Retail training service; a vocational training for retail salespeople,

Each volume has general t.-p. and special cover-title.

The U.S. Office of Personnel Management in retrospect : achievements and challenges after two decades : a report to the President and the Congress of the United States /

"December 2001."

Evaluating a GP consultative psychiatric service in an Australian metropolitan hospital district

Objective: The aim was to develop a psychiatric assessment and advisory service for local general practitioners (GPs). Method: In July 2001, five full-time psychiatrists at Royal Brisbane ­Hospital each dedicated a 1-h appointment per week in their hospital private practice clinic to assess patients referred by local GPs. The 'Psych Opinion' clinic was advertised through the Division of General Practice Newsletter. After 12 months, the referrals to the clinic had been disappointing so two surveys were carried out: one to the GPs who had used the service and the other to those who had not referred. Results: Feedback from the GPs who had used the service showed a high level of satisfaction with the service. The second survey of the GPs who had not referred showed a strong endorsement of the concept but there was poor awareness of the service's existence. Conclusions: This model offers a way for public sector psychiatrists to provide timely assessments to local GPs without additional funding. There is strong support and willingness from the GPs to refer. However, the need to actively market the service both initially and on an ongoing basis is ­highlighted.

Serious lead poisoning in childhood: Still a problem after a century

Objective: To describe a series of patients with clinically significant lead poisoning. Methodology: A case series of nine patients with lead poisoning who required inpatient management, identified through a Clinical Toxicology Service. Results: Nine children presented with clinically significant lead poisoning. The median serum lead was 2.5 mumol/L (range 1.38-4.83). Eight of the children were exposed to lead-based paint, with seven due to dust from sanded lead paint during house renovations. Serial blood determinations suggested re-exposure in four of the patients, and in one of these patients the re-exposure was from a different source of lead. Eight of the patients required chelation therapy. Conclusions: Serious lead poisoning continues to occur and there appears to be complacency regarding the hazard posed by lead paint in old houses.

Automatic message handling for a national counselling service

An automatic email handling system (AutoRouter) was introduced at a national counselling service in Australia. In 2003, counsellors responded to a total of 7421 email messages. Over nine days in early May 2004 the administrator responsible for the management of the manual email counselling service recorded the time spent on managing email messages. The AutoRouter was then introduced. Since the implementation of the AutoRouter the administrator's management role has become redundant, an average of 12 h 5 min per week of staff time has been saved. There have been further savings in supervisor time. Counsellors were taking an average of 6.2 days to respond to email messages (n=4307), with an average delay of 1.2 days from the time counsellors wrote the email to when the email was sent. Thus the response was sent on average 7.4 days after receipt of the original client email message. A significant decrease in response time has been noted since implementation of the AutoRouter, with client responses now taking an average of 5.4 days, a decrease of 2.0 days. Automatic message handling appears to be a promising method of managing the administration of a steadily increasing email counselling service.

Rehabilitation after total knee replacement via low-bandwidth telemedicine: the patient and therapist experience

After a total knee replacement, inadequate rehabilitation is associated with poor physical outcomes and a reduced longevity of the knee prosthesis. We have developed a low-bandwidth telemedicine system to enable rehabilitation services to be delivered directly to the home of patients in rural and remote areas. We have examined the experience of clinical physiotherapists and of 31 participants who received treatment via the system. High levels of satisfaction were reported by participants (mean responses >7 on a 10 cm visual analogue scale). The service was found to be effective, safe and easy to use, and it integrated well into current clinical practice. The study demonstrates the potential for delivering physiotherapy services via low-bandwidth Internet connections.

A cost-effectiveness analysis of fluvastatin in patients with diabetes after successful percutaneous coronary intervention

Background: The Lescol Intervention Prevention Study (LIPS) was a multinational randomized controlled trial that showed a 47% reduction in the relative risk of cardiac death and a 22% reduction in major adverse cardiac events (MACEs) from the routine use of fluvastatin, compared with controls, in patients undergoing percutaneous coronary intervention (PCI, defined as angioplasty with or without stents). In this study, MACEs included cardiac death, nonfatal myocardial infarction, and subsequent PCI and coronary artery bypass graft. Diabetes was the greatest risk factor for MACEs. Objective: This study estimated the cost-effectiveness of fluvastatin when used for secondary prevention of MACEs after PCI in people with diabetes. Methods: A post hoc subgroup analysis of patients with diabetes from the LIPS was used to estimate the effectiveness of fluvastatin in reducing myocardial infarction, revascularization, and cardiac death. A probabilistic Markov model was developed using United Kingdom resource and cost data to estimate the additional costs and quality-adjusted life-years (QALYs) gained over 10 years from the perspective of the British National Health Service. The model contained 6 health states, and the transition probabilities were derived from the LIPS data. Crossover from fluvastatin to other lipid-lowering drugs, withdrawal from fluvastatin, and the use of lipid-lowering drugs in the control group were included. Results: In the subgroup of 202 patients with diabetes in the LIPS trial, 18 (15.0%) of 120 fluvastatin patients and 21 (25.6%) of 82 control participants were insulin dependent (P = NS). Compared with the control group, patients treated with fluvastatin can expect to gain an additional mean (SD) of 0.196 (0.139) QALY per patient over 10 years (P < 0.001) and will cost the health service an additional mean (SD) of 10 (E448) (P = NS) (mean [SD] US $16 [$689]). The additional cost per QALY gained was;(51 (US $78). The key determinants of cost-effectiveness included the probabilities of repeat interventions, cardiac death, the cost of fluvastatin, and the time horizon used for the evaluation. Conclusion: Fluvastatin was an economically efficient treatment to prevent MACEs in these patients with diabetes undergoing PCI.

Understanding service experience in non-profit performing arts: Implications for operations and service management

Recent research in the non-profit performing arts has shown that marketing efforts designed to increase revenue from ticket sales are not achieving the results required to sustain the performing arts. This paper applies operations management analytical techniques to the non-profit performing arts to increase understanding of operational issues and inform service management strategy. The paper takes a two-study idiographic approach. Implementing a modified version of service transaction analysis (STA), Study One describes a performing arts service from provider and customer perspectives, identifies service gaps and develops an elaborated service description incorporating both perspectives. In Study Two, building on the elaborated service description and extant research, in-depth interviews are conducted to gather thick descriptions of predictors of satisfaction, value and service quality as they relate to repurchase intention (RI). Technical, functional and critical factors required to improve organizational performance are identified. Implications for operational strategy, service design and service management theory for this context are discussed. (c) 2005 Published by Elsevier B.V.

An online community of practice for pre-service and beginning teachers of secondary mathematics

The aim of this study was to investigate how a community of practice focused on learning to teach secondary mathematics was created and sustained by pre-service and beginning teachers. Bulletin board discussions of one pre-service cohort are analysed in terms of Wenger’s (1998) three defining features of a community of practice: mutual engagement, joint enterprise, and a shared repertoire. The study shows that the emergent design of the community contributed to its sustainability in allowing the pre-service teachers to define their own professional goals and values. Sustainability was also related to how the participants expanded, transformed, and maintained the community during the pre-service program and after graduation.

A model of service performance enhancement:the role of transactional and transformational leadership

This paper is concerned with the ways in which transactional and transformational leadership styles can improve the service performance of front-line staff. Past literature on services marketing has indicated the importance of leadership but has largely ignored the parallel literature in which leadership styles have been conceptualized and operationalized (e.g., sales management, organizational psychology). This paper seeks to build upon existing services marketing theory by introducing the role of leadership styles in enhancing service performance. Consequently, a conceptual framework of the effect of transactional and transformational leadership styles on service performance, anchored in a crossdisciplinary literature review, is developed. Managerial implications and future research directions are also discussed.

Enhancing service performance through transformational and transactional leadership styles

This paper is concerned with the effects that leadership styles can have upon service performance of front-line staff. Past literature on services marketing has indicated the importance of leadership but has largely ignored the parallel literature in which leadership styles have been conceptualized and operationalized (e.g., sales management, organizational psychology). Consequently, this paper develops a conceptual framework of the effect of leadership styles on service performance anchored in a cross-disciplinary literature review. Specific hypotheses are proposed and future research directions are presented.

Determining inventory service support levels in multi-national companies

Multi-national manufacturing companies are often faced with very difficult decisions regarding where and how to cost effectively manufacture products in a global setting. Clearly, they must utilize efficient and responsive manufacturing strategies to reach low cost solutions, but they must also consider the impact of manufacturing and transportation solutions upon their ability to support sales. One important sales consideration is determining how much work in process, in-transit stock, and finished goods to have on hand to support sales at a desired service level. This paper addresses this important consideration through a comprehensive scenario-based simulation approach, including sensitivity analysis on key study parameters. Results indicate that the inventory needs vary considerably for different manufacturing and delivery methods in ways that may not be obvious when using common evaluative tools.

Au service du marechal?:French documentary under German occupation

Following the fall of France in June 1940 and the installation of the Vichy Regime, government set about establishing its own New Order. A reprogramming of national consciousness was attempted through an emphasis on a return to traditional values which was disseminated in various fora. Despite publications on divers aspects of Vichy's propaganda machine, work on film production of the period has merely touched on mainstream documentary without further analysis. Such a lacuna appears inexplicable in light of the production of 550 or so documentaries between 1940 and 1944, especially in view of a 1948 comment by the film writer Roger Régent that documentary in many ways provided a focal point for the regime's wishes for "moralisation collective". This thesis sets out the first steps of a new evaluation of the role of documentary during the Occupation. After an overview of the changes to the industry and the ideological framework of the Révolution nationale, the thesis discusses theories of propaganda together with direct examples of Vichy propaganda documentary. The 'control' thus established is then applied to an examination of the 'Arts, Sciences, Voyages' series of documentary screenings (1941-43) and the Premier congrès du film documentaire (1943), tracing thematic and ideological consonances and evaluating the use of documentary film of the Occupation in the Service of the Marshal.

Third sector organisations and social welfare : a study of the role of social service and charitable organisations in Taiwan

This study is about the role and operation of ‘third sector’ organisations (TSOs) within the Taiwanese social welfare context. TSOs have increased dramatically and become actively involved in social service provision. This phenomenon has not only had significant impact on the development and operation of TSOs in Taiwan but it is also of increasing interest to public policy academics. The latter are especially interested in the implications for the government-third sector relationship. This research examines the reasons why TSOs have been established, why they actively participate in social service provision, and their role and operation within the social welfare context of Taiwan. The study has both quantitative and qualitative data. It sampled ‘social service’ and ‘charitable’ organisations (SSCOs), which are the main type of TSOs in Taiwan, to examine their role, operation and interaction with government. Questionnaires were mailed to collect quantitative data first. After the quantitative data were collected and analysed, semi-structured interviews were undertaken to collect qualitative data. The study found that TSOs in Taiwan exist in a highly institutionalised environment, which is affected by traditional Confucian ideas and contemporary Western ideas such as social justice and civil rights. The rapid growth of TSOs has a strong connection with the desire to fill social service gaps left by government and family. TSOs mainly play the role of service provider rather than that of advocate. They cooperate with government in social service provision and have developed different types of symbiotic relationships with government. A ‘resonance effect’ between government and TSOs was also found as they implement social policy.

Proliferative diabetic retinopathy (R3) referrals from the digital diabetic retinopathy screening program:urgency of appointment in the hospital eye service achieved and needed?

DESIGN. Retrospective analysis PURPOSE. To assess the clinical characteristics and outcomes of patients identified with proliferative diabetic retinopathy (PDR) referred from the screening program to the hospital eye services (HES) METHODS. a retrospective analysis of urgently referred PDR cases to Birmingham Heartlands HES from august 2008 until July 2010 RESULTS. 130 urgent diabetic retinopathy referrals were made and reviewed. 103 (68% male, 80% type 2 diabetes) were referred for PDR with a mean age of 59 years, mean diabetes duration of 17.8years. 69% were on insulin treatment at the time of the screening, with mean HbA1c of 10.4% (range-5.7 to 16.5%). 65% of the patients were offered appointments at HES within two weeks after referral from the screening. 50.5% of the patients were seen in the HES within 2 weeks, 22 and 16 % were seen 2-4 and 4-8 weeks after referral respectively. 6 patients never attended ophthalmology examination during the two years of review. Of all the attendees, 56% were booked for pan retinal photocoagulation (PRP) & 9(9.3%) for macular laser respectively on their 1st HES visit. 75% of the patients were newly diagnosed PDR and 26 had previous PRP laser but lost to follow up. 63 patients ( 66%) received either PRP or macular laser treatment (85.7% of which is PRP). 63% of the PRP treatment was performed within a month of first HES attendance. Retinopathy grading discrepancy between the screening program and HES was noted in 20% (21 patients). CONCLUSIONS. This data suggests that the digital screening programme is appropriately identifying high risk patients with PDR with timely PRP laser treatment in the majority of patients but raises concern over patients lost to follow up (hence failsafe tracking of appointment attendance), and review of grading discrepancies between the ophthalmology and screening service.