence, quality of life and National Health Service (NHS) resource utilisation were measured. Three hundred six patients accessed the service. Data to enable comparison before and after intervention was available for 137 patients. Significant improvements in patient reported adherence, utilisation of rescue packs, quality of life and a reduction in routine general practitioner (GP) visits were identified. The intervention cost was estimated to be off-set by reductions in the use of other NHS services (GP and accident and emergency visits and hospital admissions). Results suggest that the service improved patient medicine taking behaviours and that it was cost-effective. © 2014 Community Pharmacy Futures. International Journal of Pharmacy Practice published by. John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.

Grid site availability evaluation and monitoring at CMS

DOE PAGES

Lyons, Gaston; Maciulaitis, Rokas; Bagliesi, Giuseppe; ...

2017-10-01

The Compact Muon Solenoid (CMS) experiment at the Large Hadron Collider (LHC) uses distributed grid computing to store, process, and analyse the vast quantity of scientific data recorded every year. The computing resources are grouped into sites and organized in a tiered structure. Each site provides computing and storage to the CMS computing grid. Over a hundred sites worldwide contribute with resources from hundred to well over ten thousand computing cores and storage from tens of TBytes to tens of PBytes. In such a large computing setup scheduled and unscheduled outages occur continually and are not allowed to significantly impactmore » data handling, processing, and analysis. Unscheduled capacity and performance reductions need to be detected promptly and corrected. CMS developed a sophisticated site evaluation and monitoring system for Run 1 of the LHC based on tools of the Worldwide LHC Computing Grid. For Run 2 of the LHC the site evaluation and monitoring system is being overhauled to enable faster detection/reaction to failures and a more dynamic handling of computing resources. Furthermore, enhancements to better distinguish site from central service issues and to make evaluations more transparent and informative to site support staff are planned.« less

Grid site availability evaluation and monitoring at CMS

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

Lyons, Gaston; Maciulaitis, Rokas; Bagliesi, Giuseppe

The Compact Muon Solenoid (CMS) experiment at the Large Hadron Collider (LHC) uses distributed grid computing to store, process, and analyse the vast quantity of scientific data recorded every year. The computing resources are grouped into sites and organized in a tiered structure. Each site provides computing and storage to the CMS computing grid. Over a hundred sites worldwide contribute with resources from hundred to well over ten thousand computing cores and storage from tens of TBytes to tens of PBytes. In such a large computing setup scheduled and unscheduled outages occur continually and are not allowed to significantly impactmore » data handling, processing, and analysis. Unscheduled capacity and performance reductions need to be detected promptly and corrected. CMS developed a sophisticated site evaluation and monitoring system for Run 1 of the LHC based on tools of the Worldwide LHC Computing Grid. For Run 2 of the LHC the site evaluation and monitoring system is being overhauled to enable faster detection/reaction to failures and a more dynamic handling of computing resources. Furthermore, enhancements to better distinguish site from central service issues and to make evaluations more transparent and informative to site support staff are planned.« less

Grid site availability evaluation and monitoring at CMS

NASA Astrophysics Data System (ADS)

Lyons, Gaston; Maciulaitis, Rokas; Bagliesi, Giuseppe; Lammel, Stephan; Sciabà, Andrea

2017-10-01

The Compact Muon Solenoid (CMS) experiment at the Large Hadron Collider (LHC) uses distributed grid computing to store, process, and analyse the vast quantity of scientific data recorded every year. The computing resources are grouped into sites and organized in a tiered structure. Each site provides computing and storage to the CMS computing grid. Over a hundred sites worldwide contribute with resources from hundred to well over ten thousand computing cores and storage from tens of TBytes to tens of PBytes. In such a large computing setup scheduled and unscheduled outages occur continually and are not allowed to significantly impact data handling, processing, and analysis. Unscheduled capacity and performance reductions need to be detected promptly and corrected. CMS developed a sophisticated site evaluation and monitoring system for Run 1 of the LHC based on tools of the Worldwide LHC Computing Grid. For Run 2 of the LHC the site evaluation and monitoring system is being overhauled to enable faster detection/reaction to failures and a more dynamic handling of computing resources. Enhancements to better distinguish site from central service issues and to make evaluations more transparent and informative to site support staff are planned.

Videoteleconferencing for administration of a multisite obstetrics and gynecology core clerkship.

PubMed

Browne, M W; Hines, J F; Satin, A J; Haffner, W H

2000-03-01

Recent changes and trends in health care delivery have required medical schools to use multiple sites to obtain adequate patient exposure for their students. Decentralization of clinical undergraduate medical education may lead to a lack of continuity in curricula, evaluation, and feedback. We describe the use of interactive videoteleconferencing as a tool to link and improve a multi-site undergraduate core clerkship in obstetrics and gynecology. The Uniformed Services University of the Health Sciences, Bethesda, Maryland, currently utilizes five geographically separate sites for its 6-week core clerkship in obstetrics and gynecology. The site coordinators, clerkship director, and administrative personnel from the parent institution meet approximately 3 weeks after the completion of each core clerkship for live, real-time, and interactive broadcast to complete student evaluations, review curricula, and discuss problems with current students and other pertinent educational issues. Videoteleconferencing provides a mechanism to ensure consistency in curriculum and student evaluations and provides administrative support to distant sites. Furthermore, it enables site coordinators to keep the clerkship director abreast of students and clerkship issues.

Developing children’s palliative care in Africa through beacon centres: lessons learnt

PubMed Central

2013-01-01

Much progress has been made in the provision of palliative care across sub-Saharan Africa, however much still remains to be done, particularly in the area of children’s palliative care (CPC). The Beacon Centres programme was set up in 2009, aimed at improving access to CPC in South Africa, Uganda and Tanzania through more and better-trained health professionals and CPC clinical services of a high standard. Having identified sites in each country to develop into CPC Beacon Centres, Navigators were identified who would be the ‘champions’ for CPC in those sites and lead a programme of training, mentorship and support. Five navigators (2 in Uganda and Tanzania and 1 in South Africa) were trained between September and December 2009. Following this they undertook CPC needs assessments at the 3 centres and set up and delivered a six-month CPC training programme, providing mentorship and support to students to enable them to integrate CPC into their workplaces. To date, 188 participants have commenced the six-month course, with 80 having completed it. CPC has been integrated into the activities of the centres and a CPC virtual resource centre set up in South Africa. The achievements from the Beacon project have been great and the work of the navigators immense, but as in all projects it has not been without its challenges. Lessons learnt include issues around: the focus of the project; the length and nature of the training; assessment; accreditation; the choice of navigators; mentoring; administrative support; co-ordination; the choice of project sites; and the integration of CPC into services. The need for CPC is not going to go away and it is therefore important that models of scaling-up are found that are not only practical, feasible, affordable and sustainable, but that focus on the outcome of improved CPC for all those who need it. It is hoped that the lessons shared from the Beacon Project will help in developing and implementing such models. PMID:23419095

Anesthesia and the role of short-term service delivery in developing countries.

PubMed

Froese, Alison

2007-11-01

To clarify the ongoing need for involvement of anesthesiologists in short-term surgical projects in developing countries, and provide information to guide the selection of, application for, and preparation for these rewarding experiences. The lack of safe anesthesia services severely limits the performance of needed surgical procedures in developing countries around the world. Even in countries where well-trained anesthesiologists are available in major urban centres, resources are often absent or limited for large numbers of people in rural or remote areas. Anesthesiologists are highly sought members of surgical teams. Internet sites provide extensive project information. Projects occur in Central and South America, Africa, Asia and Eastern Europe. Projects can bring specialized surgical expertise to an otherwise well-serviced urban area, or work in remote areas that have surgical services only when a team comes. Available equipment, drugs, housing, food and transportation vary markedly with project site. Flexibility, adaptability and problem-solving skills are essential. Translators provide language assistance. Anesthesiologists who have experience providing anesthetics in settings with less technological support can assist other anesthesiologists in adapting to less sophisticated settings. Severe shortages of trained health professionals plague developing countries, reflecting complex economic and political problems that will require decades for resolution. Until such time as surgical services are widely available and affordable in remote as well as urban areas of developing countries, anesthesiologists will continue to provide a valuable and personally rewarding contribution through short-term assistance.

Enabling Arctic Research Through Science and Engineering Partnerships

NASA Astrophysics Data System (ADS)

Kendall, E. A.; Valentic, T. A.; Stehle, R. H.

2014-12-01

Under an Arctic Research Support and Logistics contract from NSF (GEO/PLR), SRI International, as part of the CH2M HILL Polar Services (CPS) program, forms partnerships with Arctic research teams to provide data transfer, remote operations, and safety/operations communications. This teamwork is integral to the success of real-time science results and often allows for unmanned operations which are both cost-effective and safer. The CPS program utilizes a variety of communications networks, services and technologies to support researchers and instruments throughout the Arctic, including Iridium, VSAT, Inmarsat BGAN, HughesNet, TeleGreenland, radios, and personal locator beacons. Program-wide IT and communications limitations are due to the broad categories of bandwidth, availability, and power. At these sites it is essential to conserve bandwidth and power through using efficient software, coding and scheduling techniques. There are interesting new products and services on the horizon that the program may be able to take advantage of in the future such as Iridium NEXT, Inmarsat Xpress, and Omnispace mobile satellite services. Additionally, there are engineering and computer software opportunities to develop more efficient products. We will present an overview of science/engineering partnerships formed by the CPS program, discuss current limitations and identify future technological possibilities that could further advance Arctic science goals.

Catalytic and reactive polypeptides and methods for their preparation and use

DOEpatents

Schultz, Peter

1994-01-01

Catalytic and reactive polypeptides include a binding site specific for a reactant or reactive intermediate involved in a chemical reaction of interest. The polypeptides further include at least one active functionality proximate the binding site, where the active functionality is capable of catalyzing or chemically participating in the chemical reaction in such a way that the reaction rate is enhanced. Methods for preparing the catalytic peptides include chemical synthesis, site-directed mutagenesis of antibody and enzyme genes, covalent attachment of the functionalities through particular amino acid side chains, and the like. This invention was made with Government support under Grant Contract No. AI-24695, awarded by the Department of health and Human Services, and under Grant Contract No. N 00014-87-K-0256, awarded by the Office of Naval Research. The Government has certain rights in this invention.

Forward-looking farmers owning multiple potential wetland restoration sites: implications for efficient restoration

NASA Astrophysics Data System (ADS)

Schroder (Kushch), Svetlana; Lang, Zhengxin; Rabotyagov, Sergey

2018-04-01

Wetland restoration can increase the provision of multiple non-market ecosystem services. Environmental and socio-economic factors need to be accounted for when land is withdrawn from agriculture and wetlands are restored. We build multi-objective optimization models to provide decision support for wetland restoration in the Le Sueur river watershed in Southern Minnesota. We integrate environmental objectives of sediment reduction and habitat protection with socio-economic factors associated with the overlap of private land with potential wetland restoration sites in the watershed and the costs representing forward-looking farmers voluntarily taking land out of agricultural production in favor of wetland restoration. Our results demonstrate that the inclusion of these factors early on in the restoration planning process affects both the total costs of the restoration project and the spatial distribution of optimally selected wetland restoration sites.

Is there a relationship between geographic distance and uptake of HIV testing services? A representative population-based study of Chinese adults in Guangzhou, China.

PubMed

Chen, Wen; Zhou, Fangjing; Hall, Brian J; Tucker, Joseph D; Latkin, Carl; Renzaho, Andre M N; Ling, Li

2017-01-01

Achieving high coverage of HIV testing services is critical in many health systems, especially where HIV testing services remain centralized and inconvenient for many. As a result, planning the optimal spatial distribution of HIV testing sites is increasingly important. We aimed to assess the relationship between geographic distance and uptake of HIV testing services among the general population in Guangzhou, China. Utilizing spatial epidemiological methods and stratified household random sampling, we studied 666 adults aged 18-59. Computer-assisted interviews assessed self-reported HIV testing history. Spatial scan statistic assessed the clustering of participants who have ever been tested for HIV, and two-level logistic regression models assessed the association between uptake of HIV testing and the mean driving distance from the participant's residence to all HIV testing sites in the research sites. The percentage of participants who have ever been tested for HIV was 25.2% (168/666, 95%CI: 21.9%, 28.5%), and the majority (82.7%) of participants tested for HIV in Centres for Disease Control and Prevention, public hospitals or STIs clinics. None reported using self-testing. Spatial clustering analyses found a hotspot included 48 participants who have ever been tested for HIV and 25.8 expected cases (Rate Ratio = 1.86, P = 0.002). Adjusted two-level logistic regression found an inverse relationship between geographic distance (kilometers) and ever being tested for HIV (aOR = 0.90, 95%CI: 0.84, 0.96). Married or cohabiting participants (aOR = 2.14, 95%CI: 1.09, 4.20) and those with greater social support (aOR = 1.04, 95%CI: 1.01, 1.07) were more likely to be tested for HIV. Our findings underscore the importance of considering the geographical distribution of HIV testing sites to increase testing. In addition, expanding HIV testing coverage by introducing non-facility based HIV testing services and self-testing might be useful to achieve the goal that 90% of people living with HIV knowing their HIV status by the year 2020.

From QASC to QASCIP: successful Australian translational scale-up and spread of a proven intervention in acute stroke using a prospective pre-test/post-test study design

PubMed Central

Lydtin, Anna; Comerford, Daniel; Cadilhac, Dominique A; McElduff, Patrick; Dale, Simeon; Hill, Kelvin; Longworth, Mark; Ward, Jeanette; Cheung, N Wah; D'Este, Cate

2016-01-01

Objectives To embed an evidence-based intervention to manage FEver, hyperglycaemia (Sugar) and Swallowing (the FeSS protocols) in stroke, previously demonstrated in the Quality in Acute Stroke Care (QASC) trial to decrease 90-day death and dependency, into all stroke services in New South Wales (NSW), Australia's most populous state. Design Pre-test/post-test prospective study. Setting 36 NSW stroke services. Methods Our clinical translational initiative, the QASC Implementation Project (QASCIP), targeted stroke services to embed 3 nurse-led clinical protocols (the FeSS protocols) into routine practice. Clinical champions attended a 1-day multidisciplinary training workshop and received standardised educational resources and ongoing support. Using the National Stroke Foundation audit collection tool and processes, patient data from retrospective medical record self-reported audits for 40 consecutive patients with stroke per site pre-QASCIP (1 July 2012 to 31 December 2012) were compared with prospective self-reported data from 40 consecutive patients with stroke per site post-QASCIP (1 November 2013 to 28 February 2014). Inter-rater reliability was substantial for 10 of 12 variables. Primary outcome measures Proportion of patients receiving care according to the FeSS protocols pre-QASCIP to post-QASCIP. Results All 36 (100%) NSW stroke services participated, nominating 100 site champions who attended our educational workshops. The time from start of intervention to completion of post-QASCIP data collection was 8 months. All (n=36, 100%) sites provided medical record audit data for 2144 patients (n=1062 pre-QASCIP; n=1082 post-QASCIP). Pre-QASCIP to post-QASCIP, proportions of patients receiving the 3 targeted clinical behaviours increased significantly: management of fever (pre: 69%; post: 78%; p=0.003), hyperglycaemia (pre: 23%; post: 34%; p=0.0085) and swallowing (pre: 42%; post: 51%; p=0.033). Conclusions We obtained unprecedented statewide scale-up and spread to all NSW stroke services of a nurse-led intervention previously proven to improve long-term patient outcomes. As clinical leaders search for strategies to improve quality of care, our initiative is replicable and feasible in other acute care settings. PMID:27154485

The national database of hospital-based cancer registries: a nationwide infrastructure to support evidence-based cancer care and cancer control policy in Japan.

PubMed

Higashi, Takahiro; Nakamura, Fumiaki; Shibata, Akiko; Emori, Yoshiko; Nishimoto, Hiroshi

2014-01-01

Monitoring the current status of cancer care is essential for effective cancer control and high-quality cancer care. To address the information needs of patients and physicians in Japan, hospital-based cancer registries are operated in 397 hospitals designated as cancer care hospitals by the national government. These hospitals collect information on all cancer cases encountered in each hospital according to precisely defined coding rules. The Center for Cancer Control and Information Services at the National Cancer Center supports the management of the hospital-based cancer registry by providing training for tumor registrars and by developing and maintaining the standard software and continuing communication, which includes mailing lists, a customizable web site and site visits. Data from the cancer care hospitals are submitted annually to the Center, compiled, and distributed as the National Cancer Statistics Report. The report reveals the national profiles of patient characteristics, route to discovery, stage distribution, and first-course treatments of the five major cancers in Japan. A system designed to follow up on patient survival will soon be established. Findings from the analyses will reveal characteristics of designated cancer care hospitals nationwide and will show how characteristics of patients with cancer in Japan differ from those of patients with cancer in other countries. The database will provide an infrastructure for future clinical and health services research and will support quality measurement and improvement of cancer care. Researchers and policy-makers in Japan are encouraged to take advantage of this powerful tool to enhance cancer control and their clinical practice.

Managing risk during care transitions when approaching end of life: A qualitative study of patients' and health care professionals' decision making.

PubMed

Coombs, Maureen A; Parker, Roses; de Vries, Kay

2017-07-01

Increasing importance is being placed on the coordination of services at the end of life. To describe decision-making processes that influence transitions in care when approaching the end of life. Qualitative study using field observations and longitudinal semi-structured interviews. Field observations were undertaken in three sites: a residential care home, a medical assessment unit and a general medical unit in New Zealand. The Supportive and Palliative Care Indicators Tool was used to identify participants with advanced and progressive illness. Patients and family members were interviewed on recruitment and 3-4 months later. Four weeks of fieldwork were conducted in each site. A total of 40 interviews were conducted: 29 initial interviews and 11 follow-up interviews. Thematic analysis was undertaken. Managing risk was an important factor that influenced transitions in care. Patients and health care staff held different perspectives on how such risks were managed. At home, patients tolerated increasing risk and used specific support measures to manage often escalating health and social problems. In contrast, decisions about discharge in hospital were driven by hospital staff who were risk-adverse. Availability of community and carer services supported risk management while a perceived need for early discharge decision making in hospital and making 'safe' discharge options informed hospital discharge decisions. While managing risk is an important factor during care transitions, patients should be able to make choices on how to live with risk at the end of life. This requires reconsideration of transitional care and current discharge planning processes at the end of life.

JPL's GNSS Real-Time Earthquake and Tsunami (GREAT) Alert System

NASA Astrophysics Data System (ADS)

Bar-Sever, Yoaz; Miller, Mark; Vallisneri, Michele; Khachikyan, Robert; Meyer, Robert

2017-04-01

We describe recent developments to the GREAT Alert natural hazard monitoring service from JPL's Global Differential GPS (GDGPS) System. GREAT Alert provides real-time, 1 Hz positioning solutions for hundreds of GNSS tracking sites, from both global and regional networks, aiming to monitor ground motion in the immediate aftermath of earthquakes. We take advantage of the centralized data processing, which is collocated with the GNSS orbit determination operations of the GDGPS System, to combine orbit determination with large-scale point-positioning in a grand estimation scheme, and as a result realize significant improvement to the positioning accuracy compared to conventional stand-alone point positioning techniques. For example, the measured median site (over all sites) real-time horizontal positioning accuracy is 2 cm 1DRMS, and the median real-time vertical accuracy is 4 cm RMS. The GREAT Alert positioning service is integrated with automated global earthquake notices from the United States Geodetic Survey (USGS) to support near-real-time calculations of co-seismic displacements with attendant formal errors based both short-term and long-term error analysis for each individual site. We will show the millimeter-level resolution of co-seismic displacement can be achieved by this system. The co-seismic displacements, in turn, are fed into a JPL geodynamics and ocean models, that estimate the Earthquake magnitude and predict the potential tsunami scale.

Intensive Group Learning and On-Site Services to Improve Sexual and Reproductive Health Among Young Adults in Liberia: A Randomized Evaluation of HealthyActions

PubMed Central

Firestone, Rebecca; Moorsmith, Reid; James, Simon; Urey, Marilyn; Greifinger, Rena; Lloyd, Danielle; Hartenberger-Toby, Lisa; Gausman, Jewel; Sanoe, Musa

2016-01-01

ABSTRACT Introduction: Young Liberians, particularly undereducated young adults, face substantial sexual and reproductive health (SRH) challenges, with low uptake of contraceptive methods, high rates of unintended pregnancy, and low levels of knowledge about HIV status. The purpose of this study was to assess the impact of a 6-day intensive group learning intervention combined with on-site SRH services (called HealthyActions) among out-of-school young adults, implemented through an existing alternative education program, on uptake of contraception and HIV testing and counseling (HTC). Methods: The intervention was implemented among young women and men ages 15–35 who were enrolled in alternative basic education learning sites in 5 counties of Liberia. We conducted a randomized evaluation to assess program impact. Baseline data were collected in January–March 2014, and endline data in June–July 2014. Key outcomes of condom use, contraceptive use, and HTC were estimated with difference-in-difference models using fixed effects. All analyses were conducted in Stata 13. Results: We assessed outcomes for 1,157 learners at baseline and 1,052 learners at endline, across 29 treatment and 26 control sites. After adjusting for potential confounders, learners in the HealthyActions intervention group were 12% less likely to report never using a condom with a regular partner over the last month compared with the control group (P = .02). Female learners who received HealthyActions were 13% more likely to use any form of modern contraception compared with learners in control sites (P<.001), with the greatest increase in the use of contraceptive implants. Learners in HealthyActions sites were 45% more likely to have received HTC (P<.001). Conclusion: Providing intensive group learning in a supportive environment coupled with on-site health services improved SRH outcomes among participating learners. The focus of HealthyActions on participatory learning for low-literacy populations presents an adaptable solution for health programming across Liberia and the region. PMID:27688717

Ecological criteria for evaluating candidate sites for marine reserves

USGS Publications Warehouse

Roberts, Callum M.; Andelman, Sandy; Branch, George; Bustamante, Rodrigo H.; Castilla, Juan Carlos; Dugan, Jenifer; Halpern, Benjamin S.; Lafferty, Kevin D.; Leslie, Heather; Lubchenco, Jane; McArdle, Deborah; Possingham, Hugh P.; Ruckelshaus, Mary; Warner, Robert R.

2003-01-01

Several schemes have been developed to help select the locations of marine reserves. All of them combine social, economic, and biological criteria, and few offer any guidance as to how to prioritize among the criteria identified. This can imply that the relative weights given to different criteria are unimportant. Where two sites are of equal value ecologically, then socioeconomic criteria should dominate the choice of which should be protected. However, in many cases, socioeconomic criteria are given equal or greater weight than ecological considerations in the choice of sites. This can lead to selection of reserves with little biological value that fail to meet many of the desired objectives. To avoid such a possibility, we develop a series of criteria that allow preliminary evaluation of candidate sites according to their relative biological values in advance of the application of socioeconomic criteria. We include criteria that, while not strictly biological, have a strong influence on the species present or ecological processes. Our scheme enables sites to be assessed according to their biodiversity, the processes which underpin that diversity, and the processes that support fisheries and provide a spectrum of other services important to people. Criteria that capture biodiversity values include biogeographic representation, habitat representation and heterogeneity, and presence of species or populations of special interest (e.g., threatened species). Criteria that capture sustainability of biodiversity and fishery values include the size of reserves necessary to protect viable habitats, presence of exploitable species, vulnerable life stages, connectivity among reserves, links among ecosystems, and provision of ecosystem services to people. Criteria measuring human and natural threats enable candidate sites to be eliminated from consideration if risks are too great, but also help prioritize among sites where threats can be mitigated by protection. While our criteria can be applied to the design of reserve networks, they also enable choice of single reserves to be made in the context of the attributes of existing protected areas. The overall goal of our scheme is to promote the development of reserve networks that will maintain biodiversity and ecosystem functioning at large scales. The values of ecosystem goods and services for people ultimately depend on meeting this objective.

42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL NATIONAL HEALTH SERVICE CORPS Assignment of National Health Service...

42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL NATIONAL HEALTH SERVICE CORPS Assignment of National Health Service...

42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL NATIONAL HEALTH SERVICE CORPS Assignment of National Health Service...

42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL NATIONAL HEALTH SERVICE CORPS Assignment of National Health Service...

42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL NATIONAL HEALTH SERVICE CORPS Assignment of National Health Service...

Assessment of voluntary counseling and testing service utilization and associated factors among Debre Markos University Students, North West Ethiopia: a cross-sectional survey in 2011.

PubMed

Tsegay, Girmay; Edris, Melkie; Meseret, Solomon

2013-03-19

Voluntary Counseling and Testing (VCT) is the key entry point to prevention, care, treatment and support services, where people learn whether they are infected or not and to understand the implications of their HIV status and make informed choices for the future. A cross sectional study design was done among 753 students drawn from selected departments in Debre Markos University, Ethiopia, using multi-stage sampling technique. Self-administered questionnaire was used to estimate the prevalence of VCT service utilization and to assess associated factors. Data were entered and analyzed using SPSS version 16. 711 students were participated in the study, of whom, 521 were males. Majority (93.8%) were within the age range of 15 to 24 years. The mean age was 21.5 (3.2 ±); most of the respondents (91.6%) were single. Majority (81.4%) heard about the confidential VCT service, and their major sources of information were mass media (73.3%) and health workers (71.1%). The study revealed that 58.5% of the study participants had undergone voluntary counseling and testing. It was shown that VCT service utilization was significantly associated with availability of ART drug in VCT site, heard presence of confidentiality, perceived stigma, risk perception and knowledge about HIV. The major factors identified for increased VCT service utilization were knowledge about availability of ART drug in VCT site, information about confidentiality, absence of perceived stigma, higher risk perception and knowledge about HIV. Therefore, actions targeting on these predictors are necessary to effectively enhance the use of the VCT services utilization.

Towards Assisted Moderation in Online Healthcare Social Networks: Improving Trust in YouTube Searches.

PubMed

Cañon, Daniel E; Lopez, Diego M; Blobel, Bernd

2014-01-01

Moderation of content in online Health Social Networks (HSN) is critical because information is not only published and produced by experts or health professionals, but also by users of that information. The objective of this paper is to propose a semi-automatic moderation Web Service for assessing the quality (trustworthiness) of health-related videos published on the YouTube social network. The service is relevant for moderators or community managers, who get enabled to control the quality of videos published on their online HSN sites. The HealthTrust metric was selected as the metric to be implemented in the service in order to support the assessment of trustworthiness of videos in Online HSN. The service is a RESTful service which can be integrated into open source Virtual Social Network Platforms, therefore improving trust in the process of searching and publishing content extracted from YouTube. A preliminary pilot evaluation in a simple use case demonstrated that the relevance of videos retrieved using the moderation service was higher compared to the relevance of the videos retrieved using the YouTube search engine.

Spinal Cord Injury Community Survey: Understanding the Needs of Canadians with SCI.

PubMed

Noreau, Luc; Noonan, Vanessa K; Cobb, John; Leblond, Jean; Dumont, Frédéric S

2014-01-01

There is a lack of literature regarding service needs of people with SCI living in the community. Better assessment of expressed and met and unmet needs would help in the development of effective service delivery. From a national SCI Community Survey in Canada, the aim was to identify the most critical service needs of people living in the community at least 1 year post discharge from rehabilitation and the support they received to meet their needs. Data were collected mainly through a secure Web site and encompassed demographics, personal and household income, an SCI severity measure, and an SCI community needs measure containing information on 13 SCI-related needs. A total of 1,549 persons with SCI (traumatic lesion, n = 1,137; nontraumatic lesion, n = 412) across Canada completed the survey. Most critical needs for community integration were expressed by a substantial proportion of survey participants, but significantly more expressed and met needs were reported by persons with a traumatic than a nontraumatic lesion. Personal and environmental characteristics influenced the probability of expressing and meeting needs (eg, severity of injury and household income). Help and support to meet expressed needs were received from government agencies, community organizations, and friends or family. Better assessment of expressed and met or unmet needs for services remains a challenge but will serve as a tool to optimize service delivery in the community. Environmental barriers to services, particularly the process of getting needs met and associated costs, remain an issue that requires a reconsideration of some aspects of access to services.

"What took you so long?" The impact of PEPFAR on the expansion of HIV testing and counseling services in Africa.

PubMed

Marum, Elizabeth; Taegtmeyer, Miriam; Parekh, Bharat; Mugo, Nelly; Lembariti, Salama; Phiri, Mannasseh; Moore, Jan; Cheng, Alison S

2012-08-15

HIV testing and counseling services in Africa began in the early 1990s, with limited availability and coverage. Fears of stigma and discrimination, complex laboratory systems, and lack of available care and treatment services hampered expansion. Use of rapid point-of-care tests, introduction of services to prevent mother-to-child transmission, and increasing provision of antiretroviral drugs were key events in the late 1990s and early 2000s that facilitated the expansion of HIV testing and counseling services. Innovations in service delivery included providing HIV testing in both clinical and community sites, including mobile and home testing. Promotional campaigns were conducted in many countries, and evolutions in policies and guidance facilitated expansion and uptake. Support from President's Emergency Plan for AIDS Relief and national governments, other donors, and the Global Fund for AIDS, Tuberculosis, and Malaria contributed to significant increases in the numbers of persons tested in many countries. Quality of both testing and counseling, limited number of health care workers, uptake by couples, and effectiveness of linkages and referral systems remain challenges. Expansion of antiretroviral treatment, especially in light of the evidence that treatment contributes to prevention of transmission, will require greater yet strategic coverage of testing services, especially in clinical settings and in combination with other high-impact HIV prevention strategies. Continued support from President's Emergency Plan for AIDS Relief, governments, and other donors is required for the expansion of testing needed to achieve international targets for the scale-up of treatment and universal access to knowledge of HIV status.