Coronary heart disease risk screening: the community pharmacy Healthy Heart Assessment Service

Objectives We examined the characteristics and CHD risks of people who accessed the free Healthy Heart Assessment (HHA) service operated by a large UK pharmacy chain from August 2004 to April 2006. Methods Associations between participants’ gender, age, and socioeconomics were explored in relation to calculated 10-year CHD risks by cross-tabulation of the data. Specific associations were tested by forming contingency tables and using Pearson chi-square (χ2). Results Data from 8,287 records were analysable; 5,377 were at low and 2,910 at moderate-to-high CHD risk. The likelihood of moderate-to-high risk for a male versus female participant was significantly higher with a relative risk ratio (RRR) 1.72 (P < 0.001). A higher percentage of those in socioeconomic categories ‘constrained by circumstances’ (RRR 1.15; P < 0.05) and ‘blue collar communities’ (RRR 1.13; P < 0.05) were assessed with moderate-to-high risk compared to those in ‘prospering suburbs’. Conclusions People from ‘hard-to-reach’ sectors of the population, men and people from less advantaged communities, accessed the HHA service and were more likely to return moderate-to-high CHD risk. Pharmacists prioritised provision of lifestyle information above the sale of a product. Our study supports the notion that pharmacies can serve as suitable environments for the delivery of similar screening services.

How is the language of medicines use review leaflets symbolising the service?

Introduction The medicines use review (MUR), a new community pharmacy ‘service’, was launched in England and Wales to improve patients’ knowledge and use of medicines through a private, patient–pharmacist appointment. After 18 months, only 30% of pharmacies are providing MURs; at an average of 120 per annum (maximum 400 allowed).1 One reason linked to low delivery is patient recruitment.2 Our aim was to examine how the MUR is symbolised and given meaning via printed patient information, and potential implications. Method The language of 10 MUR patient leaflets, including the NHS booklet,3 and leaflets from multiples and wholesalers was evaluated by discourse analysis. Results and Discussion Before experiencing MURs, patients conceivably ‘categorise’ relationships with pharmacists based on traditional interactions.4 Yet none of the leaflets explicitly describe the MUR as ‘new’ and presuppose patients would become involved in activities outside of their pre-existing relationship with pharmacists such as appointments, self-completion of charts, and pharmacy action plans. The MUR process is described inconsistently, with interchangeable use of formal (‘review meeting‘) and informal (‘friendly’) terminology, the latter presumably to portray an intended ‘negotiation model’ of interaction.5 Assumptions exist about attitudes (‘not understanding’; ‘problems’) that might lead patients to an appointment. However, research has identified a multitude of reasons why patients choose (or not) to consult practitioners,6 and marketing of MURs should also consider other barriers. For example, it may be prudent to remove time limits to avoid implying patients might not be listened to fully, during what is for them an additional practitioner consultation.

The business case development process in the delivery of NHS infrastructure

There is a lack of knowledge base in relation to experiences gained and lessons learnt from previously executed National Health Service (NHS) infrastructure projects in the UK. This is in part a feature of one-off construction projects, which typify healthcare infrastructure, and in part due to the absence of a suitable method for conveying such information. The complexity of infrastructure delivery process in the NHS makes the construction of healthcare buildings a formidable task. This is particularly the case for the NHS trusts who have little or no experience of construction projects. To facilitate understanding a most important aspect of the delivery process, which is the preparation of a capital investment proposal; steps taken in developing the business case for an NHS healthcare facility are examined. The context for such examination is provided by the planning process of a healthcare project, studied retrospectively. The process is analysed using a social science based method called ‘building stories’, developed at the University of California-Berkeley. By applying this method, stories or narratives are constructed around the data captured on the case study. The findings indicate that the business case process may be used to justify, rather than identify, trusts’ requirements. The study is useful for UK public sector clients as well as consultants and professionals who aim to participate in the delivery of healthcare infrastructure projects in the UK.

Achieving whole-life value: The challenges of service-led construction

Major construction clients are increasingly looking to procure built facilities on the basis of added value, rather than capital cost. Recent advances in the procurement of construction projects have emphasised a whole-life value approach to meeting the client’s objectives, with strategies put in place to encourage long-term commitment and through-life service provision. Construction firms are therefore increasingly required to take on responsibility for the operation and maintenance of the construction project on the client’s behalf - with the emphasis on value and service. This inevitably throws up a host of challenges, not the least of which is the need for construction firms to manage and accommodate the new emphasis on service. Indeed, these ‘service-led’ projects represent a new realm of construction projects where the rationale for the project is driven by client’s objectives with some aspect of service provision. This vision of downstream service delivery increases the number of stakeholders, adds to project complexity and challenges deeply-ingrained working practices. Ultimately it presents a major challenge for the construction sector. This paper sets out to unravel some of the many implications that this change brings with it. It draws upon ongoing research investigating how construction firms can adapt to a more service-orientated built environment and add value in project-based environments. The conclusions lay bare the challenges that firms face when trying to compete on the basis of added-value and service delivery. In particular, how it affects deeply-ingrained working practices and established relationships in the sector.

Nexus between contracting and construction professional service businesses: empirical evidence from international market

he construction market around the world has witnessed the growing eminence of construction professional services (CPSs), such as urban planning, architecture, engineering, and consultancy, while the traditional contracting sector remains strong. Nowadays, it is not uncommon to see a design firm taking over the work of a traditional main contractor, or vice versa, of overseeing the delivery of a project. Although the two sectors of contracting and CPS share the same purpose of materializing the built environment, they are as different as they are interrelated. Much has been mentioned about the nexus between the two but little has been done to articulate it using empirical evidence. This study examined the nexus between contracting and CPS businesses by offering and testing lead-lag effects between the two sectors in the international market. A longitudinal panel data composed of 23 top international contractors and CPS firms was adopted. Surprisingly, results of the panel data analyses show that CPS business does not have a significant positive causal effect on contracting as a downstream business, and vice versa. CPS and contracting subsidiaries, although within the same company, do not necessarily form a consortium to undertake the same project; rather, they often collaborate with other CPS or contracting counterparts to undertake projects. This paper provides valuable insights into the sophisticated nexus between contracting and CPS in the international construction market. It will support business executives’ rational decision making for selecting proper contracting or CPS allies, or a proper mergers and acquisitions strategy in the international market. The paper also provides a fresh perspective through which researchers can better investigate the diversification strategies adopted by international contracting and CPS firms.

Hierarchical clustering based web service discovery

This paper presents a hierarchical clustering method for semantic Web service discovery. This method aims to improve the accuracy and efficiency of the traditional service discovery using vector space model. The Web service is converted into a standard vector format through the Web service description document. With the help of WordNet, a semantic analysis is conducted to reduce the dimension of the term vector and to make semantic expansion to meet the user’s service request. The process and algorithm of hierarchical clustering based semantic Web service discovery is discussed. Validation is carried out on the dataset.

Delivery of crop pollination services is an insufficient argument for wild pollinator conservation

There is compelling evidence that more diverse ecosystems deliver greater benefits to people, and these ecosystem services have become a key argument for biodiversity conservation. However, it is unclear how much biodiversity is needed to deliver ecosystem services in a cost-effective way. Here we show that, while the contribution of wild bees to crop production is significant, service delivery is restricted to a limited subset of all known bee species. Across crops, years and biogeographical regions, crop-visiting wild bee communities are dominated by a small number of common species, and threatened species are rarely observed on crops. Dominant crop pollinators persist under agricultural expansion and many are easily enhanced by simple conservation measures, suggesting that cost-effective management strategies to promote crop pollination should target a different set of species than management strategies to promote threatened bees. Conserving the biological diversity of bees therefore requires more than just ecosystem-service-based arguments.

Dual semiosis analysis model managing customer-focused service innovation

Customers will not continue to pay for a service if it is perceived to be of poor quality, and/or of no value. With a paradigm shift towards business dependence on service orientated IS solutions [1], it is critical that alignment exists between service definition, delivery, and customer expectation, businesses are to ensure customer satisfaction. Services, and micro-service development, offer businesses a flexible structure for solution innovation, however, constant changes in technology, business and societal expectations means an iterative analysis solution is required to i) determine whether provider services adequately meet customer segment needs and expectations, and ii) to help guide business service innovation and development. In this paper, by incorporating multiple models, we propose a series of steps to help identify and prioritise service gaps. Moreover, the authors propose the Dual Semiosis Analysis Model, i.e. a tool that highlights where within the symbiotic customer / provider semiosis process, requirements misinterpretation, and/or service provision deficiencies occur. This paper offers the reader a powerful customer-centric tool, designed to help business managers highlight both what services are critical to customer quality perception, and where future innovation

The myGrid Notification Service

The notification service is the part of myGrid that enables asynchronous delivery of messages between distributed components. It includes features such as topic-based publish-subscribe messaging, push/pull models, asynchronous delivery, persistence, transient and durable subscriptions, durable topics, negotiation of QoS, hierarchical topic structure and federation of services. Some of these features are novel in the area of messaging middleware. A cost evaluation of some of these features indicate that the overhead incurred is justified in terms of compensating benefits gained.

Cozinha da Madeira website: the online touchpoint for a sustainability oriented service of Madeira Island

Over the past several years technology has been evolving in a way that it has become crucial for most businesses and companies to have interactive technology enabled touchpoints available online. Such interactive touchpoints can be developed as mobile application, webpages, or even through social networks. In the end such touchpoints will most surely represent the most easily reachable and marketable side of the business. Today selling a product alone is no longer enough to make consumers satisfied and complete, businesses and business models are changing. Increasingly, companies are choosing to not just sell products but to combine both sale and service. These service-based approaches will provide the client with a unique and personalized experience of what the company is selling. By selling a service the company transmits values that are more complex than the simple selling of a product. A service is something immaterial, happens over time and exists in the moment of the delivery. When conceiving and designing services, the use of the new technologies becomes a crucial step in order to craft touchpoints that facilitate the whole experience cycle of the service, from attracting, orienting, interacting and retaining the client, as well as providing later support to the consumer to advocate for the service itself. This thesis reports on the design and implementation of the online touchpoint of Cozinha da Madeira, which is a service designed to support tourism, specifically promoting the discovery of tradition and landscapes in the island of Madeira. Such touchpoint developed in the form of a website, embodies completely or partially various stages of the Service Experience cycle, from attracting and connecting, orienting, interacting as well as retaining and advocating. Through this thesis we will describe the design and implementation of such touchpoint as well as the evaluation and possible future implications.

Structural change and productivity growth, 20 years later: old problems, new opportunities

Includes bibliography

Business development service centres in Italy. An empirical analysis of three regional experiences: Emilia Romagna, Lombardia y Veneto

Includes bibliography

Web Service para geração de VRS no contexto de posicionamento GPS

Internet is fully inserted in contemporary society, specially in relation to entertainment services and trading. Its reach has transposed the traditional desktop computer models coming to mobile devices like cell phones and GPS receivers. Likewise, the scientific community takes its benefits, both for publication of studies and for communication between clusters processing information, such as at LHC, located in Switzerland. Concerning geodetic positioning, researches in the area present the concept of Virtual Reference Stations - VRS, in which is necessary a communication way between the real reference stations and a central system as well as between central system and a service requester. In this work, we analyze the current solutions for generation of VRS with regard to data delivery for the service requester and present a solution based on Web Services as an alternative to the model being developed by Spatial Geodesy Study Group – GEGE/FCT/UNESP. Comparing solutions, it was verified the potential of Web Services to aid in researches of geodetic positioning using VRS. Using such technology, it is obtained interoperability, providing greater flexibility to develop client applications, both development carried out by researchers of the university or by any person or enterprise wishing to use the service

Imaginative construction of care: the nursing professional experience in a remote care service

The direction of care delivery goes from the action to the being; a process built from professional experience, which gains special characteristics when the service is delivered by telephone. The goal of this research was to understand the interaction between professionals and users in a remote care service; to do so, a research is presented, using Grounded Theory and Symbolic Interactionism as theoretical references. Data were collected through eight interviews with professionals who deliver care by telephone. The theoretical understanding permitted the creation of the theoretical model of the Imaginative Construction of Care, which shows the interaction processes the professional experiences when delivering care by telephone. In this model, individual and social facts are added, showing the link between the concepts, with special emphasis on uncertainty, sensitivity and professional responsibility, as essential components of this experience.

Service Innovation: the state of the art and a proposal of a research agenda

The service sector has acquired a growing importance in every country economy, which has stimulated research in the field of service innovation, a new field in management studies. This text aimed to state a research agenda upon service innovation, based on an articulated discussion of the results of several articles that compose the state of the art of this concept. 73 empirical articles were analyzed, 33% of them exploring the innovation strategies and technology; 18% of the articles describe research on economic performance and enterprise productivity; 16% are related to antecedents and determinants of innovation; another 16% about network capacity development, alliances and collaboration among organizations; 9% of the articles explore service quality, innovation taxonomy, flexible systems and regional systems of innovation; and another 8% are related to themes such as intensive knowledge, research and development. The researches were concentrated in the Engineering & Technology and Hospitality Industries, which accounted for 31% and 24% of the texts, respectively. The remaining 45% of the articles referred to sectors such as Telecommunications, Health, Retail, Financial & Insurance and Public Services. The main gaps identified in these texts refer to the difficulties on measuring service innovation, besides the small number of researches on the public sector. At the end, a research agenda in the subject is presented, including the development of a scale for orientating the innovation and identifying the determining factors of the innovation in the public environment.