818 resultados para Services quality


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A number of European countries, among which the UK and Spain, have opened up their Directory Enquiry Services (DQs, or 118AB) market to competition. We analyse the Spanish case, where both local and foreign firms challenged the incumbent as of April 2003. We argue that the incumbent had the ability to abuse its dominant position, and that it was a perfectly rational strategy. In short,the incumbent raised its rivals' costs directly by providing an inferior quality version of the (essential) input, namely the incumbent's subscribers' database. We illustrate how it is possible to quantify the effect of abuse in situation were the entrant has no previous history in the market. To do this, we use the UK experience to construct the relevant counterfactual, that is the "but for abuse" scenario. After controlling for relative prices and advertising intensity, we find that one of the foreign entrants achieved a Spanish market share of only half of what it would have been in the absence of abuse.

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Efficient and effective coastal management decisions rely on knowledge of the impact of human activities on ecosystem integrity, vulnerable species, and valued ecosystem services—collectively, human impact on environmental quality (EQ). Ecosystem-based management (EBM) is an emerging approach to address the dynamics and complexities of coupled social-ecological systems. EBM “is intended to directly address the long-term sustainable delivery of ecosystem services and the resilience of marine ecosystems to perturbations” (Rosenberg and Sandifer, 2009). The lack of a tool that integrates human choices with the ecological connections between contributing watersheds and nearshore areas, and that incorporates valuation of ecosystem services, is a critical missing piece needed for effective and efficient coastal management. To address the need for an integrative tool for evaluation of human impacts on ecosystems and their services, Battelle developed the EcoVal™ Environmental Quality Evaluation System. The EcoVal system is an updated (2009) version of the EQ Evaluation System for Water Resources developed by Battelle for the U.S. Bureau of Reclamation (Dee et al., 1972). The Battelle EQ evaluation system has a thirty-year history of providing a standard approach to evaluate watershed EQ. This paper describes the conceptual approach and methodology of the updated EcoVal system and its potential application to coastal ecosystems. (PDF contains 4 pages)

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This thesis describes a compositional framework for developing situation awareness applications: applications that provide ongoing information about a user's changing environment. The thesis describes how the framework is used to develop a situation awareness application for earthquakes. The applications are implemented as Cloud computing services connected to sensors and actuators. The architecture and design of the Cloud services are described and measurements of performance metrics are provided. The thesis includes results of experiments on earthquake monitoring conducted over a year. The applications developed by the framework are (1) the CSN --- the Community Seismic Network --- which uses relatively low-cost sensors deployed by members of the community, and (2) SAF --- the Situation Awareness Framework --- which integrates data from multiple sources, including the CSN, CISN --- the California Integrated Seismic Network, a network consisting of high-quality seismometers deployed carefully by professionals in the CISN organization and spread across Southern California --- and prototypes of multi-sensor platforms that include carbon monoxide, methane, dust and radiation sensors.

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Web services can be seen as a newly emerging research area for Service-oriented Computing and their implementation in Service-oriented Architectures. Web services are self-contained, self-describing modular applications or components providing services. Web services may be dynamically aggregated, composed, and enacted as Web services Workflows. This requires frameworks and interaction protocols for their co-ordination and transaction support. In a Service-oriented Computing setting, transactions are more complex, involve multiple parties (roles), span many organizations, and may be long-running, consisting of a highly decentralized service partner and performed by autonomous entities. A Service-oriented Transaction Model has to provide comprehensive support for long-running propositions including negotiations, conversations, commitments, contracts, tracking, payments, and exception handling. Current transaction models and mechanisms including their protocols and primitives do not sufficiently cater for quality-aware and long running transactions comprising loosely-coupled (federated) service partners and resources. Web services transactions require co-ordination behavior provided by a traditional transaction mechanism to control the operations and outcome of an application. Furthermore, Web services transactions require the capability to handle the co-ordination of processing outcomes or results from multiple services in a more flexible manner. This requires more relaxed forms of transactions—those that do not strictly have to abide by the ACID properties—such as loosely-coupled collaboration and workflows. Furthermore, there is a need to group Web services into applications that require some form of correlation, but do not necessarily require transactional behavior. The purpose of this paper is to provide a state-of-the-art review and overview of some proposed standards surrounding Web services composition, co-ordination, and transaction. In particular the Business Process Execution Language for Web services (BPEL4WS), its co-ordination, and transaction frameworks (WS-Co-ordination and WS-Transaction) are discussed.

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Durbin, J., Urquhart, C. & Yeoman, A. (2003). Evaluation of resources to support production of high quality health information for patients and the public. Final report for NHS Research Outputs Programme. Aberystwyth: Department of Information Studies, University of Wales Aberystwyth. Sponsorship: Department of Health

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Aim: Diabetes is an important barometer of health system performance. This chronic condition is a source of significant morbidity, premature mortality and a major contributor to health care costs. There is an increasing focus internationally, and more recently nationally, on system, practice and professional-level initiatives to promote the quality of care. The aim of this thesis was to investigate the ‘quality chasm’ around the organisation and delivery of diabetes care in general practice, to explore GPs’ attitudes to engaging in quality improvement activities and to examine efforts to improve the quality of diabetes care in Ireland from practice to policy. Methods: Quantitative and qualitative methods were used. As part of a mixed methods sequential design, a postal survey of 600 GPs was conducted to assess the organization of care. This was followed by an in-depth qualitative study using semi-structured interviews with a purposive sample of 31 GPs from urban and rural areas. The qualitative methodology was also used to examine GPs’ attitudes to engaging in quality improvement. Data were analysed using a Framework approach. A 2nd observation study was used to assess the quality of care in 63 practices with a special interest in diabetes. Data on 3010 adults with Type 2 diabetes from 3 primary care initiatives were analysed and the results were benchmarked against national guidelines and standards of care in the UK. The final study was an instrumental case study of policy formulation. Semi-structured interviews were conducted with 15 members of the Expert Advisory Group (EAG) for Diabetes. Thematic analysis was applied to the data using 3 theories of the policy process as analytical tools. Results: The survey response rate was 44% (n=262). Results suggested care delivery was largely unstructured; 45% of GPs had a diabetes register (n=157), 53% reported using guidelines (n=140), 30% had formal call recall system (n=78) and 24% had none of these organizational features (n=62). Only 10% of GPs had a formal shared protocol with the local hospital specialist diabetes team (n=26). The lack of coordination between settings was identified as a major barrier to providing optimal care leading to waiting times, overburdened hospitals and avoidable duplication. The lack of remuneration for chronic disease management had a ripple effect also creating costs for patients and apathy among GPs. There was also a sense of inertia around quality improvement activities particularly at a national level. This attitude was strongly influenced by previous experiences of change in the health system. In contrast GP’s spoke positively about change at a local level which was facilitated by a practice ethos, leadership and special interest in diabetes. The 2nd quantitative study found that practices with a special interest in diabetes achieved a standard of care comparable to the UK in terms of the recording of clinical processes of care and the achievement of clinical targets; 35% of patients reached the HbA1c target of <6.5% compared to 26% in England and Wales. With regard to diabetes policy formulation, the evolving process of action and inaction was best described by the Multiple Streams Theory. Within the EAG, the formulation of recommendations was facilitated by overarching agreement on the “obvious” priorities while the details of proposals were influenced by personal preferences and local capacity. In contrast the national decision-making process was protracted and ambiguous. The lack of impetus from senior management coupled with the lack of power conferred on the EAG impeded progress. Conclusions: The findings highlight the inconsistency of diabetes care in Ireland. The main barriers to optimal diabetes management center on the organization and coordination of care at the systems level with consequences for practice, providers and patients. Quality improvement initiatives need to stimulate a sense of ownership and interest among frontline service providers to address the local sense of inertia to national change. To date quality improvement in diabetes care has been largely dependent the “special interest” of professionals. The challenge for the Irish health system is to embed this activity as part of routine practice, professional responsibility and the underlying health care culture.

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Aim: To investigate the value of using PROMs as quality improvement tools. Methods: Two systematic reviews were undertaken. The first reviewed the quantitative literature on the impact of PROMs feedback and the second reviewed the qualitative literature on the use of PROMs in practice. These reviews informed the focus of the primary research. A cluster randomised controlled trial (PROFILE) examined the impact of providing peer benchmarked PROMs feedback to consultant orthopaedic surgeons on improving outcomes for hip replacement surgery. Qualitative interviews with surgeons in the intervention arm of the trial examined the view of and reactions to the feedback. Results: The quantitative review of 17 studies found weak evidence to suggest that providing PROMs feedback to professionals improves patient outcomes. The qualitative review of 16 studies identified the barriers and facilitators to the use of PROMs based on four themes: practical considerations, attitudes towards the data, methodological concerns and the impact of feedback on care. The PROFILE trial included 11 surgeons and 215 patients in the intervention arm, and 10 surgeons and 217 patients in the control arm. The trial found no significant difference in the Oxford Hip Score between the arms (-0.7, 95% CI -1.9-0.5, p=0.2). Interviews with surgeons revealed mixed opinions about the value of the PROMs feedback and the information did not promote explicit changes to their practice. Conclusion: It is important to use PROMs which have been validated for the specific purpose of performance measurement, consult with professionals when developing a PROMs feedback intervention, communicate with professionals about the objectives of the data collection, educate professionals on the properties and interpretation of the data, and support professionals in using the information to improve care. It is also imperative that the burden of data collection and dissemination of the information is minimised.

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

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Recent discussions of school choice have revived arguments that the decentralization of governing institutions can enhance the quality of public services by increasing the participation of intended beneficiaries in the production of those services. We use data from the Schools and Staffing Survey to examine the extent to which the decentralization of authority to charter schools induces parents to become more involved in their children's schools. We find that parents are indeed more involved in charter schools than in observationally similar public schools, especially in urban elementary and middle schools. Although we find that this difference is partly attributable to measurable institutional and organizational factors, we also find that charter schools tend to be established in areas with above-average proportions of involved parents, and we find suggestive evidence that, within those areas, it is the more involved parents who tend to select into charter schools. Thus, while the institutional characteristics of charter schools do appear to induce parents to become more involved in their children's schools, such characteristics are only part of the explanation for the greater parental involvement in charter schools than in traditional public schools. © The Author 2005. Published by Oxford University Press. All rights reserved.

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Coastal zones and shelf-seas are important for tourism, commercial fishing and aquaculture. As a result the importance of good water quality within these regions to support life is recognised worldwide and a number of international directives for monitoring them now exist. This paper describes the AlgaRisk water quality monitoring demonstration service that was developed and operated for the UK Environment Agency in response to the microbiological monitoring needs within the revised European Union Bathing Waters Directive. The AlgaRisk approach used satellite Earth observation to provide a near-real time monitoring of microbiological water quality and a series of nested operational models (atmospheric and hydrodynamic-ecosystem) provided a forecast capability. For the period of the demonstration service (2008–2013) all monitoring and forecast datasets were processed in near-real time on a daily basis and disseminated through a dedicated web portal, with extracted data automatically emailed to agency staff. Near-real time data processing was achieved using a series of supercomputers and an Open Grid approach. The novel web portal and java-based viewer enabled users to visualise and interrogate current and historical data. The system description, the algorithms employed and example results focussing on a case study of an incidence of the harmful algal bloom Karenia mikimotoi are presented. Recommendations and the potential exploitation of web services for future water quality monitoring services are discussed.

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The aim of this paper is to study the recent changes on citizens’ satisfaction with the performance ofpublic services, in the period 2009-2011 in Spain. Using data from the surveys on Quality of PublicServices, developed by the Sociological Research Center jointly with the National Agency for theEvaluation of Public Services and Quality of Services, our results show that the level of satisfactionhas slightly increased, which seems to display a greater tendency to positively value public servicesduring economic retrenchment. A major determinant of high satisfaction is self-reported ideology.Besides, immigrants display higher levels of satisfaction than Spaniards.

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The future convergence of voice, video and data applications on the Internet requires that next generation technology provides bandwidth and delay guarantees. Current technology trends are moving towards scalable aggregate-based systems where applications are grouped together and guarantees are provided at the aggregate level only. This solution alone is not enough for interactive video applications with sub-second delay bounds. This paper introduces a novel packet marking scheme that controls the end-to-end delay of an individual flow as it traverses a network enabled to supply aggregate- granularity Quality of Service (QoS). IPv6 Hop-by-Hop extension header fields are used to track the packet delay encountered at each network node and autonomous decisions are made on the best queuing strategy to employ. The results of network simulations are presented and it is shown that when the proposed mechanism is employed the requested delay bound is met with a 20% reduction in resource reservation and no packet loss in the network.

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The development of wideband network services and the new network infrastructures to support them have placed much more requirements on current network management systems. Issues such as scalability, integrity and interoperability have become more important. Existing management systems are not flexible enough to support the provision of Quality of Service (QoS) in these dynamic environments. The concept of Programmable Networks has been proposed to address these requirements. Within this framework, CORBA is regarded as a middleware technology that can enable interoperation among the distributed entities founds in Programmable Networks. By using the basic CORBA environment in a heterogeneous network environment, a network manager is able to control remote Network Elements (NEs) in the same way it controls its local resources. Using this approach both the flexibility and intelligence of the overall network management can be improved. This paper proposes the use of two advanced features of CORBA to enhance the QoS management in a Programmable Network environment. The Transaction Service can be used to manage a set of tasks, whenever the management of elements in a network is correlated; and the Concurrency Service can be used to coordinate multiple accesses on the same network resources. It is also shown in this paper that proper use of CORBA can largely reduce the development and administration of network management applications.