Affordability, Accessibility, and Quality of Maternal Health Care Services and Level of Satisfaction of Mothers in Rural Areas in China

Objective:This study aimed to understand the affordability,accessibility,and quality of maternal and child health services for postpartum mothers,and their impact on satisfaction.Methods:The study utilized the Anderson model and revised the Maternal Pregnancy and Perinatal Health Service Questionnaire.A survey was conducted among 289 mothers aged 20–49 in Feicheng City.Results:Regarding accessibility,most respondents(133)reported that travel time to healthcare services exceeded 60 minutes,while 99 respondents indicated a travel time of 16–30 minutes.The issue of affordability was highlighted,with 86.85%of participants perceiving maternal healthcare services as costly,indicating a significant financial burden.More than 50%of respondents were satisfied with two specific dimensions(P<0.05)regarding the quality of maternal healthcare services.Conclusion:The study found that accessibility,affordability,and quality significantly affect mothers’satisfaction with maternal health services.Future research should focus on developing more suitable service pathways for rural mothers.

Spatial Disparity in Availability of Tuberculosis Diagnostic Services Based on Sector and Level of Care in Nigeria

Background: Delay in Tuberculosis (TB) diagnosis can contribute to late presentation, severe disease, and continued transmission. KNCV TB Foundation Nigeria through the United States Agency for International Development (USAID) funded the TB Local Organization Network (LON) 1 and 2 projects that explored the availability of Tuberculosis services based on sector and levels of care. Methods: TB Patient Pathway Analysis was carried out in 14 states comprising 92 facilities. It involved primary, secondary, and tertiary levels of health care in both the public and private sectors. This was a cross-sectional study under program implementation. Proforma was used to collect data on the available TB diagnostic services. Results: In public health facilities, GeneXpert was available at 100% in tertiary facilities in 8 (57%) states;up to 82% in 4 (33%) states, 50% available at secondary facilities in 2 states, and There is none at the primary facilities. Smear microscopy was available at 100% in tertiary facilities in 9 (64%) states and 3 (25%) states have 50% to 82%;secondary -10 (71%) states have > 70% at facilities;primary 1 (7%) state has it in 61% of facilities. Loop-mediated isothermal amplification (TB-LAMP) in tertiary 2 (17%) states have 20% and 100% respectively;secondary 4 (<30%) states have in 1 or 2 facilities;none for primary facilities. In private health facilities, 79% of states have Smear microscopy at both primary and secondary facilities, and only 2 states (14%) at tertiary facilities. Only 1 (7%) state has GeneXpert in all tertiary facilities, 2 (14%) states have secondary facilities, and 4 states in about 1% of facilities. TB LAMP was not available in any tertiary facility, one (7%) state at secondary with coverage of 1%, and 2 (14%) states at primary both with 4% overall facility coverage. Conclusions: There is an inequitable distribution of TB diagnostic services in both sectors and levels of care in Nigeria. TB care and control will improve with enhanced equitable distribution of TB diagnostic services across the health system.

Construction of Rural Grass-roots Water Conservancy Service System in the Context of Institutional Changes

At present,it is urgent to solve problems of reforming and improving grass-roots water conservancy management mode in rural areas and improving rural water conservancy public service ability. Through analyzing institutional changes of grass-roots water conservancy management in rural areas,this paper discussed current situations and outstanding problems in grass-roots water conservancy services in rural areas of Kunming City. On the basis of current situations and problems,it came up with policy recommendations from reform of management institutions,reform of personnel system,construction of human resources,development of rural water use cooperation organizations,and improvement of fund input mechanism,to build rural grass-roots water conservancy service system.

Price and retailer's service level decision in a supply chain under consumer returns

To investigate the optimal retail price and service level in a supply chain under consumer returns, a consumer returns model under the retailer＇s service provision is built. The optimal decision results and optimal profits are obtained in the vertical integration game and the manufacturer Stackelberg game, respectively. Through comparing the optimal profits with service provision with those of no service provision, the boundary conditions that the retailer＇s service should be provided are derived. The results show that in the manufacturer Stackelberg game, the optimal profit of the retailer and the manufacturer with service is always superior to that of a no service provision. However, in the vertical integration game, the supply chain can only benefit from the service under certain conditions. Finally, through numerical examples, the impacts of the cost for providing services and the consumer return rate on the optimal decisions are analyzed.

Auto-Scaling Framework for Enhancing the Quality of Service in the Mobile Cloud Environments

On-demand availability and resource elasticity features of Cloud computing have attracted the focus of various research domains.Mobile cloud computing is one of these domains where complex computation tasks are offloaded to the cloud resources to augment mobile devices’cognitive capacity.However,the flexible provisioning of cloud resources is hindered by uncertain offloading workloads and significant setup time of cloud virtual machines(VMs).Furthermore,any delays at the cloud end would further aggravate the miseries of real-time tasks.To resolve these issues,this paper proposes an auto-scaling framework(ACF)that strives to maintain the quality of service(QoS)for the end users as per the service level agreement(SLA)negotiated assurance level for service availability.In addition,it also provides an innovative solution for dealing with the VM startup overheads without truncating the running tasks.Unlike the waiting cost and service cost tradeoff-based systems or threshold-rule-based systems,it does not require strict tuning in the waiting costs or in the threshold rules for enhancing the QoS.We explored the design space of the ACF system with the CloudSim simulator.The extensive sets of experiments demonstrate the effectiveness of the ACF system in terms of good reduction in energy dissipation at the mobile devices and improvement in the QoS.At the same time,the proposed ACF system also reduces the monetary costs of the service providers.

Pedestrian Facilities Capacity and Level of Service at Intersections in a Connected and Autonomous Vehicle Environment

It is inevitable that Connected and Autonomous Vehicles (CAVs) will be a major focus of transportation and the automotive industry with increased use in future traffic system analysis. Numerous studies have focused on the evaluation and potential development of CAVs technology;however, pedestrians and bicyclists, as two essential and important modes of the road users have seen little to no coverage. In response to the need for analyzing the impact of CAVs on non-motorized transportation, this paper develops a new model for the evaluation of the Level of Service (LOS) for pedestrians in a CAVs environment based on the Highway Capacity Manual (HCM). The HCM provides a methodology to assess the level of service for pedestrians and bicyclists on various types of intersections in urban areas. Five scenarios were created for simulation via VISSIM (a software) that corresponds to the different proportions of the CAVs and different signal systems in a typical traffic environment. Alternatively, the Surrogate Safety Assessment Model (SSAM) was selected for analyzing the safety performance of the five scenarios. Through computing and analyzing the results of simulation and SSAM, the latter portion of this paper focuses on the development of a new model for evaluating pedestrian LOS in urban areas which are based upon HCM standards which are suitable for CAVs environments. The results of this study are intended to inform the future efforts of engineers and/or policymakers and to provide them with a tool to conduct a comparison of capacity and LOS related to the impact of CAVs on pedestrians during the process of a transportation system transition to CAVs.

Two-echelon inventory model with service level constraint and controllable lead time sensitive to order quantity

The decision-making and optimization of two-echelon inventory coordination were analyzed with service level constraint and controllable lead time sensitive to order quantity.First,the basic model of this problem was established and based on relevant analysis,the original model could be transformed by minimax method.Then,the optimal order quantity and production quantity influenced by service level constraint were analyzed and the boundary of optimal order quantity and production quantity was given.According to this boundary,the effective method and tactics were put forward to solve the transformed model.In case analysis,the optimal expected total cost of two-echelon inventory can be obtained and it was analyzed how service level constraint and safety factor influence the optimal expected total cost of two-echelon inventory.The results show that the optimal expected total cost of two-echelon inventory is constrained by the higher constraint between service level constraint and safety factor.

Discussion on Improving Decision-making Meteorological Service Level of County-level Meteorological Station

Based on experience of meteorological service at county-level meteorological station in recent 20 years,status quo of decision-making meteorological service,main influence factors of decision-making meteorological service and writing of decision-making meteorological service materials are analyzed,and measures and suggestions of improving decision-making meteorological service level are proposed. The research aims to improve public meteorological service level at grass-roots level,provide scientific decision-making basis for government departments preventing and reducing disaster,and reduce loss of life and property of the country and people caused by meteorological disasters to the maximum extent.

Pedestrian perception-based level-of-service model at signalized intersection crosswalks

Pedestrian level of service(PLOS)is an important measure of performance in the analysis of existing pedestrian crosswalk conditions.Many researchers have developed PLOS models based on pedestrian delay,turning vehicle effect,etc.,using the conventional regression method.However,these factors may not effectively reflect the pedestrians'perception of safety while crossing the crosswalk.The conventional regression method has failed to estimate accurate PLOS because of the primary assumption of an arbitrary probability distribution and vagueness in the input data.Moreover,PLOS categories in existing studies are based on rigid threshold values and the boundaries that are not well defined.Therefore,it is an important attempt to develop a PLOS model with respect to pedestrian safety,convenience,and efficiency at signalized intersections.For this purpose,a video-graphic and user perception surveys were conducted at selected nine signalized intersections in Mumbai,India.The data such as pedestrian,traffic,and geometric characteristics were extracted,and significant variables were identified using Pearson correlation analysis.A consistent and statistically calibrated PLOS model was developed using fuzzy linear regression analysis.PLOS was categorized into six levels(A–F)based on the predicted user perception score,and threshold values for each level were estimated using the fuzzy c-means clustering technique.The developed PLOS model and threshold values were validated with the fieldobserved data.Statistical performance tests were conducted and the results provided more accurate and reliable solutions.In conclusion,this study provides a feasible alternative to measure pedestrian perception-based level of service at signalized intersections.The developed PLOS model and threshold values would be useful for planning and designing pedestrian facilities and also in evaluating and improving the existing conditions of pedestrian facilities at signalized intersections.

Is the Urban Shrinkage Inhibits the Improvement of Public Service Level?

Public services provide convenient conditions for urban residents to study,work and live,and have important significance for improving the life quality of residents and improving the level of welfare.However,while China’s spatial economic is heading towards agglomeration development,a large number of cities have shrunk,which has made unbalanced supply of public services between regions increasingly prominent.Based on the existing literature and the development reality,this paper analyzes the impact of urban shrinkage on the public service level from the public service supply mechanism,and discusses the heterogeneous effects of different labor shrinkage on public services.The results of the study show that urban shrinkage will inhibit the improvement of public service level,but inter-governmental competition makes the labor shrinkage of industry and service industry promote the improvement of public service level.In addition,this paper takes economic development level as a moderating variable to study the moderating effect of economic development level in the impact of urban shrinkage on public service levels.It is found that the reduction of economic development level will promote government competition and provide more public services.

A DISCRETE TIME TWO-LEVEL MIXED SERVICE PARALLEL POLLING MODEL

We present a discrete time single-server two-level mixed service polling systems with two queue types, one center queue and N normal queues. Two-level means the center queue will be successive served after each normal queue. In the first level, server visits between the center queue and the normal queue. In the second level, normal queues are polled by a cyclic order. Mixed service means the service discipline are exhaustive for center queue, and parallel 1-limited for normal queues. We propose an imbedded Markov chain framework to drive the closed-form expressions for the mean cycle time, mean queue length, and mean waiting time. Numerical examples demonstrate that theoretical and simulation results are identical the new system efficiently differentiates priorities.

Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

Inventory Model with Supply Disruption Risk and Service Level Constraint

We develop a newsvender model with service level constraint for oneproduct and multi-supplier system, where the supplies are susceptible to disruption risks. We prove the convexity of the programming problem,and provide the necessary and sufficient conditions for the optimal order quantities. Through analysis or numerical experiments we observe the effects of the disrupt risk and the service level constraint on the optimal policy. We propose some managerial insights in managing the multi-source supply chain with disruption risks.

The Sensitivity of Model Results to Specification of Network-Based Level of Service Attributes: An Application of a Mixed Logit Model to Trave Mode Choice

The need for travel demand models is growing worldwide. Obtaining reasonably accurate level of service (LOS) attributes of different travel modes such as travel time and cost representing the performance of transportation system is not a trivial task, especially in growing cities of developing countries. This study investigates the sensitivity of results of a travel mode choice model to different specifications of network-based LOS attributes using a mixed logit model. The study also looks at the possibilities of correcting some of the inaccuracies in network-based LOS attributes. Further, the study also explores the effects of different specifications of LOS data on implied values of time and aggregation forecasting. The findings indicate that the implied values of time are very sensitive to specification of data and model implying that utmost care must be taken if the purpose of the model is to estimate values of time. Models estimated on all specifications of LOS-data perform well in prediction, likely suggesting that the extra expense on developing a more detailed and accurate network models so as to derive more precise LOS attributes is unnecessary for impact analyses of some policies.

Bicycle Level of Service Evaluation Method for Urban Road Segment

As a sustainable mode of transportation, bicycles significantly improve daily mobility. In order to provide theoretics support for improvement of the bicycling environment, this paper proposed bicycle level of service (BLOS) evaluation method for urban road segment according to cyclists’ perception. First, influence factors of BLOS were identified from aspects of road facility, traffic characteristics, and environmental condition. Second, bicycling videos were recorded and a satisfaction survey was conducted. Four BLOS evaluation models for different separation facilities were established. Last, bicycling behavioral stages of travelers were divided based on the transtheoretical model. A new BLOS classification criterion was proposed according to travelers’ demand of different stages.

Adaptive Runtime Monitoring of Service Level Agreement Violations in Cloud Computing

The cloud service level agreement(SLA)manage the relationship between service providers and consumers in cloud computing.SLA is an integral and critical part of modern era IT vendors and communication contracts.Due to low cost and flexibility more and more consumers delegate their tasks to cloud providers,the SLA emerges as a key aspect between the consumers and providers.Continuous monitoring of Quality of Service(QoS)attributes is required to implement SLAs because of the complex nature of cloud communication.Many other factors,such as user reliability,satisfaction,and penalty on violations are also taken into account.Currently,there is no such policy of cloud SLA monitoring to minimize SLA violations.In this work,we have proposed a cloud SLA monitoring policy by dividing a monitoring session into two parts,for critical and non-critical parameters.The critical and non-critical parameters will be decided on the interest of the consumer during SLA negotiation.This will help to shape a new comprehensive SLA based Proactive Resource Allocation Approach(RPAA)which will monitor SLA at runtime,analyze the SLA parameters and try to find the possibility of SLA violations.We also have implemented an adaptive system for allocating cloud IT resources based on SLA violations and detection.We have defined two main components of SLA-PRAA i.e.,(a)Handler and(b)Accounting and Billing Manager.We have also described the function of both components through algorithms.The experimental results validate the performance of our proposed method in comparison with state-of-the-art cloud SLA policies.

Nursing homes’social responsibility and competitive edge:a cross‐sectional study on elderly choices about care service and price levels in Zhejiang Province,China

Background In the context of China's aging population,meeting consumer demand is an essential way for nursing homes to fulfill social responsibilities and improve competitive advantages.However,since little is known about the elderly's service level and price choices for nursing home care,this study aims to explore the non-disabled elderly's nursing home admission intention,service level,and price choices.Methods A cross-sectional survey of 402 non-disabled respondents was conducted in three different income level cities of Zhejiang Province,in July and August 2018.Multinomial logistic regression and multiple linear regression were used to identify the determinants of admission intention,service level choice,and price choice.Results Education,residence,and number of children were significantly associated with nursing home admission intention.Compared to those with no intention,the elderly with higher income and household wealth were less likely to have conditional intentions,and those living with the family were less likely to have unconditional intentions.Compared to medium-level services,the elderly with higher monthly income(relative risk ratio[RRR]3.07,95%confidence interval[CI]:1.801 to 5.233),household wealth(RRR 5.451,95%CI:2.249 to 13.216),and age(RRR 1.528,95%CI:1.004 to 2.326)were more likely to prefer high-level services,while older adults with higher monthly income(RRR 0.516,95%CI:0.344 to 0.774),and those with pensions(RRR 0.267,95%CI:0.076 to 0.931)were less likely to prefer low-level services.The elderly's price preference increased by 398 CNY as monthly income increased by 1000 CNY,and by 270 CNY as the housing number increased by one.Having pensions increased price preference(468 CNY),whereas having health insurance decreased price preference(–690 CNY).Conclusion The elderly's intention of nursing home admission was primarily affected by sociodemographic factors,while price and service level choices were primarily affected by financial factors.Nursing homes should use the market segmentation method to provide precision nursing home care for different groups of non-disabled elderly.

Improving the Service Level of University Library by Using Micro-Blog and WeChat

In order to improve the service level of the University Library and increase the utilization rate of the students' libraries, the domestic libraries began to use micro-blog and WeChat. The use of micro-blog and WeChat is in line with the characteristics of college students and can improve the service level of University libraries effectively. In this article, I will start with introducing micro- blog and WeChat, briefly describe the current situation of using micro-blog and WeChat in university libraries, and the measures to improve the service level of university libraries by using micro-blog and WeChat.

Level of Service for Parking Facilities

As the number of motor vehicles increasing rapidly, urban parking has become an intolerable problem in major cities in China. Parking facility service evaluations play an important role in urban transportation planning and operation. This paper introduces an LOS （level of service） concept based on a comprehensive parking study in Beijing, China. The LOS methodology is developed by an integrated evaluation model that reflects the user＇s perception of the quality of service. The method combines four important service variables, namely the ratio of peak-hour demand to capacity, average parking space occupying rate, parking cost, and circulation time, into one single index to quantitatively evaluate a parking facility＇s performance. The case studies at the end of the paper demonstrate the applicability of the method.

An Automated Semantic Negotiation for Cloud Service Level Agreements

Mostly, cloud agreements are signed between the consumer and the provider using online click-through agreements. Several issues and conflicts exist in the negotiation of cloud agreement terms due to the legal and ambiguous terms in Service Level Agreements (SLA). Semantic knowledge applied during the formation and negotiation of SLA can overcome these issues. Cloud SLA negotiation consists of numerous activities such as formation of SLA templates, publishing it in registry, verification and validation of SLA, monitoring for violation, logging and reporting and termination. Though these activities are interleaved with each other, semantic synchronization is still lacking. To overcome this, a novel SLA life cycle using semantic knowledge to automate the cloud negotiation has been formulated. Semantic web platform using ontologies is designed, developed and evaluated. The resultant platform increases the task efficiency of the consumer and the provider during negotiation. Precision and recall scores for Software as a Service (SaaS), Platform as a Service (PaaS) and Infrastructure as a Service (IaaS) SLAs were calculated. And it reveals that applying semantic knowledge helps the extraction of meaningful answers from the cloud actors.