Flexible Service Provision Research Articles

Developing a model of care for substance use in pregnancy and parenting services, Sydney, Australia: Service provider perspectives

IntroductionThe absence of a clear model of care for services supporting pregnant women and mothers with substance use disorders has impeded opportunities to build an evidence base for the effectiveness of these services. Previous research has typically focused on the needs of pregnant women or mothers, as two distinct groups. This paper explores service providers' perceptions of key components of a model of care, extending from perinatal care to community-based support for up to 17 years post-delivery. A model of care is outlined and feasibility factors affecting implementation are highlighted. MethodsQualitative methods were adopted as a first step to informing development of the model of care. Semi-structured in-depth interviews were conducted with thirty-eight staff providing a range of substance use in pregnancy and parenting services (SUPPS) in hospital and community-based agencies, in a metropolitan health district in Sydney, Australia. Interview data was entered into NVivo and analysed using constant comparative methods. ResultsGuiding principles for the model of care included integrated care, harm reduction and person-centredness. Practice approaches integral to the model of care were promoting engagement with women, flexible service provision, trauma-informed care, and continuity of care. Feasibility factors influencing implementation of the model of care included fragmentation or siloing of the service network and workforce sustainability. ConclusionsA harm reduction approach was crucial for promoting engagement of women with SUPPS, particularly child protection services. A greater focus on providing ongoing community-based support for mothers also has the potential to achieve sustainable positive outcomes for women and children. Implementation of the SUPPS model of care could be undermined by threats to integration of service delivery and continuity of care. Further research is needed to explore consumer perspectives and inform the model of care as a framework for evaluation.

Towards Flexible Distribution Systems: Future Adaptive Management Schemes

During the ongoing evolution of energy systems toward increasingly flexible, resilient, and digitalized distribution systems, many issues need to be developed. In general, a holistic multi-level systemic view is required on the future enabling technologies, control and management methods, operation and planning principles, regulation as well as market and business models. Increasing integration of intermittent renewable generation and electric vehicles, as well as industry electrification during the evolution, requires a huge amount of flexibility services at multiple time scales and from different voltage levels, resources, and sectors. Active use of distribution network-connected flexible energy resources for flexibility services provision through new marketplaces will also be needed. Therefore, increased collaboration between system operators in operation and planning of the future power system will also become essential during the evolution. In addition, use of integrated cyber-secure, resilient, cost-efficient, and advanced communication technologies and solutions will be of key importance. This paper describes a potential three-stage evolution path toward fully flexible, resilient, and digitalized electricity distribution networks. A special focus of this paper is the evolution and development of adaptive control and management methods as well as compatible collaborative market schemes that can enable the improved provision of flexibility services by distribution network-connected flexible energy resources for local (distribution system operator) and system-wide (transmission system operator) needs.

The flexibility gap: Socioeconomic and geographical factors driving residential flexibility

Residential consumers are moving to the center of electricity systems and their flexibility is seen as a key resource to integrate renewable energy sources and support the grid. However, residential flexibility capacities are not homogeneous, as they depend on household appliances, comfort patterns, occupancy, and climate conditions. Here, we calculate the technical flexibility capacities of 45 consumer types in mainland Spain, organised according to income and regional criteria. We show that flexibility gaps exist at both regional and socioeconomic (income) levels with flexibility differences of up to 10 times more capacity between the household groups from the lowest to the highest capacities. These geographical and socioeconomic gaps in flexibility can lead to distortions in national markets and have the potential to exclude citizens from the provision of flexibility services. Our results show in quantitative terms that a consumer-centered approach without considering correcting measures nor these gaps in drafting energy policies may lead to increasing inequality levels in the residential sector. Under an economic competitive paradigm, households with lower income levels or located in regions with lower flexibility potential may be excluded from the provision of flexibility to the detriment of households with larger potential, raising justice concerns in a flexibility-based energy transition.

Psychodynamic interpersonal therapy as a brief telephone crisis intervention during coronavirus lockdown: Experiences of both the help seekers and the helper

Brief psychodynamic interpersonal therapy (PIT) was offered by telephone during Coronavirus lockdown, for people feeling psychologically unsafe. People testified that remote PIT created a safe space to connect with feelings, building hope and clarity after crisis. Flexible service provision of PIT with modest resources is discussed.

Reliability-Oriented and Resource-Efficient Service Function Chain Construction and Backup

In the network function virtualization (NFV) environment, network services are usually provided in the form of service function chains (SFCs), which defines the link order of virtual network functions required in service requests and are mapped to the physical network. Although NFV facilitates the flexible provision of network services, service interruptions may occur as a result of software and hardware failures. Current solutions mostly use the backup method to ensure the reliability of SFCs. However, these methods ignore the SFC construction phase that has an impact on reliability. Besides, the resource efficiency still requires improvement. To address these issues, reliability-oriented SFC construction and backup problems are investigated in this work. First, an instance-sharing and reliable construction algorithm (ISRCA) is proposed to aggregate multiple SFCs into a service function graph (SFG), and perform reliability screening for the SFG set. After mapping the SFG to the physical network, a node-ranking algorithm with centrality and reliability (NRCR) is proposed for backup node selection and backup instance deployment to improve the reliability of SFCs that have not met the requirements. Experimental results demonstrate that under the premise of ensuring reliability, the proposed backup method can reduce the consumption of bandwidth resources by about 11.7%, when combined with the proposed construction method, it can further reduce the backup resources by 13.9%.

Virtualized and Micro Services Provisioning in Space-Air-Ground Integrated Networks

In this article, we justify an online service provisioning (OSP) framework to provision virtualized and micro service (VMS) to users, which can achieve efficient, flexible, and scalable service provisioning. Compared to the onboard service provisioning framework, the system bottleneck shifts from the onboard computation limitation to the network capability and robustness in OSP, which the space-air-ground integrated network (SAGIN) can ably support. First, the motivations of OSP and VMS per the current mobile application industry are identified. Then we investigate the capabilities of the SAGIN to enable the OSP framework, where the evolution of the terrestrial network, on-demand deployment of an aerial network, and global coverage with a satellite network are reviewed. Afterward, we elaborate on three major techniques of VMS provisioning in the OSP framework: application decomposition, control protocol design, and microservice placement/replacement. Finally, we design and implement a case study to demonstrate the efficacy of provisioning VMS in OSP.

Flexible service provision for codeine-based dependencies in primary care

This article examines the recognised problem of a growing number of patients showing addictive dependencies on prescribed medications, mainly codeine-based analgesia and benzodiazepines. Public Health England has encouraged health services to try and recognise this issue and address it. The development of the Benzodiazepine and Opiate Withdrawal Service from an area of addiction services for drug and alcohol provision in Camden and Islington has been one such initiative. This article includes case studies that show what is possible in terms of treatment. It also shows that experienced nurses can play a role in achieving positive outcomes for patients dependent on prescribed medication.

Optimizing dynamic switching between fixed and flexible transit services with an idle-vehicle relocation strategy and reductions in emissions

Abstract A novel approach to dynamic switching service design based on a new queuing approximation formulation is introduced to systematically control conventional buses and enable provision of flexible on-demand mobility services. This new approach guides smart vehicles in a service area that needs last mile transit services via either traditional buses, which provide fixed-route services, or flexible-route on-demand mobility services. We also include dynamic pre-positioning of idle vehicles in anticipation of new customer arrivals, and relocation of vehicles to rebalance the use of vehicles in the system, which can have a sizable effect on energy and environmental conservation. Using a New York City transit dataset, the proposed strategy for non-myopic switching between flexible-route and fixed-route service and re-positioning of idle vehicles improves social welfare by up to 32%, while the impact of the proposed strategy on vehicle miles traveled is shown to be as high as 53% over that of the current transit service.

Energy efficient network service deployment across multiple SDN domains

The emergence of Software Defined Networking (SDN) and Network Function Virtualization (NFV) enables flexible service provisioning and deployment. However, with the continuous expansion of network scale and sharp increasing of end users, how to flexibly provide network services across multiple SDN domains for users is becoming a critical issue. A major challenge in the multi-domain network service provisioning is the network service deployment method taking into account energy efficiency. In this paper, we study the problem of how to optimally deploy network services across multiple SDN domains with the target of saving energy while achieving the load balancing of multi-domain networks. Specifically, firstly, we propose a novel multi-domain network service deployment framework by integrating SDN architecture and NFV technology, which can intelligently deploy virtual network functions (VNFs) into multi-domain networks. Secondly, we formulate this problem as a multi-objective optimization model to achieve the minimization of energy consumption and load balancing of multi-domain networks. Furthermore, we present a heuristic network service deployment algorithm to solve it. Finally, simulation results demonstrate that the proposed heuristic service deployment algorithm is efficient and outperforms comparison algorithms in terms of energy consumption and load balancing degree.

Transactive Energy for Aggregated Electric Vehicles to Reduce System Peak Load Considering Network Constraints

Due to the increasing utilization of electric vehicles (EVs), future power grids may face challenges of system peak load that are usually solved by means of grid reinforcements. By providing flexibility, acquired from flexible consumers, such as EVs, the need for grid reinforcements can be avoided or postponed. Therefore, in order to solve the peak load problem, this paper focuses on the provision of flexibility services through the local market. It presents a framework for the participation of aggregated electric vehicles in the local market, considering the operating constraints of the grid. In the proposed framework, aggregators interact in a transactive, market-based manner, with a transactive energy (TE) operator and distribution system operator (DSO) to resolve operational problems. For the market-based operation, a bidding model is proposed and formulated as an optimization problem that minimizes the total cost of DSO for acquiring flexibility services from EVs. The proposed model uses EVs as flexible loads to illustrate the method, and it is tested with case-studies conducted on two IEEE test systems.

EUniversal: the universal market enabling interface as a way to unlock flexibility solutions for cost-effective management of smarter distribution grids

This paper offers an overview of EUniversal H2020 project which aims to develop and demonstrate a replicable solution for the interaction of the DSO (through the UMEI – Universal Market Enabling Interface) with the new flexibility markets and services specified and developed within the project. The UMEI brings forward a universal, open, adaptable and modular approach to interlink active system management with electricity markets and foster the provision of flexibility services, also acknowledging the activation needs of DSOs and the coordination requirements with other commercial parties and TSOs. EUniversal comprises 3 demonstration sites: Portugal, focusing on the demonstration of the UMEI concept and of new data driven network operation tools for the management of market driven flexibility services for LV and MV grids; Germany, addressing congestion management using market-driven flexibility via the UMEI in LV networks; Poland, focusing on grid observability and future networks supporting flexibility management via the UMEI. The interdisciplinary and complementary expertise of the project partners will allow to capture and cover different requirements and solutions and to maximise their impact and replicability across Europe. Lastly, the project will develop business models archetypes for flexibility mechanisms, perform a Cost Benefit Analysis and deliver a Roadmap.

An integrated tool for optimal energy scheduling and power quality improvement of a microgrid under multiple demand response schemes

This paper presents an integrated tool to mitigate power quality issues in a microgrid through coordinating the operating schedule of its generating resources and loads. Such a microgrid includes renewable and conventional distributed energy resources, electric vehicles, energy storage, linear and nonlinear loads, while it serves as an example small-to-medium scale residential and commercial buildings. The proposed tool operates on a sequential, two-stage basis: at the first stage the energy management system (EMS) ensures that the microgrid’s generation resources and loads are dispatched at the minimum total system cost. In addition, it assesses the potential provision of flexibility services towards the system operator, relying on financially incentivized power signal requests. At the second stage, the power quality (PQ) framework evaluates whether the proposed optimal solution complies or not with several PQ standards applicable to the distribution level. The unique characteristic of the proposed tool is the self-triggered interaction between the EMS and the PQ framework, which identifies potential PQ violations, and restores the PQ indices to acceptable levels through an iterative process. Case studies have been performed with realistic model parameters to verify the performance of the proposed integrated tool. The obtained results demonstrate the effectiveness of the algorithm in managing voltage deviations, voltage unbalance, as well as harmonic distortions with a small additional cost for the total system.

Public preferences for home care services for people with dementia: A discrete choice experiment on personhood

Dementia is a progressive and debilitating neurodegenerative condition which significantly impacts on quality of life and the ability to live independently. It is a leading cause of disability in older populations and carries significant economic and social costs. It is no wonder, therefore, that dementia has been identified as a major global health and social care challenge, especially with prevalence projected to triple by 2050. In many countries, the stated policy aim is to care for people with dementia in their own homes for as long as possible and practicable. However, home care systems vary significantly across countries in their approach to personhood in dementia, particularly the extent to which care provision reflects the needs and preferences of recipients. In this paper, we undertook a discrete choice experiment, with data collected from 551 individuals in Ireland between November and December 2018, to elicit public preferences for personhood-oriented home care services for people with moderate dementia. We capture the concept of personhood with two attributes, one that refers to whether care provision is flexible and tailored to the individual needs of the person with dementia, and a second that refers to whether communication with the person with dementia is expressed in a personalised manner. Using mixed logit models, we find that flexible service provision, personalised communication and increased home care hours are highly valued by citizens. While people are indifferent to a means-tested co-payment for home care relative to no co-payment, they are opposed to a universal co-payment. We also estimate the welfare impact of a move from the status quo to alternative personhood-oriented home care arrangements, providing useful insights for policymakers regarding the future design and funding of home care services. The paper has significant implications for the recalibration of health and social care systems towards personhood in dementia care.

Dynamic network service deployment across multiple SDN domains

AbstractThe integration of software defined networking (SDN) and network function virtualization (NFV) is a promising approach to support flexible service deployment and provisioning. In particular, NFV enables a network service to be represented as one network service function chain, which is composed of several virtual network functions in a specific order. However, with regard to service provisioning in multidomain SDN networks, virtual network functions are deployed in several different SDN domains due to limited resource capacity of each SDN domain. It results in the network service deployment complexity increase and causes additional operating cost. On the other hand, most current network service deployment proposals are limited to static user request scenarios. How to effectively deploy network service across multiple SDN domains to satisfy dynamic service demands of end users is a challenging problem. To address the aforementioned challenge, in this paper, we study the problem of dynamic network service deployment across multiple SDN domains. Specifically, we first design a novel service deployment framework to support dynamic deployment and optimization of virtual network function in multidomain SDN networks. Then, we formulate the problem as a multiobjective optimization problem with the target of jointly minimizing resource consumption cost and operating cost. Furthermore, we transform the multiobjective optimization problem into a single objective optimization model and present an efficient heuristic service deployment approach to solve it by leveraging Dijkstra algorithm. The simulation results demonstrate that the proposed service deployment method is efficient and outperforms comparison methods in terms of service rejection ratio, resource cost, and operating cost.

End of life care for people with alcohol and drug problems: Findings from a Rapid Evidence Assessment.

People who use alcohol and other drugs(hereafter "substances") and who are over the age of 40 are now more likely to die of a non-drug related cause than people who use substances under the age of 40. This population will therefore potentially need greater access to palliative and end of life care services. Initially, the purpose of this rapid evidence assessment (REA), conducted August 2016-August 2017, was to explore the peer-reviewed evidence base in relation to end of life care for people with problematic substance use. The following databases were searched using date parameters of 1 January 2004-1 August 2016: Amed, Psycharticles, Ovid, Ageinfo, Medline, Ebscohost, ASSIA, Social Care Online, Web of Knowledge, Web of Science, SSCI, Samsha, NIAAA. Data were extracted using a predefined protocol incorporating inclusion and exclusion criteria. Given the dearth of evidence emerging on interventions and practice responses to problematic substance use, the inclusion criteria were broadened to include any peer-reviewed literature focussing on substance use specifically and end of life care. There were 60 papers that met the inclusion criteria. These were quality assessed. Using a textual thematic approach to categorise findings, papers fell into three broad groups (a) pain management, (b) homeless and marginalised groups, and (c) alcohol-related papers. In general, this small and diverse literature lacked depth and quality. The papers suggest there are challenges for health and social care professionals in meeting the end of life needs of people who use substances. Addressing issues like safe prescribing for pain management becomes more challenging in the presence of substance use and requires flexible service provision from both alcohol/drug services and end of life care providers. Work is needed to develop models of good practice in working with co-existing substance use and end of life conditions as well as prevalence studies to provide a wider context for policy development.

SDNMS: A software defined network measurement system for NFV networks

As a promising technology to completely transform how we architect, deploy, operate and manage various networks, software-based Network Function Virtualization (NFV) enables hardware-independent, flexible, fast and efficient network service provision. With the increasing popularity of NFV paradigm, the Internet has also transformed to be a hybrid environment where NFV-based network entities coexist with traditional network devices. To facilitate our understanding, design, evaluate and manage of such novel network environment, there is a great need for a new NFV-compatible network measurement system which is still in absent so far. To bridge this gap, a system, named Software Defined Network Measurement System (SDNMS), is presented in this paper. Firstly, the architecture of SDNMS is proposed. In this architecture, a formal method to describe the working mode of the network measurement is defined. This method can also be utilized to generate a network measurement middle box (NMMB) in a specific location of the NFV network according to the customized description file, and to flexibly deploy the network measurement function. Secondly, the technology of virtual network measurement function (VNMF) combined with LXC is studied to form NMMB function. Thirdly, a control method is presented to control the start, stop, and update NMMB to form a specific network measurement system function. Finally, a prototype of SDNMS with network monitoring function to monitor network performance anomalies and locate faults is introduced. Experimental results have shown that SDNMS architecture and related technologies are feasible and effective to deploy and control network measurement functions in NFV networks. We hope SDNMS could provide a new method for practitioners to conduct network management and research at the age of NFV.

Filling a void? The role of social enterprise in addressing social isolation and loneliness in rural communities.

Social isolation and loneliness has been classed as a major public health concern due to its negative physical and mental health implications, and living in a remote or rural area is a prominent contributing risk factor. Community-led social enterprise models are recognised in government policy as a potential preventative measure for social isolation and loneliness, yet there is a lack of understanding of their application in rural contexts. The objectives of this paper are to investigate the role of social enterprise in addressing social isolation and loneliness in rural communities, and to explore the pathways in which social enterprise activity may act upon the health and wellbeing of social enterprise beneficiaries. We also discuss the capacity of rural community members to deliver and sustain such services. The study used in-depth interviews over a three-year period with 35 stakeholders from seven social enterprises in the Highlands and Islands of Scotland, including board members, staff, volunteers and service users. Findings showed that social enterprises are successfully providing activities that counteract factors contributing to social isolation and feelings of loneliness, leading to wider health and wellbeing benefits for individuals. However, the sustainability and continuity of social enterprises are questionable due to the burden on smaller populations, limited expertise and knowledge of running social enterprises, and effects on the personal lives of social enterprise volunteers and staff. This study supports suggestions that social enterprises can be generators of health and wellbeing through their varied remit of activities that impact on the social determinants of health. However, it also shows that relying on social enterprise as a particular solution to social isolation and loneliness is precarious due to complexities associated with rurality. Therefore, rural policy and practice must move away from a ‘one size fits all’ approach to tackling social isolation and loneliness, recognise the need for local level tailored interventions and, through harnessing the potential or rural social enterprises, enable flexible service provision that correlates with rural context.

A framework for the provision of flexibility services at the transmission and distribution levels through aggregator companies

Abstract A hierarchical control framework is proposed that enables the provision of flexibility services in power systems through aggregation entities. The focus is on both wholesale energy trade functions, i.e. day-ahead market optimisation, and ancillary services to the operators of the transmission and distribution systems, i.e. provision of automatic frequency restoration reserves and peak shaving services. The control framework is generic, scalable, and is effectively configured to address all those diverse needs originating from the lower level, i.e. the device or the user, to the distribution and transmission levels. The work includes the establishment of procedures to identify and solve possible conflicts between the operators of the transmission and distribution systems when procuring ancillary services with competing objectives. The framework is applied on a case study focusing on an aggregation of residential buildings in the Netherlands which are equipped with photovoltaic installations and battery-based energy storage systems. The annual costs and benefits are calculated by using historical market data, whereas the simulation scenarios address the impact of different levels of generation and demand forecasting errors in the economic performance. The outcome of computer simulations provides an informative insight into the differences between the strategies of aggregator companies, and the potential of the investigated markets. The economic evaluation includes the value estimation of peak shaving services at the distribution level. An increase in procurement costs for such services is expected to stimulate the distribution system operators to invest into grid capacity enhancement.

Best Practices and Recommendations for Digital Interventions to Improve Engagement and Adherence in Chronic Illness Sufferers

Abstract. Chronic illnesses cause considerable burden in quality of life, often leading to physical, psychological, and social dysfunctioning of the sufferers and their family. There is a growing need for flexible provision of home-based psychological services to increase reach even for traditionally underserved chronic illness sufferer populations. Digital interventions can fulfill this role and provide a range of psychological services to improve functioning. Despite the potential of digital interventions, concerns remain regarding users’ engagement, as low engagement is associated with low adherence rates, high attrition, and suboptimal exposure to the intervention. Human–computer interaction (e.g., theoretical models of persuasive system design, gamification, tailoring, and supportive accountability) and user characteristics (e.g., gender, age, computer literacy) are the main identified culprits contributing to engagement and adherence difficulties. To date, there have not been any clear and concise recommendations for improved utilization and engagement in digital interventions. This paper provides an overview of user engagement factors and proposes research informed recommendations for engagement and adherence planning in digital intervention development. The recommendations were derived from the literature and consensualized by expert members of the European Federation of Psychology Associations, Psychology and Health Standing Committee, and e-Health Task Force. These recommendations serve as a starting point for researchers and clinicians interested in the digitalized health field and promote effective planning for engagement when developing digital interventions with the potential to maximize adherence and optimal exposure in the treatment of chronic health conditions.

Anchor Free IP Mobility

Efficient mobility management techniques are critical in providing seamless connectivity and session continuity between a mobile node and the network during its movement. However, current mobility management solutions generally require a central entity in the network core, tracking IP address movement, and anchoring traffic from source to destination through point-to-point tunnels. Intuitively, this approach suffers from scalability limitations as it creates bottlenecks in the network, due to sub-optimal routing via the anchor point. This is often termed “dog-leg” routing. Meanwhile, alternative anchorless, solutions are not feasible due to the current limitations of the IP semantics, which strongly tie addressing information to location. In contrast, this paper introduces a novel anchorless mobility solution that overcomes these limitations by exploiting a new path-based forwarding fabric together with emerging mechanisms from information-centric networking. These mechanisms decouple the end-system IP address from the path based data forwarding to eliminate the need for anchoring traffic through the network core; thereby, allowing flexible path calculation and service provisioning. Furthermore, by eliminating the limitation of routing via the anchor point, our approach reduces the network cost compared to anchored solutions through bandwidth saving while maintaining comparable handover delay. The proposed solution is applicable to both cellular and large-scale wireless LAN networks that aim to support seamless handover in a single operator domain scenario. The solution is modeled as a Markov-chain which applies a topological basis to describe mobility. The validity of the proposed Markovian model was verified through simulation of both random walk mobility on random geometric networks and trace information from a large-scale, city wide data set. Evaluation results illustrate a significant reduction in the total network traffic cost by 45 percent or more when using the proposed solution, compared to Proxy Mobile IPv6.