Consumer satisfaction with primary care provider choice and associated trust

Trust is important in medical relationships and for the achievement of better health outcomes. Developments in managed care in the recent years are believed to affect the quality of healthcare services delivery and to undermine trust in the healthcare provider. Physician choice has been identified as a strong predictor of provider trust but has not been studied in detail. Consumer satisfaction with primary care provider (PCP) choice includes having or not having physician choice. This dissertation developed a conceptual framework that guided the study of consumer satisfaction with PCP choice as a predictor of provider trust, and conducted secondary data analyses examining the association between PCP choice and trust, by identifying factors related to PCP choice satisfaction, and their relative importance in predicting provider trust. The study specific aims were: (1) to determine variables related to the factors: consumer characteristics and health status, information and consumer decision-making, consumer trust in providers in general and trust in the insurer, health plan financing and plan characteristics, and provider characteristics that may relate to PCP choice satisfaction; (2) to determine if the factors in aim one are related to PCP choice satisfaction; and (3) to analyze the association between PCP choice satisfaction and provider trust, controlling for potential confounders. Analyses were based on secondary data from a random national telephone survey in 1999, of residential households in the United States which included respondents aged over 20 and who had at least two visits with a health professional in the past two years. Among 1,117 eligible households interviewed (response rate 51.4%), 564 randomly selected to respond to insurer related questions made up the study sample. Analyses using descriptive statistics, and linear and logistic regressions found continual effective care and interaction with the PCP beyond the medical setting most predictive of PCP choice satisfaction. Four PCP choice satisfaction factors were also predictive of provider trust. Findings highlighted the importance of the PCP's professional and interpersonal competencies for the development of sustainable provider trust. Future research on the access, utilization, cognition, and helpfulness of provider specific information will further our understanding of consumer choice and trust. ^

Feminism, gender equity and sexual/reproductive health in the Middle East and North Africa (MENA) region

Sexual/reproductive/health and rights are crucial public health concerns that have been specifically integrated into the Millennium Development Goals to be accomplished by 2015. These issues are related to several health outcomes, including HIV/AIDS and gender-based violence (GBV) among women. The Middle East and North Africa (MENA) region comprises Algeria, Bahrain, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Qatar, Saudi Arabia, Syria, Tunisia, United Arab Emirates (UAE), West Bank and Gaza (WBG), and Yemen. This region is primarily Arabic speaking (except for Israel and Iran), and primarily Muslim (except for Israel). Some traditional and cultural views and practices in this region engender gender inequalities, which manifest themselves in the economic, political and social spheres. HIV and gender-based violence in the region may be interlinked with gender inequalities which breed justification for partner violence and honour killings, and increase the chance that HIV will transform into an epidemic in the region if not addressed. A feminist framework, focused on economic, political and social empowerment for women would be useful to consider applying to sexual/reproductive health in the region.^

A study of nutrition promotion in and consumer nutrition environments of hospitals

Dietary intake is a complex, health-related behavior, and although individual-level theoretical models explain some variation in dietary intake, comprehensive theoretical models such as the ecological framework describe the multiple levels which influence diet-related behaviors. Thus, the ecological framework is a preferred model for designing comprehensive nutrition interventions. While ecological-based nutrition interventions have been described, little work has focused on interventions in the hospital setting. Because hospitals are considered the hallmarks of health, it might seem that hospitals would regularly engage in worksite nutrition promotion; however, recent publications and other anecdotal evidence have indicated otherwise. The first paper of this dissertation systematically reviewed the scientific literature between 1996 and 2012 and identified 13 outcome evaluation trials for hospital-based worksite nutrition interventions. Of these 13 interventions, only one intervention targeted three of the four levels of the ecological framework and no intervention targeted all four levels. Only half of the interventions targeted the physical environment of hospitals, thus warranting more investigation into this specific level of the ecological framework in this setting. ^ A critical type of nutrition-related physical environments is the consumer nutrition environment. Although other tools measure the consumer nutrition environments of stores and restaurants, no tool specifically measured the consumer nutrition environments of hospitals until the CDC developed the Healthy Hospital Environment Scan for Cafeterias, Vending Machines, and Gift Shops (HHES-CVG). The HHES-CVG, a tool which measures the consumer nutrition environments of hospital cafeterias, vending machines, and gifts shops, was released in November 2011, and in the second paper of this dissertation, the reliability of this tool was investigated. Two trained raters visited 39 hospitals across Southern California between February and May 2012, and based on analyses of the raters' findings, the HHES-CVG exhibited strong reliability metrics (inter-observer agreement between 74 and 100%, and an intraclass correlation coefficient of 0.961 for the overall nutrition composite score). Because the HHES-CVG was found to be a reliable tool, the third paper of this dissertation presented HHES-CVG results from the 39 hospitals. Overall, hospitals only scored about one-fourth of the total possible points for the nutrition composite score, indicating that most facilities do not have acceptable consumer nutrition environments. Some of the best practices observed in cafeterias were significantly associated with having a large facility and with having a contracted foodservice operation, but overall nutrition composite score was not associated with any specific facility or operation type. ^ The dissertation concluded that much work is needed in order to improve the consumer nutrition environments of hospitals. Practitioners and healthcare administrators should consider starting with ecological-based interventions addressing all levels including the physical environment.^

Economic development capitalizing on brand agriculture : turning development strategy on its head

This paper explores the possibilities of two unique Japanese concepts - the One Village One Product Movement (OVOP) and Michino Eki (or Roadside Stations) - as potential tools for bridging the gap between cities and rural areas through community-driven development. From the viewpoint of spatial economics and endogenous growth theory, this paper considers both OVOP and Michino Eki as rural development strategies of a broader nature based on "brand agriculture." Here, brand agriculture represents a general strategy for community-based rural development that identifies, cultivates and fully utilizes local resources for the development of products or services unique to a certain "village." Selected examples of OVOP and Michino Eki from Japan and developing countries are introduced.

The business management strategy of Iran's large apparel firms : overview of results from a questionnaire survey and interviews 2009-2011

This paper is an overview of the results from a questionnaire survey and subsequent supplementary interviews of Iran's large apparel firms conducted by the author in 2009-2011. Most of the large apparel firms in Iran are based in Tehran and have been in business for some twenty years. They have a solid business with regular customers, but in general have hesitated to expand the size of their firms. Following the relaxation of restrictions on the procurement of raw materials that existed in the 1990s, the results of survey and interviews show that the firms have developed new channels of procurement although they depend to a considerable degree on imported raw materials and machinery. They have managed to maintain their level of output even with the rapid increase in imports since 2000, although the number of firms has decreased. Low-priced Chinese products have basically not been their rivals; instead, the inflow of foreign name-brand products have hit them heavily.

Quasi-experimental evidence on the drivers of index-based livestock insurance demand in Southern Ethiopia

Microinsurance is widely considered an important tool for sustainable poverty reduction, especially in the face of increasing climate risk. Although index-based microinsurance, which should be free from the classical incentive problems, has attracted considerable attention, uptake rates have generally been weak in low-income rural communities. We explore the purchase patterns of index-based livestock insurance in southern Ethiopia, focusing in particular on the role of accurate product comprehension and price, including the prospective impact of temporary discount coupons on subsequent period demand due to price anchoring effects. We find that randomly distributed learning kits contribute to improving subjects' knowledge of the products; however, we do not find strong evidence that the improved knowledge per se induces greater uptake. We also find that reduced price due to randomly distributed discount coupons has an immediate, positive impact on uptake, without dampening subsequent period demand due to reference-dependence associated with price anchoring effects.

Energy efficiency standard and labeling program and consumer welfare : a case of the air conditioner market in China

Improving energy efficiency is an unarguable emergent issue in developing economies and an energy efficiency standard and labeling program is an ideal mechanism to achieve this target. However, there is concern regarding whether the consumers will choose the highly energy efficient appliances because of its high price in consequence of the high cost. This paper estimates how the consumer responds to introduction of the energy efficiency standard and labeling program in China. To quantify evaluation by consumers, we estimated their consumer surplus and the benefits of products based on the estimated parameters of demand function. We found the following points. First, evaluation of energy efficiency labeling by the consumer is not monotonically correlated with the number of grades. The highest efficiency label (Label 1) is not evaluated to be no less higher than labels 2 and 3, and is sometimes lower than the least energy efficient label (Label UI). This goes against the design of policy intervention. Second, several governmental policies affects in mixed directions: the subsidies for energy saving policies to the highest degree of the labels contribute to expanding consumer welfare as the program was designed. However, the replacement for new appliances policies decreased the welfare.

A Video-Aware FEC-Based Unequal Loss Protection Scheme for RTP Video Streaming

A video-aware unequal loss protection (ULP) system for protecting RTP video streaming in bursty packet loss networks is proposed. Just considering the relevance of the frame, the state of the channel and the bitrate constraints of the protection bitstream, our algorithm selects in real time the most suitable frames to be protected through forward error correction (FEC) techniques. It benefits from a wise RTP encapsulation that allows working at a frame level without requiring any further process than that of parsing RTP headers, so it is perfectly suitable to be included in commercial transmitters. The simulation results show how our proposed ULP technique outperforms non-smart schemes.

VLC-based light-weight portable user interface for in-house applications.

Advances in solid-state lighting have overcome common limitations on optical wireless such as power needs due to light dispersion. It's been recently proposed the modification of lamp's drivers to take advantages of its switching behaviour to include data links maintaining the illumination control they provide. In this paper, a remote access application using visible light communications is presented that provides wireless access to a remote computer using a touchscreen as user interface

Wireless Sensor Network based on OCDMA for closed environments

An infrared optical wireless system is presented, consisting on autonomous remote nodes communicating with a central node. The network is designed for telecommand/telemetry purposes, comprising a large number of nodes at a low data rate. Simultaneous access is granted by using CDMA techniques, and an appropriate selection of the code family can also keep power consumption to a minimum

A visual object counter based on a multimodal data association for embedded systems with limited computational power

A low complex but highly-efficient object counter algorithm is presented that can be embedded in hardware with a low computational power. This is achieved by a novel soft-data association strategy that can handle multimodal distributions.

The determinants of the quality of Sales-Marketing Interface in a Multinational Customer Brand Focused Company: The Latin American Branches

Customer evolution and changes in consumers, determine the fact that the quality of the interface between marketing and sales may represent a true competitive advantage for the firm. Building on multidimensional theoretical and empirical models developed in Europe and on social network analysis, the organizational interface between the marketing and sales departments of a multinational high-growth company with operations in Argentina, Uruguay and Paraguay is studied. Both, attitudinal and social network measures of information exchange are used to make operational the nature and quality of the interface and its impact on performance. Results show the existence of a positive relationship of formalization, joint planning, teamwork, trust and information transfer on interface quality, as well as a positive relationship between interface quality and business performance. We conclude that efficient design and organizational management of the exchange network are essential for the successful performance of consumer goods companies that seek to develop distinctive capabilities to adapt to markets that experience vertiginous changes

Experiments in abstract interpretation-based code certification for pervasive systems

Proof carrying code (PCC) is a general is originally a roof in ñrst-order logic of certain vermethodology for certifying that the execution of an un- ification onditions and the checking process involves trusted mobile code is safe. The baste idea is that the ensuring that the certifícate is indeed a valid ñrst-order code supplier attaches a certifícate to the mobile code proof. which the consumer checks in order to ensure that the The main practical difñculty of PCC techniques is in code is indeed safe. The potential benefit is that the generating safety certiñeates which at the same time: i) consumer's task is reduced from the level of proving to allow expressing interesting safety properties, ii) can be the level of checking. Recently, the abstract interpre- generated automatically and, iii) are easy and efficient tation techniques developed, in logic programming have to check. In [1], the abstract interpretation techniques been proposed as a basis for PCC. This extended ab- [5] developed in logic programming1 are proposed as stract reports on experiments which illustrate several is- a basis for PCC. They offer a number of advantages sues involved in abstract interpretation-based certifica- for dealing with the aforementioned issues. In particution. First, we describe the implementation of our sys- lar, the xpressiveness of existing abstract domains will tem in the context of CiaoPP: the preprocessor of the be implicitly available in abstract interpretation-based Ciao multi-paradigm programming system. Then, by code certification to deñne a wide range of safety propermeans of some experiments, we show how code certifi- ties. Furthermore, the approach inherits the automation catión is aided in the implementation of the framework. and inference power of the abstract interpretation en- Finally, we discuss the application of our method within gines used in (Constraint) Logic Programming, (C)LP. the área, of pervasive systems

Abstract interpretation-based mobile code certification

Current approaches to mobile code safety – inspired by the technique of Proof-Carrying Code (PCC) [4] – associate safety information (in the form of a certificate) to programs. The certificate (or proof) is created by the code supplier at compile time, and packaged along with the untrusted code. The consumer who receives the code+certificate package can then run a checker which, by a straightforward inspection of the code and the certificate, is able to verify the validity of the certificate and thus compliance with the safety policy. The main practical difficulty of PCC techniques is in generating safety certificates which at the same time: i) allow expressing interesting safety properties, ii) can be generated automatically and, iii) are easy and efficient to check.

Abstract Interpretation-based verification/certification in the ciaoPP system

CiaoPP is the abstract interpretation-based preprocessor of the Ciao multi-paradigm (Constraint) Logic Programming system. It uses modular, incremental abstract interpretation as a fundamental tool to obtain information about programs. In CiaoPP, the semantic approximations thus produced have been applied to perform high- and low-level optimizations during program compilation, including transformations such as múltiple abstract specialization, parallelization, partial evaluation, resource usage control, and program verification. More recently, novel and promising applications of such semantic approximations are being applied in the more general context of program development such as program verification. In this work, we describe our extensión of the system to incorpórate Abstraction-Carrying Code (ACC), a novel approach to mobile code safety. ACC follows the standard strategy of associating safety certificates to programs, originally proposed in Proof Carrying- Code. A distinguishing feature of ACC is that we use an abstraction (or abstract model) of the program computed by standard static analyzers as a certifícate. The validity of the abstraction on the consumer side is checked in a single-pass by a very efficient and specialized abstractinterpreter. We have implemented and benchmarked ACC within CiaoPP. The experimental results show that the checking phase is indeed faster than the proof generation phase, and that the sizes of certificates are reasonable. Moreover, the preprocessor is based on compile-time (and run-time) tools for the certification of CLP programs with resource consumption assurances.