Center for Disease Control family planning services: annual summary.

Mode of access: Internet.

Annual report of the Division of Risk Assessment, National Center for Devices and Radiological Health /

Mode of access: Internet.

Guide to abstracting & indexing at the Technical Information Center /

"TID-4583."

Attaching unit costs to Australia's National Survey of Mental Health and Wellbeing

Background: In mental health, policy-makers and planners are increasingly being asked to set priorities. This means that health economists, health services researchers and clinical investigators are being called upon to work together to define and measure costs. Typically, these researchers take available service utilisation data and convert them to costs, using a range of assumptions. There are inefficiencies, as individual groups of researchers frequently repeat essentially similar exercises in achieving this end. There are clearly areas where shared or common investment in the development of statistical software syntax, analytical frameworks and other resources could maximise the use of data. Aims of the Study: This paper reports on an Australian project in which we calculated unit costs for mental health admissions and community encounters. In reporting on these calculations, our purpose is to make the data and the resources associated with them publicly available to researchers interested in conducting economic analyses, and allow them to copy, distribute and modify them, providing that all copies and modifications are available under the same terms and conditions (i.e., in accordance with the 'Copyleft' principle), Within this context, the objectives of the paper are to: (i) introduce the 'Copyleft' principle; (ii) provide an overview of the methodology we employed to derive the unit costs; (iii) present the unit costs themselves; and (iv) examine the total and mean costs for a range of single and comorbid conditions, as an example of the kind of question that the unit cost data can be used to address. Method: We took relevant data from the Australian National Survey of Mental Health and Wellbeing (NSMHWB), and developed a set of unit costs for inpatient and community encounters. We then examined total and mean costs for a range of single and comorbid conditions. Results: We present the unit costs for mental health admissions and mental health community contacts. Our example, which explored the association between comorbidity and total and mean costs, suggested that comorbidly occurring conditions cost more than conditions which occur on their own. Discussion: Our unit costs, and the materials associated with them, have been published in a freely available form governed by a provision termed 'Copyleft'. They provide a valuable resource for researchers wanting to explore economic questions in mental health. Implications for Health Policies: Our unit costs provide an important resource to inform economic debate in mental health in Australia, particularly in the area of priority-setting. In the past, such debate has largely, been based on opinion. Our unit costs provide the underpinning to strengthen the evidence-base of this debate. Implications for Further Research: We would encourage other Australian researchers to make use of our unit costs in order to foster comparability across studies. We would also encourage Australian and international researchers to adopt the 'Copyleft' principle in equivalent circumstances. Furthermore, we suggest that the provision of 'Copyleft'-contingent funding to support the development of enabling resources for researchers should be considered in the planning of future large-scale collaborative survey work, both in Australia and overseas.

Quality-of-life in children and adolescents with cystic fibrosis managed in both regional outreach and cystic fibrosis center settings in Queensland

To assess the health-related quality-of-life (HRQOL) of children/adolescents with cystic fibrosis (CF) and compare HRQOL in children managed by cystic fibrosis outreach service (CFOS) with those treated in a cystic fibrosis center (CFC). To compare HRQOL of children with CF in Queensland with previously published HRQOL data from the United States and examine the relationship between HRQOL scores and pulmonary function. Study design: Participants were children/adolescents with CF and their parents managed by the Royal Children’s Hospital Queensland at a CFC or CFOS. Two HRQOL surveys were used: PedsQL™ and Cystic Fibrosis Questionnaire (CFQ). Results: There were 91 CFC and 71 CFOS participants with similar demographics. PedsQL™ total summary score was statistically higher in CFOS, P = .05. There was no significant difference in CFQ scores between groups. Queensland parents reported lower HRQOL for their children compared with US parents (P

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.

Service quality of frontline employees:a profile deviation analysis

Using a configuration theory approach, this paper conducts a comparative study between frontline employees in phone and face-to-face service encounters for a retail bank. The study compares the top performers in service quality in relation to three components of organizational commitment and their demographics by applying a profile deviation analysis. The results show that the profile deviation for face-to-face employees is significantly negative, while for call center employees nonsignificant. Although the study finds no significant differences in the three components of commitment, significant differences exist in the total experience and age of the best performers. Also, affective commitment dominates the profile of high performers, while poor service providers seem to exhibit a higher level of continuance commitment. This study demonstrates the utility of profile deviation approaches in designing internal marketing strategies.

Reverse resource exchanges in service supply chains:the case of returnable transport packaging

Purpose: The purpose of this paper is to understand how reverse resource exchanges and resource dependencies are managed in the service supply chain (SSC) of returnable transport packaging (RTP). Design/methodology/approach: A single case study was conducted in the context of automotive logistics focusing on the RTP SSC. Data were collected through 16 interviews, primarily with managers of a logistics service provider (LSP) and document analysis of contractual agreements with key customers of the packaging service. Findings: Resource dependencies among actors in the SSC result from the importance of the RTP for the customer’s production processes, the competition among users for RTP and the negative implications of the temporary unavailability of RTP for customers and the LSP (in terms of service performance). Amongst other things, the LSP is dependent on its customers and third-party users (e.g. the customer’s suppliers) for the timely return of package resources. The role of inter-firm integration and collaboration, formal contracts as well as customers’ power and influence over third-party RTP users are stressed as key mechanisms for managing LSP’s resource dependencies. Research limitations/implications: A resource dependence theory (RDT) lens is used to analyse how reverse resource exchanges and associated resource dependencies in SSCs are managed, thus complementing the existing SSC literature emphasising the bi-directionality of resource flows. The study also extends the recent SSC literature stressing the role of contracting by empirically demonstrating how formal contracts can be mobilised to explicate resource dependencies and to specify, and regulate, reverse exchanges in the SSC. Practical implications: The research suggests that logistics providers can effectively manage their resource dependencies and regulate reverse exchanges in the SSC by deploying contractual governance mechanisms and leveraging their customers’ influence over third-party RTP users. Originality/value: The study is novel in its application of RDT, which enhances our understanding of the management of reverse exchanges and resource dependencies in SSCs.

Integrating service user and practitioner expertise within a web-based system for collaborative mental-health risk and safety management

Objectives: To develop a decision support system (DSS), myGRaCE, that integrates service user (SU) and practitioner expertise about mental health and associated risks of suicide, self-harm, harm to others, self-neglect, and vulnerability. The intention is to help SUs assess and manage their own mental health collaboratively with practitioners. Methods: An iterative process involving interviews, focus groups, and agile software development with 115 SUs, to elicit and implement myGRaCE requirements. Results: Findings highlight shared understanding of mental health risk between SUs and practitioners that can be integrated within a single model. However, important differences were revealed in SUs' preferred process of assessing risks and safety, which are reflected in the distinctive interface, navigation, tool functionality and language developed for myGRaCE. A challenge was how to provide flexible access without overwhelming and confusing users. Conclusion: The methods show that practitioner expertise can be reformulated in a format that simultaneously captures SU expertise, to provide a tool highly valued by SUs. A stepped process adds necessary structure to the assessment, each step with its own feedback and guidance. Practice Implications: The GRiST web-based DSS (www.egrist.org) links and integrates myGRaCE self-assessments with GRiST practitioner assessments for supporting collaborative and self-managed healthcare.

Mental health pharmacists views on shared decision-making for antipsychotics in serious mental illness

Background People diagnosed with serious mental illnesses (SMIs) such as schizophrenia and bipolar affective disorder are frequently treated with antipsychotics. National guidance advises the use of shared decision-making (SDM) in antipsychotic prescribing. There is currently little data on the opinions of health professionals on the role of SDM. Objective To explore the views and experiences of UK mental health pharmacists regarding the use of SDM in antipsychotic prescribing in people diagnosed with SMI. Setting The study was conducted by interviewing secondary care mental health pharmacists in the UK to obtain qualitative data. Methods Semi-structured interviews were recorded. An inductive thematic analysis was conducted using the method of constant comparison. Main outcome measure Themes evolving from mental health pharmacists on SDM in relation to antipsychotic prescribing in people with SMI. Results Thirteen mental health pharmacists were interviewed. SDM was perceived to be linked to positive clinical outcomes including adherence, service user satisfaction and improved therapeutic relations. Despite more prescribers and service users supporting SDM, it was not seen as being practised as widely as it could be; this was attributed to a number of barriers, most predominantly issues surrounding service user’s lacking capacity to engage in SDM and time pressures on clinical staff. The need for greater effort to work around the issues, engage service users and adopt a more inter-professional approach was conveyed. Conclusion The mental health pharmacists support SDM for antipsychotic prescribing, believing that it improves outcomes. However, barriers are seen to limit implementation. More research is needed into overcoming the barriers and measuring the benefits of SDM, along with exploring a more inter-professional approach to SDM.

Defining failure in the nonprofit organization: The case of four human service agencies

Private nonprofit human service organizations provide a spectrum of services that aim to resolve societal problems. Their failure may leave needed and desired services unprovided or not provided sufficiently to meet public demand. However, the concept of organizational failure has not been examined for the nonprofit organization. This research addresses the deficiency in the literatures of organization failure and nonprofit organizations.^ An eight category typology, developed from a review of the current literature and findings from expert interviews, is initially presented to define nonprofit organization failure. A multiple case study design is used to test the typology in four nonprofit human service delivery agencies. The case analysis reduces the typology to five types salient to nonprofit organization failure: input failure, legitimacy failure, adaptive failure, management failure and leadership failure.^ The resulting five category typology is useful to both theory builders and nonprofit practitioners. For theory development, the interaction of the failure types extends the literature and lays a foundation for a theory of nonprofit organization failure that diffuses management and leadership across all of the failure types, highlights management and leadership failure as collective functions shared by paid staff and the volunteer board of directors, and emphasizes the importance of organization legitimacy.^ From a practical perspective, the typology provides a tool for diagnosing failure in the nonprofit organization. Using the management indicators developed for the typology, a checklist of the warning signals of potential failure, emphasizing the key types of management and leadership, offers nonprofit decision makers a priori examination of an organization's propensity for failure. ^

Improving resource management in virtualized data centers using application performance models

The rapid growth of virtualized data centers and cloud hosting services is making the management of physical resources such as CPU, memory, and I/O bandwidth in data center servers increasingly important. Server management now involves dealing with multiple dissimilar applications with varying Service-Level-Agreements (SLAs) and multiple resource dimensions. The multiplicity and diversity of resources and applications are rendering administrative tasks more complex and challenging. This thesis aimed to develop a framework and techniques that would help substantially reduce data center management complexity.^ We specifically addressed two crucial data center operations. First, we precisely estimated capacity requirements of client virtual machines (VMs) while renting server space in cloud environment. Second, we proposed a systematic process to efficiently allocate physical resources to hosted VMs in a data center. To realize these dual objectives, accurately capturing the effects of resource allocations on application performance is vital. The benefits of accurate application performance modeling are multifold. Cloud users can size their VMs appropriately and pay only for the resources that they need; service providers can also offer a new charging model based on the VMs performance instead of their configured sizes. As a result, clients will pay exactly for the performance they are actually experiencing; on the other hand, administrators will be able to maximize their total revenue by utilizing application performance models and SLAs. ^ This thesis made the following contributions. First, we identified resource control parameters crucial for distributing physical resources and characterizing contention for virtualized applications in a shared hosting environment. Second, we explored several modeling techniques and confirmed the suitability of two machine learning tools, Artificial Neural Network and Support Vector Machine, to accurately model the performance of virtualized applications. Moreover, we suggested and evaluated modeling optimizations necessary to improve prediction accuracy when using these modeling tools. Third, we presented an approach to optimal VM sizing by employing the performance models we created. Finally, we proposed a revenue-driven resource allocation algorithm which maximizes the SLA-generated revenue for a data center.^

A Customer's Expectation and Perception of Hotel Service Quality in Cyprus

In recent years, hotels in Cyprus have encountered difficult economic times due to increasing customer demands and strong internal industry development competition. The hospitality industry’s main concern globally is to serve its customer S needs and desires, most of which are addressed through personal services. Hence, the hotel businesses that are able to provide quality services to its ever-demanding customers in a warm and efficient manner are those businesses which will be more likely to obtain a long term competitive advantage over their rivals. Ironically, the quality of services frequently cannot fully appreciated until something goes wrong, and then, the poor quality of services can have long lasting lingering effects on the customer base and, hence, often is translated into a loss of business. Nevertheless, since the issue of delivery of hospitality services always involves people, this issue must center around the management of the human resource factor, and in particular, on the way which interacts with itself and with guests, as service encounters. In the eyes of guests, hospitality businesses will be viewed successful or failure, depending on [he cumulative impact of the service encounters they have experienced on a personal level. Finally, since hotels are offering intangible and perishable personal service encounters, managing these services must be a paramount concern of any hotel business. As a preliminary exercise, visualize when you have last visited a hotel, or a restaurant, and then, ask yourself these questions: What did you feel about the quality of the experience? Was it a memorable one, which you would recommend it to others, or there were certain things, which could have made the difference? Thus, the way personalized services are provided can make the deference in attracting arid retaining long-term customers