The purpose of this research was to investigate what is involved in IT Service Management and how the NMMU can implement it to improve the quality of IT service support and service delivery. The IT Service Management approach was investigated but the main focus was on the Service Support and Service Delivery in the ITIL framework. Higher Education was analyzed to try and measure the maturity level of the ITIL process implementation to see where Higher Education in South Africa is and to determine the gaps. Findings from the empirical study will be presented and recommendations highlighted to Top management and the IT department in order to promote and improve the quality of the IT service being delivered to users and customers. The data was collected and administered by means of a structured questionnaire based on the ITIL Service Capacity Maturity Model and Rick Leopoldi’s alternative Maturity Assessment method. An Association of South African University Directors of Information Technology (ASAUDIT) questionnaire on Service Management was also used to supplement the questionnaire. It was discovered that the implementation of ITIL in most organizations brought about improvements and benefits in the quality of the IT service being delivered.

The main objective of this study was to critically investigate the mediating role that the use of mobile technology plays in the linkage between customer satisfaction and customer loyalty in a semi-urban environment. The research problem focused on the application of mobile technology in the linkage between customer satisfaction and customer loyalty in the clothing industry in King Williams Town. In accomplishing this objective, this research study hypothesised that mobile technology plays a mediating role in the linkage between customer satisfaction and customer loyalty of customers of clothing retailers in South Africa. Multiple regression was conducted to test for the first hypothesis. The first secondary objective aimed at establishing if there is disconfirmation between customer expectations and the performance of clothing retail outlets in King Williams Town. In exploring this objective, it was hypothesised that there is negative disconfirmation between customer expectations and performance. A paired sample test was conducted to test for this hypothesis. In addition, the influence of service quality and customer satisfaction on customer loyalty was explored. To accomplish these, it was hypothesised that both service quality and customer satisfaction have an influence on customer loyalty. Pearson’s Correlation and the Chi-Square Test were applied to test the influence of service quality and Customer satisfaction on Customer loyalty. Data was analysed using the Statistical Package for Social Sciences (SPSS) statistical software. Regression analysis, chi-square tests, Paired sample tests and correlation reports were used to analyse data inferentially. Reliability and validity of the research was also tested using Cronchbach’s alpha test. The results show that mobile phones have become a basic necessity for customers and that mobile technology plays a mediating role in the linkage between customer satisfaction and customer loyalty; however, the mediation is partial. The results also show that there is positive disconfirmation between customer expectations and retailer performance; that both service quality and customer satisfaction have a positive correlation with customer loyalty and that mobile technology enhances customer loyalty. Finally, the results show that the total service experience of customers is favourable vii because the five components of service quality were rendered at a high level of service quality. The study offers several managerial recommendations. Firstly, retail managers should make strategic investments in mobile technology and use this technology to the full to reap the benefits of technologically advanced mobile communication. Secondly, managers should be creative in their use of this mobile technology to enhance customer satisfaction and, hence, customer loyalty. Thirdly, managers should prioritise the improvement of all five components of service quality in order to enhance customer loyalty. Finally, managers should provide a customer-centred service experience that exceeds customer expectations for service quality and mobile communication, one that maximises customer satisfaction and loyalty. The implementation of these recommendations could result in clothing retailers providing a customer-focused service experience in all five aspects of service quality. To successfully implement these recommendations, clothing retailers should: ensure that expectations created, could be accomplished or exceeded to build and enhance customer satisfaction; create expectations that are realistic to avoid negative disconfirmation and hence customer dissatisfaction; implement innovative and creative mobile communication strategies to build and enhance customer loyalty; and finally, improve loyalty programmes to enlarge the customer base.

M.Comm. / Previously the engine components industry relied on being in the game by competing on product availability, product quality and pricing. The cost of not having customer driven strategic plans created certain drawbacks. These include: the use of crisis management (companies being reactive rather than proactive), diverse directions being taken and redundancy, loss of competitive edge and openness to outside influences. Local component manufacturers have to reduce their dependence on OEM manufacturing alone. This means that they will have to move into the after market, locally and overseas, and export more to foreign OEMs and component producers. Those who do not make the transition will have to diversify or close their doors. The result is that South African engine component companies do not only have to adapt to the reality of pricing pressure of intense competition, but also have to adapt to the increased service expectations of customers on all levels. Service quality can be defined as the extent of discrepancy between customers' expectations and their perceptions (Zeithaml, et al, 1990: 19). The question arises whether engine component companies in the current climate are basing their competitive advantage on a customer-orientated culture with an inner driving force. Service quality is an abstract and elusive concept, because it is intangible, heterogeneous and inseparable from production and consumption. In the process of growing towards customer retention and moving away from the initial concept of just providing customer satisfaction through product availability, product quality, basic service and pricing, superior service quality must be obtained. The measurement of perceived service quality within the engine component industry has not received much attention up till now. This dissertation addresses the problem of measuring the current quality of service (in the engine component industry), and provides guidelines on closing existing gaps. The objectives of the study can be summarised as follows: To assess the service expectations of engine component suppliers' customers. To assess customer perceptions of the performance of the engine component suppliers. To assess which customer - orientated strategies are perceived to be employed by engine component suppliers. To assess how engine component suppliers can narrow or eliminate the customerprovider gaps that exist.

strong>Objectives: Women with substance use disorders experience unique challenges to contraceptive obtainment and user-dependent method adherence, contributing to higher than average rates of unintended pregnancy. This study estimated the prevalence of barriers to contraception and their associations with contraceptive use and unwanted pregnancies among women receiving opioid agonist therapy (OAT) in northeast Tennessee. Methods: A cross-sectional survey was piloted among female patients aged 18 to 55 years from 2 OAT clinics. Logistic regression was used to evaluate associations between contraceptive barriers and current contraceptive use and previous unwanted pregnancies among women receiving OAT. Results: Of 91 participants, most experienced previous pregnancies (97.8%), with more than half reporting unwanted pregnancies (52.8%). Although 60% expressed a strong desire to avoid pregnancy, ambivalence toward becoming pregnant was common (30.0%). Most experienced ≥1 barriers to contraceptive use or obtainment (75.8%), the most prevalent being aversion to adverse effects (53.8%), healthcare provider stigmatization (30.7%), scheduled appointment compliance (30.3%), and prohibitive cost (25.0%). Experience of any contraceptive barrier (adjusted odds ratio [AOR] 8.64, 95% confidence interval [CI] 2.03–36.79) and access to a contraceptive provider (AOR 5.01, 95% CI 1.34–18.77) were positively associated with current use of prescribed contraceptives, whereas prohibitive cost was negatively associated (AOR 0.28, 95% CI 0.08–0.94). Conclusions: Although most participants desired to avoid pregnancy, ambivalence or uncertainty of pregnancy intention was common. Most experienced barriers to contraception, which were more strongly associated with previous unwanted pregnancy than current contraceptive use. The provision of long-acting reversible contraceptives and contraceptive education at OAT clinics represents an opportunity to reduce the incidence of neonatal abstinence syndrome.

Introduction. Research on teen childbearing has consistently noted that unfavorable socioeconomic conditions experienced at the community and family levels underpin disparities in teen birth rates. However, rather than examining socioeconomic factors alone, community-level differences in teen births could be measured by examining in tandem, the intersection between sociodemographic deprivation and health professional shortage areas (HPSA). Objectives. To examine the differences in teen birth rates by sociodemographic deprivation and HPSA in rural and urban counties of the United States. Methods. Results. Of the 3,136 counties, 78.7% of rural counties were in the highest category of socio-demographic deprivation compared to about 21.1% of urban counties. 76.0% of rural counties were categorized as having shortages of primary care, dental, and mental health providers, compared to 24.0% of urban counties. Rural counties had an additional 7.4 births per 1,000 females aged 15-19 years (p <0.0001) when compared to urban counties. The highest level of sociodemographic deprivation had a strong positive association with teen birth rates (β = 17.46; SE = 0.53; p < 0.0001). Rural counties with the whole designation of a health professional shortage increased county-level teen births by 7.18 births per 1,000 females aged 15-19 years (p <0.0001), compared to urban counties with no designation. Rural counties with higher levels of sociodemographic deprivation and a designation of health professional shortages in at least one area had significantly higher teen births than their urban counterparts (p <0.0001). Conclusions. Rural communities across different levels of deprivation and HPSA designated categories continue to have disproportionately greater teen birth rates. While these findings reveal the unique characteristics of sociodemographic and HPSA as a useful social determinant of teen birth, rural communities showed inherent vulnerabilities that contribute to poorer teen birth outcomes. Future research should examine the extent to which access to contraceptive services differs among rural and urban communities and the role of rural safety net providers in the provision of these services.

No description available.

backgroundWomen with opioid use disorder (OUD) experience unique barriers to contraception, contributing to higher than average rates of unintended pregnancy. Rates of neonatal abstinence syndrome (NAS), a drug withdrawal syndrome resulting from antenatal drug exposure, are higher in Tennessee than the nation. Few studies have quantified experience of contraceptive barriers or their associations with contraceptive use among women with OUD. objectives This study estimated prevalence of barriers to access/acceptance of contraceptive services and their associations with current contraceptive use and unwanted pregnancy among reproductive-aged women in Northeast Tennessee receiving opioid agonist therapy (OAT). methods A cross-sectional survey was administered to female patients aged 18-55 from two OAT clinics. Logistic regression was used to evaluate associations between contraceptive barriers and current contraceptive use and previous unwanted pregnancies. results Of 91 participants, most were insured (84.4%), experienced at least one barrier (75.8%), and more than half reported unwanted pregnancies (52.8%). Most desired to avoid pregnancy (60.0%) or were ambivalent (30.0%). Common barriers were side effect aversion (53.8%), provider stigmatization (30.7%), appointment compliance (30.23%), and cost (25.0%). Experience of any barrier (AOR=11.6, 2.25-59.8) and access to a contraceptive provider (AOR=9.78, 1.34-71.7) were positively associated with use, while cost was negatively associated (AOR=0.27, 0.07-0.98). Eight barriers were significantly associated with unwanted pregnancies. conclusionWhile most participants desired to avoid pregnancy, contraceptive barriers were common. Barriers were more strongly associated with previous unwanted pregnancy than current contraception. Contraceptive provision at OAT clinics may reduce incidence of unwanted pregnancy and NAS in Northeast Tennessee.

No description available.

Background: Fire fatality rates have decreased nationally while increasing in Tennessee. Individual characteristics affect the likelihood of fatality. Identification of populations sustaining greater proportions of fire fatality within the State will better inform regional fire prevention activities. Objectives: To compare individual characteristics of fatalities occurring in residential structure fires in Appalachian and Non-Appalachian counties of Tennessee. Methods: Analyses of residential structure fire fatality in Tennessee from 2005 to 2014 were conducted using Tennessee Fire Incident Reporting System data, comparing Appalachian and Non-Appalachian county regions. Analyses were restricted to incidents occurring in noninstitutionalized residential environments. Census data was used to identify county-level demographic characteristics. Direct adjustment for age effects between regions was performed. Results: There was no difference in proportion of fatalities between Appalachian (37.28%) and Non-Appalachian (36.27%) counties. Distribution of gender was similar between regions. A greater proportion of fatalities were aged 65 and older, compared to other age groups. Age- adjusted death rates were higher for Non-Appalachian (13.63/100,000) than Appalachian (11.18/100,000) counties. Age-specific death rates for persons younger than five years was greater in Appalachia (18.06/100,000 vs. 11.94/100,000), while age-specific death rates were greater among Non-Appalachian counties for persons aged 65 and older (37.23/100,000 vs. 19.75/100,000). A greater proportion of fire fatalities occurred in mobile homes in Appalachian counties (18.4%) than Non-Appalachian counties (11.3%). Conclusion:

Background: Heart failure (HF) is the leading cause of hospitalization among older adults in the United States. Health systems target readmission rates for quality improvement and cost reduction. Local Problem: Heart failure core measure (CM) scores at our medical center were lower than the national average, and methods for capturing the appropriate documentation on HF patients to ensure CM compliance were not clear. Methods: An interdisciplinary team determined barriers to increasing CM scores, gathered baseline data, and identified gaps in the existing process. Interventions: The team implemented an accurate reporting system and error-proofing process, redesigned the process for identifying patients admitted with a HF diagnosis, and developed a patient appointment section before discharge in the electronic medical record. Results: There was a decrease in readmissions within 30 days of implementation from 12% to 8%, and HF CM compliance score increased from 88% to 100%. The percentage of HF patients not identified during hospitalization decreased from 17% to 0%. Heart failure patients discharged with a 7-day follow-up appointment increased from 88% to 98%. Conclusion: Through implementation of an interdisciplinary-led process improvement and lean methodologies, metrics and CMs were achieved.