Costs of psychosis in 2010: findings from the second Australian national survey of psychosis

Objectives
To estimate the annual costs of psychosis in Australia from societal and government perspectives and assess whether average costs per person differ by principal service provider at time of census.

Methods
Costs of psychosis encompassing health sector costs, other sector costs, and productivity losses were assessed for 2010 using a prevalence-based, bottom-up approach. Resource use data were obtained from the second Australian National Survey of Psychosis and unit costs were from government and non-government organization (NGO) sources. Costs to society were assessed by principal service provider at census: public specialized mental health services (PSMHS) and NGOs during the census month (current clients), and PSMHS in the 11 months preceding census (recent clients), and any differences were ascertained.

Results
The average annual costs of psychosis to society are estimated at $77,297 per affected individual, comprising $40,941 in lost productivity, $21,714 in health sector costs, and $14,642 in other sector costs. Health sector costs are 3.9-times higher than those for the average Australian. Psychosis costs Australian society $4.91 billion per annum, and the Australian government almost $3.52 billion per annum. There are significant differences between principal service providers for each cost category. Current PSMHS clients had the highest health sector costs overall, and the highest mental health ambulatory, inpatient, and antipsychotic medication costs specifically. NGO clients had the highest other sector costs overall and the highest NGO assistance, supported employment, and supported accommodation costs. Recent PSMHS clients had the lowest productivity losses for reduced participation and the highest costs for absenteeism and presenteeism.

Conclusions
The costs of psychosis are broad ranging and very high. Development and implementation of cost-effective prevention, treatment, and support strategies is critical to maximizing the efficiency of service delivery. A needs-based framework based on principal service provider and recency of contact may facilitate this process.

Securely outsourcing attribute-based encryption with checkability

Attribute-Based Encryption (ABE) is a promising cryptographic primitive which significantly enhances the versatility of access control mechanisms. Due to the high expressiveness of ABE policies, the computational complexities of ABE key-issuing and decryption are getting prohibitively high. Despite that the existing Outsourced ABE solutions are able to offload some intensive computing tasks to a third party, the verifiability of results returned from the third party has yet to be addressed. Aiming at tackling the challenge above, we propose a new Secure Outsourced ABE system, which supports both secure outsourced key-issuing and decryption. Our new method offloads all access policy and attribute related operations in the key-issuing process or decryption to a Key Generation Service Provider (KGSP) and a Decryption Service Provider (DSP), respectively, leaving only a constant number of simple operations for the attribute authority and eligible users to perform locally. In addition, for the first time, we propose an outsourced ABE construction which provides checkability of the outsourced computation results in an efficient way. Extensive security and performance analysis show that the proposed schemes are proven secure and practical. © 2013 IEEE.

Secure outsourced attribute-based signatures

Attribute-based signature (ABS) enables users to sign messages over attributes without revealing any information other than the fact that they have attested to the messages. However, heavy computational cost is required during signing in existing work of ABS, which grows linearly with the size of the predicate formula. As a result, this presents a significant challenge for resource-constrained devices (such as mobile devices or RFID tags) to perform such heavy computations independently. Aiming at tackling the challenge above, we first propose and formalize a new paradigm called Outsourced ABS, i.e., OABS, in which the computational overhead at user side is greatly reduced through outsourcing intensive computations to an untrusted signing-cloud service provider (S-CSP). Furthermore, we apply this novel paradigm to existing ABS schemes to reduce the complexity. As a result, we present two concrete OABS schemes: i) in the first OABS scheme, the number of exponentiations involving in signing is reduced from O(d) to O(1) (nearly three), where d is the upper bound of threshold value defined in the predicate; ii) our second scheme is built on Herranz et al.'s construction with constant-size signatures. The number of exponentiations in signing is reduced from O(d2) to O(d) and the communication overhead is O(1). Security analysis demonstrates that both OABS schemes are secure in terms of the unforgeability and attribute-signer privacy definitions specified in the proposed security model. Finally, to allow for high efficiency and flexibility, we discuss extensions of OABS and show how to achieve accountability as well.

Is cost effectiveness sustained after weekend inpatient rehabilitation? 12 month follow up from a randomized controlled trial

BACKGROUND: Our previous work showed that providing additional rehabilitation on a Saturday was cost effective in the short term from the perspective of the health service provider. This study aimed to evaluate if providing additional rehabilitation on a Saturday was cost effective at 12 months, from a health system perspective inclusive of private costs. METHODS: Cost effectiveness analyses alongside a single-blinded randomized controlled trial with 12 months follow up inclusive of informal care. Participants were adults admitted to two publicly funded inpatient rehabilitation facilities. The control group received usual care rehabilitation services from Monday to Friday and the intervention group received usual care plus additional Saturday rehabilitation. Incremental cost effectiveness ratios were reported as cost per quality adjusted life year (QALY) gained and for a minimal clinical important difference (MCID) in functional independence. RESULTS: A total of 996 patients [mean age 74 years (SD 13)] were randomly assigned to the intervention (n = 496) or control group (n = 500). The intervention was associated with improvements in QALY and MCID in function, as well as a non-significant reduction in cost from admission to 12 months (mean difference (MD) AUD$6,325; 95% CI -4,081 to 16,730; t test p = 0.23 and MWU p = 0.06), and a significant reduction in cost from admission to 6 months (MD AUD$6,445; 95% CI 3,368 to 9,522; t test p = 0.04 and MWU p = 0.01). There is a high degree of certainty that providing additional rehabilitation services on Saturday is cost effective. Sensitivity analyses varying the cost of informal carers and self-reported health service utilization, favored the intervention. CONCLUSIONS: From a health system perspective inclusive of private costs the provision of additional Saturday rehabilitation for inpatients is likely to have sustained cost savings per QALY gained and for a MCID in functional independence, for the inpatient stay and 12 months following discharge, without a cost shift into the community. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry November 2009 ACTRN12609000973213 .

Consumer reactions to corporate social responsibility (CSR) in Thailand: the moderating effect of competitive positioning

Purpose – The purpose of this paper is to understand the business case for corporate social responsibility (CSR) in Thailand by focusing on the consumer-organisational relationship and test the conceptual framework of Du et al. (2007). Design/methodology/approach – A quantitative study was conducted using a mall intercept survey of 184 Thai mobile phone service provider consumers in Bangkok, Thailand. Findings – A CSR emphasised brand is more likely than non-CSR emphasised brands to accrue consumer CSR awareness, positive attitude to company motivations and beliefs in the CSR of that company. Although beliefs are associated with consumers’ greater identification and advocacy behaviours towards the CSR emphasised brand than the non-CSR emphasised brands, they are not associated with loyalty. Practical implications – The paper provides potential guidance for companies to more effectively position and communicate their CSR activities to create differential advantages. Originality/value – Findings of the study demonstrate some support for a business case for CSR in Thailand.

Adaptable, model-driven security engineering for SaaS cloud-based applications

Software-as-a-service (SaaS) multi-tenancy in cloud-based applications helps service providers to save cost, improve resource utilization, and reduce service customization and maintenance time. This is achieved by sharing of resources and service instances among multiple "tenants" of the cloud-hosted application. However, supporting multi-tenancy adds more complexity to SaaS applications required capabilities. Security is one of these key requirements that must be addressed when engineering multi-tenant SaaS applications. The sharing of resources among tenants - i.e. multi-tenancy - increases tenants' concerns about the security of their cloud-hosted assets. Compounding this, existing traditional security engineering approaches do not fit well with the multi-tenancy application model where tenants and their security requirements often emerge after the applications and services were first developed. The resultant applications do not usually support diverse security capabilities based on different tenants' needs, some of which may change at run-time i.e. after cloud application deployment. We introduce a novel model-driven security engineering approach for multi-tenant, cloud-hosted SaaS applications. Our approach is based on externalizing security from the underlying SaaS application, allowing both application/service and security to evolve at runtime. Multiple security sets can be enforced on the same application instance based on different tenants' security requirements. We use abstract models to capture service provider and multiple tenants' security requirements and then generate security integration and configurations at runtime. We use dependency injection and dynamic weaving via Aspect-Oriented Programming (AOP) to integrate security within critical application/service entities at runtime. We explain our approach, architecture and implementation details, discuss a usage example, and present an evaluation of our approach on a set of open source web applications.

Verifiable auditing for outsourced database in cloud computing

The notion of database outsourcing enables the data owner to delegate the database management to a cloud service provider (CSP) that provides various database services to different users. Recently, plenty of research work has been done on the primitive of outsourced database. However, it seems that no existing solutions can perfectly support the properties of both correctness and completeness for the query results, especially in the case when the dishonest CSP intentionally returns an empty set for the query request of the user. In this paper, we propose a new verifiable auditing scheme for outsourced database, which can simultaneously achieve the correctness and completeness of search results even if the dishonest CSP purposely returns an empty set. Furthermore, we can prove that our construction can achieve the desired security properties even in the encrypted outsourced database. Besides, the proposed scheme can be extended to support the dynamic database setting by incorporating the notion of verifiable database with updates.

Relacionamento Interpessoal entre Compradores e Vendedores: Troca de Atendimento em Vendas e o Impacto na Continuidade das Relações Comerciais.

In a highly competitive environment, the ability to retain a substantial customer base represents a tremendous competitive advantage, therefore this transaction-based emphasis in sales is increasingly being replaced by relationally focused approach. Although existing sales literature is in agreement to the theoretical composition of buyer-seller relationships, a lack of empirical evidence exists for the interrelationships of various aspects of relational selling on individual salesperson¿s performance. This paper explores the impact of interpersonal relationships on customer satisfaction and loyalty towards the firm. Based on a review of different streams of research, the paper contributes to the existing theories using a case analysis of customer behavior when there is salesperson turnover. Much of the relationship with the company comes from trust in the salesperson, which is built up through the development of the relationship. The existence of a friendship interpersonal relationship with a salesperson also increases the customer willingness to follow him in case he leaves the company, thus possibly switching to another service provider. Utilizing a case analysis method this paper has the objective to find evidences that could prove the positive or negative impact of the salesperson¿s turnover in the organizations. Finally, the paper discusses managerial implications and directions for future research.

Fatores relevantes na escolha de prestadores de serviços de atividades de apoio no Brasil

A pesquisa visou explorar o tema da escolha do prestador de serviços de atividades de apoio no Brasil. Quais são os critérios relevantes que uma organização deve adotar para escolher o prestador de serviços que contribua para a persecução dos objetivos dessa organização? Como escolher o prestador de serviços corretamente? Essas perguntas foram investigadas na pesquisa de campo. O método adotado foi o do estudo de caso único. A pesquisa exploratória utilizou-se do modelo lógico para interpretar as evidências colhidas, bem como cruzou esses dados com a pouca literatura existente sobre o tema. A análise documental, a observação direta e as entrevistas confirmaram as premissas adotadas. A análise da capacidade econômica do prestador de serviços, da habilidade técnica, do preço e o grau de confiança foram encontrados nas evidências e confirmaram a proposição inicial como fatores relevantes na escolha desse prestador de serviços. A pesquisa ainda fez novas descobertas que sugerem futuras pesquisas.

Valor percebido e a nova lógica dominante de serviço : estudo da indústria brasileira de equipamentos de refrigeração para transporte de cargas

Levitt (1960) apresentou o termo Miopia em Marketing e discutiu sobre o perigo de as organizações centralizarem seu foco no produto e descuidarem da real necessidade dos clientes, já que o produto é apenas um meio para atender à necessidade do cliente e não o fim em si. Na mesma linha, Shostack (1977), quase duas décadas mais tarde, enfatizou a urgência de se entender a posição do Marketing na economia pós-industrial de serviços, em que a lógica tradicional focada em produtos não mais atendia adequadamente o mercado. Portanto, não é recente a visão de que a posse do bem físico é secundária para o atendimento das necessidades do consumidor, sendo fundamental pensar no benefício que o bem proporciona ao cliente quando do seu uso. Mais recentemente, Vargo e Lusch (2004a) retomaram a discussão sobre a importância de as organizações atentarem para as necessidades dos clientes em vez de apenas focarem na transação, ou seja, na ideia de troca de um produto por um valor monetário. Estes autores emergiram novamente com a ideia de que as empresas precisam entregar benefícios aos seus clientes e a que apropriação do serviço gerado pela oferta da empresa é mais importante do que a transferência de posse do bem físico. Eles retomam, desta forma, as ideias de Levitt e Shostack e as modificam para criar a Service-Dominant Logic ou S-D Logic, como eles denominam. A ênfase desta proposta é que o Marketing deixe de considerar a transação de produtos ou serviços como central para a criação de valor, para uma lógica centrada no serviço produzido pelo bem – produto ou serviço. Assim, passa ser fundamental entender como o valor é percebido pelo cliente na fase de uso e focar os esforços na geração desse valor, possibilitando, assim, que empresas que entendam as reais necessidades do mercado, criem vantagem competitiva sustentável. Considerando a proposta destes autores, este trabalho testou a aplicação deste conceito na indústria de equipamentos de refrigeração para transporte de cargas com temperatura controlada no Brasil. Foram entrevistados seis importantes transportadores de carga frigorificada do país, os quais foram questionados sobre o valor do serviço usufruído pela posse do bem em contraposição ao valor percebido de usufruir o serviço sem ter que comprar o bem para tal. Os entrevistados associam muito valor à posse do bem, pois, para eles, isso garante que o serviço não sofrerá interrupções, algo muito valioso para eles. Isso evidencia uma falta de confiança nas alternativas possíveis à compra do ativo pela empresa. A confiança no prestador do serviço é, portanto, elemento chave na avaliação dos benefícios, reforçando achados de estudos anteriores. Foram identificadas diferenças de atribuição de valor para as propostas alternativas de fornecimento em razão da relevância do serviço de transporte refrigerado para a empresa – negócio central ou função de apoio para o negócio central da empresa.

What kind of judiciary do we want?: the access to justice in Brazil

The goal of this paper is to discuss a key issue in the Democratic Rule of Law State: what are the role and main functions of the Judiciary in Brazil? Is the Judiciary mainly a public service provider, adjudicating disputes and guaranteeing individual rights? Or also as a state power, it should mainly control and guide the moral values of the society, changing the status quo and reducing social conflicts? In this sense, what are the conflicts that must be examined by the Judiciary? We will seek to answer these questions based on a discussion subsidized by courts official statistics and the results of surveys conducted with the Brazilian general population. The surveys measured how do citizens feel about their judicial system and what are the circumstances and the facts that determine the judicialization of conflicts. We work with the perceptions and attitudes of citizens relating to the Judiciary as it is today and discuss the Judiciary they want. Then, we compare how attitudes and perceptions relate to actual behavior and use of courts.

Voluntariado nas entidades sem fins lucrativos, rede colaborativa para uma saúde pública de qualidade

Trata-se de um caso para ensino descritivo sobre o voluntariado em organizações da sociedade civil sem fins lucrativos na área da saúde. Identificado como um dos vértices da rede de governança colaborativa dos prestadores de serviço em saúde pública. No contexto do caso são apresentados conceitos de liderança voluntária e tomada de decisão em uma organização da sociedade civil sem fins Lucrativos na área da saúde. Análise de atores de governança colaborativa como complemento de qualidade na prestação de serviços para saúde pública é o foco do caso de ensino apresentado. O caso traz como pontos para reflexão e debate sobre a força motriz e o elemento de sustentação da rede colaborativa da saúde pública e a importância deste arranjo de relação Sociedade-Estado. O caso é indicado para estudantes de administração pública, políticas públicas, governança colaborativa, gestão social e áreas e afins.

Uma proposta para preparação de pequenas e médias empresas brasileiras prestadoras de serviços ao setor de telecomunicações para implantação da metodologia Seis Sigma

The objective of this work consists of considering a script so that operating companies in the telecommunications sector, mainly small and medium-sized enterprises, can reach excellency in its operations and get, thus, conditions to compete with companies consolidated in its niche of market. The proposal intends to lead the enterprises to a level of qualification of processes that to become them apt to adopt the Six Sigma method as part of its culture. From the analysis of the essential processes of the sector, methods and tools will be suggested for guarantee the continuous improvement of these processes, without forgetting the internal peculiarities of each company

Modelagem aplicada à análise de desempenho do provedor de serviços de uma rede de automação hospitalar ieee 802.3/pm-ah de tempo real

The incorporate of industrial automation in the medical are requires mechanisms to safety and efficient establishment of communication between biomedical devices. One solution to this problem is the MP-HA (Multicycles Protocol to Hospital Automation) that down a segmented network by beds coordinated by an element called Service Provider. The goal of this work is to model this Service Provider and to do performance analysis of the activities executed by in establishment and maintenance of hospital networks