Secondary Analysis of the 2003 Young Persons Behaviour and Attitudes Survey

(Drugs, Solvents and Alcohol)

Putting a health inequalities focus on the Northern Ireland cardiovascular service framework

The PHA, supported by the Institute of Public Health in Ireland (IPH) and other agencies and individuals, has completed a health impact assessment (HIA) on the Cardiovascular Service Framework (CVSFW) for Northern Ireland.The CVSFW is the first in a series of service frameworks developed in Northern Ireland to guide HSC provision from prevention and health improvement over early intervention in communities and general practice into hospital and other institutional settings towards rehabilitation, palliative care and end of life.The CVSFW is relevant to everyone who has a part in HSC services for health improvement, hypertension, hyperlipidaemia, diabetes, heart disease, cerebrovascular disease (stroke), peripheral vascular disease and renal disease. This includes patients, carers, families, communities, voluntary and statutory service providers, policy makers and researchers. There are many determinants which impact on cardiovascular disease. Individual lifestyles are major contributors and smoking remains one of the biggest risk factors for the disease alongside sedentary lifestyles and alcohol consumption. Circumstances experienced during the early years influence health and wellbeing into adulthood. Breastfeeding can help protect against obesity, while physical activity and eating habits developed from a young age often form lifelong patterns of behaviour. Living and working conditions also impact on health. Type of job, level of control and employment conditions are major factors. Educational achievement and income are also powerful influences on health. The environment where we live can provide access to open and green space, which plays an important part in physical activity patterns alongside available transport infrastructure. As well as physical health impacts, all of these factors also influence mental health and emotional wellbeing.

Lite4Life (Tier 2 adult weight management service)

This service Aims: To provide a multi-component weight management service that supports sustainable behaviour change and weight loss in adults 16 years and over with a BMI 28. To enable patients to develop the necessary personal attributes for their own long term weight management and to understand the impact of their weight on their health and co-morbidities. Objectives: To provide an evidence based, multi-component tier 2 weight management service that improves patients knowledge and skills for effective and sustainable weight loss helps patients identify their own facilitators for positive behaviour change and to address underlying barriers to long-term behaviour changeincreases patients self-efficacy and confidence in their ability to address their weight To be an integral part of the tiered approach to weight management services for the population of Stockton. To ensure equitable service provision across Stockton-on-Tees. To provide intensive group based service, one-to-one support and maintenance support. To support the service user to develop and review a personalised goal setting plan phase 2 and at discharge after phase 2. To ensure a smooth transition from the service (tier2) to tier 1 services to ensure continuity of care for service users.Recruit referrals using a variety of and appropriate methods. To establish a single point of contact for referrals into the service.Continually promote the service across a range of mediums and liaise and work in partnership with key interdependencies (refer to 2.4) To establish a robust database and data collection system in line with information governance. To ensure the access criteria, care pathway and referral process is clearly understood by all health care professionals and those who may refer into the service. To establish close links with, and signpost and/or enable service users to access suitable services where patient needs indicate this. This may include access to Tees Time to Talk (IAPT) for psychological therapies; Specialist Weight Management Service; physical activity programmes; Tier 1 services; and primary care. To provide the necessary venues, equipment and assets needed to deliver the programme, ensuring due regard is given to the quality and safety of all materials used. To collect and provide data in quarterly reports to the Commissioner to allow for continued monitoring and evaluation of the service in line with the Standard Evaluation Framework (available at www.noo.org.uk/core/SEF) and as specified by the Commissioner.

Health Trainers weight management service

The aim of the intervention is to offer tailored advice, motivation, and practical support to individuals who want to adopt a healthier lifestyle. The objectives are to support clients in setting goals and planning behaviour change

Behaviour of the pandemic H1N1 influenza virus in Andalusia, Spain, at the onset of the 2009-10 season.

In Andalusia, Spain, the pandemic influenza A(H1N1)v virus has spread throughout the community, being the dominant influenza strain in the season so far. The current objective of the Andalusia Health Service is focussed on the mitigation of the health and social impact by appropriate care of the patients at home or in health centres. The 2009-10 seasonal influenza epidemic started early compared with to previous seasons. This article analyses the influenza A(H1N1)v situation in Andalusia until the week 39/2009.

Qualitative and Hierarchical Analysis of Protective Factors against Illicit Use of Doping Substances in Athletes Calling a National Anti-Doping Phone-Help Service

Evidence of a sport-specific hierarchy of protective factors against doping would thus be a powerful aid in adapting information and prevention campaigns to target the characteristics of specific athlete groups, and especially those athletes most vulnerable for doping control. The contents of phone calls to a free and anonymous national anti-doping service called 'ecoute dopage' were analysed (192 bodybuilders, 124 cyclists and 44 footballers). The results showed that the protective factors that emerged from analysis could be categorised into two groups. The first comprised 'Health concerns', 'Respect for the law' and 'Doping controls from the environment' and the second comprised 'Doubts about the effectiveness of illicit products, 'Thinking skills' and 'Doubts about doctors'. The ranking of the factors for the cyclists differed from that of the other athletes. The ordering of factors was 1) respect for the law, 2) doping controls from the environment, 3) health concerns 4) doubts about doctors, and 5) doubts about the effectiveness illicit products. The results are analysed in terms of the ranking in each athlete group and the consequences on the athletes' experience and relationship to doping. Specific prevention campaigns are proposed to limit doping behaviour in general and for each sport.

Predicting overall service quality: a structural equation modelling approach

In this article, the results of a modified SERVQUAL questionnaire (Parasuraman et al., 1991) are reported. The modifications consisted in substituting questionnaire items particularly suited to a specific service (banking) and context (county of Girona, Spain) for the original rather general and abstract items. These modifications led to more interpretable factors which accounted for a higher percentage of item variance. The data were submitted to various structural equation models which made it possible to conclude that the questionnaire contains items with a high measurement quality with respect to five identified dimensions of service quality which differ from those specified by Parasuraman et al. And are specific to the banking service. The two dimensions relating to the behaviour of employees have the greatest predictive power on overall quality and satisfaction ratings, which enables managers to use a low-cost reduced version of the questionnaire to monitor quality on a regular basis. It was also found that satisfaction and overall quality were perfectly correlated thus showing that customers do not perceive these concepts as being distinct

Marketing culture of Finnish research libraries : an analysis of marketing attitude, knowledge and behaviour

The aim of the present dissertation is to investigate the marketing culture of research libraries in Finland and to understand the awareness of the knowledge base of library management concerning modern marketing theories and practices. The study was based onthe notion that a leader in an organisation can have large impact on its culture. Therefore, it was considered important to learn about the market orientation that initiates at the top management and flows throughout the whole organisationthus resulting in a particular kind of library culture. The study attempts to examine the marketing culture of libraries by analysing the marketing attitudes, knowledge (underlying beliefs, values and assumptions), behaviour (market orientation), operational policies and activities, and their service performance (customer satisfaction). The research was based on the assumption that if the top management of libraries has market oriented behaviour, then their marketing attitudes, knowledge, operational policies and activities and service performance should also be in accordance. The dissertation attempts to connect all these theoretical threads of marketing culture. It investigates thirty three academic and special libraries in the south of Finland. The library director and three to ten customers from each library participated as respondents in this study. An integrated methodological approach of qualitative as well as quantitative methods was used to gain knowledge on the pertinent issues lying behind the marketing culture of research libraries. The analysis of the whole dissertation reveals that the concept of marketing has very varied status in the Finnish research libraries. Based on the entire findings, three kinds of marketing cultures were emerged: the strong- the high fliers; the medium- the brisk runners; and the weak- the slow walkers. The high fliers appeared to be modern marketing believers as their marketing approach was customer oriented and found to be closer to the emerging notions of contemporary relational marketing. The brisk runners were found to be traditional marketing advocates as their marketing approach is more `library centred¿than customer defined and thus is in line of `product orientation¿ i.e. traditional marketing. `Let the interested customers come to the library¿ was appeared to be the hallmark of the slow walkers. Application of conscious market orientation is not reflected in the library activities of the slow walkers. Instead their values, ideology and approach to serving the library customers is more in tuneof `usual service oriented Finnish way¿. The implication of the research is that it pays to be market oriented which results in higher customer satisfaction oflibraries. Moreover, it is emphasised that the traditional user based service philosophy of Finnish research libraries should not be abandoned but it needs to be further developed by building a relational based marketing system which will help the libraries to become more efficient and effective from the customers¿ viewpoint. The contribution of the dissertation lies in the framework showing the linkages between the critical components of the marketing culture of a library: antecedents, market orientation, facilitators and consequences. The dissertationdelineates the significant underlying dimensions of market-oriented behaviour of libraries which are namely customer philosophy, inter-functional coordination,strategic orientation, responsiveness, pricing orientation and competition orientation. The dissertation also showed the extent to which marketing attitudes, behaviour, knowledge were related and impact of market orientation on the serviceperformance of libraries. A strong positive association was found to exist between market orientation and marketing attitudes and knowledge. Moreover, it also shows that a higher market orientation is positively connected with the service performance of libraries, the ultimate result being higher customer satisfaction. The analysis shows that a genuine marketing culture represents a synthesis of certain marketing attitudes, knowledge and of selective practices. This finding is particularly significant in the sense that it manifests that marketing culture consists of a certain sets of beliefs and knowledge (which form a specific attitude towards marketing) and implementation of a certain set of activities that actually materialize the attitude of marketing into practice (market orientation) leading to superior service performance of libraries.

The effects of the service process on satisfaction, trust and value as creators of customer loyalty in a daily deals concept

This study aims at applying the customer behaviour studies of satisfaction, trust, perceived value and loyalty to a daily deals concept. The goal is to find out whether the relationships are the same in this specific context when compared to previous e-commerce studies. The study examines how the daily deals service process affects customer satisfaction, trust and value, and how these in turn impact customer loyalty and each other. The data was collected via e-mail survey from case company customers, and research was conducted on a quantitative basis by using multivariate methods as tools. The results suggest that daily deals service process and service quality do have a direct and positive effect on customer satisfac-tion, trust and value. Additionally, positive correlations between the latter variables and customer loyalty were found. The results imply that the daily deals concept does not differ from other e-services when considering the studied factors. The results also emphasize the importance of recognizing what determinants have the greatest impact on customer loyalty in this specific context.

Organisational purchasing of service design – Agency and client perspectives

There has been an increase in the interest in service design, as companies have become more customer-centric and their focus has shifted to customer experiences. The actual organisational purchasing of service design has been given little attention, until recent years. The purpose of this study is to explore the purchasing of service design from the perspectives of sellers (service design agencies) and buying clients (business organisations). In order to understand the phenomenon, also agencies and clients’ approaches to service design discipline, purchasing processes, challenges related to purchasing and ways of facilitating the purchasing are explored. The research follows qualitative research method and utilises abductive reasoning. A proposition framework was formed by combining services marketing, design and organisational buying behaviour literatures, and was tested against real-life business cases. Empirical data was gathered by interviewing eight service design agency representatives and five client representatives in Finland. The results of semi-structural interviews were analysed by finding repetitive themes. The proposition framework was updated according to interview findings. There were both similarities and differences in service design agencies and clients’ approaches to service design. Service design represents a strategic activity to both parties, and it helps in clients’ business development and in discovering opportunities. It is an ideology; a way of thinking and working. The driving force for purchasing service design seemed to be something else than service design itself. Projects have been bought for 1) change and innovation related development, 2) channel related development or for 3) customer experience related development. Seven purchasing challenge themes were recognised: 1) poor or differing service design understanding, 2) selling of service design, 3) varying expectations, 4) difficulty of pre-evaluation, 5) buyers and buying companies, 6) project process and nature and 7) unclear project results. These all can be considered to cause challenges in organisational service design purchasing. Challenges can be caused by either participant, the agency or the client, and take place at any point of the purchasing process. Some of the challenges could be considered as barriers to purchasing or they play a role in an unsuccessful service project – and therefore, result in an unsuccessful organisational purchase. Purchasing could be facilitated in various ways by either participant; some ways are more attitude based, others actionable improvements. Thesis’s theoretical and managerial findings can be utilised to both improve the selling and purchasing of service design services.

The practical application of a meta-analysis of deinstitutionalization : adaptive behaviour outcomes and the piloting of a transitional questionnaire for adults with intellectual disabilities

This investigation examined the effects of de institutionalization on the adaptive behaviour and adjustment of adults with intellectual disabilities (ID). In study 1, a meta-analysis was conducted with 23 studies on deinstitutionalization adaptive behaviour outcomes. Deinstitutionalization was associated with modest improvements in adaptive behaviour however outcomes varied across adaptive behaviour domains and other substantive variables. Clinical and service implications of these results were explicated. Noting the trends from the meta-analysis, study 2 used this information in refining and piloting an Agency Transition Survey used to evaluate community transitions for persons with ID. Information derived from the survey was found to be valuable and adequate for the effective evaluation of transitional success. Potential applications of the survey and meta-analysis results were illustrated.

Service provider switching: a study on the switching process in retail banking

In a business environment that is characterized by intense competition, building customer loyalty has become a key area of focus for most financial institutions. The explosion of the services sector, changing customer demographics and deregulation and emergence of new technology in the financial services industry have had a critical impact on consumers’ financial services buying behaviour. The changes have forced banks to modify their service offerings to customers so as to ensure high levels of customer satisfaction and also high levels of customer retention. Banks have historically had difficulty distinguishing their products from one another because of their relative homogeneity; with increasing competition,the problem has only intensified with no coherent distinguishing theme. Rising wealth, product proliferation, regulatory changes and newer technologies are together making bank switching easier for customers. In order to remain competitive, it is important for banks to retain their customer base. The financial services sector is the foundation for any economy and plays the role of mobilization of resources and their allocation. The retail banking sector in India has emerged as one of the major drivers of the overall banking industry and has witnessed enormous growth. Switching behaviour has a negative impact on the banks’ market share and profitability as the costs of acquiring customers are much higher than the costs of retaining. When customers switch, the business loses the potential for additional profits from the customer the initial costs invested in the customer by the business get . The Objective of the thesis was to examine the relationship among triggers that customers experience, their perceptions of service quality, consumers’ commitment and behavioral intentions in the contemporary India retail banking context through the eyes of the customer. To understand customers’ perception of these aspects, data were collected from retail banking customers alone for the purpose of analysis, though the banks’ views were considered during the qualitative work carried out prior to the main study. No respondent who is an employee of a banking organization was considered for the final study to avoid the possibility of any bias that could affect the results adversely. The data for the study were collected from customers who have switched banks and from those who were non switchers. The study attempted to develop and validate a multidimensional construct of service quality for retail banking from the consumer’s perspective. A major conclusion from the empirical research was the confirmation of the multidimensional construct for perceived service quality in the banking context. Switching can be viewed as an optimization problem for customers; customers review the potential gains of switching to another service provider against the costs of leaving the service provider. As banks do not provide tangible products, their service quality is usually assessed through service provider’s relationship with customers. Thus, banks should pay attention towards their employees’ skills and knowledge; assessing customers’ needs and offering fast and efficient services.

Context as a Service

In the vision of Mark Weiser on ubiquitous computing, computers are disappearing from the focus of the users and are seamlessly interacting with other computers and users in order to provide information and services. This shift of computers away from direct computer interaction requires another way of applications to interact without bothering the user. Context is the information which can be used to characterize the situation of persons, locations, or other objects relevant for the applications. Context-aware applications are capable of monitoring and exploiting knowledge about external operating conditions. These applications can adapt their behaviour based on the retrieved information and thus to replace (at least a certain amount) the missing user interactions. Context awareness can be assumed to be an important ingredient for applications in ubiquitous computing environments. However, context management in ubiquitous computing environments must reflect the specific characteristics of these environments, for example distribution, mobility, resource-constrained devices, and heterogeneity of context sources. Modern mobile devices are equipped with fast processors, sufficient memory, and with several sensors, like Global Positioning System (GPS) sensor, light sensor, or accelerometer. Since many applications in ubiquitous computing environments can exploit context information for enhancing their service to the user, these devices are highly useful for context-aware applications in ubiquitous computing environments. Additionally, context reasoners and external context providers can be incorporated. It is possible that several context sensors, reasoners and context providers offer the same type of information. However, the information providers can differ in quality levels (e.g. accuracy), representations (e.g. position represented in coordinates and as an address) of the offered information, and costs (like battery consumption) for providing the information. In order to simplify the development of context-aware applications, the developers should be able to transparently access context information without bothering with underlying context accessing techniques and distribution aspects. They should rather be able to express which kind of information they require, which quality criteria this information should fulfil, and how much the provision of this information should cost (not only monetary cost but also energy or performance usage). For this purpose, application developers as well as developers of context providers need a common language and vocabulary to specify which information they require respectively they provide. These descriptions respectively criteria have to be matched. For a matching of these descriptions, it is likely that a transformation of the provided information is needed to fulfil the criteria of the context-aware application. As it is possible that more than one provider fulfils the criteria, a selection process is required. In this process the system has to trade off the provided quality of context and required costs of the context provider against the quality of context requested by the context consumer. This selection allows to turn on context sources only if required. Explicitly selecting context services and thereby dynamically activating and deactivating the local context provider has the advantage that also the resource consumption is reduced as especially unused context sensors are deactivated. One promising solution is a middleware providing appropriate support in consideration of the principles of service-oriented computing like loose coupling, abstraction, reusability, or discoverability of context providers. This allows us to abstract context sensors, context reasoners and also external context providers as context services. In this thesis we present our solution consisting of a context model and ontology, a context offer and query language, a comprehensive matching and mediation process and a selection service. Especially the matching and mediation process and the selection service differ from the existing works. The matching and mediation process allows an autonomous establishment of mediation processes in order to transfer information from an offered representation into a requested representation. In difference to other approaches, the selection service selects not only a service for a service request, it rather selects a set of services in order to fulfil all requests which also facilitates the sharing of services. The approach is extensively reviewed regarding the different requirements and a set of demonstrators shows its usability in real-world scenarios.

Predicting overall service quality: a structural equation modelling approach

In this article, the results of a modified SERVQUAL questionnaire (Parasuraman et al., 1991) are reported. The modifications consisted in substituting questionnaire items particularly suited to a specific service (banking) and context (county of Girona, Spain) for the original rather general and abstract items. These modifications led to more interpretable factors which accounted for a higher percentage of item variance. The data were submitted to various structural equation models which made it possible to conclude that the questionnaire contains items with a high measurement quality with respect to five identified dimensions of service quality which differ from those specified by Parasuraman et al. And are specific to the banking service. The two dimensions relating to the behaviour of employees have the greatest predictive power on overall quality and satisfaction ratings, which enables managers to use a low-cost reduced version of the questionnaire to monitor quality on a regular basis. It was also found that satisfaction and overall quality were perfectly correlated thus showing that customers do not perceive these concepts as being distinct