Interpretation and adherence to the updated risk-stratified guideline for colonoscopy surveillance after polypectomy – a nationwide survey

Abstract Background and study aims Low adherence to the Dutch guideline for colonoscopy surveillance after polypectomy led to release of a new guideline in 2013. This new guideline was risk-stratified at a more detailed level than the previous one to achieve more efficient use of colonoscopy resources. This study assessed the feasibility of the risk-stratified guideline by evaluating correct interpretation of and adherence to this guideline. Methods Based on semi-structured interviews with 10 gastroenterologists, we developed an online survey to evaluate gastroenterologists’ recommendations for surveillance in 15 example cases of patients with polyps. If recommended intervals differed from the new guideline, respondents were asked to indicate their motives for doing so. Results Ninety-one of 592 (15.4 %) invited gastroenterologists responded to at least one case, of whom 84 (14.2 %) completed the survey. Gastroenterologists gave a correct recommendation in a median of 10 of 15 cases and adherence per case ranged from 14 % to 95 % (median case 76 %). The two cases that addressed management of serrated polyps were least often answered correctly (14 % and 28 % correct answers). Discrepancies were mainly due to misinterpretation of the guideline with respect to serrated polyps (48 %) or misreading of the questions (30 %). Conclusions Median adherence to the updated colonoscopy surveillance guideline of 76 % seems reasonable, and is higher than adherence to the previous guideline (range: 22 %-80 %, median 59 %). This shows that detailed (more complex) risk stratification for designation of a surveillance interval is feasible. Adherence could potentially be improved by clarifying correct interpretation of serrated polyps.

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Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medication

Therapeutic Advances in Psychopharmacology ◽

10.1177/2045125321989133 ◽

2021 ◽

Vol 11 ◽

pp. 204512532198913

Author(s):

Miriam Larsen-Barr ◽

Fred Seymour

Keyword(s):

Antipsychotic Medication ◽

Online Survey ◽

Structured Interviews ◽

Obsessive Compulsive ◽

Convenience Sample ◽

Internal Resources ◽

Compulsive Disorder ◽

What Works ◽

Systemic Factors ◽

The Impact

Background: It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this. Methods: A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process. Results: Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25–25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by ‘understanding myself and my needs’, ‘finding what works for me’ and ‘connecting with support’. Sub-themes expand on the way in which they did this. For example, ‘finding what works for me’ included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences. Conclusion: This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating change.

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ICT and sustainable tourism development: an innovative perspective

Journal of Hospitality and Tourism Technology ◽

10.1108/jhtt-12-2012-0034 ◽

2014 ◽

Vol 5 (1) ◽

pp. 2-16 ◽

Cited By ~ 29

Author(s):

Alisha Ali ◽

Andrew J. Frew

Keyword(s):

Technology Acceptance ◽

Online Survey ◽

Sustainable Tourism ◽

Structured Interviews ◽

Content Type ◽

Sustainable Tourism Development ◽

Stakeholder Relationships ◽

Tourism Product ◽

Electronic Distribution ◽

Information And Communication

Purpose – The aim of this research is to foreground information and communication technology (ICT) as an innovative approach for sustainable tourism (ST) development of destinations. ICT is the technology required for information processing which facilitates data processing, information sharing, communication, searching and selection. This paper concentrates on the Abernathy and Clark model and its usefulness in applying ICT as innovative in managing ST. Design/methodology/approach – An online survey was administered to destination managers and to eTourism experts. Destination managers were selected as they were identified as the person responsible for the overall management of a Destination Management Organisation. eTourism experts were identified as someone who possesses special expertise, knowledge and skills on ICT applications to tourism and offered expertise on which ranged from such areas as electronic distribution, recommender systems, user-generated content, online communities, mobile technology, technology acceptance, tourism networks and Web 2.0. This was followed by semi-structured interviews. Findings – These ICT tools were found to be innovative for information management and distribution for critical decision-making. Innovation was fostered through the use of ICT for ST by leading to a better understanding of the tourism product, monitoring, measuring and evaluating, forecasting trends, developing partnerships and engaging and supporting stakeholder relationships. ICT would provide novel ways of approaching marketing, energy monitoring, waste management, and communication for destinations. Originality/value – This research is important in demonstrating the value that technology can have to ST and further develops the work on tourism innovation theory.

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Bureaucratic organization and innovation : a mixed-methods study of U.S. State Department of Transportation website adoption

10.32469/10355/61886 ◽

2017 ◽

Author(s):

◽

A. J. Million

Keyword(s):

Mixed Methods ◽

Online Survey ◽

State Level ◽

State Department ◽

Third Parties ◽

Department Of Transportation ◽

Structured Interviews ◽

University Of Missouri ◽

Bureaucratic Organization ◽

Barriers To Change

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] This study explores bureaucratic organization and innovation in U.S. state department of transportation (DOT) websites. To determine if working with third parties fosters change in state DOT websites, it employs a two-part, explanatory sequential mixed-methods design. In phase one, an online survey was disseminated to IT managers and communications officers in all 50 states to collect data regarding agency demographics, bureaucratic models, and Web infrastructure. In total, 45 valid responses (or 90 percent) were received from DOTs indicating that most built, hosted, and managed their websites in-house, but that state-level IT consolidations required many to pool resources with third parties. In research phase two, 12 semi-structured interviews were conducted of a maximum variation sample of survey respondents. These interviews were conducted to explain why DOTs built and operated their websites with the support of third parties. Employing a grounded theoretical approach, analysis revealed 6 themes explaining website adoption and showed that working with third parties can foster innovation; however, not all change is positive. Therefore, a need exists for governments to selectively work with others, ascertain future barriers to change, and ensure that adopted innovations meet desired ends. Finally, five best practices informed by study findings are presented that may help decision-makers and civil servants provide e-government services in a flexible manner.

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ICT to Promote Well-Being within Families

Sensors ◽

10.3390/s18092760 ◽

2018 ◽

Vol 18 (9) ◽

pp. 2760 ◽

Cited By ~ 3

Author(s):

Jure Trilar ◽

Andrej Kos ◽

Simona Jazbinšek ◽

Lea Jensterle ◽

Emilija Stojmenova Duh

Keyword(s):

Online Survey ◽

Well Being ◽

Structured Interviews ◽

Family Time ◽

Development Fund ◽

European Regional Development Fund ◽

The Family ◽

The Republic ◽

Family Centered ◽

Future Program

Within the Active Living and Well-Being Project (RRP3), funded by the Republic of Slovenia and the European Regional Development Fund Investing in Your Future program, we aim to develop different approaches and prototype solutions to provide ICT solutions for the family in order to connect its members; communicate; promote quality family time, active life, a health-friendly lifestyle and well-being; and integrate various sensor and user-based data sources into a smart city ecosystem platform. A mixed methodology, combined qualitative and quantitative approaches, was selected to conduct the study. An online survey with a structured questionnaire as well as semi-structured interviews were performed. Through the analysis of the results, we tried to establish a family-centered design approach that would be inclusive as much as possible, creating benefits for all generations in order to develop an interactive prototype solution that would allow us to further test and verify different use-case scenarios.

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Workplace exercise programmes – how organizational factors influence employee participation

Development in Learning Organizations An International Journal ◽

10.1108/dlo-10-2019-0252 ◽

2019 ◽

Vol 34 (6) ◽

pp. 37-39

Author(s):

Anna Little ◽

Russell Wordsworth ◽

Sanna Malinen

Keyword(s):

Online Survey ◽

Organizational Factors ◽

Employee Participation ◽

Past Research ◽

Well Being ◽

Practical Significance ◽

Structured Interviews ◽

Content Type ◽

Individual Level ◽

Leadership Support

Purpose Past research identifies many positive outcomes associated with workplace exercise initiatives. Realizing these outcomes is, however, dependent on securing sustained employee participation in the initiative. This study examines how organizational factors influence employee participation in workplace exercise initiatives. Design/methodology/approach The study utilizes data from 98 employees who were provided with the opportunity to participate in a workplace exercise initiative. Data were collected via an online survey as well as semi-structured interviews. Findings The paper shows that organizational, rather than individual-level, factors had the greatest impact on employee participation in workplace exercise initiatives. Leadership support for well-being was particularly important and had a significant effect on participation frequency. This relationship was moderated by employee perceptions of employer intentions, such that the more genuine and caring an employer’s intentions were perceived to be, the more likely employees were to participate. Our findings also show that perceived employer intentions have a significant direct effect on employee participation. Research implications We extend research on employee participation in well-being initiatives by considering the influence of organizational, rather than individual-level, factors. Practical implications This research is of practical significance as it highlights the importance of positive leadership in fostering physical well-being in the workplace. It reinforces that sustained participation in workplace exercise initiatives requires deliberate planning, promotion and support from organizational leaders. Originality/value Most studies of workplace exercise and well-being initiatives focus on individual barriers to participation. Our study highlights the important role of leadership support and perceived intentions as organizational influences on employee participation.

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Development of a tool for identifying and addressing prioritised determinants of quality improvement projects led by healthcare professionals: a mixed-methods study

10.21203/rs.2.24055/v2 ◽

2020 ◽

Author(s):

Anne van Tuijl ◽

Hub C. Wollersheim ◽

Cornelia R.M.G. Fluit ◽

Petra. J. van Gurp ◽

Hiske Calsbeek

Keyword(s):

Quality Improvement ◽

Mixed Methods ◽

Online Survey ◽

Healthcare Professionals ◽

Learning By Doing ◽

Mixed Methods Study ◽

Quality Improvement Initiative ◽

Structured Interviews ◽

Priority Score ◽

A Priority

Abstract Background: Several frameworks have been developed to identify essential determinants for healthcare improvement. These frameworks aim to be comprehensive, leading to the creation of long lists of determinants that are not prioritised based on being experienced as most important. Furthermore, most existing frameworks do not describe the methods or actions used to identify and address the determinants, limiting their practical value. The aim of this study is to describe the development of a tool with prioritised facilitators and barriers supplemented with methods to identify and address each determinant. The tool can be used by those performing quality improvement initiatives in healthcare practice. Methods: A mixed-methods study design was used to develop the tool. First, an online survey was used to ask healthcare professionals about the determinants they experienced as most facilitating and most hindering during the performance of their quality improvement initiative . A priority score was calculated for every named determinant, and those with a priority score ≥ 20 were incorporated into the tool. Semi-structured interviews with implementation experts were performed to gain insight on how to analyse and address the determinants in our tool Results: The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement initiatives. Of these, 12 facilitators and nine barriers were incorporated into the tool. Sufficient support from management of the department was identified as the most important facilitator, while having limited time to perform the initiative was considered the most important barrier. The interviews with 16 experts in implementation science led to various inputs for identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the initiative at a manageable size, learning by doing and being able to influence determinants. Conclusions: This paper describes the development of a tool with prioritized determinants for performing quality improvement initiatives with suggestions for analysing and addressing these determinants. The tool is developed for those engaged in quality improvement initiatives in practice, so in this ways it helps to bridging the research to practice gap of determinants frameworks. More research is needed to validate and develop the tool further.

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It’s good to talk! Reflective Discussion Forums to support and develop Reflective Practice among Pre-Hospital Emergency Care Practitioners in Ireland.

Irish Journal of Paramedicine ◽

10.32378/ijp.v3i2.157 ◽

2018 ◽

Vol 3 (2) ◽

Author(s):

Chris O'Connor ◽

Joe O'Hara

Keyword(s):

Reflective Practice ◽

Emergency Care ◽

Online Survey ◽

Learning Strategy ◽

Thinking Skills ◽

Discussion Forum ◽

Discussion Forums ◽

Structured Interviews ◽

Hospital Emergency ◽

Confidentiality Agreement

BackgroundSince the mid 1980’s, reflective practice has become formally acknowledged and adopted as a key strategy for learning and has become one of the cornerstones of medical education for doctors, nurses, and many of the allied healthcare professions. In the education of pre-hospital emergency care practitioners in Ireland, it is only in the last decade that the notion of reflective practice has been tentatively approached. Indeed until recently it has largely been ignored by practitioners and educators alike, who have been slow to engage with this new way of learning. This paper explores the attitudes of practitioners to the use of a reflective discussion forum to encourage and support reflection and reflective practice among pre-hospital emergency care practitioners in Ireland. It also examines the experiences of practitioners who participated in a collaborative reflective discussion forum.LiteratureThe research was informed by reviewing literature from a number of areas including: Adult Learning, Reflective Practice, Educational Research directly relating to Emergency Medical Services (EMS), and EMS & Nursing Journals and publications.MethodologiesThis paper is part of a larger project which consisted of three cycles of action research. Data was collected via an online survey questionnaire, and by conducting a series of semi-structured interviews with participants in the reflective discussion forum. These included all three clinical levels of pre-hospital emergency care practitioners and the three hierarchical levels within the organisation.FindingsThe collaborative reflective discussion forum was found to be beneficial. Among the benefits cited were, the opportunity to draw on the experience of more experienced colleagues, the development of critical thinking skills, and the potential for use as part of a mentoring process. It was also felt that the collaborative nature of the forum had the potential to improve workplace relationships through the empowerment of the staff. Concerns were raised regarding the potential for abuse and misuse, particularly in relation to the areas of patient confidentiality and a lack of trust within organisations.RecommendationsThe establishment of a regular Reflective Discussion Forum within organisations as a key learning strategy. Any collaborative forum must be chaired by a trusted, experienced and highly skilled facilitator. A learning contract for all participants and faculty, including a confidentiality agreement, must be in place prior to the establishment of any collaborative forum.

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Perceptions of Rheumatologists on Diagnosis of Psoriatic Arthritis in China

Frontiers in Immunology ◽

10.3389/fimmu.2021.733708 ◽

2021 ◽

Vol 12 ◽

Author(s):

Miao Chen ◽

Hua Zhang ◽

Zhiyong Chen ◽

Sheng-Ming Dai

Keyword(s):

Psoriatic Arthritis ◽

Online Survey ◽

Good Practice ◽

Diagnostic Delay ◽

Nationwide Survey ◽

Self Report ◽

Full Time ◽

Survey Tool ◽

Significant Difference ◽

Practice Habits

ObjectiveHigh prevalence of undiagnosed psoriatic arthritis (PsA) and prolonged diagnostic delay are key troubles in the appropriate management of PsA. To analyze the possible causes for this phenomenon, a web-based nationwide survey was conducted to investigate rheumatologists’ perceptions on PsA diagnosis in China.MethodsThe electronic questionnaire consisting of 38 questions were designed by an expert panel and distributed with the online survey tool Sojump, which is a professional online survey platform. The completed questionnaires by real-name rheumatologists were collected.ResultsA total of 1594 valid questionnaires were included. More than half of Chinese rheumatologists reported it was challenging to make a diagnosis of PsA. The four major challenges were “Difficulties in identification of atypical or hidden psoriasis”, “Absence of diagnostic biomarkers”, “No active self-report of history or family history of psoriasis” and “Various musculoskeletal manifestations”. In diagnosing PsA, minor participants had incorrect knowledge of inflammatory arthropathy (13.7%), acute phase reactant (23.8%), and rheumatoid factor (28.7%). There were no significant differences in the knowledge of PsA and practice habits in diagnosing PsA between modern western medicine (WM)- and traditional Chinese medicine (TCM)-rheumatologists. The part-time rheumatologists were not as good as full-time rheumatologists in diagnosing PsA.ConclusionsAbout three quarters of Chinese rheumatologists are familiar with the elements in PsA diagnosis and have good practice habits in diagnosing PsA. Four main challenges in making PsA diagnosis are revealed. There was no significant difference in the knowledge of PsA between WM- and TCM-rheumatologists.

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EFL secondary teachers’ assessment literacy: Assessment conceptions and practices

Journal on English as a Foreign Language ◽

10.23971/jefl.v10i2.2101 ◽

2020 ◽

Vol 10 (2) ◽

pp. 402-421

Author(s):

Roghibatul Luthfiyyah ◽

Iin Wariin Basyari ◽

Dwiniasih Dwiniasih

Keyword(s):

Secondary Teachers ◽

Online Survey ◽

Assessment Literacy ◽

Single Element ◽

Literacy Assessment ◽

Structured Interviews ◽

Assessment Practice ◽

Online Questionnaire ◽

Conceptions Of Assessment ◽

Literacy Level

Assessment literacy is defined as knowledge, conceptions, and skills to conduct an assessment. Having sufficient assessment literacy levels, teachers can assist students in improving learning and in achieving learning outcomes. This study employs a descriptive quantitative design that explores EFL secondary teachers' assessment literacy and assessment practice. The data were gathered using an online survey and semi-structured interviews. Forty-eight respondents willingly fulfilled an online questionnaire containing 32 questions adapted from the Teachers Assessment Literacy Questionnaire (TALQ). The data obtained from the survey were analyzed using descriptive statistics. Furthermore, three participants representing each assessment literacy level were selected for interviews to explore their classroom assessment practice. The interview data were analyzed using thematic analysis in terms of the conceptions of assessment, the procedure of assessment construction, and some challenges in assessment practice. The findings reveal that EFL secondary teachers generally have a moderate assessment literacy level. However, the participants reflect different conceptions of assessment, procedures, and challenges in assessment practice depending on an individual level of assessment literacy, institutional and national policies, and socio-culture factors. It shows that assessment literacy is not a single element that can influence teachers' assessment practices.

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