An evaluation of a community matron service from the patients’ perspective

Community matrons are a relatively new government initiative aimed at case managing people with long-term conditions to reduce the number of emergency bed days used in hospitals. Although there have been extensive evaluations of similar case management projects, to date there has been little evaluation of the community matron's role and the perceptions patients have of this new service. One of the main Government agendas for care is to deliver a high quality service driven by the needs of the service users (DH, 2000). In order to drive this agenda, care is to deliver a high quality service driven by the needs of the service users (DH, 2000). In order to drive this agenda, it is important that the views and perceptions of people on the receiving end of the services are heard, valued and appropriate actions taken. This two part evaluative report sets out to explore how people with long-term conditions perceive the impact of community matrons and the differences this new service may have had on their lives. Questionnaires were sent to 100 patients who were currently being case-managed by a community matron to evaluate the community matron service from the patients' perspective. Part two reports on patients' perceptions of the community matron role and the influences of the role on their health.

A life cycle model for product-service systems design

Western manufacturing companies are developing innovative ways of delivering value that competes with the low cost paradigm. One such strategy is to deliver not only products, but systems that are closely aligned with the customer value proposition. These systems are comprised of integrated products and services, and are referred to as Product-Service Systems (PSS). A key challenge in PSS is supporting the design activity. In one sense, PSS design is a further extension of concurrent engineering that requires front-end input from the additional downstream sources of product service and maintenance. However, simply developing products and service packages is not sufficient: the new design challenge is the integrated system. This paper describes the development of a PSS data structure that can support this integrated design activity. The data structure is implemented in a knowledge base using the Protégé knowledge base editor.

Key service issues in two UK manufacturing companies from a PSS perspective

This paper illustrates the key service issues within two UK manufacturing companies,which belong to two different industrial domains, and highlights the main points of difference. It draws also on the literature of Product-Service Systems regarding their definition, types, benefits and difficulties in their implementation

University education as a public service

There is no tradition of public service in large parts of English higher education. This is because historically HE in England has seen itself as independent of the state and unaccountable to the public for its twin roles of research and teaching. These serve its own interests conceived as advancing knowledge and ensuring the continued transmission of that knowledge to future generations. The dominance of this conception explains the so-called ‘academic community’s’ Gaderene rush to abandon free HE in England. Resistance to preserve and extend public service HE will therefore predictably come mainly from former-local authority further and higher education institutions.

Realizing an Applied Gaming Ecosystem: Towards Supporting Service-based Innovation Knowledge Management and Transfer

The EU-based industry for non-leisure games is an emerging business. As such it is still fragmented and needs to achieve critical mass to compete globally. Nevertheless its growth potential is widely recognized. To become competitive the relevant applied gaming communities and SMEs require support by fostering the generation of innovation potential. The European project Realizing an Applied Gaming Ecosystem (RAGE) is aiming at supporting this challenge. RAGE will help by making available an interoperable set of advanced technology assets, tuned to applied gaming, as well as proven practices of using asset-based applied games in various real-world contexts, and finally a centralized access to a wide range of applied gaming software modules, services and related document, media, and educational resources within an online community portal called the RAGE Ecosystem. It is based on an integrational, user-centered approach of Knowledge Management and Innovation Processes in the shape of a service-based implementation.

Putting meaning into NETMAR – the open service network for marine environmental data

The open service network for marine environmental data (NETMAR) project uses semantic web technologies in its pilot system which aims to allow users to search, download and integrate satellite, in situ and model data from open ocean and coastal areas. The semantic web is an extension of the fundamental ideas of the World Wide Web, building a web of data through annotation of metadata and data with hyperlinked resources. Within the framework of the NETMAR project, an interconnected semantic web resource was developed to aid in data and web service discovery and to validate Open Geospatial Consortium Web Processing Service orchestration. A second semantic resource was developed to support interoperability of coastal web atlases across jurisdictional boundaries. This paper outlines the approach taken to producing the resource registry used within the NETMAR project and demonstrates the use of these semantic resources to support user interactions with systems. Such interconnected semantic resources allow the increased ability to share and disseminate data through the facilitation of interoperability between data providers. The formal representation of geospatial knowledge to advance geospatial interoperability is a growing research area. Tools and methods such as those outlined in this paper have the potential to support these efforts.

Operational monitoring and forecasting of bathing water quality through exploiting satellite Earth observation and models: The AlgaRisk demonstration service

Coastal zones and shelf-seas are important for tourism, commercial fishing and aquaculture. As a result the importance of good water quality within these regions to support life is recognised worldwide and a number of international directives for monitoring them now exist. This paper describes the AlgaRisk water quality monitoring demonstration service that was developed and operated for the UK Environment Agency in response to the microbiological monitoring needs within the revised European Union Bathing Waters Directive. The AlgaRisk approach used satellite Earth observation to provide a near-real time monitoring of microbiological water quality and a series of nested operational models (atmospheric and hydrodynamic-ecosystem) provided a forecast capability. For the period of the demonstration service (2008–2013) all monitoring and forecast datasets were processed in near-real time on a daily basis and disseminated through a dedicated web portal, with extracted data automatically emailed to agency staff. Near-real time data processing was achieved using a series of supercomputers and an Open Grid approach. The novel web portal and java-based viewer enabled users to visualise and interrogate current and historical data. The system description, the algorithms employed and example results focussing on a case study of an incidence of the harmful algal bloom Karenia mikimotoi are presented. Recommendations and the potential exploitation of web services for future water quality monitoring services are discussed.

Energy and ecosystem service impacts

Ecosystems provide a range of goods and services that contribute toward human well-being through the environmental, economic, and cultural benefits they provide. Although the importance of these services is increasingly being recognized by governments, our understanding of the implications of different energy technologies on the provision of these services is limited. The chapter presents an assessment of four key energy technologies that considers the ecosystem services impacts across the entire lifecycle. In demonstrating the global implications of these energy technologies, the chapter makes the case that assessment of UK energy policy must consider a broad range of environmental and societal indicators both within the UK and overseas.

Integrating methods for ecosystem service assessment and valuation: Mixed methods or mixed messages?

A mixed-method approach was used to assess and value the ecosystem services derived from the Dogger Bank, an extensive shallow sandbank in the southern North Sea. Three parallel studies were undertaken that 1) identified and quantified, where possible, how indicators for ecosystem service provision may change according to two future scenarios, 2) assessed members of the public's willingness-to-pay for improvements to a small number of ecosystem services as a consequence of a hypothetical management plan, and 3) facilitated a process of deliberation that allowed members of the public to explore the uses of the Dogger Bank and the conflicts and dilemmas involved in its management. Each of these studies was designed to answer different and specific research questions and therefore contributes different insights about the ecosystem services delivered by the Dogger Bank. This paper explores what can be gained by bringing these findings together post hoc and the extent to which the different methods are complementary. Findings suggest that mixed-method research brings more understanding than can be gained from the individual approaches alone. Nevertheless, the choice of methods used and how these methods are implemented strongly affects the results obtained.

Chapter 11: Human activities and ecosystem service use: impacts and trade-offs

Ecosystem services provided by the marine environment are fundamental to human health and well-being. Despite this, many marine systems are being degraded to an extent that may reduce their capacity to provide these ecosystem services. The ecosystem approach is a strategy for the integrated management of land, water and living resources that promotes conservation and sustainable use in an equitable way (UN Convention on Biological Diversity, 2000). Its application to marine management and spatial planning has been proposed as a means of maintaining the economic and social value of the oceans, not only in the present but for generations to come. Characterising the susceptibility of services (and combinations of services) to particular human activities based on knowledge of impacts on biodiversity and ecosystem functioning (as described in preceding chapters) is a challenge for future management of the oceans. In this chapter, we highlight the existing, but limited knowledge of how ecosystem services may be impacted by different human activities. We discuss how impacts on one service can impact multiple services and explore how the impacts on services can vary both spatially and temporally and according to context. We focus particularly on the effects on ecosystem services of activities whose impacts on biodiversity and ecosystem functioning have already been considered in previous chapters. Some of these activities are associated with poor management of ecosystem benefits, for example, from provisioning services (aquaculture and fisheries), or with excessive input of wastes, fertilisers and contaminants into the system overburdening the waste treatment and assimilation services. Other impacts are associated with the construction of structures or use of space designed to generate benefits from environmental services such as the presence of water as a carrier for shipping, or sources of wind, wave and tidal power. We discuss the trade-offs that are made, consciously or otherwise, between different ecosystem services, which arise from human activities to optimise or manage specific ecosystem services.

The Relationship between Hospital Infection Surveillance and Control Activities and Antibiotic Resistant Pathogen Rates

Objective: The purpose of the study was to examine the relationship of surveillance and control activities in Canadian hospitals with rates of nosocomial methicillin-resistant S. aureus (MRSA), C. difficile associated diarrhea (CDAD), and vancomycin-resistant Enterococcus (VRE). Methods: Surveys were sent to Infection Control programs in hospitals that participated in an earlier survey of infection control practices in Canadian acute care hospitals. Results: One hundred and twenty of 145 (82.8%) hospitals responded to the survey. The mean MRSA rate was 2.0 (SD 2.9) per 1,000 admissions, the mean CDAD rate was 3.8 (SD 4.3), and the mean VRE rate was 0.4 (SD 1.5). Multiple stepwise regression analysis found hospitals that reported infection rates by specific risk groups (r = - 0.27, p < 0.01) and that kept attendance records of infection control teaching activities (r = - 0.23, p < 0.01) were associated with lower MRSA rates. Multiple stepwise regression analysis found larger hospitals (r = 0.25, p < 0.01) and hospitals where infection control committees or staff had the direct authority to close a ward or unit to further admissions due to outbreaks (r = 0.22, p < 0.05) were associated with higher CDAD rates. Multiple logistic regression analysis found larger hospitals (OR = 1.6, CI 1.2 - 2.0, p = 0.003) and teaching hospitals (OR = 3.7, CI 1.2 - 11.8, p = 0.02) were associated with the presence of VRE. Hospitals were less likely to have VRE when infection control staff frequently contacted physicians and nurses for reports of new infections (OR = 0.5, CI 0.3 - 0.7, p = 0.02) and there were in-service programs for updating nursing and ancillary staff on current infection control practices (OR = 0.2, CI 0.1 - 0.7, p = 0.01). Conclusions: Surveillance and control activities were associated with MRSA and CDAD rates and the presence of VRE. Surveillance and control activities might be especially beneficial in large and teaching hospitals.