Factors influencing sustainability of health service innovation, emergency nurse practitioner service

Escalating health care delivery costs and consumer expectations have led to a range of health service and workforce innovations in the provision of high quality cost effective patient care. This research has operationalised a theoretical framework to examine factors that influence sustainability of health service innovations, in particular, emergency nurse practitioner service. The results of this research will inform health service policy and practice for future implementation of innovative workforce models and add to the understanding of factors that influence sustainability.

Clustering Users of Online Content Service

Online content services can greatly benefit from personalisation features that enable delivery of content that is suited to each user's specific interests. This thesis presents a system that applies text analysis and user modeling techniques in an online news service for the purpose of personalisation and user interest analysis. The system creates a detailed thematic profile for each content item and observes user's actions towards content items to learn user's preferences. A handcrafted taxonomy of concepts, or ontology, is used in profile formation to extract relevant concepts from the text. User preference learning is automatic and there is no need for explicit preference settings or ratings from the user. Learned user profiles are segmented into interest groups using clustering techniques with the objective of providing a source of information for the service provider. Some theoretical background for chosen techniques is presented while the main focus is in finding practical solutions to some of the current information needs, which are not optimally served with traditional techniques.

Dental Service Utilization, Dental Health Production and Equity in Dental Care: the Finnish Experience

This thesis is grounded on four articles. Article I generally examines the factors affecting dental service utilization. Article II studies the factors associated with sector-specific utilization among young adults entitled to age-based subsidized dental care. Article III explores the determinants of dental ill-health as measured by the occurrence of caries and the relationship between dental ill-health and dental care use. Article IV measures and explains income-related inequality in utilization. Data employed were from the 1996 Finnish Health Care Survey (I, II, IV) and the 1997 follow-up study included in the longitudinal study of the Northern Finland 1966 Birth Cohort (III). Utilization is considered as a multi-stage decision-making process and measured as the number of visits to the dentist. Modified count data models and concentration and horizontal equity indices were applied. Dentist s recall appeared very efficient at stimulating individuals to seek care. Dental pain, recall, and the low number of missing teeth positively affected utilization. Public subvention for dental care did not seem to statistically increase utilization. Among young adults, a perception of insufficient public service availability and recall were positively associated with the choice of a private dentist, whereas income and dentist density were positively associated with the number of visits to private dentists. Among cohort females, factors increasing caries were body mass index and intake of alcohol, sugar, and soft drinks and those reducing caries were birth weight and adolescent school achievement. Among cohort males, caries was positively related to the metropolitan residence and negatively related to healthy diet and education. Smoking increased caries, whereas regular teeth brushing, regular dental attendance and dental care use decreased caries. We found equity in young adults utilization but pro-rich inequity in the total number of visits to all dentists and in the probability of visiting a dentist for the whole sample. We observed inequity in the total number of visits to the dentist and in the probability of visiting a dentist, being pro-poor for public care but pro-rich for private care. The findings suggest that to enhance equal access to and use of dental care across population and income groups, attention should focus on supply factors and incentives to encourage people to contact dentists more often. Lowering co-payments and service fees and improving public availability would likely increase service use in both sectors. To attain favorable oral health, appropriate policies aimed at improving dental health education and reducing the detrimental effects of common risk factors on dental health should be strengthened. Providing equal access with respect to need for all people ought to take account of the segmentation of the service system, with its two parallel delivery systems and different supplier incentives to patients and dentists.

See you in class: Promoting a quality program for pre-service educators in regional locations through a virtual classroom

The quality of an online university degree is paramount to the student, the reputation of the university and most importantly, the profession that will be entered. At the School of Education within Curtin University, we aim to ensure that students within rural and remote areas are provided with high quality degrees equal to their city counterparts who access face-to-face classes on campus.In 2010, the School of Education moved to flexible delivery of a fully online Bachelor of Education degree for their rural students. In previous years, the degree had been delivered in physical locations around the state. Although this served the purpose for the time, it restricted the degree to only those rural students who were able to access the physical campus. The new model in 2010 allows access for students in any rural area who have a computer and an internet connection, regardless of their geographical location. As a result enrolments have seen a positive increase in new students. Academic staff had previously used an asynchronous environment to deliver learning modules housed within a learning management system (LMS). To enhance the learning environment and to provide high quality learning experiences to students learning at a distance, the adoption of synchronous software was introduced. This software is a real-time virtual classroom environment that allows for communication through Voice over Internet Protocol (VoIP) and videoconferencing, along with a large number of collaboration tools to engage learners. This research paper reports on the professional development of academic staff to integrate a live e-learning solution into their current LMS environment. It involved professional development, including technical orientation for teaching staff and course participants simultaneously. Further, pedagogical innovations were offered to engage the students in a collaborative learning environment. Data were collected from academic staff through semi-structured interviews and participant observation. The findings discuss the perceived value of the technology, problems encountered and solutions sought.

Mask or mirrors? The emergence of consumer rights in nonprofit human service organisations

This paper reports on a study of 25 nonprofit human service organisations offering four types of human services. The purpose of the study was first to explore the manner in which consumer rights are both conceptualized and operationalized in the nonprofit human service context. Secondly the study explored whether differences occur between organisations whose primary funding body emphasized the importance of a rights framework in its program delivery and those where this is not the case.

Many disciplines-common approach: Experiences in the development and delivery of an interprofessional health subject

In 2004, the Faculty of Health Sciences at La Trobe University in Victoria, Australia, introduced a new, final-year subject ‘Interdisciplinary Professional Practice’. The subject is taught to all students enrolled in the 11 allied health and human service disciplines at La Trobe University across metropolitan and rural campuses. The delivery is online to overcome timetabling barriers and to provide time and geographic flexibility. The subject is presented using an enquiry-based learning model. Students are exposed to the concepts of interdisciplinary teamwork through shared learning across professional boundaries to enable a collaborative workforce. An outline of the background development and design of this subject, and its implementation and content areas is presented. A discussion of relevant literature and an analysis of the subject evaluations and focus groups that have guided subject development to enhance student learning over eight cohorts is included.

Pickup and delivery problem using metaheuristics techniques

Dial-a-ride problem (DARP) is an optimization problem which deals with the minimization of the cost of the provided service where the customers are provided a door-to-door service based on their requests. This optimization model presented in earlier studies, is considered in this study. Due to the non-linear nature of the objective function the traditional optimization methods are plagued with the problem of converging to a local minima. To overcome this pitfall we use metaheuristics namely Simulated Annealing (SA), Particle Swarm Optimization (PSO), Genetic Algorithm (GA) and Artificial Immune System (AIS). From the results obtained, we conclude that Artificial Immune System method effectively tackles this optimization problem by providing us with optimal solutions. Crown Copyright (C) 2011 Published by Elsevier Ltd. All rights reserved.

Radio-aware service-level scheduling to minimize downlink traffic delay through Mobile Edge Computing

One of the most challenging problems in mobile broadband networks is how to assign the available radio resources among the different mobile users. Traditionally, research proposals are either speci c to some type of traffic or deal with computationally intensive algorithms aimed at optimizing the delivery of general purpose traffic. Consequently, commercial networks do not incorporate these mechanisms due to the limited hardware resources at the mobile edge. Emerging 5G architectures introduce cloud computing principles to add flexible computational resources to Radio Access Networks. This paper makes use of the Mobile Edge Computing concepts to introduce a new element, denoted as Mobile Edge Scheduler, aimed at minimizing the mean delay of general traffic flows in the LTE downlink. This element runs close to the eNodeB element and implements a novel flow-aware and channel-aware scheduling policy in order to accommodate the transmissions to the available channel quality of end users.

Lake Victoria Fisheries Service Annual Report 1957/58

The major task in hand at the beginning of the year was the Deep Water Fishing Survey in Uganda waters. This has continued throughout the year with varying, lm generally, not particularly encouraging, results. A full account is given in paras. 33 to 67 of this Report. The new method of marking Tilapia was introduced at the beginning of the year, and, apart from delays resulting from the delivery position of marking materials, has gone ahead steadily. The improvement in results expected from this method was already evident after only nine months' work, and information has been obtained which never was-nor could have been-obtained by the old method of marking. A full account is given in paras 114 to 133.

Product Service Systems and supply network relationships: An exploratory case study

Purpose - In recent years there has been increasing interest in Product Service Systems (PSSs) as a business model for selling integrated product and service offerings. To date, there has been extensive research into the benefits of PSS to manufacturers and their customers, but there has been limited research into the effect of PSS on the upstream supply chain. This paper seeks to address this gap in the research. Design/methodology/approach - The research uses case-based research which is appropriate for exploratory research of this type. In-depth interviews were conducted with key personnel in a focal firm and two members of its supply chain, and the results were analysed to identify emergent themes.b Findings - The research has identified differences in supplier behaviour dependent on their role in PSS delivery and their relationship with the PSS provider. In particular, it suggests that for a successful partnership it is important to align the objectives between PSS provider and suppliers. Originality/value - This research provides a detailed investigation into a PSS supply chain and highlights the complexity of roles and relationships among the organizations within it. It will be of value to other PSS researchers and organizations transitioning to the delivery of PSS. © Emerald Group Publishing Limited.

Third Sector Experiences of Work Programme Delivery.

This paper explores the organisational experiences of governmental policy change and implementation on the third sector. Using a four-year longitudinal study of 13 third sector organisations (TSOs) it provides evidence based on the experiences of, and effects on, third sector organisations involved in the UK’s Work Programme in Scotland. The paper explores third sector experiences of the Work Programme during the preparation and introductory phase, as well as the effects of subsequent Work Programme implementation. By gathering evidence contemporaneously and longitudinally a unique in-depth analysis is provided of the introduction and implementation of a major new policy. The resource cost and challenges to third sector ways of working for the organisations in the Work Programme supply chain, as well as those not in the supply chain, are considered. The paper considers some of the responses adopted by the third sector to manage the opportunities and challenges presented to them through the implementation of the Work Programme. The paper also reflects on the broader context of the employability services landscape and raises questions as to whether, as a result of the manner in which the Work Programme was contracted, there is evidence of a move towards service homogenisation, challenging perceived TSO characteristics of service innovation and personalisation.

Accelerating Internet Streaming Media Delivery Using Network-Aware Partial Caching

Internet streaming applications are adversely affected by network conditions such as high packet loss rates and long delays. This paper aims at mitigating such effects by leveraging the availability of client-side caching proxies. We present a novel caching architecture (and associated cache management algorithms) that turn edge caches into accelerators of streaming media delivery. A salient feature of our caching algorithms is that they allow partial caching of streaming media objects and joint delivery of content from caches and origin servers. The caching algorithms we propose are both network-aware and stream-aware; they take into account the popularity of streaming media objects, their bit-rate requirements, and the available bandwidth between clients and servers. Using realistic models of Internet bandwidth (derived from proxy cache logs and measured over real Internet paths), we have conducted extensive simulations to evaluate the performance of various cache management alternatives. Our experiments demonstrate that network-aware caching algorithms can significantly reduce service delay and improve overall stream quality. Also, our experiments show that partial caching is particularly effective when bandwidth variability is not very high.

Scalability of Multicast Delivery for Non-sequential Streaming Access

To serve asynchronous requests using multicast, two categories of techniques, stream merging and periodic broadcasting have been proposed. For sequential streaming access where requests are uninterrupted from the beginning to the end of an object, these techniques are highly scalable: the required server bandwidth for stream merging grows logarithmically as request arrival rate, and the required server bandwidth for periodic broadcasting varies logarithmically as the inverse of start-up delay. However, sequential access is inappropriate to model partial requests and client interactivity observed in various streaming access workloads. This paper analytically and experimentally studies the scalability of multicast delivery under a non-sequential access model where requests start at random points in the object. We show that the required server bandwidth for any protocols providing immediate service grows at least as the square root of request arrival rate, and the required server bandwidth for any protocols providing delayed service grows linearly with the inverse of start-up delay. We also investigate the impact of limited client receiving bandwidth on scalability. We optimize practical protocols which provide immediate service to non-sequential requests. The protocols utilize limited client receiving bandwidth, and they are near-optimal in that the required server bandwidth is very close to its lower bound.

A Two-Tiered On-Line Server-Side Bandwidth Reservation Framework for the Real-Time Delivery of Multiple Video Streams

The advent of virtualization and cloud computing technologies necessitates the development of effective mechanisms for the estimation and reservation of resources needed by content providers to deliver large numbers of video-on-demand (VOD) streams through the cloud. Unfortunately, capacity planning for the QoS-constrained delivery of a large number of VOD streams is inherently difficult as VBR encoding schemes exhibit significant bandwidth variability. In this paper, we present a novel resource management scheme to make such allocation decisions using a mixture of per-stream reservations and an aggregate reservation, shared across all streams to accommodate peak demands. The shared reservation provides capacity slack that enables statistical multiplexing of peak rates, while assuring analytically bounded frame-drop probabilities, which can be adjusted by trading off buffer space (and consequently delay) and bandwidth. Our two-tiered bandwidth allocation scheme enables the delivery of any set of streams with less bandwidth (or equivalently with higher link utilization) than state-of-the-art deterministic smoothing approaches. The algorithm underlying our proposed frame-work uses three per-stream parameters and is linear in the number of servers, making it particularly well suited for use in an on-line setting. We present results from extensive trace-driven simulations, which confirm the efficiency of our scheme especially for small buffer sizes and delay bounds, and which underscore the significant realizable bandwidth savings, typically yielding losses that are an order of magnitude or more below our analytically derived bounds.

Service Provisioning in Mobile Networks Through Distributed Coordinated Resource Management

The pervasiveness of personal computing platforms offers an unprecedented opportunity to deploy large-scale services that are distributed over wide physical spaces. Two major challenges face the deployment of such services: the often resource-limited nature of these platforms, and the necessity of preserving the autonomy of the owner of these devices. These challenges preclude using centralized control and preclude considering services that are subject to performance guarantees. To that end, this thesis advances a number of new distributed resource management techniques that are shown to be effective in such settings, focusing on two application domains: distributed Field Monitoring Applications (FMAs), and Message Delivery Applications (MDAs). In the context of FMA, this thesis presents two techniques that are well-suited to the fairly limited storage and power resources of autonomously mobile sensor nodes. The first technique relies on amorphous placement of sensory data through the use of novel storage management and sample diffusion techniques. The second approach relies on an information-theoretic framework to optimize local resource management decisions. Both approaches are proactive in that they aim to provide nodes with a view of the monitored field that reflects the characteristics of queries over that field, enabling them to handle more queries locally, and thus reduce communication overheads. Then, this thesis recognizes node mobility as a resource to be leveraged, and in that respect proposes novel mobility coordination techniques for FMAs and MDAs. Assuming that node mobility is governed by a spatio-temporal schedule featuring some slack, this thesis presents novel algorithms of various computational complexities to orchestrate the use of this slack to improve the performance of supported applications. The findings in this thesis, which are supported by analysis and extensive simulations, highlight the importance of two general design principles for distributed systems. First, a-priori knowledge (e.g., about the target phenomena of FMAs and/or the workload of either FMAs or DMAs) could be used effectively for local resource management. Second, judicious leverage and coordination of node mobility could lead to significant performance gains for distributed applications deployed over resource-impoverished infrastructures.