Service Delivery Rates Research Articles

Learning-based joint recommendation, caching, and transmission optimization for cooperative edge video caching in Internet of Vehicles

In an era dominated by multimedia information, achieving efficient video transmission in the Internet of Vehicles (IoV) is crucial because of the inherent bandwidth constraints and network volatility within vehicular environments. In this paper, we propose a cooperative edge video caching framework designed to enhance video delivery efficiency in IoV by integrating joint recommendation, caching, and transmission optimization. Leveraging deep reinforcement learning with the discrete soft actor–critic algorithm, our methodology dynamically adapts to fluctuating network conditions and diverse user preferences, aiming to optimize content delivery efficiency and quality of experience. The proposed approach combines recommendation and caching strategies with transmission optimization to provide a comprehensive solution for high-performance video services. Extensive simulation results demonstrate that our framework significantly outperforms traditional baseline methods, achieving superior outcomes in terms of service utility, delivery rate, and delay reduction. These results highlight the robust potential of our solution to facilitate seamless and high-quality video experiences in the complex and dynamic landscape of vehicular networks, advancing the capabilities of IoV content delivery.

Navigating Patient Flow: Assessing the Bottlenecks in Out-Patient Services in a Tertiary Care Hospital in India

Abstract Introduction: Patient flow in hospital outpatient departments (OPDs) is affected by bottlenecks arising from patient load and service capacity mismatch. We evaluated OPD service bottlenecks at a medical college in India by measuring patient flow and service delivery rates and examined possible associations between the service rate and sociodemographic variables. Methods: Two hundred and fifty-two eligible patients in the queue were selected by systematic random sampling from general medicine, respiratory medicine, general surgery, and orthopedic OPDs. Structured interview schedules and checklists were used to gather required information. Waiting times and service delivery rates were compared statistically. Results: Most patients were newly registered (63.89%) and visited the institute directly (87.30%). Surgery had the highest number of doctors. In all OPDs, patient flow exceeded the doctor service rate; the orthopedic OPD had the longest waiting time to see a doctor (85.71% of total time). Patients attending the surgery OPD had the least waiting time and maximum consultation time (25.62% and 65.88% of the total time, respectively). Waiting and consultation times varied significantly between the OPDs. In respiratory medicine, patients took a significantly longer time to consult (P = 0.032). Conclusions: The study recommends facilitating properly scheduled consultation times, rearrangement of infrastructure, and a larger healthcare workforce in OPDs.

Delivery of hereditary cancer genetics services to patients newly diagnosed with ovarian and endometrial cancers at three gynecologic oncology clinics in the USA, Brazil, and Mexico

ObjectiveThree gynecologic oncology clinics located in the USA, Brazil, and Mexico collaborated to evaluate their delivery of hereditary cancer genetics services. This descriptive retrospective review study aimed to establish baseline...

Implementation of telehealth and hybrid service delivery of interdisciplinary rehabilitation for military populations withtraumatic brain injury.

The COVID-19 pandemic necessitated the implementation of telehealth and hybrid service delivery models and provided an opportunity to study the impact of this care model in military populations with history of traumatic brain injury (TBI). To present telehealth service utilization rates across rehabilitation specialties, treatment outcome indicators, and patient satisfaction outcomes from a retrospective clinical sample. The study sample consists of 34 patients who underwent telehealth/hybrid Intensive Outpatient Programming (IOP) at a major rehabilitation hospital. Retrospective chart review and clinical data extraction were performed. A historical cohort receiving in-person care was used as a comparison group. Statistical analyses included partial correlations, mixed method analysis of variance (ANOVA), and independent sample t-tests. Medical, behavioral health, physical, occupational, and speech-language therapy providers exhibited similar rates of telehealth service delivery (35 to 41% of all sessions). No significant association was found between percent telehealth sessions and the global treatment outcome indicator. Comparison of treatment effects across cohorts revealed similar benefits of IOP. No between-group differences were noted in satisfaction ratings. The comparable treatment-related gains and reports of positive patient experience support the use of a telehealth and hybrid delivery model for military service members and veterans with TBI.

Association of a Patient's Type of Insurance With Preventive Service Delivery.

Introduction Chronic disease or death associated with chronic disease is often avoidable with proper interventions, including preventive services in healthcare settings. However, preventive service delivery rates by physicians are low. This study examined the association between preventive services and the type of patient insurance, as well as the association between the duration of an office visit and the type of patient insurance. Methods A retrospective observational cohort study was conducted using multivariate logistic regression. Pooled data on physician office-based visits from the 2011-2016 and 2018 National Ambulatory Medical Care Survey (NAMCS) were used in this analysis. The main measures observed were the odds of providing preventive services as they related to the type of patient insurance. Preventive measures assessed were those recommended by the United States Preventive Services Task Force with an A or B grade, applicable to most adults 18-64. Additionally, the mean office visit duration was analyzed based on the type of insurance. Results The odds of receiving cervical cancer screenings and tobacco smoking cessation screenings were 47% (p <0.01) and 31% (p =0.10) lower with Medicaid than private insurance, respectively. The odds of receiving blood pressure screenings and cervical cancer screenings were 43% (p =0.01) and 62% (p <0.01) lower in uninsured office visits compared to private insurance, respectively. Compared to private insurance, Medicaid and uninsured visits were 2.68 minutes and 1.97 minutes shorter in duration, respectively (p <0.05). Conclusions An association was found between the type of patient's insurance and the odds of providing preventive services. If the aim of healthcare is to improve the incidence of chronic disease or death associated with chronic disease, preventive services should be provided regardless of insurance type.

Analysis of Judiciary Expenditure and Productivity Using Machine Learning Techniques

Maintaining the judiciary requires a high level of budgetary expenditure, but the specifics of this relationship have not yet been fully explored. While several studies have examined the impact of spending on the judiciary through measures related to productivity and performance, none have used machine learning techniques. This study examines the productivity of the court system based on expenditures and other variables using machine learning techniques. In the clustering process Brazilian courts are ranked according to their productivity, while in the neural network step it is verified which characteristics are most relevant at the budgetary level related to judicial productivity for each cluster formed in the first step. The final neural network model supports the results of Pearson’s parametric correlation test, which found no significant correlation between expenditure and productivity. The findings from this study demonstrate the importance of understanding that increasing public budget expenditures alone is not sufficient to improve the efficiency of the judicial system. Instead, other administrative measures are necessary to meet the demands of the Brazilian judiciary and improve service delivery rates. These results offer important theoretical and managerial contributions to the field.

POSTPARTUM MODERN CONTRACEPTIVE UTILIZATION IN ADDIS ABABA: ANTEPARTUM DECIDEDNESS FOR POSTPARTUM UPTAKE

Introduction: Family planning (FP) slows population growth and helps achieve national and international development goals. FP counselling is the first intervention in family planning programs and can be done during late pregnancy. Antepartum FP counseling is not practiced adequately during the antenatal care (ANC) service delivery at which time women can decide to use Post-Partum Modern Contraceptive (PPMC). Women’s antenatal decidedness rate to use PPMC is not known. Objective: To assess the prevalence of antenatal decidedness to use PPMC among pregnant women in Addis Ababa city. Methods: A cross-sectional study was conducted from Tir 01, 2012 to Tir 30, 2012 EC on a population of women who had their 4th ANC visits in 98 health centers in Addis Ababa. The calculated sample size was 422; and the sampling procedure was made in 2 stages: Cluster Sampling and Simple Random Sampling. Study subjects were enrolled in a continuous all-inclusive manner starting from the first woman who came on her scheduled 4th ANC visit on day one of the study period until the total number of study subjects was obtained. A semi-structured, anonymous, self-prepared &amp; pre-tested questionnaire was used to collect data; and data collection was as an exit interview. Data was entered &amp; analyzed using SPSS version 25 software. Results: During the routine ANC follow up only 153 (36.9%) have had FP counseling, and the study team delivered the service for 262 (63.1%). Three hundred eighteen (76.6%) have antenatally decided to use PPMC. The rate of antenatal decidedness to use PPMC was higher for those who had FP counseling by the study team compared to those counseled during the routine ANC follow up (77.9% Vs 74.5%). Religion, the round of ANC visit the FP counseling was given, and the number of topics covered during the FP counseling were found to be determining factors for women’s antenatal decidedness to use PPMC. Conclusion: The FP counseling service delivery rate during the routine ANC service is low. Women will decide to use PPMC antenatally if they get a FP planning counseling conducted during the ANC follow up. The FP counseling should include 4 major topics (available types, efficacy, advantages &amp; disadvantages, and side effects of each method), and an adequate duration should be allocated for it. Further study to find out why ANC care providers at health centers are not providing FP counseling service to all of their clients is recommended.

Optimisation of Queueing Efficiency and Performance of Nigeria Commercial Banks

The objective of this research is to carry out an optimisation of the comparative analysis of the queuing efficiency of commercial banks using the TORA Optimisation Approach. Based on a sample size of four commercial banks of the top two performing banks and least two performing banks in Lagos State Nigeria, the research adopted the output from the Tora Optimisation Software to show the performance of each of the banks based on queuing efficiency. The variables measured include arrival rate ( λ ) and service rate ( µ ). They were analysed for synchronised efficiency in customer satisfaction as relating to the queuing efficiency of each of the banks which were compared among commercial banks using number of queuing efficiency performances such as; the average number of customers on queue and in the system, average time each customer spends on queue and in the system and the probability of the system being idle. The results showed that Bank A had the highest traffic intensity with its customer arrival rate not being matched with faster service delivery rate by bank officials. Banks peak period with high influx of customers was 10:30 to 11:30am and between 12:30pm to 1:30pm daily is off peak period. The research made recommendation on how the queuing efficiency of each banks, can be improved upon due to its concern to most customers. Keywords: Queuing Efficiency, Peak period, Traffic Intensity, Queuing system, Arrival Rate, Service Rate

Customer Satisfaction: A Central Phenomenon in Digital Marketing J&amp;T Express

The decrease in the number of JT express users for 2017-2020 is a serious problem because consumers choose to use other expeditions.This study aims to determine the effect of service quality, delivery rates, timeliness on customer satisfaction JT Express Students of the Faculty of Economics and Business, PGRI University Semarang. In this study, students of the Faculty of Economics and Business, PGRI University Semarang in the 2017,2018,2019 class with a total of 256 respondents. The process of collecting data by distributing questionnaires through the Google Form for Students of the Faculty of Economics and Business, Universitas PGRI Semarang in the 20172018,2019 class. This study uses Multiple Linear Test with IBM SPSS 22. The results of this study indicate a positive and significant effect between service quality, shipping rates on customer satisfaction JT Express Students of the Faculty of Economics and Business, PGRI University Semarang. Punctuality has no effect on customer satisfaction JT Express Students of the Faculty of Economics and Business, PGRI University Semarang. Quality of service, delivery rates and timeliness there are variables that must be considered, namely related to timeliness because service quality and delivery rates affect customer satisfaction

An Improved Binomial Distribution-Based Trust Management Algorithm for Remote Patient Monitoring in WBANs

A wireless body area network (WBAN) is a technology that is widely employed in the medical sector. It is a low-cost network that allows for mobility and variation. It can be used for long-distance, semiautonomous remote monitoring without interfering with people’s regular schedules. Detection devices are embedded in the human body in a simple WBAN configuration to continuously screen physiological boundaries or critical pointers. Confidence among shareholders (for example, medical care suppliers, clients, and medical teachers) is recognized as an essential achievement factor for data stream reliability in such an organization. Given the inherent characteristics of remote locations, it is critical to exercise confidence and security when conducting remote comprehension testing. In the present scenario, WBAN has majorly contributed towards healthcare and its application in medical services. Solid correspondence systems are frequently used to address trust and security concerns on WBANs. In terms of purpose, we present in this study a communication approach built on trust to protect the WBAN’s integrity and confidentiality. For ensuring authenticity, an enhanced bilingual distribution-based trust-management system (PDATMS) approach is used, while a cryptographic system is used to maintain anonymity. A MATLAB simulator is used to evaluate the performance of the recommended program. The recommended approach, according to the release information, improves accuracy by 96%, service delivery rate by 99%, throughput by 99%, as well as confidence, while reducing average latency.

The First UK Experience with Single-use Disposable Flexible Cystoscopes: An In-depth Cost Analysis, Service Delivery and Patient Satisfaction Rate with Ambu® aScope™ 4 Cysto

Background and Objective Ambu® aScope™ 4 Cysto is a single-use disposable flexible cystoscope that allows clinicians to perform the procedure at any time and any place. It simplifies workflow, frees up resources and allows clinicians to treat more patients. Our trust became the first in the UK and Europe to utilise these cystoscopes. An in-depth evaluation was performed to test its practicality, cost analysis and patient satisfaction against traditional reusable flexible cystoscopes. Material and Methods We compared the cost of using Ambu® aScope™ 4 Cysto to perform flexible cystoscopies in 20 patients prospectively against traditional flexible cystoscopes in 20 patients retrospectively. The cost of the equipment, reprocessing, cleaning supplies and maintenance were consulted from relevant departments and companies. All prospective patients were also given a patient satisfaction questionnaire to complete. An unpaired t-test was used to analyse the data. Results Our study revealed that it costs £135.23 and £166.33 on average to perform a flexible cystoscopy using Ambu® aScope™ 4 Cysto and the traditional flexible cystoscopes, respectively. Our patient survey revealed that there was a statistical significance between the patient experience using the single-use disposable scopes compared with the traditional reusable flexible cystoscopes (P = 0.0455). Further, 95% of patients also preferred a single-use disposable cystoscope over traditional reusable ones, given the option. Conclusion Single-use disposable flexible cystoscopes are a safe and cost-efficient method of performing the procedure. It is portable and proves to be a simple, efficient and practical way of performing a flexible cystoscopy in an inpatient, outpatient, or emergency setting.

Make every session count for clients! Rethinking clinical social work practice from Single Session Therapy (SST): A case illustration of Emotion-Focused Therapy (EFT)

ABSTRACT Re-thinking a service delivery paradigm within a single session therapy (SST) framework inevitably changes the ways we consider the therapeutic process – making each session count! In clinical practice, this means (1) the rapid development of therapeutic alliance and (2) the life of the therapy process, from assessment to intervention to evaluation condensed into a single session. To illustrate, this article analyzes the fully transcribed one of the master tapes in Emotion-Focused Therapy where chair work is demonstrated in a single session, and finds six processes in SST: (1) history taking; (2) formulation; (3) contracting; (4) working-through change; (5) evaluation; and (6) preparing for exit. A micro-analysis of the single session details how the therapist manages multiple tasks in SST. This analysis helps social workers to re-think service delivery and attrition rates in community mental health settings to enhance health equity and the provision of socially just mental health services.

Large-Scale Intelligent Taxicab Scheduling: A Distributed and Future-Aware Approach

Intelligent taxicab scheduling systems on smartphones continue to gain popularity as they offer prominent conveniences for urban travelling as well as increase potential profits for taxicab drivers, hence inject prosperity and vitality into intelligent transportation and urban business. Existing scheduling approaches usually fall into biases and myopia due to their single target perspective of satisfying the immediate order acceptance, or maximizing the global business success rates.However, the highly complex spatiotemporal dependencies among multiple factors and the efficiency bottleneck of massive order flows make the taxicab scheduling issue still challenging. To this end, in our paper, we propose an integrated scheduling algorithm with both future-aware and context-aware mechanisms. In particular, we first present a generalized graph-based framework which aims to capture traffic dependencies, providing precise and quantified supply-demand prediction in taxicab scheduling. Then, we develop a measurement of regional supply-demand context to perform cooperative and distributed scheduling. To tackle the efficiency bottleneck in massive order flow scenario, we correspondingly design a model to learn business patterns with considering benefits from both drivers and passengers, and further promote service delivery rates via a novel bi-incentive strategy. Extensive numerical studies illustrate the remarkable significance of our method, in terms of both service delivery rates and global driver revenues. The promising results and brand-new perspectives enable our algorithm to be a paradigm in general spatiotemporal scheduling tasks.

Effects of Collaborative Care for Comorbid Attention Deficit Hyperactivity Disorder Among Children With Behavior Problems in Pediatric Primary Care.

This study evaluates the impact of a 6-month care management intervention for 206 children diagnosed with comorbid attention deficit hyperactivity disorder (ADHD) from a sample of 321 five- to 12-year-old children recruited for treatment of behavior problems in 8 pediatric primary care offices. Practices were cluster-randomized to Doctor Office Collaboration Care (DOCC) or Enhanced Usual Care (EUC). Chart reviews documented higher rates of service delivery, prescription of medication for ADHD, and titration in DOCC (vs EUC). Based on complex conditional models, DOCC showed greater acute improvement in individualized ADHD treatment goals and follow-up improvements in quality of life and ADHD and oppositional defiant disorder goals. Medication use had a significant effect on acute and follow-up ADHD symptom reduction and quality of life. Medication continuity was associated with some long-term gains. A collaborative care intervention for behavior problems that incorporated treatment guidelines for ADHD in primary care was more effective than psychoeducation and facilitated referral to community treatment.

Rate-Adaptive Fog Service Platform for Heterogeneous IoT Applications

With the advancement of the Internet of Things (IoT) technologies, the number of heterogeneous IoT applications requiring a variety of resources and services is increasing dramatically. Recently, the introduction of fog computing has further unlocked the potential of real-time services within the IoT context. On the basis of fog architecture, we herein propose a novel rate-adaptive fog service platform aiming at heterogeneous services provisioning and optimized service rate allocation. By forming several service groups in the fog network in which each service could be adequately provisioned, service consumers would always benefit from the fact that the majority of services produced by the IoT applications are in their proximity and thus are delivered to the destination promptly. Taking advantage of the well-known network utility maximization (NUM) approach, a service rate-adaptive algorithm is developed to empower fog nodes working together to adjust service delivery rate dynamically. Throughout this process, the algorithm takes the current network condition and constraint into account to ensure the rate is calibrated in favor of providing satisfactory quality of service (QoS) to each service receiver at the same time. Compared to other resource allocation strategies that mainly focus on allocating resources for a single network service, our proposed platform is capable of not only dealing with both the elastic and inelastic services but also handling the abrupt network changes and converging back to the global optimum rapidly.

Addressing the psychosocial needs of cancer patients: a retrospective analysis of a distress screening and management protocol in clinical care

Background: A growing recognition of the impact of distress on the quality of life and adherence to treatment of cancer patients has been documented. As a result, national guidelines and standards of care mandate providers to implement distress screening protocols to connect patients with psychosocial services. However, limited literature has examined whether distressed patients are referred to care and their needs addressed. This article assessed differences in rates of referral and psychosocial services by demographic factors, clinical characteristics, and distress severity. Potential predictors of these two outcomes were investigated.Methods: A retrospective analysis of patient data abstracted from electronic medical records of a NCI-designated Academic Comprehensive Cancer Center was conducted. Of the 399 cases meeting the inclusion criteria, 302 (75.7%) were screened for distress with the Distress Thermometer. Differences were examined with chi-square, t-tests, and ANOVAs. Predictors were identified with multivariate logistic regressions.Results: Overall, patients who were identified as distressed were referred to a psychosocial provider (71.4%) and psychosocial services were delivered in approximately 64% of the cases. Referrals and service delivery rates varied by age group, clinic, health insurance coverage, distress severity, and presence of psychosocial issues. Only the distress score predicted the likelihood of being referred, and of a provider intervention to occur.Conclusions and implications for psychosocial providers: Although the protocol appeared to facilitate referral and service delivery to patients scoring above the cutoff for distress, our results suggest that patients were more likely to not have their distress and psychosocial needs addressed if they were older, without insurance coverage, and were seen in clinics where a social worker was not consistently available. Future studies able to monitor patient outcomes in terms of quality of life, satisfaction with care, and service utilization are recommended.

What Are the Characteristics of Caregivers Logging in for Support Services?

Background and ObjectivesOnline service delivery options have the potential to increase access to informational resources among caregivers to older adults. However, it is unknown which caregivers will use online-delivered services over usual service delivery modes (e.g., by phone) when both options are available in social service settings. This is important for service providers to know when making decisions that best serve their communities.Research Design and MethodsGuided by Andersen’s model of health service utilization, we used step-wise logistic regression models to compare the characteristics of caregivers who used an online information service called FCA CareJourney (FCA CJ) with those who accessed the same services using the usual mode of service delivery (N = 540). Online and usual-care services were available through two social service organizations in California.ResultsIn all, 13.7% of clients used FCA CJ to receive services online. Enabling characteristics were the main predictors of using online-delivered services. Caregivers employed part-time had 3.82 times the odds of using online-delivered services compared to those employed full-time (odds ratio [OR] = 3.82; 95% confidence interval [CI]: 1.58–9.22). Caregivers who learned about services from health care providers had 2.91 times the odds of using FCA CJ as those who learned about services through social services (OR = 2.91; 95% CI: 1.28–6.62). Even among those who learned about services online, 62.2% still accessed services using usual delivery modes.Discussion and ImplicationsBased on differences in the characteristics of caregivers using different service delivery modes and the low uptake of online-delivered services, we suggest online service delivery should supplement, not replace, usual delivery modes in social service settings. At the same time, user rates of online service delivery are likely modifiable. Given the potential for online-delivered programming to expand access to information services for caregivers, we recommend further examination into the effects of marketing online service delivery options to caregivers in novel ways.

Utilization of community health workers in Canada's Children's Oral Health Initiative for indigenous communities.

The Children's Oral Health Initiative (COHI) is a federally funded community-based preventive dental programme implemented in geographically remote Canadian Indigenous communities. The study investigated the effect of the availability of local community health workers (COHI Aides) on access to the programme's preventive dental services for children. Twenty-five communities were continuously enrolled in the COHI during the 7-year study period. Communities were categorized as having uninterrupted (all 7 years), intermittent (≥4 years) or sporadic (<4 years) service from a community health worker. Four outcome variables measured longitudinal changes in access to preventive dental services: (i) the number of enrolments; (ii) the number of enrolled children with multiple fluoride varnishes delivered; (iii) the number of enrolled children with sealants placed; and (iv) the number of enrolled children receiving ART. The general longitudinal trend for programme enrolment and each of the preventive dental service delivery outcomes was similar. Children in communities with uninterrupted service tended to have the highest rates of enrolment and service delivery, which remained constant over time. Children in communities with sporadic service tended to have persistently low rates of enrolment and service delivery over the study period. Community health workers were beneficial in promoting programme enrolment, as well as facilitating and augmenting the delivery of preventive dental services.

The Impact of a Multifaceted Intervention on the Rate of Preventive Services Offered in a Student-Run Clinic

Background: The importance of preventive services has been well established, yet rates of preventive service delivery continue to lag behind national goals. While numerous studies have identified barriers to preventive service delivery and implemented interventions to improve delivery, research into this important area is lacking in the setting of student-run clinics. Methods: In this study a multifaceted intervention consisting of patient and provider education, provider check list, pre-clinic chart review, and financial assistance for preventive services was implemented for 14 months in a student-run clinic.Results: Rates of delivery of United States Preventive Services Task Force (USPSTF) Grade A and B recommended preventive services were evaluated before and after implementation of the intervention with 16 of 26 services improving during the intervention but only tetanus immunization reaching significance. In addition, rates of delivery of preventive services were compared to reported national averages and targets set by Healthy People 2020 with 16 of 20 services being offered at or above reported national averages and 10 of 16 services meeting the targets laid out in Healthy People 2020.Conclusions: The rate of preventive services can be improved in student-run clinics through the implementation of multi-faceted interventions to a level that meets national averages and targets.

Determinants of Competitiveness of the Swaziland Sugar Industry

The issue of abolishment of trade agreements preferences pose a great threat to the sugar industry in Swaziland. Using both the Relative Trade Advantage and Porter`s 1990 National Diamond concept, the major objective of the study was to examine the comparative advantage of the sugar industry in the global market with the aim of establishing the contributing factors and constraints to the competitiveness of the Swaziland sugar industry. The Relative Trade Advantage (RTA) method developed by Balassa was used to determine Swaziland global comparative advantage of the sugar industry. The study found that the Swaziland sugar industry had a relatively highly comparative advantage in the global market in terms of producing sugar. The results from the regression model indicated that global sugar market prices, exchange rate and export values had a significant influence on the Swaziland Relative Trade Advantage indices. The Porter`s (1990) National Diamond model analysis revealed factors that enhance competitiveness of the sugar industry include compensation of management, business approach to human resource, relationship and networking, telecommunication and internet service, availability of credit and availability of unskilled labour as well as production of high quality products. Some factors that have a major constraining effect on the competitiveness were the small local market size, cost of financing business, cost of transport, cost of supply of inputs, public sector effectiveness on service delivery and exchange rates. Therefore, the government in consultation with the industry representatives should consider development and implementation of an industry policy strategy for the sugar industry intended to ensure its survival. Other strategies would be to improve efficiencies at both field and factory levels as well as diversification or value addition on the product.