scholarly journals Does deprivation affect the demand for NHS Direct? Observational study of routine data from Wales

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029203
Author(s):  
Julie Peconi ◽  
Steven Macey ◽  
Sarah E Rodgers ◽  
Ian T Russell ◽  
Helen Snooks ◽  
...  
Keyword(s):  
National Health Service ◽  
Routine Data ◽  
Confounding Factors ◽  
Policy Makers ◽  
On Demand ◽  
Confounding Variables ◽  
Day Of The Week ◽  
Nhs Direct ◽  
The Relationship ◽  
Index Of Multiple Deprivation

ObjectiveTo estimate the effect of deprivation on the demand for calls to National Health Service Direct Wales (NHSDW) controlling for confounding factors.DesignStudy of routine data on over 400 000 calls to NHSDW using multiple regression to analyse the logarithms of ward-specific call rates across Wales by characteristics of call, patient and ward, notably the Welsh Index of Multiple Deprivation.Setting810 electoral wards with average population of 3300, defined by 1998 administrative boundaries.PopulationAll calls to NHSDW between January 2002 and June 2004.Main outcome measuresWe used ward populations as denominators to calculate the rates of three categories of calls: calls seeking advice, calls seeking information and all calls combined.ResultsConfounding variables explained 31% of variation in advice call rates, but only 14% of variation in information call rates and in all call rates (all significant at 0.1% level). However, deprivation was only a statistically significant predictor of information call rates. The proportion of the ward population categorised as ‘white’ was a highly significant predictor of all three call rates. For advice calls and combined calls, rates decreased highly significantly with the proportion of those who called the service for themselves. Information call rates were higher on weekdays and highest on Mondays, while advice call rates were highest on Sundays.ConclusionsDeprivation had no consistent effect on demand for the service and the relationship needs further exploration. While our data may have underestimated the ‘need’ of deprived patients, they yield no evidence that policy-makers should seek to improve demand from those patients. However, we found differences in the way callers use advice and information calls. Previously unexplored variables that help to predict ward-specific call rates include: ethnicity, day of the week and whether patients made the calls themselves.

Letter to the Editor

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 490-491
Author(s):  
Neal Halsey ◽  
Elizabeth Holt
Keyword(s):  
Multivariate Analysis ◽  
Observational Studies ◽  
Confounding Factors ◽  
Letter To The Editor ◽  
Confounding Variables ◽  
Final Sentence ◽  
The Relationship ◽  
Extensive List

Dr Brunskill's primary point appears to be in the final sentence of his letter. As noted in our discussion, we are well aware of the potential for hidden confounding factors in retrospective observational studies... We attempted to minimize this possibility by obtaining information on an extensive list of factors that might have confounded the relationship between vaccination and mortality and by controlling for these factors through multivariate analysis.1 Despite our rigor, we could have failed to measure all possible confounding variables.

scholarly journals Innovation Propensity in the Specialized Suppliers Industry

2018 ◽  
Vol 11 (10) ◽  
pp. 129
Author(s):  
Tiziana Di Cimbrini ◽  
Fabrizio Maturo ◽  
Stefania Migliori ◽  
Francesco Paolone
Keyword(s):  
Positive Impact ◽  
Policy Makers ◽  
On Demand ◽  
Demand Pull ◽  
Established Firms ◽  
Start Ups ◽  
The Relationship ◽  
Positive Effect ◽  
Moderating Role

The paper focuses on the effects of technology-push and demand-pull determinants on firm's innovation propensity comparing start-ups and established firms in the specialized suppliers' industry. Specifically, it explores technology-push and demand-pull effects in isolation and in their interaction using a sample of European firms in the period 2007-2009. Our main results show that either the technology-push and demand-pull determinants exert a positive impact on innovation propensity in both start-ups and established firms, Moreover, in start-ups, we discovered that the demand-pull determinant plays a strong moderating role in the relationship between innovation propensity and the technology-push determinant. The paper contributes in making managers more aware of the effect that some choices concerning the composition of the firm’s workforce may produce on the firm’s innovation propensity. There are also implications for policy makers whose overemphasis on demand pull incentives may disempower the positive effect of the technology determinant on the innovation propensity of start-ups. 

POLICY CHANGE – THE ROLE OF IDEAS AND POLICY ENTREPRENEURS

2018 ◽  
pp. 63-72
Author(s):  
Arwanto Arwanto ◽  
Wike Anggraini
Keyword(s):  
Policy Change ◽  
Significant Role ◽  
Policy Process ◽  
Policy Entrepreneurs ◽  
Multiple Streams ◽  
Policy Makers ◽  
Problem Framing ◽  
Exogenous Factors ◽  
The Relationship

ABSTRACT Understanding policy process involves many distinctive approaches. The most common are institutional, groups or networks, exogenous factors, rational actors, and idea-based approach. This paper discussed the idea-based approach to explain policy process, in this case policy change. It aims to analyse how ideas could assist people to understand policy change. What role do they play and why are they considered as fundamental element? It considers that ideas are belong to every policy actor, whether it is individual or institution. In order to answer these questions, this paper adopts Kingdon’s multi streams approach to analyse academic literatures. Through this approach, the relationship between ideas and policy change can be seen clearer. Ideas only can affect in policy change if it is agreed and accepted by policy makers. Therefore the receptivity of ideas plays significant role and it emerges policy entrepreneurs. They promote ideas (through problem framing, timing, and narrative construction) and manipulate in order to ensure the receptivity of ideas. Although policy entrepreneurs play significant role, political aspects remains the most important element in the policy process. Keywords: policy change, ideas, idea-based approach, Kingdon’s multiple streams, policy entrepreneurs.

An Investigation of Faculty Members' Engagement in Saudi Arabia

2018 ◽  
Vol 3 (2) ◽  
pp. 114-136
Author(s):  
Eman I AHMED
Keyword(s):  
Employee Engagement ◽  
Faculty Perceptions ◽  
Cognitive Engagement ◽  
Faculty Members ◽  
University Administrators ◽  
Point Scale ◽  
Policy Makers ◽  
Efficiency And Effectiveness ◽  
The University ◽  
The Relationship

Faculty engagement has been proved to be a critical driver of the universities’ efficiency and effectiveness. The first step towards building an engaged workforce is to get a measure of faculty perceptions of their engagement level to their universities. Accordingly, the purpose of this paper is to investigate the faculty members' engagement in the Imam Abdulrahman Bin Faisal University. It examines the relationship between the faculty professional variablesand their level of engagement to their institutions. William Kahn's (1990) three-component model of employee engagement was partially adapted as a framework to measure the faculty members' engagement. A questionnaire was used to better address the objective of this study. The data were obtained from the Imam Abdulrahman Bin Faisal University (Dammam University) through an internet-based survey. The validity and the reliability of the questionnaire has been evaluated and reported. Results of the analyses show that cognitive engagement is reported to be higher than both the emotional and physical engagement, with a mean rating of 4.040 and a standard deviation of .487, based on the five-point scale. Given the engagement level of the faculty members in this study, the university administrators should develop policies, and strategies that encourage and support engagement among faculty members at the University in order to maximize their engagement. Policy makers must also take into consideration the needs of the faculty members

An Analytical Approach to Cruise Tourism As an Option For Development: a Case Study of the Sultanate of Oman

2020 ◽  
Vol 15 (2) ◽  
pp. 95-109
Author(s):  
Heba Aziz ◽  
Osman El-Said ◽  
Marike Bontenbal
Keyword(s):  
Capital City ◽  
Sultanate Of Oman ◽  
Policy Makers ◽  
Cruise Tourism ◽  
The Impact ◽  
The Relationship ◽  
Average Expenditure ◽  
Return Intention

The objective of this study was to measure the level of cruise tourists' satisfaction as well as the relationship between satisfaction, recommendation, return intention, and expenditure. Also, the impact of factors such as nationality, length of the visit, and age on the level of expenditure was measured. An empirical approach for data collection was followed and a total of 152 questionnaires were collected from cruise tourists visiting the capital city of Oman, Muscat, as cruise liners anchor at Sultan Qaboos Port. Results of the regression analysis supported the existence of a causal relationship between satisfaction with destination attributes, overall satisfaction, recommendation, return intention, and expenditure. It was found that the average expenditure varies according to age and length of the visit. Recommendations for policy makers were suggested on how to increase the role of cruise tourism in strengthening the economy.

OP48 Nursing Requirements In Long-Term Care: A Health Technology Assessment

2019 ◽  
Vol 35 (S1) ◽  
pp. 11-12
Author(s):  
Paula Corabian ◽  
Charles Yan ◽  
Susan Armijo-Olivo ◽  
Bing Guo
Keyword(s):  
Nursing Care ◽  
Nursing Staff ◽  
Real World ◽  
Research Evidence ◽  
Long Term Care ◽  
Staff Time ◽  
Term Care ◽  
Policy Makers ◽  
The Relationship

IntroductionThe objectives of this study were to systematically review published research on the relationship between nursing staff coverage, care hours, and quality of care (QoC) in long-term care (LTC) facilities; and to conduct a real world evidence (RWE) analysis using Alberta real world data (RWD) to inform policy makers on whether any amendments could be made to current regulations.MethodsA systematic review (SR) of research evidence published between January 2000 and May 2018 on the relationship between nursing staff coverage, care hours, and QoC in LTC facilities was conducted. Panel data regressions using available RWD from Alberta, Canada, were performed to assess associations between nursing care hours and LTC outcomes. Outcomes of interest included quality indicators related to resident outcomes, hospital admissions, emergency room visits and family satisfaction. Nursing care hours considered in SR and RWE analysis included those provided by registered nurses (RNs) and licensed practical nurses (LPNs).ResultsThe SR found inconsistent and poor quality evidence relevant to the questions of interest, indicating a great uncertainty about the association between nursing staff time and type of coverage and QoC. Although some positive indications were suggested, major weaknesses of reviewed studies limited interpretation of SR results. RWE analysis found that impact of care hours on LTC outcomes was heterogeneous, dependent on outcome measurements. There was evidence that total staff, RN, and LPN hours had positive effects on some resident outcomes and magnitude of effect differed for different nursing staff.ConclusionsNo definitive conclusion could be drawn on whether changing nursing staff time or nursing staff coverage models would affect residents’ outcomes based on the research evidence gathered in the SR. RWE analysis helped to fill a gap in the available published literature and allowed policy makers to better understand the impact of revising current regulations based on actual outcomes.

scholarly journals The impact of regular sperm donation on bulls’ seminal plasma hormonal profile and phantom response

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alicja Kowalczyk ◽  
Elżbieta Gałęska ◽  
Ewa Czerniawska-Piątkowska ◽  
Anna Szul ◽  
Leszek Hebda
Keyword(s):  
Seminal Plasma ◽  
Sperm Donation ◽  
Hormonal Profile ◽  
Holstein Friesian ◽  
Different Seasons ◽  
Day Of The Week ◽  
The Impact ◽  
The Relationship ◽  
Positive Effect

AbstractThe aim of this study was to analyze the relationship between the concentration of hormones in the seminal plasma, the bull maintenance system in the insemination station, and the regularity of sperm donation and the response to the phantom (libido level). An additional goal was to determine whether there is a relationship between the hormonal profile in the blood, the sperm plasma, the oxidative and antioxidant profile in the blood of bulls and the biometry of their testicles and scrotum, as well as the quality of their sperm in both different seasons and intensities of reproductive use. For the study, 220 healthy and sexually mature Polish Holstein–Friesian bulls were used. They all had normal libido and were fed equally. The animals were grouped according to the scheme: young (16–20 month/n = 60) and old (26–30 month/n = 60) including: individually housed (n = 30) and group housed (n = 30) young, old individually housed (n = 30) and group housed (n = 30) (n total animals = 120); young animals donating semen once a week (every Thursday) (n = 25) and sporadically (once every two months on a random day of the week) (n = 25), old animals donating semen once a week (every Thursday) (n = 25 ) and sporadic donors (once every two months on a random day of the week) (n = 25) (n total animals = 100). When analyzing the results of this study, it should be stated that regular use has a positive effect on the secretion of sex hormones in bulls. Higher levels of testosterone and lower levels of estradiol and prostaglandins resulted in higher sexual performance, expressed by a stronger response to the phantom. The differences in favor of regular use were independent of the bull's age. The results of our research illustrate that the quality of semen and its freezing potential may depend on the season and frequency of its collection, as well as on the age of the males.

scholarly journals A Student’s Guide to the Classification and Operationalization of Variables in the Conceptualization and Design of a Clinical Study: Part 1

2021 ◽  
Vol 43 (2) ◽  
pp. 177-179 ◽  
Author(s):  
Chittaranjan Andrade
Keyword(s):  
Clinical Study ◽  
Significant Relationship ◽  
Research Experience ◽  
Process Variables ◽  
Know How ◽  
Independent Variables ◽  
Cause And Effect ◽  
Confounding Variables ◽  
Dependent Variables ◽  
The Relationship

Students without prior research experience may not know how to conceptualize and design a study. This article explains how an understanding of the classification and operationalization of variables is the key to the process. Variables describe aspects of the sample that is under study; they are so called because they vary in value from subject to subject in the sample. Variables may be independent or dependent. Independent variables influence the value of other variables; dependent variables are influenced in value by other variables. A hypothesis states an expected relationship between variables. A significant relationship between an independent and dependent variable does not prove cause and effect; the relationship may partly or wholly be explained by one or more confounding variables. Variables need to be operationalized; that is, defined in a way that permits their accurate measurement. These and other concepts are explained with the help of clinically relevant examples.

scholarly journals 354 Differential Attainment in Surgical Training

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Z Vinnicombe ◽  
M Little ◽  
J Super
Keyword(s):  
Academic Performance ◽  
Surgical Training ◽  
General Medical Council ◽  
Career Progression ◽  
Medical Council ◽  
Multiple Deprivation ◽  
Surgical Trainees ◽  
Economic Background ◽  
The Relationship ◽  
Index Of Multiple Deprivation

Abstract Introduction Differential attainment (DA), according to the General Medical Council (GMC), is the gap between attainment levels in different groups. Attainment measures should cover aspects that include academic performance and career progression. Two such areas in surgical training are the MRCS examinations and ARCPs, both of which are required for progression in a career in surgery. Our aim was to investigation whether socio-economic background was a significant factor for progression in surgical training. Method Data from the GMC for Core Surgical Trainees (CSTs) taking the MRCS examination between 2016 and 2019 and CST ARCP outcomes between 2017 and 2019 were obtained. Socio-economic background was assessed using the Index of Multiple Deprivation (IMD). ARCP and MRCS outcomes were assessed against IMD. Results Trainees from IMD Q1&2 (most deprived) had a significantly higher (p < 0.01) mean number of attempts (1.86) to pass MRCS examinations than trainees from IMD Q4&5 (least deprived) (1.54). IMD Q1&2 were significantly more likely to obtain unsatisfactory outcomes (24.4%) than trainees from IMD Q4&5 (14.2%) (p < 0.05). Conclusions There is clear evidence that differential attainment exists within Core Surgical Training. The reasons for this are likely to be complex and more work is needed to further investigate the relationship.

scholarly journals Association of body condition with lameness in dairy cattle: a single-farm longitudinal study

2021 ◽  
pp. 1-4
Author(s):  
Michaela Kranepuhl ◽  
Detlef May ◽  
Edna Hillmann ◽  
Lorenz Gygax
Keyword(s):  
Body Condition ◽  
Body Condition Score ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Linear Mixed Effects Models ◽  
Linear Mixed Effects ◽  
Confounding Variables ◽  
Condition Score ◽  
The Impact ◽  
The Relationship

Abstract This research communication describes the relationship between the occurrence of lameness and body condition score (BCS) in a sample of 288 cows from a single farm that were repeatedly scored in the course of 9 months while controlling for confounding variables. The relationship between BCS and lameness was evaluated using generalised linear mixed-effects models. It was found that the proportion of lame cows was higher with decreasing but also with increasing BCS, increased with lactation number and decreased with time since the last claw trimming. This is likely to reflect the importance of sufficient body condition in the prevention of lameness but also raises the question of the impact of overcondition on lameness and the influence of claw trimming events on the assessment of lameness. A stronger focus on BCS might allow improved management of lameness that is still one of the major problems in housed cows.

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