scholarly journals Multi-method evaluation of a national clinical fellowship programme to build leadership capacity for quality improvement

2020 ◽  
Vol 9 (4) ◽  
pp. e000978
Author(s):  
Madalina Toma ◽  
Avril Blamey ◽  
Dawn Mahal ◽  
Nicola M Gray ◽  
Laura Allison ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Lead Level ◽  
Great Majority ◽  
Theory And Practice ◽  
International Level ◽  
Method Evaluation ◽  
Cross Sectional ◽  
Wide Range ◽  
Four Levels ◽  
The Impact

BackgroundThis paper reports the results of the evaluation of the Scottish Quality and Safety Fellowship (SQSF)—a 10-month, lead-level international educational programme established in 2008 with the overarching aim of developing clinicians with advanced quality improvement knowledge, technical ability and essential leadership skills. The evaluation explores four levels of educational and practice outcomes associated with (1) the reaction of fellows to SQSF participation, (2) learning gained, (3) subsequent behaviour changes and (4) the overall impact on national and international level capability and capacity building.MethodsA theory-informed multi-method design was applied using (1) a search and review of the SQSF organisational database to tabulate personal, professional and demographic characteristics; (2) semi-structured telephone interviews with 16 participants using purposive and self-selected sampling; and (3) a cross-sectional online evaluation survey across all 10 cohorts involving 222 fellowsResultsSQSF was positively perceived as a high-quality learning experience containing a well-balanced mix of theory and practice, with a majority of respondents reporting career changing benefits. Most participants reported improved social, behavioural and emotional skills, knowledge and attitudes and, with sustained support of their host organisations, were able to apply and share learning in their workplace. The impact of the SQSF on a wider national and international level capability and capacity was both mediated and moderated by a wide range of interrelated contextual factors.ConclusionsThis multi-method evaluation demonstrates that SQSF has achieved significant positive outcomes for the great majority of participants. Some tentative recommendations are provided with the aim of further enhancing fellowship content, delivery, transfer and future evaluations of wider impacts at regional, national and international health system levels.

Assessing the Preparedness of Healthcare Facilities for Disasters and Emergencies in Damghan, Iran

2021 ◽  
pp. 1-7
Author(s):  
Behrad Pourmohammadi ◽  
Ahad Heydari ◽  
Farin Fatemi ◽  
Ali Modarresi
Keyword(s):  
Health Care ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Mitigation Measures ◽  
Health Staff ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Wide Range ◽  
Care Facilities ◽  
The Impact

Abstract Objectives: Iran is exposed to a wide range of natural and man-made hazards. Health-care facilities can play a significant role in providing life-saving measures in the minutes and hours immediately following the impact or exposure. The aim of this study was to determine the preparedness of health-care facilities in disasters and emergencies. Methods: This cross-sectional study was conducted in Damghan, Semnan Province, in 2019. The samples consisted of all the 11 health-care facilities located in Damghan County. A developed checklist was used to collect the data, including 272 questions in 4 sections: understanding threatening hazards, functional, structural, and nonstructural vulnerability of health-care facilities. The data were analyzed using SPSS 21. Results: The results revealed that the health-care facilities were exposed to 22 different natural and man-made hazards throughout the county. The total level of preparedness of the health-care centers under assessment was 45.8%. The average functional, structural, and nonstructural vulnerability was assessed at 49.3%, 31.6%, and 56.4%, respectively. Conclusions: Conducting mitigation measures is necessary for promoting the functional and structural preparedness. Disaster educational programs and exercises are recommended among the health staff in health-care facilities.

Tuning the Mechanical and Geometric Properties of Electrochemically Aligned Collagen Threads Towards Applications in Biohybrid Robotics

2021 ◽  
Author(s):  
Wenhuan Sun ◽  
Jason Paulovich ◽  
Victoria Webster-Wood
Keyword(s):  
Tensile Modulus ◽  
Solution Concentration ◽  
Cross Sectional ◽  
Geometric Properties ◽  
Wide Range ◽  
Crosslinker Concentration ◽  
High Degree ◽  
The Impact ◽  
Fabrication Parameters ◽  
Manufacturing Parameters

Abstract Electrochemically Aligned Collagen (ELAC) threads fabricated by the isoelectric focusing (IF) of collagen have previously shown potential in tissue engineering and more recently in the fabrication of biohybrid robot structures. For applications in biohybrid robotics, ELAC structures are needed that are both robust and compliant enough to facilitate muscle actuation. However, studies on the effects of IF parameters, and the interactions of such fabrication parameters, on the mechanical and geometric properties of resulting ELAC threads have not been previously found in literature. Understanding the impact of these manufacturing parameters on the material properties is critical to facilitate biohybrid robot design. In this study, the effects of IF duration, IF voltage, and collagen solution concentration were investigated and showed statistically significant effects on adjusting ELAC properties via single-factor experiments. The interactions between parameters exhibited significant joint effects on ELAC property tuning through two-factor experiments. Scanning electron microscopy and 2,4,6-trinitrobenzenesulfonic assays revealed the correlation between high mechanical properties and a combination of low porosity and high degree of crosslinking. By simply tuning IF parameters without changing other fabrication steps, such as crosslinker concentration, ELAC threads with a wide range of mechanical and geometric properties were fabricated. The average tensile modulus of the resulting ELAC threads ranged from 198±90 to 758±138 MPa. The average cross-sectional area ranged from 7756±1000 to 1775±457 µm2. The resultant mapping between IF parameters and ELAC thread properties enabled the production of strong and flexible threads with customizable properties.

scholarly journals Regional Integration: Do Intra-African Trade and Migration Improve Income in Africa?

2019 ◽  
Vol 43 (6) ◽  
pp. 587-631 ◽  
Author(s):  
Blaise Gnimassoun
Keyword(s):  
Regional Integration ◽  
Capita Income ◽  
Per Capita Income ◽  
Cross Sectional ◽  
Wide Range ◽  
Per Capita ◽  
Migration Flows ◽  
And Migration ◽  
The Impact

Regional integration in Africa is a subject of great interest, but its impact on income has not been studied sufficiently. Using cross-sectional and panel estimations, this article examines the impact of African integration on real per capita income in Africa. Accordingly, we consider intra-African trade and migration flows as quantitative measures reflecting the intensity of regional integration. To address the endogeneity concerns, we use a gravity-based, two-stage least-squares strategy. Our results show that, from a long-term perspective, African integration has not been strong enough to generate a positive, significant, and robust impact on real per capita income in Africa. However, it does appear to be significantly income-enhancing in the short and medium terms but only through intercountry migration. These results are robust to a wide range of specifications.

Changes in Hospital Financing and Organization and Their Impact on Hospital Performance

2019 ◽  
Author(s):  
Jonas Schreyögg
Keyword(s):  
Financial Performance ◽  
Financial Incentives ◽  
Hospital Performance ◽  
Unintended Effects ◽  
Natural Experiments ◽  
Cross Sectional ◽  
Trade Offs ◽  
Wide Range ◽  
Improve Hospital ◽  
The Impact

Since the 1980s policymakers have identified a wide range of policy interventions to improve hospital performance. Some of these have been initiated at the level of government, whereas others have taken the form of decisions made by individual hospitals but have been guided by regulatory or financial incentives. Studies investigating the impact that some of the most important of these interventions have had on hospital performance can be grouped into four different research streams. Among the research streams, the strongest evidence exists for the effects of privatization. Studies on this topic use longitudinal designs with control groups and have found robust increases in efficiency and financial performance. Evidence on the entry of hospitals into health systems and the effects of this on efficiency is similarly strong. Although the other three streams of research also contain well-conducted studies with valuable findings, they are predominantly cross-sectional in design and therefore cannot establish causation. While the effects of introducing DRG-based hospital payments and of specialization are largely unclear, vertical and horizontal cooperation probably have a positive effect on efficiency and financial performance. Lastly, the drivers of improved efficiency or financial performance are very different depending on the reform or intervention being investigated; however, reductions in the number of staff and improved bargaining power in purchasing stand out as being of particular importance. Several promising avenues for future investigation are identified. One of these is situated within a new area of research examining the link between changes in the prices of treatments and hospitals’ responses. As there is evidence of unintended effects, future studies should attempt to distinguish between changes in hospitals’ responses at the intensive margin (e.g., upcoding) versus the extensive margin (e.g., increase in admissions). When looking at the effects of entering into a health system and of privatizations, there is still considerable need for research. With privatizations, in particular, the underlying processes are not yet fully understood, and the potential trade-offs between increases in performance and changes in the quality of care have not been sufficiently examined. Lastly, there is substantial need for further papers in the areas of multi-institutional arrangements and cooperation, as well as specialization. In both research streams, natural experiments carried out using program evaluation design are lacking. One of the main challenges here, however, is that cooperation and specialization cannot be directly observed but rather must be constructed based on survey or administrative data.

scholarly journals Impacts of Anthropometric, Biochemical, Socio-Demographic, and Dietary Habits Factors on the Health Status of Urban Corporate People in a Developing Country

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 188 ◽  
Author(s):  
Masuda Begum Sampa ◽  
Md. Rakibul Hoque ◽  
Md. Nazmul Hossain
Keyword(s):  
Uric Acid ◽  
Health Status ◽  
Dietary Habits ◽  
Multinomial Logistic Regression ◽  
Significant Risk ◽  
Dietary Habit ◽  
Cross Sectional ◽  
Blood Uric Acid ◽  
Four Levels ◽  
The Impact

This study focused on urban corporate people and applied multinomial logistic regression (MLR) to identify the impact of anthropometric, biochemical, socio-demographic and dietary habit factors on health status. Health status is categorized into four levels: healthy, caution, affected, and emergent. A cross-sectional study, based on convenience sampling method, was conducted to select 271 employees from 18 institutions under the Grameen Bank Complex, Dhaka, Bangladesh. Biochemical measurements such as blood uric acid are highly significant variables in the MLR model. When holding other factors as constants, with a one-unit increase in blood uric acid, a person is 11.02 times more likely to be “emergent” compared to “caution”. The odds are also higher, at 1.82, for the blood uric acid to be “affected” compared “caution”. The results of this study can help to prevent a large proportion of non-communicable diseases (NCDs) by reducing the most significant risk factor: blood uric acid. This study can contribute to the establishment of combined actions to improve disease management.

scholarly journals Knowledge, attitudes, and perceptions on genetically modified mosquitoes: Case for sterile mosquito release in Grenada

2017 ◽  
Vol 3 (1) ◽  
pp. 57
Author(s):  
Anjali Ghodasara ◽  
Marisa Deliso ◽  
Satesh Bidaisee
Keyword(s):  
Zika Virus ◽  
Genetically Modified Organisms ◽  
Genetically Modified ◽  
Structured Interview ◽  
Sample Population ◽  
Cross Sectional ◽  
Wide Range ◽  
Attitudes And Perceptions ◽  
Genetically Modified Mosquitoes ◽  
The Impact

This study assessed knowledge, attitudes and perceptions of various stakeholders in Grenada regarding genetically modified organisms and the release of genetically modified mosquitoes. The study adopted a cross sectional design with a study population that comprised of members from seven stakeholder groups of civil society in Grenada. The sample population was obtained through a snowballing strategy and data collection for the study consisted of a semi-structured interview. Data was managed through the collection and reviewing of data from transcribed interview notes, as well as observations and interpretations made during the field collection. Interview recordings were analyzed to identify emerging themes. These themes were ranked according to the frequency with which they appeared, and main concepts identified by linking related themes. Most groups supported the use of genetically modified mosquitoes against Zika, but there were several varying concerns, including environmental worries and the impact of these organisms on humans. Many questioned the characteristics of Zika itself, and some believed Zika is a man-made virus created in a lab. Others doubted the link of Zika virus to microcephaly and other birth defects, and some were unsure if Zika virus is transmitted by mosquitoes. There is a wide range of differing knowledge, attitudes, and perceptions towards genetically modifying technology in general and towards mosquitoes in response to Zika.

The effects of mutuality in exporter-importer relationships

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Farid Ahmed ◽  
Felicitas Evangelista ◽  
Daniela Spanjaard
Keyword(s):  
Relationship Marketing ◽  
Theory And Practice ◽  
Marketing Theory ◽  
Cross Sectional ◽  
Dyadic Data ◽  
Content Type ◽  
Central Hypothesis ◽  
Relationship Performance ◽  
The Impact

PurposeRelationship marketing has been playing an important role in the development of marketing theory and practice. Though the concept has been extensively applied in international marketing in understanding the dynamics of exporter-importer relationships, few studies have looked at dyadic data to investigate the impact of mutuality of relational variables on the exporter-importer relationships. The objective of this study is to understand the impact of mutuality of key relational variables on exporter-importer relationship performance. A dyadic model of mutuality is proposed. The model highlights the impact of balance, level and quality of perceptual bi-directionality of relational variables.Design/methodology/approachThe model was tested using dyadic data collected from exporter-importer relationships involving Australian exporters and their Southeast Asian import partners through a cross-sectional, quantitative survey. Mutuality of relationship constructs was measured using the perceptual bi-directionality (PBD) method.FindingsThe results support the central hypothesis that mutuality of relational constructs has an impact on relationship performance.Originality/valueThe study is the first to apply the perceptual bi-directionality method to measure mutuality of relational constructs in an exporter-importer setting. The study contributes to the general understanding of international business and exporter-importer relationship performance in particular.

Children and war: Risk, resilience, and recovery

2012 ◽  
Vol 24 (2) ◽  
pp. 553-558 ◽  
Author(s):  
Emmy E. Werner
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Longitudinal Research ◽  
Negative Impact ◽  
Multiple Informants ◽  
Risk And Resilience ◽  
Cross Sectional ◽  
Wide Range ◽  
The Impact

AbstractThis article reviews and reflects on studies that have explored the effects of war on children around the world. Most are cross-sectional and based on self-reports. They describe a range of mental health problems, related to dose effects and to the negative impact of being a victim or witness of violent acts, threats to and loss of loved ones, prolonged parental absence, and forced displacement. The more recent the exposure to war, and the older the child, the higher was the likelihood of reported posttraumatic stress disorder symptoms. Especially vulnerable to long-term emotional distress were child soldiers, children who were raped, and children who had been forcibly displaced. In adulthood, war-traumatized children displayed significantly increased risks for a wide range of medical conditions, especially cardiovascular diseases. Among protective factors that moderated the impact of war-related adversities in children were a strong bond between the primary caregiver and the child, the social support of teachers and peers, and a shared sense of values. Among the few documented intervention studies for children of war, school-based interventions, implemented by teachers or locally trained paraprofessionals, proved to be a feasible and low-cost alternative to individual or group therapy. More longitudinal research with multiple informants is needed to document the trajectories of risk and resilience in war-affected children, to assess their long-term development and mental health, and to identify effective treatment approaches.

scholarly journals An Acute Care for Elders Quality Improvement Program for Complex, High-Cost Patients Yields Savings for the System

2019 ◽  
Vol 14 (9) ◽  
pp. 527-533 ◽  
Author(s):  
Maura J Brennan ◽  
Alexander B Knee ◽  
Erin J Leahy ◽  
Michael J Ehresman ◽  
Heidi-Ann Courtney ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Acute Care ◽  
Routine Care ◽  
Improvement Program ◽  
Cross Sectional ◽  
Comorbidity Score ◽  
Comorbidity Burden ◽  
Medical Inpatients ◽  
Comorbidity Scores ◽  
The Impact

BACKGROUND: Acute Care for Elders (ACE) programs improve outcomes for older adults; however, little is known about whether impact varies with comorbidity severity. OBJECTIVE: To describe differences in hospital-level outcomes between ACE and routine care across various levels of comorbidity burden. DESIGN: Cross-sectional quality improvement study. SETTING: A 716-bed teaching hospital. PARTICIPANTS: Medical inpatients aged ≥70 years hospitalized between September 2014 and August 2017. INTERVENTION: ACE care, including interprofessional rounds, geriatric syndromes screening, and care protocols, in an environment prepared for elders MEASUREMENTS: Total cost, length of stay (LOS), and 30-day readmissions. We calculated median differences for cost and LOS between ACE and usual care and explored variations across the distribution of outcomes at the 25th, 50th, 75th and 90th percentiles. Results were also stratified across quartiles of the combined comorbidity score. RESULTS: A total of 1,429 ACE and 10,159 non-ACE patients were included in this study. The mean age was 81 years, 57% were female, and 81% were white. ACE patients had lower costs associated with care ranging from $171 at the 25th percentile to $3,687 at the 90th percentile, as well as lower LOS ranging from 0 days at the 25th percentile to 1.9 days at the 90th percentile. After stratifying by comorbidity score, the greatest differences in outcomes were among those with higher scores. There was no difference in 30-day readmission between the groups. CONCLUSION: The greatest reductions in cost and LOS were in patients with greater comorbidity scores. Risk stratification may help hospitals prioritize admissions to ACE units to maximize the impact of the more intensive intervention.

scholarly journals Medicolegal Significance of Torture Under Police Custody on Prisoners’ Health and Recommendations for Prevention of Violence Against Torture

2019 ◽  
Vol 5 (2) ◽  
pp. 16-20
Author(s):  
Sayed Muhammad Yadain ◽  
Aftab Alam Tanoli ◽  
Riffat Masood ◽  
Shagufta Shafi ◽  
Rizwan Zafar Ansari ◽  
...  
Keyword(s):  
The Body ◽  
Physical Work ◽  
Physical Assault ◽  
Cross Sectional ◽  
Police Custody ◽  
Wide Range ◽  
Hands On ◽  
Istanbul Protocol ◽  
One Year ◽  
The Impact

OBJECTIVES:The aim of the study was to determine (a) most common sites of torture, nature of injuries and their complications and (b) psychological and physical effects of torture on the prisoner’s mental and physical health. METHODOLOGY: It was a cross-sectional descriptive study. The study was conducted on 193 prisoners admitted at District Police Hospital Peshawar over a period of one year. These prisoners were the victims of torture under police captivity. Majority of the victims were prisoners. The data was collected on a Performa mentioning age, duration of captivity; nature of injuries (simple, grievous), weapon used for physical torture (blunt, sharp) and prisoners were interviewed and examined by the medical officers and co-authors. SPSS 20 was used for data analysis. RESULTS: One hundred and eighty (93.2%) of the 193 subjects were male. Average age was 27.4 ±4 years. Hundred (51.8%) prisoners were physically tortured and 92 cases (47.6%) were due to physical assault among prisoners. Out of 92 cases 12 (13.04%) prisoners showed injuries due to strenuous physical work, mostly on palms and soles in the form of blisters. These injuries were carefully examined and correlated with history. Torture methods observed in this study were beating with hands on face (35.6%), whipping with rod (61.6%), kicking on buttock and abdomen (16.4%), forceful dragging (16.4%), burning with cigarettes (12.3%), hanging with hand cuffs (13.7%) and whipping on palms and sole (6.9%). Majority of the cases (74%) were tortured in custody, (12.3%) in prisons, (9.6%) on the street and (4.1%) at home. The impact of physical and psychological torture was variable depending upon the duration of captivity and nature of torture. Patients kept for a longer period 42 (42%) had developed post captivity psychosocial stress syndrome. Physical torture has taken 07 (3%) lives and 24 (12.4%) victims were permanently disabled in this year. CONCLUSION: A wide range of different types of injuries were observed on various parts of the body. Blunt trauma was most frequent. Violation of Istanbul Protocol for violence against torture under police custody was also clear.

Sign in / Sign up

Export Citation Format

Share Document