text:
Ancillary Services Review Guide, 1983.
National Technical Information Service (NTIS)
This guide is designed to assist those individuals/organizations who are interested in ancillary services review (ASR) programs. The background and overview of ASR is presented. A step-by-step methodology for the development and implementation of an ASR p...
S. M. McCue
Loads Providing Ancillary Services: Review of International Experience
SciTech Connect
In this study, we examine the arrangements for and experiences of end-use loads providing ancillary services (AS) in five electricity markets: Australia, the United Kingdom (UK), the Nordic market, and the ERCOT and PJM markets in the United States. Our objective in undertaking this review of international experience was to identify specific approaches or market designs that have enabled customer loads to effectively deliver various ancillary services (AS) products. We hope that this report will contribute to the ongoing discussion in the U.S. and elsewhere regarding what institutional and technical developments are needed to ensure that customer loads can meaningfully participate in all wholesale electricity markets.
Heffner, Grayson; Goldman, Charles; Kintner-Meyer, Michael
Ancillary services market in California
This report includes sections on the following topics: (1) California restructured electricity system overview; (2) Reliability criteria; (3) Design of the California ISO ancillary services market; (4) Operation of ancillary services markets; (5) Ancillary services markets redesign; and (6) Conclusions.
Gomez, T.; Marnay, C.; Siddiqui, A.; Liew, L.; Khavkin, M.
Loads Providing Ancillary Services: Review of InternationalExperience-- Technical Appendix: Market Descriptions
In this study, we examine the arrangements for andexperiences of end-use loads providing ancillary services (AS) in fiveelectricity markets: Australia, the United Kingdom (UK), the Nordicmarket, and the ERCOT and PJM markets in the United States. Our objectivein undertaking this review of international experience was to identifyspecific approaches or market designs that have enabled customer loads toeffectively deliver various ancillary services (AS) products. We hopethat this report will contribute to the ongoing discussion in the U.S.and elsewhere regarding what institutional and technical developments areneeded to ensure that customer loads can meaningfully participate in allwholesale electricity markets.
Grayson Heffner, Charles Goldman, Kintner-Meyer, M; Kirby, Brendan
Demand Response for Ancillary Services
Many demand response resources are technically capable of providing ancillary services. In some cases, they can provide superior response to generators, as the curtailment of load is typically much faster than ramping thermal and hydropower plants. Analysis and quantification of demand response resources providing ancillary services is necessary to understand the resources economic value and impact on the power system. Methodologies used to study grid integration of variable generation can be adapted to the study of demand response. In the present work, we describe and illustrate a methodology to construct detailed temporal and spatial representations of the demand response resource and to examine how to incorporate those resources into power system models. In addition, the paper outlines ways to evaluate barriers to implementation. We demonstrate how the combination of these three analyses can be used to translate the technical potential for demand response providing ancillary services into a realizable potential.
Alkadi, Nasr E [ORNL; Starke, Michael R [ORNL
Ancillary data services of NASA's Navigation and Ancillary Information Facility
Microsoft Academic Search
JPL's Navigation and Ancillary Information Facility (NAIF) has primary responsibility for design and implementation of the SPICE ancillary information system, supporting a wide range of space science mission design, observation planning and data analysis functions. NAIF also serves as the ancillary data node of the Planetary Data System (PDS). As part of the PDS, NAIF archives SPICE and other ancillary
Charles H. Acton
Power quality monitoring for substation ancillary services
The assurance of the power quality supplied to consumers represents one of the most important issues that have to be fulfilled, related to substation ancillary services power supply sources. The aspects concerning the power quality are highlighted for the designed and planning of the substations belonging to the transmission network. Within the monitoring process several quantities are analyzed. The voltage
Nicolae Chiosa; Stefan Kilyeni; Petru Dan Cristian; Constantin Barbulescu; Attila Simo
NASA Astrophysics Data System (ADS)
JPL's Navigation and Ancillary Information Facility (NAIF) has primary responsibility for design and implementation of the SPICE ancillary information system, supporting a wide range of space science mission design, observation planning and data analysis functions. NAIF also serves as the ancillary data node of the Planetary Data System (PDS). As part of the PDS, NAIF archives SPICE and other ancillary data produced by flight projects. NAIF then distributes these data, and associated data access software and high-level tools, free of charge, to researchers funded by NASA's Office of Space Science, and to the broader space science community to the extent NAIF resources and NASA and JPL policy permit. This paper describes the SPICE system, identifies current and future SPICE applications, and summarizes customer support offered by NAIF. This information is current as of Spring 1995.
Acton, Charles H.
Ancillary services definitions, markets and practices in the world
Ancillary services are some operational reserved services procured by the Transmission System Operator (TSO) for keeping a balance between supply and demand, stabilizing the transmission system and maintaining the power quality on an economical basis in any competitive electricity market environment. This paper discusses different types of ancillary services and their characteristics and challenges in the power market in order
A. M. Pirbazari
Physician ancillary services: fad or fashion? Part 1.
Ancillary services are quite fashionable in today's medical practice, but perhaps you've wondered if they are only a fad. If you're considering adding services to increase your revenue, you're not too late; this trend seems here to stay. Doing your homework and due diligence is key to the success of your ancillary service. Before introducing a service into your practice or investing in an ancillary venture, make sure that you get off on sound footing. Major investments call for experienced consulting and tapping into financial, operational, and legal specialists to address specific needs. Part 1 of this two-part article defines ancillary services and addresses the following topics: performing the feasibility study; writing the business plan; and addressing the legal and regulatory issues. Part 2 will discuss financing arrangements, opening, operational, and ongoing management elements critical to success. PMID:16471393
Reiboldt, John
Options for pricing ancillary services in a deregulated power system
GENCOs in restructured systems are compensated for selling energy in the market. In a restructured market, a mechanism is required to entice participants in the market to provide ancillary services and to ensure adequate compensation that would guarantee its economic viability. The ISO controls the dispatch of generation, manages the reliability of the transmission grid, provides open access to the transmission, buys and provides ancillary services as required, coordinates day-ahead, hour-ahead schedules and performs real time balancing of load and generation, settles real time imbalances and ancillary services sales and purchases. The ISO, also, administers congestion management protocols for the transmission grid. Since the ISO does not own any generating units it must ensure that there is enough reserves for maintaining reliability according to FERC regulations, and sufficient unloaded generating capacity for balancing services in a real-time market. The ISO could meet these requirements by creating a competitive market for ancillary services, which are metered and remain unbundled to provide an accurate compensation for each supplier and cost to each consumer, In this study, we give an overview for restructuring and ancillary services in a restructured power marketplace. Also, we discuss the effect of GENCOs' actions in the competitive energy and ancillary service markets. In addition, we propose an auction market design for hedging ancillary service costs in California market. Furthermore, we show how to include the n-1 and voltage contingencies in security constrained unit commitment. Finally, we present two approaches for GENCOs' unit commitment in a restructured power market; one is based on game theory and the other is based on market price forecasting. In each of the two GENCOs' unit commitment approaches, we discuss the GENCOs' optimal bidding strategies in energy and ancillary service markets to maximize the GENCOs' profit.
Yamin, Hatim Yahya
Ancillary-service costs for 12 US electric utilities
Ancillary services are those functions performed by electrical generating, transmission, system-control, and distribution-system equipment and people to support the basic services of generating capacity, energy supply, and power delivery. The Federal Energy Regulatory Commission defined ancillary services as ``those services necessary to support the transmission of electric power from seller to purchaser given the obligations of control areas and transmitting utilities within those control areas to maintain reliable operations of the interconnected transmission system.`` FERC divided these services into three categories: ``actions taken to effect the transaction (such as scheduling and dispatching services) , services that are necessary to maintain the integrity of the transmission system [and] services needed to correct for the effects associated with undertaking a transaction.`` In March 1995, FERC published a proposed rule to ensure open and comparable access to transmission networks throughout the country. The rule defined six ancillary services and developed pro forma tariffs for these services: scheduling and dispatch, load following, system protection, energy imbalance, loss compensation, and reactive power/voltage control.
Kirby, B.; Hirst, E.
Power quality monitoring for electric substation ancillary services supplying
Power quality is the study of the sources, effects and control of disturbances which propagate via the electric power supply. The disturbances change the supply RMS voltage or its waveform (or very occasionally the frequency) and may originate from various sources. Within the paper, the authors are focusing on power quality monitoring. The presented approach refers to substation ancillary services
N. Chiosa; S. Kilyeni; C. Barbulescu; D. Jigoria-Oprea
Optimal generator bidding strategies for power and ancillary services
As the electric power industry transitions to a deregulated market, power transactions are made upon price rather than cost. Generator companies are interested in maximizing their profits rather than overall system efficiency. A method to equitably compensate generation providers for real power, and ancillary services such as reactive power and spinning reserve, will ensure a competitive market with an adequate number of suppliers. Optimizing the generation product mix during bidding is necessary to maximize a generator company's profits. The objective of this research work is to determine and formulate appropriate optimal bidding strategies for a generation company in both the energy and ancillary services markets. These strategies should incorporate the capability curves of their generators as constraints to define the optimal product mix and price offered in the day-ahead and real time spot markets. In order to achieve such a goal, a two-player model was composed to simulate market auctions for power generation. A dynamic game methodology was developed to identify Nash Equilibria and Mixed-Strategy Nash Equilibria solutions as optimal generation bidding strategies for two-player non-cooperative variable-sum matrix games with incomplete information. These games integrated the generation product mix of real power, reactive power, and spinning reserve with the generators's capability curves as constraints. The research includes simulations of market auctions, where strategies were tested for generators with different unit constraints, costs, types of competitors, strategies, and demand levels. Studies on the capability of large hydrogen cooled synchronous generators were utilized to derive useful equations that define the exact shape of the capability curve from the intersections of the arcs defined by the centers and radial vectors of the rotor, stator, and steady-state stability limits. The available reactive reserve and spinning reserve were calculated given a generator operating point in the P-Q plane. Four computer programs were developed to automatically perform the market auction simulations using the equal incremental cost rule. The software calculates the payoffs for the two competing competitors, dispatches six generators, and allocates ancillary services for 64 combinations of bidding strategies, three levels of system demand, and three different types of competitors. Matrix Game theory was utilized to calculate Nash Equilibrium solutions and mixed-strategy Nash solutions as the optimal generator bidding strategies. A method to incorporate ancillary services into the generation bidding strategy, to assure an adequate supply of ancillary services, and to allocate these necessary resources to the on-line units was devised. The optimal generator bid strategy in a power auction was shown to be the Nash Equilibrium solution found in two-player variable-sum matrix games.
Morinec, Allen G.
Nonactive-Power-Related Ancillary Services provided by Distribute Energy Resources
The nonactive-power-related ancillary services provided by distributed energy (DE) resources are categorized by voltage regulation, reactive power compensation, power factor correction, voltage and/or current unbalance compensation, and harmonics compensation. An instantaneous nonactive power theory is adopted to control the DE system to provide these ancillary services. Three control schemes, including nonactive current compensation, power factor correction, and voltage regulation, are developed which can perform one or more of the ancillary services. The control schemes are implemented in a DE system in simulation and experiments. The simulation and the experimental results show that DE is feasible for providing nonactive-power-related ancillary services.
Xu, Yan [ORNL; Tolbert, Leon M [ORNL; Rizy, D Tom [ORNL; Kueck, John D [ORNL
Substation ancillary services fuel cell power supply. Part 1. Solution overview
Ancillary services are support services within the power system, those which are necessary to support the transmission capacity and are essential in maintaining power quality, reliability and security of the grid. Considering these facts the supply method of the ancillary services is a key feature for the appropriate operation of the power system. Within this paper the authors are focusing
I. Borlea; C. Barbulescu; D. Cristian
Short-Term Output Variations in Wind Farms--Implications for Ancillary Services in the United States: Preprint
With the advent of competition in the electric power marketplace, this paper reviews changes that affect wind and other renewable energy technologies, and discusses the role of federal and state policies in the recent wind installations in the United States. In particular, it reviews the implications of ancillary service requirements on a wind farm and presents initial operating results of
J. Cadogan; M. Milligan; Y. Wan; B. Kirby
The Participation in Ancillary Services by High Capacity Wind Power Plants: Reserve Power
The Transmission System Operator (TSO) is responsible for a stable and secure exploitation of the electricity grid in its control zone. This is mainly achieved by contracting power generators delivering ancillary services in addition to their main commercial product, active power. Electricity from Renewable Energy Sources (RES-e) is today generally exempted from the participation in ancillary services. However, the increasing
Kristof De Vos; Paula Souto Perez; Johan Driesen
Cohort Profile: Longitudinal Investigations into Supportive and Ancillary health services.
The Longitudinal Investigations into Supportive and Ancillary health services (LISA) study is a cohort of people living with HIV/AIDS who have ever accessed anti-retroviral therapy (ART) in British Columbia, Canada. The LISA study was developed to better understand the outcomes of people living with HIV with respect to supportive services use, socio-demographic factors and quality of life. Between July 2007 and January 2010, 1000 participants completed an interviewer-administered questionnaire that included questions concerning medical history, substance use, social and medical support services, food and housing security and other social determinants of health characteristics. Of the 1000 participants, 917 were successfully linked to longitudinal clinical data through the provincial Drug Treatment Program. Within the LISA cohort, 27% of the participants are female, the median age is 39 years and 32% identify as Aboriginal. Knowledge translation activities for LISA include the creation of plain language summaries, internet resources and arts-based engagement activities such as Photovoice. PMID:22461127
Duncan, Katrina C; Salters, Kate; Forrest, Jamie I; Palmer, Alexis K; Wang, Hong; O'Brien, Nadia; Parashar, Surita; Cescon, Angela M; Samji, Hasina; Montaner, Julio Sg; Hogg, Robert S
Transactive Control and Coordination of Distributed Assets for Ancillary Services
The need to diversify energy supplies, the need to mitigate energy-related environmental impact, and the entry of electric vehicles in large numbers present challenges and opportunities to power system professionals. Wind and solar power provide many benefits, and to reap the benefits the resulting increased variability�forecasted as well as unforecasted�should be addressed. Demand resources are receiving increasing attention as one means of providing the grid balancing services. Control and coordination of a large number (~millions) of distributed smart grid assets requires innovative approaches. One such is transactive control and coordination (TC2)�a distributed, agent-based incentive and control system. The TC2 paradigm is to create a market system with the following characteristics: � Participation should be entirely voluntary. � The participant decides at what price s/he is willing to participate. � The bids and responses are automated. Such an approach has been developed and demonstrated by Pacific Northwest National Laboratory for energy markets. It is the purpose of this project to develop a similar approach for ancillary services. In this report, the following ancillary services are considered: � spinning reserve � ramping � regulation. These services are to be provided by the following devices: � refrigerators � water heaters � clothes dryers � variable speed drives. The important results are summarized below: The regulation signal can be divided into an energy-neutral high frequency component and a low frequency component. The high frequency component is particularly well suited for demand resources. The low frequency component, which carries energy non-neutrality, can be handled by a combination of generators and demand resources. An explicit method for such a separation is obtained from an exponentially weighted moving average filter. Causal filters (i.e., filters that process only present and past values of a signal) introduce delays that can be issues in some signal processing applications that treat the high frequency part as a noise to be eliminated. For regulation, the high frequency component is an essential part of the signal. The delay in the low frequency component is not a problem. A stochastic self-dispatch algorithm determines the response of the devices to the regulation signal. � In an ensemble of devices under normal operation, some devices turn on and some turn off in any time interval. Demand response necessitates turning off devices that would normally be on, or turning on devices that would normally be off. Over time, some of these would have turned off on their own. A formalism to determine expectation values under a combination of natural and forced attrition has been developed. This formalism provides a mechanism for accomplishing a desired power profile within a bid period. In particular, a method to minimize regulation requirement can be developed. The formulation provides valuable insights into control. � Some ancillary services�ramping to absorb unforecasted increase in renewable generation, and regulation down�require the demand resources to increase their energy use. Some resources such as HVAC systems can do this readily, whereas some others require enabling technology. Even without such technology, it is possible to arrange refrigerators and water heaters to have an energy debt and be ready to increase their energy use. A transactive bid mechanism of revolving debt can be developed for this purpose. Dramatic changes in control systems, architecture and markets are expected in the electrical grid. The technical capabilities of a large number of devices interacting with the grid are changing. While it is too early to describe complete solutions, TC2 has attractive features suitable for adapting to the changes. The analyses in this report and the activities planned for FY 14 and beyond are designed to facilitate this transition.
Subbarao, Krishnappa; Fuller, Jason C.; Kalsi, Karanjit; Somani, Abhishek; Pratt, Robert G.; Widergren, Steven E.; Chassin, David P.
75 FR 14342 - Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and Ancillary Services by...
Federal Register 2010, 2011, 2012, 2013
...Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and Ancillary Services...Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and Ancillary Services...Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and Ancillary...
Audit of subsidized ancillary services at the Nevada Test site
The Department and its contractors have participated in at least six reviews since 1991 encompassing aspects of subsidies at the test site. Several of these reviews resulted in reports recommending reductions to the housing, food, and bus services. A strategic planning report completed in November 1994, for example, recommended closing certain food service facilities, increasing housing rates to fair market value, and studying a bus depot system. Other reports echoed the same themes. The Department should be credited for recognizing that actions should be taken to reduce subsidy costs. Moreover, the Acting Manager, Nevada Operations office, has been proactive in reducing the busing subsidy by decreasing the number of buses and bus routes. The Acting Manager has also been fully supportive of the effort to further reduce subsidies. We appreciate these efforts.
With the advent of competition in the electric power marketplace, this paper reviews changes that affect wind and other renewable energy technologies, and discusses the role of federal and state policies in the recent wind installations in the United States. In particular, it reviews the implications of ancillary service requirements on a wind farm and presents initial operating results of monitoring one Midwest wind farm. Under federal energy policy, each generator must purchase, or otherwise provide for, ancillary services, such as dispatch, regulation, operation reserve, voltage regulation, and scheduling required to move power to load. As a renewable technology that depends on the forces of nature, short-term output variations are inherently greater for a wind farm than for a gas-fired combined cycle or a supercritical coal-fired unit.
Cadogan, J. [U.S. Department of Energy (US); Milligan, M. [National Renewable Energy Laboratory (US); Wan, Y. [National Renewable Energy Laboratory (US); Kirby, B. [Oak Ridge National Laboratory (US)
Operation of Ancillary Service Markets with Large Amounts of Wind Power
High integration levels of wind energy in a restructured electricity industry will have implications for centralised and decentralised decision-making processes. This paper comments on the operation of the market-based ancillary services implemented in the Australian National Electricity Market (NEM) under such a scenario. The issues for decision- making processes are categorised into security, technical and commercial dimensions. The main focus
S. R. Thorncraft; H. R. Outhred; D. J. Clements; F. K. Barker
Unbundling of transmission and ancillary services. II. Cost-based pricing framework
For pt.I see ibid., vol.12, no.2 (1997). This paper presents a systematic framework for pricing transmission and ancillary services in competitive power markets. This framework is based on the recovery of fixed and operating costs, and it meets the traditional revenue requirements. It is practical, feasible, easy to implement, and to regulate. It can be implemented with minimum transition cost.
A. Zobian; M. D. Ilic
Participation of DFIG wind turbines in frequency control ancillary service by optimized rotational kinetic energy
The increase in renewable and distributed energy resources has given rise to new concerns about frequency stability of electric power systems, as renewable generation is considered an intermittent source, which by its nature does not participate in frequency control. In some countries, system operators demand wind turbines to provide some sort of ancillary services, such as reactive power control and
A. Z?ertek; G. Verbic?; M. Pantos?
42 CFR 413.316 - Determining payment amounts: Ancillary services.
Code of Federal Regulations, 2013 CFR
...DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospectively Determined Payment Rates for Low-Volume Skilled Nursing Facilities, for Cost Reporting Periods Beginning Prior to July 1, 1998...
Organizational boundaries of medical practice: the case of physician ownership of ancillary services
PubMed Central
Physician ownership of in-office ancillary services (IOASs) has come under increasing scrutiny. Advocates of argue that IOASs allow physicians to supervise the quality and coordination of care. Critics have argued that IOASs create financial incentives for physicians to increase ancillary service volume. In this paper we develop a conceptual framework to evaluate the tradeoffs associated with physician ownership of IOASs. There is some evidence supporting the existence of scope and transaction economies in IOASs. Improvement in flow and continuity of care are likely to generate scope economies and improvements in quality monitoring and reductions in consumer transaction costs are likely to generate transaction economies. Other factors include the capture of upstream and downstream profits, but these incentives are likely to be small compared to scope and transaction economies. Policy debates on the merits of IOASs should include an explicit assessment of these tradeoffs. This research was supported in part by funding from the American Association of Orthopaedic Surgeons (AAOS).
Electric substation ancillary services power consumption analysis. Case study: Timisoara 400\\/220\\/110 kV substation
Within the paper, the authors deal with electric substation ancillary services power consumption analysis. They are focusing on load curve numerical processing. A real case study is discussed, Timisoara 400\\/220\\/110 kV substation, the consumers being supplied from the autotransformer tertiary winding. The parameters specific to ancillary services load curves are computed using a software tool developed in Matlab, based on
C. Barbulescu; S. Kilyeni; D. Jigoria-Oprea; N. Chiosa
Culturally competent treatment practices and ancillary service use in outpatient substance abuse treatment.
To engage and retain minority clients in treatment, clinicians and researchers often suggest employing culturally competent treatment practices (CCTPs). This study provides a quantitative assessment of the association between CCTPs and the utilization of ancillary services. Using data from a nationally representative sample of 618 outpatient substance abuse treatment (OSAT) organizations (88% response rate), we looked at five CCTPs and found that OSAT units employ them to varying degrees. In addition, the CCTPs showed varying associations with the four utilization measures. Physical exams and financial services appeared more responsive to CCTPs than did mental health and transportation services. Overall, certain CCTPs may influence the use of specific medical and psychosocial services, but may not be uniformly effective in promoting utilization of all services. PMID:12039613
Campbell, Cynthia I; Alexander, Jeffrey A
Opportunities for ice storage to provide ancillary services to power grids incorporating wind turbine generation
Power generation using wind turbines increases the electrical system balancing, regulation and ramp rate requirements due to the minute to minute variability in wind speed and the difficulty in accurately forecasting wind speeds. The addition of thermal energy storage, such as ice storage, to a building's space cooling equipment increases the operational flexibility of the equipment by allowing the owner to choose when the chiller is run. The ability of the building owner to increase the power demand from the chiller (e.g. make ice) or to decrease the power demand (e.g. melt ice) to provide electrical system ancillary services was evaluated.
Finley, Christopher
Organizational boundaries of medical practice: the case of physician ownership of ancillary services.
Physician ownership of in-office ancillary services (IOASs) has come under increasing scrutiny. Advocates of argue that IOASs allow physicians to supervise the quality and coordination of care. Critics have argued that IOASs create financial incentives for physicians to increase ancillary service volume. In this paper we develop a conceptual framework to evaluate the tradeoffs associated with physician ownership of IOASs. There is some evidence supporting the existence of scope and transaction economies in IOASs. Improvement in flow and continuity of care are likely to generate scope economies and improvements in quality monitoring and reductions in consumer transaction costs are likely to generate transaction economies. Other factors include the capture of upstream and downstream profits, but these incentives are likely to be small compared to scope and transaction economies. Policy debates on the merits of IOASs should include an explicit assessment of these tradeoffs.This research was supported in part by funding from the American Association of Orthopaedic Surgeons (AAOS). PMID:22828324
Schneider, John E; Ohsfeldt, Robert L; Scheibling, Cara M; Jeffers, Sarah A
Wind Farm Power Fluctuations, Ancillary Services, and System Operating Impact Analysis Activities in the United States: Preprint
With ever increasing penetration of wind capacity and growing interest in wind power by electric utilities and other power providers, questions about the impacts and costs associated with maintaining a stable grid is receiving lots of attention. These issues are important, both in competitive and regulated monopoly markets.To evaluate the range of ancillary service impact of wind power plants, wind
B. K. Parsons; Y. Wan; B. Kirby
Utilizing Automated Demand Response in commercial buildings as non-spinning reserve product for ancillary services markets
In 2009, a pilot program was conducted to investigate the technical feasibility of bidding non-residential demand response (DR) resources into the California Independent System Operator's (CAISO) day-ahead ancillary services market as non-spinning reserves product. Three facilities, a retail store, a local government office building, and a bakery, were recruited into the pilot program and moved from automated price responsive programs
Sila Kiliccote; Mary Ann Piette; Edward Koch; Dan Hennage
Ancillary testing for diagnosis of brain death: a protocol for a systematic review and meta-analysis
Background The essential clinical diagnostic components of brain death must include evidence for an established etiology capable of causing brain death, two independent clinical confirmations of the absence of all brainstem reflexes and an apnea test, and exclude confounders that can mimic brain death. Numerous confounders can render the clinical neurological determination of death (NDD) virtually impossible. As such, clinicians must rely on additional ancillary testing. Methods/design We will conduct a systematic review and a meta-analysis of ancillary testing for the neurological determination of death. The primary objective of this systematic review is to evaluate the accuracy of these ancillary tests compared to the three accepted reference standards: (1) clinical diagnosis, (2) four-vessel angiography and (3) radionuclide imaging. This objective will be investigated using two different populations with different baseline risks of brain death: comatose patients and patients with a neurological determination of death. We will search MEDLINE, EMBASE and the Cochrane Central databases for retrospective and prospective diagnostic test studies and interventional studies. We will report study characteristics and assess methodological quality using QUADAS-2, which is used to assess the quality of diagnostic tests. If pooling is appropriate, we will compute parameter estimates using a bivariate model to produce summary receiver operating curves, summary operating points (pooled sensitivity and specificity), and 95% confidence regions around the summary operating point. Clinical and methodological subgroup and sensitivity analyses will be performed to explore heterogeneity. Discussion The results of this project will provide a critical evidence base for the neurological determination of death. The results will help clinicians to select ancillary tests based on the best available evidence. Our systematic review will also identify the strengths and weaknesses in the current evidence for the use of ancillary tests in diagnosing brain death. It will serve as a foundation for further research and the development of prospective studies on currently used or novel techniques for NDD. Protocol registration PROSPERO Registration Number: CRD42013005907
Utilization of prescription medications and ancillary pharmacy services among rural elders in west Texas: distance barriers and implications for telepharmacy.
We examine the relationship between distance and access to prescription medications and ancillary pharmacy services among rural elders in west Texas. Further understanding this relationship is important because programs such as telepharmacy are largely justified on the basis of reducing distance barriers. We use data from the Texas Tech 5000 survey to evaluate the relationship between distance and access. In addition, we examine whether regulations that prohibit competition between independent pharmacies and telepharmacies create a distance barrier to prescription medication. Our findings suggest that distance is a barrier to access, but telepharmacy regulations in Texas do not exacerbate the impact of distance. PMID:17557697
Collins, Brian; Borders, Tyrone F; Tebrink, Kristen; Xu, Ke Tom
The business of medicine: how to overcome financial obstacles and secure financing for your private practice and ancillary services business.
Doctors across the country who operate private medical practices are facing increasing financial obstacles, namely shrinking income as a result of rising costs and lower reimbursements. In addition, as hospitals have become overburdened many physicians have opened up private surgical centers; magnetic resonance imaging and computed tomography and positron emission tomography scanning facilities; pathology labs; colonoscopy/endoscopy suites; lithotripsy centers; and other medical businesses typically performed within the hospital. Moreover, many doctors seek loans to purchase existing practices or for their capital contribution in medical partnerships. The past decade has thus seen a significant increase in the number of doctors taking out small business loans. Indeed, banks view the healthcare industry as a large growth market. This article includes practical information, advice, and resources to help doctors to secure bank financing for their practices, ancillary services business, real estate, and equipment on the best possible market terms. PMID:22920034
Nayor, David
Short-Term Power Fluctuation of Wind Turbines: Analyzing Data from the German 250MW Measurement Program from the Ancillary Services Viewpoint
Short-term power fluctuations from wind farms may affect interconnected-grid operating costs and stability. With the increasing availability of wind power worldwide, this has become a concern for some utilities. Under electric industry restructuring in the United States, the impact of these fluctuations will be evaluated by examining provisions and costs of ancillary services for wind power. However, the magnitude of
B. Ernst; Y.-H. Wan; B. Kirby
This paper begins to look at issues of concern to wind in a restructured electric industry. The paper first briefly looks at the range of unbundled services and comments on their unique significance to wind. To illustrate the concerns that arise with restructuring, the paper then takes a more detailed look at a single service: regulation. Finally, the paper takes
Brendan Kirby; Eric Hirst; Brian Parsons; Kevin Porter; John B. Cadogan
The attack on ancillary service providers at the federal and state level.
The health care delivery system in the United States has witnessed more dramatic changes during the last decade than it had since the passage of Medicare. The managed care revolution and changes in reimbursement for Medicare services have forced providers to look for more efficient ways to provide services as well as for additional sources of revenue- and margin-producing business. The move toward specialized inpatient and outpatient facilities, often owned by physicians, is a natural reaction to these significant changes. These developments have resulted a "turf war" between physicians and hospitals over who should control these revenues. PMID:18061774
Cimasi, Robert
A sample of fifty-one former patients from the Intermediate Service of the Veterans Administration Hospital, West Haven, Connecticut were surveyed for the kinds of adjustment problems encountered in the home, in the community, and in job or retirement status. These long-term chronic disability patients had suffered catastrophic accidents or illnesses. The median age was 58 years; range was from 26
Gloria Bidwell; Bernard Berner; Robert D. Meier
Ancillary investigations in uveitis
Ancillary investigations are the backbone of uveitis work-up both for anterior and posterior segment diseases. They help in making the diagnosis, ruling out certain differential diagnosis and monitoring inflammation during the follow-up. This review aims to be an overview describing the role of commonly used investigations for uveitis.
Gupta, Vishali; Gupta, Amod
29 CFR 2550.408b-6 - Statutory exemption for ancillary services by a bank or similar financial institution.
...services by a bank or similar financial institution (as defined...the fiduciary bank or similar financial institution or an...service is consistent with sound banking and financial practice, as determined by...
47 CFR 25.149 - Application requirements for ancillary terrestrial components in the Mobile-Satellite Service...
...terrestrial components in the Mobile-Satellite Service networks operating in the 1...1.6/2.4 GHz and 2 GHz Mobile-Satellite Service. 25.149 Section 25.149...CONTINUED) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Applications and...
47 CFR 25.149 - Application requirements for ancillary terrestrial components in the mobile-satellite service...
Code of Federal Regulations, 2010 CFR
...terrestrial components in the mobile-satellite service networks operating in the 1...1.6/2.4 GHz and 2 GHz mobile-satellite service. 25.149 Section 25.149...CONTINUED) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Applications and...
47 CFR 1.9049 - Special provisions relating to spectrum leasing arrangements involving the ancillary terrestrial...
...ancillary terrestrial component of Mobile Satellite Services. 1.9049 Section 1.9049...ancillary terrestrial component of Mobile Satellite Services. (a) A license issued...the purpose of this subpart, a Mobile Satellite Service licensee with an ATC...
Competition policies in human services - A review of employment services
This article reviews a study of the recently commercialised employment services within Australia. I t focuses on non-government organisations and examines how government competition policies have reshaped service structure and service delivery. Studying employment services provides an opportunity to understand the impact of policies that are being implemented across a wide range of human services. Community based services are under
Carmel Laragy
Short-Term Output Variations in Wind Farms: Implications for Ancillary Services in the United States. Preprint.
With the advent of competition in the electric power marketplace, this paper reviews changes that affect wind and other renewable energy technologies, and discusses the role of federal and state policies in the recent wind installations in the United Stat...
J. Cadogan B. Kirby
Fluorescence in situ hybridization as an ancillary tool in the diagnosis of ambiguous melanocytic neoplasms: a review of 804 cases.
Previous studies have demonstrated the utility of fluorescence in situ hybridization (FISH) as an ancillary method in the diagnostic workup of histopathologically ambiguous melanocytic neoplasms. A combination of probes targeting 3 loci on chromosome 6 and 1 on 11q has been reported to distinguish unequivocal melanomas and nevi with a sensitivity and specificity of 87% and 96%, respectively. However, information on how FISH should be integrated into routine clinical testing is limited. We report our experience of FISH testing of 804 ambiguous melanocytic lesions performed as part of routine workup at University of California, San Francisco. The main category (47% of all cases) for which FISH testing was requested was Spitz tumors. Other categories included the distinction of possible melanoma from combined nevi (9%), acral or mucosal nevi (9%), Clark/dysplastic nevi (7%), and blue or deep penetrating nevi (6%) and to assess the possibility of nevoid melanoma (4%). Of the ambiguous tumors successfully tested, 88% received a more definitive benign or malignant final diagnosis. Of the 630 cases that tested negative by FISH, the final diagnosis was benign in 489 (78%) cases, ambiguous in 91 cases (14%), and malignant in 50 cases (8%). A positive FISH result was observed in 124 cases, with a final diagnosis of melanoma in 117 (94%). One (1%) FISH-positive case had an equivocal final diagnosis, and 6 (5%) were interpreted, despite the positive FISH result, as melanocytic nevi. We conclude that FISH testing can help reduce the number of equivocal diagnoses in ambiguous melanocytic neoplasms, in particular if FISH testing is positive, and discuss the challenges and limitations of FISH in clinical practice. PMID:24618603
North, Jeffrey P; Garrido, Maria C; Kolaitis, Nicholas A; LeBoit, Philip E; McCalmont, Timothy H; Bastian, Boris C
Review of Learning Assistance Services Report (1997).
ERIC Educational Resources Information Center
This report discusses the outcomes of a 1996-1997 review that investigated the current role of Learning Assistance Services in the delivery of special education support services to students in 115 British Columbia public schools and the students who receive these services. Learning Assistance Services are described as school-based, non-categorical�
British Columbia Dept. of Education, Victoria. Div. of Special Education.
Ancillary service details: Voltage control
Voltage control is accomplished by managing reactive power on an alternating-current power system. Reactive power can be produced and absorbed by both generation and transmission equipment. Reactive-power devices differ substantially in the magnitude and speed of response and in their capital costs. System operators, transmission owners, generators, customers, power marketers, and government regulators need to pay close attention to voltage control as they restructure the U.S. electricity industry. Voltage control can affect reliability and commerce in three ways: (1) Voltages must be maintained within an acceptable range for both customer and power-system equipment to function properly. (2) The movement of reactive power consumes transmission resources, which limits the ability to move real power and worsens congestion. (3) The movement of reactive power results in real-power losses. When generators are required to supply excessive amounts of reactive power, their real-power production must be curtailed. These opportunity costs are not currently compensated for in most regions. Current tariffs are based on embedded costs. These embedded-cost tariffs average about $0.51/MWh, equivalent to $1.5 billion annually for the United States as a whole. Although this cost is low when compared with the cost of energy, it still aggregates to a significant amount of money. This report takes a basic look at why the power system requires reactive power (an appendix explains the fundamentals of real and reactive power). The report then examines the various types of generation and transmission resources used to supply reactive power and to control voltage. Finally it discusses how these resources are deployed and paid for in several reliability regions around the country. As the U.S. electricity industry is restructured, the generation, transmission, and system-control equipment and functions that maintain voltages within the appropriate ranges are being deintegrated.
Ancillary service details: Voltage control.
Voltage control is accomplished by managing reactive power on an alternating-current power system. Reactive power can be produced and absorbed by both generation and transmission equipment. Reactive-power devices differ substantially in the magnitude and ...
B. Kirby E. Hirst
Prehospital digital photography and automated image transmission in an emergency medical service - an ancillary retrospective analysis of a prospective controlled trial
Background Still picture transmission was performed using a telemedicine system in an Emergency Medical Service (EMS) during a prospective, controlled trial. In this ancillary, retrospective study the quality and content of the transmitted pictures and the possible influences of this application on prehospital time requirements were investigated. Methods A digital camera was used with a telemedicine system enabling encrypted audio and data transmission between an ambulance and a remotely located physician. By default, images were compressed (jpeg, 640 x 480 pixels). On occasion, this compression was deactivated (3648 x 2736 pixels). Two independent investigators assessed all transmitted pictures according to predefined criteria. In cases of different ratings, a third investigator had final decision competence. Patient characteristics and time intervals were extracted from the EMS protocol sheets and dispatch centre reports. Results Overall 314 pictures (mean 2.77?�?2.42 pictures/mission) were transmitted during 113 missions (group 1). Pictures were not taken for 151 missions (group 2). Regarding picture quality, the content of 240 (76.4%) pictures was clearly identifiable; 45 (14.3%) pictures were considered �limited quality� and 29 (9.2%) pictures were deemed �not useful� due to not/hardly identifiable content. For pictures with file compression (n?=?84 missions) and without (n?=?17 missions), the content was clearly identifiable in 74% and 97% of the pictures, respectively (p?=?0.003). Medical reports (n?=?98, 32.8%), medication lists (n?=?49, 16.4%) and 12-lead ECGs (n?=?28, 9.4%) were most frequently photographed. The patient characteristics of group 1 vs. 2 were as follows: median age � 72.5 vs. 56.5 years, p?=?0.001; frequency of acute coronary syndrome � 24/113 vs. 15/151, p?=?0.014. The NACA scores and gender distribution were comparable. Median on-scene times were longer with picture transmission (26 vs. 22 min, p?=?0.011), but ambulance arrival to hospital arrival intervals did not differ significantly (35 vs. 33 min, p?=?0.054). Conclusions Picture transmission was used frequently and resulted in an acceptable picture quality, even with compressed files. In most cases, previously existing �paper data� was transmitted electronically. This application may offer an alternative to other modes of ECG transmission. Due to different patient characteristics no conclusions for a prolonged on-scene time can be drawn. Mobile picture transmission holds important opportunities for clinical handover procedures and teleconsultation.
The Multiple Benefits of Class-Size Research: A Review of STAR's Legacy, Subsidiary and Ancillary Studies.
This review of research connected to Project Student Teacher Achievement Ratio (STAR) is a summary of the project's ongoing work in the form of a letter from researchers to a hypothetical colleague. Project STAR has investigated the effect on student achievement and development of small classes in the primary grades (K through 3). A research�
Achilles, C. M.; And Others
78 FR 6854 - Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting
...Health Services Research and Development Service Scientific Merit Review...Health Services Research and Development Service Scientific Merit Review...and nursing research. Applications are reviewed for scientific and...
78 FR 12422 - Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting
77 FR 42365 - Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting
Managing stress and change during service reviews.
Service reviews occur throughout the National Health Service from time to time, and changes in commissioning policies have recently led many Primary Care Trusts to hold reviews of the community health services. Although reviews can provide opportunities for fresh thinking, the process can be a time of considerable stress and apprehension for many staff as current systems and ways of working are challenged and possibly changed. If this stress is not managed appropriately, staff may suffer ill health leading to possible staff absences and pressure on services. Leaders and managers are ideally placed to manage this time of stress, if they have the necessary skills and qualities. Self-help measures are also beneficial and recommended as part of a healthy lifestyle. This article discusses how change can affect people in different stages of their life and how it can be managed more positively in the workplace. PMID:19517944
Sweeney, Corinne
Ancillary human health benefits of improved air quality resulting from climate change mitigation
BACKGROUND: Greenhouse gas (GHG) mitigation policies can provide ancillary benefits in terms of short-term improvements in air quality and associated health benefits. Several studies have analyzed the ancillary impacts of GHG policies for a variety of locations, pollutants, and policies. In this paper we review the existing evidence on ancillary health benefits relating to air pollution from various GHG strategies
Michelle L Bell; Devra L Davis; Luis A Cifuentes; Alan J Krupnick; Richard D Morgenstern; George D Thurston
Crisis in our hospital kitchens: ancillary staffing levels during an outbreak of food poisoning in a long stay hospital.
An investigation into an outbreak of food poisoning caused by Clostridium perfringens showed evidence of poor food handling by catering staff. The reasons behind this were explored by interviewing catering staff, analysing shifts and rotas, and looking at staff vacancies. Morale was low because of staff shortages resulting from a long term recruitment problem. In consequence staff were working double shifts and often for weeks on end without a day off. The reasons for the recruitment problem included the difficulty of recruiting semiskilled labour from a middle class area, low wages, lack of management support, and the poor image of the hospital as a place of work. Similar factors affect the recruitment and retention of ancillary staff nationally. The NHS has a poor record as an employer of ancillary staff, paying lower wages than other organisations for equivalent posts. Competitive tendering has further worsened the position of ancillary staff, with the result that good quality of care and service has often not been achieved. The NHS Review, with its emphasis on quality of care, makes no mention of ancillary staff. Yet high standards of ancillary provision are essential if further outbreaks of food poisoning in hospitals are to be prevented.
Pollock, A M; Whitty, P M
An investigation into an outbreak of food poisoning caused by Clostridium perfringens showed evidence of poor food handling by catering staff. The reasons behind this were explored by interviewing catering staff, analysing shifts and rotas, and looking at staff vacancies. Morale was low because of staff shortages resulting from a long term recruitment problem. In consequence staff were working double shifts and often for weeks on end without a day off. The reasons for the recruitment problem included the difficulty of recruiting semiskilled labour from a middle class area, low wages, lack of management support, and the poor image of the hospital as a place of work. Similar factors affect the recruitment and retention of ancillary staff nationally. The NHS has a poor record as an employer of ancillary staff, paying lower wages than other organisations for equivalent posts. Competitive tendering has further worsened the position of ancillary staff, with the result that good quality of care and service has often not been achieved. The NHS Review, with its emphasis on quality of care, makes no mention of ancillary staff. Yet high standards of ancillary provision are essential if further outbreaks of food poisoning in hospitals are to be prevented. PMID:2106996
75 FR 53665 - Hydrographic Services Review Panel Meeting
...Meeting AGENCY: National Ocean Service, National Oceanic and Atmospheric...SUMMARY: The Hydrographic Services Review Panel (HSRP), a Federal...HSRP Most Wanted Hydrographic Services Improvements 2007.'' Date and Time:...
Evaluation of the Service Review Model with Performance Scorecards
The current study combined a management technique termed "Service Review" with performance scorecards to enhance staff and consumer behavior in a human service setting consisting of 11 supervisors and 56 front-line staff working with 9 adult consumers with challenging behaviors. Results of our intervention showed that service review and scorecards�
Szabo, Thomas G.; Williams, W. Larry; Rafacz, Sharlet D.; Newsome, William; Lydon, Christina A.
Financial Report of Ontario Universities, 1997-98. Ancillary Enterprises.
This report provides detailed information on ancillary enterprises at provincially assisted universities and affiliated and federated colleges in Ontario (Canada) for the fiscal year ending 30 April 1998. Such enterprises include school stores (including bookstores), food services, residences, conferences, parking, publishing, and other�
Council of Ontario Universities, Toronto.
Financial Report of Ontario Universities, 1996-97. Ancillary Enterprises.
This report provides detailed information on ancillary enterprises at provincially assisted universities and at affiliated and federated colleges in Ontario (Canada) for the fiscal year that ended April 30, 1997. Such enterprises include school stores (including bookstores), food services, residences, conferences, parking, publishing, and other�
Observations on a Service Review: Time to Move On?
This paper considers the functioning of one educational psychology service (EPS) at a particularly troubled point in its existence. A focus on a review of the service and resultant pilot of a new model of service delivery will lead to consideration of how and why this process took place. Implications for the service in particular and the�
Annan, Michael
75 FR 27375 - Review of Nonpostal Services Language
...457] Review of Nonpostal Services Language AGENCY: Postal Regulatory Commission...services Mail Classification Schedule language. It solicits comments to assist in this...Mail Classification Schedule (MCS) language for its authorized nonpostal...
75 FR 62591 - Performance Review Board, Senior Executive Service (SES)
...NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (10-121)] Performance Review Board, Senior Executive Service (SES) AGENCY: National Aeronautics and Space Administration (NASA). ACTION: Notice...
78 FR 57837 - Senior Executive Service Performance Review Board
...CHEMICAL SAFETY AND HAZARD INVESTIGATION...Performance Review Board AGENCY: Chemical Safety and Hazard Investigation...Performance Review Board for the Chemical Safety and Hazard Investigation...Counsel, Institute of Museum and Library Services. This notice is...
Competitive ancillary service procurement in California
California has undertaken a major restructuring of its electricity utility sector. Most electricity is now sold in open markets operated by the PX and other entities. Bilateral contracting among some market participants is also permitted. A group of independent generating companies bids into these markets together with out of state resources. In addition to these markets, CAISO operates markets for both imbalance energy and AS, a quite unusual feature of the California system. These markets were initially quite chaotic and were rife with market power problems. However, various reforms have now created a system that functions well. During the restructuring process, special provisions were made to protect public purpose programs, including renewable generation.
Marnay, Chris; Siddiqui, Afzal S.; Khavkin, Mark
Operating experience review of service water system problems
In a recent paper, selected results of a comprehensive review and evaluation of service water system problems conducted by the Office for Analysis and Evaluation of Operational Data (AEOD) of the US Nuclear Regulatory Commission (NRC) were presented. The results of this review and evaluation indicated that service water system problems have significant safety implications. These system problems are attributable
Evaluation of Reference Services--A Review
Understanding the inherent deficiencies in reference service as provided is critical to providing effective, high quality service. Quantitative and qualitative research methodologies, as well as a combination of both, are being used to evaluate these services. The identification of appropriate research methodology is critical to an effective�
Kuruppu, Pali U.
78 FR 50037 - Hydrographic Services Review Panel
...NOAA Administrator welcomes applications from individuals with expertise in navigation data, products and services; marine cartography and geospatial information systems; geodesy; physical oceanography; coastal resource management, including...
Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations
This article summarizes an extensive literature review addressing the question, How can we spread and sustain innovations in health service delivery and organization? It considers both content (defining and measuring the diffusion of innovation in organizations) and process (reviewing the literature in a systematic and reproducible way). This article discusses (1) a parsimonious and evidence-based model for considering the diffusion of innovations in health service organizations, (2) clear knowledge gaps where further research should be focused, and (3) a robust and transferable methodology for systematically reviewing health service policy and management. Both the model and the method should be tested more widely in a range of contexts.
Greenhalgh, Trisha; Robert, Glenn; Macfarlane, Fraser; Bate, Paul; Kyriakidou, Olivia
75 FR 20809 - Hydrographic Services Review Panel
...navigation data, products and services; coastal management; fisheries management; coastal and marine spatial planning; geodesy; water levels; and other science-related fields to submit applications for Panel membership. To apply for membership...
76 FR 32957 - Hydrographic Services Review Panel
...navigation data, products and services; coastal management; fisheries management; coastal and marine spatial planning; geodesy; water levels; and other science-related fields to apply for Panel membership. To apply for membership on the...
77 FR 76001 - Hydrographic Services Review Panel
Using quality service analysts to streamline record reviews.
By using registered nurse quality service analysts (RN-QSAs), the United States Air Force Medical Center in Wiesbaden, Germany, which closed in 1993, reduced physician reviews of medical records in 1991-1992 to only the records that did not meet the preestablished screening criteria. The authors relate how the screening of records by RN-QSAs increased the number of records reviewed, reduced the number of people reviewing records, established the quality services department as a repository of patient care information, and markedly improved the quantity, quality, and reproducibility of patient care reviews. PMID:10137422
Fogg, J T; Ferguson, E W
32 CFR 1656.13 - Review of alternative service job assignments.
...2013-07-01 false Review of alternative service job assignments. 1656.13 Section 1656.13...SERVICE § 1656.13 Review of alternative service job assignments. (a) Review of ASW job assignments will be accomplished in...
The Tanzania Library Service: A Review of Recent Literature.
Provides a brief overview of Tanzania; describes the infrastructure of the Tanzania Library Service, including public, school, government, special, and academic libraries, rural library service, training and staffing, professional organizations, and publishing; and reviews recent literature on Tanzanian libraries. (26 references) (LRW)
Dahlgren, Cecilia
Review of Acquisitions Supporting the Veteran Employment Services Office.
We conducted this review to determine whether the Office of Human Resources and Administration (HR&A) had adequate controls to ensure that services acquired to support the Veteran Employment Services Office (VESO) in FYs 2012 and 2013 were appropriate and...
International services marketing: review of research, 1980-1998
The literature on international services marketing from 31 academic journals in the period 1980 to 1998 is reviewed. This time frame contains the largest proportion of scholarly works published on international services marketing to date. Results reveal that the extant literature is relatively sparse, with much research focused on highly specific industries or topic areas. Major findings from leading sectors
Gary Knight
A review of telehealth service implementation frameworks.
Despite the potential of telehealth services to increase the quality and accessibility of healthcare, the success rate of such services has been disappointing. The purpose of this paper is to find and compare existing frameworks for the implementation of telehealth services that can contribute to the success rate of future endeavors. After a thorough discussion of these frameworks, this paper outlines the development methodologies in terms of theoretical background, methodology and validation. Finally, the common themes and formats are identified for consideration in future implementation. It was confirmed that a holistic implementation approach is needed, which includes technology, organizational structures, change management, economic feasibility, societal impacts, perceptions, user-friendliness, evaluation and evidence, legislation, policy and governance. Furthermore, there is some scope for scientifically rigorous framework development and validation approaches. PMID:24464237
van Dyk, Liezl
75 FR 40036 - Rehabilitation Research and Development Service Scientific Merit Review Board; Notice of Meeting
...Rehabilitation Research and Development Service Scientific Merit Review...Rehabilitation Research and Development Service Scientific Merit Review...rehabilitation research and development applications for scientific and...
75 FR 3542 - Rehabilitation Research and Development Service Scientific Merit Review Board; Notice of Meeting
Technical forum: Review of sour service definitions. Part 2
Here, the author replies to the European Federation of Corrosion`s (EFC`s) comments on his original article ``Review of Sour Service Definitions`` published in the August 1996 issue of MP. EFC`s comments are welcome; they list for MP readers the disturbing number of literature, laboratory, and field failures that EFC had to label as irrelevant in defense of the nonsour service
STS ancillary equipment study. User reference book
NASA Technical Reports Server (NTRS)
A record of what is currently known about STS ancillary equipment is presented in this user-oriented design so that a potential user may evaluate whether he could use the described ancillary equipment or if he would need to design and fabricate a payload-unique item. References that the user can use to obtain additional details and requirements to aid in his evaluation and decision are included.
Plough, J. A.
76 FR 59664 - Membership of the Defense Contract Audit Agency Senior Executive Service Performance Review Boards
...Audit Agency Senior Executive Service Performance Review Boards AGENCY: Defense Contract...Audit Agency Senior Executive Service Performance Review Boards...Defense Contract Audit Agency (DCAA) Performance Review Boards. The Performance...
New Hampshire Child and Family Services Review. Final Report.
This document presents the findings of the Child and Family Services Review (CFSR) for the State of New Hampshire. The CFSR was conducted the week of June 9, 2003. The findings were derived from the following documents and data collection procedures: The ...
Integrated Early Years Services: A Thematic Literature Review
This article reports on the findings of a thematic review of research literature about integrated early years services (IEYS) [1995-2012]. Four themes are discussed: broad support for IEYS; critiques of claims about IEYS; a focus on inter-professional practice; and the challenge of evaluating IEYS. The article concludes with reflections concerning�
Wong, Sandie; Sumsion, Jennifer
New Jersey Child and Family Services Review. Final Report.
This document presents the findings of the Child and Family Services Review (CFSR) for the State of New Jersey for the period October 1, 2002 through March 22, 2004. The CFSR assesses State performance on seven child welfare outcomes pertaining to childre...
Social Services Law: Judicial Review, Financial Resources and Legitimate Expectations
In the context of a recent judicial review case, the Court of Appeal has delivered, on the one hand, a powerful weapon for people with disabilities who need social services, but, on the other, managerial implications which are bound to be keeping budget holders awake at night. The final outcome of the case � due for hearing before the Lords
Belinda Schwehr
International outsourcing of information technology services: review and future directions
Purpose � The purpose of this paper is to review the development of the empirical literature on international outsourcing of information technology services (ITS) over the 1992-2007 period and to identify future research areas. Design\\/methodology\\/approach � A sample of 78 empirical academic publications on international outsourcing of ITS conducted between 1992 and 2007 across 46 scholarly journals constitutes the main
Doren Chadee; Revti Raman
Ancillary Care in Community-Based Public Health Intervention Research
Community-based public health intervention research in developing countries typically takes place not in clinics but in people's homes and other living spaces. Research subjects and their communities may lack adequate nutrition, clean water, sanitation, and basic preventive and therapeutic services. Researchers often encounter unmet health needs in their interactions with individual subjects and need ethical guidelines to help them decide how to respond. To what extent do researchers have an ethical obligation to provide ancillary care�health care beyond what is necessary to ensure scientific validity and subjects' safety? We discuss a case example from Nepal and propose a simple 2-step sequence of questions to aid decision making.
Taylor, Holly A.; Mullany, Luke C.
Health promoting health services: a review of the evidence.
In the last 20 years, there have been many developments in health promoting hospitals and health services (HPH), particularly in Europe. In Australia, health promotion (HP) programs are being conducted in the hospital setting; however, developments related to the HPH concept have been slower. To identify the effects and benefits of a health service working under the HPH banner, and to assist HP practitioners in advocacy and planning for their health service to become an HPH, we conducted a literature review. Eight studies met the criteria of research on HPH or evaluation of HP programs within an HPH framework. Seven key themes were identified in these studies. Enablers and barriers to HPH development were analyzed and discussed within these themes. This review found a dearth of high-level research on HPH. In particular, there were few Australian studies. There is limited evidence, therefore, of the efficacy of HPH. Much more high-level research and dissemination of the findings are needed in order to encourage policy-makers and health service administrators to invest resources in HPH and to support the work of HP practitioners interested in developing their health service into an HPH. PMID:20179015
McHugh, Clare; Robinson, Anske; Chesters, Janice
77 FR 18818 - General Services Administration Acquisition Regulation; Submission for OMB Review; Contract...
...GENERAL SERVICES ADMINISTRATION [OMB Control No. 3090-0027...Sequence 8] General Services Administration Acquisition Regulation; Submission for OMB Review; Contract Administration, Quality Assurance (GSAR...
42 CFR 416.171 - Determination of payment rates for ASC services.
Code of Federal Regulations, 2012 CFR
...416.164(b), with the exception of radiology services as provided in � 416.164...surgical procedures and covered ancillary radiology services. Notwithstanding the provisions...offices or for any covered ancillary radiology service, excluding those listed...
Code of Federal Regulations, 2011 CFR
...416.164(b), with the exception of radiology services as provided in � 416.164...surgical procedures and covered ancillary radiology services. Notwithstanding the provisions...offices or for any covered ancillary radiology service, the national unadjusted...
Health and social services integration: a review of concepts and models.
Health and social services integration is particularly relevant for populations whose needs span physical health, mental health, housing, and disability services, along with others. Veterans, homeless, chronically ill, and aging are among those populations. This review examines recent peer-reviewed literature about different approaches to services integration, rationales behind those approaches, and successes of those approaches, including factors that make them succeed or fail. The focus here is on services that cross disciplinary boundaries; that is, those that integrate health services with social services, health services with mental health services, or one social service with a categorically different social service. PMID:22873935
Fisher, Michael P; Elnitsky, Christine
Clinical pharmacy services and solid organ transplantation: a literature review
Aim of the review Organ transplantation represents the therapy of choice for most types of end-stage organ failure, and post-transplant patient\\u000a care warrants great attention. The aim of this study was to summarise the available evidence regarding the role and impact\\u000a of clinical pharmacy services in the care of solid organ transplant patients. Methods A search of the literature was
G. Stemer; R. Lemmens-Gruber
Technical forum: Review of sour service definitions. Part 1
This is a joint response to the publication in the August 1996 issue of MP of the article entitled ``Review of Sour Service Definitions`` by McIntyre and Boah. The article implied that the European Federation of Corrosion (EFC) publication No. 16 ``Guidelines on Materials Requirements for Carbon and Low Alloy Steel for H�S-Containing Environments in Oil and Gas Production`` contains
L. M. Smith; J. L. Crolet; S. Eliassen; B. Kermani; W. Nisbets
76 FR 20822 - Proposed Information Collection (Servicer's Staff Appraisal Reviewer (SAR) Application) Activity...
...Proposed Information Collection (Servicer's Staff Appraisal Reviewer (SAR) Application) Activity: Comment...comments on information needed to nominate servicer appraisal employee as a staff appraisal reviewer. DATES: Written comments and...
77 FR 21622 - Rehabilitation Research and Development Service Scientific Merit Review Board; Notice of Meeting
...Rehabilitation Research and Development Service Scientific Merit Review...Rehabilitation Research and Development Service Scientific Merit Review...and the Chief Research and Development Officer on the scientific and...
77 FR 40412 - Rehabilitation Research and Development Service Scientific Merit Review Board, Notice of Meeting
76 FR 42167 - Rehabilitation Research and Development Service Scientific Merit Review Board; Notice of Meeting
78 FR 50144 - Rehabilitation Research and Development Service Scientific Merit Review Board; Notice of Meetings
75 FR 65404 - Rehabilitation Research and Development Service Scientific Merit Review Board; Notice of Meeting
75 FR 72872 - Rehabilitation Research and Development Service Scientific Merit Review Board; Notice of Meeting
78 FR 9455 - Rehabilitation Research and Development Service Scientific Merit Review Board, Notice of Meeting
75 FR 65039 - Submission for Review: Program Services Evaluation Surveys, OMB Control No. 3206-NEW
...Review: Program Services Evaluation Surveys, OMB Control No...3206-NEW, Program Services Evaluation Surveys. As required by...including the validity of the methodology and assumptions used; 3...workforce. Program services evaluation surveys are valuable...
The outcomes of palliative care day services: a systematic review.
This systematic review evaluates the evidence underpinning the provision of palliative day care services (PDS) to determine whether such services have a measurable effect on attendees' wellbeing. The majority of studies reviewed were qualitative and elicited individual perceptions of the benefits PDS. Although it was difficult to determine the quality of many studies, it would appear that attendance at PDS had a positive impact on attendees' quality of life. Fewer studies utilized validated outcome measures to determine the effect of PDS on attendees' wellbeing and small sample sizes combined with high attrition rates influenced the significance of some the results. However little quantitative evidence was offered to prove that PDS had an impact on attendees' quality of life or wellbeing. The review concludes that dying people find attending PDS a valuable experience that allows them to engage with others and to be supported in a restorative environment. However, further well-powered empirical studies are required to provide quality evidence to determine whether or not attendance at PDS does indeed have a positive impact on the wellbeing of attendees. PMID:20929930
Stevens, Elaine; Martin, Colin R; White, Craig A
The sole source: the Library of Congress National Library Service for the Blind and Physically Handicapped.
The Library of Congress National Library Service for the Blind and Physically Handicapped leads a co-operative network of specialized libraries and ancillary agencies that are delivering a successful programme of reading and informational services to blind, visually impaired and handicapped users. Its unique position within the Library of Congress and the benefits which emanate from this relationship are described. This current review outlines and discusses the development, role and functioning of the National Library Service. PMID:10170658
Fitzpatrick, V
45 CFR 1355.31 - Elements of the child and family services review system.
...Public Welfare 4 2013-10-01 2013-10-01 false Elements of the child and family services review system. 1355.31...ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL § 1355.31 Elements of the child and family services review system....
Health and Social Services Integration: A Review of Concepts and Models
Health and social services integration is particularly relevant for populations whose needs span physical health, mental health, housing, and disability services, along with others. Veterans, homeless, chronically ill, and aging are among those populations. This review examines recent peer-reviewed literature about different approaches to services integration, rationales behind those approaches, and successes of those approaches, including factors that make them
Michael P. Fisher; Christine Elnitsky
Project Review Criteria and Standards for Rehabilitation Services in Southeastern Michigan.
Developed to provide guidelines for section 1122 and certificate of need reviews and to provide guidance to prospective providers of rehabilitation services, these criteria and standards address the provision of services in a variety of inpatient and outp...
City of Buffalo, Review of the Recommendation for a Department of General Services. Memorandum Report.
The document reviews and analyzes previously made recommendations regarding the establishment of a Department of General Services, which was to include divisions of Purchase, Motor Equipment Management, Data Processing, and Building Services.
National review of maternity services 2008: women influencing change
Background In 2009 the Australian government announced a major program of reform with the move to primary maternity care. The reform agenda represents a dramatic change to maternity care provision in a society that has embraced technology across all aspects of life including childbirth. Methods A critical discourse analysis of selected submissions in the consultation process to the national review of maternity services 2008 was undertaken to identify the contributions of individual women, consumer groups and organisations representing the interests of women. Results Findings from this critical discourse analysis revealed extensive similarities between the discourses identified in the submissions with the direction of the 2009 proposed primary maternity care reform agenda. The rise of consumer influence in maternity care policy reflects a changing of the guard as doctors' traditional authority is questioned by strong consumer organisations and informed consumers. Conclusions Unified consumer influence advocating a move away from obstetric -led maternity care for all pregnant women appears to be synergistic with the ethos of corporate governance and a neoliberal approach to maternity service policy. The silent voice of one consumer group (women happy with their obstetric-led care) in the consultation process has inadvertently contributed to a consensus of opinion in support of the reforms in the absence of the counter viewpoint.
Rejuvenation of the neck with liposuction and ancillary techniques.
An aesthetically pleasing neck is an important component of physical appearance and a frequently targeted area for a variety of rejuvenative procedures. In appropriately selected patients, liposuction of the neck using tumescent local anesthesia can effectively render a more youthful appearance to the anterior and lateral neck by removing superficial adipose tissue and redraping the skin. This article will review all aspects of neck liposuction, including neck and lower face anatomy, proper patient selection and evaluation, necessary equipment, as well as all peri-procedural management. An in-depth discussion of administration of tumescent local anesthesia and proper liposuction technique is also included. Lastly, a number of ancillary techniques to further enhance the appearance of the neck including laser lipolysis, fractional ablative CO(2) resurfacing, and treatment of platysmal banding will be briefly discussed. PMID:21276156
Stebbins, William G; Hanke, C William
Helping Children Access and Use Services: A Review
High rates of dropping out from mental health services are documented for children and their families. These high rates exist at different treatment stages, in different service settings, and for different populations of children and families. Some researchers have developed and tested engagement interventions to address barriers to service access and use and increase participation in services by children and
Marlys M. Staudt
The Impact of Child and Family Service Reviews on Knowledge Management
This article uses knowledge management as a framework to analyze the impact of the child and family review process on child protective service agencies. Results of a qualitative analysis of child and family service reviews and program improvement plans indicated that the process has led to an increase in the use of family team meetings and risk�
Mischen, Pamela A.
How far can systematic reviews inform policy development for ?wicked? rural health service problems?
Policy makers and researchers increasingly look to systematic reviews as a means of connecting research and evidence more effectively with pol- icy. Based on Australian research into rural and remote primary health care services, we note some concerns regarding the suitability of system- atic review methods when applied to such set- tings. It suggests that rural and other health services
John S Humphreys; Pim Kuipers; John Wakermann; Robert Wells; Judith A Jones; Leigh A D Kinsman
Intergenerational Service-Learning: A Review of Recent Literature and Directions for the Future
This review examines recent studies that have addressed outcomes of intergenerational service-learning courses in gerontology. The history of service-learning pedagogy in higher education and its place in today's colleges is also reviewed. Particular attention is given to evaluations of stakeholders: students, older adult participants, agencies�
Roodin, Paul; Brown, Laura Hess; Shedlock, Dorothy
77 FR 24933 - Hydrographic Services Review Panel Meeting
...multi-mission application of NOAA's geospatial, tide and water level, and hydrographic products...Arctic regional navigation and geospatial, tide and water level, products, services and...improvements to NOAA's navigation, geospatial, tide and water level products, services...
The New Service Model: a review, a critique and a way forward
The paper contributes to the debate on the New Service Model by focusing on the theoretical and practical implications that it calls for. The discussion seeks to take stock of the development of the idea of product-service integration, which is central to this New Service Paradigm, and provides a review and critique of the key principles that underpin this new
Elena P. Antonacopoulou; Efrosyni Konstantinou
Ancillary effects of selected acid deposition control policies
NAPAP is examining a number of potential ways to reduce the precursors (sulfur dioxide and nitrogen oxides) to acid deposition. However, the policies to reduce acid deposition will have other physical, biological and economic effects unrelated to acid deposition. For example, control policies that reduce sulfur dioxide emissions may also increase visibility. The effects of an acid deposition policy that are unrelated to acid deposition are referred to as ''ancillary'' effects. This reserch identifies and characterizes the principle physical and economic ancillary effects associated with acid deposition control and mitigation policies. In this study the ancillary benefits associated with four specific acid deposition policy options were investigated. The four policy options investigated are: (1) flue gas desulfurization, (2) coal blending or switching, (3) reductions in automobile emissions of NO/sub x/, and (4) lake liming. Potential ancillary benefits of each option were identified and characterized. Particular attention was paid to the literature on economic valuation of potential ancillary effects.
Moe, R.J.; Lyke, A.J.; Nesse, R.J.
Improved wetland remote sensing in Yellowstone National Park using classification trees to combine TM imagery and ancillary environmental data
The U.S. Fish and Wildlife Service uses the term palustrine wetland to describe vegetated wetlands traditionally identified as marsh, bog, fen, swamp, or wet meadow. Landsat TM imagery was combined with image texture and ancillary environmental data to model probabilities of palustrine wetland occurrence in Yellowstone National Park using classification trees. Model training and test locations were identified from National
Chris Wright; Alisa Gallant
Sexual and reproductive health services for people living with HIV: a systematic review
People living with HIV often have unmet needs for sexual and reproductive health (SRH) services. We present results of a systematic review of studies offering SRH services targeted to people living with HIV. Studies were selected from a broader SRH and HIV linkages review. Inclusion criteria included: (1) peer-reviewed journal articles with a pre�post or multiple-arm study design; (2) reported
Deborah Bain Brickley; Lucy Almers; Caitlin E. Kennedy; Alicen B. Spaulding; Joy Mirjahangir; Gail E. Kennedy; Laura Packel; Kevin Osborne; Michael Mbizvo; Lynn Collins
Apollo experience report the command and service module milestone review process
The sequence of the command and service module milestone review process is given, and the Customer Acceptance Readiness Review and Flight Readiness Review plans are presented. Contents of the System Summary Acceptance Documents for the two formal spacecraft reviews are detailed, and supplemental data required for presentation to the review boards are listed. Typical forms, correspondence, supporting documentation, and minutes of a board meeting are included.
Brendle, H. L.; York, J. A.
Distributed Smart Grid Asset Control Strategies for Providing Ancillary Services
With large-scale plans to integrate renewable generation driven mainly by state-level renewable portfolio requirements, more resources will be needed to compensate for the uncertainty and variability associated with intermittent generation resources. Distributed assets can be used to mitigate the concerns associated with renewable energy resources and to keep costs down. Under such conditions, performing primary frequency control using only supply-side resources becomes not only prohibitively expensive but also technically difficult. It is therefore important to explore how a sufficient proportion of the loads could assume a routine role in primary frequency control to maintain the stability of the system at an acceptable cost. The main objective of this project is to develop a novel hierarchical distributed framework for frequency based load control. The framework involves two decision layers. The top decision layer determines the optimal gain for aggregated loads for each load bus. The gains are computed using decentralized robust control methods, and will be broadcast to the corresponding participating loads every control period. The second layer consists of a large number of heterogeneous devices, which switch probabilistically during contingencies so that aggregated power change matches the desired amount according to the most recently received gains. The simulation results show great potential to enable systematic design of demand-side primary frequency control with stability guarantees on the overall power system. The proposed design systematically accounts for the interactions between the total load response and bulk power system frequency dynamics. It also guarantees frequency stability under a wide range of time varying operating conditions. The local device-level load response rules fully respect the device constraints (such as temperature setpoint, compressor time delays of HVACs, or arrival and departure of the deferrable loads), which are crucial for implementing real load control programs. The promise of autonomous, Grid Friendly� response by smart appliances in the form of under-frequency load shedding was demonstrated in the GridWise Olympic Peninsula Demonstration in 2006. Each controller monitored the power grid voltage signal and requested that electrical load be shed by its appliance whenever electric power-grid frequency fell below 59.95 Hz. The controllers and their appliances responded reliably to each shallow under-frequency event, which was an average of one event per day and shed their loads for the durations of these events. Another objective of this project was to perform extensive simulation studies to investigate the impact of a population of Grid Friendly� Appliances (GFAs) on the bulk power system frequency stability. The GFAs considered in this report are represented as demonstration units with water heaters individually modeled.
Kalsi, Karanjit; Zhang, Wei; Lian, Jianming; Marinovici, Laurentiu D.; Moya, Christian; Dagle, Jeffery E.
Alternative Approaches for Incentivizing the Frequency Responsive Reserve Ancillary Service
Frequency responsive reserve is the autonomous response of generators and demand response to deviations of system frequency, usually as a result of the instantaneous outage of a large supplier. This article discusses the issues that can occur without proper incentives and even disincentives, and proposes alternatives to introduce incentives for resources to provide frequency responsive reserve to ensure an efficient and reliable power system.
Ela, E.; Tuohy, A.; Milligan, M.; Kirby, B.; Brooks, D.
30 CFR 550.208 - If I conduct ancillary activities, what notices must I provide?
...2013-07-01 false If I conduct ancillary activities, what notices must I provide? 550...SHELF Plans and Information Ancillary Activities § 550.208 If I conduct ancillary activities, what notices must I provide?...
Background Greenhouse gas (GHG) mitigation policies can provide ancillary benefits in terms of short-term improvements in air quality and associated health benefits. Several studies have analyzed the ancillary impacts of GHG policies for a variety of locations, pollutants, and policies. In this paper we review the existing evidence on ancillary health benefits relating to air pollution from various GHG strategies and provide a framework for such analysis. Methods We evaluate techniques used in different stages of such research for estimation of: (1) changes in air pollutant concentrations; (2) avoided adverse health endpoints; and (3) economic valuation of health consequences. The limitations and merits of various methods are examined. Finally, we conclude with recommendations for ancillary benefits analysis and related research gaps in the relevant disciplines. Results We found that to date most assessments have focused their analysis more heavily on one aspect of the framework (e.g., economic analysis). While a wide range of methods was applied to various policies and regions, results from multiple studies provide strong evidence that the short-term public health and economic benefits of ancillary benefits related to GHG mitigation strategies are substantial. Further, results of these analyses are likely to be underestimates because there are a number of important unquantified health and economic endpoints. Conclusion Remaining challenges include integrating the understanding of the relative toxicity of particulate matter by components or sources, developing better estimates of public health and environmental impacts on selected sub-populations, and devising new methods for evaluating heretofore unquantified and non-monetized benefits.
Bell, Michelle L; Davis, Devra L; Cifuentes, Luis A; Krupnick, Alan J; Morgenstern, Richard D; Thurston, George D
How far can systematic reviews inform policy development for "wicked" rural health service problems?
Policy makers and researchers increasingly look to systematic reviews as a means of connecting research and evidence more effectively with policy. Based on Australian research into rural and remote primary health care services, we note some concerns regarding the suitability of systematic review methods when applied to such settings. It suggests that rural and other health services are highly complex and researching them is akin to dealing with "wicked" problems. It proposes that the notion of "wicked" problems may inform our understanding of the issues and our choice of appropriate methods to inform health service policy. Key issues including the complexity of health services, methodological limitations of traditional reviews, the nature of materials under review, and the importance of the service context are highlighted. These indicate the need for broader approaches to capturing relevant evidence. Sustained, collaborative synthesis in which complexity, ambiguity and context is acknowledged is proposed as a way of addressing the wicked nature of these issues. PMID:20166908
Humphreys, John S; Kuipers, Pim; Wakerman, John; Wells, Robert; Jones, Judith A; Kinsman, Leigh D
Ecosystem service trends in basin-scale restoration initiatives: a review.
The integration of ecosystem services in ecological restoration projects presents an opportunity for enhancing benefits to human livelihood and funding sources as well as generating public support for such initiatives. This study reviewed the global trends in integrating ecosystem services in basin-scale restoration projects through bibliographic analysis. Few studies appear to incorporate ecosystem services, possibly due to the inconsistency and absence of the use of universally accepted classifications. Our review notes an increasing trend from 2006 onward toward the inclusion and citation of this concept, although its use is still limited. In this review, the supporting service was found to be the most cited (8), followed by regulatory (3), cultural (1) and provisioning (1) services. Identifying the number of services related to a restoration action was problematic when the services were not explicitly cited. We identify opportunities for increased integration of ecosystem services in basin-scale restoration projects, suggesting a conceptual framework following from new hierarchical maps. This is based on congruence between degrading processes or threat maps (e.g., thresholds of impacts) and ecosystem service maps. The resultant map will facilitate the targeting of threatened service supply at different scales from the basin scale to the scale of the restoration site. We urge the scientific community to standardize definitions and create methodologies and software tools that facilitate the incorporation of ecosystem services in large-scale restoration plans. PMID:22813855
Trabucchi, Mattia; Ntshotsho, Phumza; O'Farrell, Patrick; Com�n, Francisco A
77 FR 54570 - Senior Executive Service Performance Review Board
...of the senior executive's performance, the executive's response...review and recommend executive performance bonuses and pay increases. The DNFSB is a...the members of the DNFSB SES Performance Review Board listed in...
78 FR 55244 - Senior Executive Service Performance Review Board; Membership
...rating of a senior executive's performance, the executive's response...review and recommend executive performance bonuses and pay increases. The DNFSB is a...the members of the DNFSB SES Performance Review Board listed in...
75 FR 56999 - Senior Executive Service Performance Review Board
Web Services for Analysing and Summarising Online Opinions and Reviews
\\u000a Review mining is a part of web mining which focuses on getting main information from user review. State of the art review\\u000a mining systems focus on identifying semantic orientation of reviews and providing sentences or feature scores. There has been\\u000a little focus on understanding the rationale for the ratings that are provided. This paper presents our proposed RnR system\\u000a for
Dwi A. P. Rahayu; Shonali Krishnaswamy; Cyril Labb�; Oshadi Alhakoon
Evaluation report: dialysis and ancillary equipment.
As part of the continuing programme of evaluation of medical equipment sponsored by the UK Health Departments, the evaluation of dialysis and ancillary equipment is being carried out within the University of Sheffield, under the direction of Professor M. M. Black. 'Health Equipment Information' Number 148, published in December 1985, carries full reports on the Cobe Centry 2Rx haemodialysis system with double blood pump module (DBPM), the Lucas Medical 2100 haemodialysis system, and the Permutit Series 8 water softener. It also contains summaries of full reports on the Organon-Teknika Sorbsystem and Cordis-Dow Seratron haemodialysis systems, and the Gordonsal RD500 and Elga Mediro D water softeners, which were published in 'HEI' 136. Readers should note that the Cordis Seratron and Lucas 2100 models are no longer available in the UK. Extracts of the evaluations of the Cobe Centry 2Rx + DBPM and the Permutit Series B models, together with summaries and overall comparisons, are given below. 'HEI' (ISSN 0261-0736) is free to NHS staff and 5.00 pounds/copy to others. Editorial enquiries to DHSS Scientific and Technical Branch, 14 Russell Square, London WC1B 5EP. PMID:3735384
Review of Robotics Technologies for On-Orbit Services.
Space robotics has been considered one of the most promising approaches for on-orbit services (OOS) such as docking, berthing, refueling, repairing, upgrading, transporting, rescuing, and orbit cleanup. Many enabling techniques have been developed recentl...
A. Flores-Abad K. Pham O. Ma
76 FR 57980 - Senior Executive Service Performance Review Board
...Insurance Corporation David M. Capozzi, Director of Technical and Information Services, United States Access Board Edward C. Hobson, Associate Director for Safety and Security, Peace Corps Steven G. McManus, Deputy Chief Operating Officer, Armed...
77 FR 34942 - Notice of Submission for OMB Review; Office of Special Education and Rehabilitative Services...
...DEPARTMENT OF EDUCATION Notice of Submission for OMB Review; Office of Special Education and Rehabilitative Services; Annual...of the Individuals With Disabilities Education Act SUMMARY: In accordance with...
77 FR 64383 - Agency Information Collection (Application for Voluntary Service) Activities Under OMB Review
...2900-0090. Type of Review: Extension of a currently approved collection. Abstract: Individuals expressing interest in volunteering at a VA medical center complete VA Form 10-7055 to request placement in the nationwide VA Voluntary Service Program....
Criteria and Standards Monograph for Review of Internal Medicine/Surgery Inpatient Services.
The monograph contains internal medicine/surgery criteria and standards for planning and project review of health services. The purpose of this document is to assist Health Systems Agencies and health facilities throughout the country both in planning for...
76 FR 35949 - Agency Information Collection Activity (Servicer's Staff Appraisal Reviewer (SAR) Application...
...Under OMB Review AGENCY: Veterans Health Administration, Department of...notice announces that the Veterans Health Administration (VHA), Department of Veterans Affairs...completed by servicers to nominate employees for approval as Staff...
76 FR 60840 - Updated OGE Senior Executive Service Performance Review Board
...OFFICE OF GOVERNMENT ETHICS Updated OGE Senior Executive Service Performance...Review Board AGENCY: Office of Government Ethics (OGE). ACTION: Notice...Deputy Director, Office of Government Ethics, Suite 500, 1201 New York Avenue,...
78 FR 76148 - Updated OGE Senior Executive Service Performance Review Board
...OFFICE OF GOVERNMENT ETHICS Updated OGE Senior Executive Service Performance...Review Board AGENCY: Office of Government Ethics (OGE). ACTION: Notice...Program Counsel, Office of Government Ethics, Suite 500, 1201 New York Avenue...
77 FR 64521 - Updated OGE Senior Executive Service Performance Review Board
...OFFICE OF GOVERNMENT ETHICS Updated OGE Senior Executive Service Performance...Review Board AGENCY: Office of Government Ethics (OGE). ACTION: Notice...Deputy Director, Office of Government Ethics, Suite 500, 1201 New York Avenue...
75 FR 62540 - Updated OGE Senior Executive Service Performance Review Board
...OFFICE OF GOVERNMENT ETHICS Updated OGE Senior Executive Service Performance...Review Board AGENCY: Office of Government Ethics (OGE). ACTION: Notice...General Counsel, Office of Government Ethics, Suite 500, 1201 New York Avenue,...
Ancillary Care: From Theory to Practice in International Clinical Research
How international research might contribute to justice in global health has not been substantively addressed by bioethics. This article describes how the provision of ancillary care can link international clinical research to the reduction of global health disparities. It identifies the ancillary care obligations supported by a theory of global justice, showing that Jennifer Ruger�s health capability paradigm requires the delivery of ancillary care to trial participants for a limited subset of conditions that cause severe morbidity and mortality. Empirical research on the Shoklo Malaria Research Unit�s (SMRU) vivax malaria treatment trial was then undertaken to demonstrate whether and how these obligations might be upheld in a resource-poor setting. Our findings show that fulfilment of the ancillary care obligations is feasible where there is commitment from chief investigators and funders and is strongly facilitated by SMRU�s dual role as a research unit and medical non-governmental organization.
Pratt, Bridget; Zion, Deborah; Lwin, Khin Maung; Cheah, Phaik Yeong; Nosten, Francois; Loff, Bebe
Community services for abused women: A review of perceived usefulness and efficacy
This review of 12 studies examines both the types of community and professional services that abused women most frequently\\u000a contact, and how useful and effective the women perceive those services to be. These studies show that police, social service\\u000a agencies, clergy, crisis lines, physicians, psychotherapists, women's groups, and lawyers are the sources of assistance abused\\u000a women most frequently contact. However,
Judith S. Gordon
Scientific identity in top journals of services marketing: review and evaluation
Purpose � The objective of the paper is to describe the �scientific identity� of the �top� journals in services marketing by reviewing and evaluating the methodological approaches and the geographical affiliations of authors published in selected journals. Design\\/methodology\\/approach � A sample of �top� journals in services marketing is selected on the basis of expert opinion. The selection includes the International
G�ran Svensson; Terje Sl�tten; B�rd Tronvoll
The Impact of Medical Interpreter Services on the Quality of Health Care: A Systematic Review
Twenty-one million Americans are limited in English proficiency (LEP), but little is known about the effect of medical interpreter services on health care quality. A systematic literature review was conducted on the impact of interpreter services on quality of care. Five database searches yielded 2,640 citations and a final database of 36 articles, after applying exclusion criteria. Multiple studies document
Glenn Flores
Our Children are Waiting for Adoptive Homes: A Review of New York State Adoption Services.
The history and current problems of adoption services provided by the state of New York are discussed. First, statutory reforms since the creation in 1968 of the nation's first statewide adoption subsidy program are reviewed and adoption services aimed at providing permanent homes for children in foster care are described. Subsequently, the�
Pisani, Joseph R.
75 FR 4453 - Health Services Research and Development Service Merit Review Board; Notice of Meeting
...delivery and management, and nursing research. Applications are reviewed...March 2, the subcommittee on Nursing Research Initiative will convene from...Check-in 8 a.m.-12 p.m. Nursing Research Initiative (NRI) Review...
Quantifying and mapping ecosystem services supplies and demands: a review of remote sensing applications.
Ecosystems provide services necessary for the livelihoods and well-being of people. Quantifying and mapping supplies and demands of ecosystem services is essential for continuous monitoring of such services to support decision-making. Area-wide and spatially explicit mapping of ecosystem services based on extensive ground surveys is restricted to local scales and limited due to high costs. In contrast, remote sensing provides reliable area-wide data for quantifying and mapping ecosystem services at comparatively low costs, and with the option of fast, frequent, and continuous observations for monitoring. In this paper, we review relevant remote sensing systems, sensor types, and methods applicable in quantifying selected provisioning and regulatory services. Furthermore, opportunities, challenges, and future prospects in using remote sensing for supporting ecosystem services' quantification and mapping are discussed. PMID:22816512
Ayanu, Yohannes Zergaw; Conrad, Christopher; Nauss, Thomas; Wegmann, Martin; Koellner, Thomas
Reviewing the learning organisation model in a child and adolescent mental health service.
From 1995 onwards, a child and adolescent mental health service (CAMHS) applied Senge's learning organisation model. This review compared service performance with that of peer services 5 years later and explored whether any differences were associated with the application of this model. The comparison methodology used quantitative analysis of external data from the Department of Human Services, together with qualitative analysis of material including interviews with CAMHS directors and service managers. Results showed high evaluation activity and high quality, efficiency and efficacy of care compared with other services. Several restraints to the optimal application of the model were identified, including inadequate training of new managers, service overload, major external organisational change and limited investment in information systems. Other outcomes are discussed. PMID:16646767
Birleson, Peter; Brann, Peter
A Review and Description of Services for Migrant Children.
American migrant and seasonal agricultural workers are a population needing categorical assistance due to low income, difficult working and living conditions, and a mobile lifestyle. The purpose of this study was to identify, describe, and analyze federally funded migrant services. This study, based on interviews with program officials and�
Fitzgerald, Brian K.; Hopper, Patricia A.
European air transport public service obligations: a periodic review
The �Third Package� of European Union air transport liberalisation measures came into effect on 1 January 1993 and has substantially reduced the restrictions on interstate flight operations. The package of measures also includes provision for the member states to impose �public service obligations� on low-density routes which were deemed necessary for the purposes of regional development. In this paper, it
Aisling Reynolds-Feighan
78 FR 5516 - Senior Executive Service Performance Review Board Membership
...supervisor, and makes recommendations to the Chairman of the Review Commission regarding performance ratings, performance awards, and pay-for-performance adjustments. Members of the PRB serve for a period of 24 months. In the case of an...
76 FR 39926 - Senior Executive Service Performance Review Board Membership
...supervisor, and makes recommendations to the Chairman of the Review Commission regarding performance ratings, performance awards, and pay-for-performance adjustments. In the case of an appraisal of a career appointee, more than half of...
75 FR 14214 - Senior Executive Service Performance Review Board Membership
Health Consequences of Smoking: 1969 Supplement to the 1967 Public Health Service Review.
This report is a review of the pertinent medical literature on the health consequences of smoking which has appeared since the publication of the 1968 Supplement to the 1967 Public Health Service Review. The 1964 Report of the Advisory Committee on Smokin...
The Department of Health and Human Service's Foster Care Review System Needs a Major Overhaul.
Discusses areas where federal oversight of state compliance with foster care case-review guidelines needs improvement. Suggests avenues, such as issuing more clear and precise regulation, by which the Department of Health and Human Services (HHS) could best ensure that children in foster care receive the prompt case review to which they are�
Ellertson, Christine
Barriers to the Uptake of Eye Care Services in Developing Countries: A Systematic Review of Interventions
Objective: This research identifies effective and ineffective interventions for reducing barriers to the uptake of eye care services in developing countries. Design: Systematic literature review. Setting: Only research studies done in developing countries were included. Method: The review is restricted to English-language articles published�
Abdullah, Khadija Nowaira; Al-Sharqi, Omar Zayan; Abdullah, Muhammad Tanweer
Health status in the ambulance services: a systematic review
BACKGROUND: Researchers have become increasingly aware that ambulance personnel may be at risk of developing work-related health problems. This article systematically explores the literature on health problems and work-related and individual health predictors in the ambulance services. METHODS: We identified the relevant empirical literature by searching several electronic databases including Medline, EMBASE, PsychINFO, CINAHL, and ISI Web of Science. Other
Tom Sterud; �ivind Ekeberg; Erlend Hem
Citizen Review Panels for Child Protective Services: A National Profile
Citizen Review Panels (CRPs) for Child Protective Serv- ices are groups of citizen-volunteers throughout the United States who are federally mandated to evaluate local and state child protection systems. This study pres- ents a profile of 332 CRP members in 20 states with re- gards to their demographic information, length of time on the panel, and attitudes regarding the variables
Blake L. Jones; David Royse
Medicare Prospective Reimbursement for Mental Health Services: A Literature Review.
Reviews literature evaluating appropriateness of Medicare's prospective payment system (PPS) through Diagnostic-Related Groups (DRGs), since its implementation in 1983, for psychiatric care. Cites shortcomings that make the system untenable for mental health care, including lack of homogeneity of DRGs, inability to predict length of stay, and�
Holcomb, William R.; Thompson, Warren A.
Clinical and cost-effectiveness of acute and subacute residential mental health services: a systematic review.
OBJECTIVE In recognition of a service gap between hospital inpatient and community-based care, a range of mental health services have been developed to provide treatment and support for people with mental illness outside the inpatient setting. Acute and subacute residential services provide care for individuals experiencing episodes of acute mental illness and provide transitional services to assist people in their reintegration into the community. This article provides a systematic review of studies evaluating the effectiveness of these alternative services. METHODS A systematic review of the literature was conducted by searching MEDLINE, PsycINFO, CINAHL, and Cochrane with no years specified to identify studies that have evaluated the clinical effectiveness, user satisfaction, or cost-effectiveness of acute or subacute residential treatments. Outcome data were extracted from quantitative studies, and themes relevant to service satisfaction were extracted from qualitative studies. RESULTS A total of 26 studies were identified that evaluated the effectiveness of acute or subacute residential services. Most studies of acute residential units demonstrated clinical improvements equal to those of inpatient units and similar readmission rates, as well as cost benefits. User satisfaction was generally higher for clients of acute residential units. Only three studies examined subacute units, a number not sufficient to evaluate the effectiveness of these services. CONCLUSIONS Acute residential mental health services offer treatment outcomes equivalent to those of inpatient units, with users reporting high satisfaction. Acute residential services offer a cost-effective alternative to inpatient services. Further research is needed to determine client groups that will benefit most from these alternative services. PMID:23903240
Thomas, Kerry A; Rickwood, Debra
75 FR 39734 - Health Services Research and Development Service Merit Review Board; Notice of Meeting
...methods of health care delivery and management, and nursing research. Applications are reviewed for scientific and technical...Development Officer. On August 31, the subcommittee on Nursing Research Initiative will convene from 8 a.m. to 2...
Using Technology to Deliver Mental Health Services to Children and Youth: A Scoping Review
Objective: To conduct a scoping review on the use of technology to deliver mental health services to children and youth in order to identify the breadth of peer-reviewed literature, summarize findings and identify gaps. Method: A literature database search identified 126 original studies meeting criteria for review. Descriptive numerical summary and thematic analyses were conducted. Two reviewers independently extracted data. Results: Studies were characterized by diverse technologies including videoconferencing, telephone and mobile phone applications and Internet-based applications such as email, web sites and CD-ROMs. Conclusion: The use of technologies plays a major role in the delivery of mental health services and supports to children and youth in providing prevention, assessment, diagnosis, counseling and treatment programs. Strategies are growing exponentially on a global basis, thus it is critical to study the impact of these technologies on child and youth mental health service delivery. An in-depth review and synthesis of the quality of findings of studies on effectiveness of the use of technologies in service delivery are also warranted. A full systematic review would provide that opportunity.
Boydell, Katherine M.; Hodgins, Michael; Pignatiello, Antonio; Teshima, John; Edwards, Helen; Willis, David
Ascent/descent ancillary data production user's guide
The Ascent/Descent Ancillary Data Product, also called the A/D BET because it contains a Best Estimate of the Trajectory (BET), is a collection of trajectory, attitude, and atmospheric related parameters computed for the ascent and descent phases of each Shuttle Mission. These computations are executed shortly after the event in a post-flight environment. A collection of several routines including some stand-alone routines constitute what is called the Ascent/Descent Ancillary Data Production Program. A User's Guide for that program is given. It is intended to provide the reader with all the information necessary to generate an Ascent or a Descent Ancillary Data Product. It includes descriptions of the input data and output data for each routine, and contains explicit instructions on how to run each routine. A description of the final output product is given.
Brans, H. R.; Seacord, A. W., II; Ulmer, J. W.
Review of Critiques of the USDA (United States Department of Agriculture) Forest Service Land Management Planning Process.
The report reviews a sampling of the literature evaluating the USDA Forest Service land management planning process. The Forest Service planning process and what constitutes an evaluation or critique of the process are defined. Relevant critiques are then...
T. J. Baltic J. G. Hof B. M. Kent
Effects of Lean Six Sigma application in healthcare services: a literature review.
The healthcare organization is the place where defects and mistakes cannot be tolerated. A simple mistake can cost a human life so defects or mistakes must be eliminated in healthcare service processes. A Lean Six Sigma (LSS) approach is the best option in a healthcare environment for dealing with a critical patient. The LSS methodology optimizes the average reduction of a desired process. The expected results can be reductions in several aspects of healthcare such as patient waiting time in emergency departments, lost charges for billing in patient financial services, delinquent medical records, diagnostic result turnaround times, accounts receivable days, patients' length of stay, or medication errors. This paper mainly discusses the effects of the LSS approach in different hospitals around the world according to the literature review. This review also discusses the relationship between LSS as well as their impacts on healthcare services based on literature review. PMID:24413212
Ahmed, Selim; Manaf, Noor H A; Islam, Rafikul
�Ethnocentricity� in top journals of services management : Authors, editorial review boards, editorial boards and editors
Purpose � The objective is to describe the �ethnocentricity� (i.e. geographical affiliation of editor(s), editorial board(s), editorial review board(s) and author(s)) of selected journals in services management. Design\\/methodology\\/approach � The sample is restricted to the examination and comparison of five top journals in services management during a six-year period. In total, the content analysis consisted of 1,189 articles. Findings �
A review of information flow diagrammatic models for product�service systems
A product�service system (PSS) is a combination of products and services to create value for both customers and manufacturers.\\u000a Modelling a PSS based on function orientation offers a useful way to distinguish system inputs and outputs with regards to\\u000a how data are consumed and information is used, i.e. information flow. This article presents a review of diagrammatic information\\u000a flow tools,
C. Durugbo; A. Tiwari; J. R. Alcock
Delivery of health services in Arab countries: a review.
This paper reviews the essential components of health care delivery systems in Arab countries and their development over the past 3 decades. The changes and challenges which evolved during the last half of the 20th century have had a significant impact on health systems and on health outcomes. An adequate network of hospitals and primary health care facilities has been established in most Arab countries of the Region. The increased participation of civil society has impacted positively on health systems. However, the main challenge is represented by the move towards market economies. In many developing economies, macroeconomic reforms have often necessitated cuts in public spending on social sectors. Cost-sharing policies have been implemented in order to compensate for diminishing government budgets allocated to health. However, this is not to minimize the enormous strides that have been made in all countries nor the important challenges that need to be addressed. PMID:23301398
Kronfol, N M
Involving users in the delivery and evaluation of mental health services: systematic review
Objectives To identify evidence from comparative studies on the effects of involving users in the delivery and evaluation of mental health services. Data sources English language articles published between January 1966 and October 2001 found by searching electronic databases. Study selection Systematic review of randomised controlled trials and other comparative studies of involving users in the delivery or evaluation of mental health services. Data extraction Patterns of delivery of services by employees who use or who used to use the service and professional employees and the effects on trainees, research, or clients of mental health services. Results Five randomised controlled trials and seven other comparative studies were identified. Half of the studies considered involving users in managing cases. Involving users as employees of mental health services led to clients having greater satisfaction with personal circumstances and less hospitalisation. Providers of services who had been trained by users had more positive attitudes toward users. Clients reported being less satisfied with services when interviewed by users. Conclusions Users can be involved as employees, trainers, or researchers without detrimental effect. Involving users with severe mental disorders in the delivery and evaluation of services is feasible. What is already known on this topicInvolving health service users in the NHS is recommended in UK government policyInvolving users in mental health services is generally seen as worthwhile, but the effects of involving users have not been thoroughly evaluated, and few attempts to draw evaluations together have been madeWhat this study addsThe few comparative studies of users' involvement that have been published indicate that involving users as employees, trainers, or researchers has no negative effect on services and may be of benefit
Simpson, Emma L; House, Allan O
Monitoring access to out-of-hours care services in Scotland - a review
Objectives Changes in the contractual responsibilities of primary care practitioners and health boards have resulted in a plethora of arrangements relating to out-of-hours healthcare services. Rather than being guaranteed access to a GP (usually either their own or another through a local GP co-operative), patients have a number of alternative routes to services. Our objective was to identify and assess the availability and adequacy of relevant standards, responsibilities and information systems in Scotland to monitor the impact of contractual changes to out-of-hours healthcare services on equity of access. Design Cross-sectional study. Setting All providers of primary care out-of-hours services in Scotland. Participants Not applicable. Main outcome measures First, identification and policy review of current standards and performance monitoring systems, data and information, primarily through directly contacting national and local organizations responsible for monitoring out-of-hours care, supplemented by literature searches to highlight specific issues arising from the review; and second, mapping of data items by out-of-hours provider type to identify overlap and significant gaps. Results In Scotland, data monitoring systems have not kept pace with changes in the organization of out-of-hours care, so the impact on access to services for different population groups is unknown. There are significant gaps in information collected with respect to workforce, distribution of services, service utilisation and clinical outcomes. Conclusions Since 2004 there have been major changes to the way patients access out-of-hours healthcare in the UK. In Scotland, none of the current systems provide information on whether the new services satisfy the key NHS principle of equity of access. There is an urgent need for a comprehensive review of data standards and systems relating to out-of-hours care in order to monitor and evaluate inputs, processes and outcomes of care not least in respect of access and fairness of distribution of resources.
Godden, Sylvia; Hilton, Simon; Pollock, Allyson M
Exploitation of Landsat imagery and ancillary data for battlespace characterization
Spectral data provide opportunities to discriminate targets from background clutter and to detect partially concealed objects. However, data with high spatial resolution generally are not synoptic scale (hundreds of kilometers). By analyzing courser resolution synoptic imagery, high-resolution sensors can then be cued to areas of potential targets. Multispectral images (Landsat 7) are combined with ancillary data-lines of communication, digital elevation
Seth M. Orloff; Su May Hsu; H.-H. K. Burke
Financial Report of Ontario Universities 1995-96. Ancillary Enterprises.
This supplementary volume has been compiled from submissions prepared by each of the provincially assisted universities and federated and affiliated colleges of Ontario (Canada). The information in this volume provides further details concerning sources of revenue and types of expenses as reported for various ancillary operations. These include�
A review of space robotics technologies for on-orbit servicing
Space robotics is considered one of the most promising approaches for on-orbit servicing (OOS) missions such as docking, berthing, refueling, repairing, upgrading, transporting, rescuing, and orbital debris removal. Many enabling techniques have been developed in the past two decades and several technology demonstration missions have been completed. A number of manned on-orbit servicing missions were successfully accomplished but unmanned, fully autonomous, servicing missions have not been done yet. Furthermore, all previous unmanned technology demonstration missions were designed to service cooperative targets only. Robotic servicing of a non-cooperative satellite is still an open research area facing many technical challenges. One of the greatest challenges is to ensure the servicing spacecraft safely and reliably docks with the target spacecraft or capture the target to stabilize it for subsequent servicing. This is especially important if the target has an unknown motion and kinematics/dynamics properties. Obviously, further research and development of the enabling technologies are needed. To motivate and facilitate such research and development, this paper provides a literature review of the recently developed technologies related to the kinematics, dynamics, control and verification of space robotic systems for manned and unmanned on-orbit servicing missions.
Flores-Abad, Angel; Ma, Ou; Pham, Khanh; Ulrich, Steve
GoMEx-an experimental GIS system for the Gulf of Mexico region using SAR and additional satellite and ancillary data
The National Oceanic and Atmospheric Administration (NOAA) National Environmental Satellite, Data, and Information Service (NESDIS) is in the third year of the Alaska SAR Demonstration (AKDEMO), an applications project using RADARSAT-1 synthetic aperture radar (SAR) and derived products. The success of this demonstration in providing near real-time SAR data, derived products, and other ancillary data to federal and state agencies,
Karen S. Friedman; William G. Pichel; Pablo Clemente-Col�n; Xiaofeng Li
Assessing Functional Impairment and Social Adaptation for Child Mental Health Services Research: A Review of Measures
The need for assessing impairment in functioning as an integral part of child mental health services research is discussed. Methodologic difficulties related to problems in case definition, the conceptual definition of impairment and social adaptation, and the assessment of the construct across cultures are also addressed. In addition, a critical review of existing child impairment measures with published psychometric properties
Glorisa Canino; E. Jane Costello; Adrian Angold
Wildlife Services' Safety Review: Chemical Immobilization and Euthanasia of Wildlife: Immobilization and Euthanasia Drugs Safety Report.
To assess the degree of safety for Wildlie Services in the arena of chemical immobilization and euthanasia of Wildlife (I&eE), It Identified the major risks associated with the WS I&E program, Reviewed agency policies, directives,and supporting documents,...
B. C. West M. R. Johnson S. W. Jack
Program and Service Review. Pima County Community College District Institutional Effectiveness Series: 3.
Program and Service Review (PSR) at Pima Community College in Arizona is a mechanism to provide continuous comprehensive evaluation and improvement of instructional programs and those support functions that directly serve students. The PSR's original statement of philosophy stresses the use of qualitative and quantitative measures to identify how�
Pima County Community Coll. District, AZ.
Evaluation research in occupational health services: general principles and a systematic review of empirical studies
OBJECTIVES: To study the nature and extent of evaluation research in occupational health services (OHSs). METHODS: Literature review of evaluation research in OHSs. On the basis of a conceptual model of OHS evaluation, empirical studies are categorised into aspects of input, process, output, outcome, and OHS core activities. RESULTS: Many methods to evaluate OHSs or OHS activities exist, depending on
C. T. J. Hulshof; J. H. A. M. Verbeek; F. J. van Dijk; W. E. van der Weide; I. T. J. Braam
Review of Nebraska Technical Community College System: History, Financing and Services.
The history, financing, and services of Nebraska's technical community college system are reviewed in this six-part report. Section I traces the history of the system, covering general background, two-year junior colleges, state vocational/technical colleges, the area system of vocational/technical schools, and the creation of technical community�
Hovis, Phil; And Others
Review and Analysis of Curricula For Occupations in Public Services. Information Series No. 29.
To identify major findings, promising developments, strategies, and methodological strengths and weaknesses which exist in curricula designed for training paraprofessional public service workers in the fields of education, social work, law enforcement, and fire fighting, a review and analysis was made of Educational Resources Information Center�
Lewis, Wiley B.
Test Review: Roberts, G. E., & Gruber, C. (2005). "Roberts-2." Los Angeles: Western Psychological Services
This article provides a review of Roberts-2, an individually administered narrative measure published by Western Psychological Services. Roberts-2 is a substantial revision of the earlier version of this measure, the Roberts Apperception Test for Children (RATC; McArthur & Roberts, 1982). Roberts-2 is composed of 16 stimulus cards that direct�
Flanagan, Rosemary
Police Involvement in Child Protective Services Investigations: Literature Review and Secondary Data Analysis
This article examines the relationship of police and child protective services (CPS) coinvolvement to the outcomes of child maltreatment investigations. It reviews practice and empirical literature and conducts a secondary analysis of a national CPS data set. Most sources argue that coordination of the two agencies improves investigations and benefits children and families. Yet, sources also report friction between these
Theodore P. Cross; David Finkelhor; Richard Ormrod
An Individualized Perspective of Family Support Services: A Review of the Literature. Technical Report.
The purpose of this paper is to review the existing literature on family support services for families with young children with disabilities. Within the last two decades, the focus of early intervention has begun shifting from child-centered to family-centered practice with an emphasis on providing comprehensive family support in the delivery of�
Santos, Rosa M.; Chun, Zhang
Accounting for ecosystem services in life cycle assessment, Part I: a critical review.
If life cycle oriented methods are to encourage sustainable development, they must account for the role of ecosystem goods and services, since these form the basis of planetary activities and human well-being. This article reviews methods that are relevant to accounting for the role of nature and that could be integrated into life cycle oriented approaches. These include methods developed by ecologists for quantifying ecosystem services, by ecological economists for monetary valuation, and life cycle methods such as conventional life cycle assessment, thermodynamic methods for resource accounting such as exergy and emergy analysis, variations of the ecological footprint approach, and human appropriation of net primary productivity. Each approach has its strengths: economic methods are able to quantify the value of cultural services; LCA considers emissions and assesses their impact; emergy accounts for supporting services in terms of cumulative exergy; and ecological footprint is intuitively appealing and considers biocapacity. However, no method is able to consider all the ecosystem services, often due to the desire to aggregate all resources in terms of a single unit. This review shows that comprehensive accounting for ecosystem services in LCA requires greater integration among existing methods, hierarchical schemes for interpreting results via multiple levels of aggregation, and greater understanding of the role of ecosystems in supporting human activities. These present many research opportunities that must be addressed to meet the challenges of sustainability. PMID:20178382
Zhang, Yi; Singh, Shweta; Bakshi, Bhavik R
46 CFR 58.25-80 - Automatic pilots and ancillary steering gear.
... Automatic pilots and ancillary steering gear. 58.25-80 Section 58.25-80...MACHINERY AND RELATED SYSTEMS Steering Gear § 58.25-80 Automatic pilots and ancillary steering gear. (a) Automatic pilots and...
An international review of the patterns and determinants of health service utilisation by adult cancer survivors
Background There is a need to review factors related to health service utilisation by the increasing number of cancer survivors in order to inform care planning and the organisation and delivery of services. Methods Studies were identified via systematic searches of Medline, PsycINFO, CINAHL, Social Science Citation Index and the SEER-MEDICARE library. Methodological quality was assessed using STROBE; and the Andersen Behavioural Model was used as a framework to structure, organise and analyse the results of the review. Results Younger, white cancer survivors were most likely to receive follow-up screening, preventive care, visit their physician, utilise professional mental health services and least likely to be hospitalised. Utilisation rates of other health professionals such as physiotherapists were low. Only studies of health service use conducted in the USA investigated the role of type of health insurance and ethnicity. There appeared to be disparate service use among US samples in terms of ethnicity and socio-demographic status, regardless of type of health insurance provision s- this may be explained by underlying differences in health-seeking behaviours. Overall, use of follow-up care appeared to be lower than expected and barriers existed for particular groups of cancer survivors. Conclusions Studies focussed on the use of a specific type of service rather than adopting a whole-system approach and future health services research should address this shortcoming. Overall, there is a need to improve access to care for all cancer survivors. Studies were predominantly US-based focussing mainly on breast or colorectal cancer. Thus, the generalisability of findings to other health-care systems and cancer sites is unclear. The Andersen Behavioural Model provided an appropriate framework for studying and understanding health service use among cancer survivors. The active involvement of physicians and use of personalised care plans are required in order to ensure that post-treatment needs and recommendations for care are met.
Current methods of the US Preventive Services Task Force: a review of the process.
The U.S. Preventive Services Task Force (USPSTF/Task Force) represents one of several efforts to take a more evidence-based approach to the development of clinical practice guidelines. As methods have matured for assembling and reviewing evidence and for translating evidence into guidelines, so too have the methods of the USPSTF. This paper summarizes the current methods of the third USPSTF, supported by the Agency for Healthcare Research and Quality (AHRQ) and two of the AHRQ Evidence-based Practice Centers (EPCs). The Task Force limits the topics it reviews to those conditions that cause a large burden of suffering to society and that also have available a potentially effective preventive service. It focuses its reviews on the questions and evidence most critical to making a recommendation. It uses analytic frameworks to specify the linkages and key questions connecting the preventive service with health outcomes. These linkages, together with explicit inclusion criteria, guide the literature searches for admissible evidence. Once assembled, admissible evidence is reviewed at three strata: (1) the individual study, (2) the body of evidence concerning a single linkage in the analytic framework, and (3) the body of evidence concerning the entire preventive service. For each stratum, the Task Force uses explicit criteria as general guidelines to assign one of three grades of evidence: good, fair, or poor. Good or fair quality evidence for the entire preventive service must include studies of sufficient design and quality to provide an unbroken chain of evidence-supported linkages, generalizable to the general primary care population, that connect the preventive service with health outcomes. Poor evidence contains a formidable break in the evidence chain such that the connection between the preventive service and health outcomes is uncertain. For services supported by overall good or fair evidence, the Task Force uses outcomes tables to help categorize the magnitude of benefits, harms, and net benefit from implementation of the preventive service into one of four categories: substantial, moderate, small, or zero/negative. The Task Force uses its assessment of the evidence and magnitude of net benefit to make a recommendation, coded as a letter: from A (strongly recommended) to D (recommend against). It gives an I recommendation in situations in which the evidence is insufficient to determine net benefit. The third Task Force and the EPCs will continue to examine a variety of methodologic issues and document work group progress in future communications. PMID:11306229
Harris, R P; Helfand, M; Woolf, S H; Lohr, K N; Mulrow, C D; Teutsch, S M; Atkins, D
47 CFR 90.317 - Fixed ancillary signaling and data transmissions.
...2013-10-01 2013-10-01 false Fixed ancillary signaling and data transmissions...MHz (UHF-TV Sharing) § 90.317 Fixed ancillary signaling and data transmissions...respective geographic areas may engage in fixed ancillary signaling and data...
Impact of Accreditation on the Quality of Healthcare Services: a Systematic Review of the Literature
BACKGROUND AND OBJECTIVE: Accreditation is usually a voluntary program in which trained external peer reviewers evaluate a healthcare organization's compliance and compare it with pre-established performance standards. The aim of this study was to evaluate the impact of accreditation programs on the quality of healthcare services METHODS: We did a systematic review of the literature to evaluate the impact of accreditation programs on the quality of healthcare services. Several databases were systematically searched, including Medline, Embase, Healthstar, and Cinhal. RESULTS: Twenty-six studies evaluating the impact of accreditation were identified. The majority of the studies showed general accreditation for acute myocardial infarction (AMI), trauma, ambulatory surgical care, infection control and pain management; and subspecialty accreditation programs to significantly improve the process of care provided by healthcare services by improving the structure and organization of healthcare facilities. Several studies showed that general accreditation programs significantly improve clinical outcomes and the quality of care of these clinical conditions and showed a significant positive impact of subspecialty accreditation programs in improving clinical outcomes in different subspecialties, including sleep medicine, chest pain management and trauma management. CONCLUSIONS: There is consistent evidence that shows that accreditation programs improve the process of care provided by healthcare services. There is considerable evidence to show that accreditation programs improve clinical outcomes of a wide spectrum of clinical conditions. Accreditation programs should be supported as a tool to improve the quality of healthcare services.
Alkhenizan, Abdullah; Shaw, Charles
Effectiveness of service linkages in primary mental health care: a narrative review part 1
Background With the move to community care and increased involvement of generalist health care providers in mental health, the need for health service partnerships has been emphasised in mental health policy. Within existing health system structures the active strategies that facilitate effective partnership linkages are not clear. The objective of this study was to examine the evidence from peer reviewed literature regarding the effectiveness of service linkages in primary mental health care. Methods A narrative and thematic review of English language papers published between 1998 and 2009. Studies of analytic, descriptive and qualitative designs from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted to examine what service linkages have been used in studies of collaboration in primary mental health care. Findings from the randomised trials were tabulated to show the proportion that demonstrated clinical, service delivery and economic benefits. Results A review of 119 studies found ten linkage types. Most studies used a combination of linkage types and so the 42 RCTs were grouped into four broad linkage categories for meaningful descriptive analysis of outcomes. Studies that used multiple linkage strategies from the suite of "direct collaborative activities" plus "agreed guidelines" plus "communication systems" showed positive clinical (81%), service (78%) and economic (75%) outcomes. Most evidence of effectiveness came from studies of depression. Long term benefits were attributed to medication concordance and the use of case managers with a professional background who received expert supervision. There were fewer randomised trials related to collaborative care of people with psychosis and there were almost none related to collaboration with the wider human service sectors. Because of the variability of study types we did not exclude on quality or attempt to weight findings according to power or effect size. Conclusion There is strong evidence to support collaborative primary mental health care for people with depression when linkages involve "direct collaborative activity", plus "agreed guidelines" and "communication systems".
Early intervention services, cognitive-behavioural therapy and family intervention in early psychosis: systematic review
Background Early intervention services for psychosis aim to detect emergent symptoms, reduce the duration of untreated psychosis, and improve access to effective treatments. Aims To evaluate the effectiveness of early intervention services, cognitive�behavioural therapy (CBT) and family intervention in early psychosis. Method Systematic review and meta-analysis of randomised controlled trials of early intervention services, CBT and family intervention for people with early psychosis. Results Early intervention services reduced hospital admission, relapse rates and symptom severity, and improved access to and engagement with treatment. Used alone, family intervention reduced relapse and hospital admission rates, whereas CBT reduced the severity of symptoms with little impact on relapse or hospital admission. Conclusions For people with early psychosis, early intervention services appear to have clinically important benefits over standard care. Including CBT and family intervention within the service may contribute to improved outcomes in this critical period. The longer-term benefits of this approach and its component treatments for people with early and established psychosis need further research.
Bird, Victoria; Premkumar, Preethi; Kendall, Tim; Whittington, Craig; Mitchell, Jonathan; Kuipers, Elizabeth
An ancillary pumping system for the APS vacuum system
An ancillary pumping system has been designed and installed in the Advanced Photon Source (APS) storage ring. This vacuum system has the ability to pump sectors of the storage ring down from room pressure to ultra-high vacuum (UHV). The ancillary system is a {open_quotes}dry{close_quotes} system that uses a combination of turbomolecular pumps and oil-free roughing pumps. The benefits of this system are the reduction of equipment needed for in-tunnel maintenance, essential for the operation of a UHV storage ring; rapid response to vacuum emergencies and a guard to accidental exposures to hydrocarbon contamination. The operational logic and the pump interlock and controls are described.
Walters, D.; Noonan, J.; Gagliano, J. [and others
Operational Downscaling of Soil Moisture Fields Using Ancillary Data
The scaling analysis of large-scale soil moisture data from the Southern Great Plains Hydrology experiment (SGP'97) showed that the scaling behavior of soil moisture is multifractal varying with the scale of observations and hydroclimatological conditions which can be explained with scaling behavior of soil hydraulic properties. These results suggested that it should be possible to use the spatial patterns of ancillary data at high resolution such as the sand content of soils as spatial basis functions for downscaling. This hypothesis was investigated by applying a modified fractal interpolation method for downscaling soil moisture from the SGP'97 experiment using ancillary data. The methodology should be especially useful for downscaling large-scale remotely-sensed estimates of soil moisture (e.g. AMSR) to the scales of operational hydrologic models.
Kim, G.; Barros, A. P.
76 FR 9786 - NIOSH Dose Reconstruction Program Ten-Year Review-Phase I Report on Customer Service; Request for...
NIOSH requests public review and comment on the draft publication, ``NIOSH Dose Reconstruction Program Ten-Year Review--Phase I Report on Customer Service.'' This publication is part of a review by NIOSH of its program in support of the role of the Secretary of Health and Human Services under the Energy Employees Occupational Illness Compensation Program Act of 2000 (The Act). As stated in NIOSH......
Importance of ancillary supplies for subcutaneous immunoglobulin infusion: management of the local infusion site.
A number of ancillary supplies are used in the process of administering subcutaneous immunoglobulin. The particular type of ancillary supplies used (needles, tubing, and tape) may contribute to the development of issues at the local infusion site. Patient case studies demonstrate that changes in the choice of ancillary supplies can often alleviate these issues. The use of alternative ancillary supplies should be considered prior to the possibility of changing immunoglobulin replacement products in patients experiencing local infusion-site issues in order to improve outcomes and increase compliance. A treatment progression algorithm of ancillary supply adjustments has been developed. PMID:24202117
Duff, Carla; Ochoa, Diana; Riley, Patty; Murphy, Elyse; Zampelli, Annette
Unanticipated Consequences: Thinking About Ancillary Benefits and Costs of Greenhouse Gas Emissions Mitigation
Recently there has been interest in the �ancillary benefits� of potential policies to address climate change. Ancillary benefits occur whenever a policy to address climate change also results in a reduction in some conventional pollutant. Framing the problem in terms of ancillary benefits is too narrow. In general implementation of any policy can have consequences for unpriced environmental externalities that extend beyond the original target of the policy. These ancillary consequences can be either positive, negative, or mixed. This is the inevitable implication of undertaking policy in a non-linear world. In this essay we explore some of the ancillary benefits and costs of addressing climate change.
Edmonds, James A.
Short message service (SMS) text messaging as an intervention medium for weight loss: A literature review.
Nearly 68% of American adults are obese or overweight. Mobile devices such as mobile phones have emerged as a mode of intervention delivery to help people improve their health, particularly in relation to weight loss. This literature review examines the relationship between the use of short message service (SMS) text messaging as an intervention medium and weight loss. Results from this literature review (n = 14) suggest that SMS as an intervention tool for weight loss is still in its infancy. Initial results are promising but continued investigation is needed. We offer several recommendations for future research. PMID:23257055
Shaw, Ryan; Bosworth, Hayden
Short-term medical service trips: a systematic review of the evidence.
Short-term medical service trips (MSTs) aim to address unmet health care needs of low- and middle-income countries. The lack of critically reviewed empirical evidence of activities and outcomes is a concern. Developing evidence-based recommendations for health care delivery requires systematic research review. I focused on MST publications with empirical results. Searches in May 2013 identified 67 studies published since 1993, only 6% of the published articles on the topic in the past 20 years. Nearly 80% reported on surgical trips. Although the MST field is growing, its medical literature lags behind, with nearly all of the scholarly publications lacking significant data collection. By incorporating data collection into service trips, groups can validate practices and provide information about areas needing improvement. PMID:24832401
Sykes, Kevin J
Service dogs and people with physical disabilities partnerships: a systematic review.
Occupational therapists have recognized the benefits that service dogs can provide people with disabilities. There are many anecdotal publications extolling the benefits of working with service dogs, but few rigorous studies exist to provide the evidence of the usefulness of this type of assistive technology option. This systematic review evaluates the published research that supports the use of service dogs for people with mobility-related physical disabilities. Articles were identified by computerized search of PubMed, CINAHL, PsycINFO, OT Seeker, the Cochrane Database of Systematic Reviews, SportDiscus, Education Research Complete, Public Administration Abstracts, Web of Knowledge and Academic Search Premier databases with no date range specified. The keywords used in the search included disabled persons, assistance dogs or service dogs and mobility impairments. The reference lists of the research papers were checked as was the personal citation database of the lead author. Twelve studies met the inclusion criteria and whereas the findings are promising, they are inconclusive and limited because of the level of evidence, which included one Level I, six Level III, four Level IV and one Level V. All of the studies reviewed had research design quality concerns including small participant sizes, poor descriptions of the interventions, outcome measures with minimal psychometrics and lack of power calculations. Findings indicated three major themes including social/participation, functional and psychological outcomes; all of which are areas in the occupational therapy scope of practice. Occupational therapists may play a critical role in referral, assessment, assisting clients and consulting with training organizations before, during and after the service dog placement process. In order for health care professionals to have confidence in recommending this type of assistive technology, the evidence to support such decisions must be strengthened. PMID:21858889
Winkle, Melissa; Crowe, Terry K; Hendrix, Ingrid
Background��With the move to community care and increased involvement of generalist health care providers in mental health, the need for\\u000a health service partnerships has been emphasised in mental health policy. Within existing health system structures the active\\u000a strategies that facilitate effective partnership linkages are not clear. The objective of this study was to examine the evidence\\u000a from peer reviewed literature
Jeffrey D Fuller; David Perkins; Sharon Parker; Louise Holdsworth; Brian Kelly; Russell Roberts; Lee Martinez; Lyn Fragar
Burnout in Mental Health Services: A Review of the Problem and Its Remediation
Staff burnout is increasingly viewed as a concern in the mental health field. In this article we first examine the extent\\u000a to which burnout is a problem for mental health services in terms of two critical issues: its prevalence and its association\\u000a with a range of undesirable outcomes for staff, organizations, and consumers. We subsequently provide a comprehensive review\\u000a of
Gary MorseMichelle; Michelle P. Salyers; Angela L. Rollins; Maria Monroe-DeVita; Corey Pfahler
A Systematic Review of Interventions to Increase Mental Health Service Use
Relatively few pre-treatment interventions to increase out-patient mental health (MH) service use have been created and experimentally tested. Therefore, not only is there limited availability of these interventions, it is uncertain whether existing interventions are effective. Moreover, it is unclear which components of the interventions are effective. To address these gaps in knowledge, a systematic review of pre-treatment interventions was
Jennifer Greene
A systematic review of economic analyses of telehealth services using real time video communication
Background Telehealth is the delivery of health care at a distance, using information and communication technology. The major rationales for its introduction have been to decrease costs, improve efficiency and increase access in health care delivery. This systematic review assesses the economic value of one type of telehealth delivery - synchronous or real time video communication - rather than examining a heterogeneous range of delivery modes as has been the case with previous reviews in this area. Methods A systematic search was undertaken for economic analyses of the clinical use of telehealth, ending in June 2009. Studies with patient outcome data and a non-telehealth comparator were included. Cost analyses, non-comparative studies and those where patient satisfaction was the only health outcome were excluded. Results 36 articles met the inclusion criteria. 22(61%) of the studies found telehealth to be less costly than the non-telehealth alternative, 11(31%) found greater costs and 3 (9%) gave the same or mixed results. 23 of the studies took the perspective of the health services, 12 were societal, and one was from the patient perspective. In three studies of telehealth to rural areas, the health services paid more for telehealth, but due to savings in patient travel, the societal perspective demonstrated cost savings. In regard to health outcomes, 12 (33%) of studies found improved health outcomes, 21 (58%) found outcomes were not significantly different, 2(6%) found that telehealth was less effective, and 1 (3%) found outcomes differed according to patient group. The organisational model of care was more important in determining the value of the service than the clinical discipline, the type of technology, or the date of the study. Conclusion Delivery of health services by real time video communication was cost-effective for home care and access to on-call hospital specialists, showed mixed results for rural service delivery, and was not cost-effective for local delivery of services between hospitals and primary care.
Implementation of a telepharmacy service to provide round-the-clock medication order review by pharmacists.
Purpose The implementation of a telepharmacy service to provide round-the-clock medication order review by pharmacists is described. Summary Seven critical access hospitals (CAHs) worked collaboratively as part of a network of hospitals implementing the same electronic health record (EHR), computerized prescriber-order-entry (CPOE) system, and pharmacy information system to serve as the health information technology (HIT) backbone supporting round-the-clock medication order review by pharmacists. Collaboration permitted standardization of workflow policies and procedures. Through the HIT backbone, both onsite and remote pharmacists were given access to the medication orders, the pharmacy information system, and other patient-specific clinical data in patients' EHRs. Orders are typically reviewed within 60 minutes of when they are entered into the system. The reviewing pharmacists have remote access to the EHRs in each CAH. After completing the clinical review, the pharmacist selects the appropriate medication to dispense from the CAH's formulary. If the medication order is not made using the CPOE system, the order is scanned into a document and sent via e-mail to remote pharmacists. The pharmacist enters the necessary information into the EHR and pharmacy information system. The medication order review process from this point forward is identical to that used for medications ordered via CPOE. The new medication order is then entered into the EHR, and the CAH nurse can proceed with the order. Conclusion The implementation of a telepharmacy model in a multihospital health system increased access to pharmacy services, allowing for round-the-clock medication order review by pharmacists. PMID:21098378
Wakefield, Douglas S; Ward, Marcia M; Loes, Jean L; O'Brien, John; Sperry, Leevon
Domestic water service delivery indicators and frameworks for monitoring, evaluation, policy and planning: a review.
Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating use of multiple indicators. We review the literature on water service indicators and frameworks with a view to informing debate on their relevance to national and international monitoring. We describe the evidence concerning the relevance of each identified indicator to public health, economic development and human rights. We analyze the benefits and challenges of using these indicators separately and combined in an index as tools for planning, monitoring, and evaluating water services. We find substantial evidence on the importance of each commonly recommended indicator--service type, safety, quantity, accessibility, reliability or continuity of service, equity, and affordability. Several frameworks have been proposed that give structure to the relationships among individual indicators and some combine multiple indicator scores into a single index but few have been rigorously tested. More research is needed to understand if employing a composite metric of indicators is advantageous and how each indicator might be scored and scaled. PMID:24157507
Kayser, Georgia L; Moriarty, Patrick; Fonseca, Catarina; Bartram, Jamie
Paying general practitioners: shedding light on the review of health services.
This paper reviews evidence from recent research on the effects of different methods of remunerating general practitioners. Each method is examined in terms of patient use of health services in general, use of services by different groups in society and health outcome. Little is known about the effects of capitation as it currently exists in the UK, salaries or special payments for 'good practice', although evidence from British research is likely to be forthcoming on the last of these. Both health maintenance organizations and charges deter utilization, although little is known about the effect of this reduced demand. Furthermore, these two methods of financing health care appear to discriminate between members of society on lower and higher incomes in terms of both service use and health outcome. Fees for items of service provided tend to lead to unnecessary demands for fee yielding services by patients on the recommendation of their doctors. Although more evidence on different methods of remuneration is required, the importance of what is already known depends on the objectives of health care provision.
Donaldson, C; Gerard, K
Building effective service linkages in primary mental health care: a narrative review part 2
Background Primary care services have not generally been effective in meeting mental health care needs. There is evidence that collaboration between primary care and specialist mental health services can improve clinical and organisational outcomes. It is not clear however what factors enable or hinder effective collaboration. The objective of this study was to examine the factors that enable effective collaboration between specialist mental health services and primary mental health care. Methods A narrative and thematic review of English language papers published between 1998 and 2009. An expert reference group helped formulate strategies for policy makers. Studies of descriptive and qualitative design from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted on factors reported as enablers or barriers to development of service linkages. These were tabulated by theme at clinical and organisational levels and the inter-relationship between themes was explored. Results A thematic analysis of 30 papers found the most frequently cited group of factors was "partnership formation", specifically role clarity between health care workers. Other factor groups supporting clinical partnership formation were staff support, clinician attributes, clinic physical features and evaluation and feedback. At the organisational level a supportive institutional environment of leadership and change management was important. The expert reference group then proposed strategies for collaboration that would be seen as important, acceptable and feasible. Because of the variability of study types we did not exclude on quality and findings are weighted by the number of studies. Variability in local service contexts limits the generalisation of findings. Conclusion The findings provide a framework for health planners to develop effective service linkages in primary mental health care. Our expert reference group proposed five areas of strategy for policy makers that address organisational level support, joint clinical problem solving, local joint care guidelines, staff training and supervision and feedback.
Top-to-Bottom Review. (Food Safety and Inspection Service). Preliminary Report. Volume 2. FSIS Regulatory Roles.
The review is part of the overall initiative of the Food Safety and Inspection Service (FSIS) to improve the safety of meat and poultry products and better protect consumers. It encompasses the Agency's regulatory roles, resource allocation, and organizat...
Child and Family Service Review Outcomes: Strategies to Improve Domestic Violence Responses in CFSR Program Improvement Plans.
Child and Family Service Reviews (CFSRs) evaluate public child welfare systems to determine how well they achieve safety, permanency, and well-being in difficult situations of neglect, physical and sexual abuse, and co-existing domestic violence, substanc...
S. Taggart
Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey
19. VIEW LOOKING SOUTHWEST TOWARDS THE ANCILLARY BUILDINGS. FROM LEFT TO RIGHT BACKGROUND, RETORT BUILDING, STORAGE, SMELTER BUILDING, GARAGE. THE NORTHWEST CORNER OF THE VANNER ROOM IS IN THE FOREGROUND AND LEFT. A 2000 DODGE GRAND CARAVAN IS IN THE FOREGROUND CENTER. THEIR USE OF THE SHED TO THE REAR OF THE AUTOMOBILE IS UNCERTAIN, ALTHOUGH IT IS CONNECTED TO THE MILL AT THE BASE OF THE WEST SIDE OF THE AMALGAMATING PANS ROOM. - Standard Gold Mill, East of Bodie Creek, Northeast of Bodie, Bodie, Mono County, CA
Reducing Health Inequalities in Scotland: The Involvement of People with Learning Disabilities as National Health Service Reviewers
Reducing health inequalities is a key priority for the Scottish Government. Health authorities are expected to meet quality targets. The involvement of people with learning disabilities in health service review teams has been one of the initiatives used in by National Health Service Quality Improvement Scotland to empower patients and improve�
Campbell, Martin; Martin, Mike
Early Childhood Services in the OECD Countries: Review of the literature and current policy in the early childhood field
The aim of this publication is to provide a review of the literature and current policies of early childhood education and care in the economically most advanced countries of the world. The introductory chapter provides some basic definitions: what is meant by 'early childhood services' both in the narrow sense of care and education services for young children (family day
John Bennett
Ethnic Factors in Mental Health Service Utilisation among People with Intellectual Disability in High-Income Countries: Systematic Review
Background: An emerging literature suggests that ethnic and cultural factors influence service utilisation among people with intellectual disability (ID), but this has not previously been reviewed. Aims: To investigate possible ethnic variation in uptake of mental health services in children, adolescents and adults with ID in high-income�
Dura-Vila, G.; Hodes, M.
Practitioner Review: How Can Epidemiology Help Us Plan and Deliver Effective Child and Adolescent Mental Health Services?
This review focuses on ways in which epidemiological research can inform mental health service development and clinical practice. Data from epidemiological studies can provide cross-sectional and secular estimates of the prevalence of psychopathology to support rational service development. Epidemiological surveys have difficulties in finding�
Ford, Tamsin
Influence of service temperature on tribological characteristics of self-lubricant coatings: A review
Self-lubricating coatings have been widely used to reduce friction in moving machine assemblies. However, the tribological performance of these coatings is strongly dependent on the service temperature. In this paper, an extensive review pertaining to the influence of operating service temperature on tribological performance of self-lubricating coatings has been carried out. Based on the effective lubricating temperature range, the self-lubricating coatings developed in the past have been divided into three groups: low temperature lubricant coating (from -200�C to room temperature), moderate temperature lubricant coating (from room temperature to 500�C) and high temperature lubricant coating (> 500�C). Ideas concerning possible ways to extend the operating temperature range of self-lubricating coatings have been presented as follows: hybridized tribological coating, adaptive tribological coatings, and diffusion rate limited solid lubricant coating. In addition, a new self-lubricating coating formulation for potential application at a wide operating temperature range has been proposed.
Yang, Jun-Feng; Jiang, Yan; Hardell, Jens; Prakash, Braham; Fang, Qian-Feng
A quantitative review of urban ecosystem service assessments: concepts, models, and implementation.
Although a number of comprehensive reviews have examined global ecosystem services (ES), few have focused on studies that assess urban ecosystem services (UES). Given that more than half of the world's population lives in cities, understanding the dualism of the provision of and need for UES is of critical importance. Which UES are the focus of research, and what types of urban land use are examined? Are models or decision support systems used to assess the provision of UES? Are trade-offs considered? Do studies of UES engage stakeholders? To address these questions, we analyzed 217 papers derived from an ISI Web of Knowledge search using a set of standardized criteria. The results indicate that most UES studies have been undertaken in Europe, North America, and China, at city scale. Assessment methods involve bio-physical models, Geographical Information Systems, and valuation, but few study findings have been implemented as land use policy. PMID:24740614
Haase, Dagmar; Larondelle, Neele; Andersson, Erik; Artmann, Martina; Borgstr�m, Sara; Breuste, J�rgen; Gomez-Baggethun, Erik; Gren, �sa; Hamstead, Zo�; Hansen, Rieke; Kabisch, Nadja; Kremer, Peleg; Langemeyer, Johannes; Rall, Emily Lorance; McPhearson, Timon; Pauleit, Stephan; Qureshi, Salman; Schwarz, Nina; Voigt, Annette; Wurster, Daniel; Elmqvist, Thomas
76 FR 28767 - Desert Southwest Customer Service Region-Rate Order No. WAPA-152
This action is to temporarily extend the existing NITS formula rates for the Parker-Davis Project (P-DP), and the Pacific Northwest/ Pacific Southwest Intertie Project (Intertie) and Ancillary Services Rates for Western Area Lower Colorado (WALC) Balancing Authority through September 30, 2013. The existing NITS and Ancillary Services formula rates expire on June 30,...
Undocumented Migrants in Canada: A scope literature review on health, access to services, and working conditions
It is estimated that there are 30 to 40 million undocumented workers worldwide. Although undocumented migration has become an issue of high international relevance, it has been strikingly understudied in Canada, especially with respect to its impact on health. The purpose of this study is to explore the concept of undocumentedness in Canada through a scoping review of peer-reviewed and grey literature written in English, French, Portuguese and Spanish between 2002 and 2008. The specific aims are to: i) summarize and disseminate current academic and community-based findings on the health, service access and working conditions of undocumented migrants in Canada; ii) examine the sources and use of evidence; iii) identify significant gaps in existing knowledge; iv) set recommendations for policy and research, including considerations on transnationalism, ethics, interdisciplinary approaches, gender differences, resilience, and impact on the children of non-status parents.
Carrasco, Christine; Gastaldo, Denise
National Ignition Facility sub-system design requirements ancillary systems SSDR 1.5.6
This System Design Requirement document establishes the performance, design, development, and test requirements for the Ancillary Systems, which is part of the NIF Integrated Computer Control System (ICCS).
Spann, J.; Reed, R.; VanArsdall, P.; Bliss, E.
The effectiveness of M-health technologies for improving health and health services: a systematic review protocol
BACKGROUND: The application of mobile computing and communication technology is rapidly expanding in the fields of health care and public health. This systematic review will summarise the evidence for the effectiveness of mobile technology interventions for improving health and health service outcomes (M-health) around the world. FINDINGS: To be included in the review interventions must aim to improve or promote
Caroline Free; Gemma Phillips; Lambert Felix; Leandro Galli; Vikram Patel; Philip Edwards
A systematic review of health service interventions to improve linkage with or retention in HIV care.
The importance of early linkage to and continuing retention in HIV care is increasingly recognised, particularly in light of the implications poor linkage and retention rates have for the effectiveness of HIV treatment as prevention strategies. The purpose of this systematic review was to examine the effectiveness of healthcare interventions in improving patient linkage to or retention in HIV care. We systematically searched PubMed (MEDLINE and PubMed-only citations) and EMBASE databases for articles reporting the original results of randomised controlled trials, and used a standard data collection form to extract information on study characteristics and outcome data. Five articles met the inclusion criteria, of which two articles focused on linkage to care and three on retention in care. The methodological quality, both of internal and external validity, of most of the trials was suboptimal. Wide variation in the interventions and outcome measures meant synthesis of the results using meta-analysis was not appropriate. This review shows evidence that interventions based on supporting patient self-management improves linkage to, and possibly retention in, care. Interventions aimed at delivery service design may also be effective, although evidence in this review was limited. It is vital that interventions are developed to improve patient engagement in HIV care. The dearth of research identified by this review highlights the need for well-designed trials of interventions in this area in the future. PMID:24354712
Brennan, Aline; Browne, John P; Horgan, Mary
Working conditions and health among employees at information technology--enabled services: a review of current evidence.
Workers in information technology (IT)-enabled services like business process outsourcing and call centers working with visual display units are reported to have various health and psycho-social disorders. Evidence from previously published studies in peer- reviewed journals and internet sources were examined to explore health disorders and psycho-social problems among personnel employed in IT-based services, for a systematic review on the topic. In addition, authors executed a questionnaire- based pilot study. The available literature and the pilot study, both suggest health disorders and psychosocial problems among workers of business process outsourcing. The details are discussed in the review. PMID:16864916
Kesavachandran, C; Rastogi, S K; Das, Mohan; Khan, Asif M
Traditional and innovative promotional strategies of tobacco cessation services: a review of the literature.
An estimated 43.5 million American adults currently smoke cigarettes. Well-designed tobacco education campaigns with adequate reach increase cessation and reduce tobacco use. Smokers report great interest in quitting but few use effective treatments including quitlines (QLs). This review examined traditional (TV, radio, print ads) versus innovative tobacco cessation (internet, social media) promotions for QL services. Between November 2011 and January 2012, searches were conducted on EBSCO, PubMed, Wilson, OCLC, CQ Press, Google Scholar, Gale, LexisNexis, and JSTOR. Existing literature shows that the amount of radio and print advertising, and promotion of free cessation medications increases QL call volume. Television advertising volume seems to be the best predictor of QL service awareness. Much of the literature on Internet advertising compares the characteristics of participants recruited for studies through various channels. The majority of the papers indicated that Internet-recruited participants were younger; this was the only demographic characteristic with high agreement across studies. Traditional media was only studied within mass media campaigns with TV ads having a consistent impact on increasing calls to QLs, therefore, it is hard to distinguish the impact of traditional media as an independent QL promotion intervention. With innovative media, while many QL services have a presence on social media sites, there is no literature on evaluating the effectiveness of these channels for quitline promotion. PMID:24515948
Momin, Behnoosh; Neri, Antonio; McCausland, Kristen; Duke, Jennifer; Hansen, Heather; Kahende, Jennifer; Zhang, Lei; Stewart, Sherri L
Still too far to walk: Literature review of the determinants of delivery service use
Background Skilled attendance at childbirth is crucial for decreasing maternal and neonatal mortality, yet many women in low- and middle-income countries deliver outside of health facilities, without skilled help. The main conceptual framework in this field implicitly looks at home births with complications. We expand this to include "preventive" facility delivery for uncomplicated childbirth, and review the kinds of determinants studied in the literature, their hypothesized mechanisms of action and the typical findings, as well as methodological difficulties encountered. Methods We searched PubMed and Ovid databases for reviews and ascertained relevant articles from these and other sources. Twenty determinants identified were grouped under four themes: (1) sociocultural factors, (2) perceived benefit/need of skilled attendance, (3) economic accessibility and (4) physical accessibility. Results There is ample evidence that higher maternal age, education and household wealth and lower parity increase use, as does urban residence. Facility use in the previous delivery and antenatal care use are also highly predictive of health facility use for the index delivery, though this may be due to confounding by service availability and other factors. Obstetric complications also increase use but are rarely studied. Quality of care is judged to be essential in qualitative studies but is not easily measured in surveys, or without linking facility records with women. Distance to health facilities decreases use, but is also difficult to determine. Challenges in comparing results between studies include differences in methods, context-specificity and the substantial overlap between complex variables. Conclusion Studies of the determinants of skilled attendance concentrate on sociocultural and economic accessibility variables and neglect variables of perceived benefit/need and physical accessibility. To draw valid conclusions, it is important to consider as many influential factors as possible in any analysis of delivery service use. The increasing availability of georeferenced data provides the opportunity to link health facility data with large-scale household data, enabling researchers to explore the influences of distance and service quality.
Gabrysch, Sabine; Campbell, Oona MR
Integrated Delivery of Health Services During Outreach Visits: A Literature Review of Program Experience Through a Routine Immunization Lens
Background.?Outreach services are used systematically to deliver immunization and health services to individuals with insufficient access to health facilities in lower-income countries. Currently, the topic of integrated service delivery during immunization outreach lacks the attention paid to integration at fixed sites or during campaigns. This article explores integrated outreach and risks associated with service integration. Methods.?Published and gray literature in public health databases and on organization websites were reviewed, yielding 33 articles and gray literature documents for a literature review of experience integrating other services with routine immunization at outreach sessions. Results.?The current policy climate favors service integration as a strategy for increasing the equity and efficiency of important health interventions. However, integration may also present some risk to well-established and resourced interventions, such as immunization, which must be recognized as programs compete for limited resources. Experience reveals integration opportunities in planning and intersectoral coordination, training and supervision, community participation, pooled funding, and monitoring. Conclusions.?The reviewed literature indicates that successful integration of health interventions with immunization at routine outreach sessions requires well-planned and implemented steps. It also highlights the need for additional studies or feedback on planning and implementing integrated outreach services in lower-income countries.
Partapuri, Tasnim; Steinglass, Robert
Utilization of ancillary studies in the cytologic diagnosis of biliary and pancreatic lesions: the Papanicolaou Society of Cytopathology guidelines for pancreatobiliary cytology.
The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound-guided fine-needle aspiration, terminology and nomenclature of pancreatobiliary disease, ancillary testing, and post-biopsy management. All documents are based on the expertise of the authors, a review of the literature, discussions of the draft document at several national and international meetings, and synthesis of selected online comments of the draft document. This document presents the results of these discussions regarding the use of ancillary testing in the cytologic diagnosis of biliary and pancreatic lesions.?Currently, fluorescence in situ hybridization (FISH) appears to be the most clinically relevant ancillary technique for cytology of bile duct strictures. The addition of FISH analysis to routine cytologic evaluation appears to yield the highest sensitivity without loss in specificity. Loss of immunohistochemical staining for the protein product of the SMAD4 gene and positive staining for mesothelin support a diagnosis of ductal adenocarcinoma. Immunohistochemical markers for endocrine and exocrine differentiation are sufficient for a diagnosis of endocrine and acinar tumors. Nuclear staining for beta-catenin supports a diagnosis of solid-pseudopapilary neoplasm. Cyst fluid analysis for amylase and carcinoembryonic antigen aids in the preoperative classification of pancreatic cysts. Many gene mutations (KRAS, GNAS, VHL, RNF43, and CTNNB1) may be of aid in the diagnosis of cystic neoplasms. Other ancillary techniques do not appear to improve diagnostic sensitivity sufficiently to justify their increased costs. PMID:24639398
Layfield, Lester J; Ehya, Hormoz; Filie, Armando C; Hruban, Ralph H; Jhala, Nirag; Joseph, Loren; Vielh, Philippe; Pitman, Martha B
Retrospective examination of selected outcomes of Medicines Use Review (MUR) services in New Zealand.
Background Poor adherence to medication can lead to suboptimal outcomes, and is reported to occur frequently. Pharmacists in some countries are funded to support the appropriate use of medications in patients and enhance medication adherence, by providing services such as Medicines Use Review (MUR). Objective To describe and investigate factors that may influence patients' knowledge and perceptions of and adherence to medications as determined during MUR. Setting Community pharmacies in a locality in New Zealand. Method Following consent from five MUR service providers, records of patients' MUR consultations conducted between November 2007 and December 2011 were retrospectively reviewed for information on patients, services, and outcomes. Using multilevel mixed-effects logistic regression, factors that predicted the providers' score of the patients' medication knowledge, and the patients' score of their adherence to and perceptions of medications, were investigated. Main outcome measure patients' knowledge, perceptions and adherence scores. Results A total of 353 MUR patients' records were evaluated. The median (IQR) age of patients was 73 (63-81) years. About 41.1�% of patients were M?ori. A total of 204 (57.8�%) patients had two MUR consultations and only 53 (15�%) had four. The mean score of patients' knowledge, perceptions of, and adherence to medications were found to increase in each visit which suggests that adherence support by pharmacists might improve patients' outcomes. Females had higher medication knowledge scores than males (OR 3.09, 95�% CI 1.29-7.44). There was some evidence to suggest M?ori had lower scores for knowledge of medications than non-M?ori (OR 0.092, 95�% CI 0.02-0.36). In addition, longer duration in the program predicted better scores for medication knowledge, adherence and perceptions of medications. Conclusions MUR was found to have the potential to improve the scores of patients' knowledge and perceptions of and adherence to medicines, and factors such as gender, ethnicity and longer duration in the services were found to predict these outcomes. PMID:24626968
Hatah, Ernieda; Tordoff, June; Duffull, Stephen B; Cameron, Claire; Braund, Rhiannon
STS ancillary equipment study. [user reference book for multimission modular spacecraft missions
Spaceborne and ground ancillary equipment for multimission module spacecraft are listed to provide documentation for potential users interested in utilizing existing equipment rather than developing payload unique designs. The format of the data form contained in the Ancillary Equipment user reference book is discussed.
Effective in-service training design and delivery: evidence from an integrative literature review
Background In-service training represents a significant financial investment for supporting continued competence of the health care workforce. An integrative review of the education and training literature was conducted to identify effective training approaches for health worker continuing professional education (CPE) and what evidence exists of outcomes derived from CPE. Methods A literature review was conducted from multiple databases including PubMed, the Cochrane Library and Cumulative Index to Nursing and Allied Health Literature (CINAHL) between May and June 2011. The initial review of titles and abstracts produced 244 results. Articles selected for analysis after two quality reviews consisted of systematic reviews, randomized controlled trials (RCTs) and programme evaluations published in peer-reviewed journals from 2000 to 2011 in the English language. The articles analysed included 37 systematic reviews and 32 RCTs. The research questions focused on the evidence supporting educational techniques, frequency, setting and media used to deliver instruction for continuing health professional education. Results The evidence suggests the use of multiple techniques that allow for interaction and enable learners to process and apply information. Case-based learning, clinical simulations, practice and feedback are identified as effective educational techniques. Didactic techniques that involve passive instruction, such as reading or lecture, have been found to have little or no impact on learning outcomes. Repetitive interventions, rather than single interventions, were shown to be superior for learning outcomes. Settings similar to the workplace improved skill acquisition and performance. Computer-based learning can be equally or more effective than live instruction and more cost efficient if effective techniques are used. Effective techniques can lead to improvements in knowledge and skill outcomes and clinical practice behaviours, but there is less evidence directly linking CPE to improved clinical outcomes. Very limited quality data are available from low- to middle-income countries. Conclusions Educational techniques are critical to learning outcomes. Targeted, repetitive interventions can result in better learning outcomes. Setting should be selected to support relevant and realistic practice and increase efficiency. Media should be selected based on the potential to support effective educational techniques and efficiency of instruction. CPE can lead to improved learning outcomes if effective techniques are used. Limited data indicate that there may also be an effect on improving clinical practice behaviours. The research agenda calls for well-constructed evaluations of culturally appropriate combinations of technique, setting, frequency and media, developed for and tested among all levels of health workers in low- and middle-income countries.
A Review of Services and Interventions for Runaway and Homeless Youth: Moving Forward
Research focused on the impact of community-based services and treatment interventions designed to intervene in the lives of runaway and homeless youth has increased in the last two decades in the U.S. and internationally. In light of the tremendous need for identifying effective strategies to end homelessness and its associated problems among youth, this paper summarizes and critiques the findings of the extant literature including U.S., international, and qualitative studies. Thirty-two papers met criteria for inclusion in the review. Among the conclusions are that comprehensive interventions which target the varied and interconnected needs of these youth and families may be worthy of more study than studies that isolate the intervention focus on one problem. Also, more research incorporating design strategies that increase the reliability and validity of study findings is needed. Other preliminary conclusions and future directions are offered.
Slesnick, Natasha; Dashora, Pushpanjali; Letcher, Amber; Erdem, Gizem; Serovich, Julianne
A minority report: homebirth in Australia before and after the 2009 Maternity Services Review.
In 2009 the Australian Federal Government released its Maternity Services Review. Since then, homebirth has been virtually outlawed for those women who are unable to obtain one of the limited places on a publicly funded program. However, homebirth is a valid choice for women and advocating for homebirth does not reflect a desire to "turn back the clock", as regard to the history of birth will show. At its core, the controversy over homebirth is about the control of pregnant women's bodies, particularly when they make a choice about their bodies and their babies which sits outside of the mainstream. While only a minority of Australian women presently plan a homebirth, the issues surrounding the status of homebirth have wider implications for women and illustrate a troubling trend towards restricting choice through legal and administrative back-roads, without proper consideration of the risks or benefits involved. PMID:24218788
Skerman, Jindalae Kim
A review of the Medical Agency Services Confor-Med range.
Medical Agency Services Ltd (MAS) has, since 1994, been involved in the design and development of mattresses and overlays manufactured from visco-elastic polymer foam, which is currently utilized in the manufacture of domestic, automative and specialist bedding and seating products. The foam is fire retardant and satisfies the BS 5852 (Part 2) ignition source 5. The foam is a heat and weight sensitive, visco-elastic polymer, giving a high performance, pressure redistributing surface that 'moulds' to the patient giving simultaneous muscular/skeletal support and allowing the patient to feel comfortable. The Confor-Med mattress offers a sensible alternative for patients with high Waterlow scores who have no pressure sores, but require early intervention to prevent pressure sores developing. A case study is included in this review of the products. PMID:10624200
Russell, L
Systematic review of facility-based sexual and reproductive health services for female sex workers in Africa
Background Several biological, behavioural, and structural risk factors place female sex workers (FSWs) at heightened risk of HIV, sexually transmitted infections (STIs), and other adverse sexual and reproductive health (SRH) outcomes. FSW projects in many settings have demonstrated effective ways of altering this risk, improving the health and wellbeing of these women. Yet the optimum delivery model of FSW projects in Africa is unclear. This systematic review describes intervention packages, service-delivery models, and extent of government involvement in these services in Africa. Methods On 22 November 2012, we searched Web of Science and MEDLINE, without date restrictions, for studies describing clinical and non-clinical facility-based SRH prevention and care services for FSWs in low- and middle-income countries in Africa. We also identified articles in key non-indexed journals and on websites of international organizations. A single reviewer screened titles and abstracts, and extracted data from articles using standardised tools. Results We located 149 articles, which described 54 projects. Most were localised and small-scale; focused on research activities (rather than on large-scale service delivery); operated with little coordination, either nationally or regionally; and had scanty government support (instead a range of international donors generally funded services). Almost all sites only addressed HIV prevention and STIs. Most services distributed male condoms, but only 10% provided female condoms. HIV services mainly encompassed HIV counselling and testing; few offered HIV care and treatment such as CD4 testing or antiretroviral therapy (ART). While STI services were more comprehensive, periodic presumptive treatment was only provided in 11 instances. Services often ignored broader SRH needs such as family planning, cervical cancer screening, and gender-based violence services. Conclusions Sex work programmes in Africa have limited coverage and a narrow scope of services and are poorly coordinated with broader HIV and SRH services. To improve FSWs� health and reduce onward HIV transmission, access to ART needs to be addressed urgently. Nevertheless, HIV prevention should remain the mainstay of services. Service delivery models that integrate broader SRH services and address structural risk factors are much needed. Government-led FSW services of high quality and scale would markedly reduce SRH vulnerabilities of FSWs in Africa.
USGS Publications Warehouse
The U.S. Fish and Wildlife Service uses the term palustrine wetland to describe vegetated wetlands traditionally identified as marsh, bog, fen, swamp, or wet meadow. Landsat TM imagery was combined with image texture and ancillary environmental data to model probabilities of palustrine wetland occurrence in Yellowstone National Park using classification trees. Model training and test locations were identified from National Wetlands Inventory maps, and classification trees were built for seven years spanning a range of annual precipitation. At a coarse level, palustrine wetland was separated from upland. At a finer level, five palustrine wetland types were discriminated: aquatic bed (PAB), emergent (PEM), forested (PFO), scrub-shrub (PSS), and unconsolidated shore (PUS). TM-derived variables alone were relatively accurate at separating wetland from upland, but model error rates dropped incrementally as image texture, DEM-derived terrain variables, and other ancillary GIS layers were added. For classification trees making use of all available predictors, average overall test error rates were 7.8% for palustrine wetland/upland models and 17.0% for palustrine wetland type models, with consistent accuracies across years. However, models were prone to wetland over-prediction. While the predominant PEM class was classified with omission and commission error rates less than 14%, we had difficulty identifying the PAB and PSS classes. Ancillary vegetation information greatly improved PSS classification and moderately improved PFO discrimination. Association with geothermal areas distinguished PUS wetlands. Wetland over-prediction was exacerbated by class imbalance in likely combination with spatial and spectral limitations of the TM sensor. Wetland probability surfaces may be more informative than hard classification, and appear to respond to climate-driven wetland variability. The developed method is portable, relatively easy to implement, and should be applicable in other settings and over larger extents. ?? 2006 Elsevier Inc. All rights reserved.
Wright, C.; Gallant, A.
Current Status and Future Prospects for the Assessment of Marine and Coastal Ecosystem Services: A Systematic Review
Background Research on ecosystem services has grown exponentially during the last decade. Most of the studies have focused on assessing and mapping terrestrial ecosystem services highlighting a knowledge gap on marine and coastal ecosystem services (MCES) and an urgent need to assess them. Methodology/Principal Findings We reviewed and summarized existing scientific literature related to MCES with the aim of extracting and classifying indicators used to assess and map them. We found 145 papers that specifically assessed marine and coastal ecosystem services from which we extracted 476 indicators. Food provision, in particular fisheries, was the most extensively analyzed MCES while water purification and coastal protection were the most frequently studied regulating and maintenance services. Also recreation and tourism under the cultural services was relatively well assessed. We highlight knowledge gaps regarding the availability of indicators that measure the capacity, flow or benefit derived from each ecosystem service. The majority of the case studies was found in mangroves and coastal wetlands and was mainly concentrated in Europe and North America. Our systematic review highlighted the need of an improved ecosystem service classification for marine and coastal systems, which is herein proposed with definitions and links to previous classifications. Conclusions/Significance This review summarizes the state of available information related to ecosystem services associated with marine and coastal ecosystems. The cataloging of MCES indicators and the integrated classification of MCES provided in this paper establish a background that can facilitate the planning and integration of future assessments. The final goal is to establish a consistent structure and populate it with information able to support the implementation of biodiversity conservation policies.
Liquete, Camino; Piroddi, Chiara; Drakou, Evangelia G.; Gurney, Leigh; Katsanevakis, Stelios; Charef, Aymen; Egoh, Benis
77 FR 56824 - Notice of Submission for OMB Review; Office of Special Education and Rehabilitative Services...
...Education and Rehabilitative Services; Grantee Reporting Form--Rehabilitation Services...public records. Title of Collection: Grantee Reporting Form--Rehabilitation Services...the academic institutions (i.e., grantees) that administer a RSA Long-Term...
78 FR 21952 - Submission for OMB Review; Proposed Collection; Comment Request; General Services Administration...
...Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery...Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery...Generic Clearance for the Collection of Qualitative Feedback on Agency Service...
Factors supporting good partnership working between generalist and specialist palliative care services: a systematic review
Background The care that most people receive at the end of their lives is provided not by specialist palliative care professionals but by generalists such as GPs, district nurses and others who have not undertaken specialist training in palliative care. A key focus of recent UK policy is improving partnership working across the spectrum of palliative care provision. However there is little evidence to suggest factors which support collaborative working between specialist and generalist palliative care providers Aim To explore factors that support partnership working between specialist and generalist palliative care providers. Design Systematic review. Method A systematic review of studies relating to partnership working between specialist and generalist palliative care providers was undertaken. Six electronic databases were searched for papers published up until January 2011. Results Of the 159 articles initially identified, 22 papers met the criteria for inclusion. Factors supporting good partnership working included: good communication between providers; clear definition of roles and responsibilities; opportunities for shared learning and education; appropriate and timely access to specialist palliative care services; and coordinated care. Conclusion Multiple examples exist of good partnership working between specialist and generalist providers; however, there is little consistency regarding how models of collaborative working are developed, and which models are most effective. Little is known about the direct impact of collaborative working on patient outcomes. Further research is required to gain the direct perspectives of health professionals and patients regarding collaborative working in palliative care, and to develop appropriate and cost-effective models for partnership working.
Gardiner, Clare; Gott, Merryn; Ingleton, Christine
Triage systems for pre-hospital emergency medical services - a systematic review.
The emergency medical services (EMS) cover initiatives and services established to provide essential medical assistance in situations of acute illness. Triage-methods for systematic prioritizing of patients according to how urgent patients need care, including triage of requests of acute medical treatment, are adopted in hospitals as well as in the pre-hospital settings. This systematic review searched to identify available research on the effects of validated triage systems for use in the pre-hospital EMS on health outcomes, patient safety, patient satisfaction, user-friendliness, resource use, goal achievement, and the quality on the information exchange between the different settings of the EMS (for example the quality of documentation). The specific research questions were: 1) are pre-hospital triage systems effective, 2) is one triage system more effective than others, and 3) is it effective to use the same triage system in two or more settings of the EMS-chain? We conducted a systematic literature search in nine databases up to June 2012. We searched for systematic reviews (SRs), randomized controlled trials (RCTs), non-randomized controlled trials (non-RCTs), controlled before and after studies (CBAs) and interrupted time series analyses (ITSs). Two persons independently reviewed titles and abstracts, and the same persons read all possibly relevant full text articles and rated the methodological quality where relevant. The literature search identified 11011 unique references. A total of 120 publications were read in full text. None of the identified articles fulfilled our inclusion criteria, thus our question on the effects of pre-hospital triage systems, if one system is better than other systems, and the question on effects of using the same triage system in two or more settings of the EMS, remain unanswered. We conclude that there is an evidence gap regarding the effects of pre-hospital triage systems and the effects of using the same triage system in two or more settings of the EMS. The finding does not mean that pre-hospital triage systems are ineffective, but that we lack knowledge about potential effects. When introducing a new assessment tool in the EMS, it is timely to conduct well-planned studies aimed to assess the effect. PMID:23587133
Lidal, Ingeborg Beate; Holte, Hilde H; Vist, Gunn Elisabeth
Review of Jamaica Public Service Company, Ltd. least-cost expansion plan.
Argonne National Laboratory has been asked to review the least-cost expansion plan (LCEP) of the Jamaica Public Service Company, Ltd. (JPSCo). The material that has been initially provided to Argonne included: (1) An electronic copy of the data and results from JPSCo's running the WASP electric system expansion planning model, (2) Approximately 20 pages of a document 'JPSCo Generation Expansion Plan', marked 'DRAFT 002', date unknown, and (3) The report 'JPSCo Least Cost Generation Expansion Plans, (1999-2009)', January 1999. It was noticed that the 20 pages from the 'DRAFT 002' document were different from the January 1999 report. An explanation was provided to Argonne that the excerpt was from an earlier draft and that the review should focus on the January 1999 report. Further, the electronic copy of the WASP case did not correspond to either the January 1999 report or to the 20-page excerpt. Again, the reason for these discrepancies was that the WASP case provided to Argonne was an earlier case and not the final one that was presented in the report. Based on the review of the available material, Argonne experts have prepared and submitted to the National Investment Bank of Jamaica (NIBJ) a preliminary draft report containing the initial findings, comments, questions and observations. As many of the comments and questions raised in the preliminary review needed to be discussed with the appropriate staff of JPSCo and other Jamaican experts, a 3-day mission to Jamaica was carried out by one Argonne expert (V. Koritarov) in the period July 20-23, 1999. Besides JPSCo experts, the discussions and the review of the LCEP during the mission included several experts from NIBJ, Ministry of Energy, and the Petroleum Corporation of Jamaica. Mr. Koritarov also worked with the JPSCo technical staff to reconstruct the WASP base case that was used as a basis for the January 1999 report. The first step was to verify that the results obtained after the resimulation of this case were identical to those presented in the January 1999 report. Then, in the next step, the Argonne expert and JPSCo team reviewed this case in detail and performed certain modifications and improvements of data where necessary. These modifications and data adjustments resulted in a new base case that served as a basis for further review and for the sensitivity analyses. Several sensitivity analyses were performed together with JPSCo experts and the results were discussed with the JPSCo management and other Jamaican experts at the end of the mission. Additional sensitivity analyses, as well as the cases for high and low load forecasts, were conducted by Mr. Koritarov after returning from Jamaica. The main findings of the review and issues that have been discussed with the Jamaican team can be summarized.
Koritarov, V.; Buehring, W.; Cirillo, R.; Decision and Information Sciences
In 1989 legislation was passed in New Zealand giving public transport service operators the right to register and operate commercial services and to deregister such services with 21 days' notice. Regional councils have limited information on or control over these commercial services. The councils' principal role is to plan public transport and to contract \\
Anatole Sergejew
Estimating Net Primary Productivity Using Satellite and Ancillary Data
The net primary productivity (C) or the annual rate of carbon accumulation per unit ground area by terrestrial plant communities is the difference of gross photosynthesis (A(sub g)) and respiration (R) per unit ground area. Available field observations show that R is a large and variable fraction of A(sub g), although it is generally recognized that there are considerable difficulties in determining these fluxes, and thus pose challenge in assessing the accuracy. Further uncertainties arise in extrapolating field measurements (which are acquired over a hectare or so area) to regional scale. Here, an approach is presented for determining these fluxes using satellite and ancillary data to be representative of regional scale and allow assessment of interannual variation. A, has been expressed as the product of radiation use efficiency for gross photosynthesis by an unstressed canopy and intercepted photosynthetically active radiation, which is then adjusted for stresses due to soil water shortage and temperature away from optimum. R has been calculated as the sum of growth and maintenance components (respectively, R(sub g) and R(sub m)).The R(sub m) has been determined from nitrogen content of plant tissue per unit ground area, while R(sub g) has been obtained as a fraction of the difference of A(sub g) and R(sub m). Results for five consecutive years (1986-1990) are presented for the Amazon-Tocontins, Mississippi, and Ob River basins.
Choudhury, Bhaskar J.
Information about Support Services for Families of Young Children with Hearing Loss: A Review of Some Useful Outcomes and Challenges
This paper is concerned with reviewing some useful effects of information about support services provided to families of young children with hearing loss and the challenges of providing this information to families. Evidence indicates that 95 percent of young children with hearing loss have hearing parents. With no previous experience of hearing�
Eleweke, C. Jonah; Gilbert, Sharon; Bays, Debbie; Austin, Ellen
The Internet and Library and Information Services: A Review, Analysis, and Annotated Bibliography. Occasional Papers No. 202.
This work provides a review and analysis of the literature and an annotated bibliography of 446 sources on the Internet and library and information services. The bibliography is divided alphabetically according to the following topics: academic libraries and scholarly research; bibliographies, directories, guides, and glossaries; business�
Liu, Lewis-Guodo
What is the evidence for the continuation of core podiatry services in the NHS? A review of foot surveys
The purpose of this paper is to evaluate what evidence exists to support core podiatry services by reviewing foot survey dat a on the amount and type of foot conditions suffered in different populations. Twenty-six articles published between 1967 and 2004 inclusively were appraised. The most common conditions reported were problem nails, corns, callus and toe deformities, though some complex
Lisa Farndon; Wesley Vernon; Anne Parry
76 FR 82002 - Submission for Review: SF 2800, Application for Death Benefits Under the Civil Service Retirement...
...Submission for Review: SF 2800, Application for Death Benefits Under the Civil Service Retirement...and Elections in Support of Application for Death Benefits When Deceased Was an Employee at the Time of Death AGENCY: U.S. Office of Personnel...
76 FR 39926 - Submission for Review: SF 2800, Application for Death Benefits Under the Civil Service Retirement...
Effects of user fee exemptions on the provision and use of maternal health services: a review of literature.
User fee removal has been put forward as an approach to increasing priority health service utilization, reducing impoverishment, and ultimately reducing maternal and neonatal mortality. However, user fees are a source of facility revenue in many low-income countries, often used for purchasing drugs and supplies and paying incentives to health workers. This paper reviews evidence on the effects of user fee exemptions on maternal health service utilization, service provision, and outcomes, including both supply-side and demand-side effects. We reviewed 19 peer-reviewed research articles addressing user fee exemptions and maternal health services or outcomes published since 1990. Studies were identified through a USAID-commissioned call for evidence, key word search, and screening process. Teams of reviewers assigned criteria-based quality scores to each paper and prepared structured narrative reviews. The grade of the evidence was found to be relatively weak, mainly from short-term, non-controlled studies. The introduction of user fee exemptions appears to have resulted in increased rates of facility-based deliveries and caesarean sections in some contexts. Impacts on maternal and neonatal mortality have not been conclusively demonstrated; exemptions for delivery care may contribute to modest reductions in institutional maternal mortality but the evidence is very weak. User fee exemptions were found to have negative, neutral, or inconclusive effects on availability of inputs, provider motivation, and quality of services. The extent to which user fee revenue lost by facilities is replaced can directly affect service provision and may have unintended consequences for provider motivation. Few studies have looked at the equity effects of fee removal, despite clear evidence that fees disproportionately burden the poor. This review highlights potential and documented benefits (increased use of maternity services) as well as risks (decreased provider motivation and quality) of user fee exemption policies for maternal health services. Governments should link user fee exemption policies with the replacement of lost revenue for facilities as well as broader health system improvements, including facility upgrades, ensured supply of needed inputs, and improved human resources for health. Removing user fees may increase uptake but will not reduce mortality proportionally if the quality of facility-based care is poor. More rigorous evaluations of both demand- and supply-side effects of mature fee exemption programmes are needed. PMID:24992804
Hatt, Laurel E; Makinen, Marty; Madhavan, Supriya; Conlon, Claudia M
Effects of User Fee Exemptions on the Provision and Use of Maternal Health Services: A Review of Literature
User fee removal has been put forward as an approach to increasing priority health service utilization, reducing impoverishment, and ultimately reducing maternal and neonatal mortality. However, user fees are a source of facility revenue in many low-income countries, often used for purchasing drugs and supplies and paying incentives to health workers. This paper reviews evidence on the effects of user fee exemptions on maternal health service utilization, service provision, and outcomes, including both supply-side and demand-side effects. We reviewed 19 peer-reviewed research articles addressing user fee exemptions and maternal health services or outcomes published since 1990. Studies were identified through a USAID-commissioned call for evidence, key word search, and screening process. Teams of reviewers assigned criteria-based quality scores to each paper and prepared structured narrative reviews. The grade of the evidence was found to be relatively weak, mainly from short-term, non-controlled studies. The introduction of user fee exemptions appears to have resulted in increased rates of facility-based deliveries and caesarean sections in some contexts. Impacts on maternal and neonatal mortality have not been conclusively demonstrated; exemptions for delivery care may contribute to modest reductions in institutional maternal mortality but the evidence is very weak. User fee exemptions were found to have negative, neutral, or inconclusive effects on availability of inputs, provider motivation, and quality of services. The extent to which user fee revenue lost by facilities is replaced can directly affect service provision and may have unintended consequences for provider motivation. Few studies have looked at the equity effects of fee removal, despite clear evidence that fees disproportionately burden the poor. This review highlights potential and documented benefits (increased use of maternity services) as well as risks (decreased provider motivation and quality) of user fee exemption policies for maternal health services. Governments should link user fee exemption policies with the replacement of lost revenue for facilities as well as broader health system improvements, including facility upgrades, ensured supply of needed inputs, and improved human resources for health. Removing user fees may increase uptake but will not reduce mortality proportionally if the quality of facility-based care is poor. More rigorous evaluations of both demand- and supply-side effects of mature fee exemption programmes are needed.
Makinen, Marty; Madhavan, Supriya; Conlon, Claudia M.
Efficacy of a mobile lithotripsy service: A one-year review of 222 patients.
Abstract Objective. Extracorporeal shockwave lithotripsy (ESWL) is the management of choice for ureteric and renal stones 20 mm or smaller, with a stone clearance rate of up to 89%. This study determined whether such a high success rate could apply to centres using mobile ESWL, by reviewing the performance at one centre that provides such a service. Material and methods. Between July 2011 and July 2012, 222 patients (median age 51 years, range 18-90 years) underwent one to five sessions of ESWL for ureteric and renal stones (mean size 15 mm, range 4-22 mm). Stone clearance was regarded as residual fragments 2 mm or smaller after completion of sessions. Results. In total, 110 out of 222 patients (49%) were clear of stones. Stones were radiopaque in 198 (89%) and radiolucent in 24 patients (11%), with clearance rates of 48% and 63%, respectively. Regarding size, 36 (16%) were 1-5 mm, 144 (65%) 5-10 mm, 28 (12%) 10-15 mm, eight (4%) 15-20 mm and six (3%) larger than 20 mm, with clearance rates of 61%, 55%, 18%, 13% and 50%, respectively. In total, 173 (78%) were renal stones and 49 (22%) ureteric, with respective clearance rates of 49% and 51%. For kidney stones, 15 (9%) were in the upper, 32 (18%) in the mid, 75 (43%) in the lower pole and 51 (30%) in the pelvis, with clearance rates of 52%, 59%, 49% and 41%; for ureteric stones, 32 (65%) were in the upper, 10 (20%) in the mid and seven (15%) in the lower ureter, with clearance rates of 47%, 70% and 43%, respectively. Conclusion. The performance of mobile ESWL was significantly poorer than expected, and this may be related to a lack of clinical ownership. The authors believe that such a service should be permanently placed on site. PMID:24521183
Nafie, Shady; Dyer, James Edward; Minhas, Jatinder Singh; Mills, Jonathan Arthur; Khan, Masood Ahmed
Service user involvement in pre-registration mental health nurse education classroom settings: a review of the literature.
Service user involvement in pre-registration nurse education is now a requirement, yet little is known about how students engage with users in the classroom, how such initiatives are being evaluated, how service users are prepared themselves to teach students, or the potential influence on clinical practice. The aim of this literature review was to bring together published articles on service user involvement in classroom settings in pre-registration mental health nurse education programmes, including their evaluations. A comprehensive review of the literature was carried out via computer search engines and the Internet, as well as a hand search of pertinent journals and references. This produced eight papers that fitted the inclusion criteria, comprising four empirical studies and four review articles, which were then reviewed using a seven-item checklist. The articles revealed a range of teaching and learning strategies had been employed, ranging from exposure to users' personal stories, to students being required to demonstrate awareness of user perspectives in case study presentations, with others involving eLearning and assessment skills initiatives. This review concludes that further longitudinal research is needed to establish the influence of user involvement in the classroom over time. PMID:22296494
Terry, J
Screening for Breast Cancer: Systematic Evidence Review Update for the U. S. Preventive Services Task Force
Background This systematic review is an update of evidence since the 2002 U.S. Preventive Services Task Force (USPSTF) recommendation on breast cancer screening. Purpose To determine the effectiveness of mammography screening in decreasing breast cancer mortality among average-risk women age 40 to 49 and 70 and older; the effectiveness of clinical breast examination (CBE) and breast self examination (BSE); and harms of screening. Data Sources Cochrane Controlled Trials Registry and Database of Systematic Reviews (4th Quarter 2008), MEDLINE� (January 2001 to December 2008), reference lists, and Web of Science� for published studies; Breast Cancer Surveillance Consortium for screening mammography data. Study Selection Randomized controlled trials with breast cancer mortality outcomes for screening effectiveness; multiple study designs and data sources for harms. Data Extraction Investigators abstracted relevant data and rated study quality using established criteria. Data Synthesis Mammography screening reduces breast cancer mortality by 15% for women age 39 to 49 (relative risk 0.85; 95% CrI 0.75 to 0.96; 8 trials); data are lacking for age ?70. Radiation exposure from mammography is low. Patient adverse experiences are common, transient, and do not impact screening practices. Estimates of overdiagnosis vary from 1% to 10%. Younger women have more false positive mammograms and additional imaging, but fewer biopsies than older women. Trials of CBE are ongoing; for BSE, trials showed no reductions in mortality but increased benign biopsies. Limitations Studies of older women, digital mammography, and MRI are lacking. Conclusions Mammography screening reduces breast cancer mortality for women age 39 to 69; data are insufficient for older women. False positive mammograms and additional imaging are common. No benefit has been shown for CBE or BSE.
Nelson, Heidi D.; Tyne, Kari; Naik, Arpana; Bougatsos, Christina; Chan, Benjamin K.; Humphrey, Linda
[Interventions to solve overcrowding in hospital emergency services: a systematic review].
This review discusses interventions aimed at solving the problem of overcrowding in hospital emergency services (HES), characteristic of low organizational effectiveness. In free-access and restricted-access databases, the target descriptors were 'overcrowding; emergency; medicine; first aid'. The survey identified 66 citations of interventions, grouped in 47 related interventions. The majority of the studies used observational designs that evaluated the results before and after interventions. Of the 47 related interventions, 34 had results for organizational performance. Four were the most frequently cited: implementation of an observation unit for patients already hospitalized and awaiting diagnosis or clinical stabilization; designation of a dedicated nursing station for the patient's admission, discharge, or transfer; establishment of protocols with indicators of operational saturation and implementation of an emergency care unit. Analyzing 21 interventions that were intended to solve overcrowding in HES and with positive results for length-of-stay, 15 were related to patient stream improvement, interfering actively and positively in patient stream. Interventions that increased access barriers or that merely improved the HES structure were ineffective. PMID:19578565
Bittencourt, Roberto Jos�; Hortale, Virginia Alonso
Integrated delivery of HIV and tuberculosis services in sub-Saharan Africa: a systematic review.
Tuberculosis is a major cause of morbidity and mortality in people with HIV and about a quarter of HIV-related deaths are attributed to tuberculosis. In this Review we identify and synthesise published evidence for the effectiveness and cost-effectiveness of eight integrated strategies recommended by WHO that represent coordinated delivery of HIV and tuberculosis services. Evidence supports concurrent screening for tuberculosis and HIV, and provision of either co-trimoxazole during routine tuberculosis care or isoniazid during routine HIV care and at voluntary counselling and testing centres. Although integration of antiretroviral therapy into tuberculosis care has shown promise for improving health outcomes for patients, evidence is insufficient to make conclusive claims. Evidence is also insufficient on the accessibility of condoms at tuberculosis facilities, the benefits of risk reduction counselling in patients with tuberculosis, and the effectiveness of tuberculosis infection control in HIV health-care settings. The vertical response to the tuberculosis and HIV epidemics is ineffective and inefficient. Implications for policy makers and funders include further investments in implementing integrated tuberculosis and HIV programmes with known effectiveness, preferably in a way that strengthens health systems; evaluative research that identifies barriers to integration; and research on integrated strategies for which effectiveness, efficiency, and affordability are not well established. PMID:22035614
Uyei, Jennifer; Coetzee, David; Macinko, James; Guttmacher, Sally
The impact of a supplementary medication review and counselling service within the oncology outpatient setting
The impact on the care of breast cancer patients, of a pharmacy technician-led medication review and counselling clinic, provided in an outpatient setting, was investigated using a controlled randomised study. Compared to the controls, clinic patients showed a significantly improved level of understanding of their chemotherapy support medication (95% CI for difference in mean knowledge rating scores=2.165�2.826, P<0.001) and a significant reduction in the median number of support items required (two compared to five in the control, P<0.001). This resulted in a significant reduction in mean medication expenditure per patient (�26.70 vs �10.20, 95% CI for the mean difference in cost �6.72��26.26, P<0.001). The clinic was also associated with significant reductions in chemotherapy delays (P<0.001) and dose reductions due to side effects (P=0.003). Other benefits from the clinic were a reduction in pharmacy dispensing time and a highly significant reduction in pharmacy time spent resolving post-clinic prescription queries (P<0.001). Taking into account the initial technician training cost, the scheme represented an annual saving to the Trust of over �15?000. The clinic serves as a model for those wishing to improve outpatient services to breast cancer patients.
Read, H; Ladds, S; Rhodes, B; Brown, D; Portlock, J
Review of Arizona's Medicaid Claims for School-Based Health Services.
In Arizona, the Arizona Health Care Cost Containment System Administration (the State agency) administers the Medicaid program, which covers school-based health services under the Direct Service Claiming (DSC) program. The DSC program allows local educati...
J. E. Vegrin
77 FR 50138 - Submission for OMB Review; Comment Request: Collection of Customer Service, Demographic, and...
...clients at the end of usual service--a survey that includes three customer service and twelve demographic questions (age, sex, race, ethnicity, education, household income, number in household, and five questions about health...
77 FR 26763 - General Services Administration Acquisition Regulation; Submission for OMB Review; Contract...
...Release of Claims, regarding final payment under construction and building services contract. GSA Form 1142 was inadvertently...Regulation (GSAR) clause 552.232-72 requires construction and building services contractors to submit a release...
75 FR 43168 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Service...
...Aging (SUA), Area Agencies on Aging (AAA) and Local Service Providers (LSP...questionnaire followed by interviews with AAA directors and their staff and focus groups...the SUA to represent a maximum range of AAA and service provider network...
75 FR 6729 - Senior Executive Service (SES) Performance Review Board; Members
...Archivist of the United States, Michael J. Kurtz, Assistant Archivist for Records Services--Washington, DC, and Martha A. Morphy, Assistant Archivist for Information Services. These appointments supersede all previous appointments. Dated: February...
Using ancillary ligands to tune the DNA binding properties of self-assembled luminescent metallomacrocycles.
The optical response, binding parameters, and duplex DNA binding mode of water-soluble kinetically inert tetranuclear metallomacrocycles can all be controlled by judicious selection of ancillary ligands. PMID:24589884
Ahmad, Haslina; Ghosh, Dipesh; Thomas, Jim A
This paper summarizes the current state of art of sampling, characterizing, retrieving, transferring and treating the incidental waste and stabilizing the void space in tank ancillary systems and the needs involved with closure of these systems. The overall effort for closing tank and ancillary systems is very large and is in the initial stages of being addressed in a systematic manner. It was recognized in doing this effort, that gaps in both technology and material application for characterization and removal of residual waste and closure of ancillary systems would be identified. Great efficiencies are to be gained by defining the technology need areas early in the closure process and providing recommendations for technical programs to improve the closure strategies. Therefore, this paper will not only summarize the state of closure of ancillary systems but also provide recommendations to address the technology gaps identified in this assessment.
Burns, H; Sharon Marra, S; Christine Langton, C
Extending NASA's SPICE ancillary information system to meet future mission needs
This paper summarizes the architecture, capabilities, characteristics and uses of the current SPICE ancillary information system, and then outlines plans and ideas for how this system can be extended to meet future space mission requirements.
Acton, C.; Bachman, N.; Elson, L.; Semenov, B.; Turner, F.; Wright, E.
Neutral and zwitterionic group 4 metal alkyls with ancillary boroxide ligands.
The boroxide anion, [OB(mes)(2)](-), has been applied as an ancillary ligand to generate electron-deficient group 4 metal alkyls; however, the enhanced electrophilicity results in formation of tight ion-pairs in solution. PMID:15510256
Cole, Sarah C; Coles, Martyn P; Hitchcock, Peter B
ECCAD : Emissions of Atmospheric Compounds and Compilation of Ancillary Data
There is considerable uncertainty in estimating surface emissions of atmospheric compounds for the recent past and up to now, no single data set exists which would describe the geographical and temporal distribution of emissions for all species relevant to air quality, atmospheric composition change and climate change in a comprehensive and consistent manner. We will describe the ECCAD project, which has two major goals. The first goal is to provide scientific users with an easy access to a large number of existing datasets on surface emissions of atmospheric compounds at the global and regional scales. We are also providing access to ancillary data required to quantify surface emissions. The other goal is to provide data manipulation tools as well as statistical information over the different regions (climatic regions, continents, oceans, OECD regions, etc.). These tools allow an easy identification of each dataset characteristicss and differences between the datasets. Visualization tools are also provided, and the users can download the data of interest. The data in ECCAD are currently used in different international projects. The most recent addition to the database include the emissions developed in support of the IPCC AR5 report, and the data used in the MACC and CITYZEN European projects. The emissions are provided as gridded data at a 0.5 or 1� spatial resolution. Time periodicity and temporal coverage periods vary among the datasets from one year to up to 150 years. The database will be described, and examples of the tools will be presented. We will also provide information on the access to the datasets.
Sabine, Darras; Claire, Granier; Vincent, Pignot; Renaud, Bodichon; Aude, Mieville; Cathy, Liousse; Mireille, Paulin; Cathy, Boonne
ECCAD : Emission of Atmospheric Compounds & Compilation of Ancillary Data
There is considerable uncertainty in estimating surface emissions of atmospheric compounds for the recent past and up to now, no single data set exists which would describe the geographical and temporal distribution of emissions for all species relevant to air quality, atmospheric composition change and climate change in a comprehensive and consistent manner. We will describe the ECCAD project, which has two major goals. The first goal is to provide scientific users with an easy access to a large number of existing datasets on surface emissions of atmospheric compounds at the global and regional scales. We are also providing access to ancillary data required to quantify surface emissions. The other goal is to provide data manipulation tools as well as statistical information over the different regions (climatic regions, continents, oceans, OECD regions, etc.). These tools allow an easy identification of each dataset characteristics and differences between the datasets. Visualization tools are also provided, and the users can download the data of interest. The data in ECCAD are currently used in different international projects. The most recent addition to the database include the emissions developed in support of the IPCC AR5 report, and the data used in the MACC and CITYZEN European projects. The emissions are provided as gridded data at a 0.5 or 1� spatial resolution. Time periodicity and temporal coverage periods vary among the datasets from one year to up to 150 years. The database will be described, and examples of the tools will be presented. We will also provide information on the access to the datasets.
Darras, S.; Granier, C.; Pignot, V.; Bodichon, R.; Boonne, C.; Liousse, C.; Paulin, M.
77 FR 2090 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Servicing...
...Servicing Multi-Piece and Single Piece Rim Wheels Standard ACTION: Notice...Servicing Multi-Piece and Single Piece Rim Wheels Standard,'' to the Office of Management...Servicing Multi-Piece and Single Piece Rim Wheels Standard include a requirement...
INTELLIGENT WIRELESS WEB SERVICES FOR TOURISM: A review of the enabling technologies
Intelligent wireless web (IWW) services could provide mobile tourists highly precise data and services on an as-needed basis, with flexibility of use for the user. The vision of IWW goes beyond just connecting mobile devices to the Internet. It encompasses the creation of a pervasive, user centred mobile environment, which has the ability to provide highly specific data and services
Dimitris N. Kanellopoulos
75 FR 13129 - General Services Administration Acquisition Regulation; Submission for OMB Review; Sales Practice...
...Supplies and/or Services With Market Pricing Without an Established Catalog Price AGENCY...Supplies and/or Services with Market Pricing without an Established Catalog Price...Supplies and/or Services with Market Pricing without an Established Catalog...
Review of In-Service Inspection and Repair Technique Developments for French Liquid Metal Fast Reactors
In-service monitoring of nuclear plants is indispensable for both the Operator and the Regulator. The notion of in-service monitoring ranges from the continuous monitoring of the reactor in operation to the thorough in-service reactor inspection during programmed shutdowns. However, the highly specific environment found in French liquid metal fast reactor plants - Phenix and Superphenix - makes monitoring and inspection
Delivery of mobile clinic services to migrant and seasonal farmworkers: a review of practice models for community-academic partnerships.
Farmworkers in the US are a medically underserved group, who are largely uninsured, foreign-born, and working in a hazardous industry. This review addresses the challenges of providing health services for this priority population to study the numerous health access barriers that face migrant and seasonal farmworkers (MSFW), evaluates the services provided at mobile clinics, summarizes practice models for community-academic partnerships, and synthesizes the literature on effective partnership approaches to deliver these services. Because MSFW are a difficult group to reach and access, mobile farmworker clinics provide an opportunity for unique student training experiences, in addition to small survey and feasibility studies. A literature search was conducted to identify articles for the review. Out of 196 articles identified by the article databases and manual search techniques, 18 articles were finally selected for the review based on predetermined inclusion and exclusion criteria. Half of the articles were classified as case studies or descriptive studies with lessons learned. Only three articles were classified as research studies, and six articles were not classified as research studies, but rather descriptions of the clinics only. Many of the partnership models were structured with the lead agency as either the academic partner or an Area Health Education Center. The academic partner was usually a nursing school, and less frequently a medical school. Other service partners frequently mentioned were federally-qualified Community Health Centers, Migrant Health Centers, and health departments. The review found that service partnerships were characterized by collaboration between academic institutions and community organizations, with a lead agency driving sustainability efforts. PMID:23054421
Luque, John S; Casta�eda, Heide
The net primary productivity (C) or annual rate of carbon accumulation per unit ground area by terrestrial plant communities is the difference of the rate of gross photosynthesis (A(sub g)) and autotrophic respiration (R) per unit ground area. Although available observations show that R is a large and variable fraction of A(sub g), viz., 0.3 to 0.7, it is generally recognized that much uncertainties exist in this fraction due to difficulties associated with the needed measurements. Additional uncertainties arise when these measurements are extrapolated to regional or global land surface using empirical equations, for example, using regression equations relating C to mean annual precipitation and air temperature. Here, a process-based approach has been taken to calculate A(sub g) and R using satellite and ancillary data. A(sub g) has been expressed as a product of radiation use efficiency, magnitude of intercepted photosynthetically active radiation (PAR), and normalized by stresses due to soil water shortage and air temperature away from the optimum range. A biophysical model has been used to determine the radiation use efficiency from the maximum rate of carbon assimilation by a leaf, foliage temperature, and the fraction of diffuse PAR incident on a canopy. All meteorological data (PAR, air temperature, precipitation, etc.) needed for the calculation are derived from satellite observations, while a land use, land cover data (based on satellite and ground measurements) have been used to assess the maximum rate of carbon assimilation by a leaf of varied cover type based on field measurements. R has been calculated as the sum of maintenance and growth components. The maintenance respiration of foliage and live fine roots at a standard temperature of different land cover has been determined from their nitrogen content using field and satellite measurements, while that of living fraction of woody stem (viz., sapwood) from the seasonal maximum leaf area index as determined from satellite observations. These maintenance respiration values were then adjusted to that corresponding to air temperature according to a prescribed non-linear variation of respiration with temperature. The growth respiration has been calculated from the difference of Ag and maintenance respiration, according to the two-compartment model. The results of calculations will be reported for 36 consecutive months (1987-1989) over large contiguous areas (ca. 10(exp 5) sq km) Of agricultural land and tropical humid evergreen forests, and compared with available field data.
Choudhury, B. J.; Houser, Paul (Technical Monitor)
74 FR 31445 - Submission for OMB Review; Comment Request; Collection of Customer Service, Demographic, and...
...Demographic, and Smoking/Tobacco Use Information From NCI Cancer Information Service...Demographic, and Smoking/Tobacco Use Information from NCI Cancer Information Service...1-800-4-CANCER for cancer information...1-877-44U-QUIT for smoking cessations...
Is Telephone Review Feasible and Potentially Effective in Low Vision Services?
Purpose: Demographic transformations within the UK population combine to contribute to a substantial increase in demand for low vision (LV) services, creating a pressing need to reconsider the appropriate methods for service provision. In this study, we evaluate the feasibility of using telephone triage to assess the need for, and timing of, LV�
Parkes, Claire; Lennon, Julie; Harper, Robert
Statistical process control for multistage manufacturing and service operations: a review and some extensions
Manufacturing and service processes today usually involve more than one process stages and operations. With an emphasis on achieving satisfactory product and service quality, multistage processes surveillance and fault diagnosis has become a necessity. Statistical Process Control (SPC) methods have been widely recognised as effective approaches for process monitoring and diagnosis. However, most conventional SPC methods focus on single-stage process
Fugee Tsung; Yanting Li; Ming Jin
Emotional Intelligence and Mentoring in Pre-Service Teacher Education: A Literature Review
In this article, the emerging discourse of "emotional intelligence" is discussed in relation to mentoring in pre-service teacher education. Possible reasons for the neglect of emotion and affect in pre-service teacher education, and in education more broadly, are discussed. The emerging focus on emotion in these fields is also examined in light of�
Hawkey, Kate
Service Learning: History, Literature Review, and a Pilot Study of Eighth Graders.
Within the context of current service learning legislation and litigation, a pilot study investigated effects of a service learning curriculum that was part of middle school advisory and science classes. Quantitative data indicated non-statistically significant growth in self-esteem and motivation. Student journals, essays, interviews, field�
Johnson, Angelina Marie; Notah, Deborah Jean
Review of Comprehensive Outpatient Rehabilitation Facility Therapy Services Provided by Care Alliance of America, Inc.
Comprehensive outpatient rehabilitation facilities (CORF) provide outpatient diagnostic, therapeutic, and restorative services for the rehabilitation of injured, disabled, or sick persons. Sections 4523(d) and 4541 of the Balanced Budget Act of 1997 amend...
77 FR 59004 - Membership of the Senior Executive Service Standing Performance Review Boards
78 FR 56930 - Membership of the Senior Executive Service Standing Performance Review Boards
76 FR 26707 - Appointments to Performance Review Board for Senior Executive Service
...WHO ARE BLIND OR SEVERELY DISABLED Appointments to Performance...Who Are Blind or Severely Disabled. ACTION: Appointment of...Who Are Blind Or Severely Disabled (Committee) has announced...for Senior Executive Service employees: Perry E. Anthony,...
75 FR 10789 - Appointments to Performance Review Board for Senior Executive Service
77 FR 75150 - Appointments to Performance Review Board for Senior Executive Service
76 FR 76697 - Appointments to Performance Review Board for Senior Executive Service
77 FR 31016 - General Services Administration Acquisition Regulation; Submission for OMB Review; GSA Mentor...
...information provided. FOR FURTHER INFORMATION CONTACT: Ms. Kathy Rifkin, Procurement Analyst, General Services Acquisition Policy Division, GSA (816) 823-2170 or via email at firstname.lastname@example.com. SUPPLEMENTARY INFORMATION: A. Purpose...
77 FR 50545 - Members of Senior Executive Service Performance Review Boards
...Associate CIO, Enterprise Services (IT) Michael Danilack, Deputy Commissioner, International...Business and International (LB&I) Jonathan M. Davis, Chief of Staff/Executive...of Business Modernization (SB/ SE) Michael D. Julianelle, Director,...
76 FR 52735 - Members of Senior Executive Service Performance Review Boards
...CIO, Enterprise Services (MITS); Michael Danilack, Deputy Commissioner, International (LB&I); Jonathan M. Davis, Chief of Staff, Office of...Resources and Construction (LB&I); Michael D. Julianelle, Director,...
Limitations in the design of ancillary service markets imposed by communication network delays
Real-time balancing of the European electricity grid will become increasingly dependent on market-based control mechanisms that are enabled by connecting millions of prosumers to an open communication network. The use of communication systems inevitably introduces delays in the energy balancing control loop, which could endanger market operation and stability of the electricity grid. By investigating the interaction between price-based control
R. M. Hermans; A. Jokic?; P. P. J. van den Bosch; J. Frunt; I. G. Kamphuis; C. J. Warmer
A feedback linearization based Wind turbine control system for ancillary services and standard steady state operation
In this paper the control problem of the wind turbine driven doubly fed induction generator (DFIG) is faced, both in wind park operator and system operator perspective. Two control schemes are proposed, based on feedback linearization theory for MIMO systems and PI controllers: the first one for simultaneous active and reactive power regulation, the second one for simultaneous propeller angular
Alessandro Di Giorgio; Laura Pimpinella; Andrea Mercurio
Optimal operation for a wind-hydro power plant to participate to ancillary services
To limit the impact of the intermittence of wind power, a water storage ability of the hydraulic storage plant combined with a wind power plant, called the wind-hydro power system (WS), is used. The main objective is to limit the active power output variations of wind energy resource taking into account the grid needs and the available stored energy. The
P. D. Nguyen Ngoc; T. Pham; S. Bacha; D. Roye
V2G electric power capacity estimation and ancillary service market evaluation
Sharing power assets between transportation and power system is the focus of V2G that can create a compelling new economics. Projected V2G penetration levels across utility customers are a promising clue that V2G may dominate the market in the near future. This will herald evolution of V2G parking lots. This paper describes mathematical model for estimating the electric power capacity
Uwakwe C. Chukwu; Satish M. Mahajan
Provision of ancillary services by dispersed generation and demand side response - needs, barriers and solutions
Summary��In Europe the Dispersed Generation (DG) based on renewable energy sources (RES) and cogeneration of heat and power (CHP) is\\u000a mostly operated without remote control mechanisms, feeding-in a maximum possible power corresponding to the political and\\u000a regulatory framework. The further increase of DG which is aligned with the goals of the European Commission will increase\\u000a their share in the peak
T. Kapetanovic; B. M. Buchholz; V. Buehner
Factors and Models Associated with the amount of Hospital Care Services as Demanded by Hospitalized Patients: A Systematic Review
Background Hospitals are constantly being challenged to provide high-quality care despite ageing populations, diminishing resources, and budgetary restraints. While the costs of care depend on the patients' needs, it is not clear which patient characteristics are associated with the demand for care and inherent costs. The aim of this study was to ascertain which patient-related characteristics or models can predict the need for medical and nursing care in general hospital settings. Methods We systematically searched MEDLINE, Embase, Business Source Premier and CINAHL. Pre-defined eligibility criteria were used to detect studies that explored patient characteristics and health status parameters associated to the use of hospital care services for hospitalized patients. Two reviewers independently assessed study relevance, quality with the STROBE instrument, and performed data analysis. Results From 2,168 potentially relevant articles, 17 met our eligibility criteria. These showed a large variety of factors associated with the use of hospital care services; models were found in only three studies. Age, gender, medical and nursing diagnoses, severity of illness, patient acuity, comorbidity, and complications were the characteristics found the most. Patient acuity and medical and nursing diagnoses were the most influencing characteristics. Models including medical or nursing diagnoses and patient acuity explain the variance in the use of hospital care services for at least 56.2%, and up to 78.7% when organizational factors were added. Conclusions A larger variety of factors were found to be associated with the use of hospital care services. Models that explain the extent to which hospital care services are used should contain patient characteristics, including patient acuity, medical or nursing diagnoses, and organizational and staffing characteristics, e.g., hospital size, organization of care, and the size and skill mix of staff. This would enable healthcare managers at different levels to evaluate hospital care services and organize or reorganize patient care.
van Oostveen, Catharina J.; Ubbink, Dirk T.; Huis in het Veld, Judith G.; Bakker, Piet J.; Vermeulen, Hester
Efficiency in the Consumption of Health Services: Concepts and Research Needs. Phase 1: Review of Concepts and Literature, and Preliminary Field Design.
This paper develops a conceptual framework for analyzing 'consumption inefficiencies' in the provision of government health services in developing countries, and also reviews the empirical literature in this field. The inefficiencies, causing health losse...
B. Vissandjee C. Kolars C. Peters R. Barlow
Screening for Child and Adolescent Depression in Primary Care Settings: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Evidence Synthesis Number 69.
This systematic review to aid the United States Preventive Services Task Force (USPSTF) in updating its 2002 recommendation on screening for child and adolescent depression among average-risk, primary care populations. This report summarizes the evidence ...
E. O'Connor E. Whitlock M. Eder S. B. Williams
Top-to-Bottom Review. (Food Safety and Inspection Service). Preliminary Report. Volume 4. FSIS Resource Allocation and Other Administrative Subjects.
75 FR 65528 - Membership of the National Science Board's Senior Executive Service Performance Review Board
...NATIONAL SCIENCE FOUNDATION Membership of the National...Performance Review Board AGENCY: National Science Foundation. ACTION: Announcement of Membership of the National Science Foundation's Performance...
The International Latitude Service A Historical Review, From The Beginning To Its Foundation In 1899 And The Period Until 1922
The study of Polar Motion (PM) is associated withthe work of the InternationalLatitude Service (ILS), the International PolarMotion Service (IPMS) and theBureau International de l'Heure (BIH), andthen the International Earth RotationService (IERS). After reviewing briefly thehistory of early PM research, thescientific objective of the ILS including itsrealizing, and the activities of all thecited services and giving information on thePM time series available from mid-19thcentury to the present, important details onthe events and results are presentedover the period until 1922. It is shown, inwhich way the Geodetic Institute Potsdamcontributed to the foundation of the ILS andtook part in its activities through thework of Helmert, Albrecht, Wanach and Mahnkopf.Based on international scientificcooperation, the results were the rectangularcoordinates of the Polar Motion from1890.0 to 1922.7 at 0.1 year intervals, inparticular those derived from the latitudeobservations at independent stations from 1890.0to 1899.8, and those derived fromthe latitude observations at the ILS stationsfrom 1899.9 to 1922.7.
H�pfner, Joachim
Muscle Contraction and Force: the Importance of an Ancillary Network, Nutrient Supply and Waste Removal
Muscle contraction studies often focus solely on myofibres and the proteins known to be involved in the processes of sarcomere shortening and cross-bridge cycling, but skeletal muscle also comprises a very elaborate ancillary network of capillaries, which not only play a vital role in terms of nutrient delivery and waste product removal, but are also tethered to surrounding fibres by collagen �wires�. This paper therefore addresses aspects of the ancillary network of skeletal muscle at both a microscopic and functional level in order to better understand its role holistically as a considerable contributor to force transfer within muscular tissue.
Bruggemann, Dagmar A.; Risbo, Jens; Pierzynowski, Stefan G.; Harrison, Adrian P.
Muscle contraction and force: the importance of an ancillary network, nutrient supply and waste removal.
Muscle contraction studies often focus solely on myofibres and the proteins known to be involved in the processes of sarcomere shortening and cross-bridge cycling, but skeletal muscle also comprises a very elaborate ancillary network of capillaries, which not only play a vital role in terms of nutrient delivery and waste product removal, but are also tethered to surrounding fibres by collagen "wires". This paper therefore addresses aspects of the ancillary network of skeletal muscle at both a microscopic and functional level in order to better understand its role holistically as a considerable contributor to force transfer within muscular tissue. PMID:19325816
Br�ggemann, Dagmar A; Risbo, Jens; Pierzynowski, Stefan G; Harrison, Adrian P
Benthic macrofauna and ancillary data for San Francisco Bay, California, March to November 1987
Benthic macrofauna and ancillary data were collected during 1987 as part of the U.S. Geological Survey Regional Effects Monitoring Program in San Francisco Bay, California. Data were collected during five cruises at 2-month intervals from March through November. Benthic macrofauna for identification of species and sediment for size analysis were sampled at eight stations. Ancillary data, which consisted of salinity, temperature, dissolved-oxygen concentrations, and suspended sediment, were collected at 12 stations. Salinity and temperature were measured at three stations that coincided with continuous water quality monitors. Abundances and geographical distributions of a newly introduced species of clam were measured. (USGS)
Schemel, Laurence E.; Ota, A. Y.; Harmon, J. G.; Shay, J. M.; Adorado,R. N.
Iridacyclobutanes: Nucleophilic addition to [eta][sup 3]-allyl complexes of iridium bearing reactive ancillary ligands
This investigation concerns the formation of metallacyclobutane complexes via central carbon nucleophilic addition to [eta][sup 3]-allyl complexes bearing reactive ancillary ligands and is intended to demonstrate the potential for application of such metallacyclobutane formation to organic synthesis. The effect of the ancillary ligand on the reactivity of the [eta][sup 3]-allyl complex and the potential for elaborating the targeted metallacycle via insertion of small molecules is examined. Ethylene-enabled allylic activation of monoolefins using the dicationic template, [Cp*Ir(acetone)[sub 3
Wakefield, J.B.
Clinical uncertainties, health service challenges, and ethical complexities of HIV "test-and-treat": a systematic review.
Despite the HIV "test-and-treat" strategy's promise, questions about its clinical rationale, operational feasibility, and ethical appropriateness have led to vigorous debate in the global HIV community. We performed a systematic review of the literature published between January 2009 and May 2012 using PubMed, SCOPUS, Global Health, Web of Science, BIOSIS, Cochrane CENTRAL, EBSCO Africa-Wide Information, and EBSCO CINAHL Plus databases to summarize clinical uncertainties, health service challenges, and ethical complexities that may affect the test-and-treat strategy's success. A thoughtful approach to research and implementation to address clinical and health service questions and meaningful community engagement regarding ethical complexities may bring us closer to safe, feasible, and effective test-and-treat implementation. PMID:23597344
Kulkarni, Sonali P; Shah, Kavita R; Sarma, Karthik V; Mahajan, Anish P
The Integration of Counseling and Nursing Services into Schools: A Comparative Review
The purpose of this comparative review was to examine the legislative evolution of school guidance and school nursing over the past century, in hopes of identifying reasons why guidance counselors have been more successful in compliance to recommended ratios than school nurses. A literature review was conducted including CINAHL, MEDLINE, ERIC and�
Maughan, Erin; Troup, K. D.
The implications of the feminization of the primary care physician workforce on service supply: a systematic review.
There is a widespread perception that the increasing proportion of female physicians in most developed countries is contributing to a primary care service shortage because females work less and provide less patient care compared with their male counterparts. There has, however, been no comprehensive investigation of the effects of primary care physician (PCP) workforce feminization on service supply. We undertook a systematic review to examine the current evidence that quantifies the effect of feminization on time spent working, intensity and scope of work, and practice characteristics. We searched Medline, Embase, and Web of Science from 1991 to 2013 using variations of the terms 'primary care', 'women', 'manpower', and 'supply and distribution'; screened the abstracts of all articles; and entered those meeting our inclusion criteria into a data abstraction tool. Original research comparing male to female PCPs on measures of years of practice, time spent working, intensity of work, scope of work, or practice characteristics was included. We screened 1,271 unique abstracts and selected 74 studies for full-text review. Of these, 34 met the inclusion criteria. Years of practice, hours of work, intensity of work, scope of work, and practice characteristics featured in 12%, 53%, 42%, 50%, and 21% of studies respectively. Female PCPs self-report fewer hours of work than male PCPs, have fewer patient encounters, and deliver fewer services, but spend longer with their patients during a contact and deal with more separate presenting problems in one visit. They write fewer prescriptions but refer to diagnostic services and specialist physicians more often. The studies included in this review suggest that the feminization of the workforce is likely to have a small negative impact on the availability of primary health care services, and that the drivers of observed differences between male and female PCPs are complex and nuanced. The true scale of the impact of these findings on future effective physician supply is difficult to determine with currently available evidence, given that few studies looked at trends over time, and results from those that did are inconsistent. Additional research examining gender differences in practice patterns and scope of work is warranted. PMID:24898264
Hedden, Lindsay; Barer, Morris L; Cardiff, Karen; McGrail, Kimberlyn M; Law, Michael R; Bourgeault, Ivy L
The implications of the feminization of the primary care physician workforce on service supply: a systematic review
There is a widespread perception that the increasing proportion of female physicians in most developed countries is contributing to a primary care service shortage because females work less and provide less patient care compared with their male counterparts. There has, however, been no comprehensive investigation of the effects of primary care physician (PCP) workforce feminization on service supply. We undertook a systematic review to examine the current evidence that quantifies the effect of feminization on time spent working, intensity and scope of work, and practice characteristics. We searched Medline, Embase, and Web of Science from 1991 to 2013 using variations of the terms �primary care�, �women�, �manpower�, and �supply and distribution�; screened the abstracts of all articles; and entered those meeting our inclusion criteria into a data abstraction tool. Original research comparing male to female PCPs on measures of years of practice, time spent working, intensity of work, scope of work, or practice characteristics was included. We screened 1,271 unique abstracts and selected 74 studies for full-text review. Of these, 34 met the inclusion criteria. Years of practice, hours of work, intensity of work, scope of work, and practice characteristics featured in 12%, 53%, 42%, 50%, and 21% of studies respectively. Female PCPs self-report fewer hours of work than male PCPs, have fewer patient encounters, and deliver fewer services, but spend longer with their patients during a contact and deal with more separate presenting problems in one visit. They write fewer prescriptions but refer to diagnostic services and specialist physicians more often. The studies included in this review suggest that the feminization of the workforce is likely to have a small negative impact on the availability of primary health care services, and that the drivers of observed differences between male and female PCPs are complex and nuanced. The true scale of the impact of these findings on future effective physician supply is difficult to determine with currently available evidence, given that few studies looked at trends over time, and results from those that did are inconsistent. Additional research examining gender differences in practice patterns and scope of work is warranted.
Using Ancillary Information to Reduce Sample Size in Discovery Sampling and the Effects of Measurement Error
Discovery sampling is a tool used in a discovery auditing. The purpose of such an audit is to provide evidence that some (usually large) inventory of items complies with a defined set of criteria by inspecting (or measuring) a representative sample drawn from the inventory. If any of the items in the sample fail compliance (defective items), then the audit has discovered an impropriety, which often triggers some action. However finding defective items in a sample is an unusual event--auditors expect the inventory to be in compliance because they come to the audit with an ''innocent until proven guilty attitude''. As part of their work product, the auditors must provide a confidence statement about compliance level of the inventory. Clearly the more items they inspect, the greater their confidence, but more inspection means more cost. Audit costs can be purely economic, but in some cases, the cost is political because more inspection means more intrusion, which communicates an attitude of distrust. Thus, auditors have every incentive to minimize the number of items in the sample. Indeed, in some cases the sample size can be specifically limited by a prior agreement or an ongoing policy. Statements of confidence about the results of a discovery sample generally use the method of confidence intervals. After finding no defectives in the sample, the auditors provide a range of values that bracket the number of defective items that could credibly be in the inventory. They also state a level of confidence for the interval, usually 90% or 95%. For example, the auditors might say: ''We believe that this inventory of 1,000 items contains no more than 10 defectives with a confidence of 95%''. Frequently clients ask their auditors questions such as: How many items do you need to measure to be 95% confident that there are no more than 10 defectives in the entire inventory? Sometimes when the auditors answer with big numbers like ''300'', their clients balk. They balk because a big sample size might bust the budget, or the number seems intuitively excessive. To reduce the sample size, you can increase the tolerable number of defectives, the ''10'' in the preceding example, or back off on the confidence level, say from 95% to 90%. Auditors also frequently bump up the sample size as a safety factor. They know that something can go wrong. For example, they might find out that the measurements or inspections were subject to errors. Unless the auditors know exactly how measurement error affects sample size, they might be forced to give up the safety factor. Clients often choose to ''live dangerously'' (without a compelling argument to the contrary) to save money. Thus, sometimes the auditor finds that ''you just can't get there from here'', because the goals of the audit and the resources available are inherently in conflict. For discovery audits, there is a way out of this apparent conundrum. It turns out that the classical method of confidence intervals uses an implicit and very conservative assumption. We will see that this assumption is too pessimistic and too conservative in the context of a discovery audit. If we abandon this assumption and use ancillary information about the inventory, then we can significantly reduce the sample size required to achieve the desired confidence level. We will see exactly how the classical method ignores this ancillary information and misses the opportunity for an efficient audit. In the following sections, we first review the standard approach using confidence intervals. Then we present a method that incorporates the ancillary information about the inventory to design a very efficient discovery audit. We also provide results on how measurement errors affect the audit, and how exactly how much the sample size must be modified to compensate for these errors. Finally, we state asymptotic formulas that provide useful approximations for large inventories. It is suggested that the reader review the glossary of symbols while reading the body and the appendices as there are numerous special symbols and notati
Axelrod, M
Financial incentives for return of service in underserved areas: a systematic review
BACKGROUND: In many geographic regions, both in developing and in developed countries, the number of health workers is insufficient to achieve population health goals. Financial incentives for return of service are intended to alleviate health worker shortages: A (future) health worker enters into a contract to work for a number of years in an underserved area in exchange for a
Till B�rnighausen; David E. Bloom
Maximizing Child Care Services: The Role of Owners and Boards. A Discussion Paper [and] Legislation Review.
The Early Childhood Development Communique articulated a commitment to increasing positive outcomes for children from birth to age 6 in Canada. Noting that owners and boards of child care programs are charged with providing a quality service to young children and their families, this discussion paper articulates the owners' and boards'�
Ferguson, E. Elaine; Ferguson, Tammy McCormick; Jacobs, John
With the ever increasing focus on cost reduction, product leadership and customer intimacy, the need for Supply Chain Management practices rises across many industries. Over the last two decades Logistics Service Providers have become important players in many chains and industries. New challenges arise due to the emergence of technologies. Data and information can be found anywhere, however, to make
Elfriede Krauth; Hans Moonen; Viara Popova; Martijn Schut
Alcohol Services for Mexican Americans: A Review of Utilization Patterns, Treatment Considerations and Prevention Activities
There currently exists an information gap between researchers and providers of services aimed at the Mexican American alcoholic population. While epidemiologic-based information has surfaced, providing more detailed information on high-risk segments of the Mexican American population, currently little is known with respect to the forms of alcohol treatment most relevant and effective in alleviating abuse and dependency in this ethnic
M. Jean Gilbert; Richard C. Cervantes
A Review of Processes and Outcomes in Family-Centered Services for Children with a Disability
The importance of being family centered when providing services to children with a disability and their families has gained currency in the research and practice literature. A growing body of evidence has validated many of the theoretical links between the help-giving practices of staff and desirable outcomes for families with a child with a�
Dempsey, Ian; Keen, Deb
Effective financing of maternal health services: A review of the literature
Health care can be funded in a number of ways ranging from direct user charges (out of pocket) payments to indirect methods that pool across time (prepayment) and across different risk and wealth groups (insurance and general taxation). All these methods can be used to finance maternal health services. When assessing the impact of financing mechanisms it is important to
Tim Ensor; Jeptepkeny Ronoh
A Review of ICT Related Courses in Pre-Service Teacher Education Programs
This study investigated teacher educators', prospective teachers', and K-12 teachers' opinions about the effectiveness of ICT related courses and the ways to improve the courses in Turkey's pre-service teacher education programs. The researchers used both quantitative and qualitative research approaches within the data collection and analysis�
Goktas, Yuksel; Yildirim, Zahide; Yildirim, Soner
A Review of Selected Ecosystem Services Supplied by Coastal Wetlands of the Laurentian Great Lakes
EPA Science Inventory
Significant ecosystem services derive from the coastal wetlands of the Laurentian Great Lakes even though they have undergone substantial declines since European settlement. Basin-wide, two-thirds of the original coastal wetlands have been lost, and the remaining 126,000 ha of US...
Patterns of health service use and child abuse or neglect in young childhood: a systematic review
BackgroundEvidence suggests that abused and neglected children have higher rates of healthcare need than non-abused or neglected children. Higher healthcare need should result in more frequent use of healthcare services. However, there is growing evidence that abused or neglected children do not attend emergency departments more frequently than other similar children. Understanding patterns of healthcare use among abused or neglected
J Woodman; M Brandon; D Glaser; R Gilbert
77 FR 40883 - General Services Administration Acquisition Regulation; Submission for OMB Review; Identification...
...Secretariat will be submitting to the Office of Management and Budget (OMB) a request to review and approve an extension of...Multiple Award Schedule Contracts to identify in their GSA price lists those products that they market commercially that...
75 FR 13130 - General Services Administration Acquisition Regulation; Submission for OMB Review; Submission and...
...Authorized FSS Schedule Price Lists, Contract Price Lists, and Dissemination of Information...the Office of Management and Budget (OMB) a request to review and...Distribution of Authorized FSS Schedule Price Lists, Contract Price Lists,...
Annual Reviews of User Accounting Controls for the Washington Headquarters Services Allotment Accounting System.
The purpose of annual accounting system reviews is to determine whether DoD accounting systems are in compliance with accounting principles, standards, and related accounting requirements established by the General Accounting Office, the Office of Managem...
78 FR 11188 - General Services Administration Regulation; Submission for OMB Review; Packing List Clause
...Regulation; Submission for OMB Review; Packing List Clause AGENCY: Office of Acquisition...information collection requirement regarding the packing list clause. A notice was published in...by Information Collection 3090- 0246, Packing List Clause, by any of the...
75 FR 1788 - General Services Administration Regulation; Submission for OMB Review; Packing List Clause
...Regulation; Submission for OMB Review; Packing List Clause AGENCY: Office of Acquisition...information collection requirement regarding the packing list clause. A request for public comments...Please cite OMB Control No. 3090-0246, Packing List Clause, in all...
75 FR 21716 - Agency Information Collection; Activity Under OMB Review; Airline Service Quality Performance...
...agencies outside BTS for review, analysis and possible use in regulatory and other administrative matters. Anne Suissa, Director, Office of Airline Information. [FR Doc. 2010-9556 Filed 4-23-10; 8:45 am] BILLING CODE...
Undocumented Migrants in Canada: A Scope Literature Review on Health, Access to Services, and Working Conditions
It is estimated that there are 30�40 million undocumented workers worldwide. Although undocumented migration has become an\\u000a issue of high international relevance, it has been strikingly understudied in Canada, especially with respect to its impact\\u000a on health. The purpose of this study is to explore the concept of undocumentedness in Canada through a scoping review of peer-reviewed\\u000a and grey literature
Lilian Magalhaes; Christine Carrasco; Denise Gastaldo
Towards a Global Operational Altimeter Service: RADS
DEOS' anticipation of the need for global altimeter services started the Radar Altimeter Database System (RADS) project. Embedded in the Netherlands Earth Observation NETwork (NEONET), this project is supported by the Dutch government. After defining the database content, collecting altimeter and ancillary data from all available altimeter missions and combining them with the latest (correction) models, we have arrived at
M. Naeije; E. Schrama; L. Mathers; R. Scharroo
Towards A Global Operational Altimeter Service: Rads
DEOS' anticipation of the need for global altimeter services started the Radar Altime- ter Database System (RADS) project. Embedded in the Netherlands Earth Observa- tion NETwork (NEONET), this project is supported by the Dutch government. After defining the database content, collecting altimeter and ancillary data from all available altimeter missions and combining them with the latest (correction) models, we have
Marc Naeije; Eelco Doornbos; Lucy Mathers; Remko Scharroo; Ernst Schrama
Reactions of alkynes and olefins with tantalum hydrides containing aryloxide ancillary ligation: Relevance to catalytic hydrogenation
The reactivity of three tantalum hydride compounds toward olefins and alkynes has been investigated. The reactivity observed is highly dependent on the nature of the ancillary aryloxide ligands. Structural, labeling and mechanistic studies are done to identify the reaction pathways and end-products.
Mulford, D.R.; Clark, J.R.; Schweiger, S.W.; Fanwick, P.E.; Rothwell, I.P.
Regulatory issues associated with closure of the Hanford AX Tank Farm ancillary equipment
Liquid mixed, high-level radioactive waste has been stored in underground single-shell tanks at the US Department of Energy`s (DOE`s) Hanford Site. After retrieval of the waste from the single-shell tanks, the DOE will proceed with closure of the tank farm. The 241-AX Tank Farm includes four one-million gallon single-shell tanks in addition to sluice lines, transfer lines, ventilation headers, risers, pits, cribs, catch tanks, buildings, well and associated buried piping. This equipment is classified as ancillary equipment. This document addresses the requirements for regulatory close of the ancillary equipment in the Hanford Site 241-AX Tank Farm. The options identified for physical closure of the ancillary equipment include disposal in place, disposal in place after treatment, excavation and disposal on site in an empty single-shell tank, and excavation and disposal outside the AX Tank Farm. The document addresses the background of the Hanford Site and ancillary equipment in the AX Tank Farm, regulations for decontamination and decommissioning of radioactively contaminated equipment, requirements for the cleanup and disposal of radioactive wastes, cleanup and disposal requirements governing hazardous and mixed waste, and regulatory requirements and issues associated with each of the four physical closure options. This investigation was conducted by the Sandia National Laboratories, Albuquerque, New Mexico, during Fiscal Year 1998 for the Hanford Tanks Initiative Project.
Becker, D.L.
The Adoption of Technological, Administrative, and Ancillary Innovations: Impact of Organizational Factors
The influence of six organizationalfactors on the adoption of three types of innovations was examined in public libraries. It wasfound that (a) all factors together were a better predictor of technological than administrative or ancillary innovations, and (b) specialization and organizational slack had a stronger effect on technological innovations than the other two types, whereas administrative intensity and organizational size
Fariborz Damanpour
Muscle contraction studies often focus solely on myofibres and the proteins known to be involved in the processes of sarcomere shortening and cross-bridge cycling, but skeletal muscle also comprises a very elaborate ancillary network of capillaries, which not only play a vital role in terms of nutrient delivery and waste product removal, but are also tethered to surrounding fibres by
Dagmar A. Br�ggemann; Jens Risbo; Stefan G. Pierzynowski; Adrian P. Harrison
Improving the Quality of Ability Estimates through Multidimensional Scoring and Incorporation of Ancillary Variables
For one reason or another, various sources of information, namely, ancillary variables and correlational structure of the latent abilities, which are usually available in most testing situations, are ignored in ability estimation. A general model that incorporates these sources of information is proposed in this article. The model has a general�
de la Torre, Jimmy
Empirical study of environmental ancillary benefits due to greenhouse gas mitigation in Korea
This study is a part of the International Co-Control Analysis Program (ICAP), which is an initiative sponsored by the US EPA to assist developing countries in evaluating the environmental and human health benefits of technologies and policies for reducing greenhouse gas emissions. The goal of the Korea study is primarily two-fold: i) to assess and quantify the environmental ancillary benefit
Seunghun Joh; Yun-Mi Nam; ShangGyoo Shim; Joohon Sung; Youngchul Shin
[Ancillary diagnostic imaging is useful if there is atypical evidence of appendicitis].
Patients with an atypical presentation of acute appendicitis may benefit from ancillary diagnostic imaging, especially CT. The literature shows a decrease of the number of negative appendectomies with this approach, and other causes are diagnosed in about one third of the patients. In addition, costs were reduced. Ultrasonography is a good alternative in pregnant women and in women with suspected gynaecological pathology. PMID:17441568
van Gorp, M J; Rutgers, D R; van Leeuwen, M S; Mali, W P T M
An integrative review and evidence-based conceptual model of the essential components of pre-service education
Background With decreasing global resources, a pervasive critical shortage of skilled health workers, and a growing disease burden in many countries, the need to maximize the effectiveness and efficiency of pre-service education in low-and middle-income countries has never been greater. Methods We performed an integrative review of the literature to analyse factors contributing to quality pre-service education and created a conceptual model that shows the links between essential elements of quality pre-service education and desired outcomes. Results The literature contains a rich discussion of factors that contribute to quality pre-service education, including the following: (1) targeted recruitment of qualified students from rural and low-resource settings appears to be a particularly effective strategy for retaining students in vulnerable communities after graduation; (2) evidence supports a competency-based curriculum, but there is no clear evidence supporting specific curricular models such as problem-based learning; (3) the health workforce must be well prepared to address national health priorities; (4) the role of the preceptor and preceptors� skills in clinical teaching, identifying student learning needs, assessing student learning, and prioritizing and time management are particularly important; (5) modern, Internet-enabled medical libraries, skills and simulation laboratories, and computer laboratories to support computer-aided instruction are elements of infrastructure meriting strong consideration; and (6) all students must receive sufficient clinical practice opportunities in high-quality clinical learning environments in order to graduate with the competencies required for effective practice. Few studies make a link between PSE and impact on the health system. Nevertheless, it is logical that the production of a trained and competent staff through high-quality pre-service education and continuing professional development activities is the foundation required to achieve the desired health outcomes. Professional regulation, deployment practices, workplace environment upon graduation and other service delivery contextual factors were analysed as influencing factors that affect educational outcomes and health impact. Conclusions Our model for pre-service education reflects the investments that must be made by countries into programmes capable of leading to graduates who are competent for the health occupations and professions at the time of their entry into the workforce.
Science Enabling Roles and Services of SPDF
The current Heliophysics Science Data Management Policy defines the roles of the Space Physics Data Facility (SPDF) project as a heliophysics active Final Archive, a focus for critical data infrastructure services and a center of excellence for data and ancillary information services. This presentation will highlight some of our current activities and our understanding of why and how our services are useful to researchers, as well as SPDF's programmatic emphasis in the coming year. We will discuss how. in cooperation with the Heliophysics Virtual discipline Observatories (VxOs), we are working closely with the RBSP and MMS mission teams to support their decisions to use CDF as a primary format for their public data products, to leverage the ongoing data flows and capabilities of CDAWeb (directly and through external clients such as Autoplot) to serve their data in a multi-mission context and to use SSCWeb to assist community science planning and analysis. Among other current activities, we will also discuss and demonstrate our continuing effort to make the Virtual Space Physics Observatory (VSPO) service comprehensive in all significant and NASA relevant heliophysics data. The OMNI and OMNI High Resolution datasets remain current and heavily cited in publications. We are expanding our FTP file services to include online archived non-CDF data from all active missions, which is a re-hosting of this function from NSSDC's FTP site. We have extended the definitions of time in CDF to unambiguously and consistently handle leap seconds. We are improving SSCWeb for much faster per1ormance, more capabilities and a web services inter1ace to Query functionality. We will also review how CDAWeb data can be easily accessed within IDL and new features in CDAWeb.
McGuire, Robert E.; Bilitza, Dieter; Candey, Robert M.; Chimiak, Reine A.; Cooper, John F.; Garcia, Leonard N.; Harris, Bernard T.; Johnson, Rita C.; King, Joseph H.; Kovalick, Tamara J.; Lal, Nand; Leckner, Howard A.; Liu, Michael H.; Papitashvili, Natalia E.; Roberts, D. Aaron
The current Heliophysics Science Data Management Policy defines the roles of the Space Physics Data Facility (SPDF) project as a heliophysics active Final Archive, a focus for critical data infrastructure services and a center of excellence for data and ancillary information services. This presentation will highlight some of our current activities and our understanding of why and how our services are useful to researchers, as well as SPDF's programmatic emphasis in the coming year. We will discuss how, in cooperation with the Heliophysics Virtual discipline Observatories (VxOs), we are working closely with the RBSP and MMS mission teams to support their decisions to use CDF as a primary format for their public data products, to leverage the ongoing data flows and capabilities of CDAWeb (directly and through external clients such as Autoplot) to serve their data in a multi-mission context and to use SSCWeb to assist community science planning and analysis. Among other current activities, we will also discuss and demonstrate our continuing effort to make the Virtual Space Physics Observatory (VSPO) service comprehensive in all significant and NASA relevant heliophysics data. The OMNI and OMNI High Resolution datasets remain current and heavily cited in publications. We are expanding our FTP file services to include online archived non-CDF data from all active missions, which is a re-hosting of this function from NSSDC's FTP site. We have extended the definitions of time in CDF to unambiguously and consistently handle leap seconds. We are improving SSCWeb for much faster performance, more capabilities and a web services interface to Query functionality. We will also review how CDAWeb data can be easily accessed within IDL and new features in CDAWeb.
McGuire, R. E.; Bilitza, D.; Candey, R. M.; Chimiak, R. A.; Cooper, J. F.; Garcia, L. N.; Harris, B. T.; Johnson, R. C.; King, J. H.; Kovalick, T. J.; Lal, N.; Leckner, H. A.; Liu, M. H.; Papitashvili, N. E.; Roberts, D.
Use of a systematic review to inform the infection risk for biomedical engineers and technicians servicing biomedical devices.
Many microorganisms responsible for hospital-acquired infections are able to stay viable on surfaces with no visible sign of contamination, in dry conditions and on non-porous surfaces. The infection risk to biomedical staff when servicing biomedical devices is not documented. An indirect approach has been used to examine the different aspects that will affect the risk of infection including a systematic review of microbial contamination and transmission relating to biomedical devices. A systematic review found 58% of biomedical devices have microbial contamination with 13% having at least one pathogenic organism. These microbes can persist for some months. Occupational-infections of biomedical service staff are low compared to other healthcare workers. A biomedical device with contaminated surface or dust was identified as the source of patient outbreaks in 13 papers. The cleaning agent most tested for removal of micro-organisms from devices was alcohol swabs, but sterile water swabs were also effective. However, manufacturers mainly recommend (74%) cleaning devices with water and detergent. Biomedical engineers and technicians have a small risk of being exposed to dangerous micro-organisms on most biomedical devices, but without skin breakage, this exposure is unlikely to cause ill-health. It is recommended that biomedical staff follow good infection control practices, wipe devices with detergent, sterile water or alcohol swabs as recommended by the manufacturer before working on them, and keep alcohol hand rubs accessible at all benches. PMID:22015848
Smith, Anne-Louise
How close have universal health systems come to achieving equity in use of curative services? A systematic review.
Most governments in established market economies have developed universal systems of health care, but these are being increasingly threatened by widespread health sector reforms. Hence, it is more important than ever to monitor the effects of policy changes on the ability of universal systems to achieve their equity goals. This article provides evidence for such monitoring. The authors present the results of a systematic review of equity in use of curative health services in universal systems, together with a critical appraisal of the essential components of studies to address this question. Of the 79 studies identified that addressed the review question, only 26 met the inclusion criteria and adjusted for differential health need across socioeconomic groups. The authors found a pro-rich bias in use of specialist hospital services and a reasonably equitable access to primary health care by different socioeconomic groups. There was a wide inter-study variation in the difference in utilization rates between people of high and low socioeconomic groups. Improvements are needed in the way that equity in universal systems is monitored, with particular attention to how "need" is defined and to the impact on patients of indirect costs. PMID:17436987
Hanratty, Barbara; Zhang, Tuohong; Whitehead, Margaret
Things That Work: Roles and Services of SPDF
The current Heliophysics Science Data Management Policy (HpSDMP) defines the roles of the Space Physics Data Facility (SPDF) project as a heliophysics active Final Archive (aFA), a focus for critical data infrastructure services and a center of excellence for data and ancillary information services. This presentation will highlight (1) select current SPDF activities, (2) the lessons we are continuing to
R. E. McGuire; D. Bilitza; R. M. Candey; R. A. Chimiak; J. F. Cooper; L. N. Garcia; D. B. Han; B. T. Harris; R. C. Johnson; J. H. King; T. J. Kovalick; N. Lal; H. A. Leckner; M. H. Liu; N. E. Papitashvili; D. Roberts
Gender-Related Barriers and Delays in Accessing Tuberculosis Diagnostic and Treatment Services: A Systematic Review of Qualitative Studies
Background. Tuberculosis (TB) remains a significant global public health problem with known gender-related (male versus female) disparities. We reviewed the qualitative evidence (written/spoken narrative) for gender-related differences limiting TB service access from symptom onset to treatment initiation. Methods. Following a systematic process, we searched 12 electronic databases, included qualitative studies that assessed gender differences in accessing TB diagnostic and treatment services, abstracted data, and assessed study validity. Using a modified �inductive coding� system, we synthesized emergent themes within defined barriers and delays limiting access at the individual and provider/system levels and examined gender-related differences. Results. Among 13,448 studies, 28 studies were included. All were conducted in developing countries and assessed individual-level barriers; 11 (39%) assessed provider/system-level barriers, 18 (64%) surveyed persons with suspected or diagnosed TB, and 7 (25%) exclusively surveyed randomly sampled community members or health care workers. Each barrier affected both genders but had gender-variable nature and impact reflecting sociodemographic themes. Women experienced financial and physical dependence, lower general literacy, and household stigma, whereas men faced work-related financial and physical barriers and community-based stigma. Conclusions. In developing countries, barriers limiting access to TB care have context-specific gender-related differences that can inform integrated interventions to optimize TB services.
Akande, Tokunbo; Shankar, Anita V.; McIntire, Katherine N.; Gounder, Celine R.; Gupta, Amita; Yang, Wei-Teng
Suicide: A review of calls to an adolescent peer listening phone service
Calls about suicide to a teen peer listening phone service over a period of 5 1\\/2 years are described. The majority of those\\u000a calling about suicide were females. The phone contacts were of longer duration and later in the evening than calls about other\\u000a concerns. Those concerned with suicide also discussed other serious issues such as selfesteem, family problems, substance
Kathryn E. Boehm; Nancy B. Campbell
78 FR 78415 - Submission for Review: Customer Service Surveys, OMB Control No. 3206-0236
The Office of Personnel Management (OPM) offers the general public and other Federal agencies the opportunity to comment on the information collection request (ICR) 3206-0236, Customer Service Surveys. As required by the Paperwork Reduction Act of 1995, (Pub. L. 104-13, 44 U.S.C. chapter 35) as amended by the Clinger-Cohen Act (Pub. L. 104-106), OPM is soliciting comments for this collection. The......
78 FR 78416 - Submission for Review: Program Services Evaluation Surveys, OMB Control No. 3206-0252
The Office of Personnel Management (OPM) offers the general public and other Federal agencies the opportunity to comment on the information collection request (ICR) 3206-0252, Program Services Evaluation Surveys. As required by the Paperwork Reduction Act of 1995, (Pub. L. 104-13, 44 U.S.C. chapter 35) as amended by the Clinger-Cohen Act (Pub. L. 104-106), OPM is soliciting comments for this......
75 FR 35092 - Submission for Review: Program Services Evaluation Surveys, OMB Control No. 3206-NEW
The Office of Personnel Management (OPM) offers the general public and other federal agencies the opportunity to comment on a new information collection request (ICR) 3206-NEW, Program Services Evaluation Surveys. As required by the Paperwork Reduction Act of 1995, (Pub. L. 104-13, 44 U.S.C. chapter 35), as amended by the Clinger-Cohen Act (Pub. L. 104-106), OPM is soliciting comments for this......
Complete denture services: clinical technique, lab costs, manpower, and reimbursement. One-year review.
Complete denture services at comprehensive care public health clinics are not common in part because of clinician concerns regarding outcomes. Educational debt forgiveness has attracted recent dental graduates to public health dentistry; however, not all recent graduates receive denture education experiences necessary to attain proficiency. While fundamental patient assessment and denture construction are taught, psychological assessment and communication with denture patients requires experience. A thorough understanding of occlusion, phonetics, esthetics and laboratory steps is also necessary. Expecting recent dental graduates to become proficient providing complete dentures at minimal reimbursement levels, with no mentorship or on-site laboratory support, is unrealistic. Public health dental clinics operate at full capacity performing emergency, preventive and restorative procedures. Complete dentures come with a laboratory fee approximately one-half the total reimbursement, meaning a remake drops clinic revenue to zero while doubling expenses. It is understandable that full schedules, marginal reimbursement, unpredictability and the risk of an occasional failure block clinician interest in providing denture services. This one-year report of services describes a three-appointment complete denture technique offering improved patient and laboratory communication, reduced chair time and controlled cost, resulting in high-quality complete dentures. PMID:22013657
Ewoldsen, Nels
Functional design criteria W-367, 222-S ancillary equipment addition
This paper reviews the designs and performance of tubular solid oxide fuel cells (SOFCs). A large number of tubular cells of the porous support tube type have been electrically tested, some to times over 50,000 hours; these cells have shown excellent performance and performance stability. Since 1984, successfully larger electrical generators utilizing these cells have been built and operated; a 20 kW integrated SOFC system operated for 7064 hours during 1993-1994. Results of development efforts to reduce cost and increase power output of tubular cells by eliminating porous support tube and increasing active length are described, and plans to utilize such air electrode supported cells in future SOFC systems are discussed.
McVey, C.B.
Evaluation of Landscape Structure Using AVIRIS Quicklooks and Ancillary Data
Currently the best tool for examining landscape structure is remote sensing, because remotely sensed data provide complete and repeatable coverage over landscapes in many climatic regimes. Many sensors, with a variety of spatial scales and temporal repeat cycles, are available. The Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) has imaged over 4000 scenes from over 100 different sites throughout North America. For each of these scenes, one-band "quicklook" images have been produced for review by AVIRIS investigators. These quicklooks are free, publicly available over the Internet, and provide the most complete set of landscape structure data yet produced. This paper describes the methodologies used to evaluate the landscape structure of quicklooks and generate corresponding datasets for climate, topography and land use. A brief discussion of preliminary results is included at the end. Since quicklooks correspond exactly to their parent AVIRIS scenes, the methods used to derive climate, topography and land use data should be applicable to any AVIRIS analysis.
Sanderson, Eric W.; Ustin, Susan L.
BOOK REVIEW Search for Life BOOK REVIEW Health Physics BOOK REVIEW Language and Literacy in Science Education BOOK REVIEW Science Web Reader�Physics Correction GCSE BOOK REVIEW Physics for Higher Tier GCSE BOOK REVIEW Modular Science GCSE BOOK REVIEW Modular Science for AQA: Foundation level and Higher level GCSE BOOK REVIEW Physics for OCR A GCSE BOOK REVIEW Physics Matters, 3rd edition GCSE BOOK REVIEW Physics GCSE BOOK REVIEW Science Foundations: Physics (new edition) GCSE BOOK REVIEW Target Science: Physics Foundation Tier GCSE BOOK REVIEW Target Science: Physics Foundation Tier: AQA WEB WATCH Medical physics organizations
Male sexual assault victims: a selective review of the literature and implications for support services
In recent years much has been done to publicize the plight of female rape victims. However, the sexual assault of adult males has received little attention in the research literature or by the public. This paper provides a selective review of the research into the prevalence and effects of male sexual assault victims. Research shows that the effects of sexual
Michelle Davies
Review of Education Services in Juvenile Justice Residential Facilities. Report No. 98-28.
The results of a performance review of educational programs for youth in residential commitment facilities are presented including background, methodology, and findings. Most juvenile justice students enter residential programs performing below their grade level in reading and math but improve by at least one grade level during their stay.�
Florida State Legislature, Tallahassee. Office of Program Policy Analysis and Government Accountability.
The Service Syndrome: A Book Review of Mental Health on the Campus: A Field Study.
A study sponsored by the American Psychiatric Association and the National Association for Mental Health, in which an average of five professionals each visited seven college campuses during the year 1971-1972 is reviewed. A rich catalogue of mental healt...
R. K. Yin
School Health Nursing Services Progress Review: Report of 1996 National Meeting.
Presents information from a 1996 meeting by the Centers for Disease Control and Prevention's Division of Adolescent and School Health and the American Nurses Association's National Center for School Health Nursing. Participants reviewed progress since 1994 on seven critical needs, updated priority actions, determined strategies for achieving�
Brainerd, Elaine
Disturbance ecology and forest management: A review of the literature. Forest Service general technical report
This review highlights recent work in a broad array of studies related to disturbance ecology. This publication is a resource for managers and researchers interested in disturbance theory, specific disturbance agents, their interactions, and appropriate methods of inquiry for specific geographic regions.
Rogers, P.
Letter Health Consultation: Review of Groundwater Sampling Data, Arkansas Fly Service Water Well, Brady, Arkansas.
On the basis ofa review of the groundwater sampling data collected on 08/07/07 and 11/14/07, by the Arkansas State Plant Board (ASPB) for commercial well Laffayette-06 in Bradley, AR, the Arkansas Department of Health (ADH),in a cooperative agreement with...
78 FR 22490 - Administrative Practice and Procedure; Postal Service; Review of Price Cap Rules
...POSTAL REGULATORY COMMISSION 39 CFR Part 3010 [Docket Nos. RM2011-2 and RM2013-2...initiating review of its rules in 39 CFR part 3010 and requesting comments and suggestions to clarify or improve the manner in which part 3010 implements statutory directives and...
Pre-Service Teacher Cohorts: Characteristics and Issues--A Review of the Literature
Since their introduction to teacher education programs in the 1980s, teacher education cohorts have become a standard scheme of organization in teacher preparation programs. This literature review notes some common characteristics and issues in cohort operations. Cohorts contain a standard academic core, class scheduling, and timeline to program�
Knorr, Ron
Successfully integrating aged care services: a review of the evidence and tools emerging from a long-term care program
Background Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy) project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice. The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt. Methods Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis. Results Forty-five journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional decline and handicap levels, and improving feelings of empowerment and satisfaction with care provided. The research also demonstrated benefits to the health system, including a more appropriate use of emergency rooms, and decreased consultations with medical specialists. Discussion Reviewing the body of research reveals the importance of both designing programs with an eye to local context, and building in flexibility allowing the program to be adapted to changing circumstances. Creating partnerships between policy designers, project implementers, and academic teams is an important element in achieving these goals. Partnerships are also valuable for achieving effective monitoring and evaluation, and support to �evidence-based� policy-making processes. Despite a shared electronic health record being a key component of the service model, there was an under-investigation of the impact this technology on facilitating and enabling integration and the outcomes achieved. Conclusions PRISMA provides evidence of the benefits that can arise from integrating care for older persons, particularly in terms of increased feelings of personal empowerment, and improved client satisfaction with the care provided. Taken alongside other integrated care experiments, PRISMA provides further evidentiary support to policy-makers pursuing integrated care programs. The scale and scope of the research body highlights the long-term and complex nature of program evaluations, but underscores the benefits of evaluation, review and subsequent adaptation of programs. The role of information technology in supporting integration of services is likely to substantially expand in the future and the potential this technology offers should be investigated and harnessed.
Stewart, Michael J.; Georgiou, Andrew; Westbrook, Johanna I.
[Pharmaceutical services for inpatients provided by hospital pharmacies in Brazil: a review of the literature].
This paper discusses the literature on hospital pharmacy services for in-patients in Brazil, seeking a broader view of its characteristics and priorities. Seventeen papers were located in the Medline and Lilacs databases that complied with the pre-defined inclusion/exclusion criteria. Most of them were related to teaching and research, logistics and compounding, based on observations in public hospitals in Southeast Brazil. Few studies focused on core activities such as management and selection. The academic syllabus through which pharmacy students are trained may underlie the perception that compounding is the preponderant aspect of hospital pharmacy services, although this is required in only a few institutions. Added to this is poor compliance by pharmacy activities with established norms and standards and the lack of an indexed Brazilian publication in this field. As there were far more studies of the public sector than its private counterpart, it seems as though there is either greater freedom of action in the former or less scientific output in the latter, quantified by published studies. PMID:17680156
Magarinos-Torres, Rachel; Osorio-de-Castro, Claudia Garcia Serpa; Pepe, Vera Lucia Edais
Calorie menu labeling on quick-service restaurant menus: an updated systematic review of the literature.
Nutrition labels are one strategy being used to combat the increasing prevalence of overweight and obesity in the United States. The Patient Protection and Affordable Care Act of 2010 mandates that calorie labels be added to menu boards of chain restaurants with 20 or more locations. This systematic review includes seven studies published since the last review on the topic in 2008. Authors searched for peer-reviewed studies using PUBMED and Google Scholar. Included studies used an experimental or quasi-experimental design comparing a calorie-labeled menu with a no-calorie menu and were conducted in laboratories, college cafeterias, and fast food restaurants. Two of the included studies were judged to be of good quality, and five of were judged to be of fair quality. Observational studies conducted in cities after implementation of calorie labeling were imprecise in their measure of the isolated effects of calorie labels. Experimental studies conducted in laboratory settings were difficult to generalize to real world behavior. Only two of the seven studies reported a statistically significant reduction in calories purchased among consumers using calorie-labeled menus. The current evidence suggests that calorie labeling does not have the intended effect of decreasing calorie purchasing or consumption. PMID:22152038
Swartz, Jonas J; Braxton, Danielle; Viera, Anthony J
Calorie menu labeling on quick-service restaurant menus: an updated systematic review of the literature
Nutrition labels are one strategy being used to combat the increasing prevalence of overweight and obesity in the United States. The Patient Protection and Affordable Care Act of 2010 mandates that calorie labels be added to menu boards of chain restaurants with 20 or more locations. This systematic review includes seven studies published since the last review on the topic in 2008. Authors searched for peer-reviewed studies using PUBMED and Google Scholar. Included studies used an experimental or quasi-experimental design comparing a calorie-labeled menu with a no-calorie menu and were conducted in laboratories, college cafeterias, and fast food restaurants. Two of the included studies were judged to be of good quality, and five of were judged to be of fair quality. Observational studies conducted in cities after implementation of calorie labeling were imprecise in their measure of the isolated effects of calorie labels. Experimental studies conducted in laboratory settings were difficult to generalize to real world behavior. Only two of the seven studies reported a statistically significant reduction in calories purchased among consumers using calorie-labeled menus. The current evidence suggests that calorie labeling does not have the intended effect of decreasing calorie purchasing or consumption.
Protocol: a realist review of user fee exemption policies for health services in Africa
Background Four years prior to the Millenium Development Goals (MDGs) deadline, low- and middle-income countries and international stakeholders are looking for evidence-based policies to improve access to healthcare for the most vulnerable populations. User fee exemption policies are one of the potential solutions. However, the evidence is disparate, and systematic reviews have failed to provide valuable lessons. The authors propose to produce an innovative synthesis of the available evidence on user fee exemption policies in Africa to feed the policy-making process. Methods The authors will carry out a realist review to answer the following research question: what are the outcomes of user fee exemption policies implemented in Africa? why do they produce such outcomes? and what contextual elements come into play? This type of review aims to understand how contextual elements influence the production of outcomes through the activation of specific mechanisms, in the form of context�mechanism�outcome configurations. The review will be conducted in five steps: (1) identifying with key stakeholders the mechanisms underlying user fee exemption policies to develop the analytical framework, (2) searching for and selecting primary data, (3) assessing the quality of evidence using the Mixed-Method Appraisal Tool, (4) extracting the data using the analytical framework and (5) synthesising the data in the form of context�mechanism�outcomes configurations. The output will be a middle-range theory specifying how user fee exemption policies work, for what populations and under what circumstances. Ethics and dissemination The two main target audiences are researchers who are looking for examples to implement a realist review, and policy-makers and international stakeholders looking for lessons learnt on user fee exemption. For the latter, a knowledge-sharing strategy involving local scientific and policy networks will be implemented. The study has been approved by the ethics committee of the CHUM Research Centre (CR-CHUM). It received funding from the Canadian Institutes of Health Research. The funders will not have any role in study design; collection, management, analysis, and interpretation of data; writing of the report and the decision to submit the report for publication, including who will have ultimate authority over each of these activities.
Ridde, Valery; Marchal, Bruno; Fournier, Pierre
Introduction of Electronic Referral from Community Associated with More Timely Review by Secondary Services
Background Electronic referral (eReferral) from community into public secondary healthcare services was introduced to 30 referring general medical practices and 28 hospital based services in late 2007. Objectives To measure the extent of uptake of eReferral and its association with changes in referral processing. Methods Analysis of transactional data from the eReferral message service and the patient information management system of the affected hospital; interview of clinical, operational and management stakeholders. Results eReferral use rose steadily to 1000 transactions per month in 2008, thereafter showing moderate growth to 1200 per month in 2010. Rate of eReferral from the community in 2010 is estimated at 56% of total referrals to the hospital from general practice, and as 71% of referrals from those having done at least one referral electronically. Referral latency from letter date to hospital triage improves significantly from 2007 to 2009 (p<0.001), from a paper referral median of 8 days (inter-quartile range, IQR: 4�14) in 2007 to an eReferral median of 5 days (IQR: 2�9) and paper referral median of 6 days (IQR: 2�12) in 2009. Specialists upgrade the referrer-assigned eReferral priority in 19.2% of cases and downgrade it 18.6% of the time. Clinical users appreciate improvement of referral visibility (status and content access); however, both general practitioners and specialists point out system usability issues. Discussion With eReferrals, a referral�s status can be checked, and its content read, by any authorized user at any time. The period of eReferral uptake was associated with significant speed-up in referral processing without changes in staffing levels. The eReferral system provides a foundation for further innovation in the community-secondary interface, such as electronic decision support and shared care planning systems. Conclusions We observed substantial rapid voluntary uptake of eReferrals associated with faster, more reliable and more transparent referral processing.
Warren, J.; White, S.; Day, K.J.; Gu, Y.; Pollock, M.
Solitary Tracheobronchial Papilloma: Cytomorphology and ancillary studies with histologic correlation
Solitary tracheobronchial papilloma (STBP) is a rare benign tumor that primarily involves the tracheobronchial tree. Human papilloma virus (HPV) infection is associated with dysplasia and a high risk of carcinoma in these lesions. The cytomorphology of STBP is not well established in the literature. Our aim is to characterize the cytomorphologic features of STBP, with histologic correlation in a series of 6 patients � 4 males and 2 females � with a mean age of 67 years (range, 53-88 years). There were 5 biopsy-proven squamous papillomas and 1 glandular papilloma. On surgical biopsy, squamous papillomas exhibited cytological atypia (4 graded mild and 1 graded moderate with focal severe dysplasia), surface erosion, and inflammation. Cytology specimens available for review included a combination of 4 fine-needle aspirations (FNAs), 2 bronchoalveolar lavages and 2 (of 3) bronchial brushings. Cytologic findings associated with squamous papillomas included atypical squamous cells and rare squamous cell resembling koilocyte in 1 bronchial brushing. Sheets of squamous cells were identified in another specimen. Several cases had a prominent background of acute inflammation, and candida was present in 1 specimen. HPV in-situ hybridization was positive in 1 case and negative in 2 cases. A p16 immunocytochemical stain performed on 1 cell block was negative. In conclusion, although STBP is a rare neoplasm, these cases may be encountered in respiratory cytology samples. FNA of papillomas yields fewer lesional cells compared to exfoliative samples. These lesions may be mistaken in cytology specimens for squamous cell carcinoma, squamous-lined cavitary lesions, an infectious (fungal) process, reactive squamous metaplasia, or oral contamination.
Lang, Tee U.; Khalbuss, Walid E.; Monaco, Sara E.; Pantanowitz, Liron
Solitary Tracheobronchial Papilloma: Cytomorphology and ancillary studies with histologic correlation.
Solitary tracheobronchial papilloma (STBP) is a rare benign tumor that primarily involves the tracheobronchial tree. Human papilloma virus (HPV) infection is associated with dysplasia and a high risk of carcinoma in these lesions. The cytomorphology of STBP is not well established in the literature. Our aim is to characterize the cytomorphologic features of STBP, with histologic correlation in a series of 6 patients - 4 males and 2 females - with a mean age of 67 years (range, 53-88 years). There were 5 biopsy-proven squamous papillomas and 1 glandular papilloma. On surgical biopsy, squamous papillomas exhibited cytological atypia (4 graded mild and 1 graded moderate with focal severe dysplasia), surface erosion, and inflammation. Cytology specimens available for review included a combination of 4 fine-needle aspirations (FNAs), 2 bronchoalveolar lavages and 2 (of 3) bronchial brushings. Cytologic findings associated with squamous papillomas included atypical squamous cells and rare squamous cell resembling koilocyte in 1 bronchial brushing. Sheets of squamous cells were identified in another specimen. Several cases had a prominent background of acute inflammation, and candida was present in 1 specimen. HPV in-situ hybridization was positive in 1 case and negative in 2 cases. A p16 immunocytochemical stain performed on 1 cell block was negative. In conclusion, although STBP is a rare neoplasm, these cases may be encountered in respiratory cytology samples. FNA of papillomas yields fewer lesional cells compared to exfoliative samples. These lesions may be mistaken in cytology specimens for squamous cell carcinoma, squamous-lined cavitary lesions, an infectious (fungal) process, reactive squamous metaplasia, or oral contamination. PMID:21383960
Lang, Tee U; Khalbuss, Walid E; Monaco, Sara E; Pantanowitz, Liron
Wackenhut Services, Incorporated: Report from the DOE Voluntary Protection Program onsite review, August 10--14, 1998
This report summarizes the Department of Energy Voluntary Protection Program (DOE-VPP) Review Team`s findings from the five-day onsite evaluation of Wackenhut Services, Inc. (WSI) at Savannah River Site (SRS), conducted August 10-14, 1998. The site was evaluated against the program requirements contained in US Department of Energy Voluntary Protection Program, Part 1: Program Elements to determine its success in implementing the five DOE-VPP tenets. The Team determined that WSI has met in varying degrees, all the tenets of the DOE-VPP. In every case, WSI programs and procedures exceed the level or degree necessary for compliance with existing standards, DOE Orders, and guidelines. In addition, WSI has systematically integrated their occupational safety and health (OSH) program into management and work practices at all levels. WSI`s efforts toward implementing the five major DOE-VPP tenets are summarized.
Dynamic computed tomography as an ancillary screening test for traumatic thoracic aortic injuries: a critical review.
While the divergence of opinion on the matter of diagnostic modalities will probably continue, dynamic computed tomography scans should be considered as a necessary study in assessing a possible traumatic thoracic aortic injury. The use of this modality will decrease the need for thoracic angiograms and invariably increase the yield.
Britt, L. D.; Bono, R. C.; Dascombe, W. H.; Weireter, L. J.
The TIGRESS Integrated Plunger ancillary systems for electromagnetic transition rate studies at TRIUMF
The TIGRESS Integrated Plunger device is a new experimental tool for nuclear structure investigations via gamma-ray spectroscopy with post-accelerated beams from the ISAC-II facility at TRIUMF. Several ancillary detection systems integral to the device?s capabilities for charged-particle tagging and light-ion identification following a variety of nuclear reaction mechanisms have been constructed and characterized. In particular, a silicon PIN diode wall, an annular silicon segmented detector, and a CsI(Tl) scintillator wall have together enabled particle-gamma correlations for reaction channel selectivity and precision kinematic reconstruction in recent measurements. We highlight the construction, characteristics, and implementation of the device?s ancillary detectors as they enable a rich set of electromagnetic transition rate measurements via Doppler-shift lifetime techniques and low-energy Coulomb excitation.
Voss, P.; Henderson, R.; Andreoiu, C.; Ashley, R.; Austin, R. A. E.; Ball, G. C.; Bender, P. C.; Bey, A.; Cheeseman, A.; Chester, A.; Cross, D. S.; Drake, T. E.; Garnsworthy, A. B.; Hackman, G.; Holland, R.; Ketelhut, S.; Kowalski, P.; Kr�cken, R.; Laffoley, A. T.; Leach, K. G.; Miller, D.; Mills, W. J.; Moukaddam, M.; Pearson, C. J.; Pore, J.; Rand, E. T.; Rajabali, M. M.; Rizwan, U.; Shoults, J.; Starosta, K.; Svensson, C. E.; Tardiff, E.; Unsworth, C.; Van Wieren, K.; Wang, Z.-M.; Williams, J.
75 FR 19335 - Premium Review Process; Request for Comments Regarding Section 2794 of the Public Health Service Act
...Regarding Section 2794 of the Public Health Service Act AGENCY: Office of...which added Section 2794 to the Public Health Service Act (the PHS Act...2010, added Section 2794 of the Public Health Service Act (PHS Act). In...
Evidence based mental healthcare and service innovation: review of concepts and challenges.
Health provision systems in the developed western nations are currently facing major financial challenges. In order to meet these challenges, a number of new approaches used to assist the provision of health have been introduced, including the practice of health professionals. These approaches utilize specific methods of data capture and summarization such as: evidence based medicine (EBM) and practice guidelines. Evidence is generated from systematic clinical research as well as reported clinical experience and individually case based empirical evidence. All types of research though (quantitative or qualitative) have limitations. Similarly all types of evidence have advantages and disadvantages and can be complimentary to each other. Evidencebased individual decision (EBID) making is the commonest evidence-based medicine as practiced by the individual clinician in making decisions about the care of the individual patient. It involves integrating individual clinical expertise with the best available external clinical evidence from systematic research. However this sort of evidence-based medicine, focuses excessively on the individual (potentially at the expense of others) in a system with limited budgets. Evidence-based guidelines (EBG) also support the practice of evidence-based medicine but at the organizational or institutional level. The main aim is to identify which interventions, over a range of patients, work best and which is cost-effective in order to guide service development and provision at a strategic level. Doing this effectively is a scientific and statistical skill in itself and the quality of guidelines is based primarily on the quality research evidence. It is important to note that lack of systematic evidence to support an intervention does not automatically mean that an intervention must instantly be abandoned. It is also important that guidelines are understood for what they are, i.e. not rules, or complete statements of knowledge. EBM will never have enough suitable evidence for all and every aspects of health provision in every locality. Innovation signifies a substantial positive change compared to gradual or incremental changes. Innovation using inductive reasoning has to play a major role within health care system and it is applicable to all three level of service provision: clinical practice, policy and organisation structure. The aim of this paper is to examine critically the above concepts and their complimentary role in supporting provision of health care systems which are suitable for the requirements of the population, affordable, deliverable, flexible and adaptable to social changes. PMID:23603268
Kouimtsidis, Ch; John-Smith, St; Kemp, P; Ikkos, G
Improved Sea Surface Salinity Retrievals using Ancillary data for Aquarius Ocean Roughness Correction
The Aquarius/SAC-D sea surface salinity (SSS) measurement mission was launched into polar orbit during the summer of 2011. The prime sensor is a combined L-band radiometer/scatterometer developed jointly by NASA Goddard Space Flight Center and the Jet Propulsion Laboratory, which derives SSS from ocean surface brightness temperature (Tb) measurements. This paper deals with a method of improving AQ SSS by making a making an ocean roughness brightness temperature correction (?Tbr). The ?Tbr is derived using several ancillary data sources of surface wind measurements, namely; NOAA numerical weather model - Global Data Assimilation System (GDAS), WindSat ocean vector wind, and the CONAE Microwave Radiometer (MWR). The basis of the correction is the excess (warming) brightness temperature that is produced when the ocean is roughened by the surface wind. We model the increase in L-band Tb as a function of wind speed and direction relative to the antenna azimuth look direction. Our radiative transfer model by El-Nimri [2010] has been tuned to actual AQ ocean surface Tb's with corresponding surface wind vector. Using this ocean emissivity model and the ancillary wind vector, we derive the roughness correction, ?Tbr, which is applied to the AQ measured ocean surface Tb before retrieving SSS. Finally the effect of ?Tbr is evaluated by computing the difference between the HYCOM ocean salinity model and the AQ retrievals. These differences are cross correlated with the ancillary surface wind vector to assess the effectiveness of the roughness correction. Finally, we compare our ?Tbr with the AQ scatterometer derived ?Tbr. We compare the similarities and differenced versus the ancillary surface wind speed. S. El-Nimri et al., 2010, "An improved C-band ocean surface emissivity model at hurricane force wind speeds over a wide range of earth incidence angles," IEEE Geosci. Rem. Sens. Letters, vol. 7, NO. 4, October.
Jones, L.; Hejazin, Y.; Rabollii, M.
Wheelchair interventions, services and provision for disabled children: a mixed-method systematic review and conceptual framework
Background Wheelchairs for disabled children (?18�years) can provide health, developmental and social benefits. World Health Organisation and United Kingdom Government reports demonstrate the need for improved access to wheelchairs both locally and internationally. The use of health economics within this field is lacking. Provision of wheelchairs based on cost-effectiveness evidence is not currently possible. We conducted the first systematic review in this field to incorporate evidence of effectiveness, service user perspectives, policy intentions and cost-effectiveness in order to develop a conceptual framework to inform future research and service development. Methods We used an adapted EPPI-Centre mixed-method systematic review design with narrative summary, thematic and narrative synthesis. 11 databases were searched. Studies were appraised for quality using one of seven appropriate tools. A conceptual framework was developed from synthesised evidence. Results 22 studies and 14 policies/guidelines were included. Powered wheelchairs appear to offer benefits in reduced need for caregiver assistance; improved communicative, personal-social and cognitive development; and improved mobility function and independent movement. From 14�months of age children can learn some degree of powered wheelchair driving competence. However, effectiveness evidence was limited and low quality. Children and parents placed emphasis on improving social skill and independence. Participation in wider society and development of meaningful relationships were key desired outcomes. Policy intentions and aspirations are in line with the perspectives of children and parents, although translation of policy recommendations into practice is lacking. Conclusions There is a distinct lack of high quality effectiveness and economic evidence in this field. Social and health needs should be seen as equally important when assessing the mobility needs of disabled children. Disabled children and parents placed highest priority on independence and psychosocial outcomes of wheelchair interventions. Translation of policy and guidelines into practice is lacking and more effective implementation strategies are required to improve services and outcomes. Future research should focus on outcome measure development, developing economic evaluation tools and incorporating these into high quality studies to address known research gaps. The novel conceptual framework maps current gaps in evidence and outlines areas for development.
Range water-pumping systems: state-of-the-art-review. Forest Service project report
Information learned from the investigative effort conducted in the solar-water-pumping systems portion of the Range Water System Improvement project is reviewed. The report covers the development of new windmill designs including fully counterbalanced, spring-counterbalanced and com-operated windmills, hydraulic system to replace pump rods of a conventional windmill, automatic stroke controls for a 3-bladed wind turbine, wind electric ac and dc generators driving ac and dc submersible pumps, windmill-driven air compressor operating an air lift pump, long-life well cyclinder, and performance modeling and testing of windmills. Photovoltaic-powered water-pumping systems discussed include large or oversized solar arrays, series-parallel photovoltaic-panel switching, maximum power controller systems, photovoltaic-powered pumping systems with submersible pump, and solar-thermal pumping systems.
McKenzie, D.W.
Human African Trypanosomiasis Diagnosis in First-Line Health Services of Endemic Countries, a Systematic Review
While the incidence of Human African Trypanosomiasis (HAT) is decreasing, the control approach is shifting from active population screening by mobile teams to passive case detection in primary care centers. We conducted a systematic review of the literature between 1970 and 2011 to assess which diagnostic tools are most suitable for use in first-line health facilities in endemic countries. Our search retrieved 16 different screening and confirmation tests for HAT. The thermostable format of the Card Agglutination Test for Trypanosomiasis (CATT test) was the most appropriate screening test. Lateral flow antibody detection tests could become alternative screening tests in the near future. Confirmation of HAT diagnosis still depends on visualizing the parasite in direct microscopy. All other currently available confirmation tests are either technically too demanding and/or lack sensitivity and thus rather inappropriate for use at health center level. Novel applications of molecular tests may have potential for use at district hospital level.
Mitashi, Patrick; Hasker, Epco; Lejon, Veerle; Kande, Victor; Muyembe, Jean-Jacques; Lutumba, Pascal; Boelaert, Marleen
A critical review of studies of the association between demands for hospital services and air pollution.
Studies of the associations between air pollution and hospital admissions and emergency room use are reviewed, including studies of air pollution episodes, time-series analyses, and cross-sectional analyses. These studies encompass a variety of methods of analysis and levels of air quality. Findings from all three types of studies were generally consistent in that almost all of the studies reviewed found statistically significant associations between hospital use and air pollution; this unanimity may have resulted in part from publication bias. These associations were characterized by elasticities of the order of 0.20; i.e., a 100% change in air pollution was associated with a change in hospital use of about 20%, for specific diagnoses. Respiratory diagnoses were emphasized by most studies; cardiac diagnoses were included in five of them. The air pollutants most often associated with changes in hospital use were particulate matter, sulfur oxides, and oxidants. Apart from the major air pollution episodes, there was no obvious link between air pollution level and the significance or magnitudes of the associations. Long-term indicators of hospitalization appeared to also be influenced by medical care supply factors, including the numbers of beds and physicians per capita. These nonpathological causal factors could also have influenced the findings of the time-series studies by introducing extraneous factors in the patterns of admissions. Although consistent associations have been shown between hospital use and air pollution, further research is required to distinguish among potentially responsible pollutants and to deduce specific dose-response relationships of general utility.
Lipfert, F W
Recovery Act Weekly Video: 200 Area Asbestos Removal, U-Ancillary Demolition, 200 West Transfer Building Footings
A weekly update of the Recovery Act at work. Demolition of U-Ancillary that was contaminated with uranium and asbestos as well as removing asbestos from the Steam Generation Plant in the 200 East Area.
Field Demonstration of the Conventional Steam-Drive Process with Ancillary Materials. Final Report (COR-GEL).
The primary goal of the field demonstration was to evaluate the economic merits of ancillary materials in a conventional steam drive to improve sweep efficiencies. A number of important factors regarding the behavior of steam foam treated wells were obser...
R. L. Eson
75 FR 66110 - Guidelines for Use of Stored Specimens and Access to Ancillary Data and Proposed Cost Schedule...
...and Human Development (NICHD) maintains an extensive repository of datasets from completed studies, biospecimens, and ancillary data. The Division intends to make datasets and biospecimens more widely available to the research community...
Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review
Background An ageing population is seen as a threat to the quality of life and health in rural communities, and it is often assumed that e-Health services can address this issue. As successful e-Health implementation in organizations has proven difficult, this systematic literature review considers whether this is so for rural communities. This review identifies the critical implementation factors and, following the change model of Pettigrew and Whipp, classifies them in terms of �context�, �process�, and �content�. Through this lens, we analyze the empirical findings found in the literature to address the question: How do context, process, and content factors of e-Health implementation influence its adoption in rural communities? Methods We conducted a systematic literature review. This review included papers that met six inclusion and exclusion criteria and had sufficient methodological quality. Findings were categorized in a classification matrix to identify promoting and restraining implementation factors and to explore whether any interactions between context, process, and content affect adoption. Results Of the 5,896 abstracts initially identified, only 51 papers met all our criteria and were included in the review. We distinguished five different perspectives on rural e-Health implementation in these papers. Further, we list the context, process, and content implementation factors found to either promote or restrain rural e-Health adoption. Many implementation factors appear repeatedly, but there are also some contradictory results. Based on a further analysis of the papers� findings, we argue that interaction effects between context, process, and content elements of change may explain these contradictory results. More specifically, three themes that appear crucial in e-Health implementation in rural communities surfaced: the dual effects of geographical isolation, the targeting of underprivileged groups, and the changes in ownership required for sustainable e-Health adoption. Conclusions Rural e-Health implementation is an emerging, rapidly developing, field. Too often, e-Health adoption fails due to underestimating implementation factors and their interactions. We argue that rural e-Health implementation only leads to sustainable adoption (i.e. it �sticks�) when the implementation carefully considers and aligns the e-Health content (the �clicks�), the pre-existing structures in the context (the �bricks�), and the interventions in the implementation process (the �tricks�).
Unbundling generation and transmission services for competitive electricity markets
Ancillary services are those functions performed by the equipment and people that generate, control, and transmit electricity in support of the basic services of generating capacity, energy supply, and power delivery. The Federal Energy Regulatory Commission (FERC) defined such services as those `necessary to support the transmission of electric power from seller to purchaser given the obligations of control areas and transmitting utilities within those control areas to maintain reliable operations of the interconnected transmission system.` The nationwide cost of ancillary services is about $12 billion a year, roughly 10% of the cost of the energy commodity. More important than the cost, however, is the necessity of these services for bulk-power reliability and for the support of commercial transactions. FERC`s landmark Order 888 included a pro forma tariff with provision for six key ancillary services. The Interconnected Operations Services Working Group identified another six services that it felt were essential to the operation of bulk-power systems. Several groups throughput the United States have created or are forming independent system operators, which will be responsible for reliability and commerce. To date, the electricity industry (including traditional vertically integrated utilities, distribution utilities, power markets and brokers, customers, and state and federal regulators) has paid insufficient attention to these services. Although the industry had made substantial progress in identifying and defining the key services, much remains to be doe to specify methods to measure the production, delivery, and consumption of these services; to identify the costs and cost-allocation factors for these services; and to develop market and operating rules for their provision and pricing. Developing metrics, determining costs, and setting pricing rules are important because most of these ancillary services are produced by the same pieces of equipment that produce the basic electricity commodity. Thus, the production of energy and ancillary services is highly interactive, sometimes complementary and sometimes competing. In contrast to today`s typical time-invariant, embedded-cost prices, competitive prices for ancillary services would vary with system loads and spot prices for energy.
Hirst, E.; Kirby, B.
Using Noninferiority Tests to Evaluate Telemedicine and E-Health Services: Systematic Review
Background An increasing number of studies within the field of telemedicine and e-health are designed as noninferiority studies, aiming to show that the telemedicine/e-health solution is not inferior to the traditional way of treating patients. Objective The objective is to review and sum up the status of noninferiority studies within this field, describing advantages and pitfalls of this approach. Methods PubMed was searched according to defined criteria, and 16 relevant articles were identified from the period 2008-June 2011. Results Most of the studies were related to the fields of psychiatry and emergency medicine, and most were published in journals relating to these fields or in general scientific or general medicine journals. All the studies claimed to be noninferiority studies, but 7 out of 16 tested for statistical differences as a proxy of noninferiority. Conclusions The methodological quality of the studies varied. We discuss optimal procedures for future noninferiority studies within the field of telemedicine and e-health and situations in which this approach is most appropriate.
Johnsen, Jan-Are K; Skr?vseth, Stein Olav; Wynn, Rolf
A Review of Consumer-Provided Services on Assertive Community Treatment and Intensive Case Management Teams: Implications for Future Research and Practice
BACKGROUND: Assertive community treatment (ACT) is an evidence-based practice that provides intensive, in vivo services for adults with severe mental illness. Some ACT and intensive case management teams have integrated consumers as team members with varying results. METHODS: The authors reviewed the literature examining the outcomes of having consumer providers on case management teams, with attention devoted to randomized controlled
Jennifer L. Wright-Berryman; Alan B. McGuire; Michelle P. Salyers
Barriers and Promoters of Mental Health Services Utilization in a Latino Context: A Literature Review and Recommendations from an Ecosystems Perspective
This article focuses on the problems of disparities in mental health service utilization in the Latino population in the United States. It begins with an overview of the Latino population within the United States, an exploration of the diversity within this group, and shared cultural values and traits with a particular focus on the problems of Latino poverty. A review
Sarah E. Bledsoe
Reference Reviewed and Re-Envisioned: Revamping Librarian and Desk-Centric Services with LibStARs and LibAnswers
The first section of this article reviews the literature on the changing face of reference, beginning with a discussion of the national decline in reference transactions, its causes, and the likelihood that online reference services might one day halt or reverse the decline. It then analyzes definitions of the term "reference," pointing to a�
Stevens, Christy R.
Review of findings of the Andhra Pradesh Eye Disease Study: policy implications for eye-care services.
The Andhra Pradesh Eye Disease Study (APEDS) was conducted in order to design long-term strategies to reduce blindness in the background of non-availability of recent population-based data on various aspects of blindness. The objectives of APEDS were to determine the prevalence and causes of blindness and visual impairment, prevalence of and risk factors for major eye diseases, barriers to eye-care services, and quality of life among the visually impaired. Multistage sampling was used to select 11,786 subjects of all ages from 24 urban clusters and 70 rural clusters in one urban and three rural areas belonging to different parts of Andhra Pradesh, with the aim of obtaining a study sample representative of the urban-rural and socioeconomic distribution of the population of this state. A total of 10,293 subjects underwent a detailed interview and dilated eye examination by trained professionals. The adjusted prevalence of blindness (presenting visual acuity <6/60 or central visual field <20 degrees in the better eye) was 1.84%, and moderate visual impairment (presenting visual acuity <6/18-6/60 or equivalent visual field loss in the better eye) was 8.1%. Cataract and refractive error were responsible for 60.3% of blindness and 85.7% of moderate visual impairment. Increasing age, decreasing socioeconomic status, female gender, and rural area of residence were associated with higher risk of blindness. Projections from APEDS suggest that there were 18.7 million blind people in 2000 in India, and that this number is likely to increase to 24.1 million and 31.6 million in 2010 and 2020 respectively, if the current trend continues. This review summarizes the findings of APEDS and discusses the implications of these data on the policy and planning of eye-care services. PMID:12930114
Dandona, R; Dandona, L
A qualitative study exploring the impact and consequence of the medicines use review service on pharmacy support-staff
Background Pharmacy support-staff (pharmacy technicians, dispensers and Medicines Counter Assistants) support the delivery of pharmaceutical and retail functions of the pharmacy. Workflow is supervised and at times dependent upon the pharmacist�s presence. Policy makers and pharmacy�s representative bodies are seeking to extend the community pharmacist's role including requiring the pharmacist to undertake private consultations away from the dispensary and shop floor areas. However, support-staff voices are seldom heard and little is known about the impact such policies have on them. Objective The objective of this study is to explore the impact and consequences of the English Medicine Use Review (MUR) service on pharmacy support-staff. Methods Ten weeks of ethnographic-oriented observations in two English community pharmacies and interviews with 5 pharmacists and 12 support-staff. A thematic approach was used to analyse the data. Results Despite viewing MURs as a worthwhile activity, interviews with support-staff revealed that some felt frustrated when they were left to explain to patients why the pharmacist was not available when carrying out an MUR. Dependency on the pharmacist to complete professional and accuracy checks on prescriptions grieved dispensing staff because dispensing workflow was disrupted and they could not get their work done. Medicines Counter Assistants were observed to have less dependency when selling medicines but some still reported concerns over of customers and patients waiting for the pharmacist. A range of tacit and ad hoc strategies were consequently found to be deployed to handle situations when the pharmacist was absent performing an MUR. Conclusions Consideration should be given to support-staff and pharmacists� existing work obligations when developing new pharmacy extended roles that require private consultations with patients. Understanding organisational culture and providing adequate resourcing for new services are needed to avoid improvisations or enactments by pharmacy support-staff and to allow successful innovation and policy implementation.
Latif, Asam; Boardman, Helen F.; Pollock, Kristian
A-LEVEL REVIEWS SPECIAL Pre-university textbook special OVERVIEW How to make a textbook BOOK STYLES AND CULTURES What we expect in the USA REVIEW CRITERIA Comparing Advanced Level Texts WEB WATCH Simulations BOOK REVIEW Behaviour in Schools BOOK REVIEW Shocking Science
A-LEVEL RESOURCES REVIEWS SPECIAL AS and A2 books and resources: deciding what to buy? SUMMARY Exam boards, specifications and support materials OCR (Oxford Cambridge and RSA Examinations) CORRECTION BOOK REVIEW Good Practice in Science Teaching WEB WATCH Astronomy and cosmology DVD REVIEW The Video Encyclopedia of Physics Demonstrations SOFTWARE REVIEW Graph Paper Printer
Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Noridian Administrative Services, LLC, in Jurisdiction 3 for the Period January 1, 2006 Through June 30, 2009.
Pursuant to Title XVIII of the Social Security Act, the Medicare program provides health insurance for people aged 65 and over and those who are disabled or have permanent kidney disease. The Centers for Medicare & Medicaid Services (CMS), which administe...
Planning of paratransit services
Paratransit services are being considered for an increasing role in serving travel needs. The three basic paratransit subdivisions are discussed: hail or phone services, hire and drive services, and prearranged ridesharing. These include taxi cabs, car pools, and subscription bus services. Planning for paratransit services requires coordination between the operation of transit and paratransit systems. Regulatory and managerial considerations are reviewed. (18 references)
Not Available
The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: A systematic literature review
Background The Two-Week Rule (TWR) was introduced to ensure that all patients with a suspected colorectal cancer (CRC) saw a hospital specialist within 14 days of an urgent GP referral. Guidelines were available to GPs to facilitate the appropriate TWR referral of patients exhibiting high-risk CRC symptoms. Methods We aimed to evaluate the TWR and its CRC detection rate on NHS CRC diagnostic services by performing a literature search and critically appraising the peer-reviewed studies. Only 12 studies were eligible for inclusion. Data was collected and overall results were given as weighted averages. Results The studies identified indicated that only 10.3% of patients referred by the TWR were eventually diagnosed with CRC. When examining the referral origin of all CRC patients diagnosed during the time of the studies, 24% had been referred using the TWR, 24.1% were referred as emergency cases, and 52.4% were referred using alternative routes. No evidence was found to indicate that the TWR had resulted in identifying CRC patients at an earlier, more treatable stage of their disease. Conclusion The TWR referral system needs to be improved to increase the number of CRC patients referred using this fast track method as they present to their GP. The TWR and new NICE Guidelines for the referral of patients with suspected cancer should be independently evaluated.
Thorne, Kymberley; Hutchings, Hayley A; Elwyn, Glyn
Racial Disparities in the Use of Ancillary Testing to Evaluate Individuals with Open-Angle Glaucoma
Objective To determine whether racial disparities exist in the use of ancillary testing to evaluate individuals with open-angle glaucoma (OAG). Methods We identified all enrollees aged ?40 in a large U.S. managed-care network with retinal or optic nerve conditions that could warrant the use of ancillary testing. Among persons with OAG or glaucoma suspects, we performed repeated measures multivariable logistic regression to determine the odds and probabilities each year of undergoing visual field (VF) testing, fundus photography (FP), and other ocular imaging (OOI) for black, white, Latino, and Asian-American males and females and compared the groups. Results Among the 797,879 eligible enrollees, 149,018 individuals had OAG. The odds of undergoing VF testing decreased for all groups from 2001�2009, decreasing most (63% and 57%) for Latinos and Latinas, respectively (adjusted odds ratio (OR)=0.37, 95% confidence interval (CI)=0.31�0.43 and OR=0.43, CI=0.37�0.50) and least (36%) for Asian males (OR=0.64, CI 0.51�0.80). By comparison, the odds of undergoing OOI increased for all groups from 2001�2009, increasing most (173%) for black males and females (OR=2.73, CI=2.34�3.18 for males and OR=2.73, CI=2.40�3.09 for females) and least (77%) for Latinas (OR=1.77, CI=1.49�2.09). Conclusion Latinos and Latinas had considerably reduced odds of undergoing VF testing and OOI compared with other groups over the decade. Although increases in glaucoma testing have been noted in recent years among Latinos and Latinas for some types of ancillary tests, efforts should be made to better understand and overcome some of the persistent barriers to monitoring for glaucoma in this group.
Stein, Joshua D.; Talwar, Nidhi; LaVerne, Alejandra M.; Nan, Bin; Lichter, Paul R.
Monitoring basin-scale land cover changes in Kagera Basin of Lake Victoria using ancillary data and remote sensing
The Kagera Basin is a high value ecosystem in the Lake Victoria watershed because of the hydrological and food services it provides. The basin has faced large scale human induced land use and land cover changes (LUCC), but quantitative data is to date lacking. A combination of ancillary data and satellite imagery were interpreted to construct LUCC dynamics for the last century. This study is an initial step towards assessing the impact of LUCC on sustainable agriculture and water quality in the watershed. The results show that large trends of LUCC have rapidly occurred over the last 100 years. The most dominant LUCC processes were gains in farmland areas (not detectable in 1901 to 60% in 2010) and a net reduction in dense forest (7% to 2.6%), woodlands (51% to 6.9%) and savannas (35% to 19.6%) between 1901 and 2010. Forest degradation rapidly occurred during 1974 and 1995 but the forest re-grew between 1995 and 2010 due to forest conservation efforts. Afforestation efforts have resulted in plantation forest increases between 1995 and 2010. The rates of LUCC observed are higher than those reported in Sub Saharan Africa (SSA) and other parts of the world. This is one of the few studies in SSA at a basin scale that combines multi-source spatio-temporal data on land cover to enable long-term quantification of land cover changes. In the discussion we address future research needs for the area based on the results of this study. These research needs include quantifying the impacts of land cover change on nutrient and sediment dynamics, soil organic carbon stocks, and changes in biodiversity.
Wasige, John E.; Groen, Thomas A.; Smaling, Eric; Jetten, Victor
Identification and definition of unbundled electric generation and transmission services
State and federal regulators, private and public utilities, large and small customers, power brokers and marketers, and others are engaged in major debates about the future structure of the electric industry. Although the outcomes are far from certain, it seems clear that customers will have much greater choices about the electric services they purchase and from whom they buy these services. This report examines the ``ancillary`` services that are today buried within the typical vertically integrated utility. These ancillary services support and make possible the provision of the basic services of generating capacity, energy supply, and power delivery. These ancillary services include: Management of generating units; reserve generating capacity to follow variations in customer loads, to provide capacity and energy when generating units or transmission lines suddenly fall, to maintain electric-system stability, and to provide local-area security; transmission-system monitoring and control; replacement of real power and energy losses; reactive-power management and voltage regulation; transmission reserves; repair and maintenance of the transmission network; metering, billing, and communications; and assurance of appropriate levels of power quality. Our focus in this report, the first output from a larger Oak Ridge National Laboratory project, is on identification and definition of these services. Later work in this project will examine more closely the costs and pricing options for each service.
Kirby, B.; Hirst, E.; Vancoevering, J.
Review of High-Dollar Payments Processed by National Government Services for Long-Term Care Inpatient Services Provided Between October 1, 2006, and December 31, 2007.
Pursuant to Title XVIII of the Social Security Act (the Act), the Medicare program provides health insurance for people age 65 and over and those who are disabled or have permanent kidney disease. The Centers for Medicare & Medicaid Services (CMS), which ...
Immunohistochemistry and other ancillary techniques in the diagnosis of gestational trophoblastic diseases.
Gestational trophoblastic disease (GTD) encompasses entities ranging from ubiquitous hydatidiform moles to rare neoplastic gestational trophoblastic tumors. In practice, the histological diagnosis of GTD continues to have significant diagnostic inaccuracy with marked inter- and intra-observer variability, even among expert pathologists. Studies in correlation with genotypic evidence have confirmed a lack of accuracy in diagnosis of hydatidiform moles using histology alone. Applications of new immunohistochemical markers and molecular techniques have significantly enhanced the diagnostic precision of various GTDs in recent years. p57 Immunohistochemistry is a highly useful marker in confirming complete hydatidiform mole. PCR-based DNA genotyping has emerged as a powerful diagnostic measure to precisely classify both complete and partial hydatidiform moles. With acquisition of molecular diagnostic capabilities at most medical centers, these ancillary techniques have been increasingly integrated into the routine diagnostic workup of GTD. We propose an algorithmic approach combining histology and these ancillary tests to provide the best diagnostic practice possible. Under this algorithm, all cases with histological suspicion for complete mole are subject to p57 immunohistochemical confirmation, and all cases with histological suspicion for partial mole undergo DNA genotyping workup. Beyond hydatidiform mole, recognition of gestational trophoblastic tumors requires a high index of suspicion and application of immunohistochemical markers of trophoblast is helpful to accurately diagnose these rare tumors. PMID:24907943
Buza, Natalia; Hui, Pei
Functional Association of Catalytic and Ancillary Modules Dictates Enzymatic Activity in Glycoside Hydrolase Family 43 ?-Xylosidase*
?-Xylosidases are hemicellulases that hydrolyze short xylo-oligosaccharides into xylose units, thus complementing endoxylanase degradation of the hemicellulose component of lignocellulosic substrates. Here, we describe the cloning, characterization, and kinetic analysis of a glycoside hydrolase family 43 ?-xylosidase (Xyl43A) from the aerobic cellulolytic bacterium, Thermobifida fusca. Temperature and pH optima of 55�60 �C and 5.5�6, respectively, were determined. The apparent Km value was 0.55 mm, using p-nitrophenyl xylopyranoside as substrate, and the catalytic constant (kcat) was 6.72 s?1. T. fusca Xyl43A contains a catalytic module at the N terminus and an ancillary module (termed herein as Module-A) of undefined function at the C terminus. We expressed the two recombinant modules independently in Escherichia coli and examined their remaining catalytic activity and binding properties. The separation of the two Xyl43A modules caused the complete loss of enzymatic activity, whereas potent binding to xylan was fully maintained in the catalytic module and partially in the ancillary Module-A. Nondenaturing gel electrophoresis revealed a specific noncovalent coupling of the two modules, thereby restoring enzymatic activity to 66.7% (relative to the wild-type enzyme). Module-A contributes a phenylalanine residue that functions as an essential part of the active site, and the two juxtaposed modules function as a single functional entity.
Morais, Sarah; Salama-Alber, Orly; Barak, Yoav; Hadar, Yitzhak; Wilson, David B.; Lamed, Raphael; Shoham, Yuval; Bayer, Edward A.
A review of consumer-provided services on Assertive Community Treatment and intensive case management teams: Implications for future research and practice
Background Assertive community treatment (ACT) is an evidence-based practice that provides intensive, in vivo services for adults with severe mental illness. Some ACT and intensive case management teams have integrated consumers as team members with varying results. Methods We reviewed the literature examining the outcomes of having consumer providers on case management teams, with attention devoted to randomized controlled trials (RCTs). Results We identified 16 published studies, including 8 RCTs. Findings were mixed, with evidence supporting consumer-provided services for improving engagement, and limited support for reduced hospitalizations. However, evidence was lacking for other outcomes areas such as symptom reduction or improved quality of life. Conclusion Including a consumer provider on an ACT team could enhance the outreach mechanisms of ACT, using a more recovery-focused approach to bring consumers into services and help engage them over time. More rigorous research is needed to further evaluate integrating consumer providers on teams.
Wright-Berryman, Jennifer L.; McGuire, Alan B.; Salyers, Michelle P.
BOOK REVIEWS (269) The Science of Imaging - An Introduction Northern Lights Vacuum Bazookas, Electric Rainbow Jelly, and 27 other Saturday Science Projects Physics and Engineering in Medicine in the New Millennium CD-ROM REVIEWS (272) I fell in love with a STARBase trooper Aber - greatest hits... WEB WATCH (273) 'Here is the guess of their true strength and forces' Gary Williams EDITOR'S NOTE (275) Reviews of Christopher Bishop's Astrophysics (John Murray, 2000) PHYSICS TEASER (276) Why or How, Sophistry and Guestimation
Interventions to reduce dependency in personal activities of daily living in community-dwelling adults who use homecare services: protocol for a systematic review
Background There is a growing demand for services whereby individuals receive assistance from care workers for personal care within the home. This has led to the development of re-ablement or restorative homecare services that provide time-limited input aimed at reducing dependency in personal activities of daily living, and preventing or delaying the need for further homecare support. However, little is currently known about how such interventions are configured, or how they may affect individuals� ability to carry out personal care independently. Methods/Design We will seek to identify studies that compare an intervention designed to reduce dependency in personal activities of daily living with routine input or usual care as the control. We will include randomised controlled trials, nonrandomised controlled trials, and controlled before and after studies. We will also include interrupted time series studies. We shall search electronic databases in addition to searching for ongoing and unpublished studies, and where appropriate will contact key authors. Two reviewers will independently screen articles for inclusion; will assess risk of bias using quality assessment tools; and will carry out data extraction using pre-prepared forms. Any disagreements, at any stage, will be resolved by discussion and the involvement of a third reviewer if needed. We will produce a narrative summary of the results. A meta-analysis will be conducted if sufficient data are available of appropriate quality and comparability. Discussion The findings from this review will inform future practice within homecare re-ablement services; will inform policy decisions about the structure, organisation and content of such services; and will identify areas where further research is warranted. Trial registration This review protocol has been registered on the PROSPERO database (CRD42013004163).
A hospital-based occupational health service.
Responding to the local business community, Sturdy Memorial Hospital developed an occupational health service. Situated about 35 miles south of Boston, Attleboro has a population of 130,000, with jewelry, chemicals, and light manufacturing as its predominant industries. Featuring plant visits by a medical director with specialty training in occupational and internal medicine, the program provides clinical, ancillary, consultative, educational, and a variety of special services. Clinical services include preplacement examinations and treatment of work-related injuries. Ancillary services are audiometric testing, pulmonary function testing, and screening for heavy-metal exposures. Among the consultative services are evaluations as to whether a disease is work related; counseling on the reproductive hazards in the workplace; and disability evaluations. Work-site visits are conducted by an occupational health nurse who participates in medical surveillance and health promotion programs. Within two years the service has become affiliated with more than 60 firms on a noncontractual , fee-for-service basis. Economic self-sufficiency was established within 18 months of the institution of clinical services. PMID:6726486
McCunney, R J
Reviews 17 books and curriculum materials of interest to secondary science teachers. Topics include plant science, pollution, fishes, science investigations, general zoology, neurobiology, electronics, and the environment. (MLH)
Schodde, P.; Ed.
THERACOM: a systematic review of the evidence base for interventions to improve Therapeutic Communications between black and minority ethnic populations and staff in specialist mental health services
Background Black and Minority Ethnic (BME) groups in receipt of specialist mental health care have reported higher rates of detention under the mental health act, less use of psychological therapies, and more dissatisfaction. Although many explanations have been put forward to explain this, a failure of therapeutic communications may explain poorer satisfaction, disengagement from services and ethnic variations in access to less coercive care. Interventions that improve therapeutic communications may offer new approaches to tackle ethnic inequalities in experiences and outcomes. Methods The THERACOM project is an HTA-funded evidence synthesis review of interventions to improve therapeutic communications between black and minority ethnic patients in contact with specialist mental health services and staff providing those services. This article sets out the protocol methods for a necessarily broad review topic, including appropriate search strategies, dilemmas for classifying different types of therapeutic communications and expectations of the types of interventions to improve them. The review methods will accommodate unexpected types of study and interventions. The findings will be reported in 2013, including a synthesis of the quantitative and grey literature. Discussion A particular methodological challenge is to identify and rate the quality of many different study types, for example, randomised controlled trials, observational quantitative studies, qualitative studies and case studies, which comprise the full range of hierarchies of evidence. We discuss the preliminary methodological challenges and some solutions. (PROSPERO registration number: CRD42011001661).
Effect of Health Insurance on the Use and Provision of Maternal Health Services and Maternal and Neonatal Health Outcomes: A Systematic Review
Financial barriers can affect timely access to maternal health services. Health insurance can influence the use and quality of these services and potentially improve maternal and neonatal health outcomes. We conducted a systematic review of the evidence on health insurance and its effects on the use and provision of maternal health services and on maternal and neonatal health outcomes in middle- and low-income countries. Studies were identified through a literature search in key databases and consultation with experts in healthcare financing and maternal health. Twenty-nine articles met the review criteria of focusing on health insurance and its effect on the use or quality of maternal health services, or maternal and neonatal health outcomes. Sixteen studies assessed demand-side effects of insurance, eight focused on supply-side effects, and the remainder addressed both. Geographically, the studies provided evidence from sub-Saharan Africa (n=11), Asia (n=9), Latin America (n=8), and Turkey. The studies included examples from national or social insurance schemes (n=7), government-run public health insurance schemes (n=4), community-based health insurance schemes (n=11), and private insurance (n=3). Half of the studies used econometric analyses while the remaining provided descriptive statistics or qualitative results. There is relatively consistent evidence that health insurance is positively correlated with the use of maternal health services. Only four studies used methods that can establish this causal relationship. Six studies presented suggestive evidence of overprovision of caesarean sections in response to providers� payment incentives through health insurance. Few studies focused on the relationship between health insurance and the quality of maternal health services or maternal and neonatal health outcomes. The available evidence on the quality and health outcomes is inconclusive, given the differences in measurement, contradictory findings, and statistical limitations. Consistent with economic theories, the studies identified a positive relationship between health insurance and the use of maternal health services. However, more rigorous causal methods are needed to identify the extent to which the use of these services increases among the insured. Better measurement of quality and the use of cross-country analyses would solidify the evidence on the impact of insurance on the quality of maternal health services and maternal and neonatal health outcomes.
Peterson, Lauren A.; Hatt, Laurel E.
New Challenges in Agricultural Advisory Services from a Research Perspective: A Literature Review, Synthesis and Research Agenda
Purpose: Agricultural advisory services are perceived by many actors involved in rural development as a key driver behind innovation processes in agriculture. However, changes in national and global contexts cause dramatic changes in the orientation of advisory services, their organisation and their methods of intervention. This article aims to�
Faure, Guy; Desjeux, Yann; Gasselin, Pierre
Studies of the Cost-Effectiveness of Social Work Services in Aging: A Review of the Literature
The American population aged 65 years and older is growing rapidly, creating an increased demand for social workers. Reimbursement structures of Medicare and Medicaid present significant barriers for aging individuals seeking social work services as well as social workers wanting to provide services to the elderly. To build a case for the�
Rizzo, Victoria M.; Rowe, Jeannine M.
A Review of the Elements of Human Well-Being with Emphasis on the Contribution of Ecosystem Services
Natural ecosystems perform fundamental life-support services upon which human civilization depends. However, many people believe that Nature provides these services for free and therefore, they are of little or no value. While we do not pay for them; we pay significantly for thei...
A Review of the Elements of Human Well-Being with an Emphasis on the Contribution of Ecosystem Services
Natural ecosystems perform fundamental life-support services upon which human civilization depends. However, many people believe that Nature provides these services for free and therefore, they are of little or no value. While we do not pay for them; we pay significantly for th...
Review of the Literature on Attrition from the Military Services: Risk Factors for Attrition and Strategies to Reduce Attrition.
Attrition is the failure of an enlisted service member to be retained in service within the first term of enlistment. This paper emphasizes health/ fitness-related aspects of attrition but also covers demographic and psychosocial factors. Overall 3-year m...
J. J. Knapik B. H. Jones K. Hauret S. Darakjy E. Piskator
The Effectiveness of HIV Partner Counseling and Referral Services in Increasing Identification of HIV Positive Individuals A Systematic Review
Partner counseling and referral services (PCRS) are part of the spectrum of care for HIV-positive people and their sexual or needle-sharing partners. Referral includes notify- ing partners of exposure, after which they are (ideally) tested and receive prevention or risk reduction counseling or enter into care (if they test positive). Using The Guide to Community Preventive Services's methods for systematic
Matthew Hogben; Melissa McPheeters; Angela B. Hutchinson
Ancillary diagnostic techniques in the evaluation of adult epithelial renal neoplasms: indications, caveats, and pitfalls.
The role played currently by the different ancillary diagnostic techniques in the diagnosis of adult epithelial renal tumors continues to be debated. It has also become clear that in some instances light microscopic appearance alone cannot be used to classify these neoplasms into specific categories with the degree of precision required for therapeutic purposes. Renal cell carcinoma (RCC) subtypes may share common histologic characteristics but exhibit different biological behavior and response to therapy which clearly indicates the crucial role that advanced pathologic speciation plays in the current assessment of these neoplasms. Although immunohistochemistry is widely used for the purpose of categorizing renal tumors because of its widespread availability, the immunoprofiles of the various types of renal neoplasms overlap significantly, making definitive diagnostic determinations difficult and challenging at times. This manuscript will address how ancillary diagnostic techniques can be incorporated into the routine evaluation of neoplastic renal masses to improve classification. Both cytology and surgical specimens will be addressed, as fine needle aspiration (FNA) is being used with preference in many cases in the diagnosis of renal masses. Surgical and cytopathologists must intelligently select the ancillary diagnostic technique/s that will provide the information needed to solve the differential diagnosis under consideration in a given case. However, in some cases >1 of these techniques should be used to make an accurate diagnosis with the aim of arriving at an unequivocal diagnosis. The identification of specific signaling pathways that are defective in certain types of renal neoplasms has made possible the design of target-specific therapies that are directed towards the aberrant pathways associated with the defective proteins found in these tumors. This makes the exact classification of these neoplasms and the detection of these aberrant proteins targeted for treatment an absolute requirement for the application of these molecular-based therapeutic interventions. The role that the pathologic assessment plays in the classification of renal tumors becomes more important than ever to take advantage of this and similar new molecular-oriented therapies. PMID:24162266
Herrera, Guillermo A; Turbat-Herrera, Elba A
Access to Emissions Distributions and Related Ancillary Data through the ECCAD database
The Emissions of atmospheric Compounds & Compilation of Ancillary Data (ECCAD) database provides a user-friendly access to surface emissions and ancillary data, i.e. data on land use, active fires, burned areas, population, etc. ECCAD is the emissions database of the GEIA (Global Emissions InitiAtive) project. ECCAD is a sub-project of the ETHER French Atmospheric Chemistry Data Centre (CNES and CNRS, http://www.pole-ether.fr). The ECCAD database includes a large diversity of datasets, which provide global and regional surface emissions for a large set of chemical compounds, at a 0.5x0.5 or 1x1 degree resolution. A new version of ECCAD is being developped allowing to handle any resolution grid and geographical coverage. ECCAD provides detailed metadata for each of the datasets, including information on references, how to cite the datasets when used, the methodology, and links to the original inventories. Several tools are provided for the visualization of the data, for computing global and regional totals and for an interactive spatial and temporal analysis. The data can be downloaded as interoperable NetCDF CF-compliant files, i.e. the data are compatible with many other client interfaces. ECCAD has currently more than 1200 users originating from more than 70 countries. The project benefits from this large international community of users to expand the number of emission datasets made available. The ECCAD database and the web interface are in continuous development: new tools are being built to improve the analysis and comparison of emissions and ancillary data. They include a regridding tool, arithmetic expressions to combine different maps, new tools for temporal profiles analysis, and comparisons of data at different scales. An online module to calculate biomass burning emissions is being improved and will be extended to anthropogenic emissions. The presentation will provide information on all the datasets available within ECCAD, as well as examples of the analysis work that can be done online through the website: http://eccad.pole-ether.fr
Darras, Sabine; Granier, Claire; Liousse, Catherine; Mieville, Aude; Boulanger, Damien; Brissebrat, Guillaume; Paulin, Mireille; Richard, Hitier
BOOK REVIEWS (86) Advanced Level Study Aids Interactive Physics Demonstrations Maxwell's Conundrum: A serious but not ponderous book about Relativity Safety in Physics Education Revise A2 Physics AS Science for Public Understanding Telecommunications CD-ROM REVIEWS (89) Focus on Physics: Fields Focus on Physics: Waves Spotlight Science 7 EQUIPMENT (91) STAR Digital Tape Timer WEB WATCH (92) Downloads
Reviews three computer software packages for Apple II computers. Includes "Simulation of Hemoglobin Function,""Solution Equilibrium Problems," and "Thin-Layer Chromatography." Contains ratings of ease of use, subject matter content, pedagogic value, and student reaction according to two separate reviewers for each program. (CW)
Journal of Chemical Education, 1988
BOOK REVIEWS (164) Salters GCSE Science: Teacher and Technician Resource Pack, Year 10 The NEW World of Mr Tompkins The Heinemann Science Scheme: Book 1 Advanced Physics Readers: Astrophysics Using the Internet in Secondary Schools, 2nd edition CD-ROM REVIEW (168) Particle Physics: A Keyhole to the Birth of Time (version 2) WEB WATCH (169) Hunting for new physics sites CORRECTION (171)
A review of the incidence and transmission of Listeria monocytogenes in ready-to-eat products in retail and food service environments.
Contamination of ready-to-eat products with Listeria monocytogenes may occur at several stages before consumption. Accessibility to the public and relatively limited control interventions at retail and food service establishments (compared with the processing sector of the food industry) and the lack of a specific regulatory framework increase the likelihood of introduction of this pathogen into some foods in these establishments. This review is a compilation of available information on the incidence and transmission of L. monocytogenes through ready-to-eat products at the retail and food service level. The potential transmission of L. monocytogenes within retail and food service operations has been indicated in epidemiological investigations and by survey data. Potential sources of the organism in these operations include the environment, food handlers, and incoming raw ingredients or processed products that have become contaminated after the lethality treatment at the manufacturing facility. L. monocytogenes may be present at retail and food service establishments in various ready-to-eat products, both prepackaged and those packaged in the store, and occasionally at high concentrations. This issue dictates the need for development and application of effective control measures, and potential control approaches are discussed here. Good manufacturing practices, appropriate cleaning, sanitation and hygiene programs, and temperature control required for prevention or inhibition of growth of the pathogen to high levels are critical for control of L. monocytogenes in the retail and food service sector. A comprehensive food safety system designed to be functional in retail and food service operations and based on the philosophy of hazard analysis and critical control point systems and a series of sound prerequisite programs can provide effective control of L. monocytogenes in these environments. However, competent delivery of food safety education and training to retail and food service managers and food handlers must be in place for successful implementation of such a system. PMID:17900099
Lianou, Alexandra; Sofos, John N
Services and Accomplishments
Bellevue Utilities consists of the following divisions: Engineering, Resource Management and Customer Service, and Operations and Maintenance (O&M). Engineering plans and builds the City's water, sewer and storm drainage systems and provides project review and construction quality control for development projects. Resource Management and Customer Service provides billing services for customers, develops rates and budgets, provides contract management service for
Kelsey Creeks
An overview of drugs and ancillary equipment for the dentist's emergency kit.
The concept of a basic (i.e., essential) medical emergency kit suitable for a general dental practitioner varies somewhat between different authorities. A practitioner's choice is also dependant on the proximity of medical aid and the nature of the dental practice. Over recent years the trend has been to restrict the items to a minimum, in the interest of both common sense and safety, for example, just oxygen, adrenaline 1:1000, an oral carbohydrate source, glyceryl trinitrate and aspirin as first options. Ancillary equipment should include an oxygen therapy facemask, a pocket mask and a set of oral (Guedel) airways. Two further medication options for consideration are an aerosol bronchodilator and, in certain circumstances, an injectable antihypoglycaemic agent. This paper provides a selective overview of the subject. An absolute necessity is for dentists to be competent in Basic Life Support skills, and to maintain a complete and current medical history for all patients. PMID:14649404
Chapman, P J
Ancillary operation in coal preparation instrumentation: On-line low cost sulfur and ash analysis
Progress in reported on ancillary operations in coal preparation instrumentation, and on-line low cost sulfur and ash analysis of coal. This quarter's activities consisted of the following; the assembly of the sample preparation and delivery (SPAD) system was completed and laboratory pretesting performed; the entire system was assembled and debugged at C.Q. Inc.; field tests were executed according to the Field Test Plan with certain modifications necessitated by actual field conditions and C.Q. test schedule; coal slurry samples collected at C.Q. Inc. were either sent to the Homer City Coal Lab or brought back to B W for ICP analysis; and Homer City Coal Lab analysis of field collected slurry samples was completed and results reported to B W.
Using Ancillary Information to Improve Hypocenter Estimation: Bayesian Single Event Location (BSEL).
We have developed and tested an algorithm, Bayesian Single Event Location (BSEL), for esti- mating the location of a seismic event. The estimation approach di*ers from established non-linear regression techniques by using a Bayesian prior probability density function (prior PDF) to incor- porate ancillary physical basis constraints about event location. Pwave arrival times from seismic events are used in the development. Depth, a focus of this paper, may be modeled with a prior PDF (potentially skewed) that captures physical basis bounds from ancillary event characteristics. For instance the surface wave Rg is present in a waveform only when an event is shallow. A high- condence Rg detection in one or more event waveforms implies a shallow-skewed prior PDF for the depth parameter. This PDF is constructed from a physically-based Rayleigh wave depth excitation eigenfunction that is based on the minimum period of observation from a spectrogram analysis and estimated near-source elastic parameters. The proposed Bayesian algorithm is illustrated with events that demonstrate its congruity with established hypocenter estimation methods and its application potential. The BSEL method is applied to the Mw 5.6 Dillon, MT earthquake of July 26, 2005 and a shallow Mw 4 earthquake that occurred near Bardwell, KY on June 6, 2003. In both cases we simulate BSEL on a small subset of arrival time data to illustrate the power of the technique. No Rg was actually observed for the Dillon, MT earthquake, but we used the minimum observed period of a Rayleigh wave (7 seconds) to reduce the depth and origin time uncertainty. A strong Rg was observed from the Bardwell, KY earthquake that places very strong constraints on depth and origin time
Fagan, Deborah; Taylor, Steve R.; Schult, Frederick R.; Anderson, Dale N.
Reviews two chemistry software packages: (1) "Organic Reaction Chemistry" (organic chemistry, college level, Apple II); and (2) "Chemical Reactions, Reactions in Aqueous Solution, and Oxidation Reduction Reactions" (general chemistry, college level, IBM). (MVL)
Journal of Chemical Education, 1989
Reviews three chemistry software programs at the high school and college general chemistry level for the Apple II family. Includes "Chemical Nomenclature and Balancing Equations,""Principles of Stoichiometry," and "Solubility." (MVL)
Reviews eight textbooks, readers, and books. Topics include Latin America, colonial America, the Carolinians, women in French textbooks, the Vikings, the Soviet Union, nineteenth-century Black America, and Ernest Rutherford. (TRS)
Greenleaf, Floyd; And Others
Reviewed are two computer software packages: "Introduction to Spectroscopy, IR, NMR & CMR," and "ASYSTANT" (a mathematical and statistical analysis software tool). Discussed are the functions, strengths, weaknesses, hardware requirements, components, level, and cost for each package. (CW)
Journal of Chemical Education, 1990
Reviews four software packages available for IBM PC or Apple II. Includes "Graphical Analysis III"; "Space Max: Space Station Construction Simulation"; "Guesstimation"; and "Genetic Engineering Toolbox." Focuses on each packages' strengths in a high school context. (CW)
Science Teacher, 1988
Reviews three software packages: 1) a package containing 68 programs covering general topics in chemistry; 2) a package dealing with acid-base titration curves and allows for variables to be changed; 3) a chemistry tutorial and drill package. (MVL)
Radcliffe, George; And Others
BOOK REVIEWS (71) Calculations for A-Level Physics, 4th edition The Science of Soccer New Higher Physics, 2nd edition Standard Grade Physics, 2nd edition Particle Physics WEB WATCH (75) 'Fly me to the Moon ...'
Increasing Productivity in the Delivery of Ambulatory Health Services. A Review of Literature and on Going Projects.
The document is concerned with the theory that various types of group practices, especially comprehensive health centers, are the preferred ways of delivering health services to the poor. During the course of previous cost-effectiveness studies, it had be...
D. Strope B. Chen A. Yonkers
Prenatal Screening for HIV: A Review of the Evidence for the U.S. Preventive Services Task Force.
Each year in the United States, 6000 to 7000 women with HIV give birth. The management and outcomes of prenatal HIV infection have changed substantially since the U.S. Preventive Services Task Force issued recommendations in 1996.
A. K. Smits L. H. Huffman P. T. Korthuis R. Chou R. Fu
Unit and Item Nonresponses and Ancillary Information in Web- and Paper-Based Questionnaires Administered to School Counselors
This study examined unit and item nonresponse rates and ancillary information provided for Web- and paper-based versions of a questionnaire administered to school counselors. Results indicate that the unit nonresponse rate was higher for the Web-based version but that the patterns of item nonresponse found generally did not differ between the�
Wolfe, Edward W.; Converse, Patrick D.; Airen, Osaro; Bodenhorn, Nancy
When No Bilingual Examiner Is Available: Exploring the Use of Ancillary Examiners as a Viable Testing Solution
Reliable and valid assessment of individuals who are English language learners (ELL) has presented a dilemma to psychologists, and school psychologists in particular, as it is complicated by the small number of professionals qualified to serve as bilingual examiners. Some psychologists use ancillary examiners during testing when no bilingual�
Noland, Ramona M.
Luminescence color tuning of the iridium complexes by interligand energy transfer (ILET) with ancillary ligands for organic light emitting diode.
The series of new iridium complexes, Ir(C--N)2(LX), (main ligand, C--N = the anion of 2-phenylpyridine (ppy), 4-difluoro-2-phenylpyridine (F2-ppy) and 4-methyl-2,3-diphenylquinoline (4-Me-2,3-dpq); ancillary ligand, LX = 2-(2-hydroxyphenyl)benzoxazolate (BOX) and 2-(2-hydroxyphenyl)benzothiazolate (BTZ)) were prepared and their luminescence properties were investigated. We expected that the relative energy levels of the main ligands and ancillary ligands in the complexes could determine the possibility of interligand energy transfer (ILET) in the complexes and thereby luminescence properties. As the main ligands, F2-ppy, ppy and 4-Me-2,3-dpq, which have drastically different energy gap between the HOMO and LUMO energy levels, were chosen and their complexes were synthesized. BOX and BTZ were chosen as the ancillary ligands which can form a stable 6-membered metallacycle with the iridium center. The iridium complexes showed various emission ranges from 510 to 643 nm, depending upon the relative energy levels of their main and ancillary ligands. The studies of photoabsorption, electrochemistry, photoluminescence and electroluminescence revealed that ILET might contribute to absorption and luminescence process of the iridium complexes containing the ppy-based ligands and BOX. PMID:24758022
Park, Hye Rim; Lee, Seok Jae; Kim, Young Kwan; Ha, Yunkyoung
Development of a solid polymer electrolyte electrolysis cell module and ancillary components for a breadboard water electrolysis system
Solid polymer electrolyte technology in a water electrolysis system along with ancillary components to generate oxygen and hydrogen for a manned space station application are considered. Standard commercial components are utilized wherever possible. Presented are the results of investigations, surveys, tests, conclusions and recommendations for future development efforts.
Porter, F. J., Jr.
Initial assessment of strategic plans for improving the performance of veterinary services in developing countries: a review of OIE PVS gap analysis reports.
The World Organisation for Animal Health (OIE) carries out Gap Analysis missions (if a country so wishes) as part of its programme to assess and improve the Performance of Veterinary Services (the 'PVS Pathway') in Member Countries. These Gap Analysis missions have found that many national Veterinary Services comply to only a limited extent with the international standards established by the OIE and that their competence is compromised by poor governance. This failure threatens animal and public health not only nationally but also internationally. The OIE PVS Gap Analysis reports reviewed found that all the Veterinary Services have a strong vision and commitmentto improvement but are held back by a weak chain of command, inadequate and outdated legislation, insufficient funding, weak technical competencies, compromised technical independence, poor communications and limited joint programmes. There are weaknesses across all the core technical areas of trade, animal health, veterinary public health and veterinary laboratories and also in the overall management of the Veterinary Services. The OIE PVS Gap Analysis missions recommend significant increases in budget in all countries. PMID:23413738
Weaver, J; Leon, E; Edan, M; D'Alessio, F
Providing Reliability Services through Demand Response: A Prelimnary Evaluation of the Demand Response Capabilities of Alcoa Inc.
Demand response is the largest underutilized reliability resource in North America. Historic demand response programs have focused on reducing overall electricity consumption (increasing efficiency) and shaving peaks but have not typically been used for immediate reliability response. Many of these programs have been successful but demand response remains a limited resource. The Federal Energy Regulatory Commission (FERC) report, 'Assessment of Demand Response and Advanced Metering' (FERC 2006) found that only five percent of customers are on some form of demand response program. Collectively they represent an estimated 37,000 MW of response potential. These programs reduce overall energy consumption, lower green house gas emissions by allowing fossil fuel generators to operate at increased efficiency and reduce stress on the power system during periods of peak loading. As the country continues to restructure energy markets with sophisticated marginal cost models that attempt to minimize total energy costs, the ability of demand response to create meaningful shifts in the supply and demand equations is critical to creating a sustainable and balanced economic response to energy issues. Restructured energy market prices are set by the cost of the next incremental unit of energy, so that as additional generation is brought into the market, the cost for the entire market increases. The benefit of demand response is that it reduces overall demand and shifts the entire market to a lower pricing level. This can be very effective in mitigating price volatility or scarcity pricing as the power system responds to changing demand schedules, loss of large generators, or loss of transmission. As a global producer of alumina, primary aluminum, and fabricated aluminum products, Alcoa Inc., has the capability to provide demand response services through its manufacturing facilities and uniquely through its aluminum smelting facilities. For a typical aluminum smelter, electric power accounts for 30% to 40% of the factory cost of producing primary aluminum. In the continental United States, Alcoa Inc. currently owns and/or operates ten aluminum smelters and many associated fabricating facilities with a combined average load of over 2,600 MW. This presents Alcoa Inc. with a significant opportunity to respond in areas where economic opportunities exist to help mitigate rising energy costs by supplying demand response services into the energy system. This report is organized into seven chapters. The first chapter is the introduction and discusses the intention of this report. The second chapter contains the background. In this chapter, topics include: the motivation for Alcoa to provide demand response; ancillary service definitions; the basics behind aluminum smelting; and a discussion of suggested ancillary services that would be particularly useful for Alcoa to supply. Chapter 3 is concerned with the independent system operator, the Midwest ISO. Here the discussion examines the evolving Midwest ISO market structure including specific definitions, requirements, and necessary components to provide ancillary services. This section is followed by information concerning the Midwest ISO's classifications of demand response parties. Chapter 4 investigates the available opportunities at Alcoa's Warrick facility. Chapter 5 involves an in-depth discussion of the regulation service that Alcoa's Warrick facility can provide and the current interactions with Midwest ISO. Chapter 6 reviews future plans and expectations for Alcoa providing ancillary services into the market. Last, chapter 7, details the conclusion and recommendations of this paper.
Starke, Michael R [ORNL; Kirby, Brendan J [ORNL; Kueck, John D [ORNL; Todd, Duane [Alcoa; Caulfield, Michael [Alcoa; Helms, Brian [Alcoa
Effects of Having Usual Source of Care on Preventive Services and Chronic Disease Control: A Systematic Review
Background Having usual source of care has been associated with improved receipt of preventive services and control of chronic diseases (such as hypertension, diabetes, and hypercholesterolemia). The objective of this study was to examine whether having usual source of care is associated with improved receipt of preventive services and control of chronic diseases. Methods We searched MEDLINE, EMBASE, Cochrane, CINAHL, KMbase, KoreaMed, RiSS4U, National Assembly Library, and KISS for studies released through May 31st 2011. Two authors independently extracted the data. We manually searched the references and twenty recent related articles on PubMed. To assess the risk of bias RoBANS tool was used. Results We identified 10 studies. Most having usual source of care were associated with improved receipt of preventive services (cervical cancer screening, clinical breast exam, mammogram, prostate cancer screening, and flu shot) compared with no usual source of care. However, gastric cancer and colon cancer screening were difficult to conclude and blood pressure checkup showed mixed results. Overall there was no association between having usual source of care and smoking behaviors and the effect on chronic disease control was difficult to conclude. Conclusion Having usual source of care was associated with improved receipt of preventive services and overall the results were consistent. So, the results suggested that having usual source of care may help to receive preventive services. Hereafter, cohort studies are needed to evaluate casual relationships and more studies are needed in various countries and systems.
Kim, Min Young; Kim, Ju Heon; Choi, Il-Kwon; Hwang, In Hong
48 CFR 2937.103-70 - Department of Labor checklist to aid analysis and review of requirements for service contracts.
...Department of Labor checklist to aid analysis and review of requirements...Following is a checklist to aid analysis and review of requirements...contractor to provide advice, analysis and evaluation, opinions...contractor's current or future business? (7) Will the work...
Reviews two computer programs: "Molecular Graphics," which allows molecule manipulation in three-dimensional space (requiring IBM PC with 512K, EGA monitor, and math coprocessor); and "Periodic Law," a database which contains up to 20 items of information on each of the first 103 elements (Apple II or IBM PC). (MVL)
Reviewed are two computer software packages the "Scientific Routines Diskette: Laboratory Automation Using the IBM PC" and "SEQS 3.0 Student Version Simultaneous Equation Solver" for IBM and compatible personal computers. Discussed are hardware, components, level, cost, functions, strengths, and weaknesses. (CW)
Reviews three computer software packages for chemistry education including "Osmosis and Diffusion" and "E.M.E. Titration Lab" for Apple II and "Simplex-V: An Interactive Computer Program for Experimental Optimization" for IBM PC. Summary ratings include ease of use, content, pedagogic value, student reaction, and cost. (CW)
Reviews four organic chemistry computer programs and three books. Software includes: (1) NMR Simulator 7--for IBM or Macintosh, (2) Nucleic Acid Structure and Synthesis--for IBM, (3) Molecular Design Editor--for Apple II, and (4) Synthetic Adventure--for Apple II and IBM. Book topics include physical chemistry, polymer pioneers, and the basics of�
Newland, Robert J.; And Others
DISTANCE-LEARNING COURSES (263) Planetary Science and Astronomy BOOK REVIEWS (263) A New Kind of Science Planetary Science: The Science of Planets Around Stars EQUIPMENT (265) The Science Enhancement Program (SEP) Geiger Counter WEB WATCH (265) Revision sites SOFTWARE (267) Exploration of Physics Volume 1
75 FR 63167 - San Diego Gas and Electric Company v. Sellers of Energy and Ancillary Services Into Markets...
...EL00-98-228] San Diego Gas and Electric Company v. Sellers...Corporation and the California Power Exchange; Investigation of...Operator and the California Power Exchange Corporation; Notice...October 6, 2010, the California Power Exchange Corporation filed...
77 FR 40413 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...
...Accounting and Financial Reporting for New Electric Storage Technologies; Proposed...Accounting and Financial Reporting for New Electric Storage Technologies AGENCY: Federal...Accounting and Financial Reporting for New Electric Storage Technologies, 135...
Participation of direct drive Wind Turbine to the grid ancillary services using a Flywheel Energy Storage System
Renewable energy sources have achieved increasing levels of penetration in recent years. Therefore, the impact of those sources on the power system is becoming greater, due to their intermittent source. The current tendency is to remain the Wind Turbine (WT) connected to the grid during voltage dip or frequency variation according to the grid connection requirements (GCR). This paper proposes
M. Khaterchi; J. Belhadj; M. Elleuch
Evaluation of freely available ancillary data used for detailed soil mapping in Brazil
Brazil is one of the world's largest food producers, and is home of both largest rainforest and largest supply of renewable fresh water on Earth. However, it lacks detailed soil information in extensive areas of the country. The best soil map covering the entire country was published at a scale of 1:5,000,000. Termination of governmental support for systematic soil mapping in the 1980's made detailed soil mapping of the whole country a very difficult task to accomplish. Nowadays, due to new user-driven demands (e.g. precision agriculture), most detailed soil maps are produced for small size areas. Many of them rely on as is freely available ancillary data, although their accuracy is usually not reported or unknown. Results from a validation exercise that we performed using ground control points from a small hilly catchment (20 km�) in Southern Brazil (-53.7995�E, -29.6355�N) indicate that most freely available ancillary data needs some type of correction before use. Georeferenced and orthorectified RapidEye imagery (recently acquired by the Brazilian government) has a horizontal accuracy (root-mean-square error, RMSE) of 37 m, which is worse than the value published in the metadata (32 m). Like any remote sensing imagery, RapidEye imagery needs to be correctly registered before its use for soil mapping. Topographic maps produced by the Brazilian Army and derived geological maps (scale of 1:25,000) have a horizontal accuracy of 65 m, which is more than four times the maximum value allowed by Brazilian legislation (15 m). Worse results were found for geological maps derived from 1:50,000 topographic maps (RMSE = 147 m), for which the maximum allowed value is 30 m. In most cases positional errors are of systematic origin and can be easily corrected (e.g., affine transformation). ASTER GDEM has many holes and is very noisy, making it of little use in the studied area. TOPODATA, which is SRTM kriged from originally 3 to 1 arc-second by the Brazilian National Institute for Space Research, has a vertical accuracy of 19 m and is strongly affected by double-oblique stripes which were intensified by kriging. Many spurious sinks were created which are not easily corrected using either frequency filters or sink-filling algorithms. The exceptions are SRTM v4.1, which is the most vertically accurate DEM available (RMSE = 18.7 m), and Google Earth imagery compiled from various sources (positional accuracy of RMSE = 8 m). It is likely that most mapping efforts will continue to be employed in small size areas to fulfill local user-driven demands in the forthcoming years. Also, many new techniques and technologies will possibly be developed and employed for soil mapping. However, employing better quality ancillary data still is a challenge to be overcome to produce high-quality soil information to allow better decision making and land use policy in Brazil.
Samuel-Rosa, Alessandro; Anjos, L�cia; Vasques, Gustavo; Heuvelink, Gerard
Synthetic control of excited-state properties in cyclometalated Ir(III) complexes using ancillary ligands.
The synthesis and photophysical characterization of a series of (N,C(2')-(2-para-tolylpyridyl))2 Ir(LL') [(tpy)2 Ir(LL')] (LL' = 2,4-pentanedionato (acac), bis(pyrazolyl)borate ligands and their analogues, diphosphine chelates and tert-butylisocyanide (CN-t-Bu)) are reported. A smaller series of [(dfppy)2 Ir(LL')] (dfppy = N,C(2')-2-(4',6'-difluorophenyl)pyridyl) complexes were also examined along with two previously reported compounds, (ppy)2 Ir(CN)2- and (ppy)2 Ir(NCS)2- (ppy = N,C(2')-2-phenylpyridyl). The (tpy)2 Ir(PPh2CH2)2 BPh2 and [(tpy)2 Ir(CN-t-Bu)2](CF3SO3) complexes have been structurally characterized by X-ray crystallography. The Ir-C(aryl) bond lengths in (tpy)2 Ir(CN-t-Bu)2+ (2.047(5) and 2.072(5) A) and (tpy)2 Ir(PPh2CH2)2 BPh2 (2.047(9) and 2.057(9) A) are longer than their counterparts in (tpy)2 Ir(acac) (1.982(6) and 1.985(7) A). Density functional theory calculations carried out on (ppy)2 Ir(CN-Me)2+ show that the highest occupied molecular orbital (HOMO) consists of a mixture of phenyl-pi and Ir-d orbitals, while the lowest unoccupied molecular orbital is localized primarily on the pyridyl-pi orbitals. Electrochemical analysis of the (tpy)2 Ir(LL') complexes shows that the reduction potentials are largely unaffected by variation in the ancillary ligand, whereas the oxidation potentials vary over a much wider range (as much as 400 mV between two different LL' ligands). Spectroscopic analysis of the cyclometalated Ir complexes reveals that the lowest energy excited state (T1) is a triplet ligand-centered state (3LC) on the cyclometalating ligand admixed with 1MLCT (MLCT = metal-to-ligand charge-transfer) character. The different ancillary ligands alter the 1MLCT state energy mainly by changing the HOMO energy. Destabilization of the 1MLCT state results in less 1MLCT character mixed into the T1 state, which in turn leads to an increase in the emission energy. The increase in emission energy leads to a linear decrease in ln(k(nr)) (k(nr) = nonradiative decay rate). Decreased 1MLCT character in the T1 state also increases the Huang-Rhys factors in the emission spectra, decreases the extinction coefficient of the T1 transition, and consequently decreases the radiative decay rates (k(r)). Overall, the luminescence quantum yields decline with increasing emission energies. A linear dependence of the radiative decay rate (k(r)) or extinction coefficient (epsilon) on (1/deltaE)2 has been demonstrated, where deltaE is the energy difference between the 1MLCT and 3LC transitions. A value of 200 cm(-1) for the spin-orbital coupling matrix element 3LC absolute value(H(SO)) 1MLCT of the (tpy)2 Ir(LL') complexes can be deduced from this linear relationship. The (fppy)2 Ir(LL') complexes with corresponding ancillary ligands display similar trends in excited-state properties. PMID:15762698
Li, Jian; Djurovich, Peter I; Alleyne, Bert D; Yousufuddin, Muhammed; Ho, Nam N; Thomas, J Christopher; Peters, Jonas C; Bau, Robert; Thompson, Mark E
A systematic review of the effect of primary care-based service innovations on quality and patterns of referral to specialist secondary care.
BACKGROUND: Innovations are proliferating at the primary-secondary care interface, affecting referral to secondary care and resource use. Evidence about the range of effects and implications for the healthcare system of different types of innovation have not previously been summarised. AIM: To review the available evidence on initiatives affecting primary care referral to specialist secondary care. SETTING: Studies of primary-secondary care interface. METHOD: Systematic review of trials, using adapted Cochrane Collaboration (effective practice and organisation of care) criteria. Studies from 1980 to 2001 were identified from a wide range of sources. Strict inclusion criteria were applied, and relevant clinical, service and cost data extracted using an agreed protocol. The main outcome measures were referral rates to specialist secondary care. RESULTS: Of the 139 studies initially identified. 34 met the review criteria. An updated search added a further 10 studies. Two studies provided economic analysis only. Referral was not the primary outcome of interest in the majority of included studies. Professional interventions generally had an impact on referral rates consistent with the intended change in clinician behaviour. Similarly, specialist 'outreach' or other primary care-based specialist provider schemes had at least a small effect upon referral rates to secondary care with the direction of effect being that intended or rational from a clinical and sociological perspective. Of the financial interventions, one was aimed primarily at changing the numbers or proportion of referrals from primary to specialist secondary care, and the direction of change was as expected in all cases. The quality of the reporting of the economic components of the 14 studies giving economic data was poor in many cases. When grouped by intervention type, no overall pattern of change in referral costs or total costs emerged. CONCLUSION: The studies identified were extremely diverse in methodology, clinical subject, organisational form, and quality of evidence. The number of good quality evaluations of innovative schemes to enhance the existing capacity of primary care was small, but increasing. Well-evaluated service initiatives in this area should be supported. Organisational innovations in the structure of service provision need not increase total costs to the National Health Service (NHS), even though costs associated with referral may increase. This review provides limited, partial, and conditional support for current primary care-oriented NHS policy developments in the United Kingdom.
Faulkner, Alex; Mills, Nicola; Bainton, David; Baxter, Kate; Kinnersley, Paul; Peters, Tim J; Sharp, Deborah
Bayesian Network Structure Learning for Urban Land Use Classification from Landsat ETM+ and Ancillary Data
Recognizing urban information from the satellite imagery is problematic due to the diverse features and dynamic changes of urban landuse. The use of Landsat imagery for urban land use classification involves inherent uncertainty due to its spatial resolution and the low separability among land uses. To resolve the uncertainty problem, we investigated the performance of Bayesian networks to classify urban land use since Bayesian networks provide a quantitative way of handling uncertainty and have been successfully used in many areas. In this study, we developed the optimized networks for urban land use classification from Landsat ETM+ images of Marina del Rey area based on USGS land cover/use classification level III. The networks started from a tree structure based on mutual information between variables and added the links to improve accuracy. This methodology offers several advantages: (1) The network structure shows the dependency relationships between variables. The class node value can be predicted even with particular band information missing due to sensor system error. The missing information can be inferred from other dependent bands. (2) The network structure provides information of variables that are important for the classification, which is not available from conventional classification methods such as neural networks and maximum likelihood classification. In our case, for example, bands 1, 5 and 6 are the most important inputs in determining the land use of each pixel. (3) The networks can be reduced with those input variables important for classification. This minimizes the problem without considering all possible variables. We also examined the effect of incorporating ancillary data: geospatial information such as X and Y coordinate values of each pixel and DEM data, and vegetation indices such as NDVI and Tasseled Cap transformation. The results showed that the locational information improved overall accuracy (81%) and kappa coefficient (76%), and lowered the omission and commission errors compared with using only spectral data (accuracy 71%, kappa coefficient 62%). Incorporating DEM data did not significantly improve overall accuracy (74%) and kappa coefficient (66%) but lowered the omission and commission errors. Incorporating NDVI did not much improve the overall accuracy (72%) and k coefficient (65%). Including Tasseled Cap transformation reduced the accuracy (accuracy 70%, kappa 61%). Therefore, additional information from the DEM and vegetation indices was not useful as locational ancillary data.
Park, M.; Stenstrom, M. K.
Automated ancillary cancer history classification for mesothelioma patients from free-text clinical reports
Background: Clinical records are often unstructured, free-text documents that create information extraction challenges and costs. Healthcare delivery and research organizations, such as the National Mesothelioma Virtual Bank, require the aggregation of both structured and unstructured data types. Natural language processing offers techniques for automatically extracting information from unstructured, free-text documents. Methods: Five hundred and eight history and physical reports from mesothelioma patients were split into development (208) and test sets (300). A reference standard was developed and each report was annotated by experts with regard to the patient�s personal history of ancillary cancer and family history of any cancer. The Hx application was developed to process reports, extract relevant features, perform reference resolution and classify them with regard to cancer history. Two methods, Dynamic-Window and ConText, for extracting information were evaluated. Hx�s classification responses using each of the two methods were measured against the reference standard. The average Cohen�s weighted kappa served as the human benchmark in evaluating the system. Results: Hx had a high overall accuracy, with each method, scoring 96.2%. F-measures using the Dynamic-Window and ConText methods were 91.8% and 91.6%, which were comparable to the human benchmark of 92.8%. For the personal history classification, Dynamic-Window scored highest with 89.2% and for the family history classification, ConText scored highest with 97.6%, in which both methods were comparable to the human benchmark of 88.3% and 97.2%, respectively. Conclusion: We evaluated an automated application�s perf