Service Framework Research Articles

Examining the Use and Application of the WHO Integrated People-Centred Health Services Framework in Research Globally - a Systematic Scoping Review.

The World Health Organisation (WHO) accepted the Integrated People-centred Health Services (IPCHS) framework in 2016 as an essential component for achieving universal health coverage in fragmented health systems. We aimed to examine the empirical applications of the WHO IPCHS framework to guide its use in strengthening health-service research. Academic databases and the IPCHS website were searched for relevant articles published between 2016 and July 2023. Two reviewers independently screened and extracted data on the study design, setting, IPCHS framework components, and facilitators and barriers to implementing the IPCHS strategies. Descriptive and content analyses were conducted. Six studies were identified using the IPCHS framework. Studies have examined a combination of the five IPCHS strategies. All studies reported building strong primary care-based systems and coordinating care for individuals. Continued relationships and trust, co-production of health programmes, diversity of health care team, and technology were major facilitators, while low health literacy, lack of primary setting capacity and healthcare workforce were principal barriers to IPCHS implementation. This scoping review offers an overview of IPCHS strategies employed in healthcare research. Generally, the IPCHS framework remains underutilised in primary research. These results offer guidance for future research to support effective healthcare delivery.

Matching supply and demand of cooling service provided by urban green and blue space

Urban blue-green space (UBGS) has been extensively investigated for its climate regulation capability in the context of climate change. However, current efforts are limited toward the cooling effects mismatch in supply and demand of UBGS. This study adapts the framework of ecosystem supply and demand to quantify the supply-demand matching of the cooling effects of UBGS. Two indices were proposed to evaluate cooling provision and demand of UBGS: Cooling Supply Index (CSI), accounting for cooling contribution and spatial effect, and Cooling Demand Index (CDI), considering physical and social dimensions of cooling demand. Four-quadrant analysis and bivariate local indicators of spatial autocorrelation (BiLISA) analysis were employed to distinguish the supply-demand matching status: high supply with high demand, low supply with high demand, low supply with low demand, and high supply with low demand. The results show that 1) CSI and CDI yield great performance in quantifying cooling supply and demand, respectively; 2) the four-quadrant analysis and bivariate LISA analysis are complementary to each other, and can target those areas in different matching statuses for climate-sensitive planning and design; and 3) particular attention should be given to areas characterized by low supply with high demand. This study marks a crucial step toward integrating social aspects into the analysis of cooling effects provided by UBGS. It enriches the analysis framework for urban ecosystem services and provides valuable guidance for landscape planning to mitigate heat stress.

Implementation of the Environmental Goods and Services Accounting into the Statistical Practice of the Russian Federation

The article discusses the main characteristics of the international statistical standard «System of Environmental-Economic Accounting 2012 – Central Framework» (SEEA) in terms of the Environmental Goods and Services Sector (EGSS) developing as well as the provisions of the Eurostat methodological guidelines which are designed to facilitate the monitoring of progress in the EU policy priorities implementation in the field of environmental protection, rational resource management and «green» growth economy. The authors presented a brief overview of publications made by Rosstat specialists and Russian scientists in the field of environmental protection.The body of article defines practical recommendations on the EGSS implementation into statistical practice in Russia: both the justified approach for compilation the list of environmental goods and services, and the identified statistics sources for calculation the EGSS indicators, as well as an algorithm for their calculation developed by the authors. The recommendations provided in this article are the methodological framework for environmental goods and services accounting.According to the authors, the study findings will permit further development of methodological guidelines for the EGSS compilation accordance with the Action Plan («Roadmap») for the Implementation of Priority Accounts of the System of Environmental-Economic Accounting approved by the Government of the Russian Federation.

Implementation of the Environmental Goods and Services Accounting into the Statistical Practice of the Russian Federation

The article discusses the main characteristics of the international statistical standard «System of Environmental-Economic Accounting 2012 – Central Framework» (SEEA) in terms of the Environmental Goods and Services Sector (EGSS) developing as well as the provisions of the Eurostat methodological guidelines which are designed to facilitate the monitoring of progress in the EU policy priorities implementation in the field of environmental protection, rational resource management and «green» growth economy. The authors presented a brief overview of publications made by Rosstat specialists and Russian scientists in the field of environmental protection.The body of article defines practical recommendations on the EGSS implementation into statistical practice in Russia: both the justified approach for compilation the list of environmental goods and services, and the identified statistics sources for calculation the EGSS indicators, as well as an algorithm for their calculation developed by the authors. The recommendations provided in this article are the methodological framework for environmental goods and services accounting.According to the authors, the study findings will permit further development of methodological guidelines for the EGSS compilation accordance with the Action Plan («Roadmap») for the Implementation of Priority Accounts of the System of Environmental-Economic Accounting approved by the Government of the Russian Federation.

Influence of an Early Human Milk Diet on the Duration of Parenteral Nutrition and Incidence of Late-Onset Sepsis in Very Low Birthweight (VLBW) Infants: A Systematic Review.

Introduction: Human milk is the preferred source of enteral nutrition for very low birthweight (VLBW) infants, and it possibly decreases dependence on parenteral nutrition (PN) and reduces incidence of late-onset sepsis (LOS). No systematic review to date has specifically addressed the value of early versus late introduction of human milk diet (HMD) on duration of PN and incidence of LOS among VLBW infants. Objective: To review the evidence for an early versus late introduction of HMD on duration of PN and incidence of LOS in VLBW infants. Method: Preferred reporting items for systematic reviews and meta-analysis-guided search of EMBASE and PubMed/Medline databases was conducted for this systematic review using phrases addressing population, intervention, comparator, and outcome framework to identify articles published over the past two decades without language restrictions. Full-text articles (both observational and randomized) that studied an early versus late initiation of HMD were included. Mean difference (MD) and relative risk (RR) with 95% confidence intervals (CIs) were calculated for PN and LOS. Quality of evidence was analyzed using UK National Service Framework and the risk-of-bias was assessed using Robvis®. Results: One randomized controlled trial (RCT) and two observational studies (two English and one Chinese) recruited 474 VLBW infants (455 analyzed). Among an intrauterine growth-restricted cohort enrolled in the RCT (n = 72), early HMD resulted in statistically significant reduction in PN dependence. However, no statistically significant difference was found in LOS. Two observational studies found similar reductions in PN duration and LOS incidence among the early HMD cohort. One observational study reported significant PN reduction; however, the incidence of LOS did not reach statistical significance in either case. Conclusion: An early HMD may reduce the duration of PN for a growth-restricted VLBW cohort. Observational studies suggesting reduced PN and LOS from early HMD endorse the need for bioactivity-focused human milk research. Variations in feeding guidelines among VLBW infants have the potential to influence neonatal outcomes significantly.

Legal Framework of Medical Service in the City of Osijek During the First Half of the 19th Century

The aim of this research work is to gain insight into how the medical service was legally regulated in the city of Osijek, the main Slavonian center to which a large number of people immigrated after the Great Turkish War, and which consequently spread the fear of the appearance of new infections in that area. At the same time, special attention was paid to medical regulations after the city of Osijek received the status of a Free Royal City in 1809. Despite the jurisdiction of the Royal Hungarian – Protectoral Council and the Royal Hungarian Court Chamber, the Liberation Charter enabled the city of Osijek to establish its own self-governing bodies. Thus, along with the City Council and its representatives, a lesser- known physical department was founded, which was headed by a physicist. In particular, it was a physician with the highest level of responsibility, who had the authority to protect the public health of the population of the Free Royal City of Osijek.

Implementing Telestroke in the Inpatient Setting: Identifying Factors for Success.

Inpatient telestroke programs have emerged as a solution to provide timely stroke care in underserved areas, but their successful implementation and factors influencing their effectiveness remain underexplored. This study aimed to qualitatively evaluate the perspectives of inpatient clinicians located at spoke hospitals participating in a newly established inpatient telestroke program to identify implementation barriers and facilitators. This was a formative evaluation relying on semistructured qualitative interviews with 16 inpatient providers (physicians and nurse practitioners) at 5 spoke sites of a hub-and-spoke inpatient telestroke program. The Integrated-Promoting Action on Research Implementation in Health Services framework guided data analysis, focusing on the innovation, recipients, context, and facilitation aspects of implementation. Interviews were transcribed and coded using thematic analysis. Fifteen themes were identified in the data and mapped to the Integrated-Promoting Action on Research Implementation in Health Services framework. Themes related to the innovation (the telestroke program) included easy access to stroke specialists, the benefits of limiting patient transfers, concerns about duplicating tests, and challenges of timing inpatient telestroke visits and notes to align with discharge workflow. Themes pertaining to recipients (care team members and patients) were communication gaps between teams, concern about the supervision of inpatient telestroke advanced practice providers and challenges with nurse empowerment. With regard to the context (hospital and system factors), providers highlighted familiarity with telehealth technologies as a facilitator to implementing inpatient telestroke, yet highlighted resource limitations in smaller facilities. Facilitation (program implementation) was recognized as crucial for education, standardization, and buy-in. Understanding barriers and facilitators to implementation is crucial to determining where programmatic changes may need to be made to ensure the success and sustainment of inpatient telestroke services.

Legal Services for Veterans (LSV): Protocol for evaluating the grant-based LSV initiative supporting community organizations' delivery of legal services to veterans.

1.8 million Veterans are estimated to need legal services, such as for housing eviction prevention, discharge upgrades, and state and federal Veterans benefits. While having one's legal needs met is known to improve one's health and its social determinants, many Veterans' legal needs remain unmet. Public Law 116-315 enacted in 2021 authorizes VA to fund legal services for Veterans (LSV) by awarding grants to legal service providers including nonprofit organizations and law schools' legal assistance programs. This congressionally mandated LSV initiative will award grants to about 75 competitively selected entities providing legal services. This paper describes the protocol for evaluating the initiative. The evaluation will fulfill congressional reporting requirements, and inform continued implementation and sustainment of LSV over time. Our protocol calls for a prospective, mixed-methods observational study with a repeated measures design, aligning to the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) and Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) frameworks. In 2023, competitively selected legal services-providing organizations will be awarded grants to implement LSV. The primary outcome will be the number of Veterans served by LSV in the 12 months after the awarding of the grant. The evaluation has three Aims. Aim 1 will focus on measuring primary and secondary LSV implementation outcomes aligned to RE-AIM. Aim 2 will apply the mixed quantitative-qualitative Matrixed Multiple Case Study method to identify patterns in implementation barriers, enablers, and other i-PARIHS-aligned factors that relate to observed outcomes. Aim 3 involves a mixed-methods economic evaluation to understand the costs and benefits of LSV implementation. The LSV initiative is a new program that VA is implementing to help Veterans who need legal assistance. To optimize ongoing and future implementation of this program, it is important to rigorously evaluate LSV's outcomes, barriers and enablers, and costs and benefits. We have outlined the protocol for such an evaluation, which will lead to recommending strategies and resource allocation for VA's LSV implementation.

“Dissecting the paradox: spirituality and yoga in mental wellbeing.”

ABSTRACT This research critically examines the intricate interplay between spirituality and yoga, assessing their collective impact on mental wellbeing. Amidst yoga’s transcultural proliferation, transcending its indigenous spiritual roots, this study probes the intricacies inherent in its adaptation as a mental health intervention. The research utilizes qualitative and ethnographic methodologies to dissect yoga’s therapeutic efficacy, juxtaposing its spiritual genesis with secular manifestations. Central to this analysis is the exploration of whether the secularization of yoga practices dilutes or maintains their therapeutic potential. Navigating the nuanced dynamics from both global and Indian perspectives, this study contributes to a sophisticated understanding of yoga’s evolving role within contemporary mental health paradigms. By examining the paradoxical coexistence of spiritual and secular dimensions in yoga, the research aims to inform and enhance mental health service frameworks, addressing a significant lacuna in current mental health discourse.

A Proposed Framework of VAPT Services in Web Application Deployed on Infrastructure as a Service (Iaas)

Most companies in Malaysia require their employees to work from home due to the COVID-19 pandemic. This situation also increased the number of data generated from various sources, thus exposing them to different security risks. Even though the employees are encouraged to work from home because of the COVID-19 pandemic, they still need to communicate among themselves to do their work. However, working from home depends mainly on cloud computing (CC) applications that help employees accomplish their daily work efficiently. Injection attacks, such as SQL injection and Cross-Site Scripting (XSS), are critical security vulnerabilities that can lead to unauthorized access, data breaches, and potential service disruptions in web applications. With the increasing adoption of cloud computing, web applications deployed on cloud platforms like Amazon Web Services (AWS) are becoming more prevalent and vulnerable to such attacks. Therefore, it is crucial to develop practical Vulnerability Assessment and Penetration Testing (VAPT) techniques specifically tailored to identify and detect injection vulnerabilities in web applications deployed on AWS. However, existing VAPT methodologies often need more comprehensive coverage for injection vulnerabilities in cloud-based web applications, and they may not consider the unique characteristics and challenges associated with the AWS environment. This research addresses this gap by proposing an enhanced VAPT framework focusing specifically on injection attacks in web applications deployed on AWS.

European Union media policy: a tool for strengthening members relationship

European Union media policy has evolved significantly over the years, serving as a powerful tool for fostering stronger relationships among its member states. The development of this policy can be divided into several distinct phases, each reflecting the changing landscape of media and the EU’s expansion. EU media policy aims to establish a common framework for media services, facilitating the free movement of audiovisual content across borders. The EU recognized the need to compete with non-European productions and introduced programs to support and promote European works, providing essential funding to bolster the industry. EU media policy has played a pivotal role in strengthening relationships among member states by promoting a unified media market, facilitating cross-border content sharing, and fostering a sense of common identity through media. However, it also faces ongoing challenges in adapting to the fast-paced media landscape and accommodating the diverse needs of member and candidate states. The article explores the multifaceted role of EU media policy in fostering closer ties among member states and highlights ongoing challenges in the media field.

Research on Establishing a Vocational College Employment and Education Community

This study endeavors to empower graduates in achieving personal fulfillment through employment, elevating the caliber of practical education, and fostering societal equilibrium. Employing a thorough literature review, it surveys the current landscape of research on vocational college employment and education communities. Utilizing social research methodologies and interviews with frontline employment service providers, it identifies deficiencies in the construction process across work planning, key actors, and target groups. The study proposes a strategic framework for establishing a vocational college employment and education community. It advocates firstly for refining the framework of employment and educational services, secondly for fostering collaborative efforts among key actors in employment and education, and lastly for enhancing the targeted approach to employment and educational initiatives, thereby comprehensively advancing educational outcomes and employment standards.

Integrating ecosystem service supply–demand and ecological risk assessment for urban planning: A case study in Beijing, China

The balance between ecosystem service supply–demand and landscape ecological risk are two crucial aspects influencing the sustainable development of regional ecosystems. Current evaluations ignore these aspects and lead to partial landscape planning in urban areas. As a result, a framework was built for regional planning in urban areas based on multidimensional evaluations of ecosystems for high-efficiency land use planning. First, to determine the ecosystem service balance in regional scale, the supply and demand of five ecosystem services were quantified—biodiversity conservation, carbon sequestration, water conservation, food production, and landscape recreation. Second, landscape ecological risks were identified using the “natural–social–landscape” research framework combined with spatial principal component analysis. Third, spatial clustering analysis of ecosystem service supply–demand ratios and landscape ecological risks was then performed through spatial autocorrelation, which aimed to identify areas for protection and restoration priority. Finally, GeoDetector was used to determine the main factors influencing ecosystem service balance and landscape ecological risks and develop targeted planning measures. The results revealed an imbalance in total ecosystem service supply–demand in Beijing's plain area, coupled with a high level of landscape ecological risk. The combined ecosystem service supply–demand ratios exhibited a significant negative correlation and aggregation with landscape ecological risk, and the significant area accounted for approximately 31.9% of the total area. Priority areas for protection and restoration accounted for 10.39% and 19.94%, respectively, of the total regional area. Land use, distance to settlements, and vegetation cover were the primary environmental variables influencing the distributions of the combined ecosystem service supply–demand ratios and landscape ecological risk. So, this study emphasizes the need to strengthen intensive land use and prevent the uncontrolled expansion of urban land and settlements. It is crucial to enhance urban green infrastructure construction, promote the development of biodiversity-friendly agriculture, and implement measures such as afforestation restoration to increase regional vegetation cover. Overall, by integrating a framework of ecosystem services and landscape ecological risk, a comprehensive scientific reference can be provided for the efficient land use and sustainable development planning in urban areas.

"You and Me Do It for the Love of Teaching": Exploring the Expansion of Clinical Training Opportunities for Midwives.

To better understand the barriers and facilitators to precepting midwifery students from across the healthcare ecosystem in New Jersey. Growing the midwifery workforce is a crucial step to alleviating disparately poor perinatal health outcomes and expanding access to care. Difficulty recruiting and retaining preceptors has been identified as a barrier to graduating more midwives. In-depth qualitative interviews were conducted with 19 individuals involved in different stages of the clinical training process: midwives, physicians, and administrators. Transcripts were coded using the tenets of qualitative description and thematic analysis. Analysis was guided by the Promoting Action on Research Implementation in Health Services framework. The following themes were identified and organized within the domains identified by our conceptual framework. Evidence: (mis)understanding the benefits of midwifery care and impacts on patient care. Context: the time and energy it takes to precept and practice considerations. Facilitations: developing the next generation of healthcare providers and the quiet and ever-present role of money in healthcare. Findings from this study support the importance of approaching midwifery precepting as a multifaceted endeavor, one that necessitates the full support of individuals within many different roles in an organization. Getting buy-in from various levels of the healthcare ecosystem requires a flexible approach but must include a targeted effort toward showing the value of midwifery care in terms of patient outcomes, satisfaction, and cost.

A fusion architecture to deliver multipurpose mobile health services

Mobile Health (mHealth) services typically make use of customized software architectures, leading to development-dependent fragmentation. Nevertheless, irrespective of their specific purpose, most mHealth services share common functionalities, where standard pieces could be reused or adapted to expedite service deployment and even extend the follow-up of appearing conditions under the same service. To harness compatibility and reuse, this article presents a data fusion architecture proposing a common design framework for mHealth services. An exhaustive mapping of mHealth functionalities identified in the literature serves as starting point. The architecture is then conceptualized making use of the Joint Directors of Laboratories (JDL) data fusion model. The aim of the architecture is to exploit the multi-source data acquisition capabilities supported by smartphones and Internet of Things devices, and artificial intelligence-enabled feature fusion. A series of interconnected fusion layers ensure streamlined data management; each layer is composed of microservices which may be implemented or omitted depending on the specific goals of the healthcare service. Moreover, the architecture considers essential features related to authentication mechanisms, data sharing protocols, practitioner-patient communication, context-based notifications and tailored visualization interfaces. The effectiveness of the architecture is underscored by its instantiation for four real cases, encompassing risk assessment for youth with mental health issues, remote monitoring for SARS-CoV-2 patients, liquid intake control for kidney disease patients, and peritoneal dialysis treatment support. This breadth of applications exemplifies how the architecture can effectively serve as a guidance framework to accelerate the design of mHealth services.

Impact of Perceived Servicescape on Patient Satisfaction through Mediating Role of Service Credibility and Moderating Role of Received Word of Mouth in Rehabilitation

The aim of this study was to explore the effects of perceived servicescape (PS) and credibility of the healthcare service provider (CHSP) on patient satisfaction(PtS) in rehabilitation settings of public and private hospitals of Islamabad and Rawalpindi, Pakistan. Mediating effect of CHSP and moderating effect of received word of mouth (WOM) have also been studied in this relationship. A sample of 300 patients receiving rehabilitation care was selected by applying convenience sampling technique. The design of this study was cross-sectional in nature. Self-administered questionnaire was designed to be utilized. Application of the correlation and regression were executed to analyze the collected quantitative data. The cross-sectional study method, limited geographical area coverage, and small sample size did not allow the detailed testing of the causal relations among study variables. Results of this study have indicated that there was a significant direct positive relationship between perceived servicescape and patient satisfaction and this relationship was also mediated positively by CHSP. There was a substantial direct positive relationship between perceived servicescape and CHSP and, between CHSP and patient satisfaction. However, the moderating effect of received WOM was found to be insignificant. It is recommended that healthcare managers should develop a credible service framework that focuses on better affordability, competitiveness, awareness, empathy, service expertise, pleasant interactions with patients through centeredness communication and beliefs and, subsequently, it will contribute to patient satisfaction and success of the rehabilitation settings. This is the first-ever study of the impact of perceived servicescape on patient satisfaction through CHSP as a mediator and the moderating influence of received WOM in rehabilitation.

Setting the context for a complex dental intervention of role substitution in care homes: Initial process evaluation findings.

SENIOR (uSing rolE-substitutioN In care homes to improve oRal health) is a randomised controlled trial designed to determine whether role substitution could improve oral health for this population. A parallel process evaluation was undertaken to understand context. This paper reports on the first phase of the process evaluation. The oral health and quality-of-life of older adults residing in care homes is poorer than those in the community. Oral health care provision is often unavailable and a concern and challenge for managers. The use of Dental Therapists and Dental Nurses rather than dentists could potentially meet these needs. Semi-structured interviews were conducted with 21 key stakeholders who either worked or had experience of dependent care settings. Questions were theoretically informed by the: Promoting Action on Research Implementation in Health Services (PAHRIS) framework. The focus was on contextual factors that could influence adoption in practice and the pathway-to-impact. Interviews were fully transcribed and analysed thematically. Three themes (receptive context, culture, and leadership) and 11 codes were generated. Data show the complexity of the setting and contextual factors that may work as barriers and facilitators to intervention delivery. Managers are aware of the issues regarding oral health and seek to provide best care, but face many challenges including staff turnover, time pressures, competing needs, access to services, and financial constraints. Dental professionals recognise the need for improvement and view role substitution as a viable alternative to current practice. Although role substitution could potentially meet the needs of this population, an in-depth understanding of contextual factors appeared important in understanding intervention delivery and implementation.

Flexibility services for household consumers in Finland: Requirements and provided properties

The ability to shift energy consumption to a time when a lot of energy is available supports the integration of renewable energy sources. Services that intend to do this automatically are currently emerging in the markets. These kinds of flexibility services are targeted as smart services to household consumers, promising them cost savings, optimal living conditions, and other benefits. The purpose of this paper is to examine the current demand and offering of these kinds of services in Finland. We performed an extensive consumer survey to untangle consumers’ potential, motivation, and engagement in flexibility services and surveyed the properties, similarities, and differences of the flexibility services in the markets. We then defined a quality dimensions framework for flexibility services, with which we evaluated the results to understand the required properties of the services from a consumer viewpoint and how the services respond to these requirements. The results show that Finnish household consumers are quite willing and ready for these kinds of services, and several services are currently available that fulfill some of the identified requirements. Most of the services are currently provided to larger customers, but it should be noted that there also exists demand among individual households. Therefore, clearer incentives, unambiguous definitions of responsibilities, and effortless service introductions are required to motivate consumer participation.

Terrestrial carbon dynamics and economic valuation of ecosystem service for land use management in the Mediterranean region

Land use change is a significant cause of land degradation, resulting in the removal of carbon and its transfer to the hydrosphere or atmosphere, which can have a detrimental impact on essential ecosystem functions and services. In contrast, rural landscapes offer both ecological and economic benefits to people due to their carbon storage properties. This benefit is often evaluated within the framework of Ecosystem Services (ES). The rural landscapes offer unique structures and ecosystem services. The aim of this study is to provide an economic quantification of carbon storage and sequestration in rural landscapes as an ecosystem service and to introduce carbon-based rural landscape management. The study enables the integration of carbon-based strategies and policies by generating quantitative outputs for landscape plans that have not yet been included in the spatial planning hierarchy. The Upper Seyhan Basin (USB), located on the Eastern Mediterranean coast of Turkiye, was modelled using spatiotemporal and economic valuation approaches to assess terrestrial carbon storage and sequestration in this context. The study modelled and mapped the four main terrestrial carbon storage components in the rural landscape: (i) above-ground biomass, (ii) below-ground biomass, (iii) Soil Organic Carbon (SOC), and (iv) dead organic matter carbon. The future land cover of 2055 was modelled using the Multilayer Perceptron (MLP)-Markov Chain (MC) algorithm based on the “Business-As-Usual” (BAU) scenario to determine future carbon sequestration. The Social Cost of Carbon (SCC) was estimated for Turkiye using the Regional Integrated Model of Climate and Economy (RICE) to economically model carbon services. In the final stage of the study, modelling outputs, including carbon storage pools/sinks, projected land cover dynamics, and SCC components, were used within the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model to map the carbon dynamics of the rural landscape at the regional level. This paper demonstrates the role of geospatial modelling and proposes a new planning and design logic that considers carbon-based inputs and global climate change in an appropriate format for land management by bridging the interface between earth sciences and spatial planning. The study results indicate that, the rural landscape in the study area provided an ecosystem service of 70,266 TgC carbon in 2014 with a storage value of USD 222,853,170. For the 2014–2025 projection, an estimated 1.042 TgC of carbon sequestration was valued at USD 6,234,137. The 2014–2055 projection estimated 3.185 TgC of carbon sequestration valued at USD 58,745,265.

How do the existing homecare services correspond with the preferred service ecosystem for senior citizens living at home? A qualitative interview study with multiple stakeholders.

Often, homecare services are task-focused rather than person-based and fragmented instead of integrated. Consequently, several stakeholders have requested a transformation of the service ecosystem for senior citizens living at home. This transformation may be facilitated by an idealized design approach. However, few studies have applied such an approach. Moreover, previous research did not assess the ways in which the existing homecare services correspond with the preferred service ecosystem for senior citizens living at home. Therefore, the purpose of this study is to gain an understanding of how the existing homecare services correspond with the preferred service ecosystem for senior citizens living at home, according to different stakeholders. Four stakeholder groups (n = 57) from a Norwegian municipality participated in an interview study (2019-2020): senior citizens, carers, healthcare professionals and managers. A directed qualitative content analysis was applied, guided by a four-category framework for the preferred service ecosystem. All stakeholder groups highlighted several limitations that hindered continuity of the services. There was also agreement on deficiencies in professionals' competence, yet professionals themselves did not focus on this as a significant aspect. Managers emphasised the importance of professionals' reablement competence, which was also considered to be deficient in the current homecare services. Contrary to the other stakeholder groups, most senior citizens seemed satisfied with the practical and social support they received. Together with carers, they also explained why they thought some professionals lack compassion. Their dependency on professionals may limit them in sharing honestly their opinions and preferences during care provision. Involvement of senior citizens in improvement of the current services was limited. Insufficient time and resources, as well as a complex organisation impacted the existing homecare services, and therefore served as barriers to the preferred service ecosystem. In this study there were different degrees of correspondence between the existing homecare services and the preferred service ecosystem according to four stakeholder groups. To develop the preferred service ecosystem, aspects such as predictability, adaptivity, and relationships are key, as well as continuous involvement of senior citizens and other stakeholders. The four-category framework applied in this study served as a tool to assess the existing homecare services.