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Service Contract (service + contract)

Distribution by Scientific Domains

Medical Sciences	50%

Selected Abstracts

Evaluation of glargine group-start sessions in patients with type 2 diabetes as a strategy to deliver the service

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2007
A. A. Tahrani
Summary Improving glycaemic control in patients with type 2 diabetes reduces microvascular complications. The national service framework for diabetes and the new general medical service contract have been aiming to direct more focus on improving HbA1c. These measures have resulted in increasing number of patients being initiated on insulin therapy, which increases the workload of diabetes specialist nurses (DSNs). Initiating insulin on a one-to-one basis is time consuming. As a result DSN-led insulin group-start sessions were introduced. To evaluate DSN-led glargine group-start and self-titration as a strategy of providing service. We assessed the impact of this method on the use of DSNs time, HbA1c and on patients' satisfaction. A prospective audit in a district general hospital. Groups of 5,7 patients received two 2-h sessions at weeks 0 and 2. During these sessions, patients were initiated on insulin glargine and received an educational package and a self-titration protocol. DSNs did not see patients after week 2. Patients were able to phone the DSNs for advice till the end of the titration period. Patients completed Diabetes Treatment Satisfaction Questionnaire (DTSQ) at baseline, week 2 and 12 months. Weight and HbA1c were assessed at base line and 12 months later. Twenty-nine consecutive patients were included. Baseline HbA1c improved at 6 months and remained stable at 12 months (medians 10.0, 8.7 and 8.9 respectively, p < 0.001). DTSQ score improved between week 0 and 2 and this was maintained at 12 months (medians 26, 35 and 34 respectively, p < 0.001). After week 2, the DSNs spent a median of 21 min advising patients by phone during the titration period. Weight did not increase significantly. In our centre, DSN-led insulin group-start sessions and self-titration improved glycaemic control. Patients were satisfied with this method of starting insulin. This was achieved with minimal DSNs time and input and proved to be effective, yet less time consuming. [source]

Exploration and development of Iran's oilfields through buyback

NATURAL RESOURCES FORUM, Issue 3 2006
Abdolhossein Shiravi
Abstract The use of buyback for the development of oil and gas fields is an established mechanism in Iran. Current legislation authorizes the National Iranian Oil Company (NIOC) to use buyback for both exploration and development. The buyback scheme can be defined as a risk service contract, under which the contractor is paid back by being allocated a portion of oil/gas produced as a result of providing services. Buyback is based upon a defined scope of work, a capital cost ceiling, a fixed remuneration fee and a defined cost recovery period. When buyback is used for both exploration and development, the specifications of the field to be developed are unknown at the time of contracting and therefore agreement on the scope of work, duration of development operations, ceiling for capital costs, fixed remuneration fee, and duration of cost recovery need to be deferred to the time when a commercial field is discovered. This article first outlines the introduction of buyback for development of Iran's oil and gas fields. It then examines the main features of the mechanism. Third, the use of buyback for both exploration and development is explored and related challenges discussed. Finally, the article reviews the new buyback model proposed by NIOC to address these challenges. [source]

Kaiser Permanente Community Partners Project: Improving Geriatric Care Management Practices

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2003
Susan M. Enguidanos MPH
This article describes a geriatric care management project that is testing whether geriatric care management plus a brief purchase of service (POS) intervention will lower medical costs, improve satisfaction with care, increase care plan adherence, and improve perceived quality of life. Kaiser Permanente members aged 65 and older who were eligible for geriatric care management and consented to participate in the study were randomized to one of four study groups: information and referral via mail, telephone care management, geriatric care management, or geriatric care management with POS capability. The POS intervention provides up to $2,000 of designated, paid services including in-home supportive services, transportation, respite, or medical equipment within the first 6 months of care management enrollment. Approximately 1,400 senior members were referred to the geriatric care management program, and 451 were randomly assigned to one of the four study groups. Those enrolled in the geriatric care management program were significantly more likely to be ethnic minorities and have lower income than the general Kaiser Permanente senior enrollment. Barriers encountered in implementing the POS intervention included establishing contractual agreements between Kaiser Permanente and private and community agencies, locating adequate and sufficient community agencies to provided needed services, monitoring service contracts, and delaying use of the POS benefit. [source]

In search of the wage-labour/service contract: new evidence on the validity of the Goldthorpe class schema

THE BRITISH JOURNAL OF SOCIOLOGY, Issue 4 2000
Geoffrey Evans
ABSTRACT In this paper we examine new empirical evidence on the coherence and magnitude of the main classes in the Goldthorpe class schema. Particular attention is paid to issues that have recently been a source of academic dispute: the coherence and size of the service class and the distinction between the service class and intermediate classes. Using recently available British data collected by the Office for National Statistics we examine: (i) the extent to which measures of class-relevant job characteristics are empirically discriminated by the categories of the schema; (ii) the structure of a ,contract type' dimension of employment relations conceived of as a categorical latent variable; and (iii) the association between this latent variable and both the Goldthorpe class schema and a related measure,socio-economic group (SEG). We find that the data are consistent with the existence of a three category latent ,contract type' variable largely corresponding to the notions of service, intermediate and wage-labour contracts explicit in discussions of the theoretical rationale for the Goldthorpe schema. We further find a substantial degree of fit between the latent ,contract types' and the schema. However, the service class fault line appears to lie within class I and II of the schema rather than between them and the intermediate classes which suggests a revised, smaller service class would better capture the reality of the contemporary British occupational structure. [source]