Flexible Service Research Articles

Readiness for agility adaptability and alignment in healthcare organizations

This paper aims to ‘identify,’ ‘analyze,’ and ‘categorize’ Agility, Adaptability, and Alignment (Triple-A) readiness factors in healthcare organizations using Total Interpretive Structural Modeling (TISM). This study identified nine triple-A readiness factors for healthcare organizations. The present research looked at the interrelationships between readiness variables for agility, adaptability, and alignment deployment in healthcare organizations. The findings would assist healthcare practitioners in implementing triple-A in hospitals to enhance service quality. TISM and MICMAC analysis is utilized to determine the importance of each of the elements, allowing organizations to prioritize the most important variables first, followed by the rest of the factors. The identified key factors are organizational leadership, flexible service design, advanced technology and innovativeness, strategy fits. This research will aid key stakeholders and academics in better understanding the readiness factors that influence agility, adaptability, and alignment in a healthcare organization. This study proposes the TISM technique for healthcare, which is a novel attempt in the subject of Triple-A in this sector. This research contributes to the Triple-A theory of knowledge, model conceptualizing, and organizational change.

Scheduling zonal-based flexible bus service under dynamic stochastic demand and Time-dependent travel time

This paper schedules the zonal-based flexible bus service (ZBFBS) considering elastic stochastic demand, stochastic location, time-dependent travel time, and passenger time window constraints based on a scheduled-based formulation. Unlike a traditional time–space network that stipulates the precise arrival and departure times on specific nodes, a zonal-based time–space network is proposed to define the routes in terms of zonal visits of the flexible buses while allowing for flexibility in their arrival and departure times to cater for randomness. The ZBFBS scheduling problem is formulated as a two-stage decision-dependent stochastic problem with recourse. The first stage schedules the zonal visits of flexible buses and the second stage matches each passenger with either flexible bus or ad hoc service, with the latter incurring extra cost to carry the unmatched passengers. To effectively solve the problem, a state-augmented network, that integrates time and zone, is proposed to reduce the number of variables. Moreover, relaxation formulations based on vehicle types and routes are introduced, with an insertion heuristic implemented for vehicle scheduling. The problem is solved by a gradient-based solution approach. Numerical studies demonstrate the efficiency and quality of the solution methods under a variety of ride requests, as well as its advantage over the frequency-based approach in substantially reducing the ad hoc service cost. The applicability of the model is validated by solving an instance of Chengdu, China, with real data.

Adaptation among aged care and disability service providers in response to the COVID-19 pandemic: Lessons for the future.

Aged care and disability service organizations are critical infrastructure. However, in 2020, restrictions were introduced to reduce the infection risk of the coronavirus disease 2019 (COVID-19), and these organizations needed to quickly devise COVID-safe ways of working to continue to meet the needs of their clients. To investigate how these organizations adapted their service delivery and which innovations they felt were worthwhile for sustaining beyond the COVID-19 pandemic, interviews were undertaken with representatives from 26 aged care and disability service organizations across three states in Australia (Western Australia, New South Wales, and Victoria). Findings revealed that organizations adapted their practices across three key innovation areas: (1) developing new approaches or expanding existing services, particularly around food provision, social connection, information dissemination, and technology support; (2) modifying the mode of service delivery, through safe in-person contact or offering alternative online services; and (3) reducing bureaucracy and introducing remote working. A common theme across all service innovations was the strong focus on providing clients and staff with choice and control. Moving forward, many organizations wanted to integrate and maintain these innovations, as they were associated with additional benefits such as increased client health and safety, service flexibility, and sufficient human resources to serve clients. However, continued maintenance of some initiatives require additional resourcing. The continuation of COVID-19 pandemic adaptations and, indeed, ongoing innovation, would therefore be facilitated by greater flexibility of funding to allow organizations and their clients to determine the service types and modes that best meet their needs. Further, these innovations have implications for sector-wide best practice.

Energy-Efficient Service Placement Based on Equivalent Bandwidth in Cell Zooming Enabled Mobile Edge Cloud Networks

Mobile edge computing is popular for providing services with low latency and high privacy. It becomes more powerful by leveraging the widely deployed Small cell Base Stations (SBS) with zooming cells for energy-efficient service placement. However, the literature ignores the joint optimization of SBS power control and service placement. The Quality of Services (QoS) guarantee is also challenging, taking into account the component dependency and parallelization in multi-component services and the resource slicing for separated service deployment. Moreover, prior works assume the same amount of allocated resources of links on a placed path for service edge allocation, leading to the ossification of resource allocation and inevitable resource fragments. Towards the above challenges, this paper addresses the energy-efficient and flexible service placement in cell zooming enabled Mobile Edge Cloud (MEC) networks. The delay of multi-component services is constructed depending on the allocated resource slice. Besides, the joint optimization of service placement and SBS power control is formulated and transformed into a Mixed Integer Linear Programming (MILP). More importantly, the equivalent bandwidth for an edge allocation is defined and analyzed to obtain flexible edge placement with minimum resource cost. Leveraging the results of MILP, an Energy-efficient Service placement algorithm based on equivalent Bandwidth in Cell zooming enabled MEC networks (ESBC) is proposed to improve the probability of successful service placement with QoS guarantee by optimizing the delay distribution among components and edges and reducing resource fragments. Finally, simulation results validate the effectiveness of the proposed methods.

POSTGRADUATE COMMUNITY PSYCHIATRY TRAINING IN PAKISTAN

Closure of large psychiatric hospitals across UK, Europe and the United States has shifted the services for the care of psychiatric patients to general hospitals, community based public and private facilities and social sector organizations. Underpinning the process of deinstitutionalization and the development of community psychiatric services was the ethos of providing seamless, flexible services close to where people lived, led by their needs and with involvement of them and their care givers. In Pakistan, in-patient psychiatric facilities are scarce and community psychiatry is still in its initial stages of development so the burden of care is mostly beared by the families. There is a dearth of formalized training and skill set to work effectively in the community and this is reflected in the lack of exposure of our new generation of mental health professionals who are only trained in managing patients admitted in hospitals. In the light of recent guidelines and WHO recommendations it is imperative that community based psychiatric care be incorporated in the postgraduate psychiatry curriculum. This article describes the principles of training and syllabus. However this can only possible by a proactive collaborative partnership between multiple public and private stake holders.

The digital writing café - accessibility born from necessity

The Writing Café is a creative space for students to talk about academic writing across disciplines, and to support them to become better writers, underpinned by the philosophy of inclusion and inquiry. Originally located in a café on campus, in response to the pandemic, the Writing Café transitioned online considering the additional struggles that students might be experiencing as a result of the pandemic. Within days, it had moved online with no interruption of service. Attendance in the Digital Writing Café increased by 50% during lockdown, and the service was highlighted by the Gravity Assist report as one of the most innovative examples of how universities and colleges have responded to the pandemic by providing online support to their students. Due to the successes, the Digital Café now runs concurrently alongside The Writing Café in the Library providing a flexible service to meet the varying needs of the students. Though the Writing Café has always been a space that helps bridge the gap in supporting social mobility, this new flexible approach has seen a drastic increase in engagement from students who identify as from Access and Participation Plan (APP) categories. The presentation explored the evolution of the Writing Café to the new hybrid dual delivery model, with provision located physically at the heart of the campus in our Library café, alongside an online digital provision using zoom. Our Writing Mentors will share their experience and will discuss the impact on our student engagement.

Prolonging battery lifetime in various energy markets

Li-ion batteries are more and more common not only in the sector of e-mobility but their role is increasing in stationary storage as well. The possibilities of the use of these storages are various. In this paper, the authors were focused on the possibility of providing frequency reserve and other flexibility services for the grid. The paper focuses on the operation of a battery energy storage system and not the sizing of one. In the developed model the authors consider the profit from these services and their impact on the battery lifetime. With these two main factors, the operation of the battery system is compared in the case of different frequency reserve services and other market operations. Results show that battery energy storage systems have the potential for frequency reserve services in case of an optimized operation strategy. Simulation results also show that these optimized operation strategies can be different in different phases of the battery life. The presented model was developed under the EU Horizon 2020 programme in the OneNet project.

75 EVALUATING DEMENTIA PALLIATIVE CARE SERVICES ACROSS IRELAND AND THE UK USING THE RE-AIM FRAMEWORK

Abstract Background Dementia is a life-limiting illness, requiring a Palliative Care (PC) approach from diagnosis. In Ireland, People with Dementia (PwD) and their families rarely receive PC in a timely manner. This study aimed to evaluate five exemplar community-based dementia PC services across Ireland and the UK (as identified by key stakeholders), to inform a new service delivery model. Methods Data from semi-structured interviews and focus groups with 29 service providers, and service activity data (n=5), was evaluated using the RE-AIM framework. Results ‘Reach’ - Caseloads varied significantly between 3-154 active cases. Most services accepted self-referrals; all wanted earlier referrals. Factors influencing reach included co-location, dyadic participation, service flexibility, and others’ awareness of PC appropriateness and the service’s existence. ‘Effectiveness’ - All service users received holistic assessments, person-centred care, advanced care planning, continuity of care, improved service access and ‘care-for-the-carer’. Some services offered complimentary therapies, 24/7 phone support, and bereavement support; these were perceived to improve quality-of-life, comfort, and independence. ‘Adoption’ - Staff were highly invested; some provided their personal numbers to families. Outside staff were more willing to engage (refer/support) if shared governance, training was provided, or already familiar with dementia or the tools. Incentive programmes increased adoption rates. ‘Implementation ’ - All services evolved on an ad-hoc basis, with funding provided by local organisations, and a single ‘driving force’, typically a consultant/nurse. Services heavily relied on volunteers. Perceived “essential” elements included a dyadic approach, MDT involvement, open communication, forming relationships, reflective practices, dedicated staff with problem solving skills, and staff support/training. ‘Maintenance’ - All services continued after initial project funding; three increased their activities/reach over time. Conclusion Important features and facilitators of community-based dementia palliative care services have been identified. These results are informing the development of the novel Dementia Palliative Care model for use in Ireland (https://pallcare4dementia.com/).

Digital-twin-enabled 6G network autonomy and generative intelligence: Architecture, technologies and applications

Background: The 6G network provides on-demand services and efficient governance, which is an important capability of the 6G network in the future. Providing more flexibility, availability, and dynamicity in services and network function enablement face many challenges in the 6G network due to the system complexity. To fulfill the requirement of the new generation of a digital and intelligent network, the 6G architecture with digital twin as a new enabler technology, is expected to evolve in the network autonomy and generative intelligence properties, which could optimize and adapt the network and services themselves to a variety of scenarios and deployments. Methods: To achieve 6G network autonomy and generative intelligence, we propose an architecture based on digital twin technology. This architecture integrates the digital twin network with the minimalist network and supports single-domain autonomous and cross-domain collaboration via centralized-distributed digital twin deployment, and defines the interactions between the digital twin and the service layer as well as the physical network. Results: Based on the analysis of the architecture, we put forward the following design principles for the 6G digital twin network architecture: decoupling, interactions, endogenous AI, distribution, heterogeneity, autonomous, and closed-loop. In addition, we get the key technologies achieving collaboration efficiently between the network autonomy domain and generative intelligence domain in the distributed digital twin system. Important application directions of the 6G digital twin network architecture are also analyzed. Conclusions: In this paper, the new digital-twin-enabled 6G architecture and 6G digital twin network architecture design principles are proposed. The key technologies and important application of digital-twin-enabled 6G architecture are provided.

Multi-level optimal dispatch strategy and profit-sharing mechanism for unlocking energy flexibilities of non-residential building clusters in electricity markets of multiple flexibility services

Well-managed demand-side flexibility can effectively alleviate the stress of power systems caused by the increasing renewable energy penetration. The development of smart grid technologies provides win-win opportunities for system operators and demand-side users. Buildings have great flexibility potential through smart control of flexible loads, passive thermal mass storage and distributed active storage. However, a few fundamental problems on flexibility quantification, optimal coordination and profits sharing are faced when aggregating buildings to reach sufficient size for biding multiple flexibility services in electricity markets. Therefore, this paper proposes a multi-level optimal dispatch strategy and profit-sharing mechanism for non-residential building clusters to maximize flexibility profits and reduce the complexity of the optimization. At building level, a model-based quantification method is developed to evaluate flexibility potential of multiple resources. At cluster level, the coordinated bidding strategy of the aggregator is proposed, and flexibility profits are distributed based on the cooperative game theory at the post-market stage. Test results show that the proposed dispatch strategy can reduce up to 20.4% of daily electricity cost at cluster level and ensure profit increase of individual buildings with different flexibility characteristics. The active participation of building clusters in electricity markets could reduce the use of costly backup generators.

Evaluating the Childcare Needs of Cancer Patients Undergoing Radiation Therapy

<h3>Purpose/Objective(s)</h3> About one-fifth of newly diagnosed cancer patients are parents to young children. These patients are at higher risk of psychosocial stress and inability to attend treatment due to having to balance their own healthcare needs with those of their children. Hospital-based childcare services could potentially ameliorate this problem by temporarily relieving parents of their childcare duties during their healthcare appointments. The objective of this study is to characterize the childcare needs of cancer parents undergoing radiation therapy. The results could help inform the implementation of suitable childcare programs to remove this barrier in accessing care. <h3>Materials/Methods</h3> Patients at a large Canadian comprehensive cancer treatment center were screened by a radiation oncologist for having children under the age of 18 at home. After these patients were identified and consent was obtained, secure electronic surveys were distributed. Domains surveyed included patient demographics, childcare burden, impact on treatment, and preference for how they could be supported to access care. <h3>Results</h3> 45 surveys were completed. The average age of correspondents was 44.5 (95% confidence interval: 43.0 – 46.1), 41 patients (91%) were female, 12 (27%) were employed full-time, and breast cancer was the most common primary tumor site, with 29 correspondents (64%) carrying the diagnosis. The median number of children per correspondent was two, and the median age of their children was nine. 18 correspondents (40%) reported not having reliable social supports who could assist with childcare. 29 correspondents (64%) reported it would be "extremely helpful" or "very helpful" for them to receive hospital-based childcare during their initial consultation, follow-up appointments, or radiotherapy sessions. Correspondents with an annual household income of less than $50,000 (Canadian Dollars) were more likely to report having to reschedule (P = 0.05) or miss appointments (P = 0.01) due to childcare conflicts. <h3>Conclusion</h3> Childcare is a significant psychosocial barrier for patients accessing radiation therapy for cancer. Our results indicate that most parents undergoing treatment may benefit from hospital-based childcare services, which is especially true for lower-middle income families. The implementation of a flexible childcare service would help patients with treatment compliance and reduce the socioeconomic barrier for accessing care.

TEBDS: A Trusted Execution Environment-and-Blockchain-supported IoT data sharing system

Data sharing services based on massive IoT data have been widely used in various fields such as health monitoring and image recognition, providing users with more reliable, efficient, and flexible data services and significantly improving the user service quality. With the popularization of IoT applications, the usage rate of IoT data is getting higher and higher. Due to the dangerous network environment, the security of IoT data faces challenges. On the one hand, attacks such as data tampering can lead to the failure of IoT tasks, and on the other hand, the intrusion of malicious users can lead to the collapse of the entire IoT network. In recent years, many protection schemes used for IoT data security have been proposed. However, security flaws still exist in these schemes. Therefore, to solve the data security and identity security issues in the IoT data sharing process, in this paper, we propose a TEE-and-Blockchain-supported IoT data sharing architecture(TEBDS), which combines on-chain and off-chain methods to meet the security requirements of the IoT data sharing framework. Therein, the consortium blockchain realizes the protection of on-chain IoT data and the access control of IoT users. An Intel SGX-based Distributed Storage System (SDSS) is proposed to secure off-chain data. Besides, an incentive mechanism is developed to facilitate the whole system. Security analysis shows that TEBDS meets the requirements of data security and identity security. Experimental results show that TEBDS has better performance than the centralized method SPDS.

Announcement System In Bus

Transportation in relatively congested urban areas has been the focus of transit firms. But as social economies have expanded, housing has become more scarce, demanding more flexible transit services. An odometer is a device used to figure out how far a vehicle has travelled. The car's dashboard is often where the odometer is found. The long-distance mode permits longer-distance serial communication between parallel processors through two I2C-bus controllers. When the serial interface is enabled (ESO = 1), choosing this mode requires setting ES1 to logic 1. The four unidirectional lines used to communicate the I2Cbus protocol in this mode are SDA OUT, SCL IN, SDA IN, and SCL IN (pins 2, 3, 4 and 5). The stop data, announcement audio, and advertisement elements for the bus route on Google Maps are all generated by this software. The generated information will be transmitted to the Announcer device through a Wi-Fi network with an internet connection. A diffuse reflective sensor is how an ultrasonic sensor typically operates. Compared to other sensor principles, it has better background suppression.

Priority based dynamic spectrum management using Virtual Utility Functions in Cognitive Radio enabled Internet of Things

Fast growth of wireless devices in IoT (Internet of Things), industry 5.0 and 6G cellular networks, is dealing with the challenge of spectrum scarcity and uneven utilization of available resources. To achieve Ambient Intelligence (AmI) in IoT communication network, dynamic utilization of available network resources, is a challenge faced by resource constraint IoT devices. Cognitive radio technology enables these devices to intelligently sense the free spectrum holes and smartly manage available channels opportunistically. To jointly deal with the challenge of spectrum scarcity and application specific network service provision, we propose a novel multi-attribute based two-tier framework called Cognitive Radio Efficient Spectrum Utilization (CR-ESU) which integrates the concept of Network Function Virtualization (NFV) as Virtual Utility Functions (VUFs) with cognitive radio enabled IoT devices to achieve the dynamic and flexible network services as well as spectral efficiency. The proposed framework is one of the pioneer works that incorporate the two ground breaking technologies, NFV and CRN to create a smart and flexible CR-enabled IoT network. CR-ESU also ensures the best channel selection using Dynamic Channel Reservation (DCR) scheme to decrease the channel switching rate. Continuous Time Markov Chain (CTMC) model is used for network modeling and mathematical expression formation. Promising results show the potential of CR-ESU framework to form a reconfigurable and efficient network.

Pricing and remunerating electricity storage flexibility using virtual links

Ambitious renewable portfolio standards motivate the mass deployment of energy storage resources (ESR) as sources of flexibility. As such, the design of electricity markets that properly remunerate the provision of flexibility services by ESRs is under active development. In this paper, we propose a new market clearing framework that incorporates ESR systems. Compared to existing market designs, our approach models ESR systems using the concept of virtual links (VLs), which capture the transfer/shift of power across time. The VL representation reveals economic incentives available for ESR operations and sheds light into how electricity markets should remunerate ESRs. Our framework also allows us to explore the role of ESR physical parameters on market behavior; specifically, we show that, while energy and power capacity defines the amount of flexibility each ESR can provide, charge/discharge efficiencies play a fundamental role in ESR remuneration and in the ability of the power grid to mitigate market price volatility. The new market design is also computationally attractive in that it is a linear program and thus avoids mixed-integer formulations and formulations with complementarity constraints (used in current designs to capture binary charge/discharge logic). We use our market framework to analyze the interplay between ESRs and market operators and to provide insights into optimal deployment strategies for ESRs in power grids.

The Potential Role of Flexible Transport Services in Enhancing Rural Public Transport Provision

This paper explores the existing context of public transport provision in rural and remote areas illustrated with experience from Scotland. A critical review of existing Flexible Transport Services (FTS) in rural areas is provided and illustrated with selected case studies, with the objective of identifying the extent to which FTS can enhance the public transport offer. Findings confirm that FTS offers considerable potential to contribute to and support the public transport system in rural areas; however, the paper also identifies the many challenges in successful development or enhancement of FTS in rural areas.

Estimation of Modal Shift Potential for a New Form of Dial-A-Ride Service

The concept of a dynamic and flexible Intelligent Subscription Bus Service (I-Service) was developed, and two integrated questionnaires were conducted among the commuters of a large university campus. To determine travel times to the campus by I-Service, a digital urban road network map with travel time databases was produced, and software was developed to calculate optimum routes using these databases. Travel times for each participant were determined by the shortest travel time principle. The proposed hypothetical service was introduced to participants, and anticipated advantages for each participant were reported back to them by means of a second questionnaire to determine if they would prefer using I-Service. As a result, a 49% modal shift potential from all other modes in general and a 52% modal shift potential from private car to I-Service were found.

Commuting by Customized Bus: A Comparative Analysis with Private Car and Conventional Public Transport in Two Cities

Commuting is a major component in the creation of traffic and travel problems. Thus, more attention should be given to its practice. Private car (PC) transport, the dominant mode of commuting in most of the world’s major cities, creates traffic-related social problems such as traffic congestion, traffic fatalities and injuries, and adverse environmental impacts. This study proposes a novel commuting travel mode—a customized bus (CB) transit system that provides advanced, personalized, and flexible demand-interactive minibus service using Internet, telephone, and smartphone apps. The aim was to assess and compare the performance of CB with PC and with conventional public transport (PT) systems. A methodological analysis framework was constructed to quantify operational performance measures that enable the comparison of the different travel modes. This analysis framework was then applied to two cities— Auckland, New Zealand, and Paris, France—to assess the overall performance metrics of PC, PT, and CB, such as travel costs, travel time, and fuel consumption. This comparison sheds light on the differences between the travel modes, their viability, and their competitiveness. The results of the case study show that PC is the fastest commuting mode, but the travel costs incurred by it are twice as much as for PT and CB and involve higher fuel consumption. CB also can provide a useful alternative for commuter trips in Auckland and Paris. For increased commuter trips, CB proved to be more efficient than the PC and PT modes. Finally, the CB system tends to be more profitable in Auckland than in Paris.

Service fairness and value of customer information for the stochastic container relocation problem under flexible service policy

This paper considers the optimization of service efficiency and service fairness in a Stochastic Container Relocation Problem (SCRP) under flexible service policies at a container terminal. Under the flexible service policy, the external trucks arriving within the same time window can be served out of sequence, which may raise a concern of service fairness. We incorporate the concept of service fairness into the SCRP in two phases. In phase 1, we propose a multiple sub-time windows-based flexible service policy, under which each time window will be divided into multiple sub-time windows and the flexible service policy is only applied to each individual sub-time window. In phase 2, the SCRP is formulated as a dynamic programming model with two lexicographically ordered objectives representing both relocation efficiency and service fairness, which is solved via a hierarchical iterative approach. In addition, we investigate whether the information of trucks’ arrival probability over the time window (which represents the customer preference information) would add value to the terminal operators. Extensive computational experiments are conducted to evaluate the impacts of the number of sub-time windows and to examine the impacts and value of customer preference information in various scenarios. The results show interesting trade-offs between efficiency and fairness. As the number of sub-time windows increases, the service fairness is generally improving (but not guaranteed) while the expected number of relocations is increasing. It is found that the customer preference information can be valuable in some circumstances, especially when each truck indicates a certain arrival sub-time window.

Exploring Users’ Preferences for Automated Minibuses and Their Service Type: A Stated Choice Experiment in the Netherlands

In this paper, we study the deployment potential of automated minibuses (AmBs) on the first-mile part of public transport (PT) trips or short (sub)urban commutes by comparing “regular” (fixed route and fixed schedule) and “flexible” (door-to-door and on-demand) service types. For reaching that goal, we run a stated choice experiment in the Netherlands. The participants have assessed the referred two AmB alternatives compared to their current travel mode (car, PT, or active modes (AM) – bicycle and walking) used as the main mode for unimodal travellers or as access travel mode to transit lines for multimodal travellers. The results of a joint mixed logit model estimation based on data obtained from Dutch travellers show that there are similarities and differences in the preferences for the AmBs service type within and between the segments of travellers (car, PT, and AM) and that these are mostly in instrumental variables (cost and time) and attitudes. Current PT users prefer the flexible service to regular service based on their perception of in-vehicle travel time and waiting time, while current users of car and AM do not show a difference in preference between the two services concerning these variables. Moreover, their perception of in-vehicle travel time and waiting time is not significantly different from PT users’ perception of those variables in the regular service. This may mean that for non-PT users (car and AM), AmB’s flexibility of door-to-door transport is not seen as offering a significant advantage over what they think about public transport. When looking at the preferences of potential users explained by underlying psychological factors, we conclude that a positive attitude towards riding in AmBs is a significant factor in all three segments of travellers. Trust, usefulness, and enjoyment in using AmBs are important prerequisites for car and PT users to choose either service type. The experience with technology positively influences the preferences of current PT users for both AmB services.