scholarly journals Minimally disruptive medicine (MDM) in clinical practice: a qualitative case study of the human immunodeficiency virus (HIV) clinic care model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abd Moain Abu Dabrh ◽  
Kasey R. Boehmer ◽  
Nathan Shippee ◽  
Stacey A. Rizza ◽  
Adam I. Perlman ◽  
...  
Keyword(s):  
Qualitative Case Study ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Lessons Learned ◽  
Hiv Care ◽  
Care Model ◽  
Care Clinic ◽  
Minimally Disruptive Medicine ◽  
The Impact

Abstract Background Recent evidence suggests the need to reframe healthcare delivery for patients with chronic conditions, with emphasis on minimizing healthcare footprint/workload on patients, caregivers, clinicians and health systems through the proposed Minimally Disruptive Medicine (MDM) care model named. HIV care models have evolved to further focus on understanding barriers and facilitators to care delivery while improving patient-centered outcomes (e.g., disease progression, adherence, access, quality of life). It is hypothesized that these models may provide an example of MDM care model in clinic practice. Therefore, this study aimed to observe and ascertain MDM-concordant and discordant elements that may exist within a tertiary-setting HIV clinic care model for patients living with HIV or AIDS (PLWHA). We also aimed to identify lessons learned from this setting to inform improving the feasibility and usefulness of MDM care model. Methods This qualitative case study occurred in multidisciplinary HIV comprehensive-care clinic within an urban tertiary-medical center. Participants included Adult PLWHA and informal caregivers (e.g. family/friends) attending the clinic for regular appointments were recruited. All clinic staff were eligible for recruitment. Measurements included; semi-guided interviews with patients, caregivers, or both; semi-guided interviews with varied clinicians (individually); and direct observations of clinical encounters (patient-clinicians), as well as staff daily operations in 2015–2017. The qualitative-data synthesis used iterative, mainly inductive thematic coding. Results Researcher interviews and observations data included 28 patients, 5 caregivers, and 14 care-team members. With few exceptions, the clinic care model elements aligned closely to the MDM model of care through supporting patient capacity/abilities (with some patients receiving minimal social support and limited assistance with reframing their biography) and minimizing workload/demands (with some patients challenged by the clinic hours of operation). Conclusions The studied HIV clinic incorporated many of the MDM tenants, contributing to its validation, and informing gaps in knowledge. While these findings may support the design and implementation of care that is both minimally disruptive and maximally supportive, the impact of MDM on patient-important outcomes and different care settings require further studying.

Proportional Representation and its Impacts on Multi Ethnic Society of Sri Lanka

2016 ◽  
Vol 3 (5) ◽  
Author(s):  
Seeni Mohamed Aliff
Keyword(s):  
Sri Lanka ◽  
Institutional Design ◽  
Qualitative Case Study ◽  
Secondary Data ◽  
Electoral System ◽  
Ethnic Violence ◽  
Institutional Affiliation ◽  
Secondary Data Sources ◽  
The Impact

This paper will examine the impact of PR electoral systems in a divided society. This research will explore the strength and weakness of the current electoral system and institutional design of Sri Lanka and will recommend changes to decrease the risk of minority exclusion in decision making and ethnic violence. The objectives of this research are to examine the character of the merits and demerits of the PR, and to investigate and assess the impacts of the PR in the multi ethnic societies of Sri Lanka. The study is a qualitative case study, and primary and secondary data sources have been employed to gather relevant data. The My Fieldwork was conducted in Sri Lanka, with the intention of gaining a better and more thorough understanding of the current situation. The interviews conducted were as such not structured or semi-structured, due to the interviewees’ varying professional background and institutional affiliation. Accordingly, unstructured interviews, as well as informal conversations and meetings, were conducted throughout Sri Lanka.

scholarly journals The impact of the COVID-19 pandemic on digital globalization

2021 ◽  
Vol 129 ◽  
pp. 06008
Author(s):  
Maria Loredana Popescu ◽  
Svetlana Platagea Gombos ◽  
Sorin Burlacu ◽  
Amza Mair
Keyword(s):  
Global Economy ◽  
World Economy ◽  
Value Added ◽  
Digital Transformation ◽  
Lessons Learned ◽  
Health Crisis ◽  
Main Research ◽  
Documentary Analysis ◽  
The Impact

Research background: After more than a year of the Covid-19 pandemic, we can investigate whether it caused a shock to the global economy, pushing for deglobalization, or on the contrary, it was a challenge for digital globalization and digital transformation of economies. Through this research we join the research contributions that examine the process towards digital globalization that characterizes the world economy, its impact on businesses, consumers, and governments. We also discuss the challenges posed by the crisis caused by the coronavirus pandemic to globalization and perhaps the acceleration of the digital transformation of economies. Purpose of the article: The aim of this research is to highlight the impact of the COVID-19 pandemic in the age of digital globalization. Methods: Documentary analysis, as the main research method, is doubled by a case study that allows us to highlight the specific characteristics of digital globalization. Findings & Value added: The findings of the research allowed us to highlight the essential aspects of digital globalization that were perhaps exacerbated by the Covid-19 pandemic, but which contribute greatly to understanding the phenomenon of globalization. Our research also reveals four lessons learned in the COVID-19 pandemic. We also present some considerations regarding the globalization after the health crisis.

Exploring the Hidden Costs of Human–Wildlife Conflict in Northern Kenya

2018 ◽  
Vol 61 (1) ◽  
pp. 33-54 ◽  
Author(s):  
Jennifer Bond ◽  
Kennedy Mkutu
Keyword(s):  
Political Ecology ◽  
Qualitative Case Study ◽  
Human Security ◽  
Well Being ◽  
Northern Kenya ◽  
Wildlife Conflict ◽  
The Impact ◽  
Human Wildlife Conflict

Abstract:Human–wildlife conflict (HWC) is often considered in terms of how the impact on humans can be mitigated, but in the context of the larger goal of meeting conservation goals. This article explores the hidden costs of HWC on human well-being in northern Kenya through a qualitative case study of Laikipia County. Drawing on narratives of wildlife as destructive, wildlife as inherently more important or valuable than humans, and wildlife preservation as a pathway for capturing resources, it explores the impacts of HWC on human well-being, situating the study within the HWC, political ecology, and human security literature.

The HOLA COVID-19 study: Evaluating the impact of caring for patients with COVID-19 on cancer care delivery in Latin America.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1537-1537
Author(s):  
Carolina Bernabe Ramirez ◽  
Ana I. Velazquez Manana ◽  
Coral Olazagasti ◽  
Cristiane Decat Bergerot ◽  
Enrique Soto Perez De Celis ◽  
...  
Keyword(s):  
Latin America ◽  
Latin American ◽  
Cancer Care ◽  
Online Survey ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Significant Proportion ◽  
Multiple Choice Questions ◽  
Patients With Cancer ◽  
The Impact

1537 Background: The severe acute respiratory syndrome 2 (SARS-cov-2) virus causing COVID-19 has brought great challenges to global health services affecting cancer care delivery, outcomes, and increasing the burden in oncology providers (OP). Our study aimed to describe the challenges that OP faced while delivering cancer care in Latin America. Methods: We conducted an international cross-sectional study using an anonymous online survey in Spanish, Portuguese, and English. The questionnaire included 43 multiple choice questions. The sample was stratified by OP who have treated patients with COVID-19 versus those who have not treated patients with COVID-19. Data was analyzed with descriptive statistics and Chi-square tests. Results: A total of 704 OP from 20 Latin American countries completed the survey (77% of 913 who started the survey). Oncologists represented 46% of respondents, followed by 25% surgical-oncologists. Of the respondents, 56% treated patients with COVID-19. A significant proportion of OP reported newly adopting telemedicine during COVID-19 (14% vs 72%, p=0.001). More than half (58%) of OP reported making changes to the treatments they offered to patients with cancer. As shown in the table, caring for patients with COVID-19 significantly influenced practice patterns of OP. Access to specialty services and procedures was significantly reduced: 40% noted significantly decreased or no access to imaging, 20% significantly decreased or no access to biopsies, 65% reported delays in surgical oncology referrals, and 49% in radiation oncology referrals. A vast majority (82%) reported oncologic surgeries were delayed or cancelled, which was heightened among those treating patients with COVID-19 (87% vs 77%, p=0.001). Conclusions: The COVID-19 pandemic has significantly affected the way cancer care is delivered in globally. Although changes to healthcare delivery are necessary as a response to this global crisis, our study highlights the significant disruption and possible undertreatment of patients with cancer in Latin America that results from COVID-19.[Table: see text]

scholarly journals Lessons learnt: examining the use of case study methodology for nursing research in the context of palliative care

2019 ◽  
Vol 24 (6) ◽  
pp. 446-459
Author(s):  
Paula Brogan ◽  
Felicity Hasson ◽  
Sonja McIlfatrick
Keyword(s):  
Palliative Care ◽  
Care Delivery ◽  
Case Study Research ◽  
Lessons Learned ◽  
Research Approach ◽  
Nursing Research ◽  
Case Study Methodology ◽  
Study Research ◽  
Study Methodology

Background An empirical social research approach, facilitating in-depth exploration of complex, contemporary contextualised phenomena, case study research has been used internationally in healthcare studies across clinical settings, to explore systems and processes of care delivery. In the United Kingdom, case study methods have been championed by nurse researchers, particularly in the context of community nursing and palliative care provision, where its applicability is well established. Yet, dogged by conceptual confusion, case study remains largely underutilised as a research approach. Method Drawing on examples from nursing and palliative care studies, this paper clarifies case study research, identifies key concepts and considers lessons learned about its potential for nursing research within the unique and complex palliative and end of life context. Conclusion A case study approach offers nurse researchers the opportunity for in-depth, contextualised understanding of the systems and processes which influence their role in palliative care delivery across settings. However, philosophical and conceptual understandings are needed and further training in case study methodology is required to enable researchers to articulate and conduct case study.

scholarly journals 299. “Where the Rubber Meets the Road”: Stakeholders’ Perspectives about the Current State of HCV Care Delivery in Massachusetts Jails

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S161-S162
Author(s):  
Alysse G Wurcel ◽  
Jessica Reyes ◽  
Julia Zubiago ◽  
Deirdre Burke ◽  
Tom Concannon ◽  
...  
Keyword(s):  
Public Health ◽  
Care Delivery ◽  
Mutual Recognition ◽  
Healthcare Delivery ◽  
Hiv Care ◽  
Structured Interviews ◽  
The Road ◽  
Transient Nature ◽  
Purposeful Sampling ◽  
Key Stakeholders

Abstract Background HCV is highly prevalent in criminal-justice involved populations (CJIP). Nationally, the operationalization of guideline-driven HCV care (including testing and treatment) for CJIP has been challenging, prompting this study to understand barriers and facilitators. Methods We used purposeful sampling strategies to recruit key stakeholders including people who are incarcerated, clinicians providing care in jail, clinicians providing care outside of jail, corrections administrators, and representatives of industry, public health and public policy. Semi-structured interviews were performed in Spanish or English, based on preference of participant. Written notes were used to capture details from interviews in jails and interviews outside of jail were recorded. People interviewed outside of jail were offered a stipend. Interviews were coded and analyzed with a compare and consensus approach. Results Of 120 people, 49 (41%) people agreed to be interviewed in each of the stakeholder categories including 21 men who were incarcerated (mean age 32 [IQR 25, 39], 60% non-White). Barriers to HCV care delivery included (1) Fragmented healthcare delivery because of transient nature of CJIP (2) Frustration and disempowerment experienced by people incarcerated in jail and (3) Heterogeneous views on stakeholders responsible for providing and financing HCV care in jails. Facilitators to HCV care delivery included (1) Incarcerated population’s interested in HCV care for public and personal health and (2) An existing strong public health infrastructure in place supporting HIV care delivery. Conclusion Understanding various stakeholders’ views of barriers to HCV care in jails is a necessary first step to building improved care pathways. Mutual recognition may help to focus limited administrative and fiscal resources on HCV care for this transient population. Disclosures All authors: No reported disclosures.

Meta-analysis of U.S. intermediated food markets: Measuring what matters

2016 ◽  
Vol 118 (5) ◽  
Author(s):  
Blake E. Angelo ◽  
Becca B.R. Jablonski ◽  
Dawn Thilmany
Keyword(s):  
Case Studies ◽  
Value Chain ◽  
Design Methodology ◽  
Meta Analysis ◽  
Lessons Learned ◽  
Value Chains ◽  
The Impact ◽  
Food Value ◽  
Study Development

Purpose A body of literature and case studies has developed as part of the reporting, outreach and evaluation of the local and regional food system projects supported by grants and other funders. Yet, there is concern that food value chains are promoted without adequately evaluating the viability of these businesses, or how these markets affect the performance and welfare of key stakeholders: farm vendors and local communities/economies. Design/methodology/approach This paper reviews and summarizes a comprehensive set of U.S.-based case studies focused on food value chains. We conduct a meta-analysis to systematically capture what available case study evidence tells us about: 1) trends in the viability of food value chain businesses; 2) the impact of these businesses on participating farm vendors; and, 3) the associated community economic development outcomes (framed in terms of ‘wealth creation’). Findings In addition to sharing findings from the meta-analysis, we demonstrate how the lack of standardized protocols for case study development is a barrier to learning about metric comparisons, best practices, and what impacts these food value chain businesses may have. We conclude with some recommendations of how the field can move forward to evaluate and share lessons learned using more uniform, project-driven case study development. Originality/value This is the first study to conduct a systematic meta-analysis of U.S. food value chain businesses.

Lessons Learned from the PMI Case Study: The Community Perspective

2000 ◽  
Vol 6 (1) ◽  
pp. 54-65 ◽  
Author(s):  
Martha L. Hare ◽  
Carlyn E. Orians ◽  
May G. Kennedy ◽  
Kenneth J. Goodman ◽  
Shyanika Wijesinha ◽  
...  
Keyword(s):  
Young People ◽  
Hiv Prevention ◽  
Prevention Program ◽  
Qualitative Case Study ◽  
Prevention Programs ◽  
Lessons Learned ◽  
Demonstration Project ◽  
Local Site ◽  
Over Time

Individuals from the five sites that participated in the Prevention Marketing Initiative (PMI) Local Site Demonstration Project, an HIV prevention program targeting adolescents, were interviewed in a two-part qualitative case study. This article summarizes lessons learned from 179 community participants on topics ranging from organizing initial planning committees to financially sustaining federal demonstration programs over time. The insights of participants involved in the process may help ensure the success of future Prevention Marketing efforts. Overall, they found the process to be challenging but worthwhile, and felt that the resulting multifaceted HIV prevention programs for young people were successful.

scholarly journals Methodology for integrating artificial intelligence in healthcare systems: learning from COVID-19 to prepare for Disease X

AI and Ethics ◽  
2021 ◽  
Author(s):  
Petar Radanliev ◽  
David De Roure ◽  
Carsten Maple ◽  
Uchenna Ani
Keyword(s):  
Artificial Intelligence ◽  
State Of The Art ◽  
Qualitative Case Study ◽  
Healthcare Systems ◽  
Lessons Learned ◽  
Case Study Method ◽  
Research Problems ◽  
Systems Learning ◽  
Digital Healthcare

AbstractArtificial intelligence and edge devices have been used at an increased rate in managing the COVID-19 pandemic. In this article we review the lessons learned from COVID-19 to postulate possible solutions for a Disease X event. The overall purpose of the study and the research problems investigated is the integration of artificial intelligence function in digital healthcare systems. The basic design of the study includes a systematic state-of-the-art review, followed by an evaluation of different approaches to managing global pandemics. The study design then engages with constructing a new methodology for integrating algorithms in healthcare systems, followed by analysis of the new methodology and a discussion. Action research is applied to review existing state of the art, and a qualitative case study method is used to analyse the knowledge acquired from the COVID-19 pandemic. Major trends found as a result of the study derive from the synthesis of COVID-19 knowledge, presenting new insights in the form of a conceptual methodology—that includes six phases for managing a future Disease X event, resulting with a summary map of various problems, solutions and expected results from integrating functional AI in healthcare systems.

scholarly journals Rooting out Poverty: People, Passion, and Place at Station 20 West

2019 ◽  
Vol 4 (2) ◽  
pp. 95-104
Author(s):  
Lisa Erickson ◽  
Isobel Findlay ◽  
Colleen Christopherson-Cote
Keyword(s):  
Inner City ◽  
Common Good ◽  
Poverty Reduction ◽  
Lessons Learned ◽  
Community Knowledge ◽  
Campus Engagement ◽  
The Common Good ◽  
The Common ◽  
The Impact

This case study summarizes and discusses our project exploring the impact of co-location, connectedness, and community-campus collaboration in addressing the root causes of poverty and our efforts to build capacities in Saskatoon. The site of this study is Station 20 West, a community enterprise centre in the heart of Saskatoon’s inner city that opened in the fall of 2012 as a result of community knowledge, participation, and determination to act for the common good. We share our findings, lessons learned, and project team reflections which underscore the connectedness of poverty reduction and reconciliation, the importance of including those with lived and diverse experience in community-campus engagement (CCE), and the hallmarks of good CCE.

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