Polasky, Stephen; Lewis, David J; Plantinga, Andrew J; Nelson, Erik
Many ecosystem services are public goods whose provision depends on the spatial pattern of land use. The pattern of land use is often determined by the decisions of multiple private landowners. Increasing the provision of ecosystem services, though beneficial for society as a whole, may be costly to private landowners. A regulator interested in providing incentives to landowners for increased provision of ecosystem services often lacks complete information on landowners' costs. The combination of spatially dependent benefits and asymmetric cost information means that the optimal provision of ecosystem services cannot be achieved using standard regulatory or payment for ecosystem services approaches. Here we show that an auction that sets payments between landowners and the regulator for the increased value of ecosystem services with conservation provides incentives for landowners to truthfully reveal cost information, and allows the regulator to implement the optimal provision of ecosystem services, even in the case with spatially dependent benefits and asymmetric information.
Anastasopoulos, Markos P; Tzanakaki, Anna; Georgakilas, Konstantinos
This paper focuses on energy efficient service provisioning in integrated IT and optical network infrastructures. A novel evolutionary distributed approach is proposed and compared with ILP based centralized approaches and modeling results quantify similar performance. © 2011 Optical Society of America
James Roumasset; Christopher Wada
Payments for ecosystem services should be informed by how both the providing-resource and the downstream resource are managed. We develop an integrated model that jointly optimizes conservation investment in a watershed that recharges a downstream aquifer and groundwater extraction from the aquifer. Volumetric user-fees to finance watershed investment induce inefficient water use, inasmuch as conservation projects actually lower the optimal price of groundwater. We propose a lump-sum conserva...
Kreiner, Claus Thustrup; Verdelin, Nicolaj
There currently exist two competing approaches in the literature on the optimal provision of public goods. The standard approach highlights the importance of distortionary taxation and distributional concerns. The new approach neutralizes distributional concerns by adjusting the non-linear income...... for the optimal level of a public good without imposing any separability assumptions on preferences. This formula shows that distortionary taxation may have a role to play as in the standard approach. However, the main determinants of optimal provision are completely different and the traditional formula with its...
Kreiner, Claus Thustrup; Verdelin, Nicolaj
The standard approach to the optimal provision of public goods highlights the importance of distortionary taxation and distributional concerns. A new approach neutralizes distributional concerns by adjusting the income tax schedule. We demonstrate that both approaches are derived from the same...
Kreiner, Claus Thustrup; Verdelin, Nicolaj
There currently exist two competing approaches in the literature on the optimal provision of public goods. The standard approach highlights the importance of distortionary taxation and distributional concerns. The new approach neutralizes distributional concerns by adjusting the non-linear income...... tax, and finds that this reinvigorates the simple Samuelson rule when preferences are separable in goods and leisure. We provide a synthesis by demonstrating that both approaches derive from the same basic formula. We further develop the new approach by deriving a general, intuitive formula...
Dynamic Provisioning for Community Services outlines a dynamic provisioning and maintenance mechanism in a running distributed system, e.g. the grid, which can be used to maximize the utilization of computing resources and user demands. The book includes a complete and reliable maintenance system solution for the large-scale distributed system and an interoperation mechanism for the grid middleware deployed in the United States, Europe, and China. The experiments and evaluations have all been practically implemented for ChinaGrid, and the best practices established can help readers to construc
van der Laan, G.; Ruys, P.H.M.; Talman, A.J.J.
This paper deals with the optimal provision of infrastructure by means of public-private partnership contracts.In the economic literature infrastructure is characterized as a large, indivisible and non-rival capital good that produces services for its users.Users can be both consumers and producers.
Full Text Available This article deals with the methods of services provision in Slovak towns. It addresses decision-making concerning selected services provision, based on a transaction cost economic model. The article looks at five types of services from that point of view. These are core services, i.e., services that are provided in most Slovak towns, thereby allowing outcomes of decision-making to be compared, and services which can be outsourced according to transaction cost theory. Findings partially confirm the hypothesis: Slovak towns do outsource, though “insourcing” moderately prevails. However, a comparison of several research studies in the area indicates a trend towards higher outsourcing of such local services provision. The findings show that public bodies do not always select the most suitable methods of services provision, as suggested by the transaction costs theory (the Brown-Potoski model. This indicates that it is not only economic models that influence decision-making concerning the organization of services provision in the Slovak towns.
EU policies for rural development stress the importance of investments rather than subsidies and aim at integrating different sectoral policies in order to improve the coherence and effectiveness of public expenditure. Policies also emphasize a place-based approach for rural development and thereby...... setting a competitive framework for local development. Rural municipalities are challenged due to demographic changes and population decline and consequently need to adjust municipal services. In this respect it is stressed that service provision need be linked to strategic planning based on urban...... municipalities can plan strategically, manage service provision and support place bound potential in rural communities in light of a competitive framework for local development....
Bennedsen, Morten; Schultz, Christian
We analyze the economic consequences of strategic delegation of the right to decide between public or private provision of governmental service and/or the authority to negotiate and renegotiate with the chosen service provider. Our model encompass both bureaucratic delegation from a government to...... contracts. The bargaining effect improves the bargaining position vis a vis a private firm with market power and leads to a lower price for the service......We analyze the economic consequences of strategic delegation of the right to decide between public or private provision of governmental service and/or the authority to negotiate and renegotiate with the chosen service provider. Our model encompass both bureaucratic delegation from a government...... to a privatization agency and electoral delegation from voters to a government. We identify two powerfull effects of delegation when contracts are incomplete: The incentive effect increases the incentive part of service providers' remuneration and we show that strategic delegation may substitute formal incentive...
Bailo, Daniele; Jeffery, Keith G.; Atakan, Kuvvet; Harrison, Matt
EPOS is now in IP (implementation phase) after a successful PP (preparatory phase). EPOS consists of essentially two components, one ICS (Integrated Core Services) representing the integrating ICT (Information and Communication Technology) and many TCS (Thematic Core Services) representing the scientific domains. The architecture developed, demonstrated and agreed within the project during the PP is now being developed utilising co-design with the TCS teams and agile, spiral methods within the ICS team. The 'heart' of EPOS is the metadata catalog. This provides for the ICS a digital representation of the TCS assets (services, data, software, equipment, expertise…) thus facilitating access, interoperation and (re-)use. A major part of the work has been interactions with the TCS. The original intention to harvest information from the TCS required (and still requires) discussions to understand fully the TCS organisational structures linked with rights, security and privacy; their (meta)data syntax (structure) and semantics (meaning); their workflows and methods of working and the services offered. To complicate matters further the TCS are each at varying stages of development and the ICS design has to accommodate pre-existing, developing and expected future standards for metadata, data, software and processes. Through information documents, questionnaires and interviews/meetings the EPOS ICS team has collected DDSS (Data, Data Products, Software and Services) information from the TCS. The ICS team developed a simplified metadata model for presentation to the TCS and the ICS team will perform the mapping and conversion from this model to the internal detailed technical metadata model using (CERIF: a EU recommendation to Member States maintained, developed and promoted by euroCRIS www.eurocris.org ). At the time of writing the final modifications of the EPOS metadata model are being made, and the mappings to CERIF designed, prior to the main phase of (meta
Whitfield, Lindsay; Hirvi, Marja
The politics of public-service delivery continues to be neglected under the supposedly more context-sensitive post-Washington Consensus. Using interviews and documentary evidence from Ghana, this article provides an account of the networks of political interference and informal practices in Ghana......-specific political settlement in which public-service provision operates.......'s public water utility. It argues that, in order to understand why private-sector participation succeeds or fails and why similar arrangements have different outcomes across developing countries, we need to examine the effects of the informal institutional context, particularly the country...
Karen H. Fung
Full Text Available Background: An estimated 70 million people with disabilities need wheelchairs. To address this global crisis, the World Health Organization (WHO proposed an eight-step wheelchair service provision model to ensure service quality regardless of resource setting. The International Society of Wheelchair Professionals (ISWP aims to facilitate the integration of the WHO eight-step model into professional rehabilitation programmes.Objective: To develop an enhanced understanding of the current wheelchair service provision education provided in professional rehabilitation programmes worldwide.Methods: In a cross-sectional design, an online survey was distributed to ISWP contacts of educational institutions. Quantitative responses were analysed through summary statistics and qualitative answers were analysed by content analyses. When relevant, educational institutions were stratified into resource settings.Results: Seventy-two representatives of educational institutions in 21 countries completed the survey. Wheelchair content was taught in 79% of represented institutions, of which 75% of respondents reported using original course material, 10% of respondents used WHO Wheelchair Service Training Packages and 15% of respondents used other available resources. The majority of educational institutions teaching with their own wheelchair-related course material taught ≤ 20 hours. Fourteen of the 15 respondents without wheelchair education, expressed an interest in integrating wheelchair education into their academic curricula.Conclusion: The majority of the educational institutions teach wheelchair education; however, there is great variability in what and how it is taught and evaluated. The results demonstrate the need for more in-depth investigation regarding the integration process of wheelchair education in educational institutions, with the ultimate goal of improving wheelchair service provision worldwide.
Demchenko, Y.; Ngo, C.; de Laat, C.; Lopez, D.R.; Morales, A.; García-Espín, J.A.; Pearson, S.; Yee, G.
This chapter discusses conceptual issues, basic requirements and practical suggestions for designing dynamically configured security infrastructure provisioned on demand as part of the cloud-based infrastructure. This chapter describes general use cases for provisioning cloud infrastructure services
Full Text Available Service discovery technologies are exploited to enable services to advertise their existence in a dynamic way and can be discovered, configured and used by other devices with minimum of manual efforts. Automatic service discovery plays an important role in future network scenarios. Service discovery in distributed environment is difficult that too if the availability information of the services cannot be in a centralized node. The complexity is increased even further in the case of MANETs in which there will not be central intelligence also, the nodes involved may be on the move. The mobility issue leads to the situation of uncertainty about the service availability of the service provider. In this paper we propose a decentralized discovery mechanism. The basic idea is, distributing service information along with the availability metrics to the nodes. The metrics will give us the information to evaluate the goodness of the service provider. Every node will form multi-layered overlays of service providers sorted based on the metrics. When we send a query, each node will identify the service provider from the overlay with the good metric among the available providers (i.e. the one in the first position in the overlay. We define the message structures and methods needed for this proposal. The simulation result shows that in the high mobile environment too we could have a better convergence. We believe that the architecture presented here is a necessary component of any service provision framework.
Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based on 529 health ...
Whaiduzzaman, Md; Haque, Mohammad Nazmul; Rejaul Karim Chowdhury, Md; Gani, Abdullah
Cloud computing is currently emerging as an ever-changing, growing paradigm that models "everything-as-a-service." Virtualised physical resources, infrastructure, and applications are supplied by service provisioning in the cloud. The evolution in the adoption of cloud computing is driven by clear and distinct promising features for both cloud users and cloud providers. However, the increasing number of cloud providers and the variety of service offerings have made it difficult for the customers to choose the best services. By employing successful service provisioning, the essential services required by customers, such as agility and availability, pricing, security and trust, and user metrics can be guaranteed by service provisioning. Hence, continuous service provisioning that satisfies the user requirements is a mandatory feature for the cloud user and vitally important in cloud computing service offerings. Therefore, we aim to review the state-of-the-art service provisioning objectives, essential services, topologies, user requirements, necessary metrics, and pricing mechanisms. We synthesize and summarize different provision techniques, approaches, and models through a comprehensive literature review. A thematic taxonomy of cloud service provisioning is presented after the systematic review. Finally, future research directions and open research issues are identified.
Full Text Available Cloud computing is currently emerging as an ever-changing, growing paradigm that models “everything-as-a-service.” Virtualised physical resources, infrastructure, and applications are supplied by service provisioning in the cloud. The evolution in the adoption of cloud computing is driven by clear and distinct promising features for both cloud users and cloud providers. However, the increasing number of cloud providers and the variety of service offerings have made it difficult for the customers to choose the best services. By employing successful service provisioning, the essential services required by customers, such as agility and availability, pricing, security and trust, and user metrics can be guaranteed by service provisioning. Hence, continuous service provisioning that satisfies the user requirements is a mandatory feature for the cloud user and vitally important in cloud computing service offerings. Therefore, we aim to review the state-of-the-art service provisioning objectives, essential services, topologies, user requirements, necessary metrics, and pricing mechanisms. We synthesize and summarize different provision techniques, approaches, and models through a comprehensive literature review. A thematic taxonomy of cloud service provisioning is presented after the systematic review. Finally, future research directions and open research issues are identified.
Rejaul Karim Chowdhury, Md
Cloud computing is currently emerging as an ever-changing, growing paradigm that models “everything-as-a-service.” Virtualised physical resources, infrastructure, and applications are supplied by service provisioning in the cloud. The evolution in the adoption of cloud computing is driven by clear and distinct promising features for both cloud users and cloud providers. However, the increasing number of cloud providers and the variety of service offerings have made it difficult for the customers to choose the best services. By employing successful service provisioning, the essential services required by customers, such as agility and availability, pricing, security and trust, and user metrics can be guaranteed by service provisioning. Hence, continuous service provisioning that satisfies the user requirements is a mandatory feature for the cloud user and vitally important in cloud computing service offerings. Therefore, we aim to review the state-of-the-art service provisioning objectives, essential services, topologies, user requirements, necessary metrics, and pricing mechanisms. We synthesize and summarize different provision techniques, approaches, and models through a comprehensive literature review. A thematic taxonomy of cloud service provisioning is presented after the systematic review. Finally, future research directions and open research issues are identified. PMID:25032243
The evolution of Cloud Computing brings advantages to both customers and service providers to utilize and manage computing and network resources more efficiently with virtualization, service-oriented architecture technologies, and automated on-demand resource provisioning. However, these advantages
Full Text Available Grave-sweeping is one of the popular special events in Asian cities, especially in Chinese societies, in which families express filial piety to their ancestors during two traditional grave-sweeping festivals in a year. The extraordinary high travel demand is often attracted to columbaria within a relative short period around the festivals, and induces severe impacts to the local traffic. It is challenging for the government and private operators to formulate a public transport service setting to satisfactorily cater all the visitors' travel demand. This paper aims to propose an optimization framework to identify the optimal provisions of public transport services for columbarium trips to achieve consumer surplus or profit maximization. Numerical studies are carried out using the travel demand data collected from a selected columbarium, to examine the effects of different public transport service settings to the policy objectives in various cases. The model results show that the current situation is neither consumer surplus nor profit optimum. Improvement schemes are suggested in relation to allow various fares during different visit periods and provide multiple public transport feeder services to serve the visitors during the high travel demand period.
Caba, Cosmin Marius; Soler, José
One of the applicability areas of SDN is for creating services for dynamic provisioning of network resources with strict QoS requirements. The research available in this field focuses mainly on the service logic implemented over the functionality of the SDN Controller (SDNC). However, there is much....... More specifically, the paper will look into on demand provisioning of Virtual Circuits (VCs) with specific QoS, based on the SDN paradigm. The aim is to analyze and compare the strategies for network resources management for two cases: a coarse granular and a fine granular VC provisioning service...
A narrow technocentric focus on a few favored ecosystem services (generally provisioning services) has led to ecosystem degradation globally, including catchment systems and their capacities to support human well-being. Increasing recognition of the multiple benefits provided by ecosystems is slowly being translated into policy and some areas of practice, although there remains a significant shortfall in the incorporation of a systemic perspective into operation management and decision-making tools. Nevertheless, a range of ecosystem-based solutions to issues as diverse as flooding and green space provision in the urban environment offers hope for improving habitat and optimization of beneficial services. The value of catchment ecosystem processes and their associated services is also being increasingly recognized and internalized by the water industry, improving water quality and quantity through catchment land management rather than at greater expense in the treatment costs of contaminated water abstracted lower in catchments. Parallel recognition of the value of working with natural processes, rather than "defending" built assets when catchment hydrology is adversely affected by unsympathetic upstream development, is being progressively incorporated into flood risk management policy. This focus on wider catchment processes also yields a range of cobenefits for fishery, wildlife, amenity, flood risk, and other interests, which may be optimized if multiple stakeholders and their diverse value systems are included in decision-making processes. Ecosystem services, particularly implemented as a central element of the ecosystem approach, provide an integrated framework for building in these different perspectives and values, many of them formerly excluded, into commercial and resource management decision-making processes, thereby making tractable the integrative aspirations of sustainable development. This can help redress deeply entrenched inherited assumptions
i.e. the human benefits from those) are elusive. In this paper, the food provisioning service of seagrass meadows is operationalized through the study of the stomach contents of 13 important commercial fish species in. Chwaka Bay, Zanzibar.
Nunes, João Pedro; Naranjo Quintanilla, Paula; Santos, Juliana Marisa; Serpa, Dalila; Carvalho-Santos, Cláudia; Rocha, João; Keizer, Jan Jacob; Keesstra, Saskia Deborah
Mediterranean landscapes have experienced extensive abandonment and reforestation in recent decades, which should have improved the provision of hydrological services such as flood mitigation, soil erosion protection and water quality regulation. However, these forests are fire-prone, and the
... 42 Public Health 1 2010-10-01 2010-10-01 false Provision of services. 124.603 Section 124.603 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT... determined in accordance with accepted cost accounting principles; and (ii) Federal governmental third-party...
Demchenko, Y.; Ngo, C.; de Laat, C.; Wlodarczyk, T.W.; Rong, C.; Ziegler, W.
Providing consistent security services in on-demand provisioned Cloud infrastructure services is of primary importance due to multi-tenant and potentially multi-provider nature of Clouds Infrastructure as a Service (IaaS) environment. Cloud security infrastructure should address two aspects of the
Mehmeri, Victor; Wang, Xi; Basu, Shrutarshi
We showcase demonstrations of “program & compile” styled optical networking as well as open platforms & standards based NFV service provisioning using a proof-of-concept implementation of the Software-Programmed Networking Operating System (SPN OS).......We showcase demonstrations of “program & compile” styled optical networking as well as open platforms & standards based NFV service provisioning using a proof-of-concept implementation of the Software-Programmed Networking Operating System (SPN OS)....
This report summarises the findings of a study undertaken to investigate the potential for establishing ancillary service markets at the distribution level in the UK. Existing arrangements for ancillary service markets globally, the design of these markets, regulatory and legislative changes that may be required, different forms of distributed generation (DG), and prospects of increasing the connection to the distributed network are examined along with commercial frameworks and technical procedures, infrastructure requirements, and the effects on different market participants. The scope for new ancillary services at the distribution level, ancillary services from DG, the prospects for DG, commercial and technical aspects, and impact assessments are reviewed.
Carlos Arturo Meza Carvajalino
Full Text Available This document studies the theoretical foundations, the different controversies regarding the health service and the conceptions adopted from the hypotheses related to the market efficiency in the provision of a public service and the consequent market failures. The author thinks that when the health public service was delegated to the market in Colombia they originated failures in the competition, externalities, preference goods and services, asymmetry and redistribution, among the most relevant ones.
Providing IT-based care support for elderly people at home (i.e., carereceivers) is proposed as a highly promising approach to address the aging population problem. With the emergence of homecare application service providers, a homecare system can be seen as a set of linked services. Configuring
Ndyetabula, Daniel; Temu, Andrew E.
The aim of at investigating innovations related to financial services for the agri-bussiness sector, suing examples from Tanzania......The aim of at investigating innovations related to financial services for the agri-bussiness sector, suing examples from Tanzania...
You, Shi; Træholt, Chresten; Poulsen, Bjarne
This paper develops a generic optimization model that explores the difficulty met by Electric Energy Storage (EES) systems when economic dispatch for multiple-service provision is requested. Such a model is further used to investigate the economic performance of an EES system which meets the 10...
Ngo, C.; Membrey, P.; Demchenko, Y.; de Laat, C.
Cloud computing is developing as a new wave of ICT technologies, offering a common approach to on-demand provisioning computation, storage and network resources which are generally referred to as infrastructure services. Most of currently available commercial Cloud services are built and organized
This study discussed internet, the services and the uses, it can be put to in the provision of library services, or in an information centre. Literature search was used to elicit information for this study. The results revealed that whenever internet intervenes in library operations, these is bridge in time, space, minimized cost and ...
May 21, 2008 ... Abstract—The links between ecosystem processes and functions and ecosystem services (i.e. the human benefits from those) are elusive. In this paper, the food provisioning service of seagrass meadows is operationalized through the study of the stomach contents of 13 important commercial fish species ...
Provision Of Low Vision Service In The Department Of Ophthalmology University Of Calabar Teaching Hospital. B Ekpenyong, O Ndukwe. Abstract. No Abstract Keywords: Low vision services, Residual vision, Low vision assessment, Retinal dystrophies. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT
Demchenko, Y.; Ngo, C.; de Laat, C.; Smari, W.W.; Fox, G.C.
Cloud technologies are emerging as a new way of provisioning virtualised computing and infrastructure services on-demand for collaborative projects and groups. Security in provisioning virtual infrastructure services should address two general aspects: supporting secure operation of the provisioning
Brewka, Lukasz Jerzy
This thesis addresses selected topics of Quality of Service (QoS) provisioning in heterogeneous data networks that construct the communication environment of today's Internet. In the vast range of protocols available in different domains of network infrastructures, a few chosen ones are discussed...... and their key QoS features are analysed. This thesis mainly focuses on home and access networks, and their interaction. Considering home networks, UPnP-QoS Architecture was chosen in order to analyse the possibilities of QoS provisioning at users' premises using service oriented architectures. First...
Williams, Sarah; Dickinson, Annette
Internationally, nurses have been in the forefront of delivering health care services in the school environment and whilst health care delivery in secondary and high schools is evaluated, this is not the case for services delivered in primary/elementary schools. In countries such as New Zealand there is no significant inter-service collaboration between health and education; therefore, the delivery of health services remains fragmented and underdeveloped. This discussion paper reviews the history and development of nurse-led school-based health services internationally and provides an insight into the current provision of primary school-based health services in New Zealand. The initial approach to this paper was to gain an understanding of the history of school-based health services internationally and to explore the relationship between health and education in relation to this. This assisted in providing some context and comparison with the current provision of school-based health services in New Zealand. Discussion outcome: Internationally, it is acknowledged that schools provide not only a location to deliver health services to children but also the opportunity to reach entire families and communities yet surprisingly, the development of school-based health services within the primary/elementary school sector has received minimal attention in New Zealand and worldwide. This paper supports the need for further research concerning the feasibility, provision and effectiveness of school-based health services in primary/elementary schools. In order to be effective, this should incorporate the shared needs and values of all stakeholders. The authors argue the need to develop an inter-service, collaborative, national framework for the delivery of school nursing services within the primary school sector in New Zealand. Impact statement: A collaborative framework for health service delivery into primary schools can enable early establishment of supportive health
Ankuda, Claire K; Jetty, Anuradha; Bazemore, Andrew; Petterson, Stephen
Provision of palliative care services by primary care physicians is increasingly important with an aging population, but it is unknown whether US primary care physicians see themselves as palliative practitioners. This study used cross-sectional analysis of data from the 2013 American Board of Family Medicine Maintenance of Certification Demographic Survey. Of 10,894 family physicians, 33.1% (n = 3609) report providing palliative care. Those providing palliative care are significantly more likely to provide non-clinic-based services such as care in nursing homes, home visits, and hospice. Controlling for other characteristics, physicians reporting palliative care provision are significantly (P palliative care, with physician and practice characteristics driving reporting palliative care provision. © Copyright 2017 by the American Board of Family Medicine.
Full Text Available The majority of network services provision (postal and telecommunicationsservices, rail transport, air transport, etc.were traditionally considered as natural monopoly. New scenarioof the liberalised national market and "Open NetworkProvision" require precise and concrete economic evaluationbefore implementation itselfThis paper considers the methodology for the application ofnatural monopoly with the concept of cost sub-additivity. It ispointed out that the scale and scope economies, associatedwith "plant (network sub-additivity" is not sufficient to justifythe monopoly in every service provision in the traffic system andits subsystems. The paper considers and analyses the possiblemarket configuration with various degrees of competition fortelecommunication subsystem. The asymmetric competition inthe telecommunication subsystem by means of the dominantorganisation model has been analysed.
James L. Chamberlain; Gregory E. Frey; C. Denise Ingram; Michael G. Jacobson; Cara Meghan Starbuck Downes
The purpose of this chapter is to describe approaches to calculate a conservative and defensible estimate of the marginal value of forests for non-timber forest products (NTFPs). 'Provisioning" is one of four categories of benefits, or services that ecosystems provide to humans and was described by the Millennium Ecosystem Assessment as 'products...
M.P. van Dijk (Meine Pieter)
textabstractHow does decentralization reform affect the provision of basic services, particularly water and sanitation in Ghana? We deal in particular the delivery of water and sanitation, given the importance of water and sanitation. Conclusions are drawn concerning the policy implications for the
Risk management forms an integral part of the Library's planning and monitoring process and its internal control framework. It is therefore a vital element of good governance and management. This paper discusses the strategies for managing risks in the provision of information services in University Libraries. The concept ...
Maibritt Pedersen Zari
Full Text Available This paper presents an ecosystem biomimicry methodology for urban design called ecosystem service analysis. Ecosystem services analysis can provide quantifiable goals for urban ecological regeneration that are determined by site specific ecology and climate of an urban area. This is important given the large negative environmental impact that most cities currently have on ecosystems. If cities can provide some of their own ecosystem services, pressure may be decreased on the surrounding ecosystems. This is crucial because healthier ecosystems enable humans to better adapt to the impacts that climate change is currently having on urban built environments and will continue to have in the future. A case study analyzing two ecosystem services (provision of energy and provision of water for an existing urban environment (Wellington, New Zealand is presented to demonstrate how the ecosystem services analysis concept can be applied to an existing urban context. The provision of energy in Wellington was found to be an example of an ecosystem service where humans could surpass the performance of pre-development ecosystem conditions. When analyzing the provision of water it was found that although total rainfall in the urban area is almost 200% higher than the water used in the city, if rainwater harvested from existing rooftops were to meet just the demands of domestic users, water use would need to be reduced by 20%. The paper concludes that although achieving ecological performance goals derived from ecosystem services analysis in urban areas is likely to be difficult, determining site and climate specific goals enable urban design professionals to know what a specific city should be aiming for if it is to move towards better sustainability outcomes.
Rudman, Seth M; Kreitzman, Maayan; Chan, Kai M A; Schluter, Dolph
Evolution is recognized as the source of all organisms, and hence many ecosystem services. However, the role that contemporary evolution might play in maintaining and enhancing specific ecosystem services has largely been overlooked. Recent advances at the interface of ecology and evolution have demonstrated how contemporary evolution can shape ecological communities and ecosystem functions. We propose a definition and quantitative criteria to study how rapid evolution affects ecosystem services (here termed contemporary evosystem services) and present plausible scenarios where such services might exist. We advocate for the direct measurement of contemporary evosystem services to improve understanding of how changing environments will alter resource availability and human well-being, and highlight the potential utility of managing rapid evolution for future ecosystem services. Copyright © 2017 Elsevier Ltd. All rights reserved.
Tsetis, Dimitrios, E-mail: email@example.com [University of Crete, Interventional Radiology Unit, Department of Radiology, University Hospital Heraklion, Faculty of Medicine (Greece); Uberoi, Raman, E-mail: firstname.lastname@example.org [John Radcliff Hospital, Radiology Department (United Kingdom); Fanelli, Fabrizio, E-mail: email@example.com [Sapienza – University of Rome, Interventional Radiology Unit, Department of Radiological Sciences (Italy); Roberston, Iain, E-mail: firstname.lastname@example.org [Gartnavel General Hospital, Interventional Radiology Unit (United Kingdom); Krokidis, Miltiadis, E-mail: email@example.com [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology (United Kingdom); Delden, Otto van, E-mail: firstname.lastname@example.org [Academic Medical Center, Department of Radiology (Netherlands); Radeleff, Boris, E-mail: email@example.com [University Hospital of Heidelberg, Department for Diagnostic and Interventional Radiology (Germany); Müller-Hülsbeck, Stefan, E-mail: firstname.lastname@example.org [Ev.-Luth. Diakonissenanstalt zu Flensburg – Zentrum für Gesundheit und Diakonie, Diagnostische u. Interventionelle Radiologie/Neuroradiologie (Germany); Szerbo-Trojanowska, Malgorzata, E-mail: email@example.com [Medical University of Lublin, Interventional Radiology (Poland); Lee, Michael, E-mail: firstname.lastname@example.org [Beaumont Hospital, Department of Radiology (Ireland); Morgan, Robert, E-mail: email@example.com [St George’s Hospital, Department of Radiology (United Kingdom); Brountzos, Elias, E-mail: firstname.lastname@example.org [National and Kapodistrian University of Athens (Greece); Belli, Anna Maria, E-mail: Anna.email@example.com [St George’s Hospital, Department of Radiology (United Kingdom)
Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.
Fazri Nur Yusuf
Full Text Available Studies on potentials of feedback over English language teaching seem not to have not been well-revealed, including studies on the use of feedback to improve English pre-service teachers’ competence. The present study investigates to what extent a multimodal feedback can influence pre-service teachers’ teaching, and which teaching aspects are influenced. Twenty five pre-service teachers taking Microteaching Course served as respondents supervised by a course advisor. The data were collected by teacher observation in a rating-scale form, self-appraisal, and interviews. The data were analyzed by using correlated sample t-test and the eight teaching components proposed by Brown (2001. The results showed that after multimodal feedback provision, pre-service teachers indicated an improvement significantly in seven out of eight teaching aspects. The provision of multimodal feedback could improve their teaching competence on preparation, instructional objective elicitation, mastery of instructional materials, use of media, and classroom management, including classroom language. But, the results do not indicate that they perform well on reflection and follow-up due to some reasons. In addition, the results evince that multimodal feedback provision could improve pre-service teachers’ pedagogical competence when the multimodal feedback is integrated with content, interpersonal relationship, and management.
Full Text Available Providing efficient and scalable service provisioning in Mobile Ad Hoc Network (MANET is a big research challenge. In adaptive service provisioning mechanism an adaptive election procedure is used to select a coordinator node. The role of a service coordinator is crucial in any distributed directory based service provisioning scheme. The existing coordinator election schemes use either the nodeID or a hash function to choose the coordinator. In these schemes, the leader changes are more frequent due to node mobility. We propose an adaptive scheme that makes use of an eligibility factor that is calculated based on the distance to the zone center, remaining battery power and average speed to elect a core node that change according to the network dynamics. We also retain the node with the second highest priority as a backup node. Our algorithm is compared with the existing solution by simulation and the result shows that the core node selected by us is more stable and hence reduces the number of handoffs. This in turn improves the service delivery performance by increasing the packet delivery ratio and decreasing the delay, the overhead and the forwarding cost.
Li, Ping; Omani, Nina; Chaubey, Indrajeet; Wei, Xiaomei
Drought is one of the most widespread extreme climate events with a potential to alter freshwater availability and related ecosystem services. Given the interconnectedness between freshwater availability and many ecosystem services, including food provisioning, it is important to evaluate the drought implications on freshwater provisioning and food provisioning services. Studies about drought implications on streamflow, nutrient loads, and crop yields have been increased and these variables are all process-based model outputs that could represent ecosystem functions that contribute to the ecosystem services. However, few studies evaluate drought effects on ecosystem services such as freshwater and food provisioning and quantify these services using an index-based ecosystem service approach. In this study, the drought implications on freshwater and food provisioning services were evaluated for 14 four-digit HUC (Hydrological Unit Codes) subbasins in the Upper Mississippi River Basin (UMRB), using three drought indices: standardized precipitation index ( SPI ), standardized soil water content index ( SSWI ), and standardized streamflow index ( SSI ). The results showed that the seasonal freshwater provisioning was highly affected by the precipitation deficits and/or surpluses in summer and autumn. A greater importance of hydrological drought than meteorological drought implications on freshwater provisioning was evident for the majority of the subbasins, as evidenced by higher correlations between freshwater provisioning and SSI 12 than SPI 12. Food provisioning was substantially affected by the precipitation and soil water deficits during summer and early autumn, with relatively less effect observed in winter. A greater importance of agricultural drought effects on food provisioning was evident for most of the subbasins during crop reproductive stages. Results from this study may provide insights to help make effective land management decisions in responding to
Full Text Available Drought is one of the most widespread extreme climate events with a potential to alter freshwater availability and related ecosystem services. Given the interconnectedness between freshwater availability and many ecosystem services, including food provisioning, it is important to evaluate the drought implications on freshwater provisioning and food provisioning services. Studies about drought implications on streamflow, nutrient loads, and crop yields have been increased and these variables are all process-based model outputs that could represent ecosystem functions that contribute to the ecosystem services. However, few studies evaluate drought effects on ecosystem services such as freshwater and food provisioning and quantify these services using an index-based ecosystem service approach. In this study, the drought implications on freshwater and food provisioning services were evaluated for 14 four-digit HUC (Hydrological Unit Codes subbasins in the Upper Mississippi River Basin (UMRB, using three drought indices: standardized precipitation index (SPI, standardized soil water content index (SSWI, and standardized streamflow index (SSI. The results showed that the seasonal freshwater provisioning was highly affected by the precipitation deficits and/or surpluses in summer and autumn. A greater importance of hydrological drought than meteorological drought implications on freshwater provisioning was evident for the majority of the subbasins, as evidenced by higher correlations between freshwater provisioning and SSI12 than SPI12. Food provisioning was substantially affected by the precipitation and soil water deficits during summer and early autumn, with relatively less effect observed in winter. A greater importance of agricultural drought effects on food provisioning was evident for most of the subbasins during crop reproductive stages. Results from this study may provide insights to help make effective land management decisions in responding
Methodology: This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service ...
Cámara-Leret, Rodrigo; Faurby, Søren; Macía, Manuel J
America – spanning 68 communities, 42 human cultures and 2,221 plant uses – along with a comparative dataset of four traits (leaf length, stem volume, fruit volume and range size). For 208 palm species, we test for correlations between species’ perceived value and their traits. We find that people......Human well-being around the globe rests on the provisioning services delivered by 15% of the Earth’s 350,000 plant species. Species’ traits influence the way in which plants are utilised1, yet it is not well understood which traits underpin different human needs2. Here, we focus on palms, one...... of the most economically important plant groups globally3, and show that provisioning services related to basic needs, such as food and medicine, show a strong link with different combinations of traits. We integrate data from 2,201 interviews on plant utilisation from three biodiversity hotspots in South...
Sun, Xiang; Allison, Carrie; Auyeung, Bonnie; Matthews, Fiona E.; Murray, Stuart; Baron-Cohen, Simon; Brayne, Carol
Qualitative semi-structured interviews were conducted with service providers regarding the current healthcare provision and education services for children with Autism Spectrum Conditions (ASC) and their families in mainland China. 10 service providers described the current policy and identified unmet needs within current practice. Providers…
Steiner, J. Thomas; Martin, John R.; Gordon, Neil D.; Grant, Malcolm A.
There have been significant reforms in New Zealand of government management in general and of the science and transport sectors in particular. The impact of the reforms on the provision of meteorological services is discussed as an example of the application of the general reform thrust to a specialist technical area. The eventual outcome was the establishment of Meteorological Service of New Zealand Ltd (MetService) as a commercial company, trading in the weather forecasting market but remaining under Crown ownership. At the same time the National Institute of Water and Atmosphere (NIWA) was established. It includes the climatic responsibilities and much of the scientific research component of the former NZMS. It too operates commercially and is Crown owned. Unlike MetService, NIWA is not required to return a dividend to its owners. The procedures leading to the establishment of these new organisations, their mode of operation and their initial successful performance are described.
Full Text Available With the increased reliability, security, and reduced cost of cloud services, more and more users are attracted to having their jobs and applications outsourced into IAAS data centers. For a cloud provider, deciding how to provision services to clients is far from trivial. The objective of this decision is maximizing the provider’s revenue, while fulfilling its IAAS resource constraints. The above problem is defined as IAAS cloud provider revenue maximization (ICPRM problem in this paper. We formulate a service provision approach to help a cloud provider to determine which combination of clients to admit and in what Quality-of-Service (QoS levels and to maximize provider’s revenue given its available resources. We show that the overall problem is a nondeterministic polynomial- (NP- hard one and develop metaheuristic solutions based on the genetic algorithm to achieve revenue maximization. The experimental simulations and numerical results show that the proposed approach is both effective and efficient in solving ICPRM problems.
Wu, Hong; Lu, Naiji
Background The emergence of online health communities (OHCs) broadens and diversifies channels for patient-doctor interaction. In recent times, patient satisfaction has gained new attention within the context of OHCs where unique patterns are provided: a variety of services with unique attributes are available in OHCs for patients and doctors have the options of providing and pricing for different services. OHCs are given high hopes on improving medical efficiency and patient satisfaction. Knowing how these patterns in OHCs affect patient satisfaction is crucial for the development of OHCs and medical practices. An empirical research is conducted to examine the effects of provision and pricing of online services on patient satisfaction by analyzing data from 2309 doctors in a Chinese OHC. The results from this study provided empirical support, suggesting that service quantity positively influenced patient satisfaction. A non-linear correlation between service price and satisfaction was explored and results suggested an inverted U-shaped relationship. At the low price level, service price led to an increase in patient satisfaction, whereas the high price level (over 330 CNY/US$49) could have just the opposite effect. Importantly, we found that price difference between a doctor's different services significantly decreased patient satisfaction. A mediating effect was tested in post-hoc analyses, and results revealed that the impact of price difference on patient satisfaction was partially mediated by flexibility of service selection, and the mediating effect accounted for 28.6% of the total effect. Our results indicate that patient satisfaction can be improved by effectively providing and pricing services in OHCs. Specifically, doctors can offer different type services and charge within a reasonable range. Copyright © 2017 Elsevier B.V. All rights reserved.
Fernández del Carpio, Gonzalo
Although the network-based multicast service is the optimal way to support of a large variety of popular applications such as high-definition television (HDTV), videoon- demand (VoD), virtual private LAN service (VPLS), grid computing, optical storage area networks (O-SAN), video conferencing, e-learning, massive multiplayer online role-playing games (MMORPG), networked virtual reality, etc., there are a number of technological and operational reasons that prevents a wider deployment. This Ph...
K. V. Dubych
Full Text Available In the article, the reforming progress in the social services provision in Ukraine have been analysed; its features and consequences under the present conditions have been revealed; the key problems that arise in the course of the reforms implementation in the social services provision system have been outlined as well as their possible solutions have been determined.The attention is focused on the basic forms of social protection of population in Ukraine (social benefits. The main drawbacks that slow down the progress of reforming the system of providing social services to the population in Ukraine: legislative and regulatory unsettled; the inefficiency and irrationality in approaches to financing and governance; government monopolization of the market of social services; failure mechanisms for the implementation of norms of the law on social services. Was determined that social service system characterized by poorly targeted of receiving the social benefits. Also is scattered budgetary social spending. This leads to significant differences of incomes and increasing income inequality. Researched that despite the ongoing modernization reforms the efficiency system of social protection in Ukraine remains quite low. Financial and economic crisis and other destructive processes taking place in Ukrainian society. This situation is unacceptable and requires a detailed study to key decisions for its improvement. Keywords: social protection, social services, the current status of reform, legal and regulatory framework, national model, financing, optimization.
Full Text Available It is necessary to create new knowledge for the development of the economy. The source of new knowledge are research: basic, applied and industrial, which complement each other to form one whole. Each of these research has other sources of financing and other purposes. Due to the large influx of foreign technology to Poland industrial research is not growing as we would expect. To balance this deficiency the Research Institutes may provide services on the world market. It would be advisable to seek the provision of services on the global research market so that it could became a Polish smart specialization. This specialization would include the sale of intellect, which should never run out of customers.
Brooks, Fiona; Bloomfield, Linda; Offredy, Maxine; Shaughnessy, Philomena
The aim of this paper is to identify and descriptively map the key characteristics of the model of service delivery in operation, and to explore the user, carer and professional experience of service provision. This included an exploration of congruity and mismatch between the different stakeholder groups. In the United Kingdom (UK), 15% of the children under five years of age and 20% of the 5 to 15-year age group are reported to have a complex long-term condition, with the likelihood of having a condition increasing according to socio-economic circumstances. An increasing number of young people with complex needs are now surviving into late adolescence and early adulthood. However, service provision for children with complex needs is an area that, nationally, has been underdeveloped. An exploratory single-site case study was undertaken across one Primary Care Trust in the UK. Documentary and policy review were undertaken along with in-depth qualitative exploration. Eighteen in-depth interviews were undertaken with relevant stakeholders and professionals across the multidisciplinary teams. Families with children between 12 months and 16 years of age who have continuing complex care needs were invited to take part in an interview to give their views about the care they receive. Interviews focused on the family experience and understanding of the child's condition, transition between secondary and primary care, effectiveness of admission and discharge planning and the overall contribution of different professionals. Professionals were also asked about their experiences of delivering care. Findings This study highlighted issues of communication between professionals and with parents and children as a major factor in determining the quality of service provision. Key aspects relating to the model of service provision, namely, paucity of communication, interagency collaboration and the parent as health worker, are highlighted. Parents experienced both health and social
Full Text Available This paper addresses the issue of optimally selecting the tunnel safety provisions. Tunnel safety provisions are the assets of urban road tunnels which are installed and implemented to reduce the tunnel risks, which are basically selected by expert judgment in practice. An optimization model is proposed to obtain the optimal solution for the selection of tunnel safety provisions. The objective function is to minimize the life cycle costs of tunnel safety provisions, which is subject to the requirements for tunnel safety provisions and the safety targets. Finally, by taking advantage of the special structure of the optimization model, a Bi-Section Search and Bound Algorithm (BSSBA is designed to efficiently solve the problem.
Borissov, Nikolay; Caton, Simon; Rana, Omer; Levine, Aharon
The commercial availability of computational resources enable consumers to scale their applications on-demand. However, it is necessary for both consumers and providers of computational resources to express their technical and economic preferences using common language protocols. Ultimately, this requires clear, flexible and pragmatic communication protocols and policies for the expression of bids and resulting generation of service level agreements (SLAs). Further standardization efforts in such description languages will foster the specification of common interfaces and matching rules for establishing SLAs. Grid middleware are not compatible with market-orientated resource provisioning. We aim to reduce this gap by defining extensions to a standardized specification such as JSDL. Furthermore, we present a methodology for matchmaking consumer bids and provider offers and map the additional economic attributes into a SLA. We demonstrate the usage of the message protocols in an application scenario.
BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.
Full Text Available Cloud Computing is a very fast emerging technology as every enterprise is moving fast towards this system. Cloud Computing is known as a provider of dynamic services. It optimizes a very large, scalable and virtualized resource. So lots of industries have joined this bandwagon nowadays. One of the major research issues is to maintain good Quality of Service (QoS of a Cloud Service Provider (CSP. The QoS encompasses different parameters, like, smart job allocation strategy, efficient load balancing, response time optimization, reduction in wastage of bandwidth, accountability of the overall system, etc. The efficient allocation strategy of the independent computational jobs among different Virtual Machines (VM in a Data center (DC is a distinguishable challenge in the Cloud Computing domain and finding out an optimal job allocation strategy guided by a good scheduling heuristic for such an environment is a mape-k loop problem. So different heuristic approaches may be used for better result and in this result we paper we implement worst fit in mape-k and evaluated the results.
Full Text Available Opioid dependence, despite being the subject of significantpublic funding, remains a costly burden to Australian societyin human and economic terms. The most cost-effective publichealth strategy for managing opioid dependence is opioidsubstitution therapy (OST, primarily through the use ofmethadone or buprenorphine. Supervised dispensing of OSTfrom specialist clinics and community pharmacies plays acrucial role in enhancing compliance, monitoring treatmentand reducing diversion. Australia, compared with othercountries in the world, ranks very high in illicit opioid use;hence there is a great demand for OST.The utilisation of community pharmacies for stable patientshas many advantages. For public clinics, patient transfer tocommunity pharmacies relieves workload and costs, andincreases capacity for new OST patients. From a patient’sperspective, dosing at a pharmacy is more flexible andgenerally more preferable. Pharmacists stand to gain clientele,profit and receive small incentives from state governments inAustralia, for their services. Yet, many “unmet needs” existand there is a high demand for more involvement in OSTservice provision in community pharmacy in Australia.In the UK there has been a steady increase in communitypharmacy provision of OST, and pharmacists appear ready toprovide further healthcare services to these patients.The role of pharmacy in some countries in Europe, such asGermany, is less prominent due to their approach to harmminimisation and the complex, variable nature of OSTprovision across the European Union (EU. The provisionof OST by pharmacists in the USA on the other hand is oflesser frequency as the healthcare system in the USAencourages detoxification clinics to handle cases of illicitdrug addiction.At a time when harm minimisation strategies constitute atopic of considerable political and public interest, it isimportant to understand the scope and variability ofpharmacy involvement in drug policy in Australia
Patrick T. Hurley; Marla R. Emery
Scholarship on the ecosystem services provided by urban forests has focused on regulating and supporting services, with a growing body of research examining provisioning and cultural ecosystem services from farms and gardens in metropolitan areas. Using the case of New York, New York, USA, we propose a method to assess the supply of potential provisioning ecosystem...
Kakoko, D.; Ketting, E.; Kamazima, S.R.; Ruben, R.
Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based
Green, Cheri A
Full Text Available of greatest need. In tandem with the development of service provision standards, the GIS accessibility analysis enables more effective provision, management and monitoring of publicly provided facilities and services. Importantly, this technology promotes a..., management and monitoring of publicly provided facilities and services, within a transparent process. The methodology applied ensures that the backlog and provision in facilities is based on population distribution and relative shortages...
Amorim, Gláucia Maria; Quintão, Eliana Cardoso Vieira; Martelli Júnior, Hercílio; Bonan, Paulo Rogério Ferreti
The scope of this paper was to evaluate the provision of building maintenance services in health units, by means of a descriptive, quantitative and cross-sectional study, considering the five types of facilities (Primary Health, Emergency, Specialty, Hospital and Mental Health Units). The research was approved by the Research Ethics Comittee of FHEMIG with the Terms of Agreement signed with the Unified Health System of Betim. Comparative analysis was conducted by checking the requirements of "Physical-Functional Structure Management" of the "Brazilian Hospital Accreditation Manual" of the National Accreditation Organization. Nonconformities were noted in the physical-functional management of the health centers, especially the primary health units. The assessment was important, considering that compliance with formal, technical and structural requirements, welfare activities, according to the service organization and appropriate to the profile and complexity, can collaborate to minimize the risks of users. To improve the quality of health care establishments, it is essential that managers, backed by "top management," prioritize financial, human and material resources in planning to ensure compliance with security requirements of users in buildings.
Valentini, Emiliana; Filipponi, Federico; Nguyen Xuan, Alessandra; Taramelli, Andrea
Physical, chemical and biological characteristics of seawaters are primary descriptors to assess the spatial and temporal dimensions of ecopotential productivity performances in terms of fish vitality, growth and stress. Among these characteristics, temperature can be considered the key descriptor, i.e. the Essential Variable (EV) to characterize fish vitality and thus marine food provision potential, because it influences the variation of many other parameters and as consequence the entire life cycle of marine organisms.We developed a method to identify suitable fish growth conditions sites scenario in the Mediterranean Sea and, among these sites, to estimate the potential fish growth rate. For the assessment of fish growth conditions from the Copernicus Marine Environment Monitoring Service (CMEMS) products, we consider the spatial and temporal distribution of water quality variables derived from satellite , such as Sea Surface Temperature (SST) and Chlorophyll-a concentration, together with other modeled variables like currents, dissolved oxygen (DO), etc.The final result is an integrated toolbox oriented towards the development of an EO downstreaming service, that collects the workflows of processing procedures to support the planning of maritime uses.
French, Helen P; Galvin, Rose
Aim Integrated multidisciplinary primary healthcare is still in a relatively early stage of development in Ireland, with significant restructuring occurring in the past decade. Musculoskeletal physiotherapy services traditionally provided in acute hospital settings have been relocated into the primary care setting where the physiotherapist works as part of the multidisciplinary team. This study aimed to explore physiotherapy managers' experiences of managing musculoskeletal physiotherapy services in primary care to gain an insight into the opportunities and challenges in service delivery, changing roles and ongoing professional development needs of staff. Participants Qualitative design using semi-structured interviews with primary care physiotherapy managers in the Republic of Ireland was employed. Five interviews took in a mix of rural and urban areas nationally. The relationship with the GP was an important one in musculoskeletal physiotherapy services in primary care. Physiotherapists were well skilled but opportunities for professional and career development were restricted. Methods of optimising resources in the face of staffing restrictions were identified. Whilst there were many examples of innovations in service delivery, various barriers negatively impacted on optimal service including resource constraints and national strategy. A number of factors that impact on musculoskeletal service delivery in primary care from the perspective of physiotherapy managers were identified in this study. Future research should explore the views of other stakeholders to provide a more thorough understanding of the relevant issues affecting musculoskeletal physiotherapy service provision in primary care in Ireland.
Kreye, Melanie; Nandrup-Bus, Troels
It is becoming a distinctive feature for manufacturing firms to compete strategically through service provision. In relation to reward systems the aim of this thesis is to investigate what motivates employees of servitized manufacturing firms when providing engineering services and why. Through...... quantitative and qualitative data collection with an international company within the European healthcare sector, the findings show that key motivating factors were to “delight” the customer and being able to take responsibility and accountability for ones work. Service employees were found to feel proud...
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Service of legal process under provisions of State law. 92.92 Section 92.92 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES NOTARIAL AND RELATED SERVICES Quasi-Legal Services § 92.92 Service of legal process under provisions of State law. It may be found that a State statue...
Pavao-Zuckerman, M.; Knerl, A.; Barron-Gafford, G.
Urbanization is a dominant form of landscape change that affects the structure and function of ecosystems and alters control points in biogeochemical and hydrologic cycles. Green infrastructure (GI) has been proposed as a solution to many urban environmental challenges and may be a way to manage biogeochemical control points. Despite this promise, there has been relatively limited empirical focus to evaluate the efficacy of GI, relationships between design and function, and the ability of GI to provide ecosystem services in cities. This work has been driven by goals of adapting GI approaches to dryland cities and to harvest rain and storm water for providing ecosystem services related to storm water management and urban heat island mitigation, as well as other co-benefits. We will present a modification of ecohydrologic theory for guiding the design and function of green infrastructure for dryland systems that highlights how GI functions in context of Trigger - Transfer - Reserve - Pulse (TTRP) dynamic framework. Here we also apply this TTRP framework to observations of established street-scape green infrastructure in Tucson, AZ, and an experimental installation of green infrastructure basins on the campus of Biosphere 2 (Oracle, AZ) where we have been measuring plant performance and soil biogeochemical functions. We found variable sensitivity of microbial activity, soil respiration, N-mineralization, photosynthesis and respiration that was mediated both by elements of basin design (soil texture and composition, choice of surface mulches) and antecedent precipitation inputs and soil moisture conditions. The adapted TTRP framework and field studies suggest that there are strong connections between design and function that have implications for stormwater management and ecosystem service provision in dryland cities.
Demchenko, Y.; Ham, J. van der; Strijkers, R.J.; Ghijsen, M.; Ngo, C.; Cristea, M.
This document provides information about the proposed architectural framework for Cloud Infrastructure as a Service (IaaS) provisioning model that includes the following components: the Composable Services Architecture (CSA) that intends to provide a conceptual and methodological framework for
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Licensing provisions for the Direct Broadcast Satellite Service. 25.148 Section 25.148 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED... Licensing provisions for the Direct Broadcast Satellite Service. (a) License terms. License terms for DBS...
Sun, Xiang; Allison, Carrie; Auyeung, Bonnie; Baron-Cohen, Simon; Brayne, Carol
Little is known about the current situation regarding Autism Spectrum Conditions in mainland China. Electronic databases and bibliographies were searched to identify literature on service provision for ASC in both English and Chinese databases. 14 studies and 6 reports were reviewed. The findings of identified papers on service provision were…
..., Accumulated provision for depreciation of service company property. 367.1080 Section 367.1080 Conservation of... Account 108, Accumulated provision for depreciation of service company property. (a) This account must be credited with the following: (1) Amounts charged to account 403, Depreciation expense (§ 367.4030), or to...
Waverijn, G.; Groenewegen, P.P.; Klerk, M. de
Differential provision of local services and amenities has been proposed as a mechanism behind the relationship between social capital and health. The aim of this study was to investigate whether social capital and collective efficacy are related to the provision of social support services and
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...
Cocco, Massimo; EPOS Team
EPOS brings together European nations and combines solid Earth science infrastructures and their associated data and services together with the scientific expertise into one integrated delivery system for solid Earth science. By improving and facilitating the integration, access, use, and re-use of solid Earth science data, data products, services and facilities EPOS is developing a holistic, sustainable, multidisciplinary research platform to provide coordinated access to harmonized and quality controlled data from diverse Earth science disciplines, together with tools for their use in analysis and modelling. EPOS has been designed with the vision of creating a single distributed pan-European infrastructure for solid Earth science to support a safe and sustainable society. In accordance with this scientific vision, the EPOS mission is to integrate the diverse and advanced European Research Infrastructures for solid Earth relying on new e-science opportunities to monitor and unravel the dynamic and complex Earth System. EPOS is presently in its implementation phase, which consists of the EPOS IP project and the legal establishment of EPOS-ERIC. The EPOS Implementation Phase builds on the achievements of the successful EPOS Preparatory Phase project. The EPOS implementation phase will last from 2015 to 2019. The key objectives of the project are: implementing Thematic Core Services (TCS), the domain-specific service hubs for coordinating and harmonizing national resources/plans with the European dimension of EPOS; building the Integrated Core Services (ICS) to provide a novel research platform to different stakeholders; designing the access to distributed computational resources (ICS-D); ensuring sustainability and governance of TCS and EPOS-ERIC. Here we present the activities planned for the implementation phase focusing on the TCS, the ICS and on their interoperability. We will present and discuss the data and service provision focusing on the data, data
Stark, Margaret M; Payne-James, J Jason
The provision of clinical forensic medicine services is dependent on jurisdiction and relevant legal instruments. A needs analysis was performed to understand the current service provision within NSW and compare and contrast the service with other jurisdictions in Australia. The aim of this study was therefore to identify the roles, functions and clinical forensic medical services currently provided in the different Australian jurisdictions. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Nigerian Journal of Technology. Vol. 32, No. 3, November 2013. 470. OPTIMAL GUARANTEED SERVICES TIMED TOKEN (OGSTT) MEDIA ACCESS. CONTROL (MAC) PRO. CONTROL (MAC) PROTOCOL FOR NETWORKS THAT. TOCOL FOR NETWORKS THAT. TOCOL FOR NETWORKS THAT. SUPPORT HARD REAL.
Yang, Hui; Zhang, Jie; Ji, Yuefeng; He, Yongqi; Lee, Young
Cloud radio access network (C-RAN) becomes a promising scenario to accommodate high-performance services with ubiquitous user coverage and real-time cloud computing in 5G area. However, the radio network, optical network and processing unit cloud have been decoupled from each other, so that their resources are controlled independently. Traditional architecture cannot implement the resource optimization and scheduling for the high-level service guarantee due to the communication obstacle among them with the growing number of mobile internet users. In this paper, we report a study on multi-dimensional resources integration (MDRI) for service provisioning in cloud radio over fiber network (C-RoFN). A resources integrated provisioning (RIP) scheme using an auxiliary graph is introduced based on the proposed architecture. The MDRI can enhance the responsiveness to dynamic end-to-end user demands and globally optimize radio frequency, optical network and processing resources effectively to maximize radio coverage. The feasibility of the proposed architecture is experimentally verified on OpenFlow-based enhanced SDN testbed. The performance of RIP scheme under heavy traffic load scenario is also quantitatively evaluated to demonstrate the efficiency of the proposal based on MDRI architecture in terms of resource utilization, path blocking probability, network cost and path provisioning latency, compared with other provisioning schemes.
... Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric Storage...-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric Storage... services. \\6\\ Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New...
Gibson, Grant; Newton, Lisa; Pritchard, Gary; Finch, Tracy; Brittain, Katie; Robinson, Louise
In this review we explore the provision of assistive technology products and services currently available for people with dementia within the United Kingdom. A scoping review of assistive technology products and services currently available highlighted 171 products or product types and 331 services. In addition, we assimilated data on the amount and quality of information provided by assistive technology services alongside assistive technology costs. We identify a range of products available across three areas: assistive technology used 'by', 'with' and 'on' people with dementia. Assistive technology provision is dominated by 'telecare' provided by local authorities, with services being subject to major variations in pricing and information provision; few currently used available resources for assistive technology in dementia. We argue that greater attention should be paid to information provision about assistive technology services across an increasingly mixed economy of dementia care providers, including primary care, local authorities, private companies and local/national assistive technology resources. © The Author(s) 2014.
Full Text Available Introduction: Meeting the complex health needs of people often requires interaction among numerous different sectors. No one service can adequately respond to the diverse care needs of consumers. Providers working more effectively together is frequently touted as the solution. Cross-sector service provision is defined as independent, yet interconnected sectors working together to better meet the needs of consumers and improve the quality and effectiveness of service provision. Cross-sector service provision is expected, yet much remains unknown about how it is conceptualised or its impact on health status. This umbrella review aims to clarify the critical attributes that shape cross-sector service provision by presenting the current state of the literature and building on the findings of the 2004 review by Sloper. Methods: Literature related to cross-sector service provision is immense, which poses a challenge for decision makers wishing to make evidence-informed decisions. An umbrella review was conducted to articulate the overall state of cross-sector service provision literature and examine the evidence to allow for the discovery of consistencies and discrepancies across the published knowledge base. Findings: Sixteen reviews met the inclusion criteria. Seven themes emerged: Focusing on the consumer, developing a shared vision of care, leadership involvement, service provision across the boundaries, adequately resourcing the arrangement, developing novel arrangements or aligning with existing relationships, and strengthening connections between sectors. Future research from a cross-organisational, rather than individual provider, perspective is needed to better understand what shapes cross-sector service provision at the boundaries. Conclusion: Findings aligned closely with the work done by Sloper and raise red flags related to reinventing what is already known. Future researchers should look to explore novel areas rather than looking into
Becker, T.; Hülsmann, S.; Knudsen, H. C.; Martiny, K.; Amaddeo, F.; Herran, A.; Knapp, M.; Schene, A. H.; Tansella, M.; Thornicroft, G.; Vázquez-Barquero, J. L.
Background An increasing diversity of public, voluntary sector and private providers offer services for the mentally ill in the ongoing process of psychiatric reform. Good service description is one important prerequisite for mental health service research. Aims 1) To describe service provision for
Villamagna, Amy M.; Angermeier, Paul L.; Bennett, Elena M.
Ecosystem services provide an instinctive way to understand the trade-offs associated with natural resource management. However, despite their apparent usefulness, several hurdles have prevented ecosystem services from becoming deeply embedded in environmental decision-making. Ecosystem service studies vary widely in focal services, geographic extent, and in methods for defining and measuring services. Dissent among scientists on basic terminology and approaches to evaluating ecosystem services create difficulties for those trying to incorporate ecosystem services into decision-making. To facilitate clearer comparison among recent studies, we provide a synthesis of common terminology and explain a rationale and framework for distinguishing among the components of ecosystem service delivery, including: an ecosystem's capacity to produce services; ecological pressures that interfere with an ecosystem's ability to provide the service; societal demand for the service; and flow of the service to people. We discuss how interpretation and measurement of these four components can differ among provisioning, regulating, and cultural services. Our flexible framework treats service capacity, ecological pressure, demand, and flow as separate but interactive entities to improve our ability to evaluate the sustainability of service provision and to help guide management decisions. We consider ecosystem service provision to be sustainable when demand is met without decreasing capacity for future provision of that service or causing undesirable declines in other services. When ecosystem service demand exceeds ecosystem capacity to provide services, society can choose to enhance natural capacity, decrease demand and/or ecological pressure, or invest in a technological substitute. Because regulating services are frequently overlooked in environmental assessments, we provide a more detailed examination of regulating services and propose a novel method for quantifying the flow of
Full Text Available This paper deals with the application of High Altitude Platforms for the provision of third generation mobile services in sparsely-populated areas or in developing countries. It focuses on the behavior of large cells provided via a multiple HAP deployment and shows the possibilities of using small cells located inside these large cells to serve hot-spot areas. The impact of the different types of HAP antenna masks and their adjustment on cell capacity and the quality of coverage is presented. The main parameter of the antenna radiation pattern under investigation is the power roll-off at the cell edge. Optimal values of this parameter are presented for different scenarios. Simulations of system level parameters were based on an iteration loops approach.
Full Text Available We consider a two-stage supply chain with one supplier and one retailer. The retailer sells a product to customer and the supplier provides a product in a make-to-order mode. In this case, the supplier’s decisions on service time and service level and the retailer’s decision on retail price have effects on customer demand. We develop optimization models to determine the optimal retail price, the optimal guaranteed service time, the optimal service level, and the optimal capacity to maximize the expected profit of the whole supply chain. The results of numerical experiments show that it is more profitable to determine the optimal price, the optimal guaranteed service time, and the optimal service level simultaneously and the proposed model is more profitable in service level sensitive market.
Luo, Huabin; Sotnikov, Sergey; Winterbauer, Nancy
The scope of local health department (LHD) involvement in providing personal healthcare services versus population-based services has been debated for decades. A 2012 IOM report suggests that LHDs should gradually withdraw from providing personal healthcare services. The purpose of this study is to assess the level of LHD involvement in provision of personal healthcare services during 2008-2013 and examine the association between provision of personal healthcare services and per capita public health expenditures. Data are from the 2013 survey of LHDs and Area Health Resource Files. The number, ratio, and share of revenue from personal healthcare services were estimated. Both linear and panel fixed effects models were used to examine the association between provision of personal healthcare services and per capita public health expenditures. Data were analyzed in 2014. The mean number of personal healthcare services provided by LHDs did not change significantly in 2008-2013. Overall, personal services constituted 28% of total service items. The share of revenue from personal services increased from 16.8% in 2008 to 20.3% in 2013. Results from the fixed effect panel models show a positive association between personal healthcare services' share of revenue and per capita expenditures (b=0.57, phealthcare services is associated with lower per capita expenditures. LHDs, especially those serving healthcare revenue to sustain per capita expenditures. LHDs may need to consider strategies to replace lost revenue from discontinuing provision of personal healthcare services. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.
Lindley, Lisa C; Held, Mary L; Henley, Kristen M; Miller, Kathryn A; Pedziwol, Katherine E; Rumley, Laurie E
Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1251 pediatric hospice agencies. Variable selection was guided by structural contingency theory, which posits that organizational effectiveness is dependent upon how well an organization's structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. The majority of hospices provided translation services (74.9 %) and interpreter services (87.1 %). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Findings indicate that nursing unit environment predicts provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staffs who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency and ultimately reduce ethnic disparities in end-of-life care for children and their families.
Prisons like other correctional institutions deserve organized information provision centers like a library. This study examined library services provision in the south-western part of Nigeria. It was found out that despite their incarceration, inmates desires variety of information; whereas the library stock is grossly inadequate ...
Research into geography provision in primary initial teacher education [ITE] courses in the United Kingdom and worldwide is very limited. England educates pre-service primary teachers of 5-11 year olds to be "generalists" who teach the full range of curriculum subjects, including geography. This article identifies that the provision of…
Background: The inverse-care law suggests that fewer healthcare resources are available in deprived areas where health needs are greatest. Aims: To examine the provision of paediatric speech and language services across London boroughs and to relate provision to the level of deprivation of the boroughs. Methods & Procedures: Information on the…
Chatdokmaiprai, Kannikar; Kalampakorn, Surintorn; McCullagh, Marjorie; Lagampan, Sunee; Keeratiwiriyaporn, Sansanee
The purpose of this study was to identify factors predicting occupational health nurses' provision of smoking cessation services. Data were collected via a self-administered questionnaire distributed to 254 occupational health nurses in Thailand. Analysis by structural equation modeling revealed that self-efficacy directly and positively influenced smoking cessation services, and mediated the relationship between workplace factors, nurse factors, and smoking cessation services. The final model had good fit to the data, accounting for 20.4% and 38.0% of the variance in self-efficacy and smoking cessation services, respectively. The findings show that self-efficacy is a mediator that influences provision of smoking cessation services by occupational health nurses. Interventions to enhance nurses' self-efficacy in providing smoking cessation services are expected to promote provision of smoking cessation services to workers.
... 101 Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric... 101 Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric... jurisdiction. \\2\\ Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New...
Full Text Available The current paper inscribes within those approaching the issue of public services from the interdisciplinary perspective. Public service development and imposing standards of efficiency and effectiveness, as well as for citizens’ satisfaction bring in front line the systemic modelling and establishing optimal policies for organisation and functioning of public services. The issue under discussion imposes an interface with powerful determinations of social nature. Consequently, the most adequate modelling might be that with a probabilistic and statistic nature. The fundamental idea of this paper, that obviously can be broadly developed, starts with assimilating the way of organisation and functioning of a public service with a waiting thread, to which some hypotheses are associated concerning the order of provision, performance measurement through costs or waiting time in the system etc. We emphasise the openness and dynamics of the public service system, as well as modelling by turning into account the statistic knowledge and researches, and we do not make detailed remarks on the cybernetic characteristics of this system. The optimal adjustment is achieved through analysis on the feedback and its comparison with the current standards or good practices.
Bonino da Silva Santos, L.O.; Sorathia, V.S.; Ferreira Pires, Luis; van Sinderen, Marten J.
Service-Oriented Computing (SOC) builds upon the intuitive notion of service already known and used in our society for a long time. SOC-related approaches are based on computer-executable functional units that often represent automation of services that exist at the social level, i.e., services at
Full Text Available Mobile TV has become a reality offered on several mobile delivery systems. Among them is the Advanced Television System Committee (ATSC system for mobile and handheld digital television services, known as ATSC Mobile DTV or ATSC M/H, which has moved from standardization to implementation. As the North American broadcast industry is preparing to provide Mobile DTV service to consumers, this work discusses important technical parameters that affect the TV service quality and capacity. Since additional error correction mechanisms were added to overcome mobile transmission problems, the available payload for M/H services is limited. This creates a need to efficiently use the available M/H bandwidth. The paper aims to optimize the Mobile DTV service capacity while maintaining an acceptable perceived quality. It presents tradeoffs between several factors affecting service capacity and signal robustness, which is prominent for designing Mobile TV broadcasting scenarios.
Wiersum, F.; Endalamaw, T.B.
Provisioning services are major environmental services provided by forests. Especially in tropical countries, the livelihoods of local people often partly depend on a range of timber and non-timber forest products. The governance arrangements concerning such locally valued environmental services are
... 34 Education 2 2010-07-01 2010-07-01 false Provision of services before evaluation and assessment... services before evaluation and assessment are completed. Early intervention services for an eligible child and the child's family may commence before the completion of the evaluation and assessment in § 303...
Quilliam, Richard S; Kinzelman, Julie; Brunner, Joel; Oliver, David M
Understanding and quantifying the trade-off between the requirement for clean safe bathing water and beaches and their wider ecosystem services is central to the aims of the European Union (EU) Marine Strategy Framework Directive (MSFD), and vital for the sustainability and economic viability of designated bathing waters. Uncertainty surrounding the impacts of ensuing bathing water policy transitions, e.g. the EU revised Bathing Waters Directive (rBWD), puts new urgency on our need to understand the importance of natural beach assets for human recreation, wildlife habitat and for protection from flooding and erosion. However, managing coastal zones solely in terms of public health could have potentially negative consequences on a range of other social and cultural ecosystem services, e.g. recreation. Improving our knowledge of how bathing waters, surrounding beach environments and local economies might respond to shifts in management decisions is critical in order to inform reliable decision-making, and to evaluate future implications for human health. In this paper we explore the conflicts and trade-offs that emerge at public beach environments, and propose the development of an evaluative framework of viable alternatives in environmental management whereby bathing waters are managed for their greatest utility, driven by identifying the optimal ecosystem service provision at any particular site. Copyright © 2015 Elsevier Ltd. All rights reserved.
There is minimal research that has considered influences in mental health care service delivery in rural and disadvantaged communities in South Africa. Methods: A qualitative study with ... prevalence of substance users. Keywords: community occupational therapy, rural, service delivery, service providers, substance abuse ...
The basic tenet of Service-Oriented Computing (SOC) is the possibility of building distributed applications on the Web by using Web Services as fundamental building blocks. The proliferation of such services is considered the second wave of evolution in the Internet age, moving the Web from...
Gott, Merryn; Barnes, Sarah; Payne, Sheila; Parker, Chris; Seamark, David; Gariballa, Salah; Small, Neil
The objective of the present paper is to explore levels of social service provision, the barriers to receiving these services and the experiences of social service provision amongst older people with heart failure. Five hundred and forty-two people aged over 60 years with heart failure were recruited from UK general practices in four areas of the UK, and these subjects completed quality-of-life and service-use questionnaires every 3 months for 24 months, or until death. Forty patients participated in in-depth interviews. Data collection was conducted between September 2003 and March 2006. Only 24% (n = 127) of the 460 participants who had provided information about social services contact reported having received social services during the past 24 months. Significant associations between the level of social services contact and participant characteristics were identified, with women, participants over 75 years of age, participants living alone, and those with two or more comorbidities being more likely to report receipt of social services. The qualitative data identified key barriers to using social services, including: access problems; not wanting additional help; the negative experiences of friends; and carers substituting for statutory services. The few participants interviewed who had received social services reported mixed experiences, including problems with inappropriate and insufficient services. This study indicates that only a minority of older people with heart failure have contact with social services. Improving provision for this group involves tackling the barriers to access identified above, as well as ensuring that their views influence service planning and delivery.
Prokofieva, Irina; Mavsar, Robert; Bartczak, Anna
accepted concept in theory, the legitimacy of which nevertheless has not yet been challenged in practice. In our study, we conducted an extensive survey in five European countries – Finland, Denmark, Poland, Italy and Spain – with the aim to explore citizens’ opinions of who should carry the costs......The underlying notion of payments for environmental services is that beneficiaries of environmental services (directly or indirectly) financially support their provision by covering at least part of the costs landowners incur to generate them. This so-called “beneficiary-pay principle” is a widely...... of ecosystem services provision. The ecosystem services in question were biodiversity, recreation, carbon sequestration, water quality, and scenic beauty. Our results show that the majority of respondents in all studied countries generally think that the costs of enhanced provision of ecosystem services shall...
Hood, Rick; Goldacre, Allie; Grant, Robert; Jones, Ray
This paper presents the results of an exploratory study linking the national data-sets for all children in need and child protection services in England. The study was informed by an emerging literature on systems thinking in public services, and aimed to examine variations and patterns of response in local authorities to demand for child welfare services in their area. One hundred and fifty-two local authority census returns and other statistical indicators covering up to a thirteen-year per...
Davies, N. G.; Roscoe, O. S.
Telesat Mobile Inc. (TMI) is a private company authorized to provide mobile satellite services in Canada. TMI will operate a dedicated MSAT satellite to provide mobile telephone, mobile radio and mobile data services to customers on the move in any part of Canada. The baseline TMI system is described in this paper. The network architecture and the signaling system under development to support the mobile services are discussed. The time-scale for procurement of the system is discussed.
Maibritt Pedersen Zari
This paper presents an ecosystem biomimicry methodology for urban design called ecosystem service analysis. Ecosystem services analysis can provide quantifiable goals for urban ecological regeneration that are determined by site specific ecology and climate of an urban area. This is important given the large negative environmental impact that most cities currently have on ecosystems. If cities can provide some of their own ecosystem services, pressure may be decreased on the surrounding ecosy...
Herbert, Luke Thomas; Sharp, Robin
bounds on resources consumed during execution of business processes. Accurate resource provisioning is often central to ensuring the safe execution of a process. We first introduce a formalised core subset of the Business Process Modelling and Notation (BPMN), which we extend with probabilistic and non......-deterministic branching and reward annotations. We then develop an algorithm for the efficient translation of these models into the guarded command language used by the model checker PRISM, in turn enabling model checking of BPMN processes and allowing for the calculation of a wide range of quantitative properties...
Full Text Available Background: The aim of this paper is to argue that there are a number of key drivers for Special Educational Needs (SEN provision that have to be met by Special Educational Needs Coordinators (SENCOs and teaching professionals so as to ensure optimal provision and inclusion for children with SEN in mainstream primary schools. Although the research has been carried out in England, there is a significant European Dimension to the issue, as a similar role to that of SENCOs in respect of SEN management already exists in countries such as Finland and Ireland, and is being considered in Italy. Methods: This paper focuses on the data gathered for the purpose of the author’s doctoral research in England, through questionnaires and interviews with SENCOs, head teachers and teachers. Thematic analysis was used to explore key drivers of SEN provision by practitioners who support children with SEN. Results: Data illustrate that the key drivers of SEN provision include time; teacher openness to change; target setting; evidence of tried interventions; empowerment; decision-making and approachability. The implementation of such drivers depend largely on practitioner skills and competencies. Conclusion: The main conclusion within this paper is to develop points of reference for planning and practice, with illustrations of optimal provision by all practitioners who work with children with SEN.
Kruger, Estie; Perera, Irosha; Tennant, Marc
Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.
Kuada, Eric; Olesen, Henning
This paper proposes a social network approach to the provisioning and management of cloud computing services termed Opportunistic Cloud Computing Services (OCCS), for enterprises; and presents the research issues that need to be addressed for its implementation. We hypothesise that OCCS will facilitate the adoption process of cloud computing services by enterprises. OCCS deals with the concept of enterprises taking advantage of cloud computing services to meet their business needs without hav...
Full Text Available Location Based Services can be considered as one of the most rapidly expanding fields of the mobile communications sector, with an impressively large application range. The proliferation of mobile/wireless Internet and mobile computing, and the constantly increasing use of handheld, mobile devices and position tracking technologies prepared the grounds for the introduction of this new type of services. The combination of position fixing mechanisms with location-dependent, geographical information, can offer truly customized personal communication services through the mobile phone or other type of devices. Prompted by the avalanche of technology advances in the aforementioned areas in this paper we present an integrated platform for delivering Location Based Services (LBS. The platform covers the full life cycle of a LBS starting from the specification of the service, covering issues like the deployment and maintenance of services, the service invocation and the final delivery of the produced results to the invoking user. A prototype implementation of the discussed platform was developed and used to perform a series of trial services, with the purpose of demonstrating the pursued functionality.
Savy, Pauline; Warburton, Jeni; Hodgkin, Suzanne
The Australian community aged care sector is facing a growing workforce crisis, particularly in rural and regional areas. Its predominantly female workforce is ageing, and recruiting younger, skilled workers is proving difficult. The service sector, too, is proving highly complex and diverse as a result of contemporary aged care service reforms as well as ongoing difficulties in providing services to the growing numbers of older people living in Australia's rural areas. Despite these multiple challenges, there is a gap in research that explores how rural aged care services manage their day-to-day requirements for skilled workers across the diverse service sector. To address this gap, this article reports on the experiences and perceptions of a small sample of service managers whose organisations represent this diversity, and who are accountable for care provision in regional and rural locations. In such areas, recruitment and skill needs are contoured by disproportionate aged populations, distance and reduced service availability. Eleven service managers were interviewed as part of a larger project that examined the skill and training needs of community aged care workers within the Riverina, a rural region in New South Wales. Qualitative data drawn from semi-structured interviews were thematically analysed to identify the managers' individual needs for workers and skills in the context of location, service parameters and availability of other health and community services. Thematic analysis of the interview data elicited three themes: services, roles and skill deployment; older workers and gendered roles; and barriers to recruitment. The findings illustrate the complexities that characterise the community aged care sector as a whole and the impact of these on individual services located in regional and rural parts of Australia. The participants reported diverse needs for worker skills in keeping with the particular level of service they provide. Significantly
decoupled and assumed to be fixed during the reactive power dispatch procedures; however, the effect of reactive power on real power is considered in the model by calculating the required reduction in real power output of a generator due to an increase in its reactive power supply. In this case, real power generation is allowed to be rescheduled, within given limits, from the already dispatched levels obtained from the energy market clearing process. The proposed dispatch model achieves the main objective of an ISO in a competitive electricity market, which is to provide the required reactive power support from generators at least cost while ensuring a secure operation of the power system. The proposed reactive power procurement and dispatch models capture both the technical and economic aspects of power system operation in competitive electricity markets; however, from an optimization point of view, these models represent non-convex mixed integer non-linear programming (MINLP) problems due to the presence of binary variables associated with the different regions of reactive power operation in a synchronous generator. Such MINLP optimization problems are difficult to solve, especially for an actual power system. A novel Generator Reactive Power Classification (GRPC) algorithm is proposed in this thesis to address this issue, with the advantage of iteratively solving the optimization models as a series of non-linear programming (NLP) sub-problems. The proposed reactive power procurement and dispatch models are implemented and tested on the CIGRE 32-bus system, with several case studies that represent different practical operating scenarios. The developed models are also compared with other approaches for reactive power provision, and the results demonstrate the robustness and effectiveness of the proposed model. The results clearly reveal the main features of the proposed models for optimal provision of reactive power ancillary service, in order to suit the requirements of
E. B. Krylova
Full Text Available The article presents the methodological approaches to the planning of budget expenditures for the provision of services in the field of general education. The review of existing methods of budget planning of budget expenditures, including regulatory and program-target method of budget planning in the field of general education expenses. The article is focused on the practical use of budget planning methods, evaluated the positive and negative consequences of their use.The aim of the article is to solve scientific and practical task of improving the efficiency of budget spending on general education.Results. The authors found that the conditions necessary to optimize budget spending for social purposes to the preferred state is encouraging recipients of budget funds to a more economical and efficient use of them.Conclusions and Relevance. The study conclusions are made about the need to clarify the methodology of planning of budget expenditures in the field of general education, which allows for improving the quality of educational services and contributes to solving the problem of the adequacy of the level of budgetary financing of the general education sector.
Kuada, Eric; Olesen, Henning
This paper proposes a social network approach to the provisioning and management of cloud computing services termed Opportunistic Cloud Computing Services (OCCS), for enterprises; and presents the research issues that need to be addressed for its implementation. We hypothesise that OCCS...... will facilitate the adoption process of cloud computing services by enterprises. OCCS deals with the concept of enterprises taking advantage of cloud computing services to meet their business needs without having to pay or paying a minimal fee for the services. The OCCS network will be modelled and implemented...... as a social network of enterprises collaborating strategically for the provisioning and consumption of cloud computing services without entering into any business agreements. We conclude that it is possible to configure current cloud service technologies and management tools for OCCS but there is a need...
Myers, Bronwyn; Fakier, Nuraan
To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…
Ngo, C.; Membrey, P.; Demchenko, Y.; de Laat, C.
Cloud computing is developing as a new wave of ICT technologies, offering a common approach to on-demand provisioning of computation, storage and network resources which are generally referred to as infrastructure services. Most of currently available commercial Cloud services are built and
... depreciation and amortization of service company property. 256.108 Section 256.108 Commodity and Securities... Accounts: Assets and Other Debit Accounts § 256.108 Accumulated provision for depreciation and amortization... 403, Depreciation and amortization expense. (b) At the time of retirement of depreciable service...
This paper investigated the provision of recreation services for the aged in the Durban Metropolitan Area (DMA). The main argument in the research is that the aged like any other age groups need to be provided with recreation services. The objectives underpinning this investigation include the following: •To reveal the ...
... service occasioned by or in consequence of any cause beyond the control of the Contractor, including but not limited to acts of God or of the public enemy, fires, floods, earthquakes, or other catastrophe...
Demand response has gained significant attention in recent years as it demonstrates potentials to enhance the power system's operational flexibility in a cost-effective way. Industrial loads such as aluminum smelters, steel manufacturers, and cement plants demonstrate advantages in supporting power system operation through demand response programs, because of their intensive power consumption, already existing advanced monitoring and control infrastructure, and the strong economic incentive due to the high energy costs. In this thesis, we study approaches to efficiently integrate each of these types of manufacturing processes as demand response resources. The aluminum smelting process is able to change its power consumption both accurately and quickly by controlling the pots' DC voltage, without affecting the production quality. Hence, an aluminum smelter has both the motivation and the ability to participate in demand response. First, we focus on determining the optimal regulation capacity that such a manufacturing plant should provide. Next, we focus on determining its optimal bidding strategy in the day-ahead energy and ancillary services markets. Electric arc furnaces (EAFs) in steel manufacturing consume a large amount of electric energy. However, a steel plant can take advantage of time-based electricity prices by optimally arranging energy-consuming activities to avoid peak hours. We first propose scheduling methods that incorporate the EAFs' flexibilities to reduce the electricity cost. We then propose methods to make the computations more tractable. Finally, we extend the scheduling formulations to enable the provision of spinning reserve. Cement plants are able to quickly adjust their power consumption rate by switching on/off the crushers. However, switching on/off the loading units only achieves discrete power changes, which restricts the load from offering valuable ancillary services such as regulation and load following, as continuous power changes
Hood, Rick; Goldacre, Allie; Grant, Robert; Jones, Ray
This paper presents the results of an exploratory study linking the national data-sets for all children in need and child protection services in England. The study was informed by an emerging literature on systems thinking in public services, and aimed to examine variations and patterns of response in local authorities to demand for child welfare services in their area. One hundred and fifty-two local authority census returns and other statistical indicators covering up to a thirteen-year period were combined into a single data-set. Statistical analysis was undertaken to explore the characteristics of demand, workload and workforce, trends over time and variations between local authorities. The results showed that the overall system has become increasingly geared towards protective interventions, especially since the Baby P scandal of 2008. Deprivation levels continue to be the key driver of referrals and other categories of demand, and are strongly associated with variations in service response, particularly in the initial stages of referral and assessment. Implications are considered for the current organisation of child welfare services in light of recent reviews and reforms.
Amarasena, N; Teusner, D N; Brennan, D S; Satur, J
Dental hygienists (DHs) have been practising in Australia since the early 1970s. This study describes the clinical activity of Australian DHs. A questionnaire was mailed to members of two professional associations representing DHs. Practitioner characteristics, employment characteristics and clinical activity on a self-reported typical practice day were collected. The proportion of each service item of all services provided was estimated. Associations between practice characteristics and service provision were assessed by log-binomial regression models. Adjusted response rate was 60.6%. Of the DHs included in analysis (n=341), 80% were employed in general practice, and nearly all (96%) worked in the private sector. About half (53.7%) of all service provided were preventive services, and one-fourth (23.9%) were diagnostic. Service provision varied by practice and practitioner characteristics, with the largest variations observed by practice type. Unadjusted analysis showed that general practice DHs provided a higher mean number of periodontal instrumentation and coronal polishing (0.92 vs 0.26), fluoride applications (0.64 vs 0.08), oral examinations (0.51 vs 0.22) and intraoral radiographs (0.33 vs 0.07) per patient visit and a lower mean number of impressions (0.05 vs 0.17) and orthodontic services (0.02 vs 0.59) than specialist practice DHs. In adjusted analysis, rates of periodontal services also significantly varied by practice type; other associations persisted. Service provision of DHs varied by practice type. Practice activity was dominated by provision of preventive services while provision of periodontal treatments, fissure sealants and oral examinations was relatively limited indicating areas in which DHs are possibly underutilized. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
The paper examines the extent to which information resources a nd services are provided and utilized in the surveyed library. The paper adopted a survey research method and utilized questionnaires, complemented with unstructured interviews and observation to generate data. Data were analyzed using descriptive and ...
With the increasing popularity of distance education, focus has turned to the role of libraries in the distance learning process. It is widely agreed that like their campus-based counterparts, distance education learners need adequate library services if they are to gain quality education. This paper examines the efforts being ...
Fuller, Kay; Parsons, Sarah; MacNab, Natasha; Thomas, Hywel
This study focuses on the leadership engagement of children, young people (CYP) and their families in six school-based extended services (ES) clusters in a single, large, urban local authority in England. Empirical research was carried out in two strands of activity that focused on outcomes and experiences for CYP and leaders and leadership.…
The history of the development of mental health services in Africa falls into four phases, firstly the pre-colonial phase, with care being under the traditional and spiritual healers, then the rise of asylums for mainly custodial confinement, followed by modern large asylum-like mental hospitals during and soon after the colo-.
addiction because we grew up with alcohol, we stay with alcohol and it's part of our lives so we think it's not .... as the Prevention of and Treatment for Substance Abuse (Act no. 70 of 2008),16 states that 'the minister must ... demand for the service and prevention programmes but determine trends, patterns and types of drugs ...
Objectives:To explore the overall implications for an enhanced health system administrative capacity that not only takes account of global and regional developments, but that is also seen as legitimate domestically and is well equipped theoretically to deliver quality health care services in Kenyan rural health facilities.
Braak, ter C.J.F.
The ecosystem services (EcoS) concept is being used increasingly to attach values to natural systems and the multiple benefits they provide to human societies. Ecosystem processes or functions only become EcoS if they are shown to have social and/or economic value. This should assure an explicit
The researcher recommended among others that Academic library policy must be redesigned to include disability resources and services in conformity with ALA standard and Library management should create a disability liaison office on the ground floor of their multiple storey buildings and affiliate such offices with any ...
Muljadi, Eduard; Gevorgian, Vahan; Mohanpurkar, Manish; Luo, Yusheng; Hovsapian, Rob; Koritarov, Vladimir
This paper presents a high-level overview of the capability of advanced pumped storage hydropower to provide ancillary services including frequency regulation and oscillation damping. Type 3 and Type 4 generators are discussed. The examples given are for a small power system that uses a diesel generator as the main generator and a very large system that uses a gas turbine as the main generator.
The author studies the allocation-between a central government and a local authority--of responsibility for planning, financing, and operations for the delivery of health services, in the context of an incomplete contracts model. In this model, inputs are required of both the central government and local authorities but they are unable to write down, and commit to, a complete and binding c...
Dai, Er-Fu; Wang, Xiao-Li; Zhu, Jian-Jia; Xi, Wei-Min
There is increasing interest worldwide regarding managing plantation forests in a manner that maintains or improves timber production, enhances ecosystem services, and promotes long-term sustainability of forest resources. We selected the Gan River Basin, the largest catchment of Poyang Lake and a region with a typical plantation distribution in South China, as the study region. We evaluated and mapped four important forest ecosystem services, including wood volume, carbon storage, water yield, and soil retention at a 30 × 30 m resolution, then quantified their trade-offs and synergies at the county and subwatershed scales. We found that the wood volume and carbon storage services, as well as the soil retention and water yield, exhibited synergistic relationships. However, the carbon storage displayed a trade-off relationship with the water yield. Additionally, we compared the beneficial spatial characteristics among dominant species in the study region. The results showed that the Chinese fir forest and the pine forest exhibited lower overall benefits than natural forests including the broad-leaved forest and the bamboo forest. To propose a suitable management strategy for the study region, method of spatial cluster analysis was used based on the four eco-services at the subwatershed scale. The basin was divided into four management groups instead of treating the region as a homogenous management region. Finally, we proposed more specific and diverse management strategies to optimize forest benefits throughout the entire region.
Full Text Available Recently positioning services are getting more attention not only within research community but also from service providers. From the service providers point of view positioning service that will be able to work seamlessly in all environments, for example, indoor, dense urban, and rural, has a huge potential to open new markets. However, such system does not only need to provide accurate position estimates but have to be scalable and resistant to fake positioning requests. In the previous works we have proposed a modular system, which is able to provide seamless positioning in various environments. The system automatically selects optimal positioning module based on available radio signals. The system currently consists of three positioning modules—GPS, GSM based positioning, and Wi-Fi based positioning. In this paper we will propose algorithm which will reduce time needed for position estimation and thus allow higher scalability of the modular system and thus allow providing positioning services to higher amount of users. Such improvement is extremely important, for real world application where large number of users will require position estimates, since positioning error is affected by response time of the positioning server.
Kathleen C. Stosch
Full Text Available Ensuring water, food and energy security for a growing world population represents a 21st century catchment management challenge. Failure to recognise the complexity of interactions across ecosystem service provision can risk the loss of other key environmental and socioeconomic benefits from the natural capital of catchment systems. In particular, the ability of soil and water to meet human needs is undermined by uncertainties around climate change effects, ecosystem service interactions and conflicting stakeholder interests across catchments. This critical review draws from an extensive literature to discuss the benefits and challenges of utilising an ecosystem service approach for integrated catchment management (ICM. State-of-the-art research on ecosystem service assessment, mapping and participatory approaches is evaluated and a roadmap of the key short- and longer-term research needs for maximising landscape-scale ecosystem service provision from catchments is proposed.
textabstractThe relations between central and local governments as well as with their partners in the delivery of services is the subject of this study. This subject is important in understanding the way institutions contribute to development, particularly given the argument that decentralisation
Full Text Available SUMMARY Objective: To describe the clinical and sociodemographic profile of cancer patients admitted to the Emergency Center for High Complexity Oncologic Assistance, observing the coverage of palliative and home care. Method: Cross sectional study including adult cancer patients admitted to the emergency service (September-December/2011 with a minimum length of hospital stay of two hours. Student’s t-test and Pearson chi-square test were used to compare the means. Results: 191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the city of Recife and greater area. The symptom prevalent at admission was pain (46.6%. 4.2% of patients were linked to palliative care and 2.1% to home care. The most prevalent cancers: cervix (18.3%, breast (13.6% and prostate (10.5%; 70.7% were in advanced stages (IV, 47.1%; 39.4% without any cancer therapy. Conclusion: Patients sought the emergency service on account of pain, probably due to the incipient coverage of palliative and home care. These actions should be included to oncologic therapy as soon as possible to minimize the suffering of the patient/family and integrate the skills of oncologists and emergency professionals.
Wessels, R D; de Witte, L P; Jedeloo, S; van den Heuvel, W P M; van den Heuvel, W J A
To answer the following questions: What are the problems encountered by people with outdoor mobility disabilities? What solutions are being offered to them in The Netherlands? How effective are these solutions? How responsive is the IPPA instrument (Individually Prioritized Problem Assessment)? Analysing the results of a follow-up study using the IPPA instrument. The Dutch Service for the Disabled Act (SDA, in Dutch: WVG) provision system. This act is responsible for the provision of mobility aids and home adaptations. Fifty-nine people with outdoor mobility disabilities. The provision of outdoor mobility service and devices. Effectiveness of provisions as measured using IPPA (i.e., the degree to which activities have become less difficult to perform), effect size of IPPA with this intervention. Problems identified by clients are very diverse and specific but can be classified fairly well on the basis of the International Classification of Functioning, Disability and Health (ICF); in the main, the solutions they are provided with are very similar and generic. Effectiveness is excellent at a group level, but insufficient for some at an individual level. The IPPA instrument is highly responsive in this setting. Most mobility problems respondents identified, although very individual and specific, were related to shopping, social visits or leisure activities. These specific sets of problems were solved using 'standard', generic solutions. The Dutch provision system should be more 'demand oriented' and less 'supply oriented'. IPPA turns out to be a useful, structured and individual-oriented method to evaluate service delivery.
Wilhite, B; Terry, B; Yoshioka, C F; McLean, D D
This article provides a discussion of the advantages of implementing a Quality Circles program into a therapeutic recreation setting. Quality Circles, a Japanese management concept, has received increased support in American industry and human service organizations. It is founded on the principle of employee involvement and concern for the improvement of the organization. Disadvantages of Quality Circles include: (1) lack of management support; (2) time required to implement; (3) failure to hire consultants; and (4) improper composition of Circles. Advantages of Quality Circles are (1) improved communication; (2) management awareness of employee job-related concerns; (3) personal growth and development; (4) enhanced decision making skills; (5) increased individual power; (5) improved motivation; and (6) opportunities for recognition of individual improvement.
Kent, Fiona; Lai, Francis; Beovich, Bronwyn; Dodic, Miodrag
The aim of this study was to determine the usefulness of student-led interprofessional consultations within residential aged care in augmenting patient care and enhancing student education. Volunteer fourth and final year health-care students conducted interprofessional consultations. In a mixed methods design, residents' health-care changes and perspectives were collected prospectively, and student and educator perceptions were measured by survey and interview. Sixteen aged care residents were consulted by interprofessional teams. Students identified two new health issues and proposed 17 recommendations for referrals and five changes to medication management. At six-weeks follow-up, two recommendations had been acted upon clinically, and two medication changes had been implemented. Reasons for the low uptake of recommendations were determined. Residents, students and educators reported high levels of satisfaction. Residential care facilities offer a useful interprofessional learning environment. Student consultations are positively regarded by patients, students and educators and may augment existing health services. © 2016 AJA Inc.
Jaruseviciene, L.; Valius, L.; Lazarus, J.V.
Background. General practitioners (GPs) often become the first point of care for mental health issues. Improved collaboration between GPs and mental health teams can make a GP's mental health services more efficient. Objective. The aim of this study was to assess the collaboration between GPs...... and mental health team members and determine predictors for better collaboration. Methods. In this cross-sectional study, a 41- item questionnaire was distributed to a random sample of 797 Lithuanian GPs. The purpose of this questionnaire was to obtain knowledge about current practices of GPs in providing...... mental health care for patients as well as GPs' collaboration with metal health teams. Results. The response rate was 52.2%. GPs collaborated closest with psychiatrists: 30.7% of them reported that they discuss the mental health care of their patients with psychiatrists. Predictors of greater...
Nicholas N A Kyei
Full Text Available BACKGROUND: Antenatal care (ANC presents important opportunities to reach women with crucial interventions. Studies on determinants of ANC use often focus on household and individual factors; few investigate the role of health service factors, partly due to lack of appropriate data. We assessed how distance to facilities and level of service provision at ANC facilities in Zambia influenced the number and timing of ANC visits and the quality of care received. METHODS AND FINDINGS: Using the 2005 Zambian national Health Facility Census, we classified ANC facilities according to the level of service provision. In a geographic information system, we linked the facility information to household data from the 2007 DHS to calculate straight-line distances. We performed multivariable multilevel logistic regression on 2405 rural births to investigate the influence of distance to care and of level of provision on three aspects of ANC use: attendance of at least four visits, visit in first trimester and receipt of quality ANC (4+ visits with skilled health worker and 8+ interventions. We found no effect of distance on timing of ANC or number of visits, and better level of provision at the closest facility was not associated with either earlier ANC attendance or higher number of visits. However, there was a strong influence of both distance to a facility, and level of provision at the closest ANC facility on the quality of ANC received; for each 10 km increase in distance, the odds of women receiving good quality ANC decreased by a quarter, while each increase in the level of provision category of the closest facility was associated with a 54% increase in the odds of receiving good quality ANC. CONCLUSIONS: To improve ANC quality received by mothers, efforts should focus on improving the level of services provided at ANC facilities and their accessibility.
Full Text Available ABSTRACT In recently world creating opportunities under appropriate circumstances for people to manipulate decisions that affect them will increase the sense of ownership and care that is why participation has become a question of concern for any public and private project development and sustainability. The purpose of this study was to assessing the challenges affecting participation in provision of public services in Arusha city council. The specific objective of this study was to find out the challenges affecting public consultations and involvement in provision of public services at Arusha city council. The researcher use survey design technique in studying 150 samples from 416442 which included public citizens mayor councilors and employees at the Arusha city council office. The sample was selected through non- probability sampling techniques which was purposive and convenience. The data was collected through questionnaire and structured interview schedule and data was qualitatively analyzed where the factual and logical interpretation was explained through using of table and percentages. From the findings of the study provision of effective public services in Arusha city council is less effective and unsatisfactory because of insufficient number of staff poor technology conservatism bureaucracy culture relationship politics and poor communication. In order to address the issues the researcher recommends that the governance is weak and it needed to be reviewed in order to enhance the effectiveness of the entire process in provision of effective public services.
DeFago, Jennifer Kelly
The purpose of this study was to evaluate the factors that predict provision of counseling services by Ohio-based school psychologists. In order to address the research questions, a survey instrument was created and a sample of school psychologists working in Ohio completed a questionnaire regarding their counseling practices. The data were…
Wairimu, Winnie Wangari; Christoplos, Ian; Hilhorst, D.J.M.
This paper critically evaluates the transition from crisis to development in northern Uganda from the perspective of agricultural service provision. It contributes to debates on how efforts to link relief to rehabilitation and development may bypass the underlying challenges in linking humanitarian
Following the largely unimpressive performance of the public sector in the provision of solid waste services in many cities of African countries, the search for alternative strategies for addressing this challenge became inevitable. One of the strategies is the involvement of the private
A study examined key dimensions of the pattern of learning and enterprise culture change relating to provision of training and learning services for small businesses in Australia. Barriers to training were both demand- and supply-side factors. Research showed the significance of informal learning that occurs in workplaces of small firms but was…
Gadkari, Abhijit S.; Mott, David A.; Kreling, David H.; Bonnarens, Joseph K.
Context: Higher prevalence of chronic diseases and reduced access to other health professionals in rural areas suggest that rural Medicare enrollees will benefit from pharmacist-provided drug therapy services (DTS). Purpose: The purpose of this study was to describe non-metropolitan community pharmacy sites in Wisconsin, the provision of DTS at…
Evaluating the opinions of staff and health care service provision of an std/Hiv clinic in Africa: indications for recovery. RG Cooper ... Data were analysed according to gender, using a two-sample t-test and chi-square tests. Yates' correction was made for continuity of smaller samples. A value of p<0.05 was taken a significant ...
Katusiimeh, M.W.; Mol, A.P.J.; Burger, C.P.J.
This paper compares the operations and discusses the effectiveness of public and private sector provision of solid waste collection in Kampala, Uganda. Household data suggest that the private sector is more effective than the public sector. Private sector companies provide services like container
The purpose of this study was to determine whether or not the reference interview is essential in the provision of public library reference service. A survey questionnaire was mailed to 125 small and medium sized public libraries throughout Ohio. The survey was administered in the spring of 1994 with a response rate of 56%. Respondents were asked…
Afsarmanesh, H.; Korojelo, S.P.; Karakas, O.U.; Sargolzaei, M.
The deliverable D2.1 focuses on identification and analysis of the information/knowledge related to complex products in GloNet, while aiming at the specification of a set of generic services for their provision to the stakeholders. Towards achieving this goal, a systematic process is defined and
Harryba, Sophia A.; Knight, Shirlee-ann
A qualitative case study examined the challenges of service provision and utilization regarding international students at an Australian university. Using a Social Constructivist Grounded Theory methodology, 73 participants were interviewed, including 38 staff members (16 academic, 22 non-academic), 25 international students, and 10 domestic…
Kohler, Marina; Devaux, Caroline; Fontana, Veronika; Grigulis, Karl; Lavorel, Sandra; Leitinger, Georg; Schirpke, Uta; Tasser, Erich; Tappeiner, Ulrike
Mountain grassland ecosystems are a hotspot of biodiversity and deliver a multiplicity of ecosystem services. Due to a long history of well adapted agricultural use and specific environmental conditions (e.g. slope, altitude, or climate), various types of grassland ecosystems have developed. Each of them shows specific attributes in forms of plant communities and abiotic characteristics, which lead to particular ranges of ecosystem service provision. However, ongoing climate and societal changes thread plant community composition and may lead to changes in plant traits, and therefore, the provision of ecosystem services. Currently it is not clear how vulnerable these ecosystems are to disturbances, or whether they have developed a high resilience over time. Thus, it is essential to know the ranges of resistance and resilience of an ecosystem service. We, therefore, developed a static approach based on community weighted mean plant traits and abiotic parameters to measure the boundaries of resistance and resilience of each ecosystem service separately. By calculating actual minimum and maximum amounts of ecosystem services, we define the range of resistance of an ecosystem service. We then calculate the potential amount of an ecosystem services (via simulated plant communities) by assuming that no species is lost or added to the system. By comparing actual and potential values, we can estimate whether an ecosystem service is in danger to lose its resilience. We selected different ecosystem services related to mountain grassland ecosystems, e.g. carbon storage, forage quality, forage quantity, and soil fertility. We analysed each ecosystem service for different grassland management types, covering meadows and pastures of very low land-use intensity through to grasslands of high land-use intensity. Results indicate that certain ecosystem services have a higher resilience than others (e.g. carbon storage) for all management types. The ecosystem may provide steady
Rathod, Shanaya; Pinninti, Narsimha; Irfan, Muhammed; Gorczynski, Paul; Rathod, Pranay; Gega, Lina; Naeem, Farooq
This article discusses the provision of mental health services in low- and middle-income countries (LMICs) with a view to understanding the cultural dynamics–how the challenges they pose can be addressed and the opportunities harnessed in specific cultural contexts. The article highlights the need for prioritisation of mental health services by incorporating local population and cultural needs. This can be achieved only through political will and strengthened legislation, improved resource al...
Sabina, Chiara; Ho, Lavina Y
After sexual assault or dating violence occurs, a college victim may disclose the event to formal and informal sources as well as seek services. The current review explores empirical research on formal disclosure, informal disclosure, service utilization, and service provision among college students. Forty-five empirical articles and reports that met certain criteria were reviewed. Overall, rates of informal disclosure were considerably higher than rates of formal disclosure. Characteristics of the incident, victim, and offender were associated with disclosure. Rates of service utilization were varied but appear to be low among those victimized in the past year. When services were used, physical and mental health services were most often utilized. Available services, policies for dating violence and sexual assault, and judicial processes varied according to the type of institution, and indicate several areas for improvement. A number of research, practice, and policy implications emerge from this critical review of the literature. © The Author(s) 2014.
The continuous increase in the complexity and the heterogeneity of corporate and healthcare telecommunications infrastructures will require new assessment methods of quality of service (QoS) provision that are capable of addressing all engineering and social issues with much faster speeds. Speed and accessibility to any information at any time from anywhere will create global communications infrastructures with great performance bottlenecks that may put in danger human lives, power supplies, national economy and security. Regardless of the technology supporting the information flows, the final verdict on the QoS is made by the end user. The users' perception of telecommunications' network infrastructure QoS provision is critical to the successful business management operation of any organization. As a result, it is essential to assess the QoS Provision in the light of user's perception. This article presents a cost effective methodology to assess the user's perception of quality of service provision utilizing the existing Staffordshire University Network (SUN) by adding a component of measurement to the existing model presented by Walker. This paper presents the real examples of CISCO Networking Solutions for Health Care givers and offers a cost effective approach to assess the QoS provision within the campus network, which could be easily adapted to any health care organization or campus network in the world.
McSweeney, Elizabeth; Gowran, Rosemary Joan
Improving access to education and training for those providing wheelchair and seating assistive technology to meet personal posture and mobility requirements, as a basic human right, is a priority. This review considers education and training available to personnel within low and lower middle income countries (LLMIC), to ascertain where gaps in knowledge exist and identify human resource education priorities. A scoping review, mapping out existing scientific and grey literature within the field between 1993 and 2017 was conducted. The search strategy included use of online databases, manual analogue searches and key stakeholder informant advice. A content analysis process was applied to organize the literature retrieved and extract key themes. Education and training in LLMIC appears ad hoc and limited, however, there is growing recognition as to its importance, notably by the World Health Organization and nongovernmental organizations, delivering education initiatives to a number of countries, along with the development of a credentialing test. Inconsistency exists regarding personnel responsible for wheelchair provision, with no specific professional clearly recognized to oversee the system within many LLMIC. Education and training is required for all stakeholders involved in wheelchair provision. Advocating for programme development to enhance personnel skills, build capacity and ensure best practice is a priority. Pilot sites, delivering and credentialing appropriate wheelchair provision education and training within context should be considered. Measuring outcomes and transferable skills should be part of education programme delivery structures. Considering a new discipline responsible for oversight of wheelchair provision should be investigated. Implications for rehabilitation Education and training is an essential step in the wheelchair provision process in the bid to obtain an appropriate wheelchair via appropriate provision services. However, it is more
Full Text Available Service provisioning in assisted living environments faces distinct challenges due to the heterogeneity of networks, access technology, and sensing/actuation devices in such an environment. Existing solutions, such as SOAP-based web services, can interconnect heterogeneous devices and services, and can be published, discovered and invoked dynamically. However, it is considered heavier than what is required in the smart environment-like context and hence suffers from performance degradation. Alternatively, REpresentational State Transfer (REST has gained much attention from the community and is considered as a lighter and cleaner technology compared to the SOAP-based web services. Since it is simple to publish and use a RESTful web service, more and more service providers are moving toward REST-based solutions, which promote a resource-centric conceptualization as opposed to a service-centric conceptualization. Despite such benefits of REST, the dynamic discovery and eventing of RESTful services are yet considered a major hurdle to utilization of the full potential of REST-based approaches. In this paper, we address this issue, by providing a RESTful discovery and eventing specification and demonstrate it in an assisted living healthcare scenario. We envisage that through this approach, the service provisioning in ambient assisted living or other smart environment settings will be more efficient, timely, and less resource-intensive.
Saddiki, H.; Harroud, H.; Karmouch, A.
With the increasing availability of smartphones, tablets and other computing devices, technology consumers have grown accustomed to performing all of their computing tasks anytime, anywhere and on any device. There is a greater need to support ubiquitous connectivity and accommodate users by providing software as network-accessible services. In this paper, we propose a MAS-based approach to adaptive service composition and provision that automates the selection and execution of a suitable composition plan for a given service. With agents capable of autonomous and intelligent behavior, the composition plan is selected in a dynamic negotiation driven by a utility-based decision-making mechanism; and the composite service is built by a coalition of agents each providing a component necessary to the target service. The same service can be built in variations for catering to dynamic user contexts and further personalizing the user experience. Also multiple services can be grouped to satisfy new user needs.
Waverijn, Geeke; Groenewegen, Peter P.; de Klerk, Mirjam
Differential provision of local services and amenities has been proposed as a mechanism behind the relationship between social capital and health. The aim of this study was to investigate whether social capital and collective efficacy are related to the provision of social support services and
Vedel, Suzanne Elizabeth; Jacobsen, Jette Bredahl; Thorsen, Bo Jellesmark
A key prerequisite to ensure that payment for ecosystem services is effective is that the management measures landowners are paid to undertake are in fact additional to the status quo and hence bring about a change in provision. We investigated Danish forest owners' preferences for conditional...... contracts for the provision of ecosystem services in Natura 2000 policies in a sample covering 12.5% of the total private forest area. This involves allowing old trees to decay naturally, setting aside forest areas, accepting a fixed percentage of broadleaves and increasing access for the public. Forest...... owners may already provide some of these, e.g., if they derive private benefits from them, in which case additionality becomes an issue. This study investigates the link between forest owners' current management and their willingness to accept (WTA) payments for providing specific ecosystem services...
This rule reissues the current regulations and: Establishes policy, assigns responsibilities, and implements the non-funding and non-reporting provisions in DoD for: Provision of early intervention services (EIS) to infants and toddlers with disabilities and their families, as well as special education and related services to children with disabilities entitled under this part to receive education services from the DoD; implementation of a comprehensive, multidisciplinary program of EIS for infants and toddlers with disabilities and their families who, but for age, are eligible to be enrolled in DoD schools; provision of a free appropriate public education (FAPE), including special education and related services, for children with disabilities, as specified in their individualized education programs (IEP), who are eligible to enroll in DoD schools; and monitoring of DoD programs providing EIS, and special education and related services for compliance with this part. This rule also establishes a DoD Coordinating Committee to recommend policies and provide compliance oversight for early intervention and special education.
Horwitz, Jill R; Nichols, Austin
To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost Report Information System and Prospective Payment System Minimum Data File, and primary data collection for geographic coordinates. The sample includes all nonfederal, general medical, and surgical hospitals located outside of metropolitan statistical areas and within the continental United States from 1988 to 2005. We estimate multivariate regression models to examine the effects of (1) hospital ownership and (2) hospital ownership mix within rural hospital markets on profitable versus unprofitable medical service offerings. Rural nonprofit hospitals are more likely than for-profit hospitals to offer unprofitable services, many of which are underprovided services. Nonprofits respond less than for-profits to changes in service profitability. Nonprofits with more for-profit competitors offer more profitable services and fewer unprofitable services than those with fewer for-profit competitors. Rural hospital ownership affects medical service provision at the hospital and market levels. Nonprofit hospital regulation should reflect both the direct and spillover effects of ownership. © Health Research and Educational Trust.
Passalent, Laura; Borsy, Emily; Landry, Michel D; Cott, Cheryl
To illustrate the application of geographic information systems (GIS) as a tool to assess rehabilitation service delivery by presenting results from research recently conducted to assess demand and provision for community rehabilitation service delivery in Ontario, Canada. Secondary analysis of data obtained from existing sources was used to establish demand and provision profiles for community rehabilitation services. These data were integrated using GIS software. A number of descriptive maps were produced that show the geographical distribution of service provision variables (location of individual rehabilitation health care providers and location of private and publicly funded community rehabilitation clinics) in relation to the distribution of demand variables (location of the general population; location of specific populations (i.e., residents age 65 and older) and distribution of household income). GIS provides a set of tools for describing and understanding the spatial organization of the health of populations and the distribution of health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery. Implications for Rehabilitation It is important to seek out alternative and innovative methods to examine rehabilitation service delivery. GIS is a computer-based program that takes any data linked to a geographically referenced location and processes it through a software system that manages, analyses and displays the data in the form of a map, allowing for an alternative level of analysis. GIS provides a set of tools for describing and understanding the spatial organization of population health and health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery.
Davies, Helen J; Doick, Kieron J; Hudson, Malcolm D; Schreckenberg, Kate
Urbanisation and a changing climate are leading to more frequent and severe flood, heat and air pollution episodes in Britain's cities. Interest in nature-based solutions to these urban problems is growing, with urban forests potentially able to provide a range of regulating ecosystem services such as stormwater attenuation, heat amelioration and air purification. The extent to which these benefits are realized is largely dependent on urban forest management objectives, the availability of funding, and the understanding of ecosystem service concepts within local governments, the primary delivery agents of urban forests. This study aims to establish the extent to which British local authorities actively manage their urban forests for regulating ecosystem services, and identify which resources local authorities most need in order to enhance provision of ecosystem services by Britain's urban forests. Interviews were carried out with staff responsible for tree management decisions in fifteen major local authorities from across Britain, selected on the basis of their urban nature and high population density. Local authorities have a reactive approach to urban forest management, driven by human health and safety concerns and complaints about tree disservices. There is relatively little focus on ensuring provision of regulating ecosystem services, despite awareness by tree officers of the key role that urban forests can play in alleviating chronic air pollution, flood risk and urban heat anomalies. However, this is expected to become a greater focus in future provided that existing constraints - lack of understanding of ecosystem services amongst key stakeholders, limited political support, funding constraints - can be overcome. Our findings suggest that the adoption of a proactive urban forest strategy, underpinned by quantified and valued urban forest-based ecosystem services provision data, and innovative private sector funding mechanisms, can facilitate a change to a
Full Text Available Abstract Background UK NHS Stop Smoking Services provide cost effective smoking cessation interventions but, as yet, there has been no assessment of their provision of relapse prevention interventions. Methods Electronic questionnaire survey of 185 UK Stop Smoking Services Managers. Results Ninety six Stop Smoking Service managers returned completed questionnaires (52% response rate. Of these, 58.3% (n = 56 ran NHS Stop Smoking Services which provided relapse prevention interventions for clients with the most commonly provided interventions being behavioural support: telephone (77%, group (73%, and individual (54%. Just under half (48%, n = 27 offered nicotine replacement therapy (NRT, 21.4% (n = 12 bupropion; 19.6% (n = 11 varenicline. Over 80% of those providing relapse prevention interventions do so for over six months. Nearly two thirds of all respondents thought it was likely that they would either continue to provide or commence provision of relapse prevention interventions in their services. Of the remaining respondents, 66.7% (n = 22 believed that the government focus on four-week quit rates, and 42.9% (14 services believed that inadequate funding for provision of relapse prevention interventions, were major barriers to introducing these interventions into routine care. Conclusions Just over half of UK managers of NHS Stop Smoking Services who responded to the questionnaire reported that, in their services, relapse prevention interventions were currently provided for clients, despite, at that time, there being a weak evidence base for their effectiveness. The most commonly provided relapse prevention interventions were those for which there was least evidence. If these interventions are found to be effective, barriers would need to be removed before they would become part of routine care.
Full Text Available With the high demand for freshwater and its vital role in sustaining multiple ecosystem services, it is important to quantify and evaluate freshwater provisioning for various services (e.g., drinking, fisheries, recreation. Research on ecosystem services has increased recently, though relatively fewer studies apply a data driven approach to quantify freshwater provisioning for different ecosystem services. In this study, freshwater provisioning was quantified annually from 1995 to 2013 for 13 watersheds in the Upper Mississippi River Basin (UMRB. Results showed that the annual freshwater provision indices for all watersheds were less than one indicating that freshwater provisioning is diminished in the UMRB. The concentrations of sediment and nutrients (total nitrogen, and total phosphorus are the most sensitive factors that impact freshwater provisioning in the UMRB. A significant linear relationship was observed between precipitation and freshwater provisioning index. During wet periods freshwater provisioning generally decreased in the study watersheds, primarily because of relatively high concentrations and loads of sediment and nutrients delivered from nonpoint sources. Results from this study may provide an insight, as well as an example of a data-driven approach to enhance freshwater provisioning for different ecosystem services and to develop a sustainable and integrated watershed management approach for the UMRB.
Stadler, Michael; Marnay, Christ; Lai, Judy; Siddiqui, Afzal; Limpaitoon, Tanachai; Phan, Trucy; Megel, Olivier; Chang, Jessica; DeForest, Nicholas
Non-residential sectors offer many promising applications for electrical storage (batteries) and photovoltaics (PVs). However, choosing and operating storage under complex tariff structures poses a daunting technical and economic problem that may discourage potential customers and result in lost carbon and economic savings. Equipment vendors are unlikely to provide adequate environmental analysis or unbiased economic results to potential clients, and are even less likely to completely describe the robustness of choices in the face of changing fuel prices and tariffs. Given these considerations, researchers at Lawrence Berkeley National Laboratory (LBNL) have designed the Storage Viability and Optimization Web Service (SVOW): a tool that helps building owners, operators and managers to decide if storage technologies and PVs merit deeper analysis. SVOW is an open access, web-based energy storage and PV analysis calculator, accessible by secure remote login. Upon first login, the user sees an overview of the parameters: load profile, tariff, technologies, and solar radiation location. Each parameter has a pull-down list of possible predefined inputs and users may upload their own as necessary. Since the non-residential sectors encompass a broad range of facilities with fundamentally different characteristics, the tool starts by asking the users to select a load profile from a limited cohort group of example facilities. The example facilities are categorized according to their North American Industry Classification System (NAICS) code. After the load profile selection, users select a predefined tariff or use the widget to create their own. The technologies and solar radiation menus operate in a similar fashion. After these four parameters have been inputted, the users have to select an optimization setting as well as an optimization objective. The analytic engine of SVOW is LBNL?s Distributed Energy Resources Customer Adoption Model (DER-CAM), which is a mixed
Nassl, Michael; Löffler, Jörg
Both the 'cascade model' of ecosystem service provision and the Driver-Pressure-State-Impact-Response framework individually contribute to the understanding of human-nature interactions in social-ecological systems (SES). Yet, as several points of criticism show, they are limited analytical tools when it comes to reproducing complex cause-effect relationships in such systems. However, in this paper, we point out that by merging the two models, they can mutually enhance their comprehensiveness and overcome their individual conceptual deficits. Therefore we closed a cycle of ecosystem service provision and societal feedback by rethinking and reassembling the core elements of both models. That way, we established a causal sequence apt to describe the causes of change to SES, their effects and their consequences. Finally, to illustrate its functioning we exemplified and discussed our approach based on a case study conducted in the Alpujarra de la Sierra in southern Spain.
The integration of complementary therapies within the British National Health Service (NHS) in the context of limited evidence of effectiveness has been much debated, as has the need for the provision of health services to be more evidence-based. In June 1994, a project was launched within a South-East London NHS Hospital Trust to introduce complementary therapy (acupuncture, homeopathy, and osteopathy), in the context of an evaluation program. This followed approximately 4 years of working toward raising the profile of complementary therapies within the hospital through study days, workshops, and providing a massage and osteopathic service for staff. A survey of local general practitioners highlighted areas of complementary therapy provision and interest in referring patients to a hospital-based service. A steering group was established to draw together a proposal for funding the service. Evidence for the effectiveness of acupuncture, homeopathy, and osteopathy was presented at a multidisciplinary seminar. A consensus development process, using a modified Delphi technique to establish referral indicators followed this. This study provides a useful model of service development in the absence of good quality evidence for the effectiveness of clinical interventions.
This document concerns the award of a contract for the provision of GSM mobile telephone services. Following a call for tenders (IT-3121/IT) sent on 11 March 2003 to ten firms in five Member States, CERN had received, by the closing date, two tenders from two firms in one Member State. The Finance Committee is invited to agree to the negotiation of a contract with TDC SWITZERLAND (CH), the lowest bidder, for the provision of GSM mobile telephone services for a period of six years, for a total amount not exceeding 2 308 630 Swiss francs, not subject to revision. The contract will include options for two one-year extensions beyond the initial six-year period. The firm has indicated the following distribution by country of the contract value covered by this adjudication proposal: CH - 100%.
Heaton, G T
New roles for librarians are emerging as a result of rapid changes in information technology. The literature is replete with controversy about nonprofessionals staffing the reference desk, yet such changes in staffing may provide the time librarians need to do other tasks. This paper describes a research project that examined reference desk staffing in academic medical school libraries and its effect on questions received and the provision of a consultation service. A questionnaire was sent to all academic medical school libraries in North America and a 70% return rate was achieved. Results indicated a significant relationship between nonprofessional staffing and both the questions received and the provision of research consultation by appointment. The author suggests that services be reconfigured to make more effective use of both professional and nonprofessional staff.
INFORMATION SYSTEMS TECHNOLOGY PANEL SYMPOSIUM ON „DYNAMIC COMUNICATIONS MANAGEMENT ” IST-062 October 9 - 10, 2006 Piotr Lubkowski, Jaroslaw Krygier...Provision of QoS for Multimedia Services in IEEE 802.11 Wireless Network. In Dynamic Communications Management (pp. 10-1 – 10-16). Meeting Proceedings...mechanisms have been used for managing a limited bandwidth link within the IPv6 military narrowband network. The detailed description of these
Chauhan, Aufeef; Babar, Muhammad Ali
Organizations involve in Global Software Development (GSD) face challenges in terms of having access to appropriate set of tools for performing distributed engineering and development activities, integration between heterogeneous desktop and web-based tools, management of artifacts developed...... distributed environment. In this paper, we argue the need to have a cloud-enabled platform for supporting GSD and propose reference architecture of a cloud based Platform for providing support to provision ecosystem of the Tools as a Service (PTaaS)....
de Sosa, Laura L; Glanville, Helen C; Marshall, Miles R; Prysor Williams, A; Jones, Davey L
Riparian areas, the interface between land and freshwater ecosystems, are considered to play a pivotal role in the supply of regulating, provisioning, cultural and supporting services. Most previous studies, however, have tended to focus on intensive agricultural systems and only on a single ecosystem function. Here, we present the first study which attempts to assess a wide range of ecological processes involved in the provision of the ecosystem service of water quality regulation across a diverse range of riparian typologies. Specifically, we focus on 1) evaluating the spatial variation in riparian soils properties with respect to distance with the river and soil depth in contrasting habitat types; 2) gaining further insights into the underlying mechanisms of pollutant removal (i.e. pesticide sorption/degradation, denitrification, etc.) by riparian soils; and 3) quantify and evaluate how riparian vegetation across different habitat types contribute to the provision of watercourse shading. All the habitats were present within a single large catchment and included: (i) improved grassland, (ii) unimproved (semi-natural) grassland, (iii) broadleaf woodland, (iv) coniferous woodland, and (iv) mountain, heath and bog. Taking all the data together, the riparian soils could be statistically separated by habitat type, providing evidence that they deliver ecosystem services to differing extents. Overall, however, our findings seem to contradict the general assumption that soils in riparian area are different from neighbouring (non-riparian) areas and that they possess extra functionality in terms of ecosystem service provision. Watercourse shading was highly habitat specific and was maximal in forests (ca. 52% shade cover) in comparison to the other habitat types (7-17%). Our data suggest that the functioning of riparian areas in less intensive agricultural areas, such as those studied here, may be broadly predicted from the surrounding land use, however, further research
Full Text Available The creation and wide use of new high quality demanding services (VoIP, High Quality Video Streaming and the delivery of them over already saturated core and access network infrastructures have created the necessity for E2E QoS provisioning. Network Providers use at their infrastructures several kinds of mechanisms and techniques for providing QoS. Most known and widely used technologies are MPLS and DiffServ. The IEEE 802.16-2004 standard (WiMAX refers to a promising wireless broadband technology with enhanced QoS support algorithms. This document presents an experimental network infrastructure providing E2E QoS, using a combination of MPLS and DiffServ technologies in the core network and WiMAX technology as the wireless access medium for high priority services (VoIP, High Quality Video Streaming transmission. The main scope is to map the traffic prioritization and classification attributes of the core network to the access network in a way which does not affect the E2E QoS provisioning. The performance evaluation will be done by introducing different kinds of traffic scenarios in a saturated and overloaded network environment. The evaluation will prove that this combination made feasible the E2E QoS provisioning while keeping the initial constrains as well as the services delivered over a wireless network.
Meylan, Louise; Gary, Christian; Alline, Clémentine; Ortiz, Jorge; Jackson, Louise
Intensively managed cropping systems with emphasis on productivity of the main crop can benefit from additional ecosystem services brought by integration of trees in the system − but potential drawbacks must also be accounted for. In an on-farm study, we used a variety of plant, soil and water- related variables to assess the effect of Erythrina spp. and Musa spp. on the provision of ecosystem services in productive, high-quality Coffea arabica plantations in Costa Rica. We found 1) no signif...
Full Text Available This article discusses the provision of mental health services in low- and middle-income countries (LMICs with a view to understanding the cultural dynamics–how the challenges they pose can be addressed and the opportunities harnessed in specific cultural contexts. The article highlights the need for prioritisation of mental health services by incorporating local population and cultural needs. This can be achieved only through political will and strengthened legislation, improved resource allocation and strategic organisation, integrated packages of care underpinned by professional communication and training, and involvement of patients, informal carers, and the wider community in a therapeutic capacity.
Rathod, Shanaya; Pinninti, Narsimha; Irfan, Muhammed; Gorczynski, Paul; Rathod, Pranay; Gega, Lina; Naeem, Farooq
This article discusses the provision of mental health services in low- and middle-income countries (LMICs) with a view to understanding the cultural dynamics–how the challenges they pose can be addressed and the opportunities harnessed in specific cultural contexts. The article highlights the need for prioritisation of mental health services by incorporating local population and cultural needs. This can be achieved only through political will and strengthened legislation, improved resource allocation and strategic organisation, integrated packages of care underpinned by professional communication and training, and involvement of patients, informal carers, and the wider community in a therapeutic capacity. PMID:28469456
AbstractBackgroundMental health problems are disproportionately higher amongst homeless people. Many barriers exist for homeless people with mental health problems in accessing treatment yet little research has been done on service provision and quality of care for this group. The aim of this paper is to assess current service provision and identify barriers to care for homeless people with mental health problems in 14 European capital cities.MethodTwo methods of data collection were employed; (i) In two highly deprived areas in each of the 14 European capital cities, homeless-specific services providing mental health, social care or general health services were assessed. Data were obtained on service characteristics, staff and programmes provided. (ii) Semi-structured interviews were conducted in each area with experts in mental health care provision for homeless people in order to determine the barriers to care and ways to overcome them.ResultsAcross the 14 capital cities, 111 homeless-specific services were assessed. Input from professionally qualified mental health staff was reported as low, as were levels of active outreach and case finding. Out-of-hours service provision appears inadequate and high levels of service exclusion criteria were evident. Prejudice in the services towards homeless people, a lack of co-ordination amongst services, and the difficulties homeless people face in obtaining health insurance were identified as major barriers to service provision.ConclusionsWhile there is variability in service provision across European capital cities, the reported barriers to service accessibility are common. Homeless-specific services are more responsive to the initial needs of homeless people with mental health problems, while generic services tend to be more conducive to long term care. Further research is needed to determine the effectiveness of different service delivery models, including the most effective coordination of homeless specific and generic
Full Text Available Abstract Background Mental health problems are disproportionately higher amongst homeless people. Many barriers exist for homeless people with mental health problems in accessing treatment yet little research has been done on service provision and quality of care for this group. The aim of this paper is to assess current service provision and identify barriers to care for homeless people with mental health problems in 14 European capital cities. Method Two methods of data collection were employed; (i In two highly deprived areas in each of the 14 European capital cities, homeless-specific services providing mental health, social care or general health services were assessed. Data were obtained on service characteristics, staff and programmes provided. (ii Semi-structured interviews were conducted in each area with experts in mental health care provision for homeless people in order to determine the barriers to care and ways to overcome them. Results Across the 14 capital cities, 111 homeless-specific services were assessed. Input from professionally qualified mental health staff was reported as low, as were levels of active outreach and case finding. Out-of-hours service provision appears inadequate and high levels of service exclusion criteria were evident. Prejudice in the services towards homeless people, a lack of co-ordination amongst services, and the difficulties homeless people face in obtaining health insurance were identified as major barriers to service provision. Conclusions While there is variability in service provision across European capital cities, the reported barriers to service accessibility are common. Homeless-specific services are more responsive to the initial needs of homeless people with mental health problems, while generic services tend to be more conducive to long term care. Further research is needed to determine the effectiveness of different service delivery models, including the most effective coordination of
Prokofieva, Irina; Górriz, Elena; Boon, Tove Enggrob
Incentive schemes and payments for ecosystem services attract increasing attention as a means for aligning the interests of landowners and society by remunerating forest owners for the goods and services their forests produce. As incentive schemes expand around the world, questions related...... and Italy. The analysed schemes are predominantly aimed at enhancing biodiversity and improving recreation. One of the schemes is also related to preserving a variety of forest ecosystem services from forest fires. The incentive schemes are studied following a framework for the institutional analysis of PES...... developed by Prokofieva and Gorriz (Prokofieva, I. and Gorriz, E. 2013: Institutional analysis of incentives for the provision of forest goods and services: an assessment of incentive schemes in Catalonia (North-East Spain), Forest Policy and Economics, 37, 104-114.). We focus on actor and institutional...
Muntadas, Alba; de Juan, Silvia; Demestre, Montserrat
The species interaction and their biological traits (BT) determine the function of benthic communities and, hence, the delivery of ecosystem services. Therefore, disturbance of benthic communities by trawling may compromise ecosystem service delivery, including fisheries' catches. In this work, we explore 1) the impact of trawling activities on benthic functional components (after the BTA approach) and 2) how trawling impact may affect the ecosystem services delivered by benthic communities. To this aim, we assessed the provision of ecosystem services by adopting the concept of Ecosystem Service Providers (ESP), i.e. ecological units that perform ecosystem functions that will ultimately deliver ecosystem services. We studied thirteen sites subjected to different levels of fishing effort in the Mediterranean. From a range of environmental variables included in the study, we found ESPs to be mainly affected by fishing effort and grain size. Our results suggested that habitat type has significant effects on the distribution of ESPs and this natural variability influences ESP response to trawling at a specific site. In order to summarize the complex relationships between human uses, ecosystem components and the demand for ecosystem services in trawling grounds, we adapted a DPSIR (Drivers-Pressures-State Change-Impact-Response) framework to the study area, emphasizing the role of society as Drivers of change and actors demanding management Responses. This integrative framework aims to inform managers about the interactions between all the elements involved in the management of trawling grounds, highlighting the need for an integrated approach in order to ensure ecosystem service provision. Copyright © 2014 Elsevier B.V. All rights reserved.
... HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN REQUIREMENTS FOR RATING ENDORSEMENTS Able Seamen § 12.05-11 General provisions respecting merchant mariner's document endorsed for service as able seamen... 46 Shipping 1 2010-10-01 2010-10-01 false General provisions respecting merchant mariner's...
... to the Government of Sudan, persons in Sudan, or benefitting Sudan. 538.505 Section 538.505 Money and... Licensing Policy § 538.505 Provision of certain legal services to the Government of Sudan, persons in Sudan, or benefitting Sudan. (a) The provision to the Government of Sudan, to a person in Sudan, or in...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Provision of hospital care and medical services during certain disasters and emergencies under 38 U.S.C. 1785. 17.86 Section 17.86 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Care During Certain Disasters and Emergencies § 17.86 Provision...
Background Despite abortion being legally available in South Africa after a change in legislation in 1996, barriers to accessing safe abortion services continue to exist. These barriers include provider opposition to abortion often on the grounds of religious or moral beliefs including the unregulated practice of conscientious objection. Few studies have explored how providers in South Africa make sense of, or understand, conscientious objection in terms of refusing to provide abortion care services and the consequent impact on abortion access. Methods A qualitative approach was used which included 48 in-depth interviews with a purposively selected population of abortion related health service providers, managers and policy influentials in the Western Cape Province, South Africa. Data were analyzed using a thematic analysis approach. Results The ways in which conscientious objection was interpreted and practiced, and its impact on abortion service provision was explored. In most public sector facilities there was a general lack of understanding concerning the circumstances in which health care providers were entitled to invoke their right to refuse to provide, or assist in abortion services. Providers seemed to have poor understandings of how conscientious objection was to be implemented, but were also constrained in that there were few guidelines or systems in place to guide them in the process. Conclusions Exploring the ways in which conscientious objection was interpreted and applied by differing levels of health care workers in relation to abortion provision raised multiple and contradictory issues. From providers’ accounts it was often difficult to distinguish what constituted confusion with regards to the specifics of how conscientious objection was to be implemented in terms of the Choice on Termination of Pregnancy Act, and what was refusal of abortion care based on opposition to abortion in general. In order to disentangle what is resistance to abortion
Doméjean-Orliaguet, S; Léger, S; Auclair, C; Gerbaud, L; Tubert-Jeannin, S
Little is known about how dentists implement caries management and provide restorative dental services in everyday practice. This study explored whether or not recent concepts in caries management were implemented in practice by private practitioners. The influence of patient and practitioner characteristics on the provision of restorative dental services was also investigated through multidimensional analyses. A sample of French general private dental practitioners was asked to record the characteristics of 35 preventive or restorative treatments made on vital permanent teeth. The data collection form was designed to explore dentists' attitudes towards caries management and their use of minimally invasive therapies. Twenty-six practitioners recorded the characteristics of 921 treatments performed on 457 patients. Results indicate that participants rarely performed non-invasive treatments. They used an inappropriate detection tool, as most of decisions to treat were based on visual inspection frequently associated with probing. Multidimensional analysis showed that dentists provided different restorative treatments depending on patient characteristics, with minimally invasive, esthetic restorations preferentially performed for healthy, young and well-insured patients. Restorative treatments and detection tools also varied markedly among practitioners. These variations in service patterns were not related to a specific patient profile in each dental practice. Results indicate that recent concepts in caries management have not yet been adopted in everyday practice. Patient and dentist characteristics influence the provision of restorative dental services. Decision-making in caries management not only depends on pathophysiology but also seems to be influenced by many other factors.
Yousefi, Naeimeh; Rashidian, Arash; Soleymani, Fatemeh; Kebriaeezade, Abbas
Overuse of injections is a common problem in many low-income and middle income countries. While cultural factors and attitudes of both physicians and patients are important factors, physicians› financial intensives may play an important role in overprescribing of injections. This study was designed to assess the effects of providing injection services in physicians› ambulatory offices on prescribing injectable medicines. This cross-sectional study was conducted in Tehran in 2012 -2013and included a random sample of general physicians, pediatricians and infectious disease specialists. We collected data on the provision of injection services in or in proximity of physician offices, and obtained data from physicians› prescriptions in the previous three-month period. We analyzed the data using ANOVA, Student›s t-test and linear regression methods. We obtained complete data from 465 of 600 sampled physicians. Overall 41.9% of prescriptions contained injectable medicines. 75% of physicians offered injection services in their offices. Male physicians and general physicians were more likely to offer the services, and more likely to prescribe injectables. We observed a clear linear relationship between the injection service working hours and the proportion of prescriptions containing injectables (p-value<0.001). Providing injection service in the office was directly linked with the proportion of prescriptions containing injectables. While provision of injection services may provide a direct financial benefit to physicians, it is unlikely to be able to substantially reduce injectable medicines› prescription without addressing the issue. PMID:28496493
Mitev, Miroslav; Mihovska, Albena Dimitrova; Poulkov, Vladimir
Indoor localization is very critical for the provision of Ambient Assisted Living (AAL) services, such as e-Health, smart home, etc. The success of deploying a real-time localization system depends on selecting the right performance characteristics. Bluetooth Low Energy (BLE) is a technology, which...
Beyrer, Chris; Makofane, Keletso; Orazulike, Ifeanyi; Diouf, Daouda; Baral, Stefan D
Chris Beyrer and colleagues reflect on an underappreciated trend in multiple African, Asian, and Caribbean settings, in which the provision of HIV and other essential health services for sexual and gender minorities is expanding despite challenging legal and social environments.
Full Text Available State legitimacy – particularly its alleged potential to counter state fragility – has received increasing attention in academic and policy literature concerned with African development. Service provision can substantially influence such state legitimacy. Services, however, are mostly provided by a multiplicity of (state and non-state providers. This article therefore specifically explores how joint service delivery by multiple providers shapes the attribution of state legitimacy in Burundi by means of two qualitative case studies. Empirically, the article demonstrates, first, that the process of stakeholder interaction, rather than the output of this process, most distinctly shapes state legitimacy and, second, that there are substantial variations in legitimacy attribution by different stakeholders and for different state institutions. Epistemologically, the article suggests three specific challenges that merit attention in further empirical investigation of state legitimacy in fragile settings: the diversity of people’s expectations; the artificiality of state/non-state distinctions; and the personification and politicization of state institutions.
Butterworth, C J; Baxter, A M; Shaw, M J; Bradnock, G
To assess the activity of consultants in restorative dentistry in the United Kingdom in the provision of osseointegrated dental implants within the National Health Service Hospital service and to evaluate their attitudes concerning the relevant medical and oral factors considered in patient selection for implant treatment. Anonymous postal questionnaire in the United Kingdom. Consultants in restorative dentistry. Out of the sample of 145, 109 consultants (75%) completed the questionnaire in 1999. 54 of the 109 consultants (49.5%) are involved in the provision of osseointegrated implant treatment, treating an average of 29 cases/year (range 2-150). However, over one third of the respondents treated 10 or less cases/year. 89% worked with oral surgeons as an implant team. 68% used Branemark (Nobel Biocare) implants as their main system. The majority of consultants felt that smoking, psychoses and previous irradiation were the most important medical factors that contra-indicated implant retained restorations whilst untreated periodontitis, poor oral hygiene and uncontrolled caries were the most important oral contra-indications. Many centres were experiencing significant problems with the funding of implant treatment with one centre receiving no funding. The implications for patient care and specialist training are discussed. There is a marked variation in the number of patients treated with endosseous dental implants within the United Kingdom National Health Service hospitals. Many consultants treat 10 or fewer patients each year. In the main, there is agreement about the factors that contra-indicate implant treatment; these are in line with national guidelines.
Xiong , Kaiqi
This book includes a study of trustworthiness, percentile response time, service availability, and authentication in the networks between users and cloud service providers, and at service stations or sites that may be owned by different service providers. The first part of the book contains an analysis of percentile response time, which is one of the most important SLA (service level agreements) metrics. Effective and accurate numerical solutions for the calculation of the percentile response time in single-class and multi-class queueing networks are obtained. Then, the numerical solution is
Smaill, Simeon J; Bayne, Karen M; Coker, Graham W R; Paul, Thomas S H; Clinton, Peter W
Stakeholders in plantation forestry are increasingly aware of the importance of the ecosystem services and non-market values associated with forests. In New Zealand, there is significant interest in establishing species other than Pinus radiata D. Don (the dominant plantation species) in the belief that alternative species are better suited to deliver these services. Significant risk is associated with this position as there is little objective data to support these views. To identify which species were likely to be planted to deliver ecosystem services, a survey was distributed to examine stakeholder perceptions. Stakeholders were asked which of 15 tree attributes contributed to the provision of five ecosystem services (amenity value, bioenergy production, carbon capture, the diversity of native habitat, and erosion control/water quality) and to identify which of 22 candidate tree species possessed those attributes. These data were combined to identify the species perceived most suitable for the delivery of each ecosystem service. Sequoia sempervirens (D.Don) Endl. closely matched the stakeholder derived ideotypes associated with all five ecosystem services. Comparisons to data from growth, physiological and ecological studies demonstrated that many of the opinions held by stakeholders were inaccurate, leading to erroneous assumptions regarding the suitability of most candidate species. Stakeholder perceptions substantially influence tree species selection, and plantations established on the basis of inaccurate opinions are unlikely to deliver the desired outcomes. Attitudinal surveys associated with engagement campaigns are essential to improve stakeholder knowledge, advancing the development of fit-for-purpose forest management that provides the required ecosystem services.
Smaill, Simeon J.; Bayne, Karen M.; Coker, Graham W. R.; Paul, Thomas S. H.; Clinton, Peter W.
Stakeholders in plantation forestry are increasingly aware of the importance of the ecosystem services and non-market values associated with forests. In New Zealand, there is significant interest in establishing species other than Pinus radiata D. Don (the dominant plantation species) in the belief that alternative species are better suited to deliver these services. Significant risk is associated with this position as there is little objective data to support these views. To identify which species were likely to be planted to deliver ecosystem services, a survey was distributed to examine stakeholder perceptions. Stakeholders were asked which of 15 tree attributes contributed to the provision of five ecosystem services (amenity value, bioenergy production, carbon capture, the diversity of native habitat, and erosion control/water quality) and to identify which of 22 candidate tree species possessed those attributes. These data were combined to identify the species perceived most suitable for the delivery of each ecosystem service. Sequoia sempervirens (D.Don) Endl. closely matched the stakeholder derived ideotypes associated with all five ecosystem services. Comparisons to data from growth, physiological and ecological studies demonstrated that many of the opinions held by stakeholders were inaccurate, leading to erroneous assumptions regarding the suitability of most candidate species. Stakeholder perceptions substantially influence tree species selection, and plantations established on the basis of inaccurate opinions are unlikely to deliver the desired outcomes. Attitudinal surveys associated with engagement campaigns are essential to improve stakeholder knowledge, advancing the development of fit-for-purpose forest management that provides the required ecosystem services.
Zealley, I A; Gordon, T J; Robertson, I; Moss, J G; Gillespie, I N
To evaluate the availability of out-of-hours (OOH) interventional radiology (IR) services in Scotland and discuss implications for service redesign. Data were gathered via a survey conducted by telephone/e-mail interview. The setting was hospitals in Scotland with acute medical and/or surgical beds. The interviewees were consultant interventional radiologists representing each of the 14 geographical Health Boards in Scotland. Three of the 14 geographical Health Boards provided a formal, prospectively planned OOH IR service in at least one hospital. Fourteen of the 34 acute hospitals provided an in-hours IR service, which includes endovascular haemorrhage control. Eight of the 34 acute hospitals had formal, prospectively planned on-call IR arrangements, 12 had an ad-hoc service, and 20 transferred patients to other facilities. Thirty-eight of the 223 consultant radiologists in Scotland were able to perform endovascular haemorrhage control procedures: only 18 of these 38 (47%) were included in on-call rotas. A further 42 radiologists were able to perform nephrostomy and a further 61 were able to perform abscess drainage. Eighty-two radiologists did not perform any interventional procedures. The provision of OOH IR services in Scotland is limited and available resources, both skills and equipment, are being underutilized. These data will be used to inform a process of OOH IR service redesign in Scotland. Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Andersen, Lotte Bøgh; Kristensen, Nicolai; Pedersen, Lene Holm
research on employee motivation thrives, especially in the public service motivation (PSM) literature, few studies have investigated user capacity empirically, and we know little about the combination of PSM, user capacity and models of service provision. Analyzing four central service areas (day care......This article extends the framework of Le Grand (2003, 2010) to encompass responsiveness, and the main argument is that the combination of employee motivation, user capacity, and models of public service provision potentially has serious implications for responsiveness across service areas. Although......, schools, hospitals, and universities), we find variations in both user capacity and PSM. Taking this variation as a point of departure we discuss what implications different combinations of employee motivation, user capacity, and models of public service provision may have for responsiveness....
Rendtorff, Jacob Dahl; Nielsen, Anna Lyneborg; Pedersen, John Storm
The Danish welfare state constitutes a paradigmatic case of the welfare struggle of modern welfare states. Taking care of vulnerable children and youths is used as a case study here, to illustrate the efforts of the welfare state to acquire legitimacy as a body of public administration. That is...... blindness, in order to test the legitimacy of the welfare state´s provision of welfare services at the beginning of this century. We propose a new paradigm to improve the welfare state´s legitimacy. Our case is considered critical....
Tolstrup Christensen, Lene
This doctoral thesis (PhD) explores from a public governance perspective the role of stateowned enterprises (SOEs) in an era of marketization of public service provision and thus contributes to the renewed academic interest in contemporary SOEs. It builds on an explorative comparative case study...... consists of document study and +50 interviews and is based on a historical institutionalist perspective on gradual change that emphasizes interpretation in the implementation between rule makers and rule takers as a driver of institutional change. It leads to the conceptualization of the SOE...
Lazarus, Jeffrey V; Safreed-Harmon, Kelly; Nicholson, Joey
OBJECTIVES: In response to the lack of evidence-based guidance for how to continue scaling up antiretroviral therapy (ART) in ways that make optimal use of limited resources, to assess comparative studies of ART service delivery models implemented in sub-Saharan Africa. METHODS: A systematic...... of service delivery models, making it difficult to draw conclusions about some models. The strongest evidence was related to the feasibility of decentralisation and task-shifting, both of which appear to be effective strategies....
Full Text Available Context of case: In Portugal, the integration of care services is still in its infancy. Nevertheless, a home support service called SAD (Serviço de Apoio Domiciliário—Domiciliary Support Service, provided by non-profit institutions to the elderly population is believed to be a first approach to integrated care. Purpose: The aim of this work is to describe and discuss the services provided by the institutions that participate in SAD and understand if this service is the first step in a change towards integrated care. Data sources: The main data sources were documents provided by institutions like INE (Instituto Nacional de Estatística—National Institute of Statistics and a questionnaire that was submitted to 75 institutions in order to capture: (a demographic and structural data; (b the type of information that the professionals need to fulfil their jobs and (c the kind of relationship and constraints, if they exist, to better integration, between the institutions that provide SAD and the patients, the social and health systems, and other entities. Conclusion and discussion: SAD seems to have been promoting a formal collaboration between several entities in the social and health systems. The information shared between these institutions has increased, but where cooperation in care service provision is concerned this seldom surpasses the social bounds because health care is still difficult to integrate.
Santana, Silvina; Dias, Ana; Souza, Elisabete; Rocha, Nelson
In Portugal, the integration of care services is still in its infancy. Nevertheless, a home support service called SAD (Serviço de Apoio Domiciliário-Domiciliary Support Service), provided by non-profit institutions to the elderly population is believed to be a first approach to integrated care. The aim of this work is to describe and discuss the services provided by the institutions that participate in SAD and understand if this service is the first step in a change towards integrated care. The main data sources were documents provided by institutions like INE (Instituto Nacional de Estatística--National Institute of Statistics) and a questionnaire that was submitted to 75 institutions in order to capture: (a) demographic and structural data; (b) the type of information that the professionals need to fulfil their jobs and (c) the kind of relationship and constraints, if they exist, to better integration, between the institutions that provide SAD and the patients, the social and health systems, and other entities. SAD seems to have been promoting a formal collaboration between several entities in the social and health systems. The information shared between these institutions has increased, but where cooperation in care service provision is concerned this seldom surpasses the social bounds because health care is still difficult to integrate.
Full Text Available PURPOSE: To identify and report the perceived barriers to the provision of low vision services among ophthalmologists in India. METHODS: Seventy nine ophthalmologists responded to a structured self-administered questionnaire. Information was collected to understand the level of awareness and barriers/constraints to provision of low vision services. Significant factors associated with each barrier/constraint and perceptions on providing low vision care were investigated. RESULTS: Lack of training/knowledge [65 (82.3%], lack of awareness [59 (74.7%] and non-availability of low vision devices [57 (72.2%] were perceived as the major constraints / barriers to providing low vision care. At least one significant factor was found for each of the above constraints/barriers in providing low vision care. The perception of lack of awareness as being one of the constraints/barriers was significantly higher [OR 3.97 (95% CI, 1.02 - 7.8] among ophthalmologists from organisations providing low vision services. The perception of lack of motivation as constraintd/barrier was significantly higher [OR 3.62 (95% CI, 1.3 - 10.3] among ophthalmologists from organisations providing low vision services and/or those involved in VISION 2020: The Right to Sight programmes [OR 3.83 (95% CI, 1.4 - 10.4]. The likelihood of responding that low vision care is time consuming was greater for those belonging to a teaching institute [OR 7.19 (95% CI, 2.0 - 26.1], those involved in low vision services [OR 5.45 (95% CI, 1.8 - 16.5] and those who knew that low vision is a priority in VISION 2020 [OR 15.1, 95% CI, 1.5 -155.4]. CONCLUSION: Ophthalmologists need more education about the benefits of low vision care in order to increase their level of awareness and knowledge.
.... It is found that the optimal public transport price equals the operator's marginal cost plus a negative external effect in terms of riding time and crowding costs, and that this price increases less...
Kaplan, Sigal; de Abreu e Silva, João; Di Ciommo, Floridea
This study investigates the effect of price and travel mode fairness and spatial equity in transit provision on the perceived transit service quality, willingness to pay, and habitual frequency of use. Based on the theory of planned behavior, we developed a web-based questionnaire for revealed...... preferences data collection. The survey was administered among young people in Copenhagen and Lisbon to explore the transit perceptions and use under different economic and transit provision conditions. The survey yielded 499 questionnaires, analyzed by means of structural equation models. Results show...... that higher perceived fairness relates positively to higher perceived quality of transit service and higher perceived ease of paying for transit use. Higher perceived spatial equity in service provision is associated with higher perceived service quality. Higher perceived service quality relates to higher...
Thatte, Nandita; Choi, Yoonjoung
Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be
Service Level Agreement SLALOM .................................................. Language for SLA specification and monitoring SLAng ...in the rest this paper will be in human-readable format. Other ongoing research projects for SLA specification include: SLAng –XML language for...machine-readable SLAs are not robust enough to handle the complex needs of a Cloud SLA. Specification languages, like SLALOM, SLAng , RBSLA, and WSLA, are
Dunford, Robert W; Smith, Alison C; Harrison, Paula A; Hanganu, Diana
Future patterns of European ecosystem services provision are likely to vary significantly as a result of climatic and socio-economic change and the implementation of adaptation strategies. However, there is little research in mapping future ecosystem services and no integrated assessment approach to map the combined impacts of these drivers. Map changing patterns in ecosystem services for different European futures and (a) identify the role of driving forces; (b) explore the potential influence of different adaptation options. The CLIMSAVE integrated assessment platform is used to map spatial patterns in services (food, water and timber provision, atmospheric regulation, biodiversity existence/bequest, landscape experience and land use diversity) for a number of combined climatic and socio-economic scenarios. Eight adaptation strategies are explored within each scenario. Future service provision (particularly water provision) will be significantly impacted by climate change. Socio-economic changes shift patterns of service provision: more dystopian societies focus on food provision at the expense of other services. Adaptation options offer significant opportunities, but may necessitate trade-offs between services, particularly between agriculture- and forestry-related services. Unavoidable trade-offs between regions (particularly South-North) are also identified in some scenarios. Coordinating adaptation across regions and sectors will be essential to ensure that all needs are met: a factor that will become increasingly pressing under dystopian futures where inter-regional cooperation breaks down. Integrated assessment enables exploration of interactions and trade-offs between ecosystem services, highlighting the importance of taking account of complex cross-sectoral interactions under different future scenarios of planning adaptation responses.
Purpose: The individual EU Member States have options on how they implement the new statutory audit framework in Europe. They may introduce stricter rules or apply certain exemptions where deemed appropriate. Denmark exemplifies Member States with a traditionally high level of non-audit services...... Member States, but for certain countries like Denmark, there will be greater effects on the future provision of non-audit services....... provided by its auditors. The aim of this study is to contrast the minimum implementation rationale observed in the Danish implementation process with an ex ante examination of fee dependency. Design/methodology/approach: The audit reform introduces a cap on non-audit fees which implies a regulator...
Benito-López, Bernardino; Moreno-Enguix, María del Rocio; Solana-Ibañez, José
Effective waste management systems can make critical contributions to public health, environmental sustainability and economic development. The challenge affects every person and institution in society, and measures cannot be undertaken without data collection and a quantitative analysis approach. In this paper, the two-stage double bootstrap procedure of Simar and Wilson (2007) is used to estimate the efficiency determinants of Spanish local entities in the provision of public street-cleaning and refuse collection services. The purpose is to identify factors that influence efficiency. The final sample comprised 1072 municipalities. In the first stage, robust efficiency estimates are obtained with Data Envelopment Analysis (DEA). We apply the second stage, based on a truncated-regression, to estimate the effect of a group of environmental factors on DEA estimates. The results show the existence of a significant relation between efficiency and all the variables analysed (per capita income, urban population density, the comparative index of the importance of tourism and that of the whole economic activity). We have also considered the influence of a dummy categorical variable - the political sign of the governing party - on the efficient provision of the services under study. The results from the methodology proposed show that municipalities governed by progressive parties are more efficient. Copyright © 2011 Elsevier Ltd. All rights reserved.
Marshal, Sarah L; Oades, Lindsay G; Growe, Trevor P
One key component of recovery-oriented mental health services, typically overlooked, involves genuine collaboration between researchers and consumers to evaluate and improve services delivered within a recovery framework. Eighteen mental health consumers working with staff who had received training in the Collaborative Recovery Model (CRM) took part in in-depth focus group meetings, of approximately 2.5 hours each, to generate feedback to guide improvement of the CRM and its use in mental health services. Consumers identified clear avenues for improvement for the CRM both specific to the model and broadly applicable to recovery-oriented service provision. Findings suggest consumers want to be more engaged and empowered in the use of the CRM from the outset. Improved sampling procedures may have led to the identification of additional dissatisfied consumers. Collaboration with mental health consumers in the evaluation and improvement of recovery-oriented practice is crucial with an emphasis on rebuilding mental health services that are genuinely oriented to support recovery.
Windle, E M
Catabolism and lean body mass losses in severe burn injury present an extreme challenge to the dietitian. A high level of nutritional intervention is often required, but service levels have not been described in the UK. This study aimed to identify levels of current dietetic services with respect to burns and to assess adequacy against existing nutrition support standards. A postal survey of 34 UK dietetic departments known to provide care to burned adult and paediatric admissions was undertaken. Data were collected on burns settings, hospital service characteristics, staffing and caseload issues, and absence cover. Comparison was made between funding and activity to National Health Service standards for the nutritional care of inpatients. The response rate was 71% and data were analysed for 20 departments Clinical settings were either burn units or plastic surgery wards. Dietetic care was provided to critically ill burned patients in 16 hospitals. Most hospitals had no dietetic funding assigned for burn care. The funding deficit for critical care compared to recommendations was 5.9 full-time equivalents and no individual hospital met funding standards. Thirty-seven percent of dietitians were unable to provide daily follow up for critically ill patients. Absence cover was limited in 60% of cases. Approximately one-third of dietitians were members of a nutrition support team. Compared to national guidelines for nutrition support, deficiencies of dietetic service provision exist within UK burns settings. This is further reinforced when practice is compared with existing multi-professional burns management standards.
McCabe, Karen E; Ling, Jonathan; Wilson, Graeme B; Crosland, Ann; Kaner, Eileen F S; Haighton, Catherine A
UK society is ageing. Older people who drink alcohol, drink more than those from previous generations, drink more frequently than other age groups and are more likely to drink at home and alone. Alcohol problems in later life however are often under-detected and under-reported meaning older people experiencing alcohol problems have high levels of unmet need. This study sought to identify existing services within South of Tyne, North East England to capture the extent of service provision for older drinkers and identify any gaps. The Age UK definition of 'older people' (aged 50 and over) was used. Services were contacted by telephone, managers or their deputy took part in semi-structured interviews. Forty six service providers were identified. Only one provided a specific intervention for older drinkers. Others typically provided services for age 18+. Among providers, there was no definitive definition of an older person. Data collection procedures within many organisations did not enable them to confirm whether older people were accessing services. Where alcohol was used alongside other drugs, alcohol use could remain unrecorded. To enable alcohol services to meet the needs of older people, greater understanding is needed of the patterns of drinking in later life, the experiences of older people, the scale and scope of the issue and guidance as to the most appropriate action to take. An awareness of the issues related to alcohol use in later life also needs to be integrated into commissioning of other services that impact upon older people. © Royal Society for Public Health 2015.
Schwarz, Corinne; Unruh, Erik; Cronin, Katie; Evans-Simpson, Sarah; Britton, Hannah; Ramaswamy, Megha
The medical sector presents a unique opportunity for identification and service to victims of human trafficking. In this article, we describe local and site-specific efforts to develop an intervention tool to be used in an urban hospital's emergency department in the midwestern United States. In the development of our tool, we focused on both identification and intervention to assist trafficked persons, through a largely collaborative process in which we engaged local stakeholders for developing site-specific points of intervention. In the process of developing our intervention, we highlight the importance of using existing resources and services in a specific community to address critical gaps in coverage for trafficked persons. For example, we focus on those who are victims of labor trafficking, in addition to those who are victims of sex trafficking. We offer a framework informed by rights-based approaches to anti-trafficking efforts that addresses the practical challenges of human trafficking victim identification while simultaneously working to provide resources and disseminate services to those victims.
Shah, Ajit; Bhat, Ravi
Elderly suicide rates may be influenced by mental health funding, service provision and national policy. A cross-national study examining the relationship between elderly suicide rates and (i) the presence of national policy on mental health, (ii) funding for mental health, and (iii) measures of mental health service provision was undertaken by utilizing data from the World Health Organization website. The main findings are: (i) there is no relationship between suicide rates in both sexes in both elderly age-bands and different measures of mental health policy, except they were increased in countries with a substance abuse policy; and (ii) suicide rates in both sexes in both elderly age-bands were higher in countries with greater provision of mental health services, including the number of psychiatric beds, psychiatrists, psychiatric nurses, and the availability of training in mental health for primary care professionals. Cross-national ecological studies using national-level aggregate data are not helpful in establishing a causal relationship (and the direction of this relationship) between elderly suicide rates and mental health funding, service provision and national policies. The impact of introducing national policies on mental health, increasing funding for mental health services and increasing mental health service provision on elderly suicide rates requires further examination in longitudinal within-country studies.
Waverijn, Geeke; Groenewegen, Peter P; de Klerk, Mirjam
Differential provision of local services and amenities has been proposed as a mechanism behind the relationship between social capital and health. The aim of this study was to investigate whether social capital and collective efficacy are related to the provision of social support services and amenities in Dutch municipalities, against a background of decentralisation of long-term care to municipalities. We used data on neighbourhood social capital, collective efficacy (the extent to which people are willing to work for the common good), and the provision of services and amenities in 2012. We included the services municipalities provide to support informal caregivers (e.g. respite care), individual services and support (e.g. domiciliary help), and general and collective services and amenities (e.g. lending point for wheelchairs). Data for social capital were collected between May 2011 and September 2012. Social capital was measured by focusing on contacts between neighbours. A social capital measure was estimated for 414 municipalities with ecometric measurements. A measure of collective efficacy was constructed based on information about the experienced responsibility for the liveability of the neighbourhood by residents in 2012, average charity collection returns in municipalities in 2012, voter turnout at the municipal elections in 2010 and the percentage of blood donors in 2012. We conducted Poisson regression and negative binomial regression to test our hypotheses. We found no relationship between social capital and the provision of services and amenities in municipalities. We found an interaction effect (coefficient = 3.11, 95% CI = 0.72-5.51, P = 0.011) of social capital and collective efficacy on the provision of support services for informal caregivers in rural municipalities. To gain more insight in the relationship between social capital and health, it will be important to study the relationship between social capital and differential provision of
Maria A. Osborne
Full Text Available Objective: To identify and describe Pennsylvania pharmacists who currently provide or are interested in providing community-based patient care services and are interested in joining a statewide practice network. Design: Cross-sectional survey. Setting: February to June 2009 in Pennsylvania. Participants: 1700 pharmacists. Intervention: Mailed and electronic survey. Main outcome measures: Number and geographic location of pharmacists providing or interested in providing community-based patient care in Pennsylvania. Description of patient care documentation methods; physical space; services provided; perceived barriers to providing patient care; training needs; and interest in joining a statewide practice network. Results: The final analysis included data from 1700 pharmacists. Approximately one-third of pharmacists (n=554 were providing patient care services to community-based patients. Most were routinely documenting (67.5% and many had a semi-private or private space to provide care. MTM and immunizations were the most common services provided. Respondents reported the most significant barrier to providing MTM, diabetes education, and smoking cessation education was time constraints, whereas training was a barrier for immunization provision. Most pharmacists were not being compensated for patient care services. Of the 869 pharmacists interested in joining a statewide network, those providing care were more interested in joining than those who were not (70.8% vs. 43.8%, p < 0.001. Conclusion: Pennsylvania pharmacists are interested in providing community-based patient care services and joining a statewide practice network focused on providing community-based patient care services. This research serves as a foundation for building a pharmacist practice network in Pennsylvania. Type: Original Research
... significant adverse economic impact on users of telecommunications services generally or to avoid a... 47 Telecommunication 2 2010-10-01 2010-10-01 false Conditions applicable to provision of CMRS service by incumbent Local Exchange Carriers. 20.20 Section 20.20 Telecommunication FEDERAL COMMUNICATIONS...
Piet, G.J.; Overzee, van H.M.J.; Miller, D.C.M.; Gelabert, E.R.
The ‘Wild Seafood’ Provisioning Service (WSPS), on which commercial fisheries rely, is probably one of the best studied marine ecosystem services due to its economic relevance and because extensive information sources exist for assessment purposes. Yet, the indicators often proposed are not
Koponen, Anne M; Laamanen, Ritva; Simonsen-Rehn, Nina; Sundell, Jari; Brommels, Mats; Suominen, Sakari
To investigate whether the development of job involvement of primary healthcare (PHC) employees in Southern Municipality (SM), where PHC services were outsourced to an independent non-profit organisation, differed from that in the three comparison municipalities (M1, M2, M3) with municipal service providers. Also, the associations of job involvement with factors describing the psychosocial work environment were investigated. A panel mail survey 2000-02 in Finland (n=369, response rates 73% and 60%). The data were analysed by descriptive statistics and multivariate linear regression analysis. Despite the favourable development in the psychosocial work environment, job involvement decreased most in SM, which faced the biggest organisational changes. Job involvement decreased also in M3, where the psychosocial work environment deteriorated most. Job involvement in 2002 was best predicted by high baseline level of interactional justice and work control, positive change in interactional justice, and higher age. Also other factors, such as organisational stability, seemed to play a role; after controlling for the effect of the psychosocial work characteristics, job involvement was higher in M3 than in SM. Outsourcing of PHC services may decrease job involvement at least during the first years. A particular service provision model is better than the others only if it is superior in providing a favourable and stable psychosocial work environment.
Full Text Available The aim of the present study was to assess the oral health practices, status and treatment needs of the rural elderly in national capital territory of Delhi. An effort was also made to identify patterns of utilization of dental services and test alternate strategies for service provision. A total of 96 elderly subjects (47 males and 49 females in 5 rural areas were interviewed and clinically examined using Basic Oral Health Survey criteria of W.H.O. This was followed by a community trial in which the 5 villages were divided into control and test groups. Results of the survey found that both traditional as well as modern oral health practices co-exist in the rural community. Dental services were available to a majority (mostly through private sector, and edentulousness was a condition of primary concern among the elderly as a result of unmet treatment needs for dental caries and periodontal diseases. Age was a variable that was statistically significantly associated with edentulousness (p=0.005. Results of the community trial showed that higher utilization of care can be achieved by providing on-site dental care as compared to referring cases to tertiary care centers. Nevertheless provision of treatment alone is not a suitable policy recommendation since many elderly did not avail care even at on-site community dental health programmes that were operated free of cost. This emphasizes the need of health education over treatment in order to empower the elderly, especially the non-ambulatory patients, to practice prevention and develop favourable attitudes towards accepting prompt treatment at primary health care level.
Orford, Katherine A; Murray, Phil J; Vaughan, Ian P; Memmott, Jane
Grassland for livestock production is a major form of land use throughout Europe and its intensive management threatens biodiversity and ecosystem functioning in agricultural landscapes. Modest increases to conventional grassland biodiversity could have considerable positive impacts on the provision of ecosystem services, such as pollination, to surrounding habitats.Using a field-scale experiment in which grassland seed mixes and sward management were manipulated, complemented by surveys on working farms and phytometer experiments, the impact of conventional grassland diversity and management on the functional diversity and ecosystem service provision of pollinator communities were investigated.Increasing plant richness, by the addition of both legumes and forbs, was associated with significant enhancements in the functional diversity of grassland pollinator communities. This was associated with increased temporal stability of flower-visitor interactions at the community level. Visitation networks revealed pasture species Taraxacum sp. (Wigg.) (dandelion) and Cirsium arvense (Scop.) (creeping thistle) to have the highest pollinator visitation frequency and richness. Cichorium intybus (L.) (chichory) was highlighted as an important species having both high pollinator visitation and desirable agronomic properties.Increased sward richness was associated with an increase in the pollination of two phytometer species; Fragaria × ananassa (strawberry) and Silene dioica (red campion), but not Vicia faba (broad bean). Enhanced functional diversity, richness and abundance of the pollinator communities associated with more diverse neighbouring pastures were found to be potential mechanisms for improved pollination. Synthesis and applications. A modest increase in conventional grassland plant diversity with legumes and forbs, achievable with the expertise and resources available to most grassland farmers, could enhance pollinator functional diversity, richness and abundance
Perlaza, Samir M; Lasaulce, Samson; Debbah, Mérouane
This paper introduces a particular game formulation and its corresponding notion of equilibrium, namely the satisfaction form (SF) and the satisfaction equilibrium (SE). A game in SF models the case where players are uniquely interested in the satisfaction of some individual performance constraints, instead of individual performance optimization. Under this formulation, the notion of equilibrium corresponds to the situation where all players can simultaneously satisfy their individual constraints. The notion of SE, models the problem of QoS provisioning in decentralized self-configuring networks. Here, radio devices are satisfied if they are able to provide the requested QoS. Within this framework, the concept of SE is formalized for both pure and mixed strategies considering finite sets of players and actions. In both cases, sufficient conditions for the existence and uniqueness of the SE are presented. When multiple SE exist, we introduce the idea of effort or cost of satisfaction and we propose a refinemen...
Radford, Kathryn; Grant, Mary; Terry, Jane
Purpose: This study aimed to clarify the existing service provision of stroke-specific vocational rehabilitation (VR) in one English county, in order to facilitate future service development. Method: Using soft systems methodology, services in Health, Social Care, Department of Work and Pensions, the voluntary and private sectors, which were identified as supporting return to work after stroke, were mapped using a mixed-methodology approach. Results: A lack of a sanctioned VR pathway meant access to support relied on brokered provision and tacit knowledge. The timing of an intervention was complex and there was a substantial degree of unmet need for mild stroke patients. VR was seen as “non-essential” due to competing commissioning priorities. Service providers from all sectors lacked training and cross-sector partnerships were tenuous and provider roles unclear. Conclusions: Stroke-specific VR should be delivered by an integrated, cross-sector multi-disciplinary team and integrated commissioning between health and other sectors is necessary. Although early intervention is important, support later on in the recovery process is also necessary. Service providers need adequate training to meet the needs of stroke survivors wishing to return to work and better awareness of best practice guidelines. Business cases which demonstrate the efficacy and cost-effectiveness of VR are vital. Implications for Rehabilitation The timeliness of a vocational rehabilitation (VR) intervention is complex; services need to be responsive to the changing needs of the stroke survivor throughout their recovery process and have better mechanisms to ensure re-entry into the stroke pathway is possible. Return to work is a recognised health outcome; health services need to develop better mechanisms for interagency/cross sector working and liaison with employers and not assume that VR is beyond their remit. Therapists and non-health service providers should receive sufficient training to
Sinclair, Emma; Radford, Kathryn; Grant, Mary; Terry, Jane
This study aimed to clarify the existing service provision of stroke-specific vocational rehabilitation (VR) in one English county, in order to facilitate future service development. Using soft systems methodology, services in Health, Social Care, Department of Work and Pensions, the voluntary and private sectors, which were identified as supporting return to work after stroke, were mapped using a mixed-methodology approach. A lack of a sanctioned VR pathway meant access to support relied on brokered provision and tacit knowledge. The timing of an intervention was complex and there was a substantial degree of unmet need for mild stroke patients. VR was seen as "non-essential" due to competing commissioning priorities. Service providers from all sectors lacked training and cross-sector partnerships were tenuous and provider roles unclear. Stroke-specific VR should be delivered by an integrated, cross-sector multi-disciplinary team and integrated commissioning between health and other sectors is necessary. Although early intervention is important, support later on in the recovery process is also necessary. Service providers need adequate training to meet the needs of stroke survivors wishing to return to work and better awareness of best practice guidelines. Business cases which demonstrate the efficacy and cost-effectiveness of VR are vital. Implications for Rehabilitation The timeliness of a vocational rehabilitation (VR) intervention is complex; services need to be responsive to the changing needs of the stroke survivor throughout their recovery process and have better mechanisms to ensure re-entry into the stroke pathway is possible. Return to work is a recognised health outcome; health services need to develop better mechanisms for interagency/cross sector working and liaison with employers and not assume that VR is beyond their remit. Therapists and non-health service providers should receive sufficient training to meet the needs of stroke survivors wishing to
Sriram, Veena M; Naseer, Rizwan; Hyder, Adnan A
The availability and quality of emergency medical services in low- and middle-income countries, including Pakistan, are extremely limited. New models for prehospital emergency medical services provision have recently emerged across multiple sectors, and research on these models is urgently needed to inform current and future emergency medical services systems in low-resource settings. The objective of this case study was to provide a comprehensive description of the organizational structure and service delivery model of a public sector provider in the Punjab Province of Pakistan, Rescue 1122, with a focus on operations in Lahore. We used case study methodology to systematically describe the organizational model of Rescue 1122. Qualitative data were collected during an in-person site visit to Lahore in June 2013. Three sources were utilized-semi-structured in-depth interviews, document review, and nonparticipant observation. Data were analyzed according to the health system "building blocks" proposed by the World Health Organization. Rescue 1122 is based on a legal framework that provides public financing for EMS, resulting in financial stability for the service. The organization has also reportedly taken positive steps in engaging with communities, and in coordinating across EMS, fire and rescue. We noted benefits and challenges in scaling up the service to all districts in Punjab. Finally, some areas of improvement include supply chain management and expanded data utilization. Our case study highlights key components of the model, areas for strengthening, and opportunities for further research. Rescue 1122 provides an example of a government-financed and operated emergency medical system in a low-resource setting. Copyright © 2017. Published by Elsevier Inc.
Ribeiro, Aridiane Alves; Arantes, Cássia Irene Spinelli; Gualda, Dulce Maria Rosa; Rossi, Lídia Aparecida
This case study aimed to interpret the underlying historical and cultural aspects of the provision of care at an indigenous healthcare service facility. This is an interpretive, case study-type research with qualitative approach, which was conducted in 2012 at the Indigenous Health Support Center (CASAI) of the State of Mato Grosso do Sul, Brazil. Data were collected by means systematic observation, documentary analyses and semi-structured interviews with ten health professionals. Data review was performed according to an approach based on social anthropology and health anthropology. The anthropological concepts of social code and ethnocentrism underpinned the interpretation of outcomes. Two categories were identified: CASAI, a space between streets and village; Ethnocentrism and indigenous health care. Healthcare practice and current social code are influenced by each other. The street social code prevails in the social environment under study. The institutional organization and professionals' appreciation of the indigenous biological body are decisive to provision of care under the streets social code perspective. Professionals' concepts evidence ethnocentrism in healthcare. Workers, however, try to adopt a relativized view vis-à-vis indigenous people at CASAI.
Full Text Available The MonAMI project aims to investigate the feasibility of the deployment of open platforms for Ambient Assisted Living (AAL services provision based on Ambient Intelligence (AmI and to test user acceptance and the usability of the services. Services were designed to provide support in the areas of environmental control, security, well-being and leisure. These services were installed and evaluated in a Spanish geriatric residence. The participants included elderly persons with disabilities, nursing home care givers and informal carers. The concept of the open platform proved to be satisfactory for the provision of the services in a context aware framework. Furthermore, the usability of the technology was viewed positively and the overall results indicate that this system has the potential to prolong independent living at home for elderly people with disabilities. Deployment was proven successful and awareness of open-platform AAL service delivery was raised in local communities throughout Europe.
Modernel, P.; Rossing, W. A. H.; Corbeels, M.; Dogliotti, S.; Picasso, V.; Tittonell, P.
New livestock production models need to simultaneously meet the increasing global demand for meat and preserve biodiversity and ecosystem services. Since the 16th century beef cattle has been produced on the Pampas and Campos native grasslands in southern South America, with only small amounts of external inputs. We synthesised 242 references from peer-reviewed and grey literature published between 1945 and mid-2015 and analysed secondary data to examine the evidence on the ecosystem services provided by this grassland biodiversity hotspot and the way they are affected by land use changes and their drivers. The analysis followed the requirements of systematic review from the PRISMA statement (Moher et al 2009 Acad. Clin. Ann. Intern. Med. 151 264-9). The Pampas and Campos provide feed for 43 million heads of cattle and 14 million sheep. The biome is habitat of 4000 native plant species, 300 species of birds, 29 species of mammals, 49 species of reptiles and 35 species of amphibians. The soils of the region stock 5% of the soil organic carbon of Latin America on 3% of its area. Driven by high prices of soybean, the soybean area increased by 210% between 2000 and 2010, at the expense of 2 million ha (5%) of native grassland, mostly in the Pampas. Intensification of livestock production was apparent in two spatially distinct forms. In subregions where cropping increased, intensification of livestock production was reflected in an increased use of grains for feed as part of feedlots. In subregions dominated by native grasslands, stocking rates increased. The review showed that land use change and grazing regimes with low forage allowances were predominantly associated with negative effects on ecosystem service provision by reducing soil organic carbon stocks and the diversity of plants, birds and mammals, and by increasing soil erosion. We found little quantitative information on changes in the ecosystem services water provision, nutrient cycling and erosion control
Wang, Xin; Gu, Rentao; Ji, Yuefeng; Kavehrad, Mohsen
As a variety of services have emerged, hybrid services have become more common in real optical networks. Although the elastic spectrum resource optimizations over the elastic optical networks (EONs) have been widely investigated, little research has been carried out on the hybrid services of the routing and spectrum allocation (RSA), especially over the network coding-enabled EON. We investigated the RSA for the unicast service and network coding-based multicast service over the network coding-enabled EON with the constraints of time delay and transmission distance. To address this issue, a mathematical model was built to minimize the total spectrum consumption for the hybrid services over the network coding-enabled EON under the constraints of time delay and transmission distance. The model guarantees different routing constraints for different types of services. The immediate nodes over the network coding-enabled EON are assumed to be capable of encoding the flows for different kinds of information. We proposed an efficient heuristic algorithm of the network coding-based adaptive routing and layered graph-based spectrum allocation algorithm (NCAR-LGSA). From the simulation results, NCAR-LGSA shows highly efficient performances in terms of the spectrum resources utilization under different network scenarios compared with the benchmark algorithms.
Paulo F. Azevedo
Full Text Available This paper aims to compare the performance of two modes of provision of prison services: public, and with the participation of private companies. There are few empirical studies concerning the alternative modes of governance in this sector, which differs from other public utilities in that there is an absence of network externalities and scale economies. In addition, an understanding of informal institutions is crucial for the performance of the service provider, either public or private. In this paper, we build a comparative analysis of two case studies of similar correctional facilities, one public and the other outsourced to a private company under the supervision of civil servants (hybrid governance structure, both located in the same region of Brazil. We found that the privately operated facility has achieved better performance indicators (in terms of number of escapes, riots, deaths, assistance to inmates etc. than the public facility, which in part refutes the arguments of Hart, Shleifer and Vishny (1997 against private participation in prison services. We conclude that the reasons for these differences are related to lower levels of administrative controls; to the presence of civil servants within the privately operated prison, which contributes to reducing information asymmetries; to greater incentives for the private operator: to monitor employees, to bypass local judiciary constraints and to fulfill contractual obligations.
Humphreys, Clare; Railton, Cathie; O'Moore, Éamonn; Lombard, Martin; Newton, Autilia
Prisons are an important setting to address prevention, testing and treatment of hepatitis C virus (HCV) and other blood-borne viruses. This audit examined current practice against national standards in a representative sample of prisons in England. The audit tool was developed based on best practice guidelines and piloted in one prison. In December 2012, the audit was conducted in a further 20 prisons, which were chosen to represent different types, sizes and geographical spread across England. Testing for HCV was offered in the majority of prisons audited (20 of 21), but only two-thirds had a written policy on testing and treatment; less than a third had a steering group to oversee the process. The nature of services varied greatly. There were inconsistencies across data sources on testing. This audit found that while there were many areas of good practice, the quality and content of hepatitis C service provision varied. It highlighted the need to provide appropriate guidance for prisons in delivering a high-quality service, ensuring that relevant training is available for different staff and that adequate psychosocial support is provided to patients. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Chauhan, Muhammad Aufeef; Babar, Muhammad Ali; Sheng, Quan Z.
Software Architecture (SA) plays a critical role in designing, developing and evolving cloud-based platforms that can be used to provision different types of services to consumers on demand. In this paper, we present a Reference Architecture (RA) for designing cloud-based Tools as a service SPACE...... (TSPACE) for provisioning a bundled suite of tools by following the Software as a Service (SaaS) model. The reference architecture has been designed by leveraging information structuring approaches and by using well-known architecture design principles and patterns. The RA has been documented using view...... to provision tools for software architecting. We have also evaluated the RA in terms of effectiveness of the design decisions and the RA’s completeness and feasibility using scenario-based architecture evaluation method. The proposed TSPACE RA can provide valuable insights to information structure approaches...
Chauhan, Muhammad Aufeef; Babar, Muhammad Ali; Sheng, Quan Z.
to provision tools for software architecting. We have also evaluated the RA in terms of effectiveness of the design decisions and the RA’s completeness and feasibility using scenario-based architecture evaluation method. The proposed TSPACE RA can provide valuable insights to information structure approaches......Software Architecture (SA) plays a critical role in designing, developing and evolving cloud-based platforms that can be used to provision different types of services to consumers on demand. In this paper, we present a Reference Architecture (RA) for designing cloud-based Tools as a service SPACE...... (TSPACE) for provisioning a bundled suite of tools by following the Software as a Service (SaaS) model. The reference architecture has been designed by leveraging information structuring approaches and by using well-known architecture design principles and patterns. The RA has been documented using view...
Tian, Yongzhong; Gao, Yanghua; Zhu, Lifen
The assessment of food provisioning services of ecosystems in Three-gorge areas is helpful for better understanding the function of ecosystems in local human well-beings. In this paper, process-based models are used to assess the potential food provisioning services derived from agriculture ecosystems and grassland ecosystems, a modifying model along with normal woodlands and a set of modifying coefficients is built to assess the potential food from woodland ecosystems. A set of power regression models based on environment factors are built to estimate the potential fish production from water ecosystems. Land cover data stemmed from Landsat TM images, as well as other natural and social-economic data in 1km resolution such as temperature, precipitation, and DEM, are used to support these assessment models. It shows that the four ecosystems in Three-gorge areas can provide 85.98×10 12 calories heat, 2.49 billion kilograms protein and 823.4 million kilograms fat. Human carrying capacity model under the balance nutrition pattern is built in this paper, which results in two key findings: ecosystems in Three-gorge areas can feed 45.92 million people under wealthy living standard which is 1.53 times of the current population, and the sustainable population is from 9.69 to 36.23 million under that living standard. Multi-scale population pressure model is built to calculate the population pressure index in Three-gorge areas. The grain for green pressure index, a multivariate linear weighed model, is used to determine the spatial distribution of farmland fit for grain for green and fit for protecting.
Smith, Ron J
Siege, a process of political domination aimed at isolating an entire population, represents a unique threat to healthcare provision. This study is a qualitative examination of the impacts of siege on the practices and systems that underlie health in Gaza. Data are from participant observation conducted over a period of six years (2009-2014), along over 20 interviews with doctors and health administrators in the Non-Governmental Organisation (NGO), Governmental, and United Nations sectors. Analyses were informed by two connected theories. First, the theory of surplus population was used, an idea that builds on Marx's conception of primitive accumulation and Harvey's accumulation by dispossession. Second, Roy's theory of de-development was used, particularly as it is connected to neoliberal trends in healthcare systems organizing and financing. Findings indicate that siege impinges on effective healthcare provision through two central, intertwined processes: withholding materials and resources and undermining healthcare at a systems level. These strains pose considerable threats to healthcare, particularly within the Ministry of Health but also within and among other entities in Gaza that deliver care. The strategies of de-development described by participants reflect the ways the population that is codified as a surplus population. Gazan society is continually divested of any of the underpinnings necessary for a well-functioning sovereign health care infrastructure. Instead of a self-governing, independent system, this analysis of health care structures in Gaza reveals a system that is continually at risk of being comprised entirely of captive consumers who are entirely dependent on Israel, international bodies, and the aid industry for goods and services. This study points to the importance of foregrounding the geopolitical context for analysis of medical service delivery within conflict settings. Findings also highlight the importance of advocating for
McDermott, Brett M; Cobham, Vanessa E
From a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions. To critique existing child and adolescent mental health services (CAMHS) models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model. A narrative review of traditional CAMHS is presented. Important elements of a disaster response - individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach. Difficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy. In this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach.
Brett M. McDermott
Full Text Available Background: From a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions. Objective: To critique existing child and adolescent mental health services (CAMHS models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model. Method: A narrative review of traditional CAMHS is presented. Important elements of a disaster response – individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach. Results: Difficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy. Conclusion: In this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach.
Full Text Available The crucial role of networking in Cloud computing calls for a holistic vision of both networking and computing systems that leads to composite network–compute service provisioning. Software-Defined Network (SDN is a fundamental advancement in networking that enables network programmability. SDN and software-defined compute/storage systems form a Software-Defined Cloud Environment (SDCE that may greatly facilitate composite network–compute service provisioning to Cloud users. Therefore, networking and computing systems need to be modeled and analyzed as composite service provisioning systems in order to obtain thorough understanding about service performance in SDCEs. In this paper, a novel approach for modeling composite network–compute service capabilities and a technique for evaluating composite network–compute service performance are developed. The analytic method proposed in this paper is general and agnostic to service implementation technologies; thus is applicable to a wide variety of network–compute services in SDCEs. The results obtained in this paper provide useful guidelines for federated control and management of networking and computing resources to achieve Cloud service performance guarantees.
Gregório, João; Pizarro, Ângela; Cavaco, Afonso; Wipfli, Rolf; Lovis, Christian; Mira da Silva, Miguel; Lapão, Luís Velez
Chronic diseases are pressing health systems to introduce reforms, focused on primary care and multidisciplinary models. Community pharmacists have developed a new role, addressing pharmaceutical care and services. Information systems and technologies (IST) will have an important role in shaping future healthcare provision. However, the best way to design and implement an IST for pharmaceutical service provision is still an open research question. In this paper, we present a possible strategy based on the use of Design Science Research Methodology (DSRM). The application of the DSRM six stages is described, from the definition and characterization of the problem to the evaluation of the artefact.
Full Text Available SUMMARYThis paper focuses on legal service delivery for the indigent by attorneys in private practice acting pro bono in civil rather than criminal matters. In this regard there have been and continue to be considerable gaps between the proper access to civil justice imperatives of constitutional South Africa and the status quo which has existed from the advent of a democratic South Africa until the present. Law as a vehicle for necessary positive change in the daily lives of South African residents is pertinently considered within the country’s woefully unequal socio-economic climate. This paper considers the role which pro bono work by private attorneys is playing and should play in promoting a more just and equitable society through proper access to justice. It explores the current position in South Africa as well as the position in selected foreign jurisdictions regarding pro bono services by attorneys in private practice in civil matters. Part of the discussion focuses on the question of whether pro bono work should be voluntary or mandatory. The merits of introducing a pro bono obligation are critically analysed by looking at the effect on both legal practitioners as well as those receiving the pro bono services. Having defined pro bono work, the practical need for pro bono work by lawyers in private practice is highlighted due to the dearth of legal aid in civil matters for indigent South Africans. Possible constitutional imperatives for the provision of free legal services in civil matters are highlighted. An important part of the paper is a reflection on some of the pro bono work being conducted by private firms of attorneys. The paper concludes with suggestions on means for establishing a more effective pro bono system in South Africa.
Optical transport networks based on wavelength division multiplexing (WDM) are considered to be the most appropriate choice for future Internet backbone. On the other hand, future DOE networks are expected to have the ability to dynamically provision on-demand survivable services to suit the needs of various high performance scientific applications and remote collaboration. Since a failure in aWDMnetwork such as a cable cut may result in a tremendous amount of data loss, efficient protection of data transport in WDM networks is therefore essential. As the backbone network is moving towards GMPLS/WDM optical networks, the unique requirement to support DOE’s science mission results in challenging issues that are not directly addressed by existing networking techniques and methodologies. The objectives of this project were to develop cost effective protection and restoration mechanisms based on dedicated path, shared path, preconfigured cycle (p-cycle), and so on, to deal with single failure, dual failure, and shared risk link group (SRLG) failure, under different traffic and resource requirement models; to devise efficient service provisioning algorithms that deal with application specific network resource requirements for both unicast and multicast; to study various aspects of traffic grooming in WDM ring and mesh networks to derive cost effective solutions while meeting application resource and QoS requirements; to design various diverse routing and multi-constrained routing algorithms, considering different traffic models and failure models, for protection and restoration, as well as for service provisioning; to propose and study new optical burst switched architectures and mechanisms for effectively supporting dynamic services; and to integrate research with graduate and undergraduate education. All objectives have been successfully met. This report summarizes the major accomplishments of this project. The impact of the project manifests in many aspects: First
Inclusion of ecosystem services (ES) information into national-scale development and climate adaptation planning has yet to become common practice, despite demand from decision makers. Identifying where ES originate and to whom the benefits flowunder current and future climate conditionsis especially critical in rapidly developing countries, where the risk of ES loss is high. Here, using Myanmar as a case study, we assess where and how ecosystems provide key benefits to the countrys people and infrastructure. We model the supply of and demand for sediment retention, dry-season baseflows, flood risk reduction and coastal storm protection from multiple beneficiaries. We find that locations currently providing the greatest amount of services are likely to remain important under the range of climate conditions considered, demonstrating their importance in planning for climate resilience. Overlap between priority areas for ES provision and biodiversity conservation is higher than expected by chance overall, but the areas important for multiple ES are underrepresented in currently designated protected areas and Key Biodiversity Areas. Our results are contributing to development planning in Myanmar, and our approach could be extended to other contexts where there is demand for national-scale natural capital information to shape development plans and policies
Montserrat Pallares Barbera
Full Text Available This paper examines Ildefons Cerdà’s 1860 Plan for the Urban Expansion of Barcelona; specifically, how and why it was conceived in a unique way, in which the provision of services to the population was an important part. Cerdà based his expansion proposal on an in depth socio statistical study of old Barcelona’s population conditions. The high mortality rates of the working class population and poor health and education conditions pushed Cerdà to design a new type of urban planning, which he defined as “urbanism”. In his proposal for the new city, he planned the location of services such as marketplaces, schools and hospitals. The first part of this paper introduces the urban and political preconditions of Barcelona and the statistics on which Cerdà based his contribution. The second part uses location theory and a geographic information system (GIS to analyse the pattern of location and the population served by markets and hospitals. In addition, topographic maps from 1926 and 1975 are used to study the development of the expansion up to when it was fully developed. The evolution of the city differed from Cerdà’s proposal, partly due to unexpected increases in population density, the built environment, and higher amounts of building occupation. Nevertheless, Cerdà’s layout of streets and avenues has prevailed.
Wolny, Stacie; Bhagabati, Nirmal; Helsingen, Hanna; Hamel, Perrine; Bartlett, Ryan; Dixon, Adam; Horton, Radley; Lesk, Corey; Manley, Danielle; De Mel, Manishka; Bader, Daniel; Nay Won Myint, Sai; Myint, Win; Su Mon, Myat
Inclusion of ecosystem services (ES) information into national-scale development and climate adaptation planning has yet to become common practice, despite demand from decision makers. Identifying where ES originate and to whom the benefits flow–under current and future climate conditions–is especially critical in rapidly developing countries, where the risk of ES loss is high. Here, using Myanmar as a case study, we assess where and how ecosystems provide key benefits to the country’s people and infrastructure. We model the supply of and demand for sediment retention, dry-season baseflows, flood risk reduction and coastal storm protection from multiple beneficiaries. We find that locations currently providing the greatest amount of services are likely to remain important under the range of climate conditions considered, demonstrating their importance in planning for climate resilience. Overlap between priority areas for ES provision and biodiversity conservation is higher than expected by chance overall, but the areas important for multiple ES are underrepresented in currently designated protected areas and Key Biodiversity Areas. Our results are contributing to development planning in Myanmar, and our approach could be extended to other contexts where there is demand for national-scale natural capital information to shape development plans and policies. PMID:28934282
Houle, Sherilyn K D; Charrois, Theresa L; Faruquee, Chowdhury F; Tsuyuki, Ross T; Rosenthal, Meagen M
The provision of medication management (MM) services by community pharmacists has not been as widely implemented as expected. The Promoting Action on Research Implementation in Health Services framework proposes that in addition to evidence of benefit and a practice context conducive to change, health professionals benefit from facilitation to support their efforts. However, the impact of facilitation on patient care services in community pharmacy has not been studied. The primary objective of this study was to explore the needs of community pharmacists in improving the provision of MM services to patients, and secondarily to use external facilitation to support pharmacies in increasing the number of MM services provided. Ten community pharmacies in Alberta, Canada were randomized to external task-focused facilitation or usual practice. Facilitators interviewed staff of each intervention pharmacy to determine current workflow and barriers and facilitators to service provision, and collaborated to address these site-specific barriers over 6 months. Barriers identified by all intervention sites related to the impact of MM on dispensing, lengthy documentation, inefficient use of follow-up opportunities to address lower-priority concerns, and inconsistent patient identification. Strategies to address these barriers were generally well received by sites, which noted that facilitation improved staff communication and encouraged reflection on current practices; however, MM counts across both groups decreased over the intervention versus baseline. This decline was likely due to the unanticipated effect of the influenza vaccination season occurring concurrently with the intervention period. External facilitation appears to be a feasible and acceptable method to support community pharmacy provision of MM services. However, as the scope of pharmacists' practice increases, serious consideration of how, and when, these services can be consistently offered must be made. Relevant
de Haan, C
In the future, animal health services in developing countries will need to operate in a continuously changing policy, institutional and commercial environment. Firstly, the changing policies and priorities of national policy-makers regarding public and private sector roles, reinforced in Africa by the donors, have reduced funding and support for the large number of tasks that animal health services have traditionally performed, and there is continuing pressure from policy-makers to focus on what the public sector can do best. Secondly, poverty reduction has become one of the main criteria guiding the allocation of official development assistance, which has major implications for the main target clientele of veterinary services. Thirdly, population growth, increasing income and urbanisation are causing a marked increase in demand for livestock products in the developing world. As a result, the entire livestock commodity chain is undergoing major structural changes, which has significant implications for the definition and control of food safety standards. Fourthly, globalisation, and increasing trade and travel have greatly increased the risk of disease transmission between different countries and continents. Veterinary institutions in the developing world need to adapt to these challenges. They will have to be able to focus on the essential public sector roles. At the same time they must deliver those essential services to the poor, and provide the policy framework to ensure that the inevitable structural changes in the commodity chain take place in an equitable and sustainable fashion, with an acceptable level of health risk for the consumer. According to the weight given to these different objectives, changes in the institutional set-up need to be considered. This issue of the Scientific and Technical Review addresses these challenges. It begins by reviewing the basic economic characteristics underlying the provision of animal health services, and then examines
Seth J Theuerkauf
Full Text Available Invasive species can positively, neutrally, or negatively affect the provision of ecosystem services. The direction and magnitude of this effect can be a function of the invaders' density and the service(s of interest. We assessed the density-dependent effect of an invasive marsh grass, Phragmites australis, on three ecosystem services (plant diversity and community structure, shoreline stabilization, and carbon storage in two oligohaline marshes within the North Carolina Coastal Reserve and National Estuarine Research Reserve System (NCNERR, USA. Plant species richness was equivalent among low, medium and high Phragmites density plots, and overall plant community composition did not vary significantly by Phragmites density. Shoreline change was most negative (landward retreat where Phragmites density was highest (-0.40 ± 0.19 m yr-1 vs. -0.31 ± 0.10 for low density Phragmites in the high energy marsh of Kitty Hawk Woods Reserve and most positive (soundward advance where Phragmites density was highest (0.19 ± 0.05 m yr-1 vs. 0.12 ± 0.07 for low density Phragmites in the lower energy marsh of Currituck Banks Reserve, although there was no significant effect of Phragmites density on shoreline change. In Currituck Banks, mean soil carbon content was approximately equivalent in cores extracted from low and high Phragmites density plots (23.23 ± 2.0 kg C m-3 vs. 22.81 ± 3.8. In Kitty Hawk Woods, mean soil carbon content was greater in low Phragmites density plots (36.63 ± 10.22 kg C m-3 than those with medium (13.99 ± 1.23 kg C m-3 or high density (21.61 ± 4.53 kg C m-3, but differences were not significant. These findings suggest an overall neutral density-dependent effect of Phragmites on three ecosystem services within two oligohaline marshes in different environmental settings within a protected reserve system. Moreover, the conceptual framework of this study can broadly inform an ecosystem services-based approach to invasive species
Full Text Available It is widely acknowledged that land use changes (LUC associated with climate variations are affecting the human wellbeing. This paper conducted a revisit to relevant researches on the impacts of LUC on human wellbeing via specifically altering the ecosystem provisioning services. First, the explorations on the influences of LUC on ecosystem provisioning services were reviewed, including the researches on the influences of LUC on agroecosystem services and forest and/or grassland ecosystem services. Then the quantitative identification of the impacts of LUC on ecosystem provisioning services was commented on. In the light of enhanced observation and valuation methods, several approaches to ecosystem services and improved models for assessing those ecosystem services were assessed. The major indicators used to uncover the influences of LUC on human wellbeing were summarized including the increase of inputs and the reduction of outputs in production and the augmented health risk induced by the irrational land uses. Finally, this paper uncovered the research gaps and proposed several research directions to address these gaps.
Wu, Ching-Seh; Khoury, Ibrahim; Shah, Hemant
One of the most important issues in e-healthcare information systems is to optimize the medical data quality extracted from distributed and heterogeneous environments, which can extremely improve diagnostic and treatment decision making. This paper proposes a multiagent web service framework based on service-oriented architecture for the optimization of medical data quality in the e-healthcare information system. Based on the design of the multiagent web service framework, an evolutionary algorithm (EA) for the dynamic optimization of the medical data quality is proposed. The framework consists of two main components; first, an EA will be used to dynamically optimize the composition of medical processes into optimal task sequence according to specific quality attributes. Second, a multiagent framework will be proposed to discover, monitor, and report any inconstancy between the optimized task sequence and the actual medical records. To demonstrate the proposed framework, experimental results for a breast cancer case study are provided. Furthermore, to show the unique performance of our algorithm, a comparison with other works in the literature review will be presented.
Bodnaruk, E.; Kroll, C. N.; Endreny, T. A.; Hirabayashi, S.; Yang, Y.
Urban land area and the proportion of humanity living in cities is growing, leading to increased urban air pollution, temperature, and stormwater runoff. These changes can exacerbate respiratory and heat-related illnesses and affect ecosystem functioning. Urban trees can help mitigate these threats by removing air pollutants, mitigating urban heat island effects, and infiltrating and filtering stormwater. The urban environment is highly heterogeneous, and there is no tool to determine optimal locations to plant or protect trees. Using spatially explicit land cover, weather, and demographic data within biophysical ecosystem service models, this research expands upon the iTree urban forest tools to produce a new decision support tool (iTree-DST) that will explore the development and impacts of optimal tree planting. It will also heighten awareness of environmental justice by incorporating the Atkinson Index to quantify disparities in health risks and ecosystem services across vulnerable and susceptible populations. The study area is Baltimore City, a location whose urban forest and environmental justice concerns have been studied extensively. The iTree-DST is run at the US Census block group level and utilizes a local gradient approach to calculate the change in ecosystem services with changing tree cover across the study area. Empirical fits provide ecosystem service gradients for possible tree cover scenarios, greatly increasing the speed and efficiency of the optimization procedure. Initial results include an evaluation of the performance of the gradient method, optimal planting schemes for individual ecosystem services, and an analysis of tradeoffs and synergies between competing objectives.
Sawik, Bartosz; Mikulik, Jerzy
Supporting services play an important role in health care institutions such as hospitals. This paper presents an application of operations research model for optimal allocation of workers among supporting services in a public hospital. The services include logistics, inventory management, financial management, operations management, medical analysis, etc. The optimality criterion of the problem is to minimize operations costs of supporting services subject to some specific constraints. The constraints represent specific conditions for resource allocation in a hospital. The overall problem is formulated as an integer program in the literature known as the assignment problem, where the decision variables represent the assignment of people to various jobs. The results of some computational experiments modeled on a real data from a selected Polish hospital are reported.
Amiel Castro, Rita T; Schroeder, Katrin; Pinard, Claudia; Blöchlinger, Patricia; Künzli, Hansjörg; Riecher-Rössler, Anita; Kammerer, Martin
The epidemiology of maternal perinatal-psychiatric disorders as well as their effect on the baby is well recognised. Increasingly well researched specialised treatment methods can reduce maternal morbidity, positively affect mother-baby bonding and empower women's confidence as a mother. Here, we aimed to compare guidelines and the structure of perinatal-psychiatric service delivery in the United Kingdom and in Switzerland from the government's perspective. Swiss cantons provided information regarding guidelines and structure of service delivery in 2000. A subsequent survey using the same questionnaire was carried out in 2007. In the UK, similar information was accessed through published reports from 2000-2012. Guidelines for perinatal psychiatry exist in the UK, whereas in Switzerland in 2000 none of the 26 cantons had guidelines, and in 2007 only one canton did. Joint mother-baby admissions on general psychiatric wards were offered by 92% of the Swiss cantons. In the UK, pregnant women and joint mother-baby admissions are only advised onto specialised perinatal-psychiatric units. In Switzerland, in 2007, three specialised units (max. 24 beds) were in place corresponding to 1 unit per 2.5 million people, while in the UK there were 22 mother-baby units (168 beds) in 2012 (1 unit per 2.8 million). In the UK, less than 50% of trusts provided specialised perinatal-psychiatric health care. The main difference between the UK and Switzerland was the absence of guidelines, regular assessment and plans for future development of perinatal psychiatry in Switzerland. There are still geographical differences in the provision of perinatal-psychiatric services in the UK.
Wagner, S.; Nocentini, S.; Huth, F.; Hoogstra, M.A.
The issue of rapid change in environmental conditions under which ecosystem processes and human interventions will take place in the future is relatively new to forestry, whereas the provision of ecosystem services, e.g., timber or fresh water, is at the very heart of the original concept of forest
Canavan, Réamonn; Barry, Margaret M.; Matanov, Aleksandra; Barros, Henrique; Gabor, Edina; Greacen, Tim; Holcnerová, Petra; Kluge, Ulrike; Nicaise, Pablo; Moskalewicz, Jacek; Díaz-Olalla, José Manuel; Strassmayr, Christa; Schene, Aart H.; Soares, Joaquim J. F.; Gaddini, Andrea; Priebe, Stefan
Background: Mental health problems are disproportionately higher amongst homeless people. Many barriers exist for homeless people with mental health problems in accessing treatment yet little research has been done on service provision and quality of care for this group. The aim of this paper is to
van Berkel, H.H.A.|info:eu-repo/dai/nl/075238691
This article discusses reforms of the design of the organisational arena for policy implementation and service provision in European welfare states, focusing on the policy areas of income protection and activation. First, it discusses and compares recent reform programmes in four countries: the UK,
... principles of personal financial management, banking operations, or the benefits of saving for the future... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Financial education programs that include the provision of bank products and services. 303.46 Section 303.46 Banks and Banking FEDERAL DEPOSIT INSURANCE...
Holland, Deirdre M
Medication reconciliation is a basic principle of good medicines management. With the establishment of the National Acute Medicines Programme in Ireland, medication reconciliation has been mandated for all patients at all transitions of care. The clinical pharmacist is widely credited as the healthcare professional that plays the most critical role in the provision of medication reconciliation services.
... transaction, encompassing the provision of defense articles and defense services to vetted members of the... 40A of the AECA related to such a transaction; and delegate to the Secretary of State the... exports, 15 days prior to authorizing them to proceed, that are necessary for and within the scope of this...
... different regions within that satellite's coverage area. (6) Operators of SDARS terrestrial repeaters are... 47 Telecommunication 2 2010-10-01 2010-10-01 false Licensing provisions for the 2.3 GHz satellite... (CONTINUED) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Applications and Licenses Space Stations § 25...
Freeman, Christopher R; Abdullah, Nabilah; Ford, Pauline J; Taing, Meng-Wong
This study investigated pharmacists' and pharmacy assistants' current practices and perspectives with regard to oral healthcare provision across Australian community pharmacies. Cross-sectional study. A questionnaire for each pharmacist and pharmacy assistant cohort was developed and administered by online or postal means. Pearson's χ(2) test was used to examine relationships between categorical variables. Pharmacists and pharmacy assistants working within 2100 randomly selected Australian community pharmacies. The overall response rate was 58.5% (644/1100) for the pharmacist cohort and 28% (280/1000) for the pharmacy assistant cohort. This represents pharmacy staff responses from 803 community pharmacies across Australia (approximately 14.6%, 803/5500 of community pharmacies nationally). Overall, the majority of pharmacists (80.2%; 516/644) and pharmacy assistants (83.6%; 234/280) reported providing oral health advice/consultations to health consumers up to five times each week. More than half of community pharmacists and pharmacy assistants were involved in identifying signs and symptoms for oral health problems; and the majority believed health consumers were receptive to receiving oral health advice. Additionally, more than 80% of pharmacists and 60% of pharmacy assistants viewed extended oral healthcare roles positively and supported integrating them within their workplace; extended roles include provision of prevention, early intervention and referral to oral healthcare services. The most commonly reported barriers to enhance pharmacy staff involvement in oral healthcare within Australian community pharmacies include lack of knowledge, ongoing training and resources to assist practice. This study highlights that Australian pharmacists have an important role in oral health and provides evidence supporting the need for growing partnerships/collaborations between pharmacy and dental healthcare professionals and organisations to develop, implement and evaluate
This monograph presents a tactical planning approach for service network design in metropolitan areas. Designing the service network requires the suitable aggregation of demand data as well as the anticipation of operational relocation decisions. To this end, an integrated approach of data analysis and mathematical optimization is introduced. The book also includes a case study based on real-world data to demonstrate the benefit of the proposed service network design approach. The target audience comprises primarily research experts in the field of traffic engineering, but the book may also be beneficial for graduate students.
Heller, Rebecca; Johnstone, Anne; Cameron, Sharon T
We conducted a prospective health service evaluation to assess the feasibility and acceptability of routinely offering insertion of intrauterine contraception at cesarean section in a maternity setting in the UK. One month before scheduled cesarean section, women were sent information about postpartum contraception including the option of insertion of an intrauterine contraception at cesarean. Women choosing intrauterine contraception (copper intrauterine device or levonorgestrel intrauterine system) were followed up in person at six weeks, and telephone contact was made at three, six and 12 months postpartum. Our main outcome measures were uptake of intrauterine contraception and complications by six weeks. Secondary outcomes were continuation and satisfaction with intrauterine contraception at 12 months. 120/877 women opted to have intrauterine contraception (13.7%), of which 114 were fitted. By six weeks, there were seven expulsions (6.1%). The expulsion rate by one year was 8.8%. There were no cases of uterine perforations and one case of infection (0.8%). Follow-up rates were 82.5% at 12 months, and continuation rates with intrauterine contraception at 12 months were 84.8% of those contacted. At 12 months, 92.7% of respondents asked were either 'very' or 'fairly' happy with their intrauterine contraception. Routine provision of intrauterine contraception at elective cesarean for women in a public maternity service is feasible and acceptable to women. It is associated with good uptake and good continuation rates for the first year. This could be an important strategy to increase use of intrauterine contraception and prevent short inter-pregnancy intervals and unintended pregnancies. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.
Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?
Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna
Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.
Atwal, Anita; Mcintyre, Anne; Spiliotopoulou, Georgia; Money, Arthur; Paraskevopulos, Ioannis
Measurements play a vital role in providing devices that meet the individual needs of users. There is increasing evidence of devices being abandoned. The reasons for this are complex but one key factor that plays a role in non-use of equipment is the lack of fit between the device, environment and person. In addition, the abandonment of devices can be seen as a waste of public money. The aim of this paper is to examine the type, the readability, and the content of existing guidance in relation to measuring home furniture. An online national survey involving health and social care trusts in the UK. We conducted a synthesis of leaflets associated with measurement of furniture to identify existing guidance. The content and readability of this guidance was then evaluated. From the 325 responses received, 64 therapists reported using guidance. From the 13 leaflets that were analysed, 8 leaflets were found to meet Level 3 Adult Literacy Standards (age 9-11). There were differences in the way in which the measurement of furniture items occurred within the leaflets with no measurement guidance reported for baths. There is a need to standardize guidance to ensure that measurements are reliable. Implications for Rehabilitation Our research has highlighted the need to confirm and agree measurement techniques for home furniture in the provision of assistive devices. Inaccurate guidance can lead to abandonment of devices. Inaccurate guidance could prevent service users from not participating within the self-assessment process for devices.
Fan, Hong; Li, Huan
Location-related data are playing an increasingly irreplaceable role in business, government and scientific research. At the same time, the amount and types of data are rapidly increasing. It is a challenge how to quickly find required information from this rapidly growing volume of data, as well as how to efficiently provide different levels of geospatial data to users. This paper puts forward a data-oriented access model for geographic information science data. First, we analyze the features of GIS data including traditional types such as vector and raster data and new types such as Volunteered Geographic Information (VGI). Taking into account these analyses, a classification scheme for geographic data is proposed and TRAFIE is introduced to describe the establishment of a multi-level model for geographic data. Based on this model, a multi-level, scalable access system for geospatial information is put forward. Users can select different levels of data according to their concrete application needs. Pull-based and push-based data access mechanisms based on this model are presented. A Service Oriented Architecture (SOA) was chosen for the data processing. The model of this study has been described by providing decision-making process of government departments with a simulation of fire disaster data collection. The use case shows this data model and the data provision system is flexible and has good adaptability.
Song, Wei; Deng, Xiangzheng
As a result of economics and policy, land-use/land-cover change (LUCC) in China has undergone a series of complicated changes over the past three decades. However, the effects of LUCCs on ecosystem service values (ESVs) have never been previously assessed at the national scale. Thus, on the basis of three Chinese LUCC maps from 1988, 2000, and 2008, we examined changes in land-use/land-cover and consequent ESVs using a value transfer method. We found that ESVs decreased by 0.45% and 0.10% during the periods 1988-2000 and 2000-2008, respectively, and that ESV changes in China during the period 2000-2008 were relatively moderate compared to the rest of the world over a similar period. The ESVs for provision, regulation, support, and culture decreased by 0.19%, 0.48%, 0.43%, and 0.45%, respectively, during the period 1988-2000, while they decreased by 0.11%, 0.09%, 0.14%, and 0.04%, respectively, during the period 2000-2008. We also developed an elasticity indicator to assess responses in ESV change relative to LUCCs. Results of this analysis show that 1% of land conversion in China resulted in 0.15% and 0.10% average changes in ESVs during the two periods, respectively. Copyright © 2016 Elsevier B.V. All rights reserved.
Beguería, S.; Campos, P.
Hydro-economic models that allow integrating the ecological, hydrological, infrastructure, economic and social aspects into a coherent, scientifically- informed framework constitute preferred tools for supporting decision making in the context of integrated water resources management. We present a case study of water regulation and provision services of forests in the Andalusia region of Spain. Our model computes the physical water flows and conducts an economic environmental income and asset valuation of forest surface and underground water yield. Based on available hydrologic and economic data, we develop a comprehensive water account for all the forest lands at the regional scale. This forest water environmental valuation is integrated within a much larger project aiming at providing a robust and easily replicable accounting tool to evaluate yearly the total income and capital of forests, encompassing all measurable sources of private and public incomes (timber and cork production, auto-consumption, recreational activities, biodiversity conservation, carbon sequestration, water production, etc.). We also force our simulation with future socio-economic scenarios to quantify the physical and economic efects of expected trends or simulated public and private policies on future water resources. Only a comprehensive integrated tool may serve as a basis for the development of integrated policies, such as those internationally agreed and recommended for the management of water resources.
Priebe, Stefan; Badesconyi, Alli; Fioritti, Angelo; Hansson, Lars; Kilian, Reinhold; Torres-Gonzales, Francisco; Turner, Trevor; Wiersma, Durk
Objective To establish whether reinstitutionalisation is occurring in mental health care and, if so, with what variations between western European countries. Design Comparison of data on changes in service provision. Setting Six European countries with different traditions of mental health care that have all experienced deinstitutionalisation since the 1970s—England, Germany, Italy, the Netherlands, Spain, and Sweden. Outcome measures Changes in the number of forensic hospital beds, involuntary hospital admissions, places in supported housing, general psychiatric hospital beds, and general prison population between 1990-1 and 2002-3. Results Forensic beds and places in supported housing have increased in all countries, whereas changes in involuntary hospital admissions have been inconsistent. The number of psychiatric hospital beds has been reduced in five countries, but only in two countries does this reduction outweigh the number of additional places in forensic institutions and supported housing. The general prison population has substantially increased in all countries. Conclusions Reinstitutionalisation is taking place in European countries with different traditions of health care, although with significant variation between the six countries studied. The precise reasons for the phenomenon remain unclear. General attitudes to risk containment in a society, as indicated by the size of the prison population, may be more important than changing morbidity and new methods of mental healthcare delivery. PMID:15567803
Full Text Available The service radius of public parking garage is related to the supply of parking spots and parking behavior characteristics of drivers. However, the empirical and statistical methods in the optimization of public parking garage have limitations. Based on the theory of value engineering and satisfaction, an optimization model for public parking garage service radius is established, which satisfies the requirements of both drivers and owners. Then, an amended model is proposed by using accessibility theory and the principle of moment balance. This model, in consideration of city resistance and walking impedance, is modified from the circular service scope to an irregular polygon, which is more suitable for the actual situation. Finally, the method is verified by a practical example. The results suggest that the optimization model of the service radius and the optimization method of service scope can not only balance the needs of drivers and public parking garages’ owners, but also improve the operation efficiency of parking garages, so that they are more fit for the actual situation of parking service areas. This paper provides new ideas and methods to determine public parking garage service radius and service scope.
Teunter, R.H.; Klein Haneveld, W.K.
When an expensive piece of equipment is bought, spare parts can often be bought at a reduced price. A decision must be made about the initial provisioning of spare parts. Furthermore, if at a certain time the stock drops to zero, because a number of failures have occurred, a decision must be made
Administrative Circular No. 25 (Rev. 3) entitled “Special provisions for the Fire and Rescue Service governing working and rest time”, approved by the Director-General following discussion at the Standing Concertation Committee meeting of 28 September 2012 and entering into force in October 2012, is available on the intranet site of the Human Resources Department: http://cern.ch/hr-docs/admincirc/admincirc.asp This Circular is applicable to staff members of the Fire and Rescue Service It cancels and replaces Administrative Circular No. 25 (Rev. 2) entitled “Shift work – Special provisions for the Fire and Rescue Service” of April 2003. This new version takes into account the new organisation of the Fire and Rescue Service, members of which will henceforth not exclusively perform their functions in the context of shift work, but also during reference working hours and during stand-by duty. Additionally, applicable limits regarding working and rest times an...
O'Reilly, Claire L; Bell, J Simon; Kelly, Patrick J; Chen, Timothy F
Pharmacists' provision of medication counseling and medication review has been shown to improve adherence and resolve drug-related problems. Lack of knowledge of mental health conditions and negative beliefs may act as a barrier to the provision of pharmacy services. It is unclear how pharmacists' knowledge and attitudes impact their provision of pharmacy services. To explore the relationship between pharmacists' level of mental health stigma, mental health literacy and behavioral intentions in relation to providing pharmacy services for consumers with schizophrenia. A survey instrument containing a measure of mental health literacy, the 7-item social distance scale, and 16 items relating to the provision of pharmacy services for consumers with schizophrenia compared to cardiovascular disease, was mailed to a random sample of 1000 pharmacists registered with the Pharmacy Board of New South Wales in November 2009. Multiple linear regression models were used to assess the relationship between stigma, knowledge and behavior. Responses were received from 188 pharmacists. Pharmacists were significantly more confident and comfortable to provide services to consumers with a cardiovascular illness than a mental illness. Social distance, β = -0.11 (95% CI: -0.22, -0.01, P = 0.03), and schizophrenia literacy scores, β = 1.02, (95% CI: 0.54, 1.50, P mental health stigma and high levels of schizophrenia literacy were associated with pharmacists being more willing to provide medication counseling and identify drug-related problems for consumers with schizophrenia. This demonstrates the importance of improving knowledge and stigma surrounding schizophrenia to improve service delivery for consumers taking medications for schizophrenia. Copyright © 2015 Elsevier Inc. All rights reserved.
Essington, Timothy E; Munch, Stephen B
Ecosystem-based management of natural resources involves an explicit consideration of trade-offs among ecosystem services. In marine fisheries, there is the potential for a trade-off between the supporting role of small pelagic fish and cephalopods in food webs, and the provisioning service they play as a major target of fisheries. Because these species play central roles in food webs by providing a conduit of energy from small prey to upper trophic level predators, we hypothesized that trade-offs between these two ecosystem services could be predicted based on energetic properties of predator–prey linkages and food-web structure. We compiled information from 27 marine food-web models (all within the Ecopath framework) that included either small pelagic fish or cephalopods, described predator–prey linkages involving these species, and developed a novel analytical framework to estimate how changes in yields of forage species would propagate through food webs and other fisheries. Consistent with expectations, diet overlap between predators and prey was generally low, and predator–prey linkages tended to be asymmetric; contribution of these species to predator diets was, on average, larger than the contribution of individual predator stocks to prey mortality. The estimated trade-offs between yields of forage fish and predator species were highly variable when we assumed joint bottom-up and top-down control on predation. Roughly one-third of this variance was related to an interactive effect of fishing and predation intensity; strong trade-offs were predicted when fishing intensity on forage species is high and when predators account for a high proportion of total forage mortality. When trophic connections were presumed to be driven by bottom-up processes, trade-offs were more predictable, but generally very small. Contrary to our expectations, trade-offs were not easily predicted from energetic properties, largely because predators of forage species exhibited a
Luckow, Peter W; Kenny, Avi; White, Emily; Ballard, Madeleine; Dorr, Lorenzo; Erlandson, Kirby; Grant, Benjamin; Johnson, Alice; Lorenzen, Breanna; Mukherjee, Subarna; Ly, E John; McDaniel, Abigail; Nowine, Netus; Sathananthan, Vidiya; Sechler, Gerald A; Kraemer, John D; Siedner, Mark J; Panjabi, Rajesh
To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes.
Luckow, Peter W; Kenny, Avi; White, Emily; Ballard, Madeleine; Dorr, Lorenzo; Erlandson, Kirby; Grant, Benjamin; Johnson, Alice; Lorenzen, Breanna; Mukherjee, Subarna; Ly, E John; McDaniel, Abigail; Nowine, Netus; Sathananthan, Vidiya; Sechler, Gerald A; Kraemer, John D; Siedner, Mark J
Abstract Objective To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. Methods The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. Findings Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. Conclusion We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes. PMID:28250511
Full Text Available BACKGROUND: As the global human population grows and its consumption patterns change, additional land will be needed for living space and agricultural production. A critical question facing global society is how to meet growing human demands for living space, food, fuel, and other materials while sustaining ecosystem services and biodiversity . METHODOLOGY/PRINCIPAL FINDINGS: We spatially allocate two scenarios of 2000 to 2015 global areal change in urban land and cropland at the grid cell-level and measure the impact of this change on the provision of ecosystem services and biodiversity. The models and techniques used to spatially allocate land-use/land-cover (LULC change and evaluate its impact on ecosystems are relatively simple and transparent . The difference in the magnitude and pattern of cropland expansion across the two scenarios engenders different tradeoffs among crop production, provision of species habitat, and other important ecosystem services such as biomass carbon storage. For example, in one scenario, 5.2 grams of carbon stored in biomass is released for every additional calorie of crop produced across the globe; under the other scenario this tradeoff rate is 13.7. By comparing scenarios and their impacts we can begin to identify the global pattern of cropland and irrigation development that is significant enough to meet future food needs but has less of an impact on ecosystem service and habitat provision. CONCLUSIONS/SIGNIFICANCE: Urban area and croplands will expand in the future to meet human needs for living space, livelihoods, and food. In order to jointly provide desired levels of urban land, food production, and ecosystem service and species habitat provision the global society will have to become much more strategic in its allocation of intensively managed land uses. Here we illustrate a method for quickly and transparently evaluating the performance of potential global futures.
Full Text Available Services composition technology provides a flexible approach to building Wireless Sensor Network (WSN Service Applications (WSA in a service oriented tasking system for WSN. Maintaining the data security of WSA is one of the most important goals in sensor network research. In this paper, we consider a WSN service oriented tasking system in which the WSN Services Broker (WSB, as the resource management center, can map the service request from user into a set of atom-services (AS and send them to some independent sensor nodes (SN for parallel execution. The distribution of ASs among these SNs affects the data security as well as the reliability and performance of WSA because these SNs can be of different and independent specifications. By the optimal service partition into the ASs and their distribution among SNs, the WSB can provide the maximum possible service reliability and/or expected performance subject to data security constraints. This paper proposes an algorithm of optimal service partition and distribution based on the universal generating function (UGF and the genetic algorithm (GA approach. The experimental analysis is presented to demonstrate the feasibility of the suggested algorithm.
Wu, Zhao; Xiong, Naixue; Huang, Yannong; Gu, Qiong
Services composition technology provides a flexible approach to building Wireless Sensor Network (WSN) Service Applications (WSA) in a service oriented tasking system for WSN. Maintaining the data security of WSA is one of the most important goals in sensor network research. In this paper, we consider a WSN service oriented tasking system in which the WSN Services Broker (WSB), as the resource management center, can map the service request from user into a set of atom-services (AS) and send them to some independent sensor nodes (SN) for parallel execution. The distribution of ASs among these SNs affects the data security as well as the reliability and performance of WSA because these SNs can be of different and independent specifications. By the optimal service partition into the ASs and their distribution among SNs, the WSB can provide the maximum possible service reliability and/or expected performance subject to data security constraints. This paper proposes an algorithm of optimal service partition and distribution based on the universal generating function (UGF) and the genetic algorithm (GA) approach. The experimental analysis is presented to demonstrate the feasibility of the suggested algorithm.
Host, Brian D; Anderson, Michael J; Lucas, Paul D
The rationale for and logistics of the expansion of a postgraduate year 1 (PGY1) residency program in a community hospital are described. Baptist Health Lexington, a nonprofit community hospital in Lexington, Kentucky, sought to expand the PGY1 program by having residents perform second-shift decentralized pharmacist functions. Program expansion was predicated on aligning resident staffing functions with current hospitalwide initiatives involving medication reconciliation and patient education. The focus was to integrate residents into the workflow while allowing them more time to practice as pharmacists and contribute to departmental objectives. The staffing function would increase residents' overall knowledge of departmental operations and foster their sense of independence and ownership. The decentralized functions would include initiation of clinical pharmacokinetic consultations, admission medication reconciliation, discharge teaching for patients with heart failure, and order-entry support from decentralized locations. The program grew from three to five residents and established a staffing rotation for second-shift decentralized coverage. The increased time spent staffing did not detract from the time allotted to previously established learning experiences and enhanced overall continuity of the staffing experience. The change also emphasized to the residents the importance of integration of distributive and clinical functions within the department. Pharmacist participation in admission and discharge medication reconciliation activities has also increased patient satisfaction, evidenced by follow-up surveys conducted by the hospital. A PGY1 residency program was expanded through the provision of second-shift decentralized clinical services, which helped provide residents with increased patient exposure and enhanced staffing experience. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Hill, Peter S; Pavignani, Enrico; Michael, Markus; Murru, Maurizio; Beesley, Mark E
Definitions of fragile states focus on state willingness and capacity to ensure security and provide essential services, including health. Conventional analyses and subsequent policies that focus on state-delivered essential services miss many developments in severely disrupted healthcare arenas. The research seeks to gain insights about the large sections of the health field left to evolve spontaneously by the absent or diminished state. THE STUDY EXAMINED SIX DIVERSE CASE STUDIES: Afghanistan, Central African Republic, Democratic Republic of the Congo, Haïti, Palestine, and Somalia. A comprehensive documentary analysis was complemented by site visits in 2011-2012 and interviews with key informants. Despite differing histories, countries shared chronic disruption of health services, with limited state service provision, and low community expectations of quality of care. The space left by compromised or absent state-provided services is filled by multiple diverse actors. Health is commoditized, health services are heterogeneous and irregular, with public goods such as immunization and preventive services lagging behind curative ones. Health workers with disparate skills, and atypical health facilities proliferate. Health care absorbs large private expenditures, sustained by households, remittances, charitable and solidarity funding, and constitutes a substantial portion of the country economy. Pharmaceutical markets thrive. Trans-border healthcare provision is prominent in most studied settings, conferring regional and sometimes true globalized characteristics to these arenas. We identify three distortions in the way the global development community has considered health service provision. The first distortion is the assumption that beyond the reach of state- and donor-sponsored services is a "void", waiting to be filled. Our analysis suggests that the opposite is the case. The second distortion relates to the inadequacy of the usual binary categories structuring
Ursula Loret de Mola
Full Text Available Latin American (LA megacities are facing enormous challenges to provide welfare to millions of people who live in them. High rates of urbanization and limited administrative capacity of LA cities to plan and control urban growth have led to a critical deficit of urban green space, and therefore, to sub-optimal outcomes in terms of urban sustainability. This study seeks to assess the possibility of using real estate prices to provide an estimate of the monetary value of the ecosystem services provided by urban green space across five Latin American megacities: Bogota, Buenos Aires, Lima, Mexico City and Santiago de Chile. Using Google Earth images to quantify urban green space and multiple regression analysis, we evaluated the impact of urban green space, crime rates, business density and population density on real estate prices across the five mentioned megacities. In addition, for a subset of the data (Lima and Buenos Aires we analyzed the effects of landscape ecology variables (green space patch size, connectivity, etc. on real estate prices to provide a first insight into how the ecological attributes of urban green space can determine the level of ecosystem service provision in different urban contexts in Latin America. The results show a strong positive relationship between the presence of urban green space and real estate prices. Green space explains 52% of the variability in real estate prices across the five studied megacities. Population density, business density and crime had only minor impacts on real estate prices. Our analysis of the landscape ecology variables in Lima and Buenos Aires also show that the relationship between green space and price is context-specific, which indicates that further research is needed to better understand when and where ecological attributes of green space affect real estate prices so that managers of urban green space in LA cities can optimize ecological configuration to maximize ecosystem service
Béla Illés; Richárd Ladányi; György Sárközi3
A prospering transport system is an important precondition for a modern society, for economic growth, employment and welfare. Concerning the development in rural areas an easy access to the infrastructures is essential. Making regional accessibility better is not only investing in the rolling fleets of public transport but also optimizing public transport networks. Changes in the elements and connections of transport networks have an influence on the quality and price of public services offer...
Defense-Netrval, Danielle Azarias; Fernandes, Fernanda Dreux Miranda
The increased prevalence of autism spectrum disorder (ASD) worldwide has been a major public health concern; therefore, discussion about the services and therapies required has become important. This study aimed to characterize the provision of speech-language therapy services in the metropolitan area of Sao Paulo. To this end, a questionnaire with 23 questions was developed based on the Balanced Scorecard methodology. This questionnaire was applied to 854 individuals assisted in 25 ASD services. The results show that only 64% of the ASD services offer speech-language therapy and that the number of individuals assisted is below the expected. Therefore, there is a necessity for better management in the speech-language therapy services offered to the ASD population.
Full Text Available Service routes optimization (SRO of pallet service center should meet customers’ demand firstly and then, through the reasonable method of lines organization, realize the shortest path of vehicle driving. The routes optimization of pallet service center is similar to the distribution problems of vehicle routing problem (VRP and Chinese postman problem (CPP, but it has its own characteristics. Based on the relevant research results, the conditions of determining the number of vehicles, the one way of the route, the constraints of loading, and time windows are fully considered, and a chance constrained programming model with stochastic constraints is constructed taking the shortest path of all vehicles for a delivering (recycling operation as an objective. For the characteristics of the model, a hybrid intelligent algorithm including stochastic simulation, neural network, and immune clonal algorithm is designed to solve the model. Finally, the validity and rationality of the optimization model and algorithm are verified by the case.
Brad R. Fulton
Full Text Available When congregations seek to address social needs, they often pursue this goal through acts of service and political engagement. Over the past three decades, a tremendous amount of research has been dedicated to analyzing congregation-based service provision and political participation. However, little is known about how congregations’ involvement in these arenas has changed during this period. To help fill this gap, this study analyzes three waves of data from a national survey of congregations to assess how congregations’ participation patterns in service-related and political activities have been changing since the 1990s. It also examines trends among subpopulations of congregations grouped by their religious tradition, ethnoracial composition, and ideological orientation. Overall, this study finds that among most types of congregations, the percentage participating in service-related activities is substantial and increasing, while the percentage participating in political activities is less substantial and decreasing. This decline in political participation has implications for the role congregations play in addressing social needs. Relieving immediate needs through service provision without also pursuing long-term solutions through political participation can limit congregations’ ability to comprehensively address social needs. Among the few types of congregations that have high and/or increasing participation rates in both service-related and political activities are Catholic, predominantly Hispanic, and politically liberal congregations.
Irwin, R.; Pullen, C.
Time-limited psychological therapy is increasingly the norm in publically funded healthcare systems. Although brevity of treatment is a characteristic of modern sex therapy, many practitioners would nevertheless consider the provision of effective psychosexual therapy in six or fewer sessions to be a daunting prospect. In this paper we reflect on the challenges, opportunities, and changes to practice associated with the development and delivery of a brief psychosexual therapy service within a...
Hickey, Anne; Horgan, Frances; O'Neill, Desmond; McGee, Hannah
The extent of stroke-related disability typically becomes most apparent after patient discharge to the community. As part of the Irish National Audit of Stroke Care (INASC), a national survey of community-based allied health professionals and public health nurses was conducted. The aim was to document the challenges to service availability for patients with stroke in the community and to identify priorities for service improvement. The study was a cross-sectional tailored interview survey with key managerial and service delivery staff. As comprehensive listings of community-based health professionals involved in stroke care were not available, a cascade approach to information gathering was adopted. Representative regional managers for services incorporating stroke care (N = 7) and disciplinary allied health professional and public health nurse managers (N = 25) were interviewed (94% response rate). Results indicated a lack of formal, structured community-based services for stroke, with no designated clinical posts for stroke care across disciplines nationally. There was significant regional variation in availability of allied health professionals. Considerable inequity was identified in patient access to stroke services, with greater access, where available, for older patients (≥ 65 years). The absence of a stroke strategy and stroke prevalence statistics were identified as significant impediments to service planning, alongside organisational barriers limiting the recruitment of additional allied health professional staff, and lack of sharing of discipline-specific information on patients. This study highlighted major gaps in the provision of inter-disciplinary team community-based services for people with stroke in one country. Where services existed, they were generic in nature, rarely inter-disciplinary in function and deficient in input from salient disciplines. Challenges to optimal care included the need for strategic planning; increased funding of
Full Text Available Abstract Background The extent of stroke-related disability typically becomes most apparent after patient discharge to the community. As part of the Irish National Audit of Stroke Care (INASC, a national survey of community-based allied health professionals and public health nurses was conducted. The aim was to document the challenges to service availability for patients with stroke in the community and to identify priorities for service improvement. Methods The study was a cross-sectional tailored interview survey with key managerial and service delivery staff. As comprehensive listings of community-based health professionals involved in stroke care were not available, a cascade approach to information gathering was adopted. Representative regional managers for services incorporating stroke care (N = 7 and disciplinary allied health professional and public health nurse managers (N = 25 were interviewed (94% response rate. Results Results indicated a lack of formal, structured community-based services for stroke, with no designated clinical posts for stroke care across disciplines nationally. There was significant regional variation in availability of allied health professionals. Considerable inequity was identified in patient access to stroke services, with greater access, where available, for older patients (≥ 65 years. The absence of a stroke strategy and stroke prevalence statistics were identified as significant impediments to service planning, alongside organisational barriers limiting the recruitment of additional allied health professional staff, and lack of sharing of discipline-specific information on patients. Conclusions This study highlighted major gaps in the provision of inter-disciplinary team community-based services for people with stroke in one country. Where services existed, they were generic in nature, rarely inter-disciplinary in function and deficient in input from salient disciplines. Challenges to optimal care
Vieira, Joana; Matos, Paula; Mexia, Teresa; Silva, Patrícia; Lopes, Nuno; Freitas, Catarina; Correia, Otília; Santos-Reis, Margarida; Branquinho, Cristina; Pinho, Pedro
The growing human population concentrated in urban areas lead to the increase of road traffic and artificial areas, consequently enhancing air pollution and urban heat island effects, among others. These environmental changes affect citizen's health, causing a high number of premature deaths, with considerable social and economic costs. Nature-based solutions are essential to ameliorate those impacts in urban areas. While the mere presence of urban green spaces is pointed as an overarching solution, the relative importance of specific vegetation structure, composition and management to improve the ecosystem services of air purification and climate regulation are overlooked. This avoids the establishment of optimized planning and management procedures for urban green spaces with high spatial resolution and detail. Our aim was to understand the relative contribution of vegetation structure, composition and management for the provision of ecosystem services of air purification and climate regulation in urban green spaces, in particular the case of urban parks. This work was done in a large urban park with different types of vegetation surrounded by urban areas. As indicators of microclimatic effects and of air pollution levels we selected different metrics: lichen diversity and pollutants accumulation in lichens. Among lichen diversity, functional traits related to nutrient and water requirements were used as surrogates of the capacity of vegetation to filter air pollution and to regulate climate, and provide air purification and climate regulation ecosystem services, respectively. This was also obtained with very high spatial resolution which allows detailed spatial planning for optimization of ecosystem services. We found that vegetation type characterized by a more complex structure (trees, shrubs and herbaceous layers) and by the absence of management (pruning, irrigation and fertilization) had a higher capacity to provide the ecosystems services of air
Steigen, Anne Mari; Bergh, Daniel
This article analyses the psychometric properties of the Social Provisions Scale 10-items version. The Social Provisions Scale was analysed by means of the polytomous Rasch model, applied to data on 93 young adults (16-30 years) out of school or work, participating in different nature-based services, due to mental or drug-related problems. The psychometric analysis concludes that the original scale has difficulties related to targeting and construct validity. In order to improve the psychometric properties, the scale was modified to include eight items measuring functional support. The modification was based on theoretical and statistical considerations. After modifications the scale showed not only satisfying psychometric properties, but it also clarified uncertainties regarding construct validity of the measure. However, further analysis on larger samples are required. Implications for Rehabilitation Social support is important for a variety of rehabilitation outcomes and for different patient groups in the rehabilitation context, including people with mental health or drug-related problems. Social Provisions Scale may be used as a screening tool to assess social support of participants in rehabilitation, and the scale may also be an important instrument in rehabilitation research. There might be issues measuring structural support using a 10-items version of the Social Provisions Scale but it seemed to work well as an 8-item scale measuring functional support.
... Coverage for Commercial Air Carrier Service in Domestic and International Operations #0; #0; #0... Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations...
Peijnenburg, J.M.J.; Nijman, T.E.; Werker, B.J.M.
We analyze the effect of health cost risk on optimal annuity demand and consumption/savings decisions. Many retirees are exposed to sizeable out-of-pocket medical expenses, while annuities potentially impair the ability to get liquidity to cover these costs and smooth consumption. We find that if
Upshur Ross EG
Full Text Available Abstract Background The question of how best to reduce waiting times for health care, particularly surgical procedures such as hip and knee replacements is among the most pressing concern of the Canadian health care system. The objective of this study was to test the hypothesis that significant seasonal variation exists in the performance of hip and knee replacement surgery in the province of Ontario. Methods We performed a retrospective, cross-sectional time series analysis examining all hip and knee replacement surgeries in people over the age of 65 in the province of Ontario, Canada between 1992 and 2002. The main outcome measure was monthly hospitalization rates per 100 000 population for all hip and knee replacements. Results There was a marked increase in the rate of hip and knee replacement surgery over the 10-year period as well as an increasing seasonal variation in surgeries. Highly significant (Fisher Kappa = 16.05, p 2Autoreg = 0.85 seasonality was identified in the data. Conclusion Holidays and utilization caps appear to exert a significant influence on the rate of service provision. It is expected that waiting times for hip and knee replacement could be reduced by reducing seasonal fluctuations in service provision and benchmarking services to peak delivery. The results highlight the importance of system behaviour in seasonal fluctuation of service delivery.
This paper focuses on approaches by non-government organisations (NGOs) to reach primary school-aged children excluded from access to the conventional state education system. It highlights recent shifts in international literature and agency priorities from the portrayal of NGO provision as a (non-formal) "alternative" to (formal) state…
Luck, G.W.; Harrington, R.; Harrison, P.A.; Kremen, C.; Berry, P.M.; Bugter, R.J.F.; Dawson, T.P.; Bello, de F.; Diaz, S.; Feld, C.K.; Haslett, J.R.; Hering, D.; Kontogianni, A.; Lavorel, S.; Rounsevell, M.; Samways, M.J.; Sandin, L.; Settele, J.; Sykes, M.T.; Hove, van den S.; Vandewalle, M.; Zobel, M.
Research on ecosystem services has grown rapidly over the last decade. Two conceptual frameworks have been published to guide ecological assessments of organisms that deliver services-the concepts of service-providing units (SPUs) and ecosystem service providers (ESPs). Here, we unite these
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La Peyre, Megan K.; Schwarting, Lindsay; Miller, Shea
Understanding the time frame in which ecosystem services (that is, water quality maintenance, shoreline protection, habitat provision) are expected to be provided is important when restoration projects are being designed and implemented. Restoration of three-dimensional shell habitats in coastal Louisiana and elsewhere presents a valuable and potentially self-sustaining approach to providing shoreline protection, enhancing nekton habitat, and providing water quality maintenance. As with most restoration projects, the development of expected different ecosystem services often occurs over varying time frames, with some services provided immediately and others taking longer to develop. This project was designed initially to compare the provision and development of ecosystem services by created fringing shoreline reefs in subtidal and intertidal environments in Vermilion Bay, Louisiana. Specifically, the goal was to test the null hypothesis that over time, the oyster recruitment and development of a sustainable oyster reef community would be similar at both intertidal and subtidal reef bases, and these sustainable reefs would in time provide similar shoreline stabilization, nekton habitat, and water quality services over similar time frames. Because the ecosystem services hypothesized to be provided by oyster reefs reflect long-term processes, fully testing the above-stated null hypothesis requires a longer-time frame than this project allowed. As such, this project was designed to provide the initial data on reef development and provision of ecosystem services, to identify services that may develop immediately, and to provide baseline data to allow for longer-term follow up studies tracking reef development over time. Unfortunately, these initially created reef bases (subtidal, intertidal) were not constructed as planned because of the Deepwater Horizon oil spill in April 2010, which resulted in reef duplicates being created 6 months apart. Further confounding the
Filimonau, Viachaslau; Lemmer, Christian; Marshall, D; Bejjani, G.
The sector of food service provision generates substantial environmental and societal impacts. Environmental impacts are particularly pronounced in terms of carbon footprint build-up while societal impacts are reflected in often unhealthy food choice. These impacts should be minimised to facilitate progress of the sector towards sustainability. A significant share of the negative impacts from food service provision is attributed to irresponsible consumer choice which needs to be architected a...
Paisey, R B; Abbott, A; Levenson, R; Harrington, A; Browne, D; Moore, J; Bamford, M; Roe, M
To investigate the relationship between high diabetes-related lower limb amputation incidence and foot care services in the South-West region of England. The introduction of 10 key elements of foot care service provision in one area of the South-West resulted in stabilization of foot ulcer incidence and sustained reduction in amputation incidence from 2007. Services introduced included administrative support, standardized general practice foot screening, improved community podiatry staffing, hospital multidisciplinary foot clinics, effective care pathways, availability of an orthotist and audit. Peer reviews of the region's diabetes foot care services were undertaken to assess delivery of these service provisions and compare this with major amputation incidence in other regions with data provided by Yorkshire and Humber Public Health Observatory Hospital Episode Statistics. Recommendations were made to improve service provision. In 2015 changes in service provision and amputation incidence were reviewed. Initial reviews in 2013 showed that the 3-year diabetes-related major amputation incidence correlated inversely with adequate delivery of diabetes foot care services (P=0.0024, adjusted R 2 =0.51). Repeat reviews in 2015 found that two or more foot care service improvements were reported by six diabetes foot care providers, with improvement in outcomes. The negative relationship between major amputation incidence and service provision remained strong both in the period 2012-2015 and in the year 2015 only (P ≤0.0012, adjusted R 2 =0.56, and P= 0.0005, R 2 =0.62, respectively). Major diabetes-related lower limb amputation incidence is significantly inversely correlated with foot care services provision. Introduction of more effective service provision resulted in significant reductions in major amputation incidence within 2 years. Failure to improve unsatisfactory service provision resulted in continued high amputation incidence. © 2017 The Authors. Diabetic
Taylor, M. D.; Mackay, A. D.; Dominati, E.; Hill, R. B.
This paper presents the process used to review soil quality monitoring in New Zealand to better align indicators and indicator target ranges with critical values of change in soil function. Since its inception in New Zealand 15 year ago, soil quality monitoring has become an important state of the environment reporting tool for Regional Councils. This tool assists councils to track the condition of soils resources, assess the impact of different land management practices, and provide timely warning of emerging issues to allow early intervention and avoid irreversible loss of natural capital stocks. Critical to the effectiveness of soil quality monitoring is setting relevant, validated thresholds or target ranges. Provisional Target Ranges were set in 2003 using expert knowledge available and data on production responses. Little information was available at that time for setting targets for soil natural capital stocks other than those for food production. The intention was to revise these provisional ranges as further information became available and extend target ranges to cover the regulating and cultural services provided by soils. A recently developed ecosystems service framework was used to explore the feasibility of linking soil natural capital stocks measured by the current suite of soil quality indicators to the provision of ecosystem services by soils. Importantly the new approach builds on and utilises the time series data sets collected by current suite of soil quality indicators, adding value to the current effort, and has the potential to set targets ranges based on the economic and environmental outcomes required for a given farm, catchment or region. It is now timely to develop a further group of environmental indicators for measuring specific soil issues. As with the soil quality indicators, these environmental indicators would be aligned with the provision of ecosystem services. The toolbox envisaged is a set of indicators for specific soil issues
Shawn T. Flanigan
Full Text Available Research demonstrates that service provision by violent organizations can be an effective strategy for coercing the local community to accept and conceal a group’s violent activities, and for creating loyalty to these groups. This has been most frequently explored among political organizations such as terrorist groups, with organizations like Hezbollah and Hamas very visibly engaged in providing social welfare in addition to their violent activities. Recent reports indicate that criminal organizations in Mexico also are involved in instances of public service provision in local communities. This article explores the extent to which drug cartels operating in Mexico are involved in public service provision to members of communities where they operate, and considers possible motivations and implications for public service provision by these criminal organizations, with specific attention to the organization La Familia Michoacána/ Knights Templar. The article also gives attention to the consequences to citizenship and government of service provision by violent nonstate actors, and the ways such service provision may disrupt the social contract between the citizen and the state.
von Randow, C.; Aguiar, A. P. D.; Thonicke, K.; Verbeeck, H.; Guimberteau, M.; Langerwisch, F.; Rammig, A.; Galbraith, D.; Maksic, J.; Kruijt, B.
A great challenge faced by the Amazon region is to maintain the ecosystem services provided by the pristine forest and its complex ecological processes, as well as the needs of the growing human population in the region, in face of global environmental changes and growing demands for land use. In the present study we analyze two different storylines linking different land use scenarios to possible impacts on the provision of ecosystem services in Amazonia: 1) a sustainable, environmental development scenario and 2) a chaotic, uncontrollable deforestation scenario. The future land cover maps are projected by a spatially explicit, dynamic land use model (LuccME) and are then used as inputs, in combination with climate change scenarios, to drive four biosphere models (INLAND, ORCHIDEE, JULES and LPJ). The biosphere models simulate changes in evapotranspiration and carbon fluxes and stocks. Finally, overlaying the biosphere model outputs with maps of roads or protected areas in the region, we analyze how the two land use scenarios will possibly affect the provision of key ecosystem services in the region.
Sheridan, Janie; Barnard, Matt; Webster, Stephen
Whilst service users' views of treatment have been explored, little research exists that has examined front line treatment workers' views on what they perceive are the facilitators and barriers to service provision. This study aimed to fill that gap using a qualitative methodology to explore the experiences of treatment workers. A purposive sample of four Drugs Action Teams or Drug and Alcohol Teams was selected and, in total, 32 front line treatment workers were interviewed across a range of services. Participants indicated that the influences on treatment delivery occurred at three levels. The first level was structural impacts. These included the degree to which services were resourced, the role of targets and a competitive tendering environment, and challenges to partnership working between criminal justice services and community-based services. At the second level, participants identified the influence of the local organisation of services, in particular, the importance of co-ordination in care planning and streamlining for complex cases. The final level was the impact of specific working practices. Good communication was seen as facilitating information sharing; however, a lack of support by management could undermine the benefits of both supervision and peer-support. Unmet training needs were identified by staff across a range of services and particular issues in the relationship between drug treatment and mental health services were identified. Overall, the participants indicated that drug treatment in England was delivered within a complex structure by services that had varied treatment philosophies and that sometimes competed for funding. Despite this, the system was seen as functioning due to the high level of commitment of the people who work within it. © 2011 Blackwell Publishing Ltd.
Teusner, D N; Amarasena, N; Satur, J; Chrisopoulos, S; Brennan, D S
Dental service provision rates are necessary for workforce planning. This study estimates patient and service rates for oral health therapists (OHTs), dental hygienists (DHs) and dental therapists (DTs). To identify important variables for workforce modelling, variations in rates by practice characteristics were assessed. A cross-sectional self-complete mailed questionnaire collected demographic and employment characteristics, and clinical activity on a self-selected typical day of practice. Private and public dental practices in Australia. Members of the two professional associations representing DHs, DTs and OHTs. For each practitioner type, means and adjusted rate ratios of patients per hour, services per visit and preventive services per visit were estimated. Comparisons by practice characteristics were assessed by negative binomial regression models. Response rate was 60.6% (n = 1,083), 90.9% were employed of which 86.3% were working in clinical practice and completed the service log. Mean services per patient visit provided by OHTs, DHs and DTs were 3.7, 3.5 and 3.3 and mean preventive services per patient were 2.1, 2.1 and 1.8 respectively. For all three groups, adjusting for explanatory variables, the rate of preventive services per patient varied significantly by practice type (general or specialist) and by the proportion of child patients treated. Services rates varied by age distribution of patients and type of practice. If these factors were anticipated to vary over-time, then workforce planning models should consider accounting for the potential impact on capacity to supply services by these dental workforce groups.
Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey; Green, Sherri
Aims: Community outreach services play an important role in infectious disease prevention and engaging drug users not currently in treatment. However, fewer than half of US substance abuse treatment units provide these services and many have little financial incentive to do so. Unit directors generally have latitude about scope of services,…
Today, billing is a big challenge for service providers. With a growing number of rich services such as music, mobile TV, Video-on-Demand and eHealth delivered to the mass market, service providers are missing business opportunities because current billing solutions are not fully capable. In
M. Hesselink; J.D. van Iwaarden (Jos); A. van der Wiele (Ton)
textabstractReaching service excellence through a focus on the customer, demands more than just measuring customer satisfaction by means of questionnaire surveys. Nowadays, it is not sufficient anymore to have service excellence in services, processes and relationships. Now is the time to create
Hodge, David R; Wolosin, Robert J
Using a national sample of recently hospitalized older African Americans (N = 2,227), this study identified predictors of dissatisfaction with the manner in which clients' spiritual needs were addressed during hospitalization. Of 8 major areas of service provision examined, 3 were significant predictors of dissatisfaction: nurses, physicians, and the discharge process. The findings underscore the importance of collaborative efforts to address elderly Black clients' spiritual needs. Social workers, who frequently oversee the discharge process, can play an important role in addressing African Americans' spiritual needs by developing discharge plans that incorporate clients' spiritual strengths and resources into the planning process.
Full Text Available Customization degree is a very important field of mass customization. Its improvement could enhance customer satisfaction and further increase customer demand while correspondingly it will increase service price and decrease customer satisfaction and demand. Therefore this paper discusses how to deal with such issues in logistics service supply chain (LSSC with a logistics service integrator (LSI and a customer. With the establishment of customer demand function for logistics services and profit functions of the LSI and the customer, three different decision modes are proposed (i.e., customization degree dominated by LSI, customization degree dominated by customer, and customization degree decided by concentrated supply chain; many interesting findings are achieved. Firstly, to achieve customization cooperation between LSI and customer, measures should be taken to make the unit increase cost of the customized logistics services lower than a certain value. Secondly, there are differences between the optimal customization degree dominated by LSI and that dominated by customer. And in both cases, the dominator could realize more profit than the follower. Thirdly, with the profit secondary distribution strategy, the modified decentralized decision mode could accomplish the maximum profit achieved in centralized decision mode and meanwhile get the optimal customization degree.
Weinke, Elisabeth; Hölbling, Daniel; Albrecht, Florian; Friedl, Barbara
Geo-hazards and their effects are distributed geographically over wide regions. The effective mapping and monitoring is essential for hazard assessment and mitigation. It is often best achieved using satellite imagery and new object-based image analysis approaches to identify and delineate geo-hazard objects (landslides, floods, forest fires, storm damages, etc.). At the moment, several local/national databases and platforms provide and publish data of different types of geo-hazards as well as web-based risk maps and decision support systems. Also, the European commission implemented the Copernicus Emergency Management Service (EMS) in 2015 that publishes information about natural and man-made disasters and risks. Currently, no platform for landslides or geo-hazards as such exists that enables the integration of the user in the mapping and monitoring process. In this study we introduce the concept of a spatial data infrastructure for object delineation, web-processing and service provision of landslide information with the focus on user interaction in all processes. A first prototype for the processing and mapping of landslides in Austria and Italy has been developed within the project Land@Slide, funded by the Austrian Research Promotion Agency FFG in the Austrian Space Applications Program ASAP. The spatial data infrastructure and its services for the mapping, processing and analysis of landslides can be extended to other regions and to all types of geo-hazards for analysis and delineation based on Earth Observation (EO) data. The architecture of the first prototypical spatial data infrastructure includes four main areas of technical components. The data tier consists of a file storage system and the spatial data catalogue for the management of EO-data, other geospatial data on geo-hazards, as well as descriptions and protocols for the data processing and analysis. An interface to extend the data integration from external sources (e.g. Sentinel-2 data) is planned
Hotchkiss, David R; Godha, Deepali; Do, Mai
Wealth-related inequity in the use of maternal healthcare services continues to be a substantial problem in most low- and middle-income countries. One strategic approach to increase the use of appropriate maternal healthcare services is to encourage the expansion of the role of the private sector. However, critics of such an approach argue that increasing the role of the private sector will lead to increased inequity in the use of maternal healthcare services. This article explores this issue in two South Asian countries that have traditionally had high rates of maternal mortality-Nepal and Bangladesh. The study is based on multiple rounds of nationally representative household survey data collected in Nepal and Bangladesh from 1996 to 2011. The methodology involves estimating a concentration index for each survey to assess changes in wealth-related inequity in the use of institutional delivery assistance over time. The results of the study suggest that the expansion of private sector supply of institutional-based delivery services in Nepal and Bangladesh has not led to increased horizontal inequity. In fact, in both countries, inequity was shown to have decreased over the study period. The study findings also suggest that the provision of government delivery services to the poor protects against increased wealth-related inequity in service use. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.
Full Text Available Landscapes are often patchworks of private properties, where composition and configuration patterns result from cumulative effects of the actions of multiple landowners. Securing the delivery of services in such multi-ownership landscapes is challenging, because it is difficult to assure tight compliance to spatially explicit management rules at the level of individual properties, which may hinder the conservation of critical landscape features. To deal with these constraints, a multi-objective simulation-optimization procedure was developed to select non-spatial management regimes that best meet landscape-level objectives, while accounting for uncoordinated and uncertain response of individual landowners to management rules. Optimization approximates the non-dominated Pareto frontier, combining a multi-objective genetic algorithm and a simulator that forecasts trends in landscape pattern as a function of management rules implemented annually by individual landowners. The procedure was demonstrated with a case study for the optimum scheduling of fuel treatments in cork oak forest landscapes, involving six objectives related to reducing management costs (1, reducing fire risk (3, and protecting biodiversity associated with mid- and late-successional understories (2. There was a trade-off between cost, fire risk and biodiversity objectives, that could be minimized by selecting management regimes involving ca. 60% of landowners clearing the understory at short intervals (around 5 years, and the remaining managing at long intervals (ca. 75 years or not managing. The optimal management regimes produces a mosaic landscape dominated by stands with herbaceous and low shrub understories, but also with a satisfactory representation of old understories, that was favorable in terms of both fire risk and biodiversity. The simulation-optimization procedure presented can be extended to incorporate a wide range of landscape dynamic processes, management rules
Respite services have been established to support family carers by providing a break from the responsibilities of caregiving. However the literature and anecdotal evidence suggests that respite services offer carers much more than just providing a period of rest. This study was initiated to identify and describe the health and social care services that are offered to family carers and care-recipients by respite services in South Australia. The findings show that respite providers offer a service to both the family carer and care-recipient. Both groups are offered socialisation and engagement opportunities, and care-recipients have access to a diverse range of health care services. The description of respite that emerges from this study is that of a complex service offering much more than just a period of rest from caregiving duties.
Ngoako S. Marutha
Full Text Available Background: The importance of medical records to the provision of healthcare services cannot be overemphasised. Medical practitioners need information about previous diagnoses, treatments and prescriptions in order to note the progress made with previous treatments and how to move forward. If medical records are not managed properly, it becomes difficult to retrieve such records, which results in hospitals not being able to render healthcare services or these services being rendered incorrectly, especially for chronic patients. Despite the importance of medical records, they are not being managed properly, resulting in a lack of effective systems for opening, tracking and indexing files.Objective: This study seeks to investigate the role of medical records in the provision of public healthcare services in the Limpopo province of South Africa.Method: Quantitative data were collected through questionnaires distributed to staff members in the records management unit and the information management unit in 40 hospitals in Limpopo. These units were relevant as they made use of patient files daily to discharge their duties.Results: The study revealed that missing medical records negatively affected timely and effective healthcare service delivery. This resulted in patients having to wait longer to be treated and in some instances patients being treated without medical history.Conclusion: The study concludes by arguing that missing files contribute to the length of time patients wait to be assisted. As a result, nurses and doctors are unable to assist patients or treat them immediately. The study recommends the introduction of an electronic records management system that can capture and provide access to a full patient record, as well as tracking paper records movement, irrespective of the location.
Seward, Kirsty; Finch, Meghan; Yoong, Sze Lin; Wyse, Rebecca; Jones, Jannah; Grady, Alice; Wiggers, John; Nathan, Nicole; Conte, Kathleen; Wolfenden, Luke
Children attending centre based childcare services consume as much as two thirds of their daily dietary requirements while in care. However, such services often fail to provide foods that are consistent with guideline recommendations. Developing strategies to improve childcare service adherence to menu dietary guidelines requires a comprehensive understanding of factors that may impede or promote implementation. The primary aim of this systematic review is to describe factors (barriers and facilitators) that may influence the implementation of menu dietary guidelines regarding food provision in centre-based childcare services and to map these factors to a theoretical framework. Over 7000 citations were identified from all sources. Duplicate abstracts were removed and selection criteria applied. Twelve studies (1994-2015) were included in the review. Dual data extraction was conducted and the reported factors were synthesised using the theoretical domains framework (TDF). Barriers and facilitators identified in qualitative studies were classified into 8 and 10 of the 14 TDF domains. Barriers and facilitators reported in quantitative studies covered 6 and 3 TDF domains respectively. The most common domain of which both barriers and facilitators to the implementation of menu dietary guidelines were identified was 'environmental context and resources'. This is the first study that comprehensively assesses literature to identify factors that influence the implementation of menu dietary guidelines in childcare services utilising a theoretical framework. Findings provide guidance to support researchers and policy makers design strategies to improve menu dietary guideline implementation and, as such have the potential to improve food provision in care. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
Mills, Jane; Chamberlain-Salaun, Jennifer; Christie, Leane; Kingston, Margot; Gorman, Elise; Harvey, Caroline
The role of Australian general practice nurses (PNs) has developed exponentially since the introduction of service based funding in 2005. In particular, their role has expanded to include cervical screening and well women's health care services provided under the supervision of a general practitioner (GP). While previous research identifies barriers to the provision of these services, this study sought to investigate enablers for nurse led care in this area. A number of grounded theory methods including constantly comparing data, concurrent data collection and analysis and theoretical sampling are utilised in this qualitative, exploratory study. A purposive sample of PNs who completed the required program of education in order to provide cervical screening and well women's health care services was recruited to the study. Data is presented in categories, however a limitation of the study is that a fully integrated grounded theory was unable to be produced due to sampling constraints. Four enablers for the implementation of a change in the PN role to include cervical screening and well women's health checks are identified in this study. These enablers are: GPs being willing to relinquish the role of cervical screener and well women's health service provider; PNs being willing to expand their role to include cervical screening and well women's health services; clients preferring a female practice nurse to meet their cervical screening and well women's health needs; and the presence of a culture that fosters interprofessional teamwork. Seven strategies for successfully implementing change from the perspective of PNs are also constructed from the data. This study additionally highlights the lack of feedback on smear quality provided to PNs cervical screeners and well women's health service providers. The influence of consumers on the landscape of primary care service delivery in Australia is of particular note in this study. Developing interprofessional teams that
Full Text Available Abstract Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i Telecollaboration and teleconsultation services between remotely located healthcare providers, ii telemedicine services in emergencies, iii home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G, and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances
Mougiakakou, Stavroula G; Kyriacou, Efthyvoulos; Perakis, Kostas; Papadopoulos, Homer; Androulidakis, Aggelos; Konnis, Georgios; Tranfaglia, Riccardo; Pecchia, Leandro; Bracale, Umberto; Pattichis, Constantinos; Koutsouris, Dimitrios
Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of the southeast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens.These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at-risk" citizens, and a ferry. The
Lopresti, Edmund F; Jinks, Andrew; Simpson, Richard C
Telerehabilitation (TR) services for assistive technology evaluation and training have the potential to reduce travel demands for consumers and assistive technology professionals while allowing evaluation in more familiar, salient environments for the consumer. Sixty-five consumers received TR services for augmentative and alternative communication or alternative computer access, and consumer satisfaction was compared with twenty-eight consumers who received exclusively in-person services. TR recipients rated their TR services at a median of 6 on a 6-point Likert scale TR satisfaction questionnaire, although individual responses did indicate room for improvement in the technology. Overall satisfaction with AT services was rated highly by both in-person (100% satisfaction) and TR (99% satisfaction) service recipients.
Cultural capital is assumed to benefit all members of society. It is accumulated through the consumption of cultural services and is diminished through depreciation. Using the stock of cultural goods, cultural services are provided by the cultural services industry; the stock of cultural goods is enlarged by the flow of new cultural goods created by individuals who are both consumers and creators of culture and whose utility is positively affected by the cultural goods they created. In the no...
Langerwisch, Fanny; Václavík, Tomáš; von Bloh, Werner; Vetter, Tobias; Thonicke, Kirsten
Irrigated rice croplands are among the world’s most important agro-ecosystems. They provide food for more than 3.5 billion people and a range of other ecosystem services (ESS). However, the sustainability of rice agro-ecosystems is threatened by continuing climate and land-use changes. To estimate their combined effects on a bundle of ESS, we applied the vegetation and hydrology model LPJmL to seven study areas in the Philippines and Vietnam. We quantified future changes in the provision of four essential ESS (carbon storage, carbon sequestration, provision of irrigation water and rice production) under two climate scenarios (until 2100) and three site-specific land-use scenarios (until 2030), and examined the synergies and trade-offs in ESS responses to these drivers. Our results show that not all services can be provided in the same amounts in the future. In the Philippines and Vietnam the projections estimated a decrease in rice yields (by approximately 30%) and in carbon storage (by 15%) and sequestration (by 12%) towards the end of the century under the current land-use pattern. In contrast, the amount of available irrigation water was projected to increase in all scenarios by 10%–20%. However, the results also indicate that land-use change may partially offset the negative climate impacts in regions where cropland expansion is possible, although only at the expense of natural vegetation. When analysing the interactions between ESS, we found consistent synergies between rice production and carbon storage and trade-offs between carbon storage and provision of irrigation water under most scenarios. Our results show that not only the effects of climate and land-use change alone but also the interaction between ESS have to be considered to allow sustainable management of rice agro-ecosystems under global change.
Gert van der Westhuizen
Full Text Available The South African local government sector has undergone changes in the post-apartheid era as policy makers have sought to improve basic services provided to disadvantaged local communities. While scholars have considered various dimensions of the reform program, little effort has been directed at evaluating the effectiveness and efficiency dimensions of the changes in service provision, with some notable exceptions (van der Westhuizen and Dollery, 2009; Krugell, et al., 2010. This article seeks to contribute to this literature by evaluating the efficiency with which municipalities have provided (Reconstruction and Development Program RDP water, RDP sanitation RDP electricity and RDP refuse removal, using Data Envelopment Analysis techniques (DEA applied to panel data from 2006/2007 to 2008/2009 for 231 local municipalities and 46 district municipalities. Keywords: Data warehousing, Systems thinking, Prescriptive theory, Descriptive theory, Interpretative research. Disciplines: Information technology, systems theory, data warehousing, hermeneutics
McGrath, Pam; Holewa, Hamish; McGrath, Zoe
With regards to end-of-life care, there is scant published research that looks specifically at the provision of palliative care services for Indigenous people. In addition, for Indigenous people in the rural and remote areas there is only limited literature that focuses on the problems associated with geography. To address the hiatus in the literature on Aboriginal, rural and remote palliative care, the following article provides findings from a two-year research project, funded by Australia's National Health and Medical Research Council (NH&MRC), which developed an innovative model for Indigenous palliative care. The data was collected through a qualitative methodology (descriptive phenomenology) which involved open-ended in-depth interviews, audio-recorded, transcribed verbatim and thematically analysed. The sub-set of findings from the study presented in this paper examine issues in relation to the many practical obstacles in relation to palliative care service provision to Indigenous people in the rural and remote areas. The findings are a testament to the ingenuity and dedication of those who provide end-of-life care for Aboriginal peoples in rural and remote locations. The information about the many obstacles associated with equipment, power, transport, distance and telephone access provide important insights to inform the development of health policy planning and funding. The topic is specifically relevant to nurses as further findings from the study indicate that clinic and community nurses are key health professionals providing care to Indigenous people in the rural and remote areas.
Nik, Jah; Lai, Pauline Siew Mei; Ng, Chirk Jenn; Emmerton, Lynne
Osteoporosis has significant impact on healthcare costs and quality of life. Amongst the models for collaborative disease state management services published internationally, there is sparse evidence regarding the role of community pharmacists in the provision of osteoporosis care. Hence, the aim of our study was to explore community pharmacists' opinions (including the barriers and facilitators) and scope of osteoporosis disease state management services by community pharmacists in Malaysia, informing a vision for developing these services. Semi-structured individual interviews and focus groups discussions were conducted with community pharmacists from October 2013 to July 2014. Three trained researchers interviewed the participants. Interviews were recorded and transcribed verbatim. Data were analyzed thematically using an interpretative description approach. Nineteen community pharmacists with 1-23 years of experience were recruited (in depth interviews: n = 9; focus group discussions: n = 10). These participants reflected on their experience with osteoporosis-related enquiries, which included medication counseling, bone density screening and referral of at-risk patients. Key barriers were the lack of numerous factors: public awareness of osteoporosis, accurate osteoporosis screening tools for community pharmacists, pharmacists' knowledge on osteoporosis disease and medications, time to counsel patients about bone health, collaboration between pharmacists and doctors, and support from the government and professional body. The pharmacists wanted more continuing education on osteoporosis, osteoporosis awareness campaigns, a simple, unbiased osteoporosis education material, and inter-professional collaboration practices with doctors, and pharmacists' reimbursement for osteoporosis care. The involvement of community pharmacists in the provision of osteoporosis disease state management was minimal. Only ad-hoc counseling on osteoporosis prevention was
Diamond-Smith, Nadia; Sudhinaraset, May; Montagu, Dominic
The majority of women in sub-Saharan Africa now deliver in a facility, however, little is known about the quality of services for maternal and newborn basic and emergency care, nor how this is associated with patient's perception of their experiences. Using data from the Service Provision Assessment (SPA) survey from Kenya 2010 and Namibia 2009, we explore whether facilities have the necessary signal functions for providing emergency and basic maternal (EmOC) and newborn care (EmNC), and antenatal care (ANC) using descriptives and multivariate regression. We explore differences by type of facility (hospital, center or other) and by private and public facilities. Finally, we see if patient satisfaction (taken from exit surveys at antenatal care) is associated with the quality of services (specific services provided). We find that most facilities do not have all of the signal functions, with 46 and 27 % in Kenya and 18 and 5 % in Namibia of facilities have high/basic scores in routine and emergency obstetric care, respectively. We found that hospitals preform better than centers in general and few differences emerged between public and private facilities. Patient perceptions were not consistently associated with services provided; however, patients had fewer complaints in private compared to public facilities in Kenya (-0.46 fewer complaints in private) and smaller facilities compared to larger in Namibia (-0.26 fewer complaints in smaller facilities). Service quality itself (measured in scores), however, was only significantly better in Kenya for EmOC and EmNC. This analysis sheds light on the inadequate levels of care for saving maternal and newborn lives in most facilities in two countries of Africa. It also highlights the disconnect between patients' perceptions and clinical quality of services. More effort is needed to ensure that high quality supply of services is present to meet growing demand as an increasing number of women deliver in facilities.
Aisling J. Reynolds-Feighan
Social air services continue to be provided by governments in liberalized air transport markets for reasons of regional economic development and social or political integration. Here the service policies for the US, EU and EFTA countries, Australia and Canada are examined and it is argued that policies should rely on market forces in order to obtain social, economic and political goals most economically
Conclusion: The status of mental disorders and the mental health services in Eritrea from the policy to management guidelines requires urgent review. Significant Outcomes: a) In resource limited settings, the integrated primary health care approach for mental health services is cost effective and avoids associated stigma.
Wac, K.E.; van Halteren, Aart; Broens, T.H.F.; Delgado Kloos, C.; Larrabeiti, D.; Marin, A.
Inevitably, healthcare goes mobile. Recently developed mobile healthcare (i.e. m-health) services allow healthcare professionals to monitor a mobile patient’s vital signs and provide feedback to this patient anywhere and any time. Due to the nature of current supporting mobile services platforms,
Methods: The study involved a review of health service management information documents at selected health facilities in nine regions within mainland Tanzania, interviews with health service workers (HWs) at selected health facilities and health managers at district and regional levels as well as focus group discussions ...
... contain data for reporting categories that are still active, such as business and Centrex-based services....S. Providers of International Telecommunications Services, Amendment of Part 43 of the Commission's... information in the context of an individual complaint proceeding under section 208 of the Act than through...
de Blok, C.; Meijboom, B.R.; Luijkx, K.G.; Schols, J.M.G.A.; Schroeder, R.G.
We conduct case research in a particular service context, i.e. the sector for elderly care, in order to explore characteristics of interfaces and the role they play in service customization. Even though the study of modularity in areas other than goods production is increasing, little is known about
Wac, K.E.; Delgado Kloos, C.; Larrabeiti, D.; van Halteren, Aart; Bults, Richard G.A.; Lopez, A.M.; Broens, T.H.F.
Inevitably, healthcare goes mobile. Recently developed mobile healthcare (i.e., m-health) services allow healthcare professionals to monitor mobile patient’s vital signs and provide feedback to this patient anywhere at any time. Due to the nature of current supporting mobile service platforms,
... through comparably efficient interconnection (CEI) and open network architecture (ONA) services; proposes... BOCs use for their own enhanced services offerings. The BOCs' ONA plans, based on the architecture of... structure and what safeguards are appropriate to ensure the continued competitiveness of the enhanced...
Codina-Solà, Marta; Pérez-Jurado, Luis A.; Cuscó, Ivon; Serra-Juhé, Clara
Although a genetic evaluation can identify the etiology in 15-30% of individuals with autism spectrum disorder, several studies show an underuse of genetic services by affected families. We have explored the access to genetic services and perception of genetics and recurrence risk in parents of autistic children in Spain. Despite the high interest…
Lakerveld, R.P.; Lele, S.; Crane, T.A.; Fortuin, K.P.J.; Springate-Baginski, O.
Ecosystem services research has highlighted the importance of ecosystems for human well-being. Most of the research, however, focuses only on aggregate human well-being and disregards distributional and equity issues associated with ecosystem services. We review approaches from institutional
individual realizes his or her own abilities, can cope with the normal stresses of life, can ... Conclusion: The status of mental disorders and the mental health services in Eritrea from the policy to management guidelines requires urgent ... care approach for mental health services is cost effective and avoids associated stigma.
Salanova Grau, J.M.; Estrada Romeu, M.
This paper presents a mathematical model for supporting the decision and policy making related to the optimal determination of shifts and fares of taxi services in a major city. The model is based on the system’s generalized cost function and uses continuous approximations and geometric probabilities for estimating the key performance indicators of the taxi market, which are waiting and access time for the customers (in-vehicle travel time does not depend on the offer side) and benefits for the drivers. The model is based on an econometric model with the inclusion of an elastic demand, which allows the estimation of the optimal values for the two decision variables of the problem: fare structure and the taxi fleet size. The model also accounts for a full-day time period instead of the one-hour time frame models used in most of the taxi models, which allows for providing insights on the daily duration and distribution of the shifts that should be defined by the policy makers. (Author)
Afifi, Ladan; Shinkai, Kanade
A consultative dermatology service plays an important role in patient care and education in the hospital setting. Optimizing education in balance with high-quality dermatology consultative services is both a challenge and an opportunity for dermatology consultation teams. There is an emergence of new information about how dermatology can best be taught in the hospital, much of which relies on principles of workplace learning as well as the science of how learning and teaching best happen in work settings. These best practices are summarized in this narrative review with integrated discussion of concepts from outpatient dermatology education and lessons learned from other inpatient teaching models. In addition, consultative dermatology curricula should utilize a blended curriculum model comprised of patient care and active learning and self-study modalities. Specific educational methods will discuss 2 strategies: (1) direct patient-care activities (ie, bedside teaching rounds) and (2) nonpatient care activities (ie, case presentations, didactic sessions, online modules, and reading lists). ©2017 Frontline Medical Communications.
Full Text Available The article presents a case study whereby the service performance of a single-choice information technology service provider in the parastatal industry of South Africa is measured against multi-choice private service providers without any provisional agreements. The outcome of the case study reveals that single-choice service provision options with provisional agreements have a limited chance of success if they are not supported by strong service user inputs. In fact, provisional strategies that disallow sound competition among service providers are bound to impact negatively on user preferences as well as information technology skills development opportunities that are required to improve service provision generally and long-term survival in particular.
Legrand, I.; Newman, H.; Voicu, R.; Cirstoiu, C.; Grigoras, C.; Dobre, C.; Muraru, A.; Costan, A.; Dediu, M.; Stratan, C.
The MonALISA (Monitoring Agents in a Large Integrated Services Architecture) framework provides a set of distributed services for monitoring, control, management and global optimization for large scale distributed systems. It is based on an ensemble of autonomous, multi-threaded, agent-based subsystems which are registered as dynamic services. They can be automatically discovered and used by other services or clients. The distributed agents can collaborate and cooperate in performing a wide range of management, control and global optimization tasks using real time monitoring information. Program summaryProgram title: MonALISA Catalogue identifier: AEEZ_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEEZ_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Caltech License - free for all non-commercial activities No. of lines in distributed program, including test data, etc.: 147 802 No. of bytes in distributed program, including test data, etc.: 2 5913 689 Distribution format: tar.gz Programming language: Java, additional APIs available in Java, C, C++, Perl and python Computer: Computing Clusters, Network Devices, Storage Systems, Large scale data intensive applications Operating system: The MonALISA service is mainly used in Linux, the MonALISA client runs on all major platforms (Windows, Linux, Solaris, MacOS). Has the code been vectorized or parallelized?: It is a multithreaded application. It will efficiently use all the available processors. RAM: for the MonALISA service the minimum required memory is 64 MB; if the JVM is started allocating more memory this will be used for internal caching. The MonALISA client requires typically 256-512 MB of memory. Classification: 6.5 External routines: Requires Java: JRE or JDK to run. These external packages are used (they are included in the distribution): JINI, JFreeChart, PostgreSQL (optional). Nature of problem: To monitor and control
... PROVISION OF EARLY INTERVENTION AND SPECIAL EDUCATION SERVICES TO ELIGIBLE DOD DEPENDENTS Pt. 57, App. C... education and related services, and oversees an EDIS evaluation used in determining a child's need for... of gross motor and fine motor adaptive skills, psychological status, and visual and audiological...
Lin, Jin-Ding; Hsu, Shang-Wei; Yen, Chia-Feng; Chou, Ying-Ting; Wu, Chia-Ling; Chu, Cordia M.; Loh, Ching-Hui
Aims: The aims of the present study were to explore the perceptions of general practitioners (GPs) in the provision of health care services for people with intellectual disabilities and to analyse GPs' priorities in the delivery of health care services to this group of people in Taiwan. Methods: The study employed a cross-sectional design and was…
... allot space in Federal buildings for the provision of child care services? 102-79.25 Section 102-79.25... Federal buildings to individuals or entities who will provide child care services to Federal employees if... Utilization of Space Child Care § 102-79.25 May Federal agencies allot space in Federal buildings for the...
Kopp, Thomas J.; Rosetti, Joseph L.
Out-of-class faculty services, such as advising, career advice, and lecture series, stimulate student interest, retention, and graduation rates. Through modeling the interrelationships between the allocation of faculty lines and a college's general education core requirements, its impact on the provision of out-of-class faculty services is…
Cocco, Massimo; Freda, Carmela; Haslinger, Florian; Consortium, Epos
Addressing Ethics issues is nowadays a relevant challenge for any initiative, program or project dealing with scientific data and products provision, access to services for scientific purposes and communication with different stakeholders, including society. This is corroborated by the evidence that Ethics has very high priority in EU funded research. Indeed, all the activities carried out under Horizon 2020 must comply with ethical principles and national, Union and international legislation. This implies that "For all activities funded by the European Union, Ethics is an integral part of research from beginning to end, and ethical compliance is seen as pivotal to achieve real research excellence." Here, we present the experience of EPOS, a public pan-European research infrastructure. EPOS aims at integrating data, data products, services and software (DDSS) for solid Earth science generated and provided by monitoring networks, observing systems and facilities belonging to European countries. EPOS fosters the integrated use of multidisciplinary solid Earth data to improve the understanding of physical and chemical processes controlling earthquakes, volcanic eruptions, tsunamis as well as those driving tectonics and surface dynamics. The EPOS integration plan will make significant contributions to understanding and mitigating geo-hazards, yielding data for hazard assessment, data products for engaging different stakeholders, and services for training, education and communication to society. Numerous national research infrastructures engaged in EPOS are deployed for the monitoring of areas prone to geo-hazards and for the surveillance of the national territory including areas used for exploiting geo-resources. The EPOS community is therefore already trained to provide services to public (civil defence agencies, local and national authorities) and private (petroleum industry, mining industry, geothermal companies, aviation security) stakeholders. Our ability to
Full Text Available African Government has prioritised entrepreneurship and the advancement of Small, Medium and Micro Enterprises (SMMEs) as the catalyst to achieving economic growth and development the application domain for service selection in this paper are SMMEs...
Matheson, Lauren; Asherson, Philip; Wong, Ian Chi Kei; Hodgkins, Paul; Setyawan, Juliana; Sasane, Rahul; Clifford, Sarah
...) in the published scientific literature. This study aimed to explore the experiences of adults in England with ADHD regarding access to diagnostic and treatment services, ADHD-related impairment and to compare experiences between patients...
Cooter, Ellen J; Rea, Anne; Bruins, Randy; Schwede, Donna; Dennis, Robin
Solving the environmental problems that we are facing today requires holistic approaches to analysis and decision making that include social and economic aspects. The concept of ecosystem services, defined as the benefits people obtain from ecosystems, is one potential tool to perform such assessments. The objective of this paper is to demonstrate the need for an integrated approach that explicitly includes the contribution of atmospheric processes and functions to the quantification of air-ecosystem services. First, final and intermediate air-ecosystem services are defined. Next, an ecological production function for clean and clear air is described, and its numerical counterpart (the Community Multiscale Air Quality model) is introduced. An illustrative numerical example is developed that simulates potential changes in air-ecosystem services associated with the conversion of evergreen forest land in Mississippi, Alabama and Georgia to commercial crop land. This one-atmosphere approach captures a broad range of service increases and decreases. Results for the forest to cropland conversion scenario suggest that although such change could lead to increased biomass (food) production services, there could also be coincident, seasonally variable decreases in clean and clear air-ecosystem services (i.e., increased levels of ozone and particulate matter) associated with increased fertilizer application. Metrics that support the quantification of these regional air-ecosystem changes require regional ecosystem production functions that fully integrate biotic as well as abiotic components of terrestrial ecosystems, and do so on finer temporal scales than are used for the assessment of most ecosystem services. Published by Elsevier B.V.
Dooris, Mark; McArt, Dervla; Hurley, Margaret A; Baybutt, Michelle
The NHS Health Trainer Programme was launched in England and Wales in 2005 with the aim of tackling health inequalities. While initially focusing on geographical communities, the initiative has extended its reach to particular population groups, such as offenders and their families, who experience high levels of physical and mental health needs and wider social exclusion. This paper reports on the evaluation of the Offender Health Trainer service delivered in probation settings in Bury, Rochdale and Oldham (Greater Manchester). This service has sought to improve the health of offenders, improve their access to mainstream services, and help reduce health inequalities - as well as facilitate rehabilitation and improve job prospects for ex-offenders through employment as health trainers. This evaluative research study aimed to explore the delivery of the Offender Health Trainer service and examine its impact on service users. The study design and limited time frame meant that the research was focused on the journeys of service users rather than on long-term outcomes. The evaluation used a mixed-methods approach, comprising two key elements: the interrogation and analysis of routinely collected quantitative data extracted from the National Health Trainer Data Collection Recording System (DCRS); and in-depth qualitative research using interviews and focus groups with clients and health trainers. The evaluation points to the overall success of the service in meeting its aims and impacting positively on the lives of offenders. It reveals promising trends in behaviour change and self-perceived health and well-being, articulating a rich narrative detailing how the service has helped probation clients tackle multiple interwoven problems and build hope and self-belief. Of particular importance was the health trainers' experience of the criminal justice system, which resonated with and inspired clients, developing trust and motivation to change. While the research inevitably
Michelson, Daniel; Sclare, Irene
This study addressed psychological needs, patterns of service utilization and provision of care in a specialist mental health service for young refugees and asylum seekers in London. Comparisons were made between two groups with different levels of postulated mental health need: unaccompanied minors (UAMs; n = 49) and children accompanied to the UK by one or more primary caregivers (n = 29). Significant differences were observed in referral pathways, with UAMs more likely to be referred by social services and less likely to be referred from medical agencies. UAMs also attended fewer sessions during treatment, and missed a greater proportion of scheduled appointments. Contrary to prediction, group comparisons revealed similar levels of post-migration stress and overall psychological morbidity. However, UAMs experienced significantly more traumatic events prior to resettlement, and were more likely to exhibit symptoms of post-traumatic stress disorder (PTSD) than their accompanied peers. Despite their elevated risk of PTSD, UAMs were less likely than accompanied children to have received trauma-focused interventions. UAMs were also significantly less likely to have been treated using cognitive therapy, anxiety management and parent/carer training, as well as receiving fewer types of practical assistance with basic social needs. The clinical and service implications of these findings are discussed.
Full Text Available Terrestrial carbon resources are major drivers of development in West Africa. The distribution of these resources co-varies with ecosystem type and rainfall along a strong Northeast-Southwest climatic gradient. Soil organic carbon, a strong indicator of soil quality, has been severely depleted in some areas by human activities, which leads to issues of soil erosion and desertification, but this trend can be altered with appropriate management. There is significant potential to enhance existing soil carbon stores in West Africa, with benefits at the global and local scale, for atmospheric CO2 mitigation as well as supporting and provisioning ecosystem services. Three key factors impacting carbon stocks are addressed in this review: climate, biotic factors, and human activities. Climate risks must be considered in a framework of global change, especially in West Africa, where landscape managers have few resources available to adapt to climatic perturbations. Among biotic factors, biodiversity conservation paired with carbon conservation may provide a pathway to sustainable development, and biodiversity conservation is also a global priority with local benefits for ecosystem resilience, biomass productivity, and provisioning services such as foodstuffs. Finally, human management has largely been responsible for reduced carbon stocks, but this trend can be reversed through the implementation of appropriate carbon conservation strategies in the agricultural sector, as shown by multiple studies. Owing to the strong regional climatic gradient, country-level initiatives will need to consider carbon sequestration approaches for multiple ecosystem types. Given the diversity of environments, global policies must be adapted and strategies developed at the national or sub-national levels to improve carbon storage above and belowground. Initiatives of this sort must act locally at farmer scale, and focus on ecosystem services rather than on carbon
Nunes, João Pedro; Naranjo Quintanilla, Paula; Santos, Juliana; Serpa, Dalila; Carvalho-Santos, Cláudia; Rocha, João; Keizer, Jan Jacob; Keesstra, Saskia
Mediterranean landscapes have experienced extensive abandonment and reforestation in recent decades, which should have improved the provision of hydrological services, such as flood mitigation, soil erosion protection and water quality regulation. However, these forests are fire-prone, and the post-fire increase in runoff, erosion and sediment exports could negatively affect service provision. This issue was assessed using the SWAT model for a small mountain agroforestry catchment, which was monitored between 2010 and 2014 and where some eucalypt stands burned in 2011 and were subsequently plowed for replanting. The model was calibrated and validated for streamflow, sediment yield and erosion in agricultural fields and the burnt hillslopes, showing that it can be adapted for post-fire simulation. It was then used to perform a decadal assessment of surface runoff, erosion, and sediment exports between 2004 and 2014. Results show that the fire did not noticeably affect flood mitigation but that it increased erosion by 3 orders of magnitude, which subsequently increased sediment yield. Erosion in the burnt forest during this decade was one order of magnitude above that in agricultural fields. SWAT was also used to assess different fire and land-use scenarios during the same period. Results indicate that the impacts of fire were lower without post-fire soil management, and when the fire occurred in pine forests (i.e. before the 1990s) or in shrublands (i.e. before afforestation in the 1930s). These impacts were robust to changes in post-fire weather conditions and to a lower fire frequency (20-year intervals). The results suggest that, in the long term, fire-prone forests might not provide the anticipated soil protection and water quality regulation services in wet Mediterranean regions.
Zagaria, Cecilia; de Vente, Joris; Perez-Cutillas, Pedro
Topical research investigating climate, land-use and management scenarios in the Segura catchment (SE Spain), depicts a landscape at high-risk of, quite literally, deserting agriculture. Land degradation in the semi-arid region of SE Spain is characterized by water shortage, high erosion rates and salinization, increasingly exacerbated by climatic changes, scarce vegetation cover and detrimental farming practices. Future climate scenarios predict increases in aridity, variability and intensity of rainfall events, leading to increasing pressure on scarce soil and water resources. This study conceptualized the impending crisis of agro-ecological systems of the Segura basin (18800 km2) as a crisis of ecosystem service deterioration. In light of existing land degradation drivers and future climate scenarios, the potential of Sustainable Land Management (SLM) strategies was evaluated to target three priority ecosystem services (water provision, sediment retention and carbon sequestration) as a means to achieve climate change adaptation and mitigation. A preceding thorough process of stakeholder engagement (as part of the EU funded DESIRE project) indicated five SLM technologies for potential implementation, all with a focus upon reducing soil erosion, increasing soil water holding capacity and soil organic matter content. These technologies have been tested for over four years in local experimental field plots, and have provided results on the local effects upon individual environmental parameters. Despite the growing emphasis witnessed in literature upon the context-specificity which characterizes adaptation solutions, the frequent analysis at the field scale is limited in both scope and utility. There is a need to investigate the effects of adaptive SLM solutions at wider, regional scales. Thus, this study modeled the cumulative effect of each of the five selected SLM technologies with InVEST, a spatial analyst tool designed for ecosystem service quantification and
Dogra, Nisha; Vostanis, Panos; Abuateya, Hala; Jewson, Nick
The aim of this study was to explore Gujarati parents' and adolescents' perceptions of child and adolescent mental health services and how these should be improved to best meet their needs. Semi-structured qualitative interviews were carried out with 15 parents and 15 young people, recruited from a community centre. Overall, the quality of the service appeared more important than its responsiveness to culture or ethnicity for both young people and their parents. These findings indicate the need for further evidence and debate on whether Black and ethnic minority families should be treated as though they are a homogenous group.
Macy, Rebecca J; Graham, Laurie M
Children, youth, and adults of both genders are sex trafficked into and throughout the United States every day. Regrettably, little attention has been given to how human service providers might identify the sex-trafficking victims they are likely to encounter. To address this knowledge gap, the authors review 20 documents with the aim of detecting and synthesizing service identification recommendations in the scientific literature, government reports, and documents produced by organizations working with sex-trafficking victims. The review shows consensus regarding identification recommendations, including (a) trafficking indicators, (b) victim interaction strategies, (c) immediate response strategies, and (d) child-specific information. The review also shows consensus regarding screening questions that are important for service providers to use in identifying sex-trafficking victims. These questions relate to the victims' safety, employment, living environment, and travel and immigration status in addition to specific questions used with children and youth. The review results offer human service providers a preliminary set of screening strategies and questions that can be used to identify sex-trafficking victims in the context of human services. Building on the review findings, the authors offer policy and research recommendations.
Singer, S; Bretschneider, N; Lehmann-Laue, A; Schröter, K; Porzig, R; Frenschkowski, S; Riedel, S
The aim of this study was to understand the quantity and quality of psychosocial services offered at counselling centres for outpatients with cancer in Saxony, a federal state of Germany. Structured interviews with employees on site at the counselling centres in Saxony (N=30) and an analysis of their yearly reports were undertaken. The majority of the counselling centres (N=25) was situated at local health departments. All institutions document their activities regularly and offer continuous training for their employees. Services include primarily information on and admission to social services whereas psychological and psychotherapeutic services are rare. Considering the guideline criteria for staffing with a ratio of one counsellor per 75,000 inhabitants, a total of 23 counsellors were lacking in the federal state of Saxony at the time of investigation. The method of situating counselling centres at local health departments ensures good access for almost all cancer patients and relatives seeking counselling. However, due to restricted financial resources the services offered are not sufficient according to the guidelines and solutions for this situation are needed. © Georg Thieme Verlag KG Stuttgart · New York.
Nicole, Madelyn; Fairbrother, Michele; Nagarajan, Srivalli Vilapakkam; Blackford, Julia; Sheepway, Lyndal; Penman, Merrolee; McAllister, Lindy
Through a collaborative university-hospital partnership, a student-led service model (SLS-model) was implemented to increase student placement capacity within a physiotherapy department of a 150 bed Sydney hospital. This study investigates the perceived barriers and enablers to increasing student placement capacity through student-led services…
been extremely difficult in the past; but with the advent of cloud computing, this problem should be less difficult to solve. Opportunistic Cloud Services (OCS) is about enterprises leveraging cloud computing technologies to contribute spare IT resources to a platform so that others on the platform can...... utilize them as and when needed. The OCS network is modelled as a social network of enterprises collaborating strategically in contributing and utilizing cloud services without entering into any business agreements. Such a platform faces several problems. One of such problems is the free riding problem...... challenges that were discovered during this study, the obtained results demonstrate both the technical feasibility and the existence of enabling conditions for the implementation of opportunistic cloud services for enterprises....
Full Text Available Nature, ecosystems and biodiversity provide human society with many benefits known as ecosystem services. Functional diversity is an important aspect of biodiversity. In this paper, we applied inductive approach to the identification, mapping and evaluation of ecosystem services of the Aegopodio-Alnetum glutinosae community in Tribeč Mts. The results from 2015 show that the alder floodplain forest represents one of the most productive forest ecosystems with seasonal maximum production of 59.03 g m−2, species diversity of N0 = 40 and functional diversity of FD = 10. The forage potential of this community is medium, the melliferous potential is high and the therapeutic potential was estimated as extremely rich in medicinal plants. From the functional groups for providing ecosystem services, woody plants and hemicryptophytes play the most significant role.
Ulfbeck, Vibe Garf; Andrecka, Marta
there is no contract between the individual and the private service provider there may be several obstacles to a claim against the private service provider based on contract. At the same time it is a general tort law principle that there is no vicarious liability for independent contractors, making it difficult also...... to succeed with a claim against the public entity based on tort law. Thus, a liability gap seems to exist. However, the article demonstrates that there are signs in different jurisdictions that solutions are being found in case law to this problem allowing to some extent for the imposition of some kind...... of vicarious liability on the public entity. Four different models are identified. The reasoning behind these models varies but they all have in common that the public law nature of the service that has been outsourced somehow plays a role....
Vogdrup-Schmidt, Mathias; Strange, Niels; Olsen, Søren Bøye
We propose a spatial multi-criteria decision analysis approach as a value-focused decision support tool for evaluating land use change decisions affecting multiple ecosystem services. In an empirical case study concerned with creating a robust and interconnected network of natural areas in a Danish...... municipality, we first conduct a biophysical and economic baseline mapping of ecosystem services. We then construct a spatially explicit multi-criteria decision analysis model which is utilized to identify candidate areas for inclusion in the network. We define a base scenario for future land use in the area......, where all criteria have equal weight, and assess the outcome in terms of welfare economic benefits of ecosystem services and opportunity cost of reducing forest and agricultural production. As weights in multi-criteria analysis is innately a subjective task, we conduct a sensitivity analysis using four...
Knochel, K Abel; Croghan, Catherine F; Moone, Rajean P; Quam, Jean K
This research study surveyed leaders of Area Agencies on Aging (agencies) to understand their services, training, and beliefs about serving lesbian, gay, bisexual, and transgender (LGBT) older adults. Half of the existing agencies in the United States (320) participated. Few agencies provided LGBT services or outreach. One-third had trained staff around LGBT aging and four-fifths were willing to offer training; these numbers were significantly higher for urban-based agencies. Agencies that had provided staff training and urban-based agencies were more likely to provide LGBT outreach and services, to believe in addressing LGBT issues, and to receive LGBT assistance requests. Training, policy, organizing, and research implications are considered.
Do Manh, Thai; Williams, Idongesit
are very important in formulating and implementing universal service policy. Originality/value - There have been a few studies applying actor network theory in analysing the formulation of policy, especially in universal service. The paper wants to close this gap.......Purpose - The paper looks at the formulation of the BMGF-VN project to examine which actors participated in the formulation of this project, how their interests were translated into this project, and what lessons may be drawn for the formulation and implementation of universal service policy...... in Vietnam in general. Design/methodology/approach - The paper recruits the actor network theory and qualitative analysis to analyse the BMGF-VN project. Findings - the involvement of non-government actors in formulating and implementing the project, the focus not only on the supply side but also demand side...
Bell, Andrew; Zhang, Wei
The contribution of synthetic pesticides to closing yield gaps around the world is undeniable; however, their use is also a classic double-edged sword. Beyond the well-recognized social costs (e.g., pollution to soil and water, and health effects both on consumers and other species) there are also private costs on farmers beyond the direct costs of inputs, associated with elevated risks of both acute and chronic damage to farmers’ health, and with the destruction of populations of beneficial organisms. Managing agricultural land use to enhance natural pest control services (also called mobile agent-based ecosystem services or MABES) holds promise to reduce this growing reliance on pesticides, though it too carries costs. In particular, uncertainty in crop yield due to pest damages, as well as the need to coordinate pesticide use with neighboring farms, can be important obstacles to establishing the longer-term public good of natural pest regulation. Current thinking on promoting ecosystem services suggests that payments or other economic incentives are a good fit for the promotion of public good ecosystem services such as MABES. We undertook a framed field experiment to examine the role of subsidies for non-crop habitat in improving insect-based ecosystem services in two separate samples in Southeast Asia—Cambodia and Vietnam. Our central finding is that these two contexts are not poised equally to benefit from incentives promoting MABES, and in fact may be left worse off by payments schemes. As the study and practice of payments for ecosystem services programs grows, this finding provides an important qualifier on recent theory supporting the use of payments to promote public good ecosystem services—where the nature of the coordination problem is complex and nonlinear, farm systems can be made worse off by being encouraged to attempt it.
Morton, Don; Arnold, Dèlia
We are developing a RESTful set of modeling services for the FLEXPART modeling system. FLEXPART (FLEXible PARTicle dispersion model) is a Lagrangian transport and dispersion model used by a growing international community. It has been used to simulate and forecast the atmospheric transport of wildfire smoke, volcanic ash and radionuclides and may be run in backwards mode to provide information for the determination of emission sources such as nuclear emissions and greenhouse gases. This open source software is distributed in source code form, and has several compiler and library dependencies that users need to address. Although well-documented, getting it compiled, set up, running, and post-processed is often tedious, making it difficult for the inexperienced or casual user. Well-designed modeling services lower the entry barrier for scientists to perform simulations, allowing them to create and execute their models from a variety of devices and programming environments. This world of Service Oriented Architectures (SOA) has progressed to a REpresentational State Transfer (REST) paradigm, in which the pervasive and mature HTTP environment is used as a foundation for providing access to model services. With such an approach, sound software engineering practises are adhered to in order to deploy service modules exhibiting very loose coupling with the clients. In short, services are accessed and controlled through the formation of properly-constructed Uniform Resource Identifiers (URI's), processed in an HTTP environment. In this way, any client or combination of clients - whether a bash script, Python program, web GUI, or even Unix command line - that can interact with an HTTP server, can run the modeling environment. This loose coupling allows for the deployment of a variety of front ends, all accessing a common modeling backend system. Furthermore, it is generally accepted in the cloud computing community that RESTful approaches constitute a sound approach towards
Cass, Tony; CERN. Geneva. IT Department
Much effort (and money) has been invested in recent years to ensure that academic and research sites are well interconnected with high-capacity networks that, in most cases, span national and continental boundaries. However, these dedicated research and education networks, whether national (NRENs) or trans-continental (RENs), frequently have Acceptable Use Policies (AUPs) that restrict their use by commercial entities, notably Cloud Service Providers (CSPs). After a brief summary of the issues involved, we describe three approaches to removing the network connectivity barrier that threatens to limit the ability of academic and research institutions to profit effectively from services offered by CSPs.
Fürst, Christine; Frank, Susanne; Witt, Anke; Koschke, Lars; Makeschin, Franz
This paper presents results of a case study in Middle Saxony, Germany, where the impact of conversion, afforestation and alternatively introduction of short rotation coppice areas on the provision of ecosystem services was tested in a spatially inexplicit and a spatially explicit way to formulate recommendations for regional planning. While the spatially inexplicit testing did not lead to clear results regarding to what degree forests or short rotation coppice areas are desirable and applicable, the spatially explicit testing revealed that an increase in the forest area or area with short rotation coppice by 29.7% in unstructured agriculturally dominated Loess regions, 14.4% in more topographically structured parts in the North-East of the model region and 23.6% in its mountainous parts would be beneficial. Potentially resulting losses in the provision of bioresources and regional economy can be considerably reduced by replacing afforestation areas with short rotation coppice. In summary, we found that the spatially explicit analysis of land use scenarios in combination with a more detailed land use classification and including an assessment of changes in land use pattern gave us an improved basis for assessing different possible planning strategies and to enhance the communication between forest management planners and regional planners. Copyright © 2012 Elsevier Ltd. All rights reserved.
Full Text Available We analyze the feasibility of providing Wireless Sensor Network-data-based services in an Internet of Things scenario from an economical point of view. The scenario has two competing service providers with their own private sensor networks, a network operator and final users. The scenario is analyzed as two games using game theory. In the first game, sensors decide to subscribe or not to the network operator to upload the collected sensing-data, based on a utility function related to the mean service time and the price charged by the operator. In the second game, users decide to subscribe or not to the sensor-data-based service of the service providers based on a Logit discrete choice model related to the quality of the data collected and the subscription price. The sinks and users subscription stages are analyzed using population games and discrete choice models, while network operator and service providers pricing stages are analyzed using optimization and Nash equilibrium concepts respectively. The model is shown feasible from an economic point of view for all the actors if there are enough interested final users and opens the possibility of developing more efficient models with different types of services.
Sanchis-Cano, Angel; Romero, Julián; Sacoto-Cabrera, Erwin J; Guijarro, Luis
We analyze the feasibility of providing Wireless Sensor Network-data-based services in an Internet of Things scenario from an economical point of view. The scenario has two competing service providers with their own private sensor networks, a network operator and final users. The scenario is analyzed as two games using game theory. In the first game, sensors decide to subscribe or not to the network operator to upload the collected sensing-data, based on a utility function related to the mean service time and the price charged by the operator. In the second game, users decide to subscribe or not to the sensor-data-based service of the service providers based on a Logit discrete choice model related to the quality of the data collected and the subscription price. The sinks and users subscription stages are analyzed using population games and discrete choice models, while network operator and service providers pricing stages are analyzed using optimization and Nash equilibrium concepts respectively. The model is shown feasible from an economic point of view for all the actors if there are enough interested final users and opens the possibility of developing more efficient models with different types of services.
... for the child as well as home visits to the parents. The major purpose of the classroom or socialization activities is to help meet the child's development needs and to foster the child's social... Start grantees must provide comprehensive child development services, as defined in the Head Start...
Beck, Tanja; Diaz del Castillo, Patricia; Fovet, Frederic; Mole, Heather; Noga, Brodie
This article presents out an outcome analysis of a Universal Design (UD) audit to the various professional facets of a disability service (DS) provider's office on a large North American campus. The context of the audit is a broad campus-wide drive to implement Universal Design for Learning (UDL) in teaching practices. In an effort for consistency…
Martinenas, Sergejus; Marinelli, Mattia; Andersen, Peter Bach
of electric vehicles. EVs are a fast responding energy resource with high availability. This work evaluates and experimentally shows the limits of EV charging controllability with the focus on its suitability for providing ancillary grid services. Three different series produced EVs are tested...
Yee, S; Buckett, W; Campbell, S; Yanofsky, R A; Barr, R D
The purpose of this study was to survey the current state of oncology sperm banking services provided by fertility clinics across Canada. A total of 78 Canadian fertility facilities were invited to complete a questionnaire related to the availability, accessibility, affordability and utilisation of sperm banking services for cancer patients. The total response rate was 59%, with 20 (69%) in vitro fertilisation clinics and 26 (53%) other fertility centres returning the survey. A total of 24 responding facilities accepted oncology sperm banking referrals. The time frame to book the first banking appointment for 19 (79%) facilities was within 2 days. Inconsistent practice was found regarding the consent process for cancer patients who are of minority age. Eight (33%) facilities did not provide any subsidy and charged a standard banking fee regardless of patients' financial situations. Overall, the utilisation of oncology sperm banking services was low despite its availability and established efficacy, suggesting that Canadian cancer patients are notably underserved. The study has highlighted some important issues for further consideration in improving access to sperm banking services for cancer patients, especially for adolescents. Better collaboration between oncology and reproductive medicine to target healthcare providers would help to improve sperm banking rates. © 2013 John Wiley & Sons Ltd.
Eklund, Katie; Meyer, Lauren; Way, Samara; Mclean, Deija
As one out of five children in the United States demonstrate some type of mental or behavioral health concern warranting additional intervention, federal policies have emphasized the need for school-based mental health (SBMH) services and an expansion of Medicaid reimbursement for eligible children and families. Most youth access mental health…
... available for patient use. (v) Procedures for reporting adverse drug reactions and errors in the...: (i) Chemical examination of urine by stick or tablet method or both (including urine ketones); (ii... procedures as a first response to common life-threatening injuries and acute illness. (c) Standard: Services...
Reddy, Ashok; Sessums, Laura; Gupta, Reshma; Jin, Janel; Day, Tim; Finke, Bruce; Bitton, Asaf
Risk-stratified care management is essential to improving population health in primary care settings, but evidence is limited on the type of risk stratification method and its association with care management services. We describe risk stratification patterns and association with care management services for primary care practices in the Comprehensive Primary Care (CPC) initiative. We undertook a qualitative approach to categorize risk stratification methods being used by CPC practices and tested whether these stratification methods were associated with delivery of care management services. CPC practices reported using 4 primary methods to stratify risk for their patient populations: a practice-developed algorithm (n = 215), the American Academy of Family Physicians' clinical algorithm (n = 155), payer claims and electronic health records (n = 62), and clinical intuition (n = 52). CPC practices using practice-developed algorithm identified the most number of high-risk patients per primary care physician (282 patients, P = .006). CPC practices using clinical intuition had the most high-risk patients in care management and a greater proportion of high-risk patients receiving care management per primary care physician (91 patients and 48%, P =.036 and P =.128, respectively). CPC practices used 4 primary methods to identify high-risk patients. Although practices that developed their own algorithm identified the greatest number of high-risk patients, practices that used clinical intuition connected the greatest proportion of patients to care management services. © 2017 Annals of Family Medicine, Inc.
Modernel Hristoff, Pablo; Rossing, W.A.H.; Corbeels, M.; Dogliotti, S.; Picasso, V.; Tittonell, P.
New livestock production models need to simultaneously meet the increasing global demand for meat and preserve biodiversity and ecosystem services. Since the 16th century beef cattle has been produced on the Pampas and Campos native grasslands in southern South America, with only small amounts of
Timur A. Tultaev
Full Text Available In the modern world innovation is one of the key factors determining the economic prospects of enterprises development, commodity markets, sectors of the economy and the state generally. The complete implementation of innovative technologies in marketing communicative policy of intangible enterprises contributes to the effective promotion of their services on the market and building a loyal consumer audience.
Cole, Amanda; Vidgen, Helen; Cleland, Phoebe
The aim of this study was to explore the methods, processes and strategies used by early childhood education and care (ECEC) services when determining the nutritional adequacy of food provided to children in their care. Semi-structured interviews (n = 22) were conducted with directors, educators and cooks at long day care services (LDCS) (n = 12) regarding nutritional adequacy, the use of tools, guidelines and checklists, menu planning and identification and management of unhealthy foods. A qualitative thematic approach was used to identify anticipated and emergent themes. Case-by-case comparisons were then made, and tables and models were created to allow for comparative analysis. LDCS relied on personal knowledge, experience and 'common sense' when determining the nutritional adequacy of the food provided to children. LDCS demonstrated a lack of awareness and use of current regulatory requirements, nutrition guidelines and recommendations, although the services were confident in providing nutrition advice to parents/carers. LDCS staff use personal knowledge and experience over evidence-based nutrition guidelines and recommendations when determining if the food provided to children is nutritionally adequate. ECEC services are recognised as important settings for obesity prevention and the development of lifetime healthy eating habits. This study highlights the complexities and inconsistencies in providing food that is nutritious and appropriate to children in care while highlighting the need to improve the use and accessibility of nutrition guidelines. © 2016 Dietitians Association of Australia.
Roy, R.; van Etten, Wim
The paper proposes a design for traffic engineering to provide Ethernet services using an extended access network. Ethernet has remained the dominant technology for Local Area and Enterprise Networks, the use of Ethernet in metro networks has seen significant interest of late to provide for end to
Objectives. To assess the extent of inequalities in availability and utilisation of HIV services across South Africa. Design. Cross-sectional descriptive study. Setting. Three districts reflecting different socio-economic conditions, but with similar levels of HIV infection, were purposively sampled. Outcome measures. Availability ...
Wisdom, Jennifer P.; Olin, Serene; Shorter, Priscilla; Burton, Geraldine; Hoagwood, Kimberly
Professional family peer advocates are increasingly employed by public mental health systems to deliver family-to-family support that reduces barriers families face in accessing children's mental health care. These services, however, are neither uniformly available nor standardized. This pilot study describes the process, content and context of…
Imbody, Bethany; Vandsburger, Etty
With our communities rapidly aging, there is always a clear need for greater knowledge on how to serve elders. Professionals must be able to recognize cases of abuse and neglect and provide appropriate follow up services. Through reviewing recent literature, this paper surveys existing assessment tools and interventions, describes characteristics…
Knezovic, Katarina; Marinelli, Mattia; Codani, Paul
. However, an alternative solution, enabled by the expected roll-out of smart meters and high penetration of flexible loads, would be the increased use of flexibility services. Flexible loads, with EVs at their forefront, can modulate their consumption or even inject power back to the grid depending...
... accordance with § 302.33(d) of this chapter, except that a IV-D agency may not recover costs from an FRC or from a foreign obligee in that FRC, when providing services under sections 454(32) and 459A of the Act. ...
Jorritsma, P.Y.; Wilderom, Celeste P.M.
Purpose – Headquarters managers of a medium-sized manufacturing company initiated a culture change in five of their dispersed wholesale units. The aim was for more external service quality. This paper aims to report the results of a test of three hypotheses, shedding light on the behavior of the
... designers of methods for analysing impacts of diseases like this should consider a mixture of both quantitative and qualitative techniques. Meanwhile concerted measures are needed to improve health service record keeping so as enhancing data usability for research and rational management decision-making purposes ...
Kahabuka, Catherine; Pembe, Andrea; Meglioli, Alejandra
To investigate the feasibility of providing harm-reduction services to reduce unsafe abortion in Tanzania. A cross-sectional study was conducted among 110 women who received harm-reduction counseling at a public health center in Dar es Salaam between February 10 and October 10, 2014. Background and clinical information was collected for all women; a subgroup (n=50) undertook a semi-structured survey that measured the type of services women received, women's perception of the services, and pregnancy outcome. The main study outcomes were attendance at the follow-up visit, type and quality of information women received on both visits, and misoprostol use for pregnancy termination. Overall, 55 (50.0%) women attended follow-up services. Misoprostol was used for induced abortion among 54 (98.2%); 38 (70.4%) of these women had obtained contraception at the follow-up visit. Likelihood of attendance for follow-up was increased among women who were older than 34 years (odds ratio [OR] 2.2, 95% confidence interval [CI] 0.1-35.8), were married (OR 2.1, 95% CI 0.8-5.7), and had a post-primary education level (OR 2.0, 95% CI 0.8-5.3). On average, 44 (87.0%) women received all required information at the initial counseling session and none reported major complications that required hospitalization. Harm-reduction services for unsafe abortion are feasible and acceptable, and could provide an excellent opportunity to fight abortion-related morbidity and mortality in Tanzania. © 2016 CSK Research Solutions Limited.International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
Full Text Available Abstract The decline in dairy herd fertility internationally has highlighted the limited impact of traditional veterinary approaches to bovine fertility management. Three questionnaire surveys were conducted at buiatrics conferences attended by veterinary practitioners on veterinary dairy herd fertility services (HFS in countries with a seasonal (Ireland, 47 respondents and non-seasonal breeding model (The Netherlands, 44 respondents and Portugal, 31 respondents. Of the 122 respondents, 73 (60% provided a HFS and 49 (40% did not. The majority (76% of all practitioners who responded stated that bovine fertility had declined in their practice clients' herds with inadequate cow management, inadequate nutrition and increased milk yield as the most important putative causes. The type of clients who adopted a herd fertility service were deemed more educated than average (70% of respondents, and/or had fertility problems (58% and/or large herds (53%. The main components of this service were routine postpartum examinations (95% of respondents, fertility records analysis (75% and ultrasound pregnancy examinations (69%. The number of planned visits per annum varied between an average of four in Ireland, where breeding is seasonal, and 23 in Portugal, where breeding is year-round. The benefits to both the practitioner and their clients from running a HFS were cited as better fertility, financial rewards and job satisfaction. For practitioners who did not run a HFS the main reasons given were no client demand (55% and lack of fertility records (33%. Better economic evidence to convince clients of the cost-benefit of such a service was seen as a major constraint to adoption of this service by 67% of practitioners.
Full Text Available With the widespread use of Internet, the scale of mobile data traffic grows explosively, which makes 5G networks in cellular networks become a growing concern. Recently, the ideas related to future network, for example, Software Defined Networking (SDN, Content-Centric Networking (CCN, and Big Data, have drawn more and more attention. In this paper, we propose a service-customized 5G network architecture by introducing the ideas of separation between control plane and data plane, in-network caching, and Big Data processing and analysis to resolve the problems traditional cellular radio networks face. Moreover, we design an optimal routing algorithm for this architecture, which can minimize average response hops in the network. Simulation results reveal that, by introducing the cache, the network performance can be obviously improved in different network conditions compared to the scenario without a cache. In addition, we explore the change of cache hit rate and average response hops under different cache replacement policies, cache sizes, content popularity, and network topologies, respectively.
O'Driscoll, Jamie M; Shave, Robert; Cushion, Christopher J
This paper reports a study examining the effectiveness of a London National Health Service Trust Hospital's cardiac rehabilitation programme, from the perspectives of healthcare professionals and patients. Cardiovascular disease is the world's leading cause of death and disability. Substantial research has reported that, following a cardiac event, cardiac rehabilitation can promote recovery, improve exercise capacity and patient health, reduce various coronary artery disease risk factors and subsequently reduce hospitalization costs. Despite these findings and the introduction of the National Service Framework for Coronary Heart Disease, there is wide variation in the practice, management and organization of cardiac rehabilitation services. A purposeful sample of three postmyocardial infarction patients registered on the selected hospital's cardiac rehabilitation programme, coupled with 11 healthcare professionals were selected. The patients acted as individual case studies. The authors followed all three patients through phase III of their cardiac rehabilitation programme. The research attempted to explore the roles and procedures of a London hospital's cardiac rehabilitation programme through an interpretative framework involving qualitative research methods. Participant observation and in-depth semi-structured interviews were the instruments used to collect data. Whilst the healthcare professionals were enthusiastic about coronary heart disease prevention, the London NHS trust hospital's cardiac rehabilitation programme had several barriers, which reduced the programme's success and prevented it from achieving National Service Framework targets. The barriers were complex and mainly included service-related factors, such as lack of professional training, weak communication between primary and secondary care and confused roles and identities. Although the study has immediate relevance for the local area, it highlighted issues of more general relevance to cardiac
Pereira, Paulo; Depellegrin, Daniel; Misiune, Ieva; Cerda, Artemi
Maps are fundamental to understand the spatial pattern of natural and human impacts on the landscape (Brevik et al., 2016; Lavado Contador et al., 2009; Pereira et al., 2010a,b). Urban areas are subjected to an intense human pressure (Beniston et al., 2015), contributing to the degradation of the ecosystems, reducing their capacity to provide services in quality and quantity (Requier-Desjardins et al., 2011; Zhang et al., 2011). Environments that can provide a high number and quality of ecosystem services (ES) must be identified and managed correctly, since are spaces that can mitigate the impacts of human settlements and improve their quality. thus is of major importance have identify the areas that can provide better ES (Deppelegrin and Pereira, 2015). The aim of this work is to identify areas with high ES potential in Vilnius city. Here, we identified a total of 4 different land uses, agricultural areas (32.48%), water bodies (1.46%), forest and semi-natural (31.91%) areas and artificial surfaces (34.16%). CORINE land cover 2006 was used as base information to classify ES potential. The assessment of each land cover potential was carried out using expert assessment. Each land use type was ranked from 0 (no potential) to 5 (High potential). In this work the sum of total regulating, providing and cultural ES were assessed. The areas with optimal ES were the ones with the sum of all ranks equal or higher than the 3rd Quartil of each distribution. After identifying these areas, data was mapped using ArcGIS software. The results showed that on average Vilnius city has a higher potential for regulating services (20.35±15.92), followed by cultural (14.43±8.81) and providing (14.26±8.87). There was a significant correlation among the different type of services. Regulating vs cultural (0.92, psoil quality for urban agriculture in a vacant lot soil. Land Degradation and Development, DOI: 10.1002/ldr.2342 Brevik, E., Baumgarten, A., Calzolari, C., Miller, B., Pereira, P
Isaki, Emi; Fangman Farrell, Cynthia
This exploratory study evaluated the effectiveness of Apple (Cupertino, CA) iPad(®) (second generation) to deliver telepractice speech and/or language services. Five children and their parents/guardians, as well as four adult participants, received services for communication disorders in a university clinic setting over two academic semesters. The children met some of their speech goals and all of their language goals. All adult clients met some of their communication goals. Personal opinions about telepractice did not change statistically before and after therapy. The major problem identified during the study was skipping and/or freezing of images on the iPads during interactions with FaceTime(®) (Apple). Further studies are needed to investigate the feasibility of using Apple iPads in telepractice.
Nursing in the prison service is an emerging area of practice and the benefits nurses provide to patients/prisoners’ mental health and physical well-being is widely recognised. This article highlights some of the common wounds seen in prisons and discusses the unique challenges of addressing tissue viability in this specific environment, where patients often have a range of complex health problems, including mental health issues and drug dependency.\\ud .
McCabe, Karen E.; Ling, Jonathan; Wilson, Graeme B.; Crosland, Ann; Kaner, Eileen F.S.; Haighton, Catherine A
Background: UK society is ageing. Older people who drink alcohol, drink more than those from previous generations, drink more frequently than other age groups and are more likely to drink at home and alone. Alcohol problems in later life however are often under-detected and under-reported meaning older people experiencing alcohol problems have high levels of unmet need. Methods: This study sought to identify existing services within South of Tyne, North East England to capture the extent of s...
Watila, Musa M; Keezer, Mark R; Angwafor, Samuel A; Winkler, Andrea S; Sander, Josemir W
Epilepsy is a public health issue in sub-Saharan Africa (SSA) where many people with the condition receive no treatment. Health-care services for epilepsy in this region have not been comprehensively assessed. We examined key features of epilepsy health services provided in SSA. This was a scoping review conducted using pre-specified protocols. We implemented an electronic search strategy to identify relevant citations using PUBMED, EMBASE, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), African Index Medicus (AIM), Open Grey, Cochrane database, and Google Scholar. Articles eligible for full-text review were screened and data of interest were reported. The search identified 81 eligible articles, forty-nine from East Africa, 19 from West Africa, 8 from South Africa, and 5 from Central Africa. A variety of care services were identified, with reporting of rural epilepsy care in 75% of retrieved articles mainly from East and South African countries. The majority of the rural epilepsy clinics were health worker- or nurse-led, reporting good seizure control in about two-thirds of patients using phenobarbital as the most commonly prescribed antiepileptic drug. Funding for rural epilepsy care came mainly from external donor agencies. We attempted to provide a 'snapshot' of epilepsy care services in SSA. The successes achieved in some of the centers are due to the use of existing primary health-care systems and employing non-physician health-care personnel. The true picture of epilepsy care coverage is not apparent due to the lack of data and proper health system structure in most parts of SSA. As more individuals begin to receive care, the long-term funding for epilepsy care in African countries will depend on the commitment of their respective governments. Copyright © 2017 Elsevier Inc. All rights reserved.
The complex interrelationships between age, class, ethnicity, poverty, sexual orientation and a number of other social divisions have a significant impact upon the experience of domestic violence and abuse (DVA) (Sokoloff & Dupont, 2006). In dialogue with other feminist approaches to marginalised identities (Crenshaw, 1993, Skeggs 1997, Brah & Phoenix, 2004, Yuval-Davis, 2006), this qualitative study explores the intersection of age, class and gender as experienced by adolescent service users...
Miao, Lei; Xu, Lijian
Today's fixed-cycle traffic signaling is highly suboptimal and aggravates traffic congestion and waste of energy in urban areas. In addition, it offers no quality-of-service guarantee and makes travel time prediction extremely hard. While existing traffic light control research primarily focuses on improving the average wait time of cars, we study in this paper how traffic light scheduling affects the worst-case wait time. In particular, we derive the time a car spends at an intersection in t...
Longo, Francesco; Notarnicola, Elisabetta; Tasselli, Stefano
The mechanisms through which the relationships among public institutions, private providers and families affect care and service provision systems are puzzling. How can we understand the mechanisms in these contexts? Which elements should we explore to capture the complexity of care provision? The aim of our study is to provide a framework that can help read and reframe these puzzling care provision mechanisms in a welfare mix context. First, we develop a theoretical framework for understanding how service provision occurs in care systems that are characterised by a variety of relationships between multiple actors, using an evidence-based approach that looks at both public and private expenditures and the number of users relative to the level of needs coverage and compared with declared values and political rhetoric. Second, we test this framework in two case studies built on data from two prominent Italian regions, Lombardy and Emilia-Romagna. We argue that service provision models depend on the interplay among six conceptual elements: policy values, governance rules, resources, nature of the providers, service standards and eligibility criteria. Our empirical study shows that beneath the relevant differences in values and political rhetoric between the case studies of the two Italian regions, there is a surprising isomorphism in service standards and the levels of covering the population's needs. The suggested framework appears to be effective and feasible; it fosters interdisciplinary approaches and supports policy-making discussions. This study may contribute to deepening knowledge about public care service provision and institutional arrangements, which can be used to promote more effective reforms and may advance future research. Although the framework was tested on the Italian welfare system, it can be used to assess many different systems.
Pan, Shilong; Yao, Jianping
A simple scheme to simultaneously generate an on-off keying or bi-phase modulation (BPM) impulse radio ultra wideband (IR-UWB) signal and a baseband wired signal in the optical domain using a dual-drive modulator is proposed and demonstrated. Although the two signals have spectral overlap in the optical spectrum, they are located at different frequency bands when converted to electrical signals at a photodetector (PD), which can be well separated by an electrical filter. An experiment is carried out. Eye diagrams, electrical spectra and BER measurements show that the co-channel interference between the UWB and the wired signals is small for a single-channel 36-km fiber link to provide 1.25-Gb/s UWB wireless and 1.25-Gb/s baseband wired services. The inter-channel interference is also small and negligible when the link is operated together with two other 1.25 Gb/s baseband wired links, which demonstrates that a conventional WDM-PON can be upgraded to provide additional UWB services without affecting the existing services by modifying the modulators in the center office and inserting UWB antennas in the optical network units. © 2011 Optical Society of America
Thiel de Bocanegra, Heike; Cross Riedel, Julie; Menz, Mary; Darney, Philip D; Brindis, Claire D
This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. A significantly greater proportion of Title X-funded providers compared to non-Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non-Title X, 38% private); contraceptive implants (58% Title X, 19% public non-Title X, 7% private); vasectomy (8% Title X, 4% public non-Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non-Title X, 49% private) (all pTitle X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training.
Full Text Available Abstract Background Mulago National Referral Hospital (MNRH, Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23 and focus group discussions (n=7 were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies, staff inadequacies (knowledge, motivation, and professionalism, overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism
Mendonça, Simone de Araújo Medina; Freitas, Erika Lourenço de; Ramalho de Oliveira, Djenane
To understand students' and tutors' perceptions of the development of clinical competencies for the delivery of comprehensive medication management services in an experiential learning project linked to a Brazilian school of pharmacy. An autoethnographic qualitative study was carried out based on participant observation, focus groups and individual interviews with students and tutors involved in an experiential learning project. The study revealed the development of competencies related to the philosophy of practice, the pharmacotherapy workup of drug therapy and interprofessional relationships. The experiential learning project contributed to the professional development of pharmacy students in pharmaceutical care practice, pointing to its potential benefits for incorporation into professional pharmacy curricula.
Many studies have attributed the disproportionately high rate of domestic violence in Asian communities to Asian patriarchal "cultural norms" and the psychological and behavioral traits that these norms produce in individuals. This article seeks to expand the scope of domestic violence analysis beyond these individual and cultural frameworks, arguing that Asian domestic violence is also a product of larger scale, social systems of inequality. By examining the funding criteria of the Family Violence Prevention Services Administration (FVPSA) and the Quality-Adjusted Life Year (QALY) standard used by Robin Hood, my research shows how state and private organizations systematically devalue and underfund minority-targeted programs.
Dowell, Paula Elizabeth Kay
Restructuring activity in the electric utility industry is threatening a once stable and significant source of revenue for local governments. Potentially declining revenues from electric utilities leaves local policymakers with the unpopular decision of raising taxes or reducing the level of public services provided. This has led to pressure on state governments to introduce legislation aimed at mitigating potential revenue loss for local government due to restructuring activity. However, before imposing such legislation, a better understanding of the potential distortionary effects of internal subsidization by electric utilities is needed. Two models of the demand for local public services--a structural model using the Stone-Geary utility framework and a reduced form model--are developed in an attempt to model the behavioral responses of local public expenditures to revenue contributions from electric utilities. Empirical analysis of both models is conducted using a panel data set for 242 municipalities in Tennessee from 1988 to 1998. Aggregate spending and expenditures on four specific service functions are examined. The results provide evidence of a positive flypaper effect. Furthermore, the source of the flypaper effect is attributed to fiscal illusion caused by price distortions. The stimulative effect of electric utility revenue contributions on the level of local public services indicate that a 1.00 change in electric utility subsidies results in a change in local expenditures ranging from 0.22 to 1.32 for the structural model and 1.97 to 2.51 for the reduced form model. The amount of the marginal effect directly attributed to price illusion is estimated to range from 0.04 to $0.85. In addition, the elasticities of electric utility revenue contributions are estimated to range from 0.05 to 0.90. The results raise a number of interesting issues regarding municipal ownership of utilities and legislation regarding tax treatment of utilities after restructuring
An economic model by DeAngelo shows that the existence of client-specific quasi-rents impairs auditor independence. The provison of non-audit advisory services (NAS) increases quasi-rents, and thus it is a threat to independence. Recently, a number of changes have been made not only to the relevent...... international and US regulations, but also to the German regulations related to NAS. A large number of empirical studies have investigated the influence of NAS on the perceived auditor independence. Most of these studies were performed in Anglo-Saxon countries, particularly in the US, and a majority found...... by a seperate department of the audit firm....
Svirydzenka, Nadzeya; Ronzoni, Pablo; Dogra, Nisha
Defining quality in health presents many challenges. The Institute of Medicine (IOM) defined quality clinical care as care that is equitable, timely, safe, efficient, effective and patient centred. However, it is not clear how different stakeholders within a child and adolescent mental health service (CAMHS) understand and/or apply this framework. This project aims to identify key stakeholders" understanding of the meaning of quality in the context of CAMHS. The study sample comprised of three groups: (i) patients and carers, (ii) CAMHS clinical staff, and (iii) commissioners (Total N = 24). Semi-structured interviews were used to collect data and thematic analysis was applied to explore participant's views on the meaning and measurement of quality and how these might reflect the IOM indicators and their relevance in CAMHS. An initial barrier to implementing quality care in CAMHS was the difficulty and limited agreement in defining the meaning of quality care, its measurement and implementation for all participants. Clinical staff defined quality as personal values, a set of practical rules, or clinical discharge rates; while patients suggested being more involved in the decision-making process. Commissioners, while supportive of adequate safeguarding and patient satisfaction procedures, did not explicitly link their view on quality to commissioning guidelines. Identifying practical barriers to implementing quality care was easier for all interviewees and common themes included: lack of meaningful measures, recourses, accountability, and training. All interviewees considered the IOM six markers as comprehensive and relevant to CAMHS. No respondent individually or within one stakeholder group identified more than a few of the indicators or barriers of a quality CAMHS service. However, the composite responses of the respondents enable us to develop a more complete picture of how to improve quality care in practice and guide future research in the area.
Full Text Available As Internet usage grows exponentially, network security issues become increasingly important. Network security measures are needed to protect data during transmission. Various security controls are used to prevent the access of hackers in networks. They are firewall, virtual private networks and encryption algorithms. Out of these, the virtual private network plays a vital role in preventing hackers from accessing the networks. A Virtual Private Network (VPN provides end users with a way to privately access information on their network over a public network infrastructure such as the internet. Using a technique called “Tunneling”, data packets are transmitted across a public routed network, such as the internet that simulates a point-to-point connection. Virtual private networks provide customers with a secure and low-cost communication environment. The basic structure of the virtual circuit is to create a logical path from the source port to the destination port. This path may incorporate many hops between routers for the formation of the circuit. The final, logical path or virtual circuit acts in the same way as a direct connection between the two ports. The K-Cost Optimized Delay Satisfied Virtual Private Networks Tree Provisioning Algorithm connects VPN nodes using a tree structure and attempts to optimize the total bandwidth reserved on the edges of the VPN tree that satisfies the delay requirement. It also allows sharing the bandwidth on the links to improve the performance. The proposed KCDVT algorithm computes the optimal VPN Tree. The performance analysis of the proposed algorithm is carried out in terms of cost, the number of nodes, and the number of VPN nodes, delay, asymmetric ratio and delay with constraints with Breadth First Search Algorithm. The KCDVT performs better than the Breadth First Search Algorithm.
Chan, Y T; Ho, H K; Lai, Christopher K W; Lau, C S; Lau, Y L; Lee, T H; Leung, T F; Wong, Gary W K; Wu, Y Y
Many children in Hong Kong have allergic diseases and epidemiological data support a rising trend. Only a minority of children will grow out of their allergic diseases, so the heavy clinical burden will persist into adulthood. In an otherwise high-quality health care landscape in Hong Kong, allergy services and training are a seriously unmet need. There is one allergy specialist for 1.5 million people, which is low not only compared with international figures, but also compared with most other specialties in Hong Kong. The ratio of paediatric and adult allergists per person is around 1:460 000 and 1:2.8 million, respectively, so there is a severe lack of adult allergists, while the paediatric allergists only spend a fraction of their time working with allergy. There are no allergists and no dedicated allergy services in adult medicine in public hospitals. Laboratory support for allergy and immunology is not comprehensive and there is only one laboratory in the public sector supervised by accredited immunologists. These findings clearly have profound implications for the profession and the community of Hong Kong and should be remedied without delay. Key recommendations are proposed that could help bridge the gaps, including the creation of two new pilot allergy centres in a hub-and-spoke model in the public sector. This could require recruitment of specialists from overseas to develop the process if there are no accredited allergy specialists in Hong Kong who could fulfil this role.
Tianviwat, Sukanya; Chongsuvivatwong, Virasakdi; Birch, Stephen
To identify the optimal levels and mix of basic dental services (sealants and fillings for permanent teeth and extraction of primary teeth) under two different dental settings: hospital-based and mobile dental clinics under specified resource constraints. A linear programming model is used based on explicit identification of system objectives and resource constraints. The objective was to maximize benefits as measured by parental willingness to pay (WTP) for basic dental services provided to schoolchildren subject to constraints on total resources, service need and parental preferences among different dental care settings. Optimization was identified to require 270, 180, 552, 828, 228 and 532 cases of hospital sealant, mobile sealant, hospital filling, mobile filling, hospital extraction and mobile extraction, respectively. The corresponding current service levels were 48, 281, 191, 170, 479, and 677 respectively. The optimal service configuration produced a total WTP of 485 860 baht which exceeded the WTP for the current service configuration by more than 75.4%. Mobile clinic fillings were the highest priority among basic dental services. The current service configurations fail to reflect the setting preferences and provide greater emphasis to extractions than the optimal configuration with less emphasis given to preventive and restorative services.
Cavalari, Rachel N S; Gillis, Jennifer M; Kruser, Nathan; Romanczyk, Raymond G
While the use of computer-based communication, video recordings, and other "electronic" records is commonplace in clinical service settings and research, management of digital records can become a great burden from both practical and regulatory perspectives. Three types of challenges commonly present themselves: regulatory requirements; storage, transmission, and access; and analysis for clinical and research decision-making. Unfortunately, few practitioners and organizations are well enough informed to set necessary policies and procedures in an effective, comprehensive manner. The three challenges are addressed using a demonstrative example of policies and procedural guidelines from an applied perspective, maintaining the unique emphasis behavior analysts place upon quantitative analysis. Specifically, we provide a brief review of federal requirements relevant to the use of video and electronic records in the USA; non-jargon pragmatic solutions to managing and storing video and electronic records; and last, specific methodologies to facilitate extraction of quantitative information in a cost-effective manner.
Full Text Available In this article, I reflect on my experiences using institutional ethnography to support socially just policy, practice and organizational change. I focus specifically on three inter-related institutional ethnographic research projects that have informed my approach to working with social workers, shelter workers, lawyers, policy analysts, community organizers, teachers, probation officers and youth to create change. Although strategic collaborations to change institutional practices and knowledge are rife with tensions, I show how institutional ethnography can be used reflexively throughout the collaborative process to create conditions for critical consciousness-raising among participants; inspire reflection and action on the part of human service professionals and inform collective efforts to create systemic change, as well as to guide the research process itself. I conclude by suggesting that institutional ethnographers seeking to influence socially just change need to find ways to balance the demands of academic writing, while being true to the activist origins of this sociological approach.
Chang, Eva; Buist, Diana Sm; Handley, Matthew; Pardee, Roy; Gundersen, Gabrielle; Reid, Robert J
There has been significant research on provider attribution for quality and cost. Low-value care is an area of heightened focus, with little of the focus being on measurement; a key methodological decision is how to attribute delivered services and procedures. We illustrate the difference in relative and absolute physician- and panel-attributed services and procedures using overuse in cervical cancer screening. A retrospective, cross-sectional study in an integrated health care system. We used 2013 physician-level data from Group Health Cooperative to calculate two utilization attributions: (1) panel attribution with the procedure assigned to the physician's predetermined panel, regardless of who performed the procedure; and (2) physician attribution with the procedure assigned to the performing physician. We calculated the percentage of low-value cervical cancer screening tests and ranked physicians within the clinic using the two utilization attribution methods. The percentage of low-value cervical cancer screening varied substantially between physician and panel attributions. Across the whole delivery system, median panel- and physician-attributed percentages were 15 percent and 10 percent, respectively. Among sampled clinics, panel-attributed percentages ranged between 10 percent and 17 percent, and physician-attributed percentages ranged between 9 percent and 13 percent. Within a clinic, median panel-attributed screening percentage was 17 percent (range 0 percent-27 percent) and physician-attributed percentage was 11 percent (range 0 percent-24 percent); physician rank varied by attribution method. The attribution method is an important methodological decision when developing low-value care measures since measures may ultimately have an impact on national benchmarking and quality scores. Cross-organizational dialogue and transparency in low-value care measurement will become increasingly important for all stakeholders.
Full Text Available Epidemiological surveys over the last 20 years show a steady increase in the amount of alcohol consumed by older age groups. Physiological changes and an increased likelihood of health problems and medication use make older people more likely than younger age groups to suffer negative consequences of alcohol consumption, often at lower levels. However, health services targeting excessive drinking tend to be aimed at younger age groups. The aim of this study was to gain an in-depth understanding of experiences of, and attitudes towards, support for alcohol related health issues in people aged 50 and over.Qualitative interviews (n = 24, 12 male/12 female, ages 51-90 years and focus groups (n = 27, 6 male/21 female, ages 50-95 years were carried out with a purposive sample of participants who consumed alcohol or had been dependent.Participants' alcohol misuse was often covert, isolated and carefully regulated. Participants tended to look first to their General Practitioner for help with alcohol. Detoxification courses had been found effective for dependent participants but only in the short term; rehabilitation facilities were appreciated but seen as difficult to access. Activities, informal groups and drop-in centres were endorsed. It was seen as difficult to secure treatment for alcohol and mental health problems together. Barriers to seeking help included functioning at a high level, concern about losing positive aspects of drinking, perceived stigma, service orientation to younger people, and fatalistic attitudes to help-seeking. Facilitators included concern about risk of fatal illness or pressure from significant people.Primary care professionals need training on improving the detection and treatment of alcohol problems among older people. There is also a compelling need to ensure that aftercare is in place to prevent relapse. Strong preferences were expressed for support to be provided by those who had experienced alcohol problems themselves.
Smith, Megan G; Shea, Christopher M; Brown, Patrick; Wines, Kristen; Farley, Joel F; Ferreri, Stefanie P
To examine pharmacy operational and personnel characteristics that influence engagement in providing a community pharmacy medication management service within a statewide integrated care management program. Before the program launch, all of the pharmacies were surveyed to collect demographic, operational, and personnel characteristics such as weekly prescription volume and number of staff, respectively. Those data were then compared with engagement in the program. Engagement was defined as providing initial comprehensive medication review as part of the medication management service. Three months after program launch, pharmacies were dichotomized as consistently engaged or inconsistently engaged. Data were analyzed with the use of descriptive statistics and chi-square and t tests to test for statistical significance between consistent and inconsistent engagement groups. A baseline survey was collected for all 123 pharmacies who joined the integrated care management program. After the first 3 months, 50 pharmacies were consistently engaged in the program. Compared with inconsistently engaged pharmacies, consistently engaged pharmacies employed more full-time pharmacists (mean 2.1 vs. 1.8; P = 0.05) and more full-time technicians (mean 4.0 vs. 3.0; P <0.01), allocated more nondispensing hours for pharmacists (88% vs 60%; P <0.01), were more likely to employ a dedicated clinical pharmacist (20% vs 5%; P = 0.013), and hosted more pharmacy residents (78% vs 22%; P = 0.02). Years of pharmacy operation (P = 0.05) and pharmacy store type (P = 0.05) also were significantly associated with level of engagement. Neither prescription volume dispensed per week, number of hours of pharmacist overlap, nor hosting pharmacy students was statistically different between consistent and inconsistent pharmacies. Engagement in clinical activities in community pharmacy appears to improve with adequate staffing, availability of time for nondispensing activities, and having 1 or more
de Cerio, David Perez-Diaz; Valenzuela, José Luis
It is very common to rule out Bluetooth as a suitable technology for vehicular communications. The reasons behind this decision usually result from misconceptions such as accepting that Bluetooth has a short application range, or assuming its connection setup is not fast enough to allow communication which involves high speed moving nodes. This paper refutes those assertions and proposes the use of Bluetooth not only for Infrastructure-to-Vehicle (I2V) or Road-to-Vehicle (R2V) communications, but also for Vehicle-to-Vehicle (V2V) or Vehicle-to-Infrastructure (V2I) communications. This novel proposal is based on using the remote name request procedure of the standard, combined with an adjustment and optimization of the parameters present in the inquiry and page procedures. The proposed modifications reduce the information exchange delay, thus making Bluetooth a suitable technology for high-speed vehicle communications. The feasibility of the proposed scheme has been validated through experimental tests conducted in different scenarios: laboratory, a real highway and a racing test circuit. There, the communication system was installed in a vehicle circulating at speeds of up to 250 km/h, whereas autonomous devices were disseminated throughout the road path to communicate with the on board devices obtaining satisfying results.
free clinic and the community health center. Conclusion: A clinical pharmacy services model provides a role for the pharmacist in an interdisciplinary team (beyond the traditional dispensing role to identify medication related problems in the drug therapy of patients who utilize safety-net provider health care services.
Larsen, Hogne Nersund
This thesis describes the development and application of a tool to assess and document the life cycle greenhouse gas emissions of municipalities and other public-service providers. The model is linked to the financial accounting system of municipalities and counties to calculate the Carbon Footprint (CF) of all purchases/activities made. In particular indirect emissions (Scope 3 according to the greenhouse gas (GHG) protocol) will effectively be accounted for with this system. One of the main findings of the thesis is indeed the importance of Scope 3 emissions to the total CF of the cases investigated. Within the local climate action framework, this thesis focuses on the CF resulting from the activities of the municipal/county administration. This will largely be the provision of services. Insights in the structure of the CF of services will therefore be provided in the papers presented in the thesis. Results show that direct GHG emissions from the burning of fossil fuels are not very significant. At the same time, indirect GHG emissions embodied in the purchase of products and services from sub-suppliers are very significant. Furthermore, when time series are investigated, we identify a shift from direct emissions (e.g. the combustion of diesel in municipal vehicles) to indirect Scope 3 emissions (e.g. the purchase of transportation services from a private company). This outsourcing of activities indicates a necessary shift to complete consumption-based inventories that include all direct and indirect GHG emissions in developing comparable indicators of sustainability. The comparability of municipal CFs is the focus of one of the papers in the thesis. In the paper, we investigate how the CF of all Norwegian municipalities compares to a set of key characteristics. The main finding here is that the CF is highly dependent on both municipal wealth and municipal size. Small and wealthy municipalities tend to have a significantly higher CF per capita relating to the
Customer satisfaction is a concern to service industries as customers expect to be served promptly when they arrive. Demand for service is highly variable: depends on hour of the day, or day of the week, or even dates of the month. For a service industry like a Bank, there is a need for effcient Bank Teller scheduling system ...
Wand, Timothy; Isobel, Sophie; Derrick, Kate
This study aimed to survey multidisciplinary mental health staff on their perceptions of risk assessment and management practices in a local health district in Sydney. The research team developed the risk assessment and management survey (RAMS) which was distributed to staff across the district from November 2013 to January 2014. A total of 340 RAMS were distributed and 164 were returned (48% response rate). There was considerable agreement that risk assessment and management is essential to maintaining safety and delivering good mental health care, and respondents reported high levels of confidence in their judgement when carrying out such practices. Respondents identified organisational pressure in relation to risk assessment and management but also felt supported. However, 65% of respondents considered that there 'is good evidence that risk assessment and management practices are effective in reducing risk in mental health care', when this is not the case. The confidence that clinicians placed in risk assessment and management practices (despite an absence of evidence) is disconcerting. Given the dominance of risk assessment and management, health services mandating such practices have a duty to inform employees of the current evidence base for this approach in reducing risk. © The Royal Australian and New Zealand College of Psychiatrists 2015.
Strauch, Ayron M; Rurai, Masegeri T; Almedom, Astier M
Social, religious and economic facets of rural livelihoods in Sub-Saharan Africa are heavily dependent on natural resources, but improper resource management, drought, and social instability frequently lead to their unsustainable exploitation. In rural Tanzania, natural resources are often governed locally by informal systems of traditional resource management (TRM), defined as cultural practices developed within the context of social and religious institutions over hundreds of years. However, following independence from colonial rule, centralized governments began to exercise jurisdictional control over natural resources. Following decades of mismanagement that resulted in lost ecosystem services, communities demanded change. To improve resource protection and participation in management among stakeholders, the Tanzanian government began to decentralize management programs in the early 2000s. We investigated these two differing management approaches (traditional and decentralized government) in Sonjo communities, to examine local perceptions of resource governance, management influences on forest use, and their consequences for forest and water resources. While 97% of households understood the regulations governing traditionally-managed forests, this was true for only 39% of households for government-managed forests, leading to differences in forest use. Traditional management practices resulted in improved forest condition and surface water quality. This research provides an essential case study demonstrating the importance of TRM in shaping decision frameworks for natural resource planning and management. Copyright © 2016 Elsevier Ltd. All rights reserved.
This article describes the nature of the Household Energy Action Training (HEAT) program in South Africa. A HEAT Task Force was given the task of ensuring that the health benefits were received for services upgraded over a 5-year period for 1 million low-income households. HEAT was established in order to develop a strategy for building energy knowledge, capacity, and skills among low-income populations in urban and rural areas. Low-income communities were targeted with education programs that focused on basic needs, such as water, sanitation, and energy. HEAT established a Steering Committee in 1996, and began the first phase of activities. Other departments joined the effort in creating health and hygiene awareness. Researchers have begun a situation analysis of the agencies over the past 10 years that have provided health and hygiene education. A think tank of national and provincial professionals will review materials and prepare future strategies and plans. Phase I of HEAT was completed in 1996, with a pilot in the Western Cape. HEAT is moving into a detailed research phase. HEAT will be establishing networks in each of 9 provinces. Although HEAT was to have developed policy first, plans have shifted to enhancing training that will reveal which approaches have the greatest impact. Plans include the retraining of Environmental Health Officers (EHOs), changes in the school curricula and EHO training curricula, compulsory inclusion of health and hygiene in infrastructure projects, and national campaigns. The second phase will focus on national capacity building.
Shah, Ajit; Bhandarkar, Ritesh; Bhatia, Gurleen
The main aims were to examine the relationship between general population suicide rates and the presence of national policies on mental health, funding for mental health, and measures of mental health service provision. Data on general population suicide rates for both genders were obtained from the World Health Organization (WHO) databank available on the WHO website. Data on the presence of national policies on mental health, funding for mental health and measures of mental health service provision were obtained from the Mental Health Atlas 2005, also available on the WHO website. The main findings were: (i) there was no relationship between suicide rates in both genders and different measures of mental health policy, except they were increased in countries with mental health legislation; (ii) there was a significant positive correlation between suicide rates in both genders and the percentage of the total health budget spent on mental health; and (iii) suicide rates in both genders were higher in countries with greater provision of mental health services, including the number of psychiatric beds, psychiatrists and psychiatric nurses, and the availability of training in mental health for primary care professionals. Cross-national ecological studies using national-level aggregate data are not helpful in establishing a causal relationship (and the direction of this relationship) between suicide rates and mental health funding, service provision and national policies. The impact of introducing national policies on mental health, increasing funding for mental health services and increasing mental health service provision on suicide rates requires further examination in longitudinal within-country studies.
Terefe, T.; Lee, van der J.
This study was conducted in the Dale and Shebedino districts of southern Ethiopia during the period October 2014 to January 2015. It investigates dairy-related input and service provision in mixed crop-livestock production systems. Data were collected from 120 dairy producers, six focus group
Akingbade, A.O.; Navarra, D.D.; Georgiadou, P.Y.; Zevenbergen, J.A.
This paper examines the role of the Abuja geographic information systems as an e-government policy initiative for promoting the reduction in corruption in the provision of e-land administration services and good governance in general. The paper explores the contribution of e-land administration with
Ponnusamy, Vellapandian; Grove, J. Robert
Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key points Consultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services. Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values. Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach. Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year. PMID:25177193
Makropoulos, C; Rozos, E; Tsoukalas, I; Plevri, A; Karakatsanis, G; Karagiannidis, L; Makri, E; Lioumis, C; Noutsopoulos, C; Mamais, D; Rippis, C; Lytras, E
Water scarcity, either due to increased urbanisation or climatic variability, has motivated societies to reduce pressure on water resources mainly by reducing water demand. However, this practice alone is not sufficient to guarantee the quality of life that high quality water services underpin, especially within a context of increased urbanisation. As such, the idea of water reuse has been gaining momentum for some time and has recently found a more general context within the idea of the Circular Economy. This paper is set within the context of an ongoing discussion between centralized and decentralized water reuse techniques and the investigation of trade-offs between efficiency and economic viability of reuse at different scales. Specifically, we argue for an intermediate scale of a water reuse option termed 'sewer-mining', which could be considered a reuse scheme at the neighbourhood scale. We suggest that sewer mining (a) provides a feasible alternative reuse option when the geography of the wastewater treatment plant is problematic, (b) relies on mature treatment technologies and (c) presents an opportunity for Small Medium Enterprises (SME) to be involved in the water market, securing environmental, social and economic benefits. To support this argument, we report on a pilot sewer-mining application in Athens, Greece. The pilot, integrates two subsystems: a packaged treatment unit and an information and communications technology (ICT) infrastructure. The paper reports on the pilot's overall performance and critically evaluates the potential of the sewer-mining idea to become a significant piece of the circular economy puzzle for water. Copyright © 2017 Elsevier Ltd. All rights reserved.
Ponnusamy, Vellapandian; Grove, J Robert
Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key pointsConsultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services.Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values.Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach.Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year.
Newlands, Rumana S; Watson, Margaret C; Lee, Amanda J
The extent to which community pharmacists contribute to the management of the global obesity epidemic is unclear. Local, regional and national obesity management schemes need to be informed by existing services which will be influenced by health professionals' attitudes and willingness to engage in service provision. The purpose of this study was to derive an accurate account of community pharmacists' activities and attitudes towards the provision of current and future Healthy Weight Management (HWM) services. A postal survey was developed and disseminated to all 128 community pharmacies in Grampian, north-east Scotland. The response rate was 64.8% (83/128). A range of HWM services was already being provided. The most common services offered were the supply of weight-loss medication (n=69, 84.1%) and advice about its use (n=68, 84.0%). Other services commonly offered were dietary advice (n=59, 72.8%), physical activity advice (n=53, 66.3%) and body mass index (BMI) calculation (n=56, 68.3%). Most pharmacists were confident in measuring weight (n=78, 93.9%), height (n=78, 93.9%) and BMI (n=78, 93.9%). Many pharmacists perceived a need for HWM services in their local area (n=56, 67.5%) as well as a need to extend these services within their pharmacies (n=48, 57.9%). Barriers to the provision of HWM services included workload (n=77, 92.8%) and the need for additional reimbursement (n=63, 75.9%) and additional staff (n=49, 59.7%). The pharmacists' perceived training needs included estimation of body fat (n=67, 81.7%), one-to-one consultation skills (n=60, 73.2%), advice on weight-loss products (n=52, 63.4%), measurement of blood cholesterol (n=51, 63%) and advice on weight-loss drugs (n=49, 60.5%). Community pharmacies could be an ideal setting for the provision of HWM services. The barriers to service provision need to be addressed. Furthermore, the development of appropriate undergraduate and postgraduate training is required to equip pharmacists and their staff with
Aparna Gupta; Chaipat Lawsirirat
Long-term service agreements (LTSAs) for the maintenance of capital-intensive products are gaining popularity. Without a thorough understanding of risk exposures and their impact on the service delivery, the providers can be exposed to the possibility of extensive losses and financial ruin, as well as endanger the productsâ€™ end-consumers. This article develops a rigorous risk assessment and management framework for developing an optimal service operations strategy for the delivery of LTSAs....
Yeh, Ruey Huei; Lin, Yi-Fang
For survival and success, pricing is an essential issue for service firms. This article deals with the pricing strategies for services with substantial facility maintenance costs. For this purpose, a mathematical framework that incorporates service demand and facility deterioration is proposed to address the problem. The facility and customers constitute a service system driven by Poisson arrivals and exponential service times. A service demand with increasing price elasticity and a facility lifetime with strictly increasing failure rate are also adopted in modelling. By examining the bidirectional relationship between customer demand and facility deterioration in the profit model, the pricing policies of the service are investigated. Then analytical conditions of customer demand and facility lifetime are derived to achieve a unique optimal pricing policy. The comparative statics properties of the optimal policy are also explored. Finally, numerical examples are presented to illustrate the effects of parameter variations on the optimal pricing policy.
Full Text Available In the current global crises situation, it is essential to contemplate the administrative organization in terms of efficiency, effectiveness and rationality. A remodeling of the public sector is imperative and to do so requires a type of organizational engineering, which is able to optimize control over public expenses and the provision of essential services. This work looks at an agency’s potential for such a mission, and particularly employs the perspective of the Spanish State Agencies. This paper begins by abstractly addressing the polymorphic and polysemic phenomenon of agencies from a Comparative Law perspective and then moves on to analyze the specific background of state agencies in Spain and their present and future situation.
Lingamdenne Paul Emerson
Full Text Available ENT problems are the most common reason for a visit to a doctor in both rural and urban communities. In many developing countries, there is a lack of ENT specialists and overburdened hospital facilities. To date, there is no comprehensive study that has evaluated the spectrum of ENT disorders in a rural community. Methods. A prospective study was done for a period of three years to profile the cases presenting to the outpatient clinic in a secondary care hospital and in the camps conducted in tribal areas in Vellore District of Tamil Nadu, India. Trained community volunteers were used to identify ENT conditions and refer patients. Results. A total of 2600 patients were evaluated and treated. Otological symptoms were the most commonly reported with allergic rhinitis being the second most commonly reported. Presbycusis was the most common disability reported in the rural community. The other symptoms presented are largely related to hygiene and nutrition. Conclusion. Using trained community workers to spread the message of safe ENT practices, rehabilitation of hearing loss through provision of hearing aids, and the evaluation and surgical management by ENT specialist helped the rural community to access the service.
Full Text Available Integrated forest management is faced with the challenge that the contribution of forests to economic and ecological planning targets must be assessed in a socio-ecological system context. This paper introduces a way to model spatio-temporal dynamics of biomass production at a regional scale in order to derive land use strategies that enhance biomass provision and avoid trade-offs for other ecosystem services. The software platform GISCAME was employed to bridge the gap between local land management decisions and regional planning by linking growth and yield models with an integrative mesoscale modeling and assessment approach. The model region is located in Saxony, Germany. Five scenarios were simulated, which aimed at testing different alternatives for adapted land use in the context of climate change and increasing biomass demand. The results showed, for example, that forest conversion towards climate-change-adapted forest types had positive effects on ecological integrity and landscape aesthetics. In contrast, negative impacts on landscape aesthetics must be expected if agricultural sites were converted into short rotation coppices. Uncertainties with stem from assumptions regarding growth and yield models were discussed. Future developmental steps which consider, for example, accessibility of the resources were identified.
Full Text Available Abstract Background Approximately one in ten of the UK population are unpaid carers supporting a family member or friend who could not manage without their help, saving the UK economy an estimated £87 billion. This role is known to sometimes have a negative impact on carers and to require support both informally and from statutory services. General practice is a first point of contact for carers but research investigating general practitioners' (GPs' attitudes towards carers and awareness of issues facing carers is rare. This study therefore aimed to identify GPs' attitudes, awareness of issues, and perceptions of the barriers and enablers to provision of services. Methods Using a self-completion questionnaire distributed at a series of workshops, this study investigates GPs' attitudes to carers; awareness and knowledge of carers' issues; services offered in general practice and barriers to supporting carers. Results Seventy eight out of a total of 95 GPs (82% response rate from a variety of areas in England completed the questionnaires. The GPs identified time, resources and lack of knowledge as barriers, but only 9% agreed with the statement that there is little support they can offer carers. However, nine in ten GPs (89% feel they have insufficient training here and approximately half of them (47% lack confidence that they are meeting carers' needs. Confidence in identifying carers is also low (45%. Issues that GPs would look out for amongst carers include emotional and physical health problems and financial and isolation difficulties. GPs specifically highlighted educational and isolation issues for young carers. Few services were described that targeted carers. Conclusions GPs recognise that they have an important role to play in supporting carers but would like training and support. Further investigation is needed both to determine how best to train and facilitate GPs and general practice teams in their role in supporting carers and to
Bodkin, Kate; Delahunty-Pike, Alannah; O'Shea, Tim
Providing services for street level sex workers requires a multidisciplinary approach, addressing both health and safety concerns typical of their age and gender and those that arise specific to their line of work. Despite being a diverse population, studies have identified some specific health needs for sex workers including addictions treatment, mental health. Additionally, studies have shown a higher risk of physical and sexual assault for this population. The Persons at Risk program (PAR) in London, Ontario, Canada was started in 2005 to address the specific needs of street level sex workers by using a harm-reduction model for policing and healthcare provision. This qualitative study evaluated this model of care in terms of improving access to healthcare and essential police services for street level sex workers. A total of 14 semi-structured interviews were conducted with current and former female street level sex workers enrolled in the PAR program. In addition, 3 semi-structured interviews were conducted with health and law enforcement professionals. The research team then analyzed and coded the transcripts using qualitative description to identify key themes in the data. Results indicated that participants represent a vulnerable population with increased safety concerns and healthcare needs relating to addictions, mental health and infectious disease. Despite this, participants reported avoiding healthcare workers and police officers in the past because of fear of stigma or repercussions. All participants identified the harm reduction approach of the PAR program as being essential to their continued engagement with the program. Other important aspects included flexible hours, the location of the clinic, streamlined access to mental health and addictions treatment and the female gender of the police and healthcare worker. The PAR program provides sex workers access to much needed primary healthcare that is flexible and without judgment. In addition, they are
Full Text Available Long-term quality of life of children with special needs has not been studied in Latvia, and information on changes of quality of life (QoL rates during child’s development period is insufficient. The aim of the study was to analyze and compare the QoL related self-reports of school age children with special needs, which were repeatedly carried out once a year (2009–2010, with the proxy reports of their parents, as well as to compare the obtained results with Europe normative data on QoL developed by KIDSCREEN research group; to investigate the provision of social rehabilitation services for such families. The study was carried out in Riga municipality 2009–2010. Altogether 34 families with 8–11 years of age children with developmental disabilities participated in the study. Both parents and children filled KIDSCREEN-52 questionnaire, but a survey developed by a group of researchers “Social services” was used to gather information from the parents about the received children and family centered social services in the period between the both quality of life assessments. Results showed statistically significant changes in the latest quality of life self-assessment rates of school-age boys and girls with special needs in time period 2009–2010. Participants of the study – children with developmental disabilities – in both cases reported a lower QoL in comparison with Europe normative data on QoL developed by KIDSCREEN research group.
Zivkovic, M.; Bosman, J.W.; Berg, J.L. van den; Mei, R.D. van der; Meeuwissen, H.B.; Nunez-Queija, R.
In this paper we investigate sequential decision mechanisms for composite web services. After executing each sub-service within a sequential workflow, decisions are made whether to terminate or continue the execution of the workflow. These decisions are based on observed response times, expected
Full Text Available Web service composition is one of the core technologies of realizing service-oriented computing. Web service composition satisfies the requirements of users to form new value-added services by composing existing services. As Cloud Computing develops, the emergence of Web services with different quality yet similar functionality has brought new challenges to service composition optimization problem. How to solve large-scale service composition in the Cloud Computing environment has become an urgent problem. To tackle this issue, this paper proposes a parallel optimization approach based on Spark distributed environment. Firstly, the parallel covering algorithm is used to cluster the Web services. Next, the multiple clustering centers obtained are used as the starting point of the particles to improve the diversity of the initial population. Then, according to the parallel data coding rules of resilient distributed dataset (RDD, the large-scale combination service is generated with the proposed algorithm named Spark Particle Swarm Optimization Algorithm (SPSO. Finally, the usage of particle elite selection strategy removes the inert particles to optimize the performance of the combination of service selection. This paper adopts real data set WS-Dream to prove the validity of the proposed method with a large number of experimental results.
Brewka, Lukasz Jerzy; Gavler, Anders; Wessing, Henrik
End-to-end quality of service provisioning is still a challenging task despite many years of research and development in this area. Considering a generalized multi-protocol label switching based core/metro network and resource reservation protocol capable home gateways, it is the access part...... of the network where quality of service signaling is bridged. This article proposes strategies for generalized multi-protocol label switching control over next emerging passive optical network standard, i.e., the 10-gigabit-capable passive optical network. Node management and resource allocation approaches...... are discussed, and possible issues are raised. The analysis shows that consideration of a 10-gigabit-capable passive optical network as a generalized multi-protocol label switching controlled domain is valid and may advance end-to-end quality of service provisioning for passive optical network based customers....
Li, Yajie; Zhao, Yongli; Zhang, Jie; Yu, Xiaosong; Chen, Haoran; Zhu, Ruijie; Zhou, Quanwei; Yu, Chenbei; Cui, Rui
A Virtual Network Operator (VNO) is a provider and reseller of network services from other telecommunications suppliers. These network providers are categorized as virtual because they do not own the underlying telecommunication infrastructure. In terms of business operation, VNO can provide customers with personalized services by leasing network infrastructure from traditional network providers. The unique business modes of VNO lead to the emergence of network on demand (NoD) services. The conventional network provisioning involves a series of manual operation and configuration, which leads to high cost in time. Considering the advantages of Software Defined Networking (SDN), this paper proposes a novel NoD service provisioning solution to satisfy the private network need of VNOs. The solution is first verified in the real software defined multi-domain optical networks with multi-vendor OTN equipment. With the proposed solution, NoD service can be deployed via online web portals in near-real time. It reinvents the customer experience and redefines how network services are delivered to customers via an online self-service portal. Ultimately, this means a customer will be able to simply go online, click a few buttons and have new services almost instantaneously.
In this technical note, we discuss the optimality properties of service rate control in closed Jackson networks. We prove that when the cost function is linear to a particular service rate, the system performance is monotonic w.r.t. (with respect to) that service rate and the optimal value of that service rate can be either maximum or minimum (we call it Max-Min optimality); When the second-order derivative of the cost function w.r.t. a particular service rate is always positive (negative), which makes the cost function strictly convex (concave), the optimal value of such service rate for the performance maximization (minimization) problem can be either maximum or minimum. To the best of our knowledge, this is the most general result for the optimality of service rates in closed Jackson networks and all the previous works only involve the first conclusion. Moreover, our result is also valid for both the state-dependent and load-dependent service rates, under both the time-average and customer-average performance criteria.
Full Text Available Oriented the amounts of the service requests on the user’s demand, it is possible to provide the service to the users with the lowest price, the most economical resource and the type of service closest to the users’ requests. In order to provide the different resources to the users effectively, the optimization model of the management about the cloud services resources is set up. In the first place, under the guidance of the resources management center, it is best to match the most suitable cloud service resources for the user needs with the grey relational comprehensive evaluation, then according to the time, the price, the data workflow and the service type attribute value. Optimal resource deployment algorithm is established with the target of the best cloud service resources offered to the users. Finally, it is verified the validity and rationality of the method by the simulation.
Full Text Available The Next Generation Network (NGN vision is tending towards the convergence of internet and mobile services providing the impetus for new market opportunities in combining the appealing services of internet with the roaming capability of mobile networks. However, this convergence does not go far enough, and with the emergence of new coexistence scenarios, there is a clear need to evolve the current architecture to provide cost-effective end-to-end communication. The LOOP project, a EUREKA-CELTIC driven initiative, is one piece in the jigsaw by helping European industry to sustain a leading role in telecommunications and manufacturing of high-value products and machinery by delivering pioneering converged wireless networking solutions that can be successfully demonstrated. This paper provides an overview of the LOOP project and the key achievements that have been tunneled into first prototypes for showcasing next generation services for operators and process manufacturers.
Full Text Available A location-aware service (LAS is an imperative topic in ambient intelligence; an LAS recommends suitable utilities to a user based on the user’s location and context. However, current LASs have several problems, and most of these services do not last. This study proposes an optimization-based approach for enhancing the sustainability of an LAS. In this paper, problems related to optimizing a LAS system are presented. The distinct nature of a LAS optimization problem in comparison with traditional optimization problems is subsequently described. Existing methods applicable to solving a LAS optimization problem are also reviewed. The advantages and disadvantages of each method are then discussed as a motive for combining multiple optimization methods in this study, as illustrated by an example. Finally, opportunities and challenges faced by researchers in this field are presented.
Iversen, Villy Bæk
In mobile communications an efficient utilization of the channels is of great importance.In this paper we consider the basic principles for obtaining the maximum utilization, and we study strategies for obtaining these limits.In general a high degree of sharing is efficient, but requires service...... protection mechanisms for protecting services and subscriber groups.We study cellular systems with overlaid cells, and the effect of overlapping cells, and we show that by dynamic channel allocation we obtain a high utilization.The models are generalizations of the Erlang-B formula, and can be evaluated...
Iovanna, Richard; Ando , Amy W.; Swinton, Scott; Hellerstein, Daniel; Kagan, Jimmy; Mushet, David M.; Otto, Clint R.; Rewa, Charles A.
Pollination services have received increased attention over the past several years, and protecting foraging area is beginning to be reflected in conservation policy. This case study considers the prospects for doing so in a more analytically rigorous manner, by quantifying the pollination services for sites being considered for ecological restoration. The specific policy context is the Conservation Reserve Program (CRP), which offers financial and technical assistance to landowners seeking to convert sensitive cropland back to some semblance of the prairie (or, to a lesser extent, forest or wetland) ecosystem that preceded it. Depending on the mix of grasses and wildflowers that are established, CRP enrollments can provide pollinator habitat. Further, depending on their location, they will generate related services, such as biological control of crop pests, recreation, and aesthetics. While offers to enroll in CRP compete based on cost and some anticipated benefits, the eligibility and ranking criteria do not reflect these services to a meaningful degree. Therefore, we develop a conceptual value diagram to identify the sequence of steps and associated models and data necessary to quantify the full range of services, and find that critical data gaps, some of which are artifacts of policy, preclude the application of benefit-relevant indicators (BRIs) or monetization. However, we also find that there is considerable research activity underway to fill these gaps. In addition, a modeling framework has been developed that can estimate field-level effects on services as a function of landscape context. The approach is inherently scalable and not limited in geographic scope, which is essential for a program with a national footprint. The parameters in this framework are sufficiently straightforward that expert judgment could be applied as a stopgap approach until empirically derived estimates are available. While monetization of benefit-relevant indicators of yield
Klaassen, F.J.G.M.; Magnus, J.R.
We consider the question whether top tennis players in a top tournament (Wimbledon) employ an optimal (efficient) service strategy. We show that top players do not, in general, follow an optimal strategy, and we provide a lower bound of the inefficiency. The inefficiency regarding winning a point on
Vigo, D.; Caremi, C.; Gordini, A.; Bosso, S.; D'Aleo, G.; Beleggia, B.
In this paper, we discuss a decision support system for optimizing staff management of desk customer relations services at Hera, a large Italian multiutility company. The system, SPRINT, which is based on state-of-the-art demand forecasting, implements a novel two-phase optimization procedure based
Background Definitions of fragile states focus on state willingness and capacity to ensure security and provide essential services, including health. Conventional analyses and subsequent policies that focus on state-delivered essential services miss many developments in severely disrupted healthcare arenas. The research seeks to gain insights about the large sections of the health field left to evolve spontaneously by the absent or diminished state. Methods The study examined six diverse case studies: Afghanistan, Central African Republic, Democratic Republic of the Congo, Haïti, Palestine, and Somalia. A comprehensive documentary analysis was complemented by site visits in 2011–2012 and interviews with key informants. Results Despite differing histories, countries shared chronic disruption of health services, with limited state service provision, and low community expectations of quality of care. The space left by compromised or absent state-provided services is filled by multiple diverse actors. Health is commoditized, health services are heterogeneous and irregular, with public goods such as immunization and preventive services lagging behind curative ones. Health workers with disparate skills, and atypical health facilities proliferate. Health care absorbs large private expenditures, sustained by households, remittances, charitable and solidarity funding, and constitutes a substantial portion of the country economy. Pharmaceutical markets thrive. Trans-border healthcare provision is prominent in most studied settings, conferring regional and sometimes true globalized characteristics to these arenas. Conclusions We identify three distortions in the way the global development community has considered health service provision. The first distortion is the assumption that beyond the reach of state- and donor-sponsored services is a “void”, waiting to be filled. Our analysis suggests that the opposite is the case. The second distortion relates to the
Full Text Available Abstract Background Recent developments within the United Kingdom's (UK health care system have re-awakened interest in community hospitals (CHs and their role in the provision of health care. This integrative literature review sought to identify and assess the current evidence base for CHs. Methods A range of electronic reference databases were searched from January 1984 to either December 2004 or February 2005: Medline, Embase, Web of Knowledge, BNI, CINAHL, HMIC, ASSIA, PsychInfo, SIGLE, Dissertation Abstracts, Cochrane Library, Kings Fund website, using both keywords and text words. Thematic analysis identified recurrent themes across the literature; narrative analyses were written for each theme, identifying unifying concepts and discrepant issues. Results The search strategy identified over 16,000 international references. We included papers of any study design focussing on hospitals in which care was led principally by general practitioners or nurses. Papers from developing countries were excluded. A review of titles revealed 641 potentially relevant references; abstract appraisal identified 161 references for review. During data extraction, a further 48 papers were excluded, leaving 113 papers in the final review. The most common methodological approaches were cross-sectional/descriptive studies, commentaries and expert opinion. There were few experimental studies, systematic reviews, economic studies or studies that reported on longer-term outcomes. The key themes identified were origin and location of CHs; their place in the continuum of care; services provided; effectiveness, efficiency and equity of CHs; and views of patients and staff. In general, there was a lack of robust evidence for the role of CHs, which is partly due to the ad hoc nature of their development and lack of clear strategic vision for their future. Evidence for the effectiveness and efficiency of the services provided was limited. Most people admitted to CHs
Full Text Available For an online-shopping company, whether it can provide its customers with customized service is the key to enhance its customers’ experience value and its own competence. A good customized service requires effective integration and reasonable allocation of the company’s supply chain resources running in the background. Based on the analysis of the allocation of supply chain resources in the customized online shopping service mode and its operational characteristics, this paper puts forward an optimization model for the resource allocation and builds an improved ant algorithm to solve it. Finally, the effectiveness and feasibility of the optimization method and algorithm are demonstrated by a numerical simulation. This paper finds that the special online shopping environments lead to many dynamic and uncertain characters of the service demands. Different customized service patterns and their combination patterns should match with different supply chain resource allocations. The optimization model not only reflects the required service cost and delivery time in the objective function, but also considers the service scale effect optimization and the relations of integration benefits and risks. The improved ant algorithm has obvious advantages in flexibly balancing the multiobjective optimizations, adjusting the convergence speed, and adjusting the operation parameters.
Eekman, D.A.; van Helden, S.H.; Huisman, A.M.; Verhaar, H.J.J.; Bultink, I.E.M.; Geusens, P.P.; Lips, P.T.A.M.; Lems, W.F.
Summary: The response rate to the invitation to the fracture liaison service and reasons for non-response were evaluated in 2,207 fragility fracture patients. Fifty-one percent responded; non-responders were most often not interested (38%) or were hip fracture patients. After 1 year of treatment,
Lazarus, Jeffrey V; Safreed-Harmon, Kelly; Nicholson, Joey; Jaffar, Shabbar
In response to the lack of evidence-based guidance for how to continue scaling up antiretroviral therapy (ART) in ways that make optimal use of limited resources, to assess comparative studies of ART service delivery models implemented in sub-Saharan Africa. A systematic literature search and analysis of studies that compared two or more methods of ART service delivery using either CD4 count or viral load as a primary outcome. Most studies identified in this review were small and non-randomised, with low statistical power. Four of the 30 articles identified by this review conclude that nurse management of ART compares favourably to physician management. Seven provide evidence of the viability of managing ART at lower levels within the health system, and one indicates that vertical and integrated ART programmes can achieve similar outcomes. Five articles show that community/home-based ART management can be as effective as facility-based ART management. Five of seven articles investigating community support link it to better clinical outcomes. The results of four studies suggest that directly observed therapy may not be an important component of ART programmes. Given that the scale-up of antiretroviral therapy represents the most sweeping change in healthcare delivery in sub-Saharan Africa in recent years, it is surprising to not find more evidence from comparative studies to inform implementation strategies. The studies reported on a wide range of service delivery models, making it difficult to draw conclusions about some models. The strongest evidence was related to the feasibility of decentralisation and task-shifting, both of which appear to be effective strategies. © 2014 John Wiley & Sons Ltd.
McBeath, Bowen; Chuang, Emmeline; Bunger, Alicia; Blakeslee, Jennifer
In this article, we examine child welfare caseworkers' housing-related service strategies when they serve culturally similar versus culturally dissimilar clients. Testing hypotheses drawn from representative bureaucracy theory and using data from the second cohort of the National Survey of Child and Adolescent Well-Being, we find that when non-Caucasian caseworkers share the same racial/ethnic background as caregivers, caseworkers use more active strategies to connect caregivers to needed housing services. The relationship between racial/ethnic matching and frontline workers' repertoire of service strategies is most pronounced when the need for housing has been registered formally via referrals and case plans and thus legitimated institutionally. These results reinforce basic tenets of representative bureaucracy theory and provide evidence of the benefits of racial and ethnic diversity in the human service workforce. Our findings also highlight the need for research identifying institutional and frontline organizational factors that enhance the quality of service provision.
Full Text Available Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV and to acquired immunodeficiency syndrome (AIDS than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.
M. L.S. Mataboge
Full Text Available Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV and to acquired immunodeficiency syndrome (AIDS than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.
This document concerns the award of two contracts for the provision of mechanical design and draughting services on and off the CERN site. The Finance Committee is invited to agree to the negotiation of two contracts with: 1. ACROTECNA (FR), the lowest bidder, for approximately 55% of the provision of mechanical design and draughting services on and off the CERN site, for a period of three years for a total amount not exceeding 794 200 euros (1 239 006 Swiss francs), not subject to revision. The contract will include options for two one-year extensions beyond the initial three-year period. The rate of exchange used is that stipulated in the tender. 2. TECNICAS AERONAUTICAS MADRID (ES), the joint lowest bidder after alignment, for approximately 45% of the provision of mechanical design and draughting services on and off the CERN site, for a period of three years for a total amount not exceeding 1 013 730 Swiss francs, not subject to revision. The contract will include options for two one-year extensions beyond...
Facility-level, state, and financial factors associated with changes in the provision of smoking cessation services in US substance abuse treatment facilities: Results from the National Survey of Substance Abuse Treatment Services 2006 to 2012.
Cohn, Amy; Elmasry, Hoda; Niaura, Ray
Cigarette smoking is common among patients in substance abuse treatment. Tobacco control programs have advocated for integrated tobacco dependence treatment into behavioral healthcare, including within substance abuse treatment facilities (SATFs) to reduce the public health burden of tobacco use. This study used data from seven waves (2006 to 2012) of the National Survey of Substance Abuse Treatment Services (n=94,145) to examine state and annual changes in the provision of smoking cessation services within US SATFs and whether changes over time could be explained by facility-level (private vs public ownership, receipt of earmarks, facility admissions, acceptance of government insurance) and state-level factors (cigarette tax per pack, smoke free policies, and percent of CDC recommended tobacco prevention spending). Results showed that the prevalence of SATFs offering smoking cessation services increased over time, from 13% to 65%. The amount of tax per cigarette pack, accepting government insurance, government (vs private) ownership, facility admissions, and CDC recommended tobacco prevention spending (per state) were the strongest correlates of the provision of smoking cessation programs in SATFs. Facilities that received earmarks were less likely to provide cessation services. Adult smoking prevalence and state-level smoke free policies were not significant correlates of the provision of smoking cessation services over time. Policies aimed at increasing the distribution of tax revenues to cessation services in SATFs may offset tobacco-related burden among those with substance abuse problems. Copyright © 2017. Published by Elsevier Inc.
Full Text Available This paper investigates an incentive pricing problem for relaying services in multihop cellular networks. Providing incentives to encourage mobile nodes to relay data is a critical factor in building successful multihop cellular networks. Most existing approaches adopt fixed-rate or location-based pricing on rewarding packets forwarding. This study applies a mathematical programming model to determine an optimal incentive price for each intermediate node that provides relaying services. Under the obtained incentive price, the connection availability of the networks is maximized by using the same relaying costs as other pricing schemes. A signomial geometric programming problem is constructed, and a deterministic optimization approach is employed to solve the problem. Besides, quality-of-service constraints are added in the proposed model to mitigate the unfairness between connection availabilities of individual nodes. Computational results demonstrate that the proposed model obtains the optimal incentive price on relaying services to maximize connection availability of the networks.
Full Text Available Tasks of this paper are research of input flow statistic parametres influence and parameters demands relating to VP (Virtual Path or VC (Virtual Channel dimensioning. However it is necessary to consider different time of flow arrival and differend time of holding time during connection level. Process of input flow arrival is considered as Poisson process. Holding time is considered as exponential function. Permanent allocation of VP is made by separate VP, where each of VPs enable transmitting offered laod with explicit bandwidth and explicit loss. The mathematic model was created to verify the above mentioned dependences for different types of telecomunications signals and different input flows. "Comnet III" software was selected for experimental verification of process optimization. The simulation model was based on thiss software, which simulate ATM network traffic in behalf of different input flow.
Full Text Available Abstract Background Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. Methods In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. Results There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Conclusions Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations.
Abstract Background Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. Methods In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. Results There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Conclusions Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations.
Ilukor, John; Birner, Regina; Nielsen, Thea
Providing adequate animal health services to smallholder farmers in developing countries has remained a challenge, in spite of various reform efforts during the past decades. The focuses of the past reforms were on market failures to decide what the public sector, the private sector, and the "third sector" (the community-based sector) should do with regard to providing animal health services. However, such frameworks have paid limited attention to the governance challenges inherent in the provision of animal health services. This paper presents a framework for analyzing institutional arrangements for providing animal health services that focus not only on market failures, but also on governance challenges, such as elite capture, and absenteeism of staff. As an analytical basis, Williamson's discriminating alignment hypothesis is applied to assess the cost-effectiveness of different institutional arrangements for animal health services in view of both market failures and governance challenges. This framework is used to generate testable hypotheses on the appropriateness of different institutional arrangements for providing animal health services, depending on context-specific circumstances. Data from Uganda and Kenya on clinical veterinary services is used to provide an empirical test of these hypotheses and to demonstrate application of Williamson's transaction cost theory to veterinary service delivery. The paper concludes that strong public sector involvement, especially in building and strengthening a synergistic relation-based referral arrangement between paraprofessionals and veterinarians is imperative in improving animal health service delivery in developing countries. Copyright © 2015 Elsevier B.V. All rights reserved.
von Faber, Eberhard
This book introduces a reference architecture that enhances the security of services offered in the information and communication technology (ICT) market. It enables customers to compare offerings and to assess risks when using third-party ICT services including cloud computing and mobile services. Service providers are given a comprehensive blueprint for security implementation and maintenance covering service portfolio management, bid phases and realization projects as well as service delivery management. The architecture is completely modular and hierarchical. It contains a security taxonom
Escalona, E.; Peng, S.; Nejabati, R.; Simeonidou, D.; García-Espín, J.A.; Ferrer, J.; Figuerola, S.; Landi, G.; Ciulli, N.; Jiménez, J.; Belter, B.; Demchenko, Y.; de Laat, C.; Chen, X.; Yukan, A.; Soudan, S.; Vicat-Blanc, P.; Buysse, J.; de Leenheer, M.; Develder, C.; Tzanakaki, A.; Robinson, P.; Brogle, M.; Bohnert, T.M.
GEYSERS aims at defining an end-to-end network architecture that offers a novel planning, provisioning and operational framework for optical network and IT infrastructure providers and operators. In this framework, physical infrastructure resources (network and IT) are dynamically partitioned to
Coker, R J; Dimitrova, B; Drobniewski, F; Samyshkin, Y; Pomerleau, J; Hohlova, G Y; Skuratova, N; Kuznetsov, S; Fedorin, I; Atun, R
The aim of this study was to describe health system challenges faced by tuberculosis (TB) treatment facilities in Russia through an analysis of formal institutional dietary provisions to patients in an inpatient facility that provides care for poor patients. Analysis of formal dietary provisions by institutions and financing data from TB hospitals in Samara Oblast, Russia. Formal dietary provision for inpatients with TB has fallen substantially in recent years. In a hospital providing inpatient care for the poorest patients with fewest social support networks, this has been very pronounced. The likely reason for this is that financial support for other budget lines, principally salaries, has required protection. Formal institutional nutritional support in institutions providing care for the poorest patients with TB is unlikely to be enhancing the speed of recovery, or reducing the duration of infectiousness. Furthermore, the role that hospital may have played in the past in enabling patients to regain weight lost before admission may have been limited by reductions in formal financing. Reductions in state provision of food for patients may serve as an important illustration of wider TB control system frailties in the Russian Federation.
Duncan, Fiona; Day, Ruth; Haigh, Carol; Gill, Stuart; Nightingale, Jeremy; O'Neill, Olga; Counsell, David
Pain management for patients in hospital is a major problem. There is significant variation in care provision. Evidence is needed about the ways in which acute pain services are organized in order to understand whether these are linked to important differences in patient outcomes. The National Inpatient Pain Study group is a voluntary collaborative venture of inpatient pain specialists in the United Kingdom who are working toward establishing a national prospective database of service provision and activity. The objectives of this article are (1) to describe current pain service provision and activity (2) to define and monitor the quality and side effects of the primary analgesic techniques, such as central neuraxial block or systemic analgesia, and identify variations in practice. Phase 1: Surveys were conducted in two phases during 2010-2011. Information about the organization of services was collected from 121 centers via a live Website. Phase 2: The pilot clinical dataset was collected from 13 hospitals in 2011. Results indicated that staffing varied widely from one to nine nurses per hospital site. Twelve percent of hospitals did not routinely collect data. The main workload was orthopedic and general surgery based on data from 13 hospitals and 29,080 patients in 2011. Thirty-seven percent of patients reported a pain score of moderate to severe pain on the first assessment by the specialist pain team, and 21% reported severe pain. Nausea and vomiting was the most frequent adverse event reported. Sixty-nine major adverse events were logged, of which 64 documented respiratory depression (N = 29,080, 0.22%). Prospective longitudinal data has the potential to improve our understanding of variation in process and outcome measures and establish future research priorities. Wiley Periodicals, Inc.
..., AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF..., whether government, contractor, or employee-owned, used to transport passengers for medical services.) ... 25 Indians 2 2010-04-01 2010-04-01 false Do covered services include the conduct of clinical...
Rajavel, Rajkumar; Thangarathinam, Mala
Optimization of negotiation conflict in the cloud service negotiation framework is identified as one of the major challenging issues. This negotiation conflict occurs during the bilateral negotiation process between the participants due to the misperception, aggressive behavior, and uncertain preferences and goals about their opponents. Existing research work focuses on the prerequest context of negotiation conflict optimization by grouping similar negotiation pairs using distance, binary, co...
Sekoni, Adekemi O; Jolly, Kate; Gale, Nicola K; Ifaniyi, Oluwafemi A; Somefun, Esther O; Agaba, Emmanuel I; Fakayode, Victoria A
After signing of the Same-Sex Marriage (Prohibition) Act 2013 in Nigeria, media reports portray widespread societal intolerance toward the lesbian, gay, and bisexual population. This study was conducted to assess the attitudes of university undergraduates in Lagos state, Nigeria, toward provision of healthcare services for men who have sex with men (MSM), because the 2014 same-sex marriage prohibition law stipulates a jail sentence for organizations providing services to MSM. A cross-sectional descriptive study was conducted by using self-administered questionnaires to collect information, including homophobic attitudes and views on access to healthcare, from 4000 undergraduates in 10 randomly selected faculties in two universities. During analysis, inter-university and inter-faculty comparison was carried out between medical and nonmedical students. Outright denial of healthcare services to MSM was supported by 37.6% of the 3537 undergraduates who responded, whereas denial of HIV prevention services was supported by 32.5%. However, compared with 38.7% and 34.1% of undergraduates from other faculties, 23.7% and 18.2% of medical students agreed that healthcare providers should not provide services to MSM and that MSM should not have access to HIV prevention services, respectively (P = 0.000). Although a significant proportion of the medical students supported the statement that doctors and other healthcare workers should be compelled to give priority to other groups before MSM (29.4% of medical vs. 47.2% of students from other faculties), a statistically significant difference was observed between the two groups of students. The homophobic statement with the highest support was that doctors and healthcare workers should be compelled to report MSM who come to access treatment (48.1% of medical vs. 57.4% of students from other faculties). A very high proportion of the undergraduate students had a negative attitude toward provision of healthcare services to MSM in
Full Text Available The maternal health issue was a part of the Millennium Development Goals (MDGs, Target-5. Now it has been incorporated into Target-3 of 17 points Sustainable Development Goal-2030, declared by the United Nations, 2015. In India, about 50% of newborn deaths can be reduced by taking good care of the mother during pregnancy, childbirth and postpartum period. This requires timely, well-equipped healthcare by trained providers, along with emergency transportation for referral obstetric emergency. Governments need to ensure physicians in the rural underserved areas. The utilisation of maternal healthcare services (MHCSs depends on both the availability and accessibility of services along with accountability. This study is based on an empirical retrospective survey, also called a historic study, to evaluate the influences of distance on the provision of maternal health services and on its accountability in Murarai-II block, Birbhum District. The major objective of the study is to identify the influence of distance on the provision and accountability of the overall MHCSs. The investigation has found that there is a strong inverse relationship (-0.75 between accessibility index and accountability score with p-value = 0.05. Tracking of pregnant women, identification of high risk pregnancy and timely Postnatal Care (PNC have become the dominant factors of the maternal healthcare services in the first Principal Component Analysis (PCA, explaining 49.67% of the accountability system. Overall, institutional barriers to accessibility are identified as important constraints behind lesser accountability of the services, preventing the anticipated benefit. This study highlights the critical areas where maternal healthcare services are lacking. The analysis has highlighted the importance of physical access to health services in shaping the provision of maternal healthcare services. Drawing on empirical observations of operation of public distribution system in
Full Text Available At present the cloud computing is one of the newest trends of distributed computation, which is propelling another important revolution of software industry. The cloud services composition is one of the key techniques in software development. The optimization for reliability and performance of cloud services composition application, which is a typical stochastic optimization problem, is confronted with severe challenges due to its randomness and long transaction, as well as the characteristics of the cloud computing resources such as openness and dynamic. The traditional reliability and performance optimization techniques, for example, Markov model and state space analysis and so forth, have some defects such as being too time consuming and easy to cause state space explosion and unsatisfied the assumptions of component execution independence. To overcome these defects, we propose a fast optimization method for reliability and performance of cloud services composition application based on universal generating function and genetic algorithm in this paper. At first, a reliability and performance model for cloud service composition application based on the multiple state system theory is presented. Then the reliability and performance definition based on universal generating function is proposed. Based on this, a fast reliability and performance optimization algorithm is presented. In the end, the illustrative examples are given.
Full Text Available After introductory considerations, arguments are put forward for non-governmental organisations as exclusive providers of social services. The negative characteristics of the non-governmental organization are subject of the third part of the paper. In the fourth part, the meaning of the social funds is explained (they are a kind of non-governmental organisations, and in Part 5, we explain the importance of the synergy between the government and society in the provision of social services. After the explanation of the situation in Croatia, in the Part 6 of the paper we give our final considerations. In Croatia non-governmental organizations that provide social services are slowly developing. In their further strengthening it is necessary to change the general viewpoints concerning the role and importance of the non-governmental sector in the alleviation of poverty, as well as to achieve better coordination between the state and the sector.
Full Text Available The study examined the ODL learners’ perceptions of the quality of provision of research support services to the ODL learners by tutors. It focused on the Zimbabwe Open University’s (ZOU Bachelor of Education (Educational Management research students’ experiences. It was a qualitative multiple case study of four of the 10 Regional Centres of the ZOU. It purposively sampled 40 out of 160 research participants because they possessed desirable research characteristics for this study. The study was deemed significant in influencing tutors and policy makers to consider their research students’ supervision experiences as a basis for improving the quality of services for future research supervision practices and research projects. The study was guided by a two fold theory namely, thee Facilitation Theory (Nyawaranda, 2005 and the Nurturing Theory (Anderson, Pay and Mac Laughlin, 2006. Both theories advocate for the need of the supervisors to give their students a big heart. In terms of research supervision services offered by tutors the study indicated the time students were offered to meet research supervisors, prompt returns of marked work, and tutor student motivation and counselling as key services. In connection with the joys about research supervision, the students highly regarded: the manner in which tutors motivated them, tutors guidance in choosing research topic, tutor mentorship during research supervision and provision of workshops to polish up their research skills. In line with the challenges to the provision of research support services, three categories of challenges emerged. First, student-related challenges included lack of time, lack of money, lack of library facilities, lack of motivation and commitment to do research, lack of adequate theory in the area being researched on and family problems. Second, supervisor-related challenges included: too little direction, too little practical help given, too few meeting with students
Tassi, Andrea; Chatzigeorgiou, Ioannis; Roetter, Daniel Enrique Lucani
techniques, and without any assumption on the implementation of the RLNC decoder in use, we provide an efficient way to characterize the performance of users targeted by ultra-reliable layered multicast services. The proposed modeling allows to efficiently derive the average number of coded packet...... transmissions needed to recover one or more service layers. We design a convex resource allocation framework that allows to minimize the complexity of the RLNC decoder by jointly optimizing the transmission parameters and the sparsity of the code. The designed optimization framework also ensures service......Point-to-multipoint communications are expected to play a pivotal role in next-generation networks. This paper refers to a cellular system transmitting layered multicast services to a multicast group of users. Reliability of communications is ensured via different random linear network coding (RLNC...
Saheb-Koussa, D.; Haddadi, M.; Belhamel, M.
In engineering, simulation is an effective and economical, commonly used to make preliminary or comparative studies, both during development (design) and normal operation of systems. Currently, several simulation tools, using HOMER, are used in academia. Thus, in this work, we present the principle of feasibility study and optimization of a stand alone hybrid system (wind-photovoltaic-diesel). Furthermore, we determined the price per kWh of electricity supplied by the stand alone hybrid ...
Zhao Li; Zhiqiang Ma; Wei Shi; Xianggen Qian
At present, the optimization of medicine distribution route has become an urgent issue that needs to be solved in the unified medicine distribution for community health service institutions. Considering the characteristics of medicine distribution for community health service institutions, to minimize the overall cost (including refrigeration storage cost, vehicle fixed cost, and transportation cost) of medicine distribution in a certain region, a transport-distance-constrained local communit...
Osis, Maria José Duarte; Carvalho, Luiz Eduardo Campos de; Cecatti, José Guilherme; Bento, Silvana Ferreira; Pádua, Karla Simônia de
This study describes the perceptions of public health services managers and professionals concerning provision of voluntary surgical sterilization in the Campinas Metropolitan Area, São Paulo State, Brazil. The study adopted a qualitative approach in four municipalities (counties), where semi-structured interviews were conducted with 26 health professionals and health services managers involved in the provision of surgical sterilization. The interviewees identified difficulties in scheduling visits at Outpatient Family Clinics or Reference Centers (APF/CR), and the number of available surgeries in the accredited hospitals was insufficient. They emphasized the lack of physical infrastructure and human resources for conducting family planning activities in the primary health units as well as in the APF/CR.They also criticized the legal criteria for authorizing surgical sterilization, and mentioned adaptations to make them more appropriate to the each municipality's situation. According to the health services managers and professionals, despite the efforts, meeting the demand for surgical sterilization in the Campinas Metropolitan Area was jeopardized by its centralization in the APF/CR, which in practice had to cover the gap in family planning activities in each municipality's primary care units.
Fleming, Padraic; McGilloway, Sinead; Barry, Sarah
Background: Day services for people with intellectual disabilities are experiencing a global paradigm shift towards innovative person-centred models of care. This study maps changing trends in day service utilization to highlight how policy, emergent patterns and demographic trends influence service delivery. Methods: National intellectual…
Maltzkait, Anika; Pfurtscheller, Clemens
Multihazard risk analysis and disaster planning for emergency services as a basis for efficient provision in the case of natural hazards - case study municipality of Au, Austria A. Maltzkait (1) & C. Pfurtscheller (1) (1) Institute for Interdisciplinary Mountain Research (IGF), Austrian Academy of Sciences, Innsbruck, Austria The extreme flood events of 2002, 2005 and 2013 in Austria underlined the importance of local emergency services being able to withstand and reduce the adverse impacts of natural hazards. Although for legal reasons municipal emergency and crisis management plans exist in Austria, they mostly do not cover risk analyses of natural hazards - a sound, comparable assessment to identify and evaluate risks. Moreover, total losses and operational emergencies triggered by natural hazards have increased in recent decades. Given sparse public funds, objective budget decisions are needed to ensure the efficient provision of operating resources, like personnel, vehicles and equipment in the case of natural hazards. We present a case study of the municipality of Au, Austria, which was hardly affected during the 2005 floods. Our approach is primarily based on a qualitative risk analysis, combining existing hazard plans, GIS data, field mapping and data on operational efforts of the fire departments. The risk analysis includes a map of phenomena discussed in a workshop with local experts and a list of risks as well as a risk matrix prepared at that workshop. On the basis for the exact requirements for technical and non-technical mitigation measures for each natural hazard risk were analysed in close collaboration with members of the municipal operation control and members of the local emergency services (fire brigade, Red Cross). The measures includes warning, evacuation and, technical interventions with heavy equipment and personnel. These results are used, first, to improve the municipal emergency and crisis management plan by providing a risk map, and a
Hortos, William S.
Mobile ad hoc networking (MANET) supports self-organizing, mobile infrastructures and enables an autonomous network of mobile nodes that can operate without a wired backbone. Ad hoc networks are characterized by multihop, wireless connectivity via packet radios and by the need for efficient dynamic protocols. All routers are mobile and can establish connectivity with other nodes only when they are within transmission range. Importantly, ad hoc wireless nodes are resource-constrained, having limited processing, memory, and battery capacity. Delivery of high quality-ofservice (QoS), real-time multimedia services from Internet-based applications over a MANET is a challenge not yet achieved by proposed Internet Engineering Task Force (IETF) ad hoc network protocols in terms of standard performance metrics such as end-to-end throughput, packet error rate, and delay. In the distributed operations of route discovery and maintenance, strong interaction occurs across MANET protocol layers, in particular, the physical, media access control (MAC), network, and application layers. The QoS requirements are specified for the service classes by the application layer. The cross-layer design must also satisfy the battery-limited energy constraints, by minimizing the distributed power consumption at the nodes and of selected routes. Interactions across the layers are modeled in terms of the set of concatenated design parameters including associated energy costs. Functional dependencies of the QoS metrics are described in terms of the concatenated control parameters. New cross-layer designs are sought that optimize layer interdependencies to achieve the "best" QoS available in an energy-constrained, time-varying network. The protocol design, based on a reactive MANET protocol, adapts the provisioned QoS to dynamic network conditions and residual energy capacities. The cross-layer optimization is based on stochastic dynamic programming conditions derived from time-dependent models of
Spekken, M.; Bruin, de S.
Agricultural machines spend a significant part of their time on non-productive operations such as maneuvering near the boundaries of the field and loading or offloading of inputs or outputs (here referred to as servicing). This paper integrates existing methods for route optimization so as to
Liu, Xiaochen; Zhan, Zhiqiang
Cloud Computing has become more and more prevalent over the past few years, and we have seen the importance of Infrastructure-as-a-service (IaaS). This kind of service enables scaling of bandwidth, memory, computing power and storage. But the SLA in IaaS also faces complexity and variety. Users also consider the business of the service. To meet the most users requirements, a methodology for designing optimal SLA in IaaS from the business perspectives is proposed. This method is different from the conventional SLA design method, It not only focuses on service provider perspective, also from the customer to carry on the design. This methodology better captures the linkage between service provider and service client by considering minimizing the business loss originated from performance degradation and IT infrastructure failures and maximizing profits for service provider and clients. An optimal design in an IaaS model is provided and an example are analyzed to show this approach obtain higher profit.
Full Text Available This paper presents a decision support system (DSS and its models for patrol service center (PSC. PSC plays an important role in public security and emergency management. The configuration, deployment, and scheduling of resources of PSC are important for improving the efficiency of patrol-related resources, service quantity, and emergency response capability. A series of decision-making models of the DSS are studied. First, the criteria and models are proposed for configuring and deploying PSCs; second, three types of models for incremental, direct, and redeployment optimization are built in views for decisions aiming at PSC configuration, deployment, and scheduling problems; third, considering three typical patrol-related service scenarios (alarm assignment, main road blockade, and besiege program, three scheduling models are built, respectively, for PSC-related service and coordination of multiple PSCs. This work contributes to the literature on patrol services and network optimization problems in the following aspects: based on a series of models, a DSS framework is designed for PSCs; the models are formulated for resource management and scheduling upon geography information system; coordination strategies among close PSCs are incorporated into decision models. These features are examined in integration manners. The assessment criteria and optimization models studied in the paper are beneficial for building DSSs for PSC.
Johansen, Søren Glud; Larsen, Christian
We present an algorithm for computing a near optimal service policy for a single-server queueing system when the service cost is a convex function of the service time. The policy has state-dependent service times, and it includes the options to remove jobs from the system and to let the server...
Johansen, Søren Glud; Larsen, Christian
We present an algorithm for computing a near-optimal service policy for a single-server queueing system when the service cost is a convex function of the service time. The policy has state-dependent service times, and it includes the options to remove jobs from the system and to let the server...
... toddler's present levels of physical development, cognitive development, communication development, social... other family members will accept or decline any early intervention service without jeopardizing the...