Approach For Service Providers Research Articles

Ileoanal pouch revision and excision surgery in a newly established pouch center: requirements and costs for service provision.

Complications of ileoanal pouch surgery affecting function and quality of life may require surgical correction or pouch excision. The management of patients with pouch dysfunction requires a multidisciplinary approach and demand for service provision include multiple healthcare professionals and resources. The aim of this study is to present the service requirements, and surgical outcomes for redo pouch surgery and pouch excision, with cost analysis of the required resources. All patients undergoing surgery for revision or excision of the ileoanal pouch from June 2021 to May 2023 were prospectively included. Patient undergoing only diagnostic procedures, or perineal procedures were excluded. Outcomes within 30days of surgery were collected, including readmissions and re-operations. Cost analysis of all investigations, outpatient appointments and procedures prior to pouch revision or pouch excision was conducted. Twenty patients were included during the 24months study period: 13 underwent abdominal revisional pouch surgery, 7 had ileoanal pouch excision. 15 patients (75%) were tertiary referrals from other hospitals in the UK. The median interval between index IPAA surgery and revision was 113months. Three multidisciplinary clinical appointments, two imaging modalities, and at least one invasive day-surgery procedure were required for each patient prior to surgery. Expertise and infrastructure are needed for indication and peri-operative management of patients with pouch dysfunction requiring pouch revision or pouch excision. We estimated a starting cost of £22.605 ($29.589) for provision of pouch revision or excision surgery for investigations and treatments from referral to the pouch unit to surgery. This likely represents an underestimate as only accounts for procedures performed since referral with pouch dysfunction.

Getting the job done: A narrative approach in person-centered service provision for unemployed people in a vulnerable position.

Getting the job done: A narrative approach in person-centered service provision for unemployed people in a vulnerable position.

Australian healthcare professionals' perspectives on genetic counseling and genetic diagnosis in vascular anomalies.

Genomic technologies are now utilized for the genetic diagnosis of vascular anomalies. This provides the opportunity for genetic counselors to make a significant contribution to patient care for this complex disease. The aim of this study was to explore Australian healthcare professionals' perspectives on the relatively recent integration of molecular diagnostic testing for vascular anomalies, with or without genetic counseling support. Nine semi-structured interviews were conducted with Australian healthcare professionals involved in the provision of care for individuals with vascular anomalies. Thematic analysis identified six themes: (1) Molecular diagnosis is beneficial; (2) psychosocial needs can motivate families to pursue a molecular diagnosis; (3) molecular genetic testing for vascular anomalies is complex; (4) genetic service provision is not a one size fits all; (5) a client-centered approach for genetic service provision can go a long way; and (6) the value of genetic counselors. Based on our findings, implementation of a vascular anomalies genetic diagnostic program inclusive of genetic counseling may be challenging, yet such programs are likely to benefit both patients and their families, as well as healthcare professionals. As this paradigm shift unfolds, genetic counselors have an opportunity to contribute to the vascular anomaly field by educating healthcare professionals and patients, by participating in multidisciplinary clinics to support complex cases and by raising awareness regarding their practice and potential contributions.

Supporting Families from a Distance: Implementing Routines-Based Home Visits via Telepractice.

Early intervention is a system of services designed to strengthen child outcomes and build family capacity. One approach of service provision is the Routines-Based Model which implements adult-learning practices wherein service providers and caregivers partner to build family-mediated interventions for children. Owing to COVID-19 and the benefits of telepractice, more and more service providers are likely to incorporate a telepractice modality into service provision. Because the Routines-Based Model uses family consultation, these home-visiting practices translate well to telepractice. In addition to consultation techniques, however, service providers must use technology advantageously to ensure effective communication practices. This article discusses technology uses in telepractice that can be incorporated in the Routines-Based Model, Tele-Routines-Based Home Visits, and examples of Tele-Routines-Based Home Visits.

Quantitative Assessment of Service Pattern: Framework, Language, and Metrics

For modern service industry (MSI), service pattern is a service provision approach to support the realisation of business model that involves participants from various domains and organizations. A comprehensive description and quantitative assessment of service patterns is of great significance for optimizing the organizational cooperation process in MSI and improving the competitiveness of enterprises. However, most relevant studies on service patterns stay at the level of business processes and qualitative analysis, lacking a comprehensive description of data, resources, and value exchanges among participants. Studies related to pattern assessment focus more on QoS (Quality of Service) rather than consideration of the utility of multi-participant collaboration. Hence, two issues need to be tackled for future development of MSI: a) How to systematically describe and distinguish service patterns with the same business processes. b) How to assess and compare service patterns quantitively and comprehensively. In this article, we propose a service pattern assessment framework which consists of two parts. As part one, we complement the service pattern description language (SPDL) with extended elements and observable attributes to empower it with quantitative analysis, namely Quantitative SPDL (SPDL-Q). In part two, a set of service pattern assessment metrics are designed to assess not only the quality of the services but also the cooperation efficiency of the participants and the orchestration effect of the service patterns elements. The proposed framework was then further validated by a case study, of which four E-commerce service patterns were studied to reveal their evolvement processes. Correlation experiments were also performed to identify the pattern features that have the greatest impact on each metric, so to provide guidance and suggestions for pattern design. Finally, the innovation and significance of the work are outlined and discussed.

Public and private healthcare sectors during COVID-19: the main challenges in Lithuania

The coronavirus (COVID-19) pandemic has overwhelmed the Lithuanian healthcare system. In an attempt to meet its emergency situation and mitigate the new challenges, the Government reached out to the private sector, aiming to develop a sustainable cooperation approach in healthcare service provision. The article examines the potential implications for the healthcare system in Lithuania and adaptation paths. The preliminary overview refers to the assumption that the efforts to deliver sustainable service in the healthcare sector were uncoordinated and showed institutional vulnerability in both private and public sectors.

From Deinstitutionalization to Community-Based Urban Development: Investigating Accessibility of Urban Systems in Calabria through Network Analytics

Community-based urban development is an inclusive approach for local service provision and management centered on the proactive partnerships between urban communities and local governments. Rooted in the deinstitutionalization of public services, the European Union and national policy effort is pushing towards the organization of community-based alternatives in response to the evolving needs of local communities. As the pandemic has shown, service accessibility has proven to be a key concern element that needs to be addressed to increase communities’ and cities’ resilience. In this direction, the paper aims to propose data-driven alternative approaches to assess urban systems’ accessibility and connectivity as an element of leveraging the resilience-oriented planning process and facilitating community-based development. The methodological approach focuses on the case of the Calabria region, where community-based alternatives for the provision of public services found difficulties to be operationalized through an integrated planning approach. The case study is explored by experimenting on the spatial connections of two purposefully selected clusters to assess the accessibility and connectivity of urban systems within the region through network analysis visualization tools: health and social-related services and transportation and logistics. The analytical approach outlines the accessibility level of urban systems in the region examined, proving its relevance in detecting social, economic, and environmental dynamics. This approach shows how using non-traditional data-driven perspectives can detect development dynamics—which affect local community’s needs—and their limitations in the organization of community-based development alternatives.

Mapping of Rural Health Services during Covid-19 Pandemic in Central Java, Indonesia: Rethinking Remoteness

Covidl9 pandemic, since 2019 in global world and 2020 in Indonesia, changed human daily life and affected the provision of public services, especially health services. As Covid19 spread through close interactions among humans, rural areas have the advantage of remoteness compared to higher-density urban areas. In the villages with relatively isolated access, the spread of Covid-19 is very low compared to the national average. This paper discusses how remoteness has become two sides of the coin during pandemic by examining at the data of health services in three rural areas in Provinsi Jawa Tengah, Indonesia. Data collected by in-depth interviews showed that although remoteness became a key factor in delaying the spread of Covid19, it also became a key factor in the deterioration of advanced health services in non-covid diseases throughout the pandemic. These findings confirmed the vulnerability of basic services in rural areas, even on Java Island as a center of growth in Indonesia. Using causal network analysis, the discussion revealed that the vulnerability stem from the territorial approach in health service provision making rural areas less resilient during pandemic. This paper concludes that while remoteness provides a barrier in retaining the spread of pandemic disease, it also worsens the medical treatment capacity in non-pandemic diseases in rural areas. Covid19 pandemic raises the need of specific arrangement public health services in remote rural areas.

The Influence of Linguistic Bias Upon Speech-Language Pathologists' Attitudes Toward Clinical Scenarios Involving Nonstandard Dialects of English.

Purpose Variation within languages, including dialects, takes on an indexical function, marking belonging and connection. Meanwhile, attitudes toward these speech varieties become marked by linguistic bias. Within the speech-language pathology profession, research evidence, assessment tools, and intervention programs have largely been designed for and by the White, English-speaking middle class. As such, linguistic bias with a preference for standardized dialects is prevalent in the training and practice of the speech-language pathology profession, resulting in discriminatory and racialized practices. Method To investigate the influence of linguistic bias upon speech-language pathologists' (SLPs') clinical decision making, data were collected from 129 Australian SLPs via an online survey. Inferential statistics were used to investigate the relationship between clinical decision making and SLPs' attitudes toward nonstandard dialects as well as personal and professional factors. A content analysis of extended responses was conducted to identify themes in clinical decision making. Results SLPs with more years of experience and those who had received professional development were significantly more likely to seek out more information before making a diagnosis, while those with more negative attitudes toward linguistic diversity were significantly more likely to identify a disorder than a difference. SLPs provided a range of justifications for their clinical decision making, but few acknowledged the influence of their own attitudes and bias upon their decision making. Conclusions SLPs' linguistic bias towards speakers of nonstandard dialects has the potential to impact upon their clinical judgment of difference versus disorder and lead to inequality of service provision for speakers who do not express themselves in standardized forms. Before the profession can truly move toward an antiracist approach of equitable service provision for all, SLPs must engage in critical self-reflection to disrupt the adherence of the speech-language pathology profession to standardized "White" norms of communication.

A Scoping Review of the Contextual Factors Impacting Employment in Neurodevelopmental Disorders

Individuals with neurodevelopmental disorders (NDD) are unemployed and underemployed at staggering rates and experience challenges associated with employment procurement. The International Classification of Functioning, Disability and Health (ICF) is a biopsychosocial framework of health that includes contextual factors and their influence on health and health-related states. This article examines the contextual factors—environmental and personal—impacting employment procurement for individuals with NDD to aid in the understanding of current facilitators and barriers. Employing the Arksey & O’Malley framework, a scoping review of the literature was conducted. Findings were categorised based on the ICF’s contextual domains and were further classified as facilitators or barriers toward employment procurement. Forty-one articles met the inclusion criteria. The environmental factors ‘Support and relationships’, ‘Attitudes’ and ‘Services, systems and policies’ were found to be both facilitators and barriers toward employment procurement. The personal factors ‘Age’, ‘Gender’, ‘Education’, ‘Character’, ‘Social background’, ‘Past and current experiences’, ‘Overall behaviour pattern’ and ‘Ethnicity/Race’ were also found to influence employment procurement. Environmental and personal factors influence employment procurement for individuals with NDD. Research should now focus on understanding the strength of these relationships and the importance and application of a biopsychosocial approach in research and service provision.

Explaining a Model of Human Resource Development and Empowerment Using the Service Provision Approach

INTRODUCTION: Health and healthcare services are of paramount importance in every society and are regarded as the essential needs of people. The present study aimed to assess, describe, and explore the model of human resource development and empowerment adopting a service provision approach in Ilam University of Medical Sciences and Health Services in 2019. METHODS: In the current study, theoretical sources were collected using systematic and library studies, and expertschr('39') opinions were collected through open-ended interviews. Thereafter, these sources were analyzed using grounded theory and structural modeling. In this qualitative study, a researcher-made checklist was provided to experts to identify the internal relationship among the components of each variable. The exploratory approach was used in the current study since the focus was on the use of qualitative methods. To identify the dimensions of the model and its associated factors, the indicators were firstly extracted using library studies. The Delphi method was then performed in three steps to monitor the indicators and obtain the final dimensions of the model. The statistical population of the study included all managers and experts of the human resources unit with more than 15 years of work experience in the studied university. MAXQDA software was used to record and manage the codes, and finally, the concept model was designed. FINDINGS: After analyzing the studies and conducting interviews with experts, "employee development and empowerment" was selected as the main category. It encompasses such issues as training and productivity of human resources, development of personnel capabilities, sustainable development of human capital, highlighting the importance of strategic human resource management by the management system, senior managerschr('39') support from human resources, and the independence of human resources unit. The relationship of other classes with the central class can be realized in five ways: causal conditions, control system, motivation, and appropriate counseling lead to the development and empowerment of employees. CONCLUSION: Healthcare organizations assume more importance since their human resources are mostly experts in charge of specialized activities. As evidenced by qualitative and library studies, as well as the conducted interviews, the development and empowerment of human resources in Ilam University of Medical Sciences and Health Services is positively correlated with the service provision approach and exerts a significant impact on it.

Effectiveness of the lead farmer approach in agricultural extension service provision: Nationally representative panel data analysis in Malawi

The lead farmer (LF) approach has been implemented and heavily promoted nationwide in Malawi since 2009 to support government extension workers and accelerate technology dissemination. Earlier reports have shown that donor-funded projects in Malawi widely adopted the LF approach, indicating positive roles and contributions of LFs. However, national data show persistently low rates of adoption of management practices being promoted by the LFs, prompting this study to look closely at the nationwide implementation and effectiveness of the LF approach. Specifically, we model the effects of farmers’ interaction with and exposure to LFs, and farmers’ access to LFs’ advice, on farmers’ awareness and adoption of several promoted technologies and management practices. We use data from 531 randomly selected LFs linked to panel data from 2,880 farming households and, using correlated random effects, model the effectiveness of the LF approach on technology awareness and adoption. This modeling is complemented by 52 focus group discussions and in-depth interviews with agricultural extension development officers (AEDOs) and service providers.Our results point to two major conclusions. First, LFs support and assist AEDOs in their work, especially in organizing community meetings and farm demonstrations, and are also an important bridge between farmers and AEDOs. But LFs complement AEDOs’ work rather than substitute for it. In communities without strong AEDOs and community leaders to work with and monitor them, LFs were not active or performed at a substandard level. Second, results show limited coverage and weak implementation and effectiveness of the LF approach at the national level. Only 13 percent of farmers reported receiving agricultural advice from an LF in the last two years, and only 20 percent reported having interacted with an LF. Our econometric models also consistently show neither the farmers’ exposure or interaction with LFs nor farmers’ access to LFs’ advice had an effect on awareness and adoption of the major agricultural management practices being promoted. When heterogeneity and types of LFs are unpacked, results show that quality of LFs, adoption behavior of LFs, and regular training of LFs have strong and consistent effect on the awareness and adoption of most agricultural practices promoted.

Health service provision for disease control among prisoners: a conceptual note

PurposeThe aim of present study was to integrate vital noncommunicable diseases (coronary artery disease, hypertension, diabetes mellitus and mental health disorders) into Prison-Based Active Health Services Provision (PAHSP).Design/methodology/approachOn Jan 1, 2018, there were 230,000 prisoners in Iran. Timely and systematic detection and diagnosis of chronic health conditions among this population are imperative. The collaboration between healthcare providers in prison and members of the multidisciplinary team of the healthcare community outside prison initiated an active health service provision approach for HIV and tuberculosis (TB). Guidelines for the control of HIV and TB in prison were piloted, and the finalized version was named “Prison-based Active Health Services Provision” (PAHSP), which has been scaled up in 16 of 260 Iranian prisons.FindingThe PAHSP approach emphasizes the importance of early identification of key symptoms and risk factors. This approach provides an opportunity for improved prevention and treatment, enabling prisoners identified at risk or those who have been diagnosed with a target disease to be followed up and receive the appropriate health care.Originality/valueInitiatives such as screening for chronic health conditions coupled with treatment will reduce the burden of chronic illness among prisoners and the broader community, thereby saving on healthcare costs and lives.

Adolescent Friendly Centre Service Provision Approach and Delivery of Health Information and Services for Peri- Urban Adolescents Enrolled in Reproductive Health Projects in Kisumu City, Kenya

Adolescent Friendly Centre Service Provision Approach and Delivery of Health Information and Services for Peri- Urban Adolescents Enrolled in Reproductive Health Projects in Kisumu City, Kenya

A corridor selection for locating autonomous vehicles using an interval-valued intuitionistic fuzzy AHP and TOPSIS method

Autonomous vehicles (AVs) provide a new mobility option and have been becoming widespread around the world. They can be used not only as automobiles but also as public transport vehicles in the form of shuttles, buses and pods. One of the problem areas in implementing AVs as a public transport vehicle is to choose a suitable road for operating them. A fuzzy decision model combining analytic hierarchy process (AHP) and technique for order of preference by similarity to ideal solution (TOPSIS) techniques with intuitionistic fuzzy sets is used to solve this problem. The results show that the BRT corridor is the most suitable option for operating AVs according to the decision criteria. Furthermore, operating AVs on a BRT corridor provides an unprecedented service provision approach.

Family support services delivered using a restorative approach: A framework for relationship and strengths-based whole-family practice.

Family support services, an integral part of many welfare systems across the developed world, have witnessed a growing demand for the use of relationship and strengths‐based whole‐family approaches in the belief that this increases service engagement and effect. Despite this, knowledge that delivering services using such approaches can be challenging and calls for the identification and exploration of methods likely to promote and sustain their use. Restorative approach is an ethos and method centred on building and sustaining positive relationships, which is increasingly being adopted in family and children's services in the United Kingdom. Despite this, the scarcity of research conducted in this area as yet, means little is known of its use and effect in this context. This article draws on empirical data collected in a wider study exploring the efficacy of different family service delivery models to describe the use of restorative approach in family service provision and determine whether its adoption promotes sustained use of strengths and relationship‐based whole‐family approaches when working with families. Furthermore, it explores whether the process incorporates wider evidence‐based methods of change.

Exploring and Addressing 'Concerns' for Significant Others to Extend the Understanding of Quality of Life With Amyotrophic Lateral Sclerosis: A Qualitative Study.

Background:The absence of curative medication for amyotrophic lateral sclerosis (ALS) makes palliative care and understanding quality of life (QoL) in ALS a clinical priority. Previous qualitative research has explored the concept of QoL in terms of illness impact on life perspectives and sense of self.Objective:In this research, we explored ‘concerns’ – one of the four aspects in the World Health Organisation’s conceptualisation of QoL – towards adding to the literature.Methods:In-depth interviews with 26 individuals with ALS were subjected to thematic analysis involving both inductive and deductive approaches to explore participant’s concerns, and to evaluate the relevance of their concerns for understanding QoL in ALS.Findings:The analysis showed that concerns for significant others contribute to participant’s QoL because of their existential value. It was important for participants to minimise the impact of limitations and burdens associated with ALS on significant others, even at a cost to self.Discussion:The current study supports a holistic approach in service provision, ensuring the inclusion of relevant significant others. It is further suggested that clinicians explore the specifics of burdens perceived by patients in order to support them in minimising the burdens for their significant others.

Seeking Refuge: An Exploration of Unaccompanied Women, Minors from Somalia and Families from Pakistan Experiences of Services in Bangkok, Thailand

The number of unprotected urban refugees in Bangkok has grown over the past few years with new migrations of young women, men and families from Somalia and Pakistan. An urban environment can mean opportunity for some but for many the environment can increase vulnerability to exploitation and detention. This study aimed to explore refugees’ experiences in Bangkok, assess agencies’ service delivery models, and strengthen their capabilities to address service gaps. Participants were recruited using purposeful sampling and snowball. Using CBPR, focus groups discussion with Somali and Pakistani refugees (n=63) and individual interviews (n=42) were conducted. Agencies’ staff (n=23) were interviewed regarding challenges in providing services to refugees. Qualitative data analysis revealed four major themes: lack of basic need, problems with legal services, agencies revealed urgent need for shifting from emergency services towards long-term strategies given the protracted immigration status of urban refugees, and the need for a collaborative approach in service provision emerged as an urgent call. Implications to social work practice with urban refugees focusing on potentials for innovative service provision and collective agency responses are discussed.

Thinking through ALMOLIN: the community bio-centre approach in water and sewerage service provision in Nairobi's informal settlements

About 55% of Nairobi's population lives in informal settlements, which lie beyond the reach of municipal water and sewerage networks. As a coping mechanism, deprived communities in Nairobi's large informal settlements are increasingly devising new strategies, technologies, institutional frameworks and servicing models to satisfy their water needs, in the face of neglect by the state, private sector and conventional market suppliers. Through the lens of Alternative Model of Local Innovation, this paper interrogates the viability of community-led infrastructure provision exemplified by the bio-centre model as an alternative servicing model that also claims to promote bottom-linked governance and inclusive urban development policies. It examines whether such a model may contribute to the bridging of socio-spatial differences within and across informal settlements.

Development of a Conceptual Model for Restorative Approach in Family Service Provision

Knowledge of ‘what works’ in early-intervention family services has prompted moves away from approaches which see varied services working autonomously with individual family members, towards provision of multi-agency cross-sector programmes working at a family level. Latterly, some such programmes have adopted Restorative Approach in the belief that delivering services using a more participatory relationship-based framework will support families more effectively. To consider this shift towards use of a Restorative Approach this article explores the concepts and theory that underpin the approach, reflects on how these relate to recommended UK early-intervention family service practice, and constructs a model of family service provision based on the approach. The aim of this article is to consider whether adoption of Restorative Approach has the potential to improve early-intervention family service effectiveness and ultimately have a positive outcome on families.