Context aware M-commerce services: C-IOB model approach

Context-aware computing is useful in providing individualized services focusing mainly on acquiring surrounding context of user. By comparison, only very little research has been completed in integrating context from different environments, despite of its usefulness in diverse applications such as healthcare, M-commerce and tourist guide applications. In particular, one of the most important criteria in providing personalized service in a highly dynamic environment and constantly changing user environment, is to develop a context model which aggregates context from different domains to infer context of an entity at the more abstract level. Hence, the purpose of this paper is to propose a context model based on cognitive aspects to relate contextual information that better captures the observation of certain worlds of interest for a more sophisticated context-aware service. We developed a C-IOB (Context-Information, Observation, Belief) conceptual model to analyze the context data from physical, system, application, and social domains to infer context at the more abstract level. The beliefs developed about an entity (person, place, things) are primitive in most theories of decision making so that applications can use these beliefs in addition to history of transaction for providing intelligent service. We enhance our proposed context model by further classifying context information into three categories: a well-defined, a qualitative and credible context information to make the system more realistic towards real world implementation. The proposed model is deployed to assist a M-commerce application. The simulation results show that the service selection and service delivery of the system are high compared to traditional system.

Helping ourselves: the role of self-help groups in poverty alleviation through aquaculture

Self-help groups (SHGs) are ways for farmers and fishers, especially those who are poor, to come together and work together. They can be a useful entry point for outsiders, promote a supportive local environment, strengthen voices in decision-making and in negotiations with more powerful forces, increase the effectiveness of local actions, and provide easier access to micro-credit and other resources and services. This case study describes a rural aquaculture development context, in India, the development of SHGs and the concept of a ‘one-stop aqua shop’, set up and run by a federation of self-help groups in Kaipara village, West Bengal (a pilot state along with Jharkhand and Orissa). It outlines testing new ways to share information, as part of a series of revised procedures and institutional arrangements for service delivery recommended by farmers and fishers and prioritized by government, with support from the Department of International Development, London (DFID) Natural Resources Support Programme (NRSP) and the Network of Aquaculture Centres in Asia-Pacific (NACA) to the Support to Regional Aquatic Resources Management (STREAM) Initiative (10 p.)

Telling stories, understanding lives, working toward change

Stories are helping us learn more about the livelihoods of the fishers and farmers with whom we work in eastern India. We are engaged with these communities in processes and activities aimed at improving their lives and promoting changes in government policy and service delivery in aquaculture and fisheries. Stories are told in several languages by women and men who fish and farm, about their lives, their livelihoods and significant changes they have experienced. We also record stories as narrated to us by colleague-informants. The written and spoken word, photographs, drawings and films – all are used to document the stories of people’s lives, sometimes prompted by questions as simple as “What do people talk about in the village?” Through the power of language, stories can be an entry point into livelihoods programming, monitoring and evaluation, conflict transformation and ultimately a way of giving life to a rights-based approach to development. (PDF contains 10 pages).

Estudo da oferta e produção de atendimentos das práticas integrativas e complementares no SUS no município do Rio de Janeiro

Esta pesquisa é um estudo de caso com abordagem qualitativa e quantitativa, de natureza exploratória que se propõe a analisar as características de oferta e produção das práticas integrativas e complementares, no período de 2006 a 2013 no município do Rio de Janeiro. Como fontes de dados foram utilizados os bancos de dados nacionais sobre oferta de serviços, de profissionais e de produção: o SCNES- Sistema do Cadastro Nacional de Estabelecimentos de Saúde onde são registrados dados da capacidade física e recursos humanos dos estabelecimentos de saúde e o SIASUS Sistema de Informação Ambulatorial onde são registrados os dados da produção ambulatorial do SUS. Optou-se por esses dois bancos de dados por serem ferramentas institucionais de gerenciamento da capacidade instalada e produção utilizadas pelas esferas federal, estadual e municipal. Buscou identificar profissionais cadastrados no SCNES que são autorizados a oferecer práticas integrativas e complementares no município do Rio de Janeiro, detectar os serviços de práticas integrativas e complementares cadastrados no CNES do município do Rio de Janeiro e analisar no Sistema de Informação Ambulatorial, registros de produção em práticas integrativas e complementares do município do Rio de Janeiro. A lista de práticas integrativas e complementares estabelecidas na portaria no 971 de 2006 são homeopatia, medicina tradicional chinesa (onde se inclui a acupuntura), medicina antroposófica, plantas medicinais e fitoterapia, termalismo/crenoterapia. Este estudo proporciona maior visibilidade quanto às características de implementação e institucionalização de uma recente política pública de saúde e contribui com base na análise dos dados encontrados em ferramentas de gestão, para o aprimoramento de ações de acompanhamento e avaliação, estruturação dos serviços, bem como o desenvolvimento sustentável de políticas locais de oferta das terapias complementares do SUS, em consonância com as diretrizes da Política Nacional de Práticas Integrativas e Complementares.

Dimensionamento da Carga de Trabalho em Unidade de Alta Complexidade em Traumatologia e Ortopedia.

Os gestores de saúde enfrentam desafios crescentes e recursos insuficientes em todo o mundo para referente às atividades realizadas, assim como observação direta dos profissionais para medir o tempo gasto em cada uma de suas atividades durante intervalos de tempo predeterminados. Posteriormente, os resultados encontrados no estudo foram aplicados ao instrumento informatizado de indicadores de carga de trabalho para estimativa do dimensionamento de pessoal (Workload Indicators of Staffing Need responder à demanda de serviços de saúde, especialmente relacionados à ortopedia e traumatologia, causando agravamento de casos e aumento do número de sequelas que reverterão em maior demanda por procedimentos de média e alta complexidade. Este estudo foi motivado pela necessidade de se analisar de forma consistente a composição e o desempenho dos profissionais na área de saúde e afins para o funcionamento pleno de uma unidade de saúde de alta complexidade em ortopedia e traumatologia. Teve como objetivo contribuir para o desenvolvimento da metodologia, disseminação do conhecimento e importância do dimensionamento da força de trabalho em instituições complexas de saúde, além de oportunidade para testar e disseminar o método de indicadores de carga de trabalho para dimensionamento de pessoal e sua importância para o planejamento e a gestão de recursos humanos em saúde. O projeto se desenvolveu em três estudos sequenciais e complementares. Inicialmente, foi feita uma revisão da bibliografia sobre o dimensionamento de recursos humanos em saúde (RHS), buscando reduzir lacuna da escassez de modelos e metodologias, bem como contribuir para o desenho e a utilização de modelos de organização e prestação de serviços que assegurem a oferta de serviços de saúde com qualidade e segurança. Em seguida, realizou-se um estudo de caso no Instituto Nacional de Traumatologia e Ortopedia (INTO)/Ministério da Saúde (MS), utilizando metodologia quantitativa e roteiros semiestruturados para estimar o tempo WISN), como testagem da metodologia promovida pela Organização Mundial da Saúde (OMS). Os resultados da análise da carga de trabalho e estimativa do dimensionamento de pessoal de saúde podem apoiar e nortear a elaboração e a implementação de políticas para melhorias na qualidade e na produtividade dos serviços de saúde. Os resultados encontrados revelam que não há déficit de profissionais médicos nos três grupos estudados, tornando-se imperioso a realização de alguns questionamentos em relação à produção cirúrgica versus entrada na fila de espera.

Developing a toolkit for assessing the impact of health library services on patient care

Urquhart,C., Spink, S., Thomas, R. & Weightman, A. (2007). Developing a toolkit for assessing the impact of health library services on patient care. Report to LKDN (Libraries and Knowledge Development Network). Aberystwyth: Department of Information Studies, Aberystwyth University. Sponsorship: Libraries and Knowledge Development Network/ NHS

How Much Does It Cost to Provide Antiretroviral Therapy for HIV/AIDS in Africa?

Background: Many African countries are rapidly expanding HIV/AIDS treatment programs. Empirical information on the cost of delivering antiretroviral therapy (ART) for HIV/AIDS is needed for program planning and budgeting. Methods: We searched published and gray sources for estimates of the cost of providing ART in service delivery (non-research) settings in sub-Saharan Africa. Estimates were included if they were based on primary local data for input prices. Results: 17 eligible cost estimates were found. Of these, 10 were from South Africa. The cost per patient per year ranged from $396 to $2,761. It averaged approximately $850/patient/year in countries outside South Africa and $1,700/patient/year in South Africa. The most recent estimates for South Africa averaged $1,200/patient/year. Specific cost items included in the average cost per patient per year varied, making comparison across studies problematic. All estimates included the cost of antiretroviral drugs and laboratory tests, but many excluded the cost of inpatient care, treatment of opportunistic infections, and/or clinic infrastructure. Antiretroviral drugs comprised an average of one third of the cost of treatment in South Africa and one half to three quarters of the cost in other countries. Conclusions: There is very little empirical information available about the cost of providing antiretroviral therapy in non-research settings in Africa. Methods for estimating costs are inconsistent, and many estimates combine data drawn from disparate sources. Cost analysis should become a routine part of operational research on the treatment rollout in Africa.

Providing psychological services for people with diabetes

Previous research and service development guidelines have highlighted the importance of psychological issues in diabetes care, and both people with diabetes and diabetes professionals recognise the need for specialist psychological input. This article outlines the development of a service delivery model for psychological services in diabetes care, based on a patient needs assessment and the advice of diabetes professionals. This involved an assessment of the psychological needs of people with diabetes within an urban Health Trust in Northern Ireland, and the collation of the views of local diabetes professionals. Questionnaires to assess for depression, anxiety, binge eating behaviour and diabetes-specific worries were completed by 300 people with diabetes. The participants were accessed through both primary and secondary care diabetes teams. As expected, a high level of psychological distress relative to population norms was illustrated by the patient needs assessment. Particularly high levels of binge eating behaviour were reported, and levels of distress were higher for community-managed patients than for hospital-managed patients. The diabetes professionals unanimously agreed that there is a need for specialist psychological input and contributed to the service delivery model which is outlined in this article.

Education, Education, Education: the Third Way and PFI

In 1997, New Labour set about the task of reforming public services in the United Kingdom through the use of an ideology that became known as the ‘Third Way’. This research examines the context from which this concept emerged, and explores its relationship with the tools of delivery, with particular reference to the Private Finance Initiative (PFI). The paper begins by reviewing the Third Way, before analysing the arguments for and against PFI. Using an example from the Northern Ireland education sector, the paper argues that the characteristics associated with the Third Way are mirrored in the operational tools of public service delivery, such as PFI. The paper concludes that, within the context of the case study reviewed, there is a ‘consistent pragmatism’ in play in relation to how these delivery initiatives are operated and how they relate to their conceptual underpinnings.

Bridging and Linking in a Divided Society: A Social Capital Case Study from Northern Ireland

This paper reports the results of research into social capital levels in the Central Housing Community Network, part of the community consultation structure of the Northern Ireland Housing Executive. Membership of the forum increased the bonding, bridging and linking social capital of its members and appeared to improve community relations, although that was not its stated purpose. However, the empirical link between social capital and the quality of community relations remains unproven. The research provides an example of the state creating a positive space for interaction with civil society through consultation on service delivery issues. In an international policy environment where ‘mixed’ communities are the ideal, the potential of service-based forums to contribute to community cohesion may have been underestimated.

Bereavement Assessment Practice in Hospice Settings: Challenges for Palliative Care Social Workers

The management and delivery of bereavement support services in palliative care settings presents practical and ethical challenges. A national survey, conducted in 2007, examined bereavement practice in ten Marie Curie hospices across the United Kingdom. This qualitative study was undertaken using semi-structured telephone interviews with Bereavement Service Leaders located in each hospice. Although findings revealed that bereavement services were in operation and had been reviewed in response to the National Institute for Clinical Excellence Guidance (2004), and all bereaved families were offered support, there was no standardisation of service delivery across sites. Multi-disciplinary team meetings facilitated shared decision-making for bereavement follow-up, and expanded and clarified documentation completed by nursing staff around the time of the patient’s death. However, there was ambiguity regarding professional ‘duty of care’ and agency responses to bereaved individuals who were suicidal. Questions were raised around clinical effectiveness, reliability and professional accountability. The study highlighted ethical issues centred on documentation, user participation and consent, and found staff training was variable across the 10 hospices. The findings have informed the development of a post-bereavement service model which has been subsequently implemented across Marie Curie Cancer Care.

A systematic review of instruments related to family caregivers of palliative care patients

Support for family caregivers is a core function of palliative care. However, there is a lack of consistency in the way needs are assessed, few longitudinal studies to examine the impact of caregiving, and a dearth of evidence-based interventions. In order to help redress this situation, identification of suitable instruments to examine the caregiving experience and the effectiveness of interventions is required. A systematic literature review was undertaken incorporating representatives of the European Association for Palliative Care’s International Palliative Care Family Caregiver Research Collaboration and Family Carer Taskforce. The aim of the review was to identify articles that described the use of instruments administered to family caregivers of palliative care patients (pre and post-bereavement). Fourteen of the 62 instruments targeted satisfaction with service delivery and less than half were developed specifically for the palliative care context. In approximately 25% of articles psychometric data were not reported. Where psychometric results were reported, validity data were reported in less than half (42%) of these cases. While a considerable variety of instruments have been administered to family caregivers, the validity of some of these requires further consideration. We recommend that others be judicious before developing new instruments for this population.

The Government – Voluntary Sector Compacts: Governance, Governmentality and Civil Society

In 1998 government and the main representatives of the voluntary sector in each of the four countries in the United Kingdom published "compacts" on relations between government and the voluntary sector. These were joint documents, carrying forward ideas expressed by the Labor Party when in opposition, and directed at developing a new relationship for partnership with those "not-for-profit organizations" that are involved primarily in the areas of policy and service delivery. This article seeks to use an examination of the compacts, and the processes that produced them and that they have now set in train, to explore some of the wider issues about the changing role of government and its developing relationships with civil society. In particular, it argues that the new partnership builds upon a movement from welfarism to economism which is being developed further through the compact process. Drawing upon a governmentality approach, and illustrating the account with interview material obtained from some of those involved in compact issues from within both government and those umbrella groups which represent the voluntary sector, an argument is made that this overall process represents the beginning of a new reconfiguration of the state that is of considerable constitutional significance.

Moral distress experienced by health care professionals who provide home-based palliative care

Health care providers regularly encounter situations of moral conflict and distress in their practice. Moral distress may result in unfavorable outcomes for both health care providers and those in their care. The purpose of this study was to examine the experience of moral distress from a broad range of health care occupations that provide home-based palliative care as the initial step of addressing the issue. A critical incident approach was used in qualitative interviews to elicit the experiences on moral distress from 18 health care providers drawn from five home visiting organizations in south central Ontario, Canada. Most participants described at least two critical incidents in their interview generating a total of 47 critical incidents. Analyses of the critical incidents revealed 11 issues that triggered moral distress which clustered into three themes, (a) the role of informal caregivers, b) challenging clinical situations and (c) service delivery issues. The findings suggest that the training and practice environments for health care providers need to be designed to recognize the moral challenges related to day-to-day practice.

Joined-up government in Ireland:From un-strategic choices to patriotic imperatives

Over the last decade, joined-up government has assumed a prominent place in the study and practice of public management. In this article, drawing on the Irish case we adopt an institutionalist approach to the issue of joining-up government and bureaucratic reform. We explore how the period of sustained and rapid economic growth in Ireland during the 1990s was also characterised by a fragmentation of the public service and proliferation of agencies. Subsequently, as a consequence of the sharp contraction in public spending brought about by the global financial crisis, we find an accelerated process of public sector recentralisation, retrenchment and de-agencification. Much of this is occurring in an unplanned manner but under the generic banner of 'joining up' government. We identify the drivers behind these dynamics and how they have manifested themselves, as well as the changes to politicaladministrative relationships brought about by new initiatives, the power imbalances they expose, and ultimately their consequences on public service delivery. © Taylor & Francis Group, LLC.