P-OGC63 Care Close to Home in the Era of Centralisation

Background With increasingly centralised services for people diagnosed with OG Cancer we wanted to ensure our local service was maintained to provide the appropriate care and management by collaborating with the Specialist Sites and raising the profile of local services. Most patients remain local due to their disease stage, performance status or through choice. We wanted those patients who have tests and treatment on other sites to be able to have their care managed locally as much as possible and therefore only have to travel when absolutely necessary. We aim to facilitate and deliver a streamlined service. Methods Weekly Local MDT triages patients to Specialist MDT once appropriate information is available. Established local outreach clinic for specialist service. Ensures patients are known to specialist service from diagnosis. Patients will be diagnosed and managed locally unless input required elsewhere. Local CNS attends both Local/Specialist MDT as patient advocate and provides cross site communication and care planning. Local User Involvement- contributes to service development and feedback both locally and beyond. Local HNA at point of diagnosis to establish a bench mark. Ongoing emotional support is integral to the local service and continues wherever the patient is in their care pathway. Results Streamlined care with local and specialist team contacts. Improved communication between professionals. Identifiable contact for patients Rapid referral process - timely and appropriate discussions. Improved patient satisfaction. Direct access to specialist site from point of diagnosis. Improved patient advocacy across sites Effective use of clinic time. The right patient being seen at the right time in the right hospital with the right information. Local follow up enables integration of additional local services/teams into patient care More inclusion for local teams in wider service development. Local leadership within the network has ensured investment in local services and raised the profile. Conclusions Care is more streamlined Patients are assessed by the right person at the right time enabling more open communication Avoids unnecessary referrals Less travelling between sites Reduces patient anxiety Encourages user involvement- more personalised care. Promotes continuity of patient care Allows inclusion of local teams in decision making at specialist level Promotes collaboration and team working with flexible leadership amongst team members Improved job satisfaction by establishing a shared vision Upper GI Cancer delivery will continue to go through changes but with a motivated team who work together these changes can be implemented efficiently and effectively.

Reverse Privatization as a Reaction to the Competitive Environment: Evidence from Solid Waste Collection in Germany

After earlier waves of privatization, local governments have increasingly taken back control of local service provisions in some sectors and countries and instead started providing those services themselves (reverse privatization). Using a unique panel dataset on the mode of service provision for solid waste collection for German municipalities that cover the years 2003, 2009, and 2015, we investigate the motives for reverse privatization. Our results show that—in deciding whether to insource or not—municipalities react to the cost advantages of private suppliers as well as to the competitive environment and municipal activity: there is more switching to insourcing in concentrated markets and in markets with horizontally or vertically related public services. Local interest groups influence this decision as well.

THE USE OF PHET SIMULATION ON PHYSICS CHAPTER WAVE AND VIBRATION IN 3T REGION

Learning to use PhET as a virtual laboratory can improve students’ understanding of abstract concepts or material that is difficult to experiment in a real laboratory. The purpose of this local service activity is to conduct training for teachers and students at SMAN 1 Nimboran, Jayapura Regency. This is to find out how the implementation of the PhET Simulation learning media in the 3T region which stands for terdepan (frontier), terpencil (remote), and tertinggal (disadvantaged) in Indonesia. This service activity was attended by physics teachers and students of class XI-IPA at SMAN 1 Nimboran, Jayapura Regency. The method of this activity is carried out in the form of virtual laboratory training through PhET Simulation, face-to-face/offline at SMAN 1 Nimboran. The success of this training program for teachers and students can be seen from the enthusiasm and attainment of skills to use PhET Simulation smoothly. Students better understand the concepts of vibration and waves through simulation. The plan for the next stage of this service activity is to follow up for other subjects and 3T area.

Unemployment as a determinant of local service-oriented entrepreneurship: a case study of Poland

Motivation: Unemployment is an important entrepreneurship determinant which is captured by the unemployment push/pull hypotheses. Those issues remain underexplored, with only few studies investigating the relationship between unemployment and the sector structure of entrepreneurship, while considering the specificity of the local economy. Aim: The main goal of the study is to assess the impact of local unemployment rate on the number of newly registered service businesses in Poland, taking into account both the heterogeneity of that sector and the specificities of local economies in 2003–2018. Results: The research results show that in Poland growing unemployment contributed to the increasing registration of new service businesses, which empirically supports the unemployment-push hypothesis. Both the occurrence and the intensity of the unemployment-push effect were conditioned by territorial factors, with the higher elasticity of entrepreneurship in relation to unemployment changes in lagged local units.

Subnational Capital Finance

Chapter 1 introduces the book by presenting the main arguments that information resolution is a necessary component of SNG capital market development and access to external financing. It also argues that local policy and management agency vis-à-vis financial sector firms is critical to achieve SNG governance tasks in the face of decentralized governance and growing local service pressures. This chapter defines the key terminology of information problems, information institutions, and information resolution. It situates the focus on SNGs, and more narrowly on policy makers at the city level, that are embedded within the national contexts and financial markets. Finally, the chapter identifies the book’s contributions and details the organization of the book’s remaining chapters.

Participation of local service providers in systemic market approaches in the dairy sector of Rangpur district

The main purpose of the study was to determine the participation of Local Service Providers (LSPs) in systemic market approaches (SMA) in dairy sectors in two Upazilla Pirgacha and Badargonj under Rangpur district. Ninety-nine (99) LSPs were randomly selected as sample from an updated list of 495 LSPs. A pretested and structured interview schedule was used to collect data from the respondents during 16 August to 17 September 2018. Simple and direct questions with different appropriate scales were used to obtain information. Descriptive statistics, correlation, and multiple regression analysis were used. The top-ranked activities regarding the participation of LSPs was referral linkage with DLS for the critical or serious condition of livestock treatment, linkage with dairy producers’ group to assess the demand of information, develop collection point’s adjacent place of the community. Slightly above four-fifths (84.8 percent) of the respondent had high participation in systemic market approaches. Correlation analysis indicated that among seven selected characteristics of the respondent’s annual income, cosmopoliteness, training received, innovativeness, and extension media contact of the respondents had significant positive relationship with their participation in SMA, however, age and family size had no significant positive relationship. Regression analysis indicated that cosmopoliteness, training received, innovativeness, and extension media contact of the respondents had a positive contribution with their participation in SMA. The top-ranked problem (1st) faced by the LSPs was ‘legal permission from Government authority and apparently, the lowest proportion of LSP faced problems on ‘Lack of vehicle service for their movement’ service on dairy subsectors. Res. Agric., Livest. Fish.8(2): 211-221, August 2021

Polycentricity of the City's Metropolitan System as a Factor Increasing Security in Times of Danger - On the Example of Cracow

Service polycentricism, in the face of the pandemic, took on a new significance because of sanitary requirements. Population concentrations in large service centres face a high risk of infection both at their destination and during the trip. Higher-tier services were largely closed during the threat’s peak. In this paper, the focus of the study has been placed on the urban scale of a large city’s polycentricism as seen through the prism of service concentrations, which, to a degree, are commuter destinations, but primarily act as attractors that are not associated with work—they satisfy higher-tier service needs. To formulate the investigative apparatus used to study the functio-spatial structure of Cracow. The current threat, as well as the high probability of similar situations happening in the future, will probably lead to changes in behaviour patterns of consumers and service providers in reference to siting. Local service centres that are accessible to pedestrians, due to safety-related considerations, can gain significant popularity.

Covid child in a Vaccine Center of Local Service Agency – West Bergamo - Italy

New Coronavirus 2019 pandemic has created problems in the Health & Care System and we have seen additional changes in the managements of babies during transition period between post-partum or hospitalization and the across of vaccine and routine well child screening. International indications suggest the post-partum discharge management of newborns and preventive take care of basic pediatrician, like referents before one mount of life in the ambulatory setting and start of universal immunization about 2 mounts of age in base of health status for a routine childhood screening during Sars-Covid-19 pandemic.