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In this review, we provide a summary of recent progress in ontology mapping (OM) at a crucial time when biomedical research is under a deluge of an increasing amount and variety of data. This is particularly important for realising the full potential of semantically enabled or enriched applications and for meaningful insights, such as drug discovery, using machine-learning technologies. We discuss challenges and solutions for better ontology mappings, as well as how to select ontologies before their application. In addition, we describe tools and algorithms for ontology mapping, including evaluation of tool capability and quality of mappings. Finally, we outline the requirements for an ontology mapping service (OMS) and the progress being made towards implementation of such sustainable services.

The Public Bodies Joint Working Scotland Act 2014 and the World Health Organisation’s document Strengthening a Component HealthWorkforce for the Provision of Coordinated / Integrated Health Services Langins and Borgermans, 2015, position the integration of health and social care services as the principal means of transforming the delivery of services. In relation to staff, the Scottish Government’s 2017 National Health and Social Care workforce plan, acknowledge that the planning for the future workforce within NHS Scotland will require a broad range of professionals who will recognise inter-dependence, the importance of ‘whole of workforce’ and that a distributed model of professional leadership will support the provision of more sustainable services. From an international perspective, the World Health Organization’s 2015 Strengthening a Component Workforce for the Provision of Coordinated / Integrated Health Provision Langins and Borgermans, 2015 highlights that, “all health professionals in all countries to be educated to mobilize knowledge and to engage in critical reasoning and ethical conduct so they are competent to participate in patient and population-centred health systems as members of locally responsive and globally connected teams” Frenk et al 2010. This highlights that delivering integrated care across the globe requires that the workforce are appropriately educated. At the University of West of Scotland UWS we have responded to this need by developing undergraduate and post graduate programmes in integrating health and social care. These have been developed to address the educational needs of a cross-sectoral health and social care workforce in cultural transformation focusing on educating for enablement and empowerment through co-production and an asset based approach. The programmes we deliver at UWS are the BA Hons Integrated Health and Social Care programmes, which have been successfully running since 2011 and the recently validated MSc in Leading People-centred Integrated Care at the University of the West of Scotland. These programmes are reflective of 3 stages of education as identified by Frenk et al 2010, informative education, formative education and transformative education. The undergraduate programme is focused on informative education and the post graduate on transformative education, the ethos behind both are to enable and empower the students to deliver, develop and lead integrated services to promote and enhance quality, effective and efficient people-centred services. A key feature of the programmes are through the multi-professional and multi-sectoral nature of shared co-productive learning to Integrated Care education students can explore the complexities and challenges of delivering and leading system integration. This is advocated as a way of breaking down professional boundaries and in developing a more cohesive approach to professional practice. The principle of co-production is evident throughout both the ongoing developments in the undergraduate programme and in the development of the Masters programme. Both programme teams have been commended for the co-productive approach taken, which has included Subject specialists in Integrated Care, students and programme staff. Delivering and developing programmes relating to integration cannot be done in isolation and must up hold the very principles of integration it is aiming to achieve.

In the last decades, sustainable development has increasingly gained importance to service industry and the integration between Green, Lean and Six Sigma approaches in service systems is necessary in order to balance the need for operational efficiency with environmental commitment and social fairness. Because of that, the purpose of this paper is to critically review the Lean and Lean Six Sigma (LSS) methodologies and highlight their importance to achieve sustainable services. To do this, a systematic literature review of the subjects under investigation was conducted. The study has two major contributions. First, it is one of the first researches that examine the compatibility and divergences of Green, Lean and Six Sigma concepts and implications regarding its sustainable implementation in service industry. Second, it provides a holistic Green LSS framework attempting to help practitioners to find ways of institutionalizing it in numerous kinds of services, by pointing out nine critical factors for its implementation, such as continuous customer satisfaction, ethical relations and regulatory compliance, focus on knowledge management and human behaviors, and effective Jidoka automation. The proposed framework indicates new paradigms and pathways to achieve the balance in technical, economic, social and environmental priorities in services.

How is digital scholarship supported in practice? This chapter aims to respond to this question, informed by the results of a small-scale survey of 20 UK and Irish Higher Education (HE) libraries carried out in January 2016. The quantitative data generated by the survey is supplemented by a small number of case studies to provide a more detailed view of individual institutions’ activities. The survey's aim was to capture the extent to which libraries are engaged with a range of services and systems associated with digital scholarship. Responses were gathered from institutions ranging from research intensive to small specialist, from different mission groups and locations. The survey considered the impact a technology-rich learning and research environment has on the role of the library and, conversely, how libraries are optimizing their contribution to emerging digital practices and how this is helping to develop new expertise. It is evident that the skills librarians are developing are often in response to emerging service needs alongside new uses of library spaces, as Sinclair (2014) comments: Although the library incubator can be a catalyst, it is up to all of us – librarians, faculty, central IT staff, senior administrators, leading IT thinkers, alumni, and citizens, as well as our funding agencies and professional associations – to work together to encourage, promote, and support new forms of open scholarship over the more closed and insular forms of discourse from the past. The context for the survey drew on the work of Vinopal and McCormick (2013), who in their article ‘Digital Scholarship in Research Libraries’ included a model for the delivery of scalable and sustainable services in support of digital scholarship. The model emerged from research, observation of trends and interviews with peer US institutions. The principles underpinning it have been adapted and reworked to fit the UK and Irish HE context and were used as a basis for the survey questions. The approach taken by Vinopal and McCormick places emphasis ‘on developing, maintaining and integrating standard tools, platforms, and support services for a large community of users’ and, as such, stresses the importance of scalability, reuse and impact.

Application of new technology and “smart” devices is the most well-known experience in all type of works for sustainable services, including water supply networks. Measuring from the distance including online monitoring is one of the easiest way to control flow and pressure on these networks, especially on District Metering Areas (DMA). In order to reduce losses in the network, nowadays, online monitoring and controlling is more than a necessity. Water loss reduction is one of the biggest challenges today in the industry of water treatment. Applying these automatic and electronic devices will be presented below with real measures on site and real examples on Regional Water Company Prishtina service area.

Children with palliative care needs are increasing in prevalence and complexity of need. 49,000 children (under 19 years) were estimated to be living in the UK in 2012 with a life limiting/life threatening condition that might require palliative care. Palliative care requires a total and active approach, with transparent, communicated, agreed provision of appropriate and proportionate care. Planning improves care, supported by documentation of plans. Advance planning enables management of both reversible and chronic aspects of the condition, as well as utilising parallel planning when end of life approaches. Challenges in palliative care include the commissioning of sustainable services across organisations to deliver, often over years, but sometimes briefly and rapidly, 24/7 access to skilled palliative care, including hands on care at the end of life. Care is integrally intertwined with other clinical, social, education and voluntary services to ensure that families receive the spectrum of care required throughout their journey.

Purpose – The purpose of this paper is to examine Canadian organizational and systemic factors that made it possible to keep wait times within federally established limits for at least 18 months. Design/methodology/approach – The research design is a multiple cases study. The paper selected three cases: Case 1 – staff were able to maintain compliance with requirements for more than 18 months; Case 2 – staff were able to meet requirements for 18 months, but unable to sustain this level; Case 3 – staff were never able to meet the requirements. For each case the authors interviewed persons involved in the strategies and collected documents. The paper analysed systemic and organizational-level factors; including governance and leadership, culture, resources, methods and tools. Findings – Findings indicate that the hospital that was able to maintain compliance with the wait time requirements had specific characteristics: an exclusive mandate to do only hip and knee replacement surgery; motivated staff who were not distracted by other concerns; and a strong team spirit. Originality/value – The authors’ research highlights an important gradient between three cases regarding the factors that sustain waiting times. The paper show that the hospital factory model seems attractive in a super-specialized surgery context. However, patients are selected for simple surgeries, without complications, and so this cannot be considered a unique model.

Propósito: a partir del análisis del concepto, así como de las tipologías del riesgo sistémico, se pretende reflexionar en torno al sector cooperativo financiero español.Descripción: el modelo de negocio propuesto por las cooperativas de crédito en España tiene unas fuertes bases de cultura financiera ortodoxa en el sentido de que estas entidades, por lo general, han tenido como horizonte estratégico lo que se denomina “sostenibilidad financiera”.Punto de vista: en términos generales, dada una serie de procedimientos normativos que se han producido en España, se puede afirmar que, en gran medida, las cooperativas de crédito no se han visto afectadas, cosa que no aplica, por ejemplo, para las cajas de ahorro.Conclusiones: las cooperativas de crédito, en relación con el resto de las figuras que componen el sistema bancario, disponen de una menor exposición frente a los riesgos, de manera que se ve afectado el resto de las entidades que componen el sistema. Además, la gran ventaja competitiva con la que podrán contar estas entidades será la combinación de dimensión, eficacia y prestación de servicios financieramente sostenibles para afrontar un futuro convulso y en convivencia con entidades de banca comercial cada vez más competitivas.

Purpose The purpose of this paper is to present exciting and innovative research questions in service operations that are aligned with eight key themes and related topics determined by the Journal of Service Management (JOSM) Service Operations Expert Research Panel. By offering a good number of such research questions, this paper provides a broad range of ideas to spur conceptual and empirical research related to service operations and encourage the continued creation of deep knowledge within the field, as well as collaborative research across disciplines that develops and incorporates insights from service operations. Design/methodology/approach Based on a Delphi study, described in the companion article, “Service Operations: What Have We Learned?,” the panel identified eight key research themes in service operations where leading-edge research is being done or has yet to be done (Victorino et al., 2018). In this paper, three or four topics within each theme are selected and multiple questions for each topic are proposed to guide research efforts. The topics and questions, while wide-ranging, are only representative of the many ongoing research opportunities related to service operations. Findings The field of service operations has many interesting research topics and questions that are largely unexplored. Furthermore, these research areas are not only increasingly integrative across multiple themes within operations but often transcend functional disciplines. This creates opportunities for ever more impactful research with a greater reach throughout the service system and suggests that service researchers, regardless of functional affiliation, can contribute to the ongoing conversation on the role of service operations in value creation. Originality/value Leveraging the collective knowledge of the JOSM Service Operations Expert Research Panel to expand on the research themes generated from the Delphi study, novel questions for future study are put forward. Recognizing that the number of potential research questions is virtually unlimited, summary questions by theme and topic are also provided. These questions represent a synopsis of the individual questions and can serve as a quick reference guide for researchers interested in pursuing new directions in conceptual and empirical research in service operations. This summary also serves as a framework to facilitate the formulation of additional research topics and questions.

Innovating with services and integrating sustainability in economics are research issues of increasing importance. Green services are a recently relevant type in service research combining both fields. The potential seen in ecologically sustainable services is high, while a comprehensive approach in new service development is still missing. Based on an empirical study, a set of requirements for developing green services is introduced, considering specific criteria of ecological sustainability.

Waste management and other services of general economic interest are normally out of market. Therefore, regulation may be required to provide sustainable services with the desired quality of service at affordable and fair prices. Some countries have created regulatory authorities to supervise service levels and tariffs. However, the implementation of such entities is still a novelty being relevant to open the discussion about the explicit regulation of the waste sector. This study addresses the waste sector in Portugal and the regulator’s role in setting prices and providing proper incentives to ensure efficiency and added value. In this context, regulation was proposed to implement a tariff setting mechanism based on a productivity-related X factor linked to revenue caps. This innovative application (in the waste sector) calculates the X factor through a catch-up factor (static efficiency determined by Data Envelopment Analysis) and a production technology change or frontier shift (dynamic efficiency calculated by a Tornqvist index). Besides targeting the financial sustainability of waste utilities, there is also a focus to achieve reasonable environmental and quality of service standards. This study argues that economic regulation is required for this sector since it can be prone to the quiet life and inefficiency due to market failures and lack of incentives. Thus, a tariff setting system may be important and, perhaps, unavoidable to prevent these misbehaviors. The results highlight several predicaments and opportunities related to the application of this innovative performance-based approach.

Municipal performance plays a vital role in measuring an ideal municipality (IM) in South Africa. The IM includes a democratic and accountable government, the needs of local community, sustainable services, etc. However, the existing studies reflect a lack of sufficient models showing the relationship between these core areas of concern (CAC) and their significance to key performance areas (KPAs). This paper presents a conceptual model that represents the CAC and KPAs and the key determinants of an IM. The model was tested through Structural Equation Modelling to determine the relationships among the CAC, KPAs and IM. A comprehensive multi-layered approach to the complex issues facing local government in South Africa was utilised. The model shows that it is crucial for local municipalities to look into the CAC for continuous improvement of KPAs. The paper further recommends that the model can be used to measure KPAs at national level.

Receipt of accessible and appropriate specialist services and resources by all people with communication and/or swallowing disability is a human right; however, it is a right rarely achieved in either Minority or Majority World contexts. This paper considers communication specialists' efforts to provide sustainable services for people with communication difficulties living in Majority World countries. The commentary draws on human rights literature, particularly Article 19 of the Universal Declaration of Human Rights and the Communication Capacity Research program that includes: (1) gathering knowledge from policy and literature; (2) gathering knowledge from the community; (3) understanding speech, language and literacy use and proficiency; and (4) developing culturally and linguistically appropriate resources and assessments. To inform the development of resources and assessments that could be used by speech-language pathologists as well as other communication specialists in Fiji, the Communication Capacity Research program involved collection and analysis of data from multiple sources including 144 community members, 75 school students and their families, and 25 teachers. The Communication Capacity Research program may be applicable for achieving the development of evidence-based, culturally and linguistically sustainable SLP services in similar contexts.

Background: Post-apartheid South Africa faces major challenges in ensuring that it provides high quality and sustainable services that meet citizens’ expectations. The public wants local government that is not only responsive to their needs but also provides high quality services equitably to all people irrespective of their socioeconomic status. Sadly, basic services delivery has been on a downward spiral, characterised by ongoing community protests in many local municipalities. The article premises that municipalities need effective monitoring and evaluation systems to operate optimally.Objectives: The article sought to show that monitoring and evaluation is a critical development tool that needs to be supported by municipal political and administrative leadership to ensure that it functions optimally by offering citizen-responsive services.Method: The study focused on KwaZulu-Natal province, the second largest province in South Africa, predominantly rural with a significant poverty and underdevelopment. The study utilised a mixed method participatory design, comprising quantitative and qualitative approaches.Results: The study found that monitoring and evaluation capacity is low in the majority of municipalities besides the Metro. The municipalities were inadequately resourced with competent monitoring and evaluation human personnel, thereby stifling their capacity to deliver quality monitoring and evaluation services.Conclusion: The article concluded that effective monitoring and evaluation in local government that is responsive to citizens’ needs is a non-negotiable imperative for government. It recommended that municipalities be adequately resourced with competent monitoring and evaluation human personnel. This is important for strengthening their capacity to deliver efficient monitoring and evaluation services.

Sustainability is at the heart of many application fields where the use of Unmanned Aerial Systems (UAS) is becoming more and more important (e.g., agriculture, fire detection and prediction, environmental surveillance, mapping, etc.). However, their usage and evolution are highly conditioned by the specific application field they are designed for, and thus, they cannot be easily reused among different application fields. From this point of view, being that they are not multipurpose, we can say that they are not fully sustainable. Bearing this in mind, the objective of this paper is two-fold: on the one hand, to identify the whole set of features that must be provided by a UAS to be considered sustainable and to show that there is no UAS satisfying all these features; on the other hand, to present an open and sustainable UAS architecture that may be used to build UAS on demand to provide the features needed in each application field. Since this architecture is mainly based on software and hardware adaptability, it contributes to the technical sustainability of cities.

Providing sustainable water supply and sanitation (WSS) services in developing countries remains an immense, and increasingly urgent, challenge. Chapter two sets out how the sector is currently funded and why business as usual is insufficient for meeting WSS-related goals, covering the size of the investment gap, and the challenges presented by the status quo. Chapter three proposes a financing framework toward more effective use of existing funds to enable the mobilization of new sources of finance, and explains the benefits and costs of commercial finance. Chapters four to six detail the three components of the financing framework, providing practical advice and global experiences that demonstrate how countries can begin to make progress. Chapter seven summarizes how stakeholders can bring the three components together to mobilize commercial finance, and provides the main conclusions and recommendations of the report.

Many contemporary states in Africa are not economically viable and will remain mired in political crises because of the unsustainable and low levels of economic production and demand in the domestic markets. The institutional infrastructures–education, healthcare and information technology – remain inadequate or noncompetitive in the engineering of sustainable services industry in place of unlikely investments in manufacturing activities in these states. For institutionalists, individuals and their preferences and the institutional contexts in which public policies are made are at the center of resolving public economic and political problems. Understanding the differences in the economic and political contexts of public policy is important because the process in an economic context is mostly based on voluntary individual rational decision making in largely decentralized levels of interaction, with passive public purpose. Given the rules and institutions, individual capacity to change them is largely dictated by the individual or group resources matched against those of the opposition in the context of politics.

As the World Bank and partners aim to support governments in the Middle East and North Africa address the challenges that confront the water and sanitation sector, the development of an effective regulatory framework is seen as increasingly salient. In order to have impact in this space, some basic information is needed. The objective of this study is to collect information through a regulatory lens and present it to serve as part of the foundation for sector reviews and operations. It is not the objective of this study to analyze or critique the performance of water and sanitation services or the effectiveness of regulation in each country or to make recommendations. Thus the approach is positive rather than normative. The report is part of a wider World Bank initiative to provide government officials and other stakeholders including civil society, service providers, potential financiers, and development practitioners with the resources to better understand current conditions and consider approaches to policies, institutions and regulation that can best incentivize the delivery of sustainable services. The report discusses the different approaches in implementing regulatory functions specific to economic regulation and highlights aspects of the operating environment particular to each country context including sector institutional roles and responsibilities, tariff formulation processes, private sector participation and public-private partnerships, and the role of citizen engagement in sector regulation. This desk study is a first step intended to provide some basic information on selected countries that will serve as a foundation for determining where further support in the area of regulatory reform might be best concentrated. The authors review the status of regulatory institutions and practices in five MENA countries which were chosen to include different historic and legal frameworks and fragile/conflict states as well as those that are attempting broader sector reform.

The term 'metabolism' identifies the set of chemical processes that occur within a living organism in order to maintain its life. By analogy, we use the 'urban metabolism' concept showing the life of a city. A city is a set of very complex processes involving both public and private stakeholders, areas and infrastructures. Urban metabolism can be analysed and therefore its status evaluated based on measuring specific parameters in order to offer sustainable services for people. The internet of things (IoT) paradigm helps the collection of large amounts of data that become available for decision makers and city managers to improve the urban metabolism. Based on these consideration, in this paper we present and discuss the Arancino.ccTM architecture, in order to achieve 'green' benefits: a better quality of life, a more efficient city management also optimising energy consumptions and costs.

As demand for advanced logistics services grows, third-party logistics providers (3PLs) are being requested to provide more environmentally sustainable services. This development presents 3PLs with opportunities but also challenges and concerns about how to translate green efforts into practice. The purpose of this paper is to analyse environmental sustainability initiatives undertaken by 3PLs and the factors influencing them, both positively and negatively. The research methodology used in this paper is based on two-phase approach. In the first phase, a systematic literature review on the adoption of green initiatives by 3PLs has been carried out and two research questions have been identified. In the second phase, the research questions have been addressed by a case study analysis conducted on 13 Italian transport and logistics service providers. The research has distinguished three groups of companies with slightly different environmental profiles in terms of the green initiatives implemented and the main drivers and inhibitors. The surveyed companies show a differing degree of involvement in green initiatives due to variations in the breadth of service offered and the importance attributed to environmental issues. The paper concludes with a discussion of the managerial implications of the research, particularly for the development of 3PL's green strategies.

Collaboration among different stakeholders is a key factor in the design of Ambient Assisted Living (AAL) environments and services. Throughout several AAL projects we have found repeated difficulties in this collaboration and have learned lessons by the experience of solving real situations. This paper highlights identified critical items for collaboration among technicians, users, company and institutional stakeholders and proposes as a communication tool for a project steering committee a service description tool which includes information from the different fields in comprehensible format for the others. It was first generated in the MonAMI project to promote understanding among different workgroups, proven useful there, and further tested later in some other smaller AAL projects. The concept of scalable service description has proven useful for understanding of different disciplines and for participatory decision making throughout the projects to adapt to singularities and partial successes or faults of each action. This paper introduces such tool, relates with existing methodologies in cooperation in AAL and describes it with a example to offer to AAL community. Further work on this tool will significantly improve results in user-centered design of sustainable services in AAL.

Sustainable tourism management is becoming an increasingly important factor in the image of tourist destinations. Therefore, it is appropriate to consider the possibility of charging a premium price on certain tourism products or services in exchange for making them more sustainable. Generally, eco-friendly management of cultural heritage sites, and particularly World Heritage sites, along with protected natural areas, is essential for the image enhancement of tourist destinations. In line with these considerations, this paper aims to quantify the willingness to pay (WTP) an extra amount in order for certain tourism products and services to become more sustainable in a World Heritage city such as Caceres, Spain. By using the contingent valuation method, the average price increase that tourists visiting the city would be willing to pay for a double room in a hotel, a restaurant, entrance to a museum, or a taxi ride, all of which would become more sustainable services, has been estimated. In addition to the aggregate analysis, diverse average-comparison statistical techniques have been used in order to determine the possible influence of sociodemographic factors on the WTP for more sustainable products and services. Specifically, factors including the effect resulting from a tourist&rsquo, s place of origin, gender, the year when the survey was conducted (through t-tests), and the effect of age and educational levels (through ANOVA tests) on the WTP for sustainability, have been analyzed. When considering all of the sociodemographic factors involved, notable statistical differences have been found. This implies that when a hypothetical increase in tourism prices for the purpose of financing public or private sustainability actions is considered, different segments of the tourism market should be taken into account, since it would not be appropriate to apply the same policy of price increases to all tourists equally.

PurposeThe authors aim to describe the mutual perspectives of sustainability and service science and characterize them for the design and development of more sustainable services and to promote an overall shift toward sustainability.Design/methodology/approachThe paper presents a novel model for the design of services that fulfill customer demands and that can be continued for long periods of time without having a negative impact on either the natural or the social environment. Sustainability was therefore incorporated into the service supply chain not only as a primary value, but also as a super value that enables the customer to deliver sustainability to the next generation.FindingsThe authors' findings suggest that a sustainable service should both imbue the core‐value of the service with sustainability and recruit the customer as a supplier of sustainability to future generations. Thus, sustainable service should mimic natural processes, in so doing achieving energy efficiency, using future‐oriented and life cycle perspectives, and evolving to smoothly adapt to changes in its environment. Moreover, sustainable service should account for the rational use of natural resources, technologies, and information and knowledge and integrate environmental, social, and economic elements together with the inclusion of services and of manufacturing and agricultural processes.Originality/valueThe authors present a novel approach and a model that conceptualizes sustainability as a service while exploring the benefit of doing so, both for sustainability and for service science.

The Internet has affected a revolution in our behavior and communication as well as in how we perceive and implement services. It offers new opportunities, like the self-service mode, a service operated mainly by the customer, which enables the more efficient and conscious use of resources, technologies, and knowledge, and thus an opportunity to imbue the service with sustainability. Yet, such a move does not occur in a vacuum, and it demands a corresponding behavioral shift by both provider and customer, who have the shared responsibility to educate themselves about, and to monitor, the sustainability of the service(s) in which they are interested. As such, it is the provider’s duty to supply a sustainable solution while the customer, who has obtained the information necessary to rate the alternatives, should choose the most sustainable one.The power of internet-based services is not only in their availability and ease of operation, but also in the efficiency manifested in the customer’s ability to perform several services together with virtually the same resources and effort. While these advantages can be easily superimposed on any design to ensure more sustainable services, the same properties may lead to increased, unsustainable consumerism.

Islamic microfinance provides an alternative model for a significant number of underprivileged people who are not served by conventional microfinance. In order to give access to sustainable services with a greater extent, the Islamic microfinance is in paramount need of the adoption of innovative business models and sound practices into the industry. To this end, the research seeks to propose a two-tier mudarabah model based on cash waqf as an alternative to Islamic microfinance institutions. The objectives of the study are twofold: (1) help develop and implement an appropriate business model; and (2) help make a reform in the present institutional framework for Islamic microfinance and waqf institutions. To test the feasibility and possible implication of the proposed model, this test employed cointegration, vector error correction model (VECM) and the system generalized method of moments (GMM) technique. A total number of 90 conventional and Islamic microfinance institutions are taken as a sample of the empirical study. The study finds that cash waqf-based microfinance institutions can play an important role in financial inclusion and developing socio-economic conditions of the poor and underprivileged people in society.

Two Norwegian offshore shipping firms facing the challenge of developing more environmentally sustainable services choose divergent strategies. One focuses on managerial innovation and develops a new business model equally dividing fuel-savings achieved through operational optimization between customers and the Norwegian Rainforest Foundation, thus operating climate neutrally. The other firm develops a technology-driven strategy and develops LNG-propulsion for part of its fleet. Following the firms through the innovation processes, the study finds that implementing environmentally sustainable innovations requires managerial capability to provide a holistic and integrative perspective on organizational innovation processes which align technical and managerial actions and activities. The findings indicate that a business model can be used as a boundary-spanning tool that goes beyond the ambidextrous challenges of balancing and integrating exploration and exploitation and provides a complementary view on organizational innovation processes. The comparative case study looks inside the “black box” of sustainable innovation and offers theoretical and practical insights to academics and students. The study also contributes guiding principles for practitioners and policymakers.

Sustainability is a service that should be produced and delivered in any process that generates tangible or intangible values and that should be incorporated into each phase of the value chain. Moreover, sustainability should also be an essential part of value co-creation, the process of which eventually recruits the customer as a provider of sustainability to current and future generations. In so doing, the value co-creation process and subsequent propagation of sustainability can mimic the cyclic and evolutionary aspects of nature.

This article explores the possibility of incorporating traditional water management experiences into modern water management. After the literature review, two case studies are presented from Borana and Konso communities in southern Ethiopia. The study was conducted through interviews, discussions, and observations. The two cases were selected due to their long existence. Both communities have their own water source types, depending on local hydrogeological conditions. Borana is known for the so-called Ella (wells) and Konso for Harta (ponds), which have been managed for more than five centuries. All government and development partners strive to achieve sustainable services in water supply and sanitation. Therefore, they design various management packages to engage the communities and keep the systems sustainable. However, the management components are often designed with little attention to local customs and traditions. The cases in the two communities show that traditional knowledge is largely ignored when replaced by modern one. However, the concepts of cost recovery, ownership experience, equity, enforcement, integrity, and unity, which are highly pronounced in modern systems, can also be found in the traditional water managements of Borana and Konso. Naturally, one shoe never fits all. Borana and Konso experiences are working for their own community. This research implies that when we plan a project or a program for a particular community, the starting point should be the indigenous practices and thoughts on life.

Introduction: This study was carried out as a sub-activity for the project Model for Telecare Alarm Services. The project is participated by 8 Norwegian municipalities, the academic partner University of Agder, the research partner SINTEF IKT and the business partner Imatis. Municipalities are facing new challenges in the organization of the future Telecare alarm services in the response centres. Currently, municipal health- and social care services are responsible for 24/7 duties in emergency primary health care, including telephone calls (number 116117). In addition, similar 24/7 duties for Telecare alarm services and Telemedicine services on daytime are carried out. The scope of the project is to gain knowledge in how existing telecare alarm services are tackled and pinpoint important challenges when designing new services for the future. The project aims to identify similarities and synergies for combining existing municipal services as inter-municipal collaborative services. Context: Welfare technology is expected to have a great potential to improve safety and security for people living at home while increasing the quality of nursing and care, and contributing to achieve cost-effective services. Today, new digital sensor technologies are in pilot evaluations in several municipalities, while the design of Response Centre services models for the future still is under consideration. In order to scale-up new digital services, it is important to evaluate how a combined alert service can be organized, and how such services can interact with the emergency team of home-based services, while including family relatives involved in the process. Methods: During Autumn 2015 and Spring 2016 health care professionals, representatives from patients and operators at existing alarm centres participated in several workshops focusing on challenges in existing services based on experiences from piloting new digital solutions. Different organizational and future electronic collaboration models between the operator and the emergency home nurse service were evaluated in different lab-test scenarios. Conclusions and discussion: There is a lack of empirical knowledge from existing operational services, and information tracking actions for actual alarm conditions to necessary actions taken at the patient’s home is not available. How the Telecare alarm services are organized differs between the 429 Norwegian municipalities, and there is a clear need of re-organizing to sustainable services for the future change in digital welfare sensor technologies. The project identified several important aspects of requirements for a qualified Response centre service: 1) Certified medical expertise as the response centre operators, 2) Relational skills (personal suitability), 3) Access to updated information about the user's situation, services and past events (registry information, etc. derived from existing Electronic Health Records stored within all the actual municipalities organized within the Response Centre administration), 4) Standardized procedures for urgency assessment and follow-up, 5) Guidelines for evaluation of user needs for sensors and alarm functions, 6) National guidelines for standardized procedures and quality standards including monitoring of process quality indicators. There is a huge potential in designing integrated Response Centre services by combining the different 24/7 duties of today, in robust and uniform services with high skills and certified quality. The project is to be continued in 2016-17 in order to develop methods for effect evaluations, study of possible technical infrastructure solutions, evaluation of legal conditions and guidelines, initiating development of suitable decision support systems tailored to those new services, and giving guidelines on how close relatives and voluntary services could be incorporated in the acute response team. References: Svagard, S., Boysen, E.S., Fensli, R, Vatnoy, T. Response Centres for Telecare Services: Needs and vision of the future. Sub-report 1-2016 M4ALMO Project. SINTEF A27689. 2016. 74p. (in Norwegian).

Palliative care must change, grow and mature in response to the growing number and complexity of needs of community patients. Such demands particularly challenge conventional delivery of day hospice. In response our hospice redesigned day service provision to modernise bespoke day facilities, appoint a day hospice sister and introduce several novel clinical interventions. Patient outcome measures were introduced and research projects undertaken. The aim of the study was to evaluate whether extended day hospice services could address more patient needs. Newly developed services were introduced in the period April 2015 – May 2016. Management and clinical key performance indicators were obtained for this period and compared with annual data from the previous year. Two facilitated focus groups were undertaken with the multidisciplinary team and with the management team to better understand the service developments and participant’s aspirations for day services. It was found that introducing five additional patient services – Blood transfusion clinic; Progressive Supranuclear Palsy support group; Motor Neurone Disease clinic; Multi System Atrophy support group and a Carers’ support group – led to a 27% increase in attendances. Staff, patients and their families were recruited to three research projects by three hospice staff as a core part of their role, and five staff contributed to qualitative studies or data collection. The qualitative data indicated that staff were pioneering the new well-coordinated services but were challenged by the time available to capture data. The management team had a vision for further expansion of sustainable services and innovative approaches of working in partnership with the local acute trust and community care providers. In conclusion, a diversification of day services offered to patients and carers can be facilitated with engaged managerial and professional staff without a significant increase in core workforce.

Introduction With the escalating costs of health care, issues with recruitment and retention of health practitioners in rural areas, and poor economies of scale, the question of delivering people to services or services to people is a dilemma for health authorities around the world. People living in rural areas have poorer health outcomes compared to their urban counterparts, and the problem of how to provide health care and deliver services in rural locations is an ongoing challenge. Telehealth services can efficiently and effectively improve access to healthcare for people living in rural and remote areas of Australia. However, telehealth services are not mainstream or routinely available in many rural and remote locations. The barriers to integration of telehealth into mainstream practice have been well described, but not the factors that may influence the success and sustainability of a service. Our aim was to collate, review and synthesise the available literature regarding telehealth services in rural and remote locations of Australia, and to identify the factors associated with their sustained success. Methods A systematic literature review of peer-reviewed and grey literature was undertaken. Electronic databases were searched for potentially relevant articles. Reference lists of retrieved articles and the grey literature were also searched. Searches identified 970 potentially eligible articles published between 1988 and 2015. Studies and manuscripts of any type were included if they described telehealth services (store-and-forward or real-time videoconferencing) to provide clinical service or education and training related to health care in rural or remote locations of Australia. Data were extracted according to pre-defined criteria and checked for completeness and accuracy by a second reviewer. Any disagreements were resolved with discussion with a third researcher. All articles were appraised for quality and levels of evidence. Data were collated and grouped into categories including clinical speciality, disciplines involved, geographical location and the role of the service. Data relating to the success or sustainability of services were grouped thematically. Results Inclusion criteria were met by 116 articles that described 72 discrete telehealth services. Telehealth services in rural and remote Australia are described and we have identified six key factors associated with the success and sustainability of services: vision, ownership, adaptability, economics, efficiency and equipment. Conclusions Telehealth has the potential to address many of the key challenges to providing health in Australia, with its substantial land area and widely dispersed population. This review collates information regarding the telehealth services in Australia and describes models of care and characteristics of successful and sustainable services. We identified a wide variety of telehealth services being provided in rural and remote areas of Australia. There is great potential to increase this number by scaling up and replicating successful services. This review provides information for policy makers, governments and public and private health services that wish to integrate telehealth into routine practice and for telehealth providers to enhance the sustainability of their service.

English sexual and reproductive health (SRH) services are commissioned by local authority councils from their public health budget. Their allocations are predicted to shrink by up to 50% by 2017.1 To show that SRH care is good value for money it has to generate net earnings or net savings for those commissioning services. Clinical commissioning groups (CCGs) and NHS (National Health Service) trusts gain little from preventing uncomplicated pregnancies because they generate a net income from these pregnancies. SRH commissioners do not fund maternity care, abortion services, paediatric care or services for children and as a result do not benefit from any savings created from prevention initiatives. In order to have sustainable services we need to work with those who will have a net savings as a result of our care. New funding could come from two sources: (1) NHS or mental health trusts and (2) social services. Most SRH services in England are now also integrated with hospital-based genitourinary …

Objective To describe the attitudes and beliefs of health professionals working in Aboriginal Community Controlled Health Services (ACCHS) towards the access, usage and potential value of routinely obtained clinical and research data. Design, setting and participants Face-to-face, semistructured interviews were conducted with 35 health professionals from 2 urban and 1 regional ACCHS in New South Wales. The interviews were transcribed and themes were identified using an adapted grounded theory approach. Results Six major themes were identified: occupational engagement (day-to-day relevance, contingent on professional capacity, emphasising clinical relevance), trust and assurance (protecting ownership, confidence in narratives, valuing local sources), motivation and empowerment (engaging the community, influencing morale, reassuring and encouraging clients), building research capacity (using cultural knowledge, promoting research aptitude, prioritising specific data), optimising service provision (necessity for sustainable services, guiding and improving services, supporting best practice), and enhancing usability (ensuring ease of comprehension, improving efficiency of data management, valuing accuracy and accessibility). Conclusions Participants were willing to learn data handling procedures that could further enhance health service delivery and enable more ACCHS-led research, but busy workloads restrict these opportunities. Staff held concerns regarding the translation of research data into beneficial services, and believed that the outcome and purpose of data collection could be communicated more clearly. Promoting research partnerships, ensuring greater awareness of positive health data and the purposes of data collection, and communicating data in a user-friendly format are likely to encourage greater data use, build research capacity and improve health services within the Aboriginal community.

Jude Kornelsen raises several issues, almost all of which are focused on rural obstetrics rather than rural general surgery, which was the focus of the proposed training curricula.1 In response to the concerns regarding volume outcomes, the literature we referenced was not limited to complex major surgery, but included hernia repairs and endoscopy, which are largely elective outpatient procedures wherein distance to care would be irrelevant and system issues are minimized, yet a clear signal of volume to outcome is still seen. We agree that time and distance to emergency care is a determinant to outcome and always will be. The effects are not limited to rural environments nor to obstetrical situations. They also apply to fire, security and policing services. Outcomes of cardiac arrest in Canada’s largest city are worse on the upper floors of high-rise buildings than at street level.2 Unless all people live at equidistant locations from emergency services there will always be inequitable outcomes. The important questions are what high-quality services can be sustainably provided in remote communities, by whom and at what cost, and when should we expect the patient or provider to travel to enable health care services. We reiterate that a comprehensive analysis of geographic and demographic parameters that can support sustainable services analogous to that done in Australia would be helpful in depoliticizing the issue. We disagree that the higher cesarean section (C section) rates when performed by general surgeons in the studies referenced are an argument in favour of family physicians providing the service. The optimal rate of C section is still unclear, but a recent major study3 has suggested that maternal and neonatal mortality are minimized at C section rates of 19%, far higher than previous recommendations. We reiterate that quality outcomes are far more important than travel time or distance and should not be compromised for expediency. Outcomes are measured in lifetimes, whereas travel time is measured in hours. We see absolutely no evidence that supports the premise that training family physicians to do hernia repairs, endoscopy or other minor surgery will enhance obstetrical outcomes in remote communities. The proposed surgical curriculum deviates so substantially from standard surgical curricula that we consider it highly unlikely to result in surgical competency. Solutions to obstetrical issues should not compromise the quality of surgical care.

BackgroundPeople living and dying with non-cancer diagnoses, including dementia, have poorer access to generalist and specialist palliative care than people with cancer, and experience worse outcomes in terms of pain and symptom control, and quality and experience of care. In the UK, the National Council for Palliative Care (NCPC) ran a national survey of services for end-of-life care for people with dementia (2008) in which 16 services were identified, and reported on case studies and examples of good practice. We updated the NCPC survey to review progress in previously identified services, identify factors that lead to sustainable services and identify new initiatives in this area of care.MethodsAn online survey was developed and piloted before use. Initiatives were contacted via targeted (N=63) and open call invitations. The survey was made up of 5 sections. Quantitative data were analysed using descriptive statistics.Results15 services responded. They engaged in a wide range of activities predominately providing direct care (80%) and workforce development/advisory or educational activities (87%). Results suggest that sustainability of services is reliant on clinicians with a leadership role and wider system support through funding mechanisms and a minimum level of integration within normal service provision.ConclusionsRecent initiatives are largely built on the expertise of the nursing profession (with or without input from medical consultants), and driven mainly by the charity and hospice sector. This has generated a potential new model of care provision in end of life dementia care, ‘Hospice-enabled Dementia Care’.

This report, developed for policy makers and sector development partners, highlights the manner in which the domestic private sector is successfully participating in the delivery of water and sanitation services in Niger. It outlines the factors for success as well as the challenges that need to be addressed to harness private sector resources and motivation for improved and sustainable services.There is a need to further strengthen the capacities of various rural water supply stakeholders, particularly communes, which contract and supervise the work of the operators. The capacities of operators and users’ associations also need to be developed to pursue ensure the operational sustainability of the systems.The technical assistance (TA) described in this Note has, over the past five years, supported the sector’s stakeholders’ efforts to work in synergy to foster the participation of domestic private entities in the management of rural water supply systems (RWSSs).The purpose of the TA hasbeen to ensure improved operational policy applicationof the PPP frameworks in the context of water supplyand urban sanitation in rural and small towns , which hasnot evolved much over time in relation to urban waterservices. The TA program consisted of training activities,market assessments, and options development studiesto inform decision-making and consensus-building ofdifferent stakeholders on resolving some challenges facingthese subsectors.Opportunities exist for the Government to promote the emerging domestic private operators with a view to raising their level of professionalism for better service delivery.

This report, developed for policy makers and sector development partners, highlights the manner in which the domestic private sector is successfully participating in the delivery of water and sanitation services in Niger. It outlines the factors for success as well as the challenges that need to be addressed to harness private sector resources and motivation for improved and sustainable services.There is a need to further strengthen the capacities of various rural water supply stakeholders, particularly communes, which contract and supervise the work of the operators. The capacities of operators and users’ associations also need to be developed to pursue ensure the operational sustainability of the systems.The technical assistance (TA) described in this Note has, over the past five years, supported the sector’s stakeholders’ efforts to work in synergy to foster the participation of domestic private entities in the management of rural water supply systems (RWSSs).The purpose of the TA hasbeen to ensure improved operational policy applicationof the PPP frameworks in the context of water supplyand urban sanitation in rural and small towns , which hasnot evolved much over time in relation to urban waterservices. The TA program consisted of training activities,market assessments, and options development studiesto inform decision-making and consensus-building ofdifferent stakeholders on resolving some challenges facingthese subsectors.Opportunities exist for the Government to promote the emerging domestic private operators with a view to raising their level of professionalism for better service delivery.

It is evident from the records of national and state governments that the infrastructure for safe drinking water has been provided to more than 97% of India’s urban and rural population in most of the states. The current issue in rural drinking water sector for safe drinking water is to sustain these infrastructures through maintenance mechanism. The various reforms in the rural drinking water sector were adopted in 1999 through Sector Reform project (SRP) on pilot basis and scaled up throughout the country in the form of Swajaldhara launched on 25 December 2002. These programme were a paradigm shift from supply driven to demand driven, centralized to decentralized implementation and transforming the government’s role from service provider to facilitator. In Maharashtra state the various Regional Rural Water Supply Schemes (RRWSS) were planned and executed by Maharashtra Jeevan Pradhikaran (MJP), which was the nodal agency in water supply and sanitation area in Maharashtra. These schemes were funded by the United Kingdom through Overseas Development Institute (ODI). The concept was developed in United Kingdom in 1970s and the same was introduced in developing nation in 1990 onward. The RRWS Schemes for Fagane and 20 villages, which is one of the schemes funded by national and state government, executed in 1999-2000 and started functioning in 2001, is selected for study. The scheme was operated by MJP for about five years and thereafter taken over by Zilha Parishad Dhule. The scheme is facing the crisis since its beginning. Many times the scheme was inoperative for many months due to various reasons. It is observed that in spite of huge capital investment and flawless technological features, the consumers in many of the villages are unsatisfied with the functioning of scheme. There are always disputes among the various local governments i.e. Zilha Parishad, Group Grampanchyats and Grampanchyats. The operation and maintenance (OM as Fully Covered (FC) for 40 lpcd or more, Partially Covered (PC) for 10 lpcd or more but less than 40 lpcd and Not Covered (NC) when the rate of supply is less than 10 lpcd. According to WHO/UNICEF an improved source of drinking water includes water piped into dwelling/yard/plot, water available from public tap or stand pipe or a tube well or borehole, or a protected well or spring [3]. According to the various surveys conducted by government and non government organizations that the infrastructure for safe drinking water has been provided to more than 97% of India’s urban and rural population, however the ground realities shows that there are remaining significant challenges in providing sustainable services, especially in rural India. The coverage of FC category villages in 2002, 2005 and 2007 were 82.00%, 95.00% and 97.06% respectively, however based on record of Planning Commission and Habitation Survey the coverage in these years have been slipped down by 22.65%, 23.16% & 10.90% respectively [5]. In Maharashtra state the various Regional Rural Water Supply Schemes (RRWSS) were planned and executed by Maharashtra Jeevan Pradhikaran (MJP), which is the nodal agency in water supply area in Maharashtra. These schemes were funded by the United Kingdom through ODI. The concept was developed in United Kingdom in 1970s and the same was introduced in developing nation thereafter. It is observed that in spite of huge capital investment and flawless technological features in RRWSS, the stakeholders in many of the villages are unsatisfied with the functioning of scheme. There are always disputes among the various local governments i.e. Zilha Parishad, Group Grampanchyats and Grampanchyats. The operation and maintenance (O&M) and the financial matters

While information and communication technologies (ICT) can play a crucial role in tackling issues related to sustainability, and reducing resource consumption in every sector, they also consume huge amounts of energy, andthis, combined with the predicted rapid growth of demand for communication services, is expected to make the whole sector more and more energy-hungry in the coming years. The sustainability of ICT itself is also becoming an urgent challenge. Actions can be taken in several directions: i) introducing a massive and pervasive use of renewable energy sources, a step that requires the design of communication services to be revised; ii) enforcing rules and policies that induce the provisioning of sustainable services and promote the adoption of proper attitudes; and iii) involving the users who will become conscious consumers and participate in crowdsourcing projects tomonitor consumption and foster energy-aware behaviours.

Environmental issues have become an integral factor in any decision-making process and in the design and implemen-tation of manufacturing and agricultural production systems. As the service sector continuously grows in size and importance and service systems become more comprehensive, complex, and interdisciplinary, the creation of new services should be imbued with sustainability as the primary value of each service and as a service in and of itself. The paper presents a natural mimetic approach that follows the ground rules of nature to characterize the sustainability of a service and to choose the most sustainable service alternative.

Review question/objective The objective of this review is to synthesise the best available evidence on the experiences of women.s needs in maternity care and existing sustainable service models in rural areas. Specifically, the review questions are: 1. What are maternity care needs for women in rural areas? 2. What are existing models of sustainable services in maternity care in rural areas? Inclusion criteria Women who have child birth experience(s) in rural areas in developed countries such as Australia, England, USA, Canada, New Zealand and others. Since research on these topics aims to improve access and outcomes for women in rural areas, all women regardless of being classified as low risk or high risk should be included. Maternity services in rural areas should provide care for all women regardless of their health conditions. There is no any other restriction. Phenomena of interest The phenomena of interest are women.s experiences of maternity care in a rural setting. The review will focus on the whole period of maternal care including antenatal care, birthing and early postnatal care.

Local water supply based on community development were built by using funding from Local government. Accountability of this funding for local community entrepreneurship is debatable. This paper will explain how local water community entrepreneurship in Bogor can be determined in four community-based: aspect of infrastructure, training of human resources, revenue collection, and post onstruction support. The rural water supply in Bogor were studied by combining quantitative and qualitative methods. The study provides evidence on the need todesign policies and programs that provide sustainable services in Community-BasedEntrepreneurship.

The Social Welfare Department of the Hong Kong Special Administrative Region government attaches great importance to building a caring and harmonious society. The department has spearheaded social welfare reform initiatives to meet the community's changing needs, maximize utilization of public funds, ensure sustainability of welfare services, and promote service diversity, choice and accessibility. Achievements in the various service areas exemplify the policy of building a caring and harmonious society. In the coming years, the department will strive for continuous improvement by forging partnership with the government, the welfare sector, the business sector, and the public at large to provide quality and sustainable services to meet life's challenges.

Sustainable services are often regarded as sustainable strategies and operations producing goods and services that satisfy customer needs and significantly improve social and environmental performance. To be sustainable, service providers must satisfy consumers’ needs or otherwise they will become redundant and economically irrelevant. This paper presents the results of an empirical study on the determinants of customer satisfaction and loyalty in life-insurance services in Vietnam based on a database collected through a questionnaire survey of 1476 customers during 2017. A path analysis technique is applied to test the proposed framework on the direct and indirect relationship between variables. The results of statistical analysis indicate that customer satisfaction in life-insurance services is significantly explained by such factors as corporate image, service quality and perceived value. Our findings suggest that a life-insurance service provider should focus on enhancing service quality and corporate image in order to obtain customer satisfaction that leads to customer loyalty.

In an era of global warming, rising energy costs and increasing volumes of wastes destined for landfills and incinerators, communities should set up environmentally sustainable services that are cost-effective for their citizens and revenue generators for municipalities. A win-win garbage collection and kerbside recycling program established more than eight years ago in a small rural community in Ohio, US is still going strong. It is offering a relatively inexpensive way for waste disposal by providing an incentive-based and highly participatory kerbside recycling and at the same time bringing in substantial franchise fees for the municipal coffers. Unlike garbage contracts in most communities that are designed for only residential waste collection, this program extends disposal and recycling services to non-residential establishments. It picks up hard-to-dispose household furniture, appliances and other bulky items without additional costs to the residents. By being creative and assessing local political and socio-economic milieu, public officials can implement a comprehensive service package for taking care of their community throwaways. However, before establishing such programs in partnership with a private firm, city administrators must understand the intricacies of bid specifications customized for municipal wastes and recyclable materials.

Given that the lack of qualified human resources devoted to primary health care (PHC) is one of the reasons why Alma Ata goals are as yet unattained, PAHO/WHO sponsored the design and implementation of a virtual course for training health care professionals at this level. The course was designed around competencies identified as being necessary for renewing primary care, founded on the premise that providing quality, sustainable services amenable to the public must emanate from professionals who lead the change process at all levels in the system. In this first phase, instruction is aimed at PHC leaders, managers, and other decision makers. The course is offered through the Virtual Public Health Campus and is 27 weeks long.