Co-located Services Research Articles

INNOVATIVE APPROACHES TO MENTAL HEALTH SERVICES FOR DIVERSE COMMUNITY OLDER ADULTS

Abstract Addressing the triple stigma (age, mental health, race) faced by older adults in need of mental health services has necessitated innovations that move the service provision needle. Co-located services within community settings, mental health interventions addressing those with nutritional needs, and victims of elder abuse and elder crime benefit from innovative services. The following session will highlight research outcomes from innovative treatment models: (a) In a sample of 138 diverse individuals participating in PROTECT (a brief behavioral intervention for late-life depression among elder abuse/crime victims) showed 5.15 point reductions in PhQ-9 scores across the sample and found video-delivery was non-inferior to traditional in-person therapy. Those receiving video therapy completed treatment faster, with more rapid rate of symptom reduction. (b) Do More Feel Better (a 9-week peer-led manualized intervention for those with depression and nutritional needs) found 78% experienced clinically significant reduction in depressive symptoms and over two-thirds (66%) reported satisfaction with the program. (c) DGMH (mental health services co-located in older adult centers) data indicate that of the 4,118 clients assessed, 3,373 endorsed at least one mental health need (81.9%), significantly higher than the mental health literature indicates. Over 2,133 clients have been treated in 67,597 sessions since program inception in 2018. Within 3-months of treatment, 60.8% and 52% showed clinically significant improvements in depression and anxiety, respectively. A third reported decreased loneliness and 39.4% indicated feeling less socially isolated. Further data will be presented (demographic, racial, ethnic differences). Data supported efficacy lend support to innovative mental health treatment approaches.

How co-locating public mental health interventions in community settings impacts mental health and health inequalities: a multi-site realist evaluation

BackgroundPublic mental health interventions are non-clinical services that aim to promote wellbeing and prevent mental ill health at the population level. In England, the health, social and community system is characterised by complex and fragmented inter-sectoral relationships. To overcome this, there has been an expansion in co-locating public mental health services within clinical settings, the focus of prior research. This study evaluates how co-location in community-based settings can support adult mental health and reduce health inequalities.MethodsA qualitative multi-site case study design using a realist evaluation approach was employed. Data collection took place in three phases: theory gleaning, parallel testing and refining of theories, and theory consolidation. We collected data from service users (n = 32), service providers (n = 32), funders, commissioners, and policy makers (n = 11), and members of the public (n = 10). We conducted in-depth interviews (n = 65) and four focus group discussions (n = 20) at six case study sites across England, UK, and two online multi-stakeholder workshops (n = 20). Interview guides followed realist-informed open-ended questions, adapted for each phase. The realist analysis used an iterative, inductive, and deductive data analysis approach to identify the underlying mechanisms for how community co-location affects public mental health outcomes, who this works best for, and understand the contexts in which co-location operates.ResultsFive overarching co-location theories were elicited and supported. Co-located services: (1) improved provision of holistic and person-centred support; (2) reduced stigma by creating non-judgemental environments that were not associated with clinical or mental health services; (3) delivered services in psychologically safe environments by creating a culture of empathy, friendliness and trust where people felt they were being treated with dignity and respect; (4) helped to overcome barriers to accessibility by making service access less costly and more time efficient, and (5) enhance the sustainability of services through better pooling of resources.ConclusionCo-locating public mental health services within communities impacts multiple social determinants of poor mental health. It has a role in reducing mental health inequalities by helping those least likely to access services. Operating practices that engender inter-service trust and resource-sharing are likely to support sustainability.

Maximising the health impacts of free advice services in the UK: A mixed methods systematic review.

After a decade of austerity spending cuts and welfare reform, the COVID‐19 pandemic has posed further challenges to the finances, health and wellbeing of working‐age, low‐income people. While advice services have been widely seen (and funded) as an income maximisation intervention, their health and well‐being impact is less clear. Previous systematic reviews investigating the link between advice services and health outcomes have found a weak evidence base and cover the period up until 2010. This mixed methods review examined up to date evidence to help understand the health impacts of free and independent welfare rights advice services. We included evaluations of free to access advice services on social welfare issues for members of the public that included health outcomes. Through comprehensive searches of two bibliographic databases and websites of relevant organisations we identified 15 articles based on a mixture of study designs. The advice interventions evaluated were based in a range of settings and only limited information was available on the delivery and nature of advice offered. We undertook a convergent synthesis to analyse data on the effectiveness of advice services on health outcomes and to explain variation in these outcomes. Our synthesis suggested that improvements in mental health and well‐being measures are commonly attributed to advice service interventions. However, there is little insight to explain these impacts or to inform the delivery of services that maximise health benefits. Co‐locating services in health settings appears promising and embracing models of delivery that promote collaboration between organisations tackling the social determinants of health may help to address the inherent complexities in the delivery of advice services and client needs. We make recommendations to improve routine monitoring and reporting by advice services, and methods of evaluation that will better account for complexity and context.

Rural service hubs and socially innovative rural-urban linkages: A conceptual framework for nexogenous development

Co-locating services has become a common solution to the many longstanding challenges of service access and provision in rural areas. Rural service hubs – which offer two or more services at the same outlet – take many forms, typically responding to triggers for social innovation. Despite their growing ubiquity, however, rural service hubs have been little studied in comparative perspective. This article shifts the lens on service hubs from place-based solutions towards a broader, multi-scalar and multi-level perspective on rural connectivity. We propose a five dimension conceptual framework in contribution to the emerging theorisation of nexogenous rural development a model for resourceful reconnection beyond place and across rural–urban space. Drawing on examples from Austria, Finland and Wales, we illustrate how diverse service hub models mobilise social innovation, networks, scale and proximity to support service access and provision.

Using human centered design to identify opportunities for reducing inequities in perinatal care

BackgroundExtreme disparities in access, experience, and outcomes highlight the need to transform how pregnancy care is designed and delivered in the United States, especially for low-income individuals and people of color.MethodsWe used human-centered design (HCD) to understand the challenges facing Medicaid-insured pregnant people and design interventions to address these challenges. The HCD method has three phases: Inspiration, Ideation, and Implementation. This study focused on the first and second. In the Inspiration phase we conducted semi-structured interviews with a purposeful sample of stakeholders who had either received or participated in the care of Medicaid-insured pregnant people within our community, with a specific emphasis on representation from marginalized communities. Using a general inductive approach to thematic analysis, we identified themes, which were then framed into design opportunities. In the Ideation phase, we conducted structured brainstorming sessions to generate potential prototypes of solutions, which were tested and iterated upon through a series of community events and engagement with a diverse community advisory group.ResultsWe engaged a total of 171 stakeholders across both phases of the HCD methodology. In the Inspiration phase, interviews with 23 community members and an eight-person focus group revealed seven insights centered around two main themes: (1) racism and discrimination create major barriers to access, experience, and the ability to deliver high-value pregnancy care; (2) pregnancy care is overmedicalized and does not treat the pregnant person as an equal and informed partner. In the Ideation phase, 162 ideas were produced and translated into eight solution prototypes. Community scoring and feedback events with 140 stakeholders led to the progressive refinement and selection of three final prototypes: (1) implementing telemedicine (video visits) within the safety-net system, (2) integrating community-based peer support workers into healthcare teams, and (3) delivering co-located pregnancy-related care and services into high-need neighborhoods as a one-stop shop.ConclusionsUsing HCD methodology and a collaborative community-health system approach, we identified gaps, opportunities, and solutions to address perinatal care inequities within our urban community. Given the urgent need for implementable and effective solutions, the design process was particularly well-suited because it focuses on understanding and centering the needs and values of stakeholders, is multi-disciplinary through all phases, and results in prototyping and iteration of real-world solutions.

DOES SPEED MATTER? THE ROLE OF HIGH‐FREQUENCY TRADING FOR ORDER BOOK RESILIENCY

AbstractWe analyze limit order book resiliency following liquidity shocks initiated by large market orders. Based on a unique data set, we investigate whether high‐frequency traders are involved in replenishing the order book. Therefore, we relate the net liquidity provision of high‐frequency traders, algorithmic traders, and human traders around these market impact events to order book resiliency. Although all groups of traders react, our results show that only high‐frequency traders reduce the spread within the first seconds after the market impact event. Order book depth replenishment, however, takes significantly longer and is mainly accomplished by human traders’ liquidity provision.

Destitution and Paths to Justice

This report, jointly commissioned by The Legal Education Foundation and The Joseph Rowntree Foundation, is one of a number of parallel reports published alongside Fitzpatrick et al’s (2018) research “Destitution in the UK”. Fitzpatrick et al’s (2018) research estimates that: “approximately 1,550,000 people, 365,000 of them children, were destitute in UK at some point over the course of 2017” (Fitzpatrick et al. 2018:2). This report explores the role of the law and access to legal services (or lack thereof) in creating pathways into, and out of, destitution. The key recommendations are as follows: A statutory duty on destitution should be created: Primary legislation should establish a clear definition of destitution and a duty on public bodies to protect all persons lawfully present in the UK from destitution. Legal services should be co-located with other crisis and support services: Co-locating services would reduce referral fatigue and improve the ability of advisors to intervene earlier. The resourcing of legal services is vital in order to render any statutory duty to prevent destitution meaningful. Government should be placed under a positive duty to facilitate access to social security: The government should be placed under a positive duty to ensure that individuals are receiving the social security benefits they are entitled to. This would require government to address systemic issues in the administration of benefits.

Impact of Algorithmic Trading on Speed of Adjustment to New Information: Evidence from Interest Rate Derivatives

This study examines the impact of algorithmic trading (AT) on the speed of adjustment and price discovery during scheduled macroeconomic announcements for interest rate derivatives. In February 2012, the Australian Securities Exchange (ASX) introduced co-location services for futures traders. This change in market structure increases AT and, in this study, we examine price efficiency for both exchange-traded futures and over-the-counter (OTC)-traded swaps in the pre- and post-AT periods. Our results demonstrate that, in the presence of AT, the speed of adjustment to new information has improved for both futures and swaps. In addition, we find that the price discovery contribution of the futures market improves in the post-AT period, with this improvement significant for announcement days. We conclude that AT stimulates market adjustment to new information and enhances the price discovery of futures on days with scheduled macroeconomic releases.

Interprofessional Education: Co-located Services, Not Just Classwork

Interprofessional Education: Co-located Services, Not Just Classwork

The Impact of Latency Sensitive Trading on High Frequency Arbitrage Opportunities

Classical economic theory suggests that excess returns should be competed away as new participants enter the market. This is especially true for the profits from riskless arbitrage. Yet, there is conflicting evidence in the financial economic literature over whether high frequency trading (HFT) profits, in general, (Baron et al [2012]) and arbitrage profits, in particular (Budish et al [2013] and Chaboud et al [2013]), decline as high frequency or other algorithmic trading increases. There are important public policy implications for market microstructure and the social value of investments by HFT firms in being faster if arbitrage profit opportunities persist (in the absence of limits to arbitrage). There are several different strategies that high frequency and other latency sensitive traders engage in. These include: index arbitrage; spread arbitrage/market making; and correlated arbitrage among others. This study focuses on only one - index arbitrage. Specifically, it examines whether the duration, frequency and profitability of potential arbitrage opportunities between the Australian Securities Exchange (ASX) Share Price Index (SPI) futures contract and the exchange traded fund (ETF), STW, have changed as the number of HFT firms (or intensity of HFT activity) has increased, since the ASX’s introduction of co-location services in February 2012. In addition, we use estimated potential arbitrage profits and compare them to the cost of being co-located to determine the value of minimum latency. Not surprisingly, we find the frequency and profitability of potential arbitrage opportunities are greater during volatile and high turnover periods - other things equal. We examine the increased competition in high frequency trading by identifying the number of ‘cabinets’ co-located in the ASX’s liquidity center. With increased HFT connections, we observe increasing value, frequency and duration of index arbitrage profit opportunities. Our results are robust to the inclusion of transaction costs. We conclude that the activity of disruptive HFT outweighs the activity of index arbitrage HFTs.

Does Speed Matter? The Role of High-Frequency Trading for Order Book Resiliency

This paper explores limit order book resiliency following liquidity shocks in the presence of high-frequency traders. Based on a unique data set that enables the identification of orders submitted by algorithms and subscribers of co-location services, we study whether high-frequency traders are involved in the replenishment of the order book. We analyze order submission and deletion activity before and after liquidity shocks initiated by large market orders. Our results show that exclusively high-frequency traders reduce the spread within the first seconds after the liquidity shock making use of their speed advantage. However, liquidity recovery in terms of order book depth takes significantly longer and is accomplished by human traders' submission activity only.

Is integration an add-on or a new way of working for health professionals in co-located medical practices?

Introduction: Characteristically health services within the community are not separated based on illness/condition but rather on profession for example, GP services, physiotherapy clinics. In the primary health sector government policy at federal and state levels has established integrated health services. Functional and operationalised integration does not spontaneously arise from colocating health professionals. Despite primary health reforms there is no prescriptive method whereby services are integrated. For those health professionals working in a co-located primary health care environment how integrated is ‘integrated’? Practice and context: Our study examines integration at the point of service delivery, within colocated community medical practices in Australia: five different case study practices in areas of high population need. These are a purposeful mix of the state government model, Commonwealth government model (university linked Superclinic), a hybrid of state and Commonwealth model, and private for profit models. Change implemented: These practices commenced delivering co-located health services with an underlying philosphy of service integration to better address patient health outcomes (between 3 and 10 years). Objective of the change: We examine health professionals’ experience of health service integration. Targeted population: Health professionals in an integrated service delivery environment. Stakeholders engaged: Health professionals in the case study clinics. World Congress on Integrated Care 2014, Sydney, November 23-26, 2014. International Journal of Integrated Care – Volume 14, 8 December – URN:NBN:NL:UI:10-1-116679– http://www.ijic.org/ Timeline: These are practices offering a range of services for between 3 and 10 years. The questionnaire was completed over a 3 week period (July 2014) and focus groups were conducted from July – September 2014. Theory/method: Our research method plan is a multiple case study (mixed methods design) of contemporary co-location service models. The case study approach incorporates close interaction with practitioners and deals with real management situations. Our data collection method was twofold; individual questionnaires designed for our research questions, and focus groups. Highlights (innovation/impact/outcomes): This is timely research with the increasing emphasis on patient centred care and recognition that more than one discipline can contribute to patient wellbeing. Health professionals varied in their expectations of integration. There was variability across the models on different components of health professional experience. Integration was described as lacking direct leadership and overt expectations of health professionals. Some infrastructure supported integration at an operational level but integration regarding patient care was relatively informal. Co-location may be the only form of health professional interface. Sustainability: Co-located services can be sustained without health professional integration because patients can continue to receive services but health professional retention and patient services can arguably be impacted by dealing with patients with multiple and chronic conditions on a longer term basis. Transferability: Outcomes of this research can be transferred and adapted across co-located health services to improve levels of integration. Conclusions: Integration as it impacts health professionals has been under-researched in colocated health services. The case study environments were not obstructive but were not making optimal use of co-located services. Discussions: Co-location is a start towards integration but health professionals see greater potential in higher levels of integration. Lessons learned: Health professionals favour integration and there are key factors that feature in their expectations of integrated health service delivery.

Co-locating services in IoT systems to minimize the communication energy cost

Ubiquitous sensing and actuating devices are now everywhere in our living environment as part of the global cyber–physical ecosystem. Sensing and actuating capabilities can be modeled as services to compose intelligent Internet of Things (IoT) applications. An issue for perpetually running and managing these IoT devices is the energy cost. One energy saving strategy is to co-locate several services on one device in order to reduce the computing and communication energy. In this paper, we propose a service merging strategy for mapping and co-locating multiple services on devices. In a multi-hop network, the service co-location problem is formulated as a quadratic programming problem. We show a reduction method that reduces it to the integer programming problem. In a single hop network, the service co-location problem can be modeled as the Maximum Weighted Independent Set (MWIS) problem. We show the algorithm to transform a service flow to a co-location graph, then use known heuristic algorithms to find the maximum independent set which is the basis for making service co-location decisions. The performance of different co-location algorithms are evaluated by simulation in this paper.

Trade size, high-frequency trading, and colocation around the world

We examine the impact of changes in market microstructure, particularly algorithmic trading (AT) and high-frequency trading (HFT), on trade size across 24 stock exchanges around the world. Using colocation services as a proxy for AT and HFT, we find mixed results on the impact of AT and HFT on the average trade size. Furthermore, we test whether the presence of HFT leads to the introduction of colocation services. The data are consistent with the view that HFT pre-dates colocation by at least eight months on most exchanges, and has strong power in explaining the introduction of colocation services. In effect, our results show that colocation services do not properly measure effective AT and HFT; rather, colocation services are the result of HFT. Exchanges choose to offer colocation services due to the fact HFT requires higher speed transactions. Finally, we show there have been substantial changes in trade size in other countries such as China where there is no HFT and offer explanations for these changes and suggest avenues for future research.

Identifying International Start Dates for Algorithmic Trading and High Frequency Trading

We examine the impact of changes in market microstructure, particularly algorithmic trading (AT) and high frequency trading (HFT), on trade size across 24 stock exchanges around the world. Using colocation services as a proxy for AT and HFT, we find mixed results on the impact of AT and HFT on the average trade size. Furthermore, we test whether the presence of HFT leads to the introduction of colocation services. The data are consistent with the view that HFT pre-dates colocation by at least 8 months on most exchanges, and has strong power in explaining the introduction of colocation services. In effect, our results show that colocation services do not properly measure effective AT and HFT; rather, colocation services are the result of HFT. Exchanges choose to offer colocation services due to the fact HFT requires higher speed transactions. Finally, we show there have been substantial changes in trade size in other countries such as China where there is no HFT, and offer explanations for these changes and suggest avenues for future research.

Teleport Services: NOC The state of the Art

With the state-of-the-art teleport and broadcast satellite space segment today host of services are provided for the media companies to address their broadcasting needs across Asia Pacific, Middle East, Africa and India etc. In addition subfeature support of Co-location Services, Data Centers and at par Telecom Services, are ideal choice for the media companies. Numerous automation and optimization techniques adds to its ease of use [1][5]. General Terms Teleport Services, Network Operation Center, Teleport architecture.

Co-located health and social care services in Wales: What are the benefits to professionals?

Our study investigated two co-located learning disability services in Wales. The paper reports the views of professionals who were involved in planning the new services as well as of those who eventually worked in the services. Fourteen professionals from health, social care, voluntary service providers, and advocacy groups were interviewed over an 8-month period. The main focus of the investigation was on problems in establishing the co-located services, what the existing barriers to improved learning disabilities services are and how co-location may address these barriers. Respondents were positive about the dynamism that the service planning phase brought, but there was also a consensus that some aspects of multi-agency work across professional divides were outside the control of the new services. Overall, although there are clear benefits of co-location for professionals, co-locating services largely appear to be a missed opportunity on the way towards more integrated health and social care services in the learning disabilities sector. This raises questions about the usefulness of co-location as part of the integration policy agenda.