D3M: multicast listener mobility support mechanisms over distributed mobility anchoring architectures

The explosion in mobile data traffic is a driver for future network operator technologies, given its large potential to affect both network performance and generated revenue. The concept of distributed mobility management (DMM) has emerged in order to overcome efficiency-wise limitations in centralized mobility approaches, proposing not only the distribution of anchoring functions but also dynamic mobility activation sensitive to the applications needs. Nevertheless, there is not an acceptable solution for IP multicast in DMM environments, as the first proposals based on MLD Proxy are prone to tunnel replication problem or service disruption. We propose the application of PIM-SM in mobility entities as an alternative solution for multicast support in DMM, and introduce an architecture enabling mobile multicast listeners support over distributed anchoring frameworks in a network-efficient way. The architecture aims at providing operators with flexible options to provide multicast mobility, supporting three modes: the first one introduces basic IP multicast support in DMM; the second improves subscription time through extensions to the mobility protocol, obliterating the dependence on MLD protocol; and the third enables fast listener mobility by avoiding potentially slow multicast tree convergence latency in larger infrastructures, by benefiting from mobility tunnels. The different modes were evaluated by mathematical analysis regarding disruption time and packet loss during handoff against several parameters, total and tunneling packet delivery cost, and regarding packet and signaling overhead.

Customer Support, Motivation to participate and participation in services : a first step.

International audience

Chronic respiratory diseases and quality of life in elderly nursing home residents

Few studies have assessed the quality of life (QOL) related to chronic respiratory diseases in the elderly. In the framework of the geriatric study on the health effects of air quality in elderly care centers (GERIA) study, a questionnaire was completed by elderly subjects from 53 selected nursing homes. It included various sections in order to assess respiratory complaints, QOL (World Health Organization QOL (WHOQOL)-BREF), and the cognitive and depression status. The outcome variables were the presence of a score lower than 50 (<50) in each of the WHOQOL-BREF domains (physical health, psychological health, social relationships, and environmental health). Chronic bronchitis, frequent cough, current wheezing, asthma, and allergic rhinitis were considered as potential risk factors. The surveyed sample was (n = 887) 79% female, with a mean age of 84 years (SD: 7 years). In the multivariable analysis, a score of <50 in the physical domain was associated with wheezing in the previous 12 months (odds ratio (OR): 2.03, confidence interval (CI): 1.25-3.31) and asthma (OR: 1.95, CI: 1.12-3.38). The psychological domain was related with a frequent cough (OR: 1.43, CI: 0.95-2.91). A score of <50 in the environmental domain was associated with chronic bronchitis (OR: 2.89, CI: 1.34-6.23) and emphysema (OR: 3.89, CI: 1.27-11.88). In view of these findings, the presence of respiratory diseases seems to be an important risk factor for a low QOL among elderly nursing home residents.

Development of an historical landscape photography database to support landscape change analysis in the Northeast of Portugal

Repeat photography is an efficient, effective and useful method to identify trends of changes in the landscapes. It was used to illustrate long-term changes occurring in the landscapes. In the Northeast of Portugal, landscapes changes is currently driven mostly by agriculture abandonment and agriculture and energy policy. However, there is a need to monitoring changes in the region using a multitemporal and multiscale approach. This project aimed to establish an online repository of oblique digital photography from the region to be used to register the condition of the landscape as recorded in historical and contemporary photography over time as well as to support qualitative and quantitative assessment of change in the landscape using repeat photography techniques and methods. It involved the development of a relational database and a series of web-based services using PHP: Hypertext Preprocessor language, and the development of an interface, with Joomla, of pictures uploading and downloading by users. The repository will make possible to upload, store, search by location, theme, or date, display, and download pictures for Northeastern Portugal. The website service is devoted to help researchers to obtain quickly the photographs needed to apply RP through a developed search engine. It can be accessed at: http://esa.ipb.pt/digitalandscape/.

Perceção dos cuidadores informais sobre o planeamento da alta

Enquadramento: Conhecer a perceção que os cuidadores informais possuem sobre o planeamento da alta dos idosos internados, permite que os enfermeiros conheçam as reais necessidades do cuidador e do idoso, contribuindo assim, para a diminuição da ansiedade, prevenção de complicações e consequentemente uma maior satisfação pelos cuidados recebidos. Objetivos: Conhecer a perceção dos cuidadores informais sobre o planeamento da alta hospitalar do idoso, e analisar associações entre as variáveis sociodemográficas, profissionais, familiares, clínicas e psicossociais e a referida perceção. Métodos/ Procedimentos: Realizou-se um estudo quantitativo, transversal, descritivo e correlacional, utilizando uma amostra não probabilística por conveniência, constituída por 41 cuidadores informais de idosos internados no serviço de Medicina 1 do Centro Hospitalar do Algarve – Unidade de Faro. Recorreu-se ao questionário de caracterização sociodemográfica, profissional, familiar e clínica, bem como a utilização do Índice de Barthel, questionário de Planeamento da Alta (PREPARED) e a escala de Ansiedade e Depressão Hospitalar (HADS). Resultados: Dos 41 cuidadores informais,73,17 % são do género feminino, 78% são casados/ união de fato, 39,0% mantêm-se ativos profissionalmente a tempo inteiro e em 51,2% são filhos do idoso, que apresentam uma média de idade de 78,78 anos. A maioria (82,9%) reside na mesma habitação que o idoso, sendo cuidadores informais há menos de 3 meses (58,5%). Os cuidadores apresentam um nível de ansiedade leve a moderada, sendo superior para o género feminino, embora não se verificasse diferenças estatisticamente significativas. Relativamente à perceção dos cuidadores relacionados com o planeamento da alta, a maioria privilegia as informações relacionadas como conseguir fazer as AVD, afirmando que se sentem preparados para regressar a casa, contudo a maioria não sente confiança para executar as tarefas diárias no domicílio. Constatou-se que a presença de apoio da rede formal influencia significativamente a perceção do planeamento da alta (p< 0,05), sendo que o género, agregado familiar e grau de dependência, embora de forma parcial (apenas para um indicador) também são preditivas da perceção. Conclusões: Apesar do número reduzido da amostra, os resultados obtidos evidenciam a relevância de organização dos cuidados face à satisfação das necessidades dos idosos e seus cuidadores em cuidados de saúde, no que dizem respeito ao planeamento da alta, como busca da qualidade. Palavras-chave: perceção do planeamento da alta, cuidadores informais, idosos.

Parents’ experiences during the transition from childhood to adolescence with Type 1 Diabetes: Parent-child relationships and support received during this time and clinical research portfolio

Background: Type 1 Diabetes (T1D) management often worsens as children become adolescents. This can be a difficult time for parents as they hand over responsibility of diabetes management to their adolescent. Objectives: To look at the experiences of parents with a child with T1D as they move to adolescence and take more responsibility for their diabetes management. To find out about parents’ experience of support during this transition. Subjects: Three parents of adolescents with T1D. Participants were recruited from the NHS Highland Paediatric Diabetes Service. Methods: Participants took part in a one-to-one semi-structured interview with a researcher. Interpretative Phenomenological Analysis was used to analyse the interviews and find common themes across the interviews. Results: Participants experienced worry throughout their child’s transition to adolescence. They found it difficult to let their child take responsibility for their diabetes but acknowledged that their involvement caused tensions with their adolescent. Participants’ experience was that there were a number of practical adjustments to be made with a diagnosis of T1D and educating the network around their child was important. The participants reported that the diagnosis of T1D had an impact on the whole family and not just the child with the diagnosis. The parents felt well supported medically but said that the amount of time before their first clinic appointment felt too long. All participants had concerns about their adolescent moving to the adult diabetic service. Conclusions: Participants experienced worry relating to aspects of their adolescents T1D that they could not control, but were aware of the tensions caused by trying to keep elements of control. Areas of future research were identified.

Satisfação dos utentes de uma unidade de cirurgia de ambulatório de um hospital central : contributo para melhor cuidar

Enquadramento: O carácter inovador da Cirurgia de Ambulatório reside no seu modelo organizativo específico, centrado no doente, que o envolve num circuito independente do de internamento, procurando-se ganhos em eficiência e em qualidade e obtendo-se níveis de maior humanização e satisfação dos utentes e seus familiares. Objetivos: Analisar de que forma as variáveis sociodemográficos influenciam a qualidade percebida dos utentes de uma Unidade de Cirurgia de Ambulatório de um Hospitalar Central; verificar se existem efeitos significativos das variáveis circunstanciais na qualidade percebida dos utentes de uma Unidade de Cirurgia de Ambulatório de um Hospitalar Central; verificar a existência de efeitos significativos das variáveis sociofamiliares na qualidade percebida nos utentes. Métodos: Estudo quantitativo, com corte transversal, descritivo e correlacional; enquadra-se num estudo descritivo analítico-correlacional porque o mesmo tem por objetivo explorar as relações entre variáveis e descrevê-las. Os dados foram colhidos junto dos utentes tendo como base escalas e questionários. A amostra é não probabilística por conveniência, constituída por 140 utentes de uma Unidade de Cirurgia de Ambulatório de um Hospitalar Central, na maioria, do sexo masculino (60,7%), com uma idade mínima de 19 anos e uma máxima de 94 anos, ao que corresponde uma idade média de 58,01 (±19.26 anos). Foi aplicado um Questionário de caracterização sociodemográfica e sociofamiliar, incluindo-se o Questionário (Medical Outcomes Study Social Support Survey) MOS-SSS (Fachado et al., 2007) e o Questionário Service Quality (SERVQUAL) (Parasuraman et al., 1988). Resultados: Os utentes do sexo feminino manifestam mais satisfação em relação à UCA (cortesia/empatia p=0.000; compreensão do utente p=0.000; fiabilidade p=0.005; acessibilidade p=0.010; qualidade global p=0.001; os utentes idosos obtiveram valores mais elevados em quase todas as dimensões e na qualidade global (aspetos físicos p=0.006); os participantes com o ensino básico manifestaram mais satisfação (fiabilidade p<0,016); os que possuem um rendimento familiar até 1000€ apresentaram maior nível de satisfação (cortesia/empatia p=0,033); os utentes que não se deslocam em meio de transporte próprio atribuem mais qualidade à UCA (fiabilidade p=0,028); aqueles cuja residência está situada a uma distância superior a 15 km do hospital revelam índices mais elevados de qualidade (cortesia/simpatia p=0.037; compreensão do utente p=0.044; fiabilidade p=0.022; acessibilidade p=0.001; qualidade global p=0.013); os participantes cuja distância de casa ao centro de saúde é superior a 9 km revelam mais satisfação (fiabilidade p=0.038); os utentes com tempos de espera para a cirurgia entre 6-12 meses atribuem mais qualidade à UCA (cortesia/empatia p=0.000; compreensão do utente p=0.011; fiabilidade p=0.007; acessibilidade p=0.001; qualidade global p=0.001). Conclusão: A maioria dos utentes atribui qualidade à UCA, tendo em conta a cortesia/empatia, a compreensão do utente, fiabilidade, acessibilidade e aspetos físicos, pode afirmar-se que a referida Unidade adequa os serviços prestados às suas necessidades, garantindo, deste modo, a satisfação dos utentes. Palavras-chave: Cirurgia de Ambulatório; Satisfação dos utentes; Qualidade; Atendimento.

Stress ocupacional e satisfação laboral no atendimento ao público

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Social e das Organizações.

Transition to Product Service Systems: methodology based on scenarios identification, modelling and evaluation

Part 4: Transition Towards Product-Service Systems

REFUGEES AND RESETTLEMENT: A QUALITATIVE ANALYSIS OF REFUGEE INTEGRATION THROUGH SOCIAL & SUPPORT SERVICES

This dissertation studies refugee resettlement in the United States utilizing the Integration Indicator’s framework developed by Ager and Strang for the U.S. context. The study highlights the U.S. refugee admissions program and the policies in the states of Maryland and Massachusetts while analyzing the service delivery models and its effects on refugee integration in these locations. Though immigration policy and funding for refugee services are primarily the domain of the federal government, funds are allocated through and services are delivered at the state level. The Office of Refugee Resettlement (ORR), which operates under the Department of Health and Human Services, was established after the Refugee Act of 1980 to deliver assistance to displaced persons. The ORR provides funds to individual states primarily through The Refugee Social Service and Targeted Assistance Formula Grant programs. Since the inauguration of the ORR three primary models of refugee integration through service delivery have emerged. Two of the models include the publicly/privately administered programs, where resources are allocated to the state in conjunction with private voluntary agencies; and the Wilson/Fish Alternative programs, where states sub-contract all elements of the resettlement program to voluntary agencies and private organizations —in which they can cease all state level participation and voluntary agencies or private organizations contract directly from the ORR in order for all states to deliver refugee services where the live. The specific goals of this program are early employment and economic self-sufficiency. This project utilizes US Census, state, and ORR data in conjunction with interviews of refugee resettlement practitioners involved in the service delivery and refugees. The findings show that delivery models emphasizing job training, English instruction courses, institutional collaboration, and monetary assistance, increases refugee acclimation and adaptation, providing insight into their potential for integration into the United States.

Applying Platform Design to Improve Product-Service Systems Collaborative Development

Part 3: Product-Service Systems

Effects of an in-service training program using the routines-based interview

The focus of this study is an in-service training program rooted in routines-based early intervention and designed to improve the quality of goals and objectives on individualized plans. Participants were local intervention team members and other professionals who worked closely with each team. This training program involved a small number of trainees per group, providing multiple learning experiences across time and various opportunities for self-assessment and monitoring. We investigated (a) the perceptions of the participants about the strengths and weaknesses of the training program, (b) medium-term outcomes of the training with a comparison group, (c) and variables associated with the quality of goals and objectives. This study involved training more than 200 professionals, and results support the effectiveness of the program in improving the quality of goals and objectives, showing the importance of the routines-based interview in producing that improvement.

Experiences of health professionals with nutritional support of critically ill patients in tertiary hospitals in Malawi

Background Nutritional support is a recognized determinant of outcome in critically ill patients. Development of critical care services in low-income countries has not been accompanied by certain appropriate ancillary services and interventions, such as adequate nutritional support. This study was designed to investigate the experiences of health professionals who have provided nutritional supportive care to critically ill patients admitted to two major central hospitals in Malawi, with the aim of identifying the common practices in nutritional support in these settings. Materials and Methods A cross-sectional study in which 50 health professionals working in intensive care and high dependency units, admitting both adult and pediatric patients, were interviewed using a semi-structured questionnaire. Data were coded and then analyzed using SPSS version 16.0. Responses between the two hospitals were compared using Fisher’s exact test. Results There was no difference in the composition of respondents from the two hospitals. About 60% of respondents had had experience with nutritional supplementation in their patients—mainly enteral. The most commonly used formulations were the “ready-to-use therapeutic feeds,” followed by modified milk. A high percentage of respondents (40%) reported having used dextrose solution as the sole nutritional supplement. Lack of in-service training, nonexistent nutrition protocols pertaining to acutely and critically ill patients, and a lack of clinical nutritionists were the major challenges identified. Conclusion Knowledge of nutrient supplementation was poor among the respondents. The use of ready-to-use therapeutic feeds was quite common, although there is no evidence of its effectiveness in care of acutely critically ill patients. There is a need to establish nutritional support teams in these tertiary hospitals. Clinical nutritionists would ideally help train and play leadership roles in such teams, who would be responsible for assessing patients for their nutritional needs, and ensuring that the feeds provided to patients are appropriate and adequate for their needs.

How do servant leaders ignite absorptive capacity?: the role of epistemic motivation and organizational support

This study examines the role of servant leadership in absorptive capacity. Data from manufacturing and service sector organizations found that: a) there was moderation of servant leadership influence on knowledge identification through POS by high need for cognition, b) there was moderation of servant leadership influence on knowledge application through POS by low time pressure, and c) POS mediated relationship between servant leadership and knowledge dissemination. The findings illustrate and support the importance of a comprehensive model integrating servant leadership, POS, and epistemic motivation in determining absorptive capacity.

Human resource management reform in the Indonesian civil service : towards strategic fit?

Studies of strategic HRM have dominated HRM research over the last three decades. Focusing on the HRM-organisation performance relationship, researchers take various themes and perspectives in their approach to strategic HRM. Among these themes, two contrasting approaches of strategic HRM continue to flourish: first, the best practice approach suggests that certain HRM practices will have the same effect irrespective of context and, second, the best fit approach suggests that the choice of HRM practices should be designed in accordance with an organisations’ specific context. While there is little consensus on what constitutes strategic HRM, the most common feature agreed in this field is the notion of the strategic integration; aligning HRM practices with organisations’ overall strategic objectives (vertical fit) and with each other (horizontal fit). Utilising the best fit approach as its theoretical framework, this study examines how vertical and horizontal fit is practised in the Indonesian civil service and what factors likely influence the prevalence of vertical and horizontal fit in the Indonesian civil service context. This study is significant for two important reasons. Firstly, the literature suggests that there are limited studies examining the best fit concept in the civil sector despite its implementation in the private sector positively contributing to organisational performance improvement. Secondly, the study provides enlightenment on how the best fit approach could contribute to performance improvement in the Indonesian civil service. This is in line with the fact that negative images of the Indonesian civil service are continuously highlighted although various HRM reform initiatives have been put in place. To achieve the objectives of the study, the qualitative case study approach accompanied by semi-structured interviews was employed involving 53 senior officials and one focus group discussion from eight Indonesian government agencies, consisting of three central agencies mandated to manage human resources, the National Bureaucratic Reform Team and four line agencies from both central and local governments. Thematic analysis was employed for data analyses and NVIVO software was used to manage the data. The study suggests three main findings. First, various HRM initiatives in relation to the HRM reform have been introduced in the Indonesian civil service differentiating them from the old HRM practices. However, the findings indicate that some HRM policies are still contradicting and hinder vertical and horizontal fit. Second, despite the contradictory policies, vertical and horizontal fit can be seen in the line agencies which have been acknowledged as ‘reformed agencies’. This demonstrates that the line agencies play an important role in aligning HRM practices with the line agencies’ goals and objectives and with one another although they are bounded by HRM policies that are unlikely to support the vertical and horizontal fit concept. Third, factors influencing the prevalence of vertical and horizontal fit include knowledge of contemporary HRM in both central agencies and line agencies, commitment from the line agencies’ leaders, devolvement of HRM to the line agencies and the socio-political and economic environments of the Indonesian civil service. The findings of the study raise policy, practical and theoretical implications. In terms of policy implications, the study highlights the importance of fit in HRM policies to support the achievement of the line agencies’ goals. Therefore, when formulating an HRM policy, the central agencies need to ensure that the HRM policy is linked to line agencies’ goals and to other HRM policies. This is to ensure synchronisation among the policies and thus maximising the achievement of the line agencies’ goals. From the practical perspectives, the study highlights important points which can be learned by the central agencies in carrying out their strategic role with regard to the formulation of HRM policies; by the line agencies in maximising the contribution of HRM to the achievement of the goals and objectives of the agencies through the implementation of the best fit concept, and by the leaders of the agencies in providing continuous support to each of the involved parties in the line agencies and involving the HRM department in all agency’s strategic decision-making. In relation to the theoretical implication, it is clear that the best fit approach is not thoroughly applied due to factors discussed previously. However, this does not mean that the best fit concept cannot be implemented. As argued by McCourt & Ramgutty-Wong (2003), instead of adopting the whole concept of best fit, a modulated approach reflecting the best fit concept, such as selecting individual HRM practices and experimenting with devolution, is possible for civil service organisations which still embrace centralised HRM systems. As demonstrated in the findings, some of the line agencies being studied seem to be ready to adopt the best fit approach given that they have knowledge of the best fit concept, strong support from the top leader, less political intervention and less corruption, collusion, and nepotism practices in their HRM practices.