Client Selection Research Articles

Not just surviving, but thriving: perceived strengths of successful US‐based travel agencies

AbstractIn‐depth interviews with owners of 19 exceptionally successful US‐based travel agencies were analyzed using a ground theory approach to reveal customer service excellence, employee enrichment and effective networking as three core perceived strengths that comprise a theme of ‘relationship building’. The latter is supported by a theme of ‘facilitation’ entailing diligent client selection, a culture of learning, high adaptability (related to technology and product realignment), scale, adherence to business basics, and owner optimism. Together, both themes suggest a macro‐theme of ‘deep commitment’. The results provide guidelines for aspiring travel agency owners. Copyright © 2007 John Wiley & Sons, Ltd.

Adding Consumer-Providers to Intensive Case Management: Does It Improve Outcome?

Adding Consumer-Providers to Intensive Case Management: Does It Improve Outcome?

Consecuencias del uso de cocaína en las personas que ejercen la prostitución

Objective To describe the circumstances and consequences of cocaine use in the setting of prostitution. Material and method We performed a qualitative study with fieldwork in 6 Spanish cities. Semi-structured interviews were carried out to 60 persons aged between 18 and 50 years old involved in prostitution in different settings: street, flat and brothel. Results The main substances used in prostitution were alcohol and cocaine. Consumption was occasional and instrumental and helped to reduce psychological barriers or inhibition and increase tolerance to long hours of sex work with different clients, thus increasing earnings. Cocaine use was also associated with providing clients with company without having to perform sexual services. Among the consequences of drug use in prostitutes were unprotected sex and a higher risk of violence by clients. Prostitutes developed harm reduction strategies for drug use: dose reduction, simulated drug use, and selection of clients who were users. Conclusions This study shows that there is connection between drug use and the provision of sexual services. Drug use can pose a health risk as consumption is associated with unprotected sex.

Nurse taking care and teaching to the family of the client with gastrostomy in home scene . Preview note

The client that suffered a gastrostomy needs the full attention of a stomaterapist nurse. This support starts with the feeding tube installation and should be followed in homecare attention by motivating the family to take part of this process, giving them the necessary support, teaching how to manage the feeding tube, how to handle it in the process of feeding the client and also the physical and emotional care required in order to prevent difficulties and contributing effectively to the health promotion, maintenance and rehabilitation of the client in the family scenario. The aim of this work is to know the new possibilities of innovation in the nurse’s practice and teaching when attending the gastrostomy client’s family, identifying the needs of the family in this kind of care in the family scenario and elaborating a homecare program to the family of a gastrostomy client. It is a qualitative research which will count with: a selection of clients submitted to gastrostomy in the Video-Endo Clinic; home visits evaluations by participative observation of the family scenario conditions to attend the clients´s needs; orientations with practical demonstrations of care actions with the client in nutritional support by gastrostomy, thorough the identification of the family’s needs concerned the client care, by analyzing the interviews and observation, and the elaboration of a homecare program for these

Nurse taking care and teaching to the family of the client with gastrostomy in home scene . Preview note

The client that suffered a gastrostomy needs the full attention of a stomaterapist nurse. This support starts with the feeding tube installation and should be followed in homecare attention by motivating the family to take part of this process, giving them the necessary support, teaching how to manage the feeding tube, how to handle it in the process of feeding the client and also the physical and emotional care required in order to prevent difficulties and contributing effectively to the health promotion, maintenance and rehabilitation of the client in the family scenario. The aim of this work is to know the new possibilities of innovation in the nurse’s practice and teaching when attending the gastrostomy client’s family, identifying the needs of the family in this kind of care in the family scenario and elaborating a homecare program to the family of a gastrostomy client. It is a qualitative research which will count with: a selection of clients submitted to gastrostomy in the Video-Endo Clinic; home visits evaluations by participative observation of the family scenario conditions to attend the clients´s needs; orientations with practical demonstrations of care actions with the client in nutritional support by gastrostomy, thorough the identification of the family’s needs concerned the client care, by analyzing the interviews and observation, and the elaboration of a homecare program for these

Sex workers' accounts of condom use: implications for condom production, promotion and health policy

ObjectivesTo explore sex workers' accounts of condom use and their recommendations about how condoms might be improved.MethodsIn-depth interviews were conducted with 22 female sex workers in sex work premises in...

Gendered small‐business assistance: lessons from a Swedish project

PurposeThe purpose of this paper is to deal with the design of small‐business training programs and focuses on women business owners, their real needs and the supply of adequate training. How and to what extent are client selection and support needs influenced by the gender system?Design/methodology/approachAn in‐depth study of an ambitious Swedish project is reported. Interviews with the participating business‐owners and advisors, combined with observations during lectures and coaching sessions have been conducted.FindingsEven gender‐conscious support organizations may have a biased process of client recruitment, leading to an unintended discrimination of women business owners. The women meet the same obstacles as men but also give witness to the subtle obstacles which originate in the gender‐system.Research limitations/implicationsThe study is qualitative and does not aim to provide statistically valid generalizations.Practical implicationsGender awareness of support organizations is crucial, in client selection as well as in designing programs and when coaching. These business owners need to understand the gender system in order to handle it more effectively. It is argued that special programs are still needed, even in a country like Sweden known for its relative equality between women and men.Originality/valueThe context is interesting and the longitudinal in‐depth approach brought the author unusually close to advisors and participants. It enabled an understanding of what happened over a short period of time in the minds of those involved, regarding sensitive issues.

A factor in quality: information on client satisfaction/dissatisfaction

AbstractThe interrelation of client satisfaction with quality of service or product produced is brought out in the discussion on the importance to know whether a client (customer) is satisfied or dissatisfied with a company's (contractor's) service or product. Nine factors to be considered in determining client satisfaction or dissatisfaction are discussed. An algorithm is given for determining the client's figure of merit, which gives a means for prioritizing clients to be contacted. The nine factors are types of clients, which includes advantages and disadvantages of clients by class and contact comparisons; criteria for selection of clients to be contacted; the four types of contact and considerations for types to use; those to make the contact; when to contact client; contactor training topics; analysis of results of contact findings; documentation of contacts: and follow‐up and follow‐through activities. Items concerning the contact plan also are given as well as a sample plan. The paper closes with a set of inferred conclusions. Copyright © 2007 John Wiley & Sons, Ltd.

THE ACCESS OF AGRICULTURAL FARMS TO BANK CREDITS OFFER

The access of agricultural farms to the bank credit offer is determined by a series of factors having a negative or positive influence, meaning the farms financial performances and the efficient management of risks by commercial banks. The analysis made by commercial banks in crediting begins with client selection and stretches to the dimensioning of the maximum credit volume that can be given to a petitioner. The evolution of agricultural credits in the period 2004 - May 2007 and their percentage in the total bank crediting is unsatisfactory and extremely low for the development of a performing agriculture. This means it is necessary for banks to rethink and implement a flexible crediting system.

Performance-based Funding of Supported Employment for Persons with Severe Mental Illness: Vocational Rehabilitation and Employment Staff Perspectives

Vocational rehabilitation (VR) supervisors and counselors (n = 35) as well as supported employment (SE) program managers and employment specialists (n = 26) were enrolled in a 12-month evaluation comparing two models of funding services for persons with severe mental illness: fee-for-service and results-based funding (RBF). Quantitative measures of job satisfaction and preference for funding method were obtained prospectively on a quarterly basis, and SE staff activity logs were collected monthly. Qualitative data were collected using a series of focus groups conducted at the conclusion of the study. Despite recording a substantial increase in semi-annualized VR billing charges when using RBF (45-49%), SE staff expressed less satisfaction with RBF over time. Staff raised concerns about increased financial risks and pressures to achieve job placements under RBF. Vocational rehabilitation staff were consistently more satisfied with RBF, expressing particular satisfaction with perceived effectiveness and the payment authorization process. Both VR and SE staff expressed some reservations about RBF, primarily concerning possible pressures for adverse client selection.

Non-hormonal methods of contraception

<h2>Abstract</h2> Non-hormonal methods of contraception cover a range of methods from permanent sterilization, requiring an invasive surgical procedure, to natural family planning, which relies on women's own fertility awareness, and is often taught by non-clinical volunteers. Sterilization and IUDs are the most popular methods worldwide, with 200 million and 100 million users respectively. Sterilization is intended to be permanent, and comprehensive preoperative counselling is essential to ensure appropriate client selection and reduce subsequent regret and reversal requests. IUDs offer long-acting, reversible and highly effective contraception. Post-insertion complications are rare, but infection is increased in the first 3 weeks after insertion. Sexual history-taking before insertion identifies those in whom an STI screen is indicated. Male condoms have regained popularity over the last two decades and can offer reliable contraception when used consistently. Protection against STIs, including HIV, is an obvious advantage. Female barrier methods include the female condom and diaphragm and are used by a small number of women, but offer a female-controlled method, with minimal associated health risks. Natural family planning, when used by motivated couples, can offer acceptable fertility control, and is often attractive to those who may find other methods unacceptable.

Non-hormonal methods of contraception

From a global perspective, non-hormonal methods of contraception are used on an impressive scale. The two most common methods of contraception worldwide, namely sterilization and the intrauterine device, are used by over 200 and 100 million couples respectively. Both methods offer highly effective methods of fertility control, and other than undergoing the initial procedure, require minimal ongoing effort from the user. Of course both methods are associated with some risk of complications, but this can be minimized by appropriate counselling and client selection. The male condom has seen a resurgence in popularity over the past years, and is now used by many couples for protection against sexually transmitted infection, including HIV. It continues to offer reasonable protection against pregnancy, although is often combined with use of another method, when prevention of pregnancy is paramount. Although female barrier methods, such as the vaginal diaphragm, cervical cap and spermicides are used by small numbers of women, they represent an important choice for those wishing a female controlled method, with minimal health implications and side effects. Some women continue to opt for natural family planning, using a variety of methods to identify the fertile time of the menstrual cycle. These methods offer moderate pregnancy protection in well motivated couples, and may be acceptable when other methods are rejected on moral grounds.

The Societal, Social, and Economic Impacts of the World Weather Research Programme Sydney 2000 Forecast Demonstration Project (WWRP S2000 FDP)

The Sydney 2000 (S2000) Forecast Demonstration Project (FDP) was initiated by the World Meteorological Organization (WMO) World Weather Research Programme (WWRP) to enable the world meteorological community to cooperatively demonstrate advanced technologies and methods for accurate and specific short-term weather forecasting (nowcasting). FDP output was developed in support of the Sydney 2000 Olympics and trialed throughout and beyond the Olympic period. As is the case with all WWRP projects, the WWRP S2000 FDP included an assessment of the social, societal, and economic impacts of the project's forecasts. The Impacts Study considered how Bureau of Meteorology (BoM) forecasters employed the enhanced FDP information to produce more “useful” nowcasts, and how selected end users accessed, utilized, and acted upon these enhanced forecasts. End users included the Sydney Organizing Committee for the Olympic Games (SOCOG) and a small selection of other BoM clients. With few storms or severe weather events during the 2.5-month trial period the opportunity to fully evaluate the impact of the FDP technologies was limited. Nevertheless, positive social, societal, and economic impacts were clearly indicated and additional potential benefits were identified by users. This paper details the WWRP S2000 FDP environment, discusses the processes and outcomes of the WWRP FDP Impacts Study, and outlines the benefits and implications of this type of research to both the producers and users of weather forecast products.

Sentenced to Treatment: Early Experience of Drug Treatment and Testing Orders in England

Drug Treatment and Testing Orders (DTTOs) were introduced in the 1998 Crime and Disorder Bill and were piloted in three areas in England over the subsequent 18 months. The orders, funded by the Home Office, allow drug using offenders to be coerced into attending for treatment, to have regular urine tests and to be reviewed by the courts. In Croydon an equal partnership was set up between probation, a local statutory provider of drug services and a voluntary sector agency. Treatment plans were individualised and included a variety of treatment options. Forty-eight orders were imposed mainly for persistent shoplifting. Sixty-three percent of individuals had used heroin and 54% crack cocaine in the 30 days before the order was imposed. Ethical issues raised in coerced treatment were important for the individuals providing treatment although the clients all had to consent to treatment. The pilot programme raised issues about the nature of treatment, clinical responsibility, the selection of clients for orders and the objectives of treatment. Frequent urine testing was problematic but in the vast majority of cases clients were not breached just because of positive tests. The provision of DTTOs in an area created unacceptable inequalities in access to treatment. The paper concludes that partnership working and clear objectives are vital for treatment programmes to operate effectively. More research is needed to explore the most optimum way to deliver treatment in the context of a DTTO.

Titrating versus targeting home care services to frail elderly clients: an application of agency theory and cost-benefit analysis to home care policy.

The article summarizes the shortcomings of current home care targeting policy, provides a conceptual framework for understanding the sources of its problems, and proposes an alternative resource allocation method. Methods required for different aspects of the study included synthesis of the published literature, regression analysis of risk predictors, and comparison of actual resource allocations with simulated budgets. Problems of imperfect agency ranging from unclear goals and inappropriate incentives to lack of information about the marginal effectiveness of home care could be mitigated with an improved budgeting method that combines client selection and resource allocation. No program can produce its best outcome performance when its goals are unclear and its technology is unstandardized. Titration of care would reallocate resources to maximize marginal benefit for marginal cost.

Assertive community treatment: development of the team, selection of clients, and impact on length of hospital stay.

Mental health services have been criticized for the lack of focus and response to people suffering from a serious mental illness (SMI). Assertive community treatment (ACT) offers the potential for greater partnership working between the user and provider of mental health services. The author describes one approach in developing ACT in the UK. Four criteria were developed to identify the most appropriate service users for ACT: those with SMI, illness instability, illness disability and risk to self or others. Fifty-five clients were identified using these criteria and tracked for their length of hospital stay and frequency of admission 2 years before acceptance to an ACT team and for 12 months after. Duration of hospital stay was unchanged although both the frequency and total numbers of bed days were reduced.

Norplant® Expansion in Kenya

Norplant is a long-acting contraceptive that has been introduced into family planning programs all over the world. Its efficacy, safety and acceptability in the introductory phases have been widely tested, and most studies point to the need for good provider training in insertion and removal; good client counseling on side effects, suitable client selection to limit early removal, and attention to client access to removal services. Some problems with the method in the developed world, and a belief that it is too costly for developing countries, have led to a waning of support by international donors. Few studies have examined how service delivery expansion in the developing world can minimise and address potential problems as well as maintain Norplant's cost-effective edge against other methods. We examine the expansion of Norplant services in Kenya between 1992 and 1996, specifically in relation to client access to services, removal issues, and cost. Well-supervised and careful expansion has resulted in quality services being provided at more than 70 sites in the country. Early removal is limited, removals seem to have posed few problems, and Norplant offers a welcome and cost-effective addition to the family planning method mix.

Perinatal mortality in breech delivery.

Single babies delivered by breech at Mansa General Hospital (Zambia) during a 12 month period from September 1993 to August 1994 were studied retrospectively. Breech delivery accounted for 2.44% single births. The perinatal mortality rate was high (341/1000) and involved mainly the low birth weight babies. This study confirms previously published reports of higher perinatal mortality in breech presentation. However, with proper selection of clients, intrapartum fetal monitoring and skilful birth attendants, a substantial proportion of breech presentations could have been safely delivered vaginally.

A Career Choice Critique of Legal Ethics Theory

The article contends that legal ethics theory would benefit from incorporating an oft-overlooked reality of modern law practice: career choices often predetermine the clients that lawyers represent and the legal strategies that attorneys pursue. The problem with many existing ethics models is that they incorrectly assume that lawyers have sufficient autonomy to select their clients and legal strategies. In fact, most types of law practice place such significant restrictions on lawyers' freedom that career choices provide many attorneys with their main source of discretion. The article suggests that, in light of these client selection and strategy choice constraints, theorists need to explore the ethical dimensions of career choices but have repeatedly failed to do so. The piece ultimately suggests several ways in which existing models can incorporate the important constraining effects of career decisions and how they can consequently offer a richer vision of legal ethics.

'Are you poor enough?' - client selection by microfinance institutions

The debate between the proponents of maximizing sustainability, outreach and scale and thus serving many poor people (including poorer people) and the proponents of targeting 'the poorest of the poor' (discussed by Dunford in SED Vol. 11 No. 1) continues. The debate is essentially a healthy one, helping everyone involved in the industry focus on what matters: providing financial services to poor people. This article argues that MFI programmes should include the 'nonpoor' on the grounds that this more profitable business can crosssubsidize outreach to the poor, and because, without access to any financial services, vulnerable non-poor people are likely to be reduced to poverty when a crisis arises. Regarding 'the poor', MFIs wishing to service this group should offer savings and other innovative products, since poor people have few opportunities to utilize Grameen-type credit efficiently. Finally, the very poor or destitute may require relief services before they can use most financial products. The challenge overall is to design appropriate products, and efficient systems - and in this way both MFIs and their clients will benefit.