Sensing design and workmanship: the haptic skills of shoppers in eighteenth-century London.

This article explores how eighteenth-century shoppers understood the material world around them. It argues that retail experiences exposed shoppers to different objects, which subsequently shaped their understanding of this world. This article builds on recent research that highlights the importance of shop environments and browsing in consumer choice. More particularly, it differentiates itself by examining the practice of handling goods in shops and arguing that sensory interaction with multiple goods was one of the key means by which shoppers comprehended concepts of design and workmanship. In doing so, it affirms the importance of sensory research to design history. The article focuses on consumer purchases of ceramic objects and examines a variety of sources to demonstrate the role of haptic skills in this act. It shows how different literary sources described browsing for goods in gendered and satirical terms and then contrasts these readings against visual evidence to illustrate how handling goods was also represented as a positive act. It reads browsing as a valued practice requiring competence, patience and haptic skills. Through an examination of diary sources, letters and objects this article asks what information shoppers gained from touching various objects. It concludes by demonstrating how repetitive handling in search of quality meant that shoppers acquired their own conception of what constituted workmanship and design.

Using GIS and perceived distance to understand the unequal geographies of healthcare in lower-income urban neighbourhoods.

Geographers play important roles in public health research, particularly in understanding healthcare accessibility, utilisation, and individual healthcare experiences. Most accessibility studies have benefited from the increased sophistication of geographic information systems (GIS). Some studies have been enhanced with semi-structured in-depth interviews to understand individual experiences of people as they access healthcare. However, few accessibility studies have explicitly utilised individual in-depth interview data in the construction of new GIS accessibility measures. Using mixed methods including GIS analysis and individual data from semi-structured in-depth interviews, we offer satisfaction-adjusted distance as a new way of conceptualising accessibility in GIS. Based on fieldwork in a predominantly lower-income community in Columbus, Ohio (USA), we find many residents felt neighbourhood healthcare facilities offered low-quality care, which suggested an added perceived distance as they attempt to access high-quality healthcare facilities. The satisfaction-adjusted distance measure accounts for the perceived distance some residents feel as they search for high-quality healthcare in lower-income urban neighbourhoods. In moving beyond conventional GIS and re-conceptualising accessibility in this way, we offer a more realistic portrayal of the issues lower-income urban residents face as they attempt to access high-quality healthcare facilities. The work has theoretical implications for conceptualising healthcare accessibility, advances the mixed-methodologies literature, and argues for a more equitable distribution of high-quality healthcare in urban neighbourhoods.

Racialized customer service in restaurants: a quantitative assessment of the statistical discrimination explanatory framework.

Despite popular claims that racism and discrimination are no longer salient issues in contemporary society, racial minorities continue to experience disparate treatment in everyday public interactions. The context of full-service restaurants is one such public setting wherein racial minority patrons, African Americans in particular, encounter racial prejudices and discriminate treatment. To further understand the causes of such discriminate treatment within the restaurant context, this article analyzes primary survey data derived from a community sample of servers (N = 200) to assess the explanatory power of one posited explanation­statistical discrimination. Taken as a whole, findings suggest that while a statistical discrimination framework toward understanding variability in servers' discriminatory behaviors should not be disregarded, the framework's explanatory utility is limited. Servers' inferences about the potential profitability of waiting on customers across racial groups explain little of the overall variation in subjects' self-reported discriminatory behaviors, thus suggesting that other factors not explored in this research are clearly operating and should be the focus of future inquires.

[Features of the regulation of legal relations in the field of sanitary and epidemiological welfare in the Eurasian Economic Community member-states].

The aim of this work was identification of both general trends and approaches, and the differences in the regulation of relations in the field of sanitary and epidemiological welfare of the population, determination of the necessary measures to harmonize legislation states in the countries - members of the Eurasian Economic Community (EurAsEC) in the noted sphere. As a result of the present research recommendations about unification and harmonization of legislations in member states of EurAsEC are developed for formation of uniform economic policy in noted sphere.

Household use of and satisfaction with alternative water sources in Victoria Australia.

Climate change is increasing the variability of rainfall, and thus the availability of water supplies in many areas of the world. These impacts are already being felt in the state of Victoria, Australia where a 12 year drought period was recently experienced. Restrictions to water use have been implemented, as one component of a broad policy approach to manage the drought. While anecdotal evidence suggests that the substitution of centralised water supplies is occurring, this has not been proven empirically. This paper reports results from a survey of households in Victoria regarding their use of alternative water sources. The study found that substitution is occurring. Garden watering is the purpose which has the highest rate of alternative water source use. In total 41.6% of respondents always, and 33.2% sometimes use an alternative water source for garden watering. The most commonly used alternative source of water for garden watering is water previously used in the laundry (30.7%). The alternative source of water used was found to vary depending on the purpose of the water use. High levels of satisfaction were found for all alternative water sources used. Several barriers were found to the use of alternative water sources, the main of which were: inflexibility of existing infrastructure, cost, policy, and housing status. The results have implications for water retailers, policy makers and governments in locations facing water shortage.

[The tasks of the Federal Service for the implementation of the legislation of the Russian Federation aimed at optimizing the compliance and enforcement].

The priority of the Federal Service's activity in protecting consumer rights and human welfare is to execute a number of basic documents recently endorsed and directed towards observing the legislation on the optimization of supervision and control activities. To implement measures on the professional orientation and prehigher education preparation of schoolchildren and on the assistance with their entrance into the medical prophylaxis faculties of higher medical educational establishments within the framework of target enrollment, etc. is an urgent problem for the agencies and bodies of the Russian Inspectorate for the Protection of Consumer Rights and Human Welfare. Interaction with civil society has recently been activated, which is required to ensure the transparency of the Service's work, to enhance its efficiency, and to optimize supervision. Public reception rooms have been set up, the function of which is to receive citizens, the representatives of legal persons, and individual employers concerning the matters of sanitary-and-epidemiological well-being, protection of the rights of consumers and a consumer market, and the activities of the agencies and bodies of the Russian Inspectorate for the Protection of Consumer Rights and Human Welfare. The better activities of the agencies and bodies of the Service will call for a set of complex tasks to be accomplished in the immediate future. The end result will depend on how competently, responsibly, and cooperatively the appropriate measures will be carried out in all the agencies of the Federal service.

Voice and choice in health care in England: understanding citizen responses to dissatisfaction.

Using data from a five-year online survey the paper examines the effects of relative satisfaction with health services on individuals' voice-and-choice activity in the English public health care system. Voice is considered in three parts ­ individual voice (complaints), collective voice voting and participation (collective action). Exercising choice is seen in terms of complete exit (not using health care), internal exit (choosing another public service provider) and private exit (using private health care). The interaction of satisfaction and forms of voice and choice are analysed over time. Both voice and choice are correlated with dissatisfaction with those who are unhappy with the NHS more likely to privately voice and to plan to take up private health care. Those unable to choose private provision are likely to use private voice. These factors are not affected by items associated with social capital ­ indeed, being more trusting leads to lower voice activity.

Transição tecnológica em uma operadora de plano de saúde: o olhar do usuário / Technological transition in a supplemental health care provider: the user's viewpoint

O setor de saúde suplementar no Brasil vem experimentando, nos últimos anos, novos modelos de atenção à saúde. O presente estudo teve como objetivo caracterizar como os usuários percebem e se posicionam em relação à implantação da Estratégia Saúde da Família (ESF) por uma operadora do tipo autogestão. Utilizando-se de grupos focais com usuários considerados "aderidos" e "não-aderidos" à ESF, a pesquisa revela que os usuários têm uma compreensão bastante clara do significado da estratégia, inclusive de seus fortes elementos racionalizadores, percebem as contradições e deficiências no seu processo de formulação e implantação e mantêm um elevado grau de autonomia na escolha dos serviços que lhe sejam mais adequados, muito influenciados pelo tipo de inserção que têm no estabelecimento bancário que mantém a operadora. O usuário percebe, ainda, o impasse da autogestão entre manter uma ampla rede credenciada de livre acesso ou conseguir avançar no sentido de fazer da ESF o eixo estruturante de sua rede assistencial.

The Brazilian supplemental health care sector has been experiencing new health care models in the last few years. This paper aims at featuring how users perceive and how they express themselves in relation to the deployment of a program known as Family Health Strategy (FHS) by a self-management health care provider. Through focal groups, the research reveals that users present a rather clear view on the meaning of strategy, including its remarkable rationalizing elements. In addition, they percept contradictions as well as deficiencies in the formulation and deployment process, and they keep a high level of autonomy in the choice for more adequate services, which are greatly influenced by the type of insertion that they exert in the bank institution that maintains the health care service provider. Users also perceive the predicament presented by self-management regarding the maintenance of a broad authorized free access network and the advance towards turning FHS into the structuring backbone of its assistance network.

What is the "neighbourhood" in neighbourhood satisfaction? Comparing the effects of structural characteristics measured at the micro-neighbourhood and tract levels.

Using the neighbourhood sub-sample from the American Housing Survey for 1985, 1989 and 1993, this study tests whether the social context of the local micro-neighbourhood or of the broader census tract more strongly affects neighbourhood satisfaction. It is found that the local context of the micro-neighbourhood generally has a stronger effect on residents' reported satisfaction. In contrast to studies aggregating to larger units, it is found that greater residential stability in the micro-neighbourhood increases reported neighbourhood satisfaction. A low socioeconomic status of the local micro-neighbourhood decreases neighbourhood satisfaction more than does the socioeconomic status of the surrounding tract and this effect is amplified in low-income tracts. Whereas prior evidence is mixed when aggregating perceptions of crime to larger units, a robust negative effect on satisfaction is found when aggregated to the micro-neighbourhood.

[Effectiveness of the Federal Inspectorate for the Protection of Consumer Rights and Human Welfare in the Novosibirsk Region in 2007 to 2009].

A system for monitoring and analyzing the effectiveness and efficiency of the performance of the Board of the Federal Inspectorate for the Protection of Consumer Rights and Human Welfare in the Novosibirsk Region was introduced into its activities to estimate the provision of the Novosibirsk Region's population with sanitary epidemiological wellbeing in 2007-2009. The introduction of monitoring was ascertained to increase the effectiveness of budgetary fund surveillance and spending, by predicting the effectiveness and choice of priority lines of activities, by increasing the quality of budgetary services rendered in the provision of sanitary and epidemiological well-being to the population.

Implementation of mental health parity: lessons from california.

OBJECTIVE: This article reports the experiences of health plans, providers, and consumers with California's mental health parity law and discusses implications for implementation of the 2008 federal parity law. METHODS: This study used a multimodal data collection approach to assess the first five years of California's parity implementation (from 2000 to 2005). Telephone interviews were conducted with 68 state-level stakeholders, and in-person interviews were conducted with 77 community-based stakeholders. Six focus groups included 52 providers, and six included 32 consumers. A semistructured interview protocol was used. Interview notes and transcripts were coded to facilitate analysis. RESULTS: Health plans eliminated differential benefit limits and cost-sharing requirements for certain mental disorders to comply with the law, and they used managed care to control costs. In response to concerns about access to and quality of care, the state expanded oversight of health plans, issuing access-to-care regulations and conducting focused studies. California's parity law applied to a limited list of psychiatric diagnoses. Health plan executives said they spent considerable resources clarifying which diagnoses were covered at parity levels and concluded that the limited diagnosis list was unnecessary with managed care. Providers indicated that the diagnosis list had unintended consequences, including incentives to assign a more severe diagnosis that would be covered at parity levels, rather than a less severe diagnosis that would not be covered at such levels. The lack of consumer knowledge about parity was widely acknowledged, and consumers in the focus groups requested additional information about parity. CONCLUSIONS: Experiences in California suggest that implementation of the 2008 federal parity law should include monitoring health plan performance related to access and quality, in addition to monitoring coverage and costs; examining the breadth of diagnoses covered by health plans; and mounting a campaign to educate consumers about their insurance benefits.

Consumer views of community pharmacy services in Bangalore city, India / Visión de los consumidores de los servicios de farmacia comunitaria en Bangalore City, India

Objective: The opinion about pharmacy services was studied using an instrument which measured satisfaction with pharmacy services. The main focus of the instrument was to assess patients’ opinion and expectation of the present pharmacy services. Method: The instrument contained 20 items, which were grouped based on their similarity into eight dimensions, namely, General satisfaction, Interpersonal Skill, Evaluation, Gathering non medical information, Trust, Helping Patients, Explanation, and Finance. Chance random sampling was done and the participants were the general public above the age of 18 years. The main outcome measure was to study participants’ opinion regarding the current and desired pharmacy services. Descriptive statistics are presented for the satisfaction dimension score. The level of satisfaction with the different dimensions was compared across the different demographic characteristics. Result: The study results revealed significant difference in the General satisfaction and Interpersonal skill amongst the gender. Significant difference was seen in the Helping patients, Evaluation and Explanation skill among the various age groups. Education background showed significant difference in evaluation, Gathering-nonmedical information, Helping patients and Explanation skills of the pharmacist. There was an overall satisfaction dimension score of 56.83% in the current practice and 68.83% in the desired practice. Conclusion: Awareness about pharmacy service continuing education programme for practicing pharmacist will heighten the pharmacy profession in our country (AU)

Objetivo: Se estudió la opinión de los servicios de las farmacias usando un instrumento que media la satisfacción con los servicios. El principal foco del instrumento era evaluar la opinión y las expectativas de los actuales servicios de las farmacias. Método: El instrumento contenía 20 ítems, que estaban agrupados, en función de su similitud, en 8 dimensiones, específicamente, satisfacción general, habilidades interpersonales, evaluación, recogida de información no-médica, confianza, ayuda apacientes, explicación, y financieros. Se realizó un muestreo aleatorio y los participantes eran público general mayor de 18 años. La variable de resultado medida fue estudiar la opinión de los participantes en relación a los servicios actuales y los deseados de las farmacias. Se presenta la estadística descriptiva para la puntuación de la dimensión satisfacción. Se compara el nivel de satisfacción con las diferentes dimensiones con las diferentes variables demográficas. Resultados: Los resultados del estudio revelaron diferencias significativas entre los géneros en la satisfacción general y las habilidades interpersonales. También se vieron diferencias significativas entre los grupos de edad para ayuda a los pacientes, evaluación y habilidades de explicación. El nivel educativo mostró diferencias significativas en evaluación, recogida de información no-médica, ayuda a pacientes, y habilidades de explicación del farmacéutico. Hubo una puntuación de la dimensión satisfacción global de 56,83% en el ejercicio actual y de 68,83% en la práctica deseada. Conclusión: El conocimiento del programa de formación continuada de servicios farmacéuticos para farmacéuticos en ejercicio elevará la profesión farmacéutica en el país (AU)

Who speaks for the health consumer?

Although consumer-directed health care has become a fashionable concept in recent years, stories abound asking whether the so-called free market in health care can provide adequate access to quality health care at an affordable price. In spite of these concerns, consumer-directed health care continues as the face of legitimacy behind an industry-driven campaign to limit regulatory protections of the consumer in the market and encourage the growth of health insurance products that place spending options closer to the consumer, whether or not these options are available, affordable, or easily understood. Understanding whether this empowerment is real begins with first asking what it now means to be a health consumer. This commentary offers perspective on the dilemma faced by millions of Americans in navigating our health care system under the assumption that market-driven choices foster consumer empowerment in health care, and suggests approaches for expanding the true consumer voice.

Distinctiveness of management in a university psychiatric hospital as a public health institution.

The distinctiveness of management of a university psychiatric hospital which has the status of a public health institution is manifested in the following ways: * Distinctive features and characteristics of managing service provider organizations compared to those whose operational results involve tangible products; * Distinctive features of management which originate from its role as a regional hospital and a tertiary research and educational institution in the field of psychiatry, with special importance for the Republic of Slovenia as a whole; * Distinctive features of management that are defined by the social and legal framework of operation of public health institutions and their special social mission. This paper therefore discusses the specific theoretical and practical findings regarding management of service provider organizations from the viewpoint of their social mission and significance, as well as their legal organization, internal structure and values.