scholarly journals Understanding variations and influencing factors on length of stay for T2DM patients based on a multilevel model

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248157
Author(s):  
Wen Liu ◽  
Jingcheng Shi ◽  
Simin He ◽  
Xi Luo ◽  
Weijun Zhong ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Influencing Factors ◽  
Multilevel Model ◽  
Health Resources ◽  
Medical Insurance ◽  
International Classification Of Diseases ◽  
Cluster Effect ◽  
Hospital Level ◽  
Individual Level ◽  
Multi Stage

Aim Shortening the length of stay (LOS) is a potential and sustainable way to relieve the pressure that type 2 diabetes mellitus (T2DM) patients placed on the public health system. Method Multi-stage random sampling was used to obtain qualified hospitals and electronic medical records for patients discharged with T2DM in 2018. A box-cox transformation was adopted to normalize LOS. Multilevel model was used to verify hospital cluster effect on LOS variations and screen potential factors for LOS variations from both individual and hospital levels. Result 50 hospitals and a total of 12,888 T2DM patients were included. Significant differences in LOS variations between hospitals, and a hospital cluster effect on LOS variations (t = 92.188, P<0.001) was detected. The results showed that female patients, patients with new rural cooperative’ medical insurance, hospitals with more beds, and hospitals with faster bed turnovers had shorter LOS. Conversely, elderly patients, patients with urban workers’ medical insurance, patients requiring surgery, patients with the International Classification of Diseases coded complication types E11.1, E11.2, E11.4, E11.5, and other complications cardiovascular diseases, grade III hospitals, hospitals with a lower doctor-to-nurse ratio, and hospitals with more daily visits per doctor had longer LOS. Conclusions The evidence proved that hospital cluster effect on LOS variation did exist. Complications and patients features at individual level, as well as organization and resource characteristics at hospital level, had impacted LOS variations to varying degrees. To shorten LOS and better meet the medical demand for T2DM patients, limited health resources must be allocated and utilized rationally at hospital level, and the patients with the characteristics of longer LOS risk must be identified in time. More influencing factors on LOS variations at different levels are still worth of comprehensive exploration in the future.

scholarly journals Development of the new CPTSD diagnosis for ICD-11

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Andreas Maercker
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
International Classification Of Diseases ◽  
Personality Change ◽  
World Health ◽  
Post Traumatic Stress ◽  
Multi Stage ◽  
Post Traumatic ◽  
Health Organization

Abstract Background The diagnosis of complex post-traumatic stress disorder (CPTSD) was proposed several decades ago by scientist-practitioners, almost parallel to the first description of the diagnosis of post-traumatic stress disorder (PTSD). In the previous International Classification of Diseases, version 10 (ICD-10) issued by the World Health Organization (WHO), this symptom constellation was termed ‘enduring personality change after catastrophic experience’. This diagnosis has not been clinically influential, nor has it been subjected to much research. Thus, in a multi-stage process of ICD-11 development, the diagnosis of CPTSD was developed. Methods This paper provides a review of the historical lines of development that led to the CPTSD diagnosis, as well as the results since the ICD-11 publication in 2018. Results The CPTSD diagnosis comprises the core symptoms of the – newly, narrowly defined – PTSD diagnosis, the three symptom groups of affective, relationship, and self-concept changes. The diagnosis is clinically easy to use in accordance with the WHO development goals for the ICD-11 and has shown good psychodiagnostic properties in various studies, including good discrimination from personality disorder with borderline pattern. Conclusion The scholarly use of the new diagnosis has resulted in an increasing number of published studies on this topic in the diagnostic and therapeutic fields.

scholarly journals A Multilevel Model of Environmentally Specific Social Identity in Predicting Environmental Strategies: Evidence from Technology Manufacturing Businesses

2021 ◽  
Vol 13 (8) ◽  
pp. 4567
Author(s):  
Stanley Y. B. Huang ◽  
Chih-Wen Ting ◽  
Yu-Ming Fei
Keyword(s):  
Transformational Leadership ◽  
Social Identity ◽  
Social Identity Theory ◽  
Multilevel Model ◽  
Hierarchical Linear Model ◽  
Chief Executive ◽  
Individual Level ◽  
Upper Echelons Theory ◽  
Environmental Strategies ◽  
Identity Based

This study proposed a multilevel model of environmentally specific social identity based on upper echelons theory and examined how environmentally specific transformational leadership influenced the environmentally specific social identity of the top management team (TMT), which consequently influenced a corporation’s choices of proactive environmental strategies. Besides, the environmentally specific transformational leadership atmosphere at the TMT level also influenced the environmentally specific social identity atmosphere at the TMT level, which consequently influenced a corporation’s choices of proactive environmental strategies at the same time. In particular, this study proposed a novel concept–environmentally specific social identity based on social identity theory, including environmentally specific self-categorization, environmentally specific affective commitment, environmentally specific self-esteem. This study employed a hierarchical linear model and collected longitudinal data of 210 chief executive officers with their 840 members of TMTs at technology manufacturing businesses of Greater China at three waves over six months to analyze the theoretical model. This study found that individual-level environmentally specific transformational leadership and TMT-level environmentally specific transformational leadership (atmosphere) influenced individual-level environmentally specific social identity and TMT-level environmentally specific social identity (atmosphere), which consequently influenced proactive environmental strategies. These findings provide theoretical insights for the field of sustainable development that can advance the literature on proactive environmental strategies.

scholarly journals Emergence of cultural intelligence and global mindset capital: a multilevel model

2016 ◽  
Vol 24 (2) ◽  
pp. 106-122 ◽  
Author(s):  
Jase R. Ramsey ◽  
Amine Abi Aad ◽  
Chuandi Jiang ◽  
Livia Barakat ◽  
Virginia Drummond
Keyword(s):  
Multilevel Model ◽  
Cultural Intelligence ◽  
The Other ◽  
Global Mindset ◽  
Firm Level ◽  
Content Type ◽  
Individual Level ◽  
Other Hand ◽  
Underlying Mechanisms ◽  
Conceptual Study

Purpose The purpose of this paper is to establish under which conditions researchers should use the constructs cultural intelligence (CQ) and global mindset (GM). The authors further seek to understand the process through which these constructs emerge to a higher level and link unit-level knowledge, skills and abilities (KSAs) capital to pertinent firm-level outcomes. Design/methodology/approach This paper is a conceptual study with a multilevel model. Findings This paper differentiates two similar lines of research occurring concordantly on the CQ and GM constructs. Next, the authors develop a multilevel model to better understand the process through which CQ and GM emerge at higher levels and their underlying mechanisms. Finally, this paper adds meaning to the firm-level KSAs by linking firm-level KSAs capital to pertinent firm-level outcomes. Research limitations/implications The conclusion implies that researchers should use CQ when the context is focused on interpersonal outcomes and GM when focused on strategic outcomes. The multilevel model is a useful tool for scholars to select which rubric to use in future studies that have international managers as the subjects. The authors argue that if the scholar is interested in an individual’s ability to craft policy and implement strategy, then GM may be more parsimonious than CQ. On the other hand, if the focus is on leadership, human resources or any other relationship dependent outcome, then CQ will provide a more robust measure. Practical implications For practitioners, this study provides a useful tool for managers to improve individual-level commitment by selecting and training individuals high in CQ. On the other hand, if the desired outcome is firm-level sales or performance, the focus should be on targeting individuals high in GM. Originality/value This is the first theoretical paper to examine how CQ and GM emerge to the firm level and describe when to use each measure.

Evaluation of health system in Iraq from people's point of view: a comparative study of two different eras

2021 ◽  
Vol 4 (2) ◽  
pp. 380-387
Author(s):  
Saad Ahmed Ali Jadoo ◽  
Adil H. Alhusseiny ◽  
Shukr Mahmood Yaseen ◽  
Mustafa Ali Mustafa Al-Samarrai ◽  
Anmar Shukur Mahmood
Keyword(s):  
Health System ◽  
Health Sector ◽  
Health Resources ◽  
Sampling Technique ◽  
Point Of View ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Current Health ◽  
Multi Stage ◽  
Geographical Regions

Background: Since the 2003 United States–British Coalition military invasion, Iraq has been in a state of continuous deterioration at all levels, including the health sector. This study aimed to elicit the viewpoints of the Iraqi people on the current health system, focusing on many provided health services and assessing whether the public prefers the current health system or that was provided before the invasion. Methods: A cross-sectional survey designed to explore the Iraqi people’s opinions on their health system. A self-administered questionnaire using a multi-stage sampling technique was distributed in five geographical regions in Iraq to collect the data from the head of household between 1st October and 31st of December 2019. Multiple logistic regressions were recruited to determine the significant contributing variables in this study. Results: A total of 365 heads of households (response rate: 71.7%) with the mean age of 48.36 + 11.92 years (ranged 35-78) included in the study. Most of the respondents (61.4%) complained of healthcare inaccessibility, 59.7% believed that health resources were not available, 53.7% claimed a deterioration in the quality of care, and 62.2% believed that the political / media position did not contribute to positive changes during the past two decades. Indeed, most respondents (66.0%) believe that the current healthcare system is worse than before. In the multivariate analysis, there was a statistically significant relationship between the characteristics and opinions of the respondents. Young age group (p = 0.003), men (p = < 0.001), unmarried (p = 0.001), high educated (p = < 0.001), rural resident (p = < 0.001), unemployed (p = 0.003), monthly income of less than USD 400 (p = < 0.001), consider themselves to be unhealthy (p = 0.001),  and those who think that people are unhappy now than two decades ago (p = 0.012) have a more negative opinion of the health system. Conclusions: Most Iraqis surveyed expressed disappointment from the health system after the 2003 US-led invasion. The current health system is faltering at all levels and does not meet the citizens' basic needs. Health Transformation Program (HTP) has become inevitable to develop an accessible, affordable, high-quality, efficient, and effective health system.

Shaping employee green behavior: a multilevel approach with Pygmalion effect

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ziying Mo ◽  
Matthew Tingchi Liu ◽  
Peiguan Wu
Keyword(s):  
Self Efficacy ◽  
Multilevel Model ◽  
Design Methodology ◽  
Study Data ◽  
Content Type ◽  
Individual Level ◽  
Multilevel Theory ◽  
Green Behavior ◽  
Time Lagged ◽  
The Relationship

PurposeThe purpose of this study was to theorize and examine a Pygmalion perspective in how leader and coworker expectations predict in-role and ex-role employee green behavior (EGB).Design/methodology/approachUsing a time-lagged field study, data were collected from a sample of 71 leaders and 340 members to examine the hypothesized relationships with a multilevel model (group level and individual level).FindingsThe results showed that leader green behavior and self-efficacy for EGB (i.e. the Pygmalion process) mediate the relationship between leader expectations and EGB, while self-efficacy mediates the relationship between coworker expectations and EGB. In addition, this study found that the effect of coworker expectations and EGB via self-efficacy is stronger when leaders themselves demonstrate a higher level of green behavior.Originality/valueThis study also aims to provide a multilevel theory and investigates the interplay between multilevel variables in encouraging EGB. It also extends previous EGB literature through investigating a different process (i.e. the Pygmalion process) relating leader expectations for EGB to EGB. Moreover, this study develops implications of Pygmalion process on EGB from theoretical and practical perspectives.

scholarly journals Key Factors Influencing Low-Carbon Behaviors of Staff in Star-Rated Hotels—An Empirical Study of Eastern China

2020 ◽  
Vol 17 (21) ◽  
pp. 8222
Author(s):  
Jie Li ◽  
Peng Mao ◽  
Hui Liu ◽  
Jiawei Wei ◽  
Hongyang Li ◽  
...  
Keyword(s):  
Influencing Factors ◽  
Structural Equation ◽  
Eastern China ◽  
Consumer Attitude ◽  
Low Carbon ◽  
Key Factors ◽  
Factors Affecting ◽  
Individual Level ◽  
Multiple Dimensions ◽  
Perceived Behavior Control

To guide sustainable development in the hospitality industry requires hotel staff engagement, so what causes and how to facilitate the implementation of low-carbon behaviors should be high priorities. However, most prior studies focused on hotel guest behavior or discussed, on an individual level, the psychological aspects of the factors of the low-carbon behavior of either managers or employees. Therefore, this research aims to examine the effect of influencing factors inside and outside of the hotel context on hotel staff’s low-carbon behaviors in star-rated hotels. A set of influencing factors were identified by using literature retrieval, ground theory and in-depth interviews. Structural equation modelling was then applied with 440 valid questionnaires collected from representative star-rated hotels in Eastern China. The results revealed that low-carbon managerial activities, strategic orientation, social norms, and perceived behavior control were four key factors affecting the low-carbon behavior adoption of staff from star-rated hotels. Among them, low-carbon managerial activities were found to be the strongest factor affecting hotel staff’s low-carbon behaviors. Consumer attitude, however, exerted no significant impact. Targeted strategies were finally proposed for the improvement of hotel staff’s low-carbon behavior from the perspectives of hoteliers and governments. This study contributes to the generation mechanism of low-carbon behavior among staff and, in practice, towards behavioral improvement by providing comprehensive insights about the attribution of factors belonging to multiple dimensions related to the low-carbon behavior of staff in the hotel industry.

scholarly journals Workplace team resilience: A systematic review and conceptual development

2020 ◽  
Vol 10 (3-4) ◽  
pp. 169-200 ◽  
Author(s):  
Angelique Hartwig ◽  
Sharon Clarke ◽  
Sheena Johnson ◽  
Sara Willis
Keyword(s):  
Multilevel Model ◽  
Conceptual Development ◽  
Work Teams ◽  
Individual Level ◽  
Team Resilience ◽  
The Face ◽  
Multilevel Perspective ◽  
Personal Resilience ◽  
The Relationship ◽  
Conceptual Nature

Workplace team resilience has been proposed as a potential asset for work teams to maintain performance in the face of adverse events. Nonetheless, the research on team resilience has been conceptually and methodologically inconsistent. Taking a multilevel perspective, we present an integrative review of the workplace team resilience literature to identify the conceptual nature of team resilience and its unique value over and above personal resilience as well as other team concepts. We advance resilience research by providing a new multilevel model of team resilience that offers conceptual clarification regarding the relationship between individual-level and team-level resilience. The results of our review may form the basis for the development of a common operationalization of team resilience, which facilitates new empirical research examining ways that teams can improve their adversity management in the workplace.

scholarly journals The Spatial Correlations of Health Resource Agglomeration Capacities and Their Influencing Factors: Evidence from China

2020 ◽  
Vol 17 (22) ◽  
pp. 8705
Author(s):  
Qingbin Guo ◽  
Kang Luo ◽  
Ruodi Hu
Keyword(s):  
Influencing Factors ◽  
Spillover Effect ◽  
Health Resources ◽  
Eastern Region ◽  
Spatial Network ◽  
Health Resource ◽  
Spatial Correlations ◽  
Entropy Weight ◽  
Entropy Weight Method ◽  
Positive Correlations

We measured the health resource agglomeration capacities of 31 Chinese provinces (or municipalities) in 2004–2018 based on the entropy weight method. Using a modified spatial gravity model, we constructed and analyzed the spatial correlation network of these health resource agglomeration capacities and their influencing factors through social network analysis. We found that: (i) China’s health resource agglomeration capacity had a gradual strengthening trend, with capacity weakening from east to west (strongest in the eastern region, second strongest in the central region, and weakest in the western region). (ii) The spatial network of such capacities became more densely connected, and the network density and level (efficiency) showed an upward (downward) trend. (iii) In terms of centrality, the high-ranking provinces (or municipalities) were Beijing, Shanghai, Jiangsu, Zhejiang, Guangdong, Shandong, Hunan, Hubei, Fujian, Anhui, Jiangxi, and Tianjin, while the low-ranking were Tibet, Qinghai, Gansu, Ningxia, Inner Mongolia, Heilongjiang, Yunnan, Guizhou, Xinjiang, Hainan, Shaanxi, and Shanxi. (iv) Block 1 (eight provinces or municipalities), including Beijing, Tianjin, and Hebei, had a “net spillover” effect in the spatial network of health resource agglomeration capacities; Block 2, (seven provinces or municipalities), including Shanghai, Jiangsu, and Zhejiang, had a “bidirectional spillover” effect in the spatial network; Block 3 (seven provinces or municipalities), including Anhui, Hubei, and Hunan, had a “mediator” effect in the network; and Block 4, (nine provinces or municipalities), including Sichuan, Guizhou, and Tibet, had a “net beneficial” effect in the network. (v) The economic development, urbanization wage, and financial health expenditure levels, and population size had significant positive correlations with the spatial network of health resource agglomeration capacities. Policy recommendations to enhance the radiating role of health resources in core provinces (or municipalities), rationally allocate health resources, and transform ideas to support public health resource services were provided.

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