An analysis of the Concessions Policy Act of 1965 (P.L. 89-249)

Concession operations within the National Park System have become one of the most visible aspects of park management. Moreover, it is viewed as a gauge which detects trends in the evolving concept of preservation and use. Also, it is used as a yard stick to measure the overall health of the National Park Service\u27s (NPS) administration. Currently, major reforms in the management of concession operations are supported by Secretary of the Interior, Manuel Lujan, certain members of Congress, the National Parks and Conservation Association, as well as other environmental groups. The targeted area of focus for these reforms center on the Concessions Policy Act of 1965 (P.L. 89-249). The hypotheses of this research are (i) the implementation of the legislation is very systemic (a change in one part can have significant impacts on other parts), and (ii) differences in perceptions do occur between NPS concession managers and concessioners. A mail survey instrument was sent to 20 NPS concession managers and 100 concessioners. The study encompassed the entire continental United States. NPS officials and concessioners were asked to determine the importance of eight listed components, which are found in P.L. 89-249. NPS officials indicated that preferential right to provide new facilities , 30-year length of contract, and the use of one concessioner per park were not important policy components in today\u27s operating environment. Concessioners viewed preferential right to provide new facilities as being very important and 30-year length of contract and the use of one concessioner per park as being moderately important. A possible explanation for NPS\u27s response is the existence of a perception that the other incentives provided for in the Act possess enough inducement that those three are no longer needed. This finding further suggests that the Act has become partially outdated. A second major finding occurred with significant differences determined in the degree to which P.L. 89-249 was functioning (i.e., meetings its intended objective). Concessioners perceived the Act was functioning at a higher level of effectiveness than perceived by NPS officials. Both groups indicated that the Act was, to some degree, accomplishing its intended tasks (i.e., reducing the difficulties of obtaining a concessioner and loan). This study also revealed that NPS officials perceived P.L. 89-249 contributed more to the well being of concessioners than it did to them. For example, possessory interest was viewed by NPS officials as a policy component which placed them at a moderate disadvantage while highly contributing to the well being of the concessioner. It became important to know why NPS officials perceived P.L. 89- 249 as not protecting their interest more fully. Possible answers were found as a result of reviewing the history of concessions management within the National Park system. This historical review suggested that NFS lacked the necessary technical and political expertise to influence not only concessioners, but also Congress and the general public. The above statement can be supported by the agencies struggle to realize their mission statement (preservation and use) and NPS\u27s placement within the Department of Interior. A fourth component of this research addressed the perception of how interconnected the different policy components were to one another. Overall, concessioners ranked each component as being more interconnected than NFS officials. However, both groups viewed P.L. 89-249 as being a very interconnected system. In other words, when one policy component is altered (for example, as a result of a reform measure), it will affect the functioning of other components. This concept is extremely important to understand. Without this knowledge, the likelihood of making effective changes is greatly diminished. For example, length of contract was ranked as being highly interconnected to protection against loss of investment. Thus, if the length of concessioners contract was significantly limited, the level of protection against a loss of investment could decrease. Other alternatives need to be explored. There is no quick solution which can satisfy all interests. It is hoped this study can provide a foundation for future studies

Emergency Departments and Care for Marginalized Populations

Healthcare providers in emergency departments (EDs) face a daunting daily task: providing health care in a triage setting to a diverse group of patients many with complex medical issues. Many patients rely on ED services out of financial necessity, when their healthcare issues could be better suited for care from a primary care physician. Many of these already vulnerable patients – minorities, those health illiterate, low-income, uninsured and those with language barriers – must also deal with ED overcrowding and staffing conditions. In some cases, patients leave without being seen while others face bed shortages. This study explores healthcare provider experiences and highlights some of the challenges of health care in the ED. This study also provides insight into possible interventions designed to better address the needs of ED patients. Through the use of a questionnaire, this study relays the experiences of 27 professionals who have worked in EDs the Hampton Roads area. While heart attacks, breathing problems, and trauma comprise the most common diagnoses and treatments cited by questionnaire respondents, this study found that overcrowding, long wait times, and staffing shortages were the biggest challenges that regional ED staffs faced. Caregivers surveyed in the study suggested that increased staffing, more beds, better transportation and more diligence in following up with patients could improve conditions in emergency departments

College of Health Sciences e-Newsletter, January 2019

January 2019 issue of Old Dominion University\u27s College of Health Sciences Newsletter.https://digitalcommons.odu.edu/healthsciences_newsletters/1067/thumbnail.jp

College of Health Sciences Newsletter, December 2015

December 2015 isse of Old Dominion University\u27s College of Health Sciences Newsletter.https://digitalcommons.odu.edu/healthsciences_newsletters/1002/thumbnail.jp

College of Health Sciences Newletter, November 2016

November 2016 issue of Old Dominion University\u27s College of Health Sciences Newsletter.https://digitalcommons.odu.edu/healthsciences_newsletters/1047/thumbnail.jp

College of Health Sciences e-Newsletter, February 2019

February 2019 issue of Old Dominion University\u27s College of Health Sciences Newsletter.https://digitalcommons.odu.edu/healthsciences_newsletters/1066/thumbnail.jp

College of Health Sciences Newsletter, January 2018

January 2018 issue of Old Dominion University\u27s College of Health Sciences Newsletter.https://digitalcommons.odu.edu/healthsciences_newsletters/1058/thumbnail.jp

College of Health Sciences Newsletter, September 2016

September 2016 issue of Old Dominion University\u27s College of Health Sciences Newsletter.https://digitalcommons.odu.edu/healthsciences_newsletters/1045/thumbnail.jp

College of Health Sciences Newsletter, August 2015

August 2015 issue of Old Dominion University\u27s College of Health Sciences Newsletter.https://digitalcommons.odu.edu/healthsciences_newsletters/1001/thumbnail.jp