scholarly journals Health System Strengthening Using Problem Solving for Better Health in Lesotho

2021 ◽  
Author(s):  
Grace Hyojung Yoon ◽  
Shannon N Ogden ◽  
Elizabeth Limakatso Nkabane-Nkholongo ◽  
Mantoetse Jobo ◽  
Chelsea M McGuire ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Problem Solving ◽  
Structured Interview ◽  
Health System Strengthening ◽  
Matrix Analysis ◽  
Ripple Effect ◽  
Healthcare Facilities ◽  
National Quality ◽  
Administrative Leaders ◽  
The Impact

Abstract Background Problem Solving for Better Health ® (PSBH ® ) is a system-strengthening workshop designed to empower healthcare workers (HCWs) to solve problems. We report on the perspectives of HCWs trained in PSBH to better understand the impact and challenges of PSBH in Lesotho, a country with among the highest prevalence of HIV and tuberculosis in the world.Methods HCWs who attended PSBH workshops in 2018 – 2019 were interviewed using a semi-structured interview guide developed from a hybrid conceptual framework that captured the HCWs’ personal, interpersonal, and systemic levels of experience. Interviews were transcribed and analyzed using the framework matrix analysis method using NVivo. Results We interviewed 22 of the 86 HCWs who participated in PSBH workshops in 2018-2019. Twenty out of 22 interview participants reported that they initiated a project that was planned during the PSBH workshop. Participants reported that PSBH provided them with a new way of viewing, addressing, and solving everyday problems that can have a tangible impact on the function of healthcare facilities and the health of the community. Trainees were motivated to see the impact of their work in their jobs and in the work of subordinates as a sustained ripple effect favoring quality improvement. Participants suggested that training of district administrative leaders in PSBH would facilitate successful dissemination and help overcome the challenge of adding more work for the already-overburdened HCWs.Conclusions HCWs in Lesotho report that PSBH assists them in solving problems in their everyday work. This led the national Ministry of Health Quality Assurance Unit to request that PSBH workshops be conducted to train Ministry personnel to allow them to oversee national dissemination of PSBH, thereby fulfilling a component of the National Quality Assurance Strategic Objectives.

scholarly journals Evolution of quality culture in an HEI: critical insights from university staff in Bangladesh

2020 ◽  
Vol 32 (1) ◽  
pp. 53-81 ◽  
Author(s):  
Naureen Rahnuma
Keyword(s):  
Higher Education ◽  
Quality Assurance ◽  
Teaching And Learning ◽  
Evaluation Process ◽  
Internal Quality ◽  
Quality Culture ◽  
National Quality ◽  
Administrative Leaders ◽  
Framework Document ◽  
Western Perspective

AbstractThis paper evaluates experiences of quality culture as actualized by academic and administrative leaders in a nonprofit, private Bangladeshi university, ensuing the recent implementation of a state-stipulated national quality framework. Based on the data derived from ten interviews integrated with the Quality Assurance Framework document objectives, the purpose of this paper is to gain critical insight on what is working and what might need changing or developing in the future to support quality culture at higher education institutions. The article translates the key themes and elements of the evaluation process into a logic model to show the processes and structures through which the university can support the development of its internal quality culture. It offers a focused pathway for quality assurance activities, crucial in reinforcing and strengthening a culture of quality in Bangladeshi universities. As such, the paper seeks to make a contribution to Bangladesh’s higher education by providing a broad, evaluative insight into the preparedness and receptivity of the institutions to integrate sustainability into their teaching and learning as guided by the new quality assurance framework, mindful of the imperatives for quality assurance and enhancement coming mainly from the Western perspective, hence placing its development in the regional, and then global, context.

Voices of Distress: The Emotional Peril of Not Attaining a Dietetic Internship in Ontario

2013 ◽  
Vol 1 (3) ◽  
pp. 9
Author(s):  
Jennifer Lee Brady ◽  
Annie Hoang ◽  
Olivia Siswanto ◽  
Jordana Riesel ◽  
Jacqui Gingras
Keyword(s):  
Empirical Research ◽  
Current Model ◽  
Well Being ◽  
Structured Interview ◽  
Application Process ◽  
Dietetic Education ◽  
Dietetic Internship ◽  
The Impact ◽  
And Training ◽  
Future Growth

Obtaining dietetic licensure in Ontario requires completion of a Dietitians of Canada (DC) accredited four-year undergraduate degree in nutrition and an accredited post-graduate internship or combined Master’s degree program. Given the scarcity of internship positions in Ontario, each year approximately two-thirds of the eligible applicants who apply do not receive a position XX, XX, XX, XX, XX, XX, in press). Anecdotally, not securing an internship position is known to be a particularly disconcerting experience that has significant consequences for individuals’ personal, financial, and professional well-being. However, no known empirical research has yet explored students’ experiences of being unsuccessful in applying for internship positions. Fifteen individuals who applied between 2005 and 2009 to an Ontario-based dietetic internship program, but were unsuccessful at least once, participated in a one-on-one semi-structured interview. Findings reveal that participants’ experiences unfold successively in four phases that are characterized by increasingly heightened emotional peril: naïveté, competition, devastation, and frustration. The authors conclude that the current model of dietetic education and training in Ontario causes lasting distress to students and hinders the future growth and vitality of the dietetic profession. Further research is required to understand the impact of the current model on dietetic educators, internship coordinators, and preceptors as coincident participants in the internship application process.

The Impact of Visual Thinking Approach to Promote Elementary Students’ Problem Solving Skill in Mathemathics

2018 ◽  
Vol 1 (2) ◽  
pp. 98
Author(s):  
Muhammad Fendrik ◽  
Elvina Elvina
Keyword(s):  
Elementary Schools ◽  
Problem Solving ◽  
Elementary Students ◽  
Visual Learning ◽  
Control Group ◽  
Visual Thinking ◽  
Quasi Experimental ◽  
Student Skill ◽  
Mathematical Skill ◽  
The Impact

This study aims to examine the influence of visual thinking learning to problemsolving skill. Quasi experiments with the design of this non-equivalent controlgroup involved Grade V students in one of the Elementary Schools. The design ofthis study was quasi experimental nonequivalent control group, the researchbullet used the existing class. The results of research are: 1) improvement ofproblem soving skill. The learning did not differ significantly between studentswho received conventional learning. 2) there is no interaction between learning(visual thinking and traditional) with students' mathematical skill (upper, middleand lower) on the improvement of skill. 3) there is a difference in the skill oflanguage learning that is being constructed with visual learning of thought interms of student skill (top, middle and bottom).

HOME VISITS DURING THE FIRST MONTH OF DELIVERY FOR RECENTLY DELIVERED WOMEN IN UTTAR PRADESH, INDIA

2020 ◽  
Vol 6 (5) ◽  
pp. 1183-1189
Author(s):  
Dr. Tridibesh Tripathy ◽  
Dr. Umakant Prusty ◽  
Dr. Chintamani Nayak ◽  
Dr. Rakesh Dwivedi ◽  
Dr. Mohini Gautam
Keyword(s):  
Large Scale ◽  
National Level ◽  
Uttar Pradesh ◽  
Life Time ◽  
Structured Interview ◽  
The Other ◽  
Registration System ◽  
Action Group ◽  
Current Article ◽  
The Impact

The current article of Uttar Pradesh (UP) is about the ASHAs who are the daughters-in-law of a family that resides in the same community that they serve as the grassroots health worker since 2005 when the NRHM was introduced in the Empowered Action Group (EAG) states. UP is one such Empowered Action Group (EAG) state. The current study explores the actual responses of Recently Delivered Women (RDW) on their visits during the first month of their recent delivery. From the catchment area of each of the 250 ASHAs, two RDWs were selected who had a child in the age group of 3 to 6 months during the survey. The response profiles of the RDWs on the post- delivery first month visits are dwelled upon to evolve a picture representing the entire state of UP. The relevance of the study assumes significance as detailed data on the modalities of postnatal visits are available but not exclusively for the first month period of their recent delivery. The details of the post-delivery first month period related visits are not available even in large scale surveys like National Family Health Survey 4 done in 2015-16. The current study gives an insight in to these visits with a five-point approach i.e. type of personnel doing the visit, frequency of the visits, visits done in a particular week from among those four weeks separately for the three visits separately. The current study is basically regarding the summary of this Penta approach for the post- delivery one-month period.     The first month period after each delivery deals with 70% of the time of the postnatal period & the entire neonatal period. Therefore, it does impact the Maternal Mortality Rate & Ratio (MMR) & the Neonatal Mortality Rates (NMR) in India and especially in UP through the unsafe Maternal & Neonatal practices in the first month period after delivery. The current MM Rate of UP is 20.1 & MM Ratio is 216 whereas the MM ratio is 122 in India (SRS, 2019). The Sample Registration System (SRS) report also mentions that the Life Time Risk (LTR) of a woman in pregnancy is 0.7% which is the highest in the nation (SRS, 2019). This means it is very risky to give birth in UP in comparison to other regions in the country (SRS, 2019). This risk is at the peak in the first month period after each delivery. Similarly, the current NMR in India is 23 per 1000 livebirths (UNIGME,2018). As NMR data is not available separately for states, the national level data also hold good for the states and that’s how for the state of UP as well. These mortalities are the impact indicators and such indicators can be reduced through long drawn processes that includes effective and timely visits to RDWs especially in the first month period after delivery. This would help in making their post-natal & neonatal stage safe. This is the area of post-delivery first month visit profile detailing that the current article helps in popping out in relation to the recent delivery of the respondents.   A total of four districts of Uttar Pradesh were selected purposively for the study and the data collection was conducted in the villages of the respective districts with the help of a pre-tested structured interview schedule with both close-ended and open-ended questions.  The current article deals with five close ended questions with options, two for the type of personnel & frequency while the other three are for each of the three visits in the first month after the recent delivery of respondents. In addition, in-depth interviews were also conducted amongst the RDWs and a total 500 respondents had participated in the study.   Among the districts related to this article, the results showed that ASHA was the type of personnel who did the majority of visits in all the four districts. On the other hand, 25-40% of RDWs in all the 4 districts replied that they did not receive any visit within the first month of their recent delivery. Regarding frequency, most of the RDWs in all the 4 districts received 1-2 times visits by ASHAs.   Regarding the first visit, it was found that the ASHAs of Barabanki and Gonda visited less percentage of RDWs in the first week after delivery. Similarly, the second visit revealed that about 1.2% RDWs in Banda district could not recall about the visit. Further on the second visit, the RDWs responded that most of them in 3 districts except Gonda district did receive the second postnatal visit in 7-15 days after their recent delivery. Less than half of RDWs in Barabanki district & just more than half of RDWs in Gonda district received the third visit in 15-21 days period after delivery. For the same period, the majority of RDWs in the rest two districts responded that they had been entertained through a home visit.

ANAAC AND HIGHER EDUCATION IN, INDIA

2018 ◽  
Vol 6 (26) ◽  
Author(s):  
Seema Singh
Keyword(s):  
Higher Education ◽  
Quality Assurance ◽  
Manufacturing Industry ◽  
Practical Experience ◽  
Individual Autonomy ◽  
Economic Activities ◽  
Quality Of Higher Education ◽  
National Quality ◽  
Education In India

Quality, as we know so far, was originally developed in the manufacturing industry. In the area of higher education, the adoption of quality control has been superficial and diluted by the exercise of academic . Further, the prevailing culture of universities is often based on individual autonomy, which is zealously guarded. Thus, it is usually difficult to apply the features of quality to higher education considering the fact that quality requires. However, the quality of higher education is very important for its stakeholders. Notably, providers (funding bodies and the community at large), students, staff and employers of graduates are. The most commonly grouped dimensions of quality are product, software and service. In the changing context marked by expansion of higher education and globalization of economic activities, education has become a national concern with an international dimension. To cope with this changing context, countries have been pressurized to ensure and assure quality of higher education at a nationally comparable and internationally acceptable standard. Consequently, many countries initiated “national quality assurance mechanisms” and many more are in the process of evolving a suitable strategy. Most of the quality assurance bodies were established in the nineties and after a few years of practical experience, they are rethinking many issues of quality assurance. At this juncture where countries look for experiences and practices elsewhere, the experience of India has many valuable lessons and this report is an attempt to share those developments..

scholarly journals National Colorectal Cancer Screening Program in Lithuania: Description of the 5-Year Performance on Population Level

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1129
Author(s):  
Audrius Dulskas ◽  
Tomas Poskus ◽  
Inga Kildusiene ◽  
Ausvydas Patasius ◽  
Rokas Stulpinas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Quality Assurance ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Program ◽  
Histopathological Examination ◽  
Insurance Fund ◽  
Crc Screening ◽  
Cancer Screening Program ◽  
The Impact

We aimed to report the results of the implementation of the National Colorectal Cancer (CRC) Screening Program covering all the country. The National Health Insurance Fund (NHIF) reimburses the institutions for performing each service; each procedure within the program has its own administrative code. Information about services provided within the program was retrieved from the database of NHIF starting from the 1 January 2014 to the 31 December 2018. Exact date and type of all provided services, test results, date and results of biopsy and histopathological examination were extracted together with the vital status at the end of follow-up, date of death and date of emigration when applicable for all men and women born between 1935 and 1968. Results were compared with the guidelines of the European Union for quality assurance in CRC screening and diagnosis. The screening uptake was 49.5% (754,061 patients) during study period. Participation rate varied from 16% to 18.1% per year and was higher among women than among men. Proportion of test-positive and test-negative results was similar during all the study period—8.7% and 91.3% annually. Between 9.2% and 13.5% of test-positive patients received a biopsy of which 52.3–61.8% were positive for colorectal adenoma and 4.6–7.3% for colorectal carcinoma. CRC detection rate among test-positive individuals varied between 0.93% and 1.28%. The colorectal cancer screening program in Lithuania coverage must be improved. A screening database is needed to systematically evaluate the impact and performance of the national CRC screening program and quality assurance within the program.

scholarly journals Cosmological model parameter dependence of the matter power spectrum covariance from the DEUS-PUR Cosmo simulations

2020 ◽  
Vol 500 (2) ◽  
pp. 2532-2542
Author(s):  
Linda Blot ◽  
Pier-Stefano Corasaniti ◽  
Yann Rasera ◽  
Shankar Agarwal
Keyword(s):  
Dark Energy ◽  
Power Spectrum ◽  
Cold Dark Matter ◽  
Matter Density ◽  
Density Fluctuations ◽  
Matrix Analysis ◽  
Model Parameter ◽  
Matter Power Spectrum ◽  
Non Gaussian ◽  
The Impact

ABSTRACT Future galaxy surveys will provide accurate measurements of the matter power spectrum across an unprecedented range of scales and redshifts. The analysis of these data will require one to accurately model the imprint of non-linearities of the matter density field. In particular, these induce a non-Gaussian contribution to the data covariance that needs to be properly taken into account to realize unbiased cosmological parameter inference analyses. Here, we study the cosmological dependence of the matter power spectrum covariance using a dedicated suite of N-body simulations, the Dark Energy Universe Simulation–Parallel Universe Runs (DEUS-PUR) Cosmo. These consist of 512 realizations for 10 different cosmologies where we vary the matter density Ωm, the amplitude of density fluctuations σ8, the reduced Hubble parameter h, and a constant dark energy equation of state w by approximately $10{{\ \rm per\ cent}}$. We use these data to evaluate the first and second derivatives of the power spectrum covariance with respect to a fiducial Λ-cold dark matter cosmology. We find that the variations can be as large as $150{{\ \rm per\ cent}}$ depending on the scale, redshift, and model parameter considered. By performing a Fisher matrix analysis we explore the impact of different choices in modelling the cosmological dependence of the covariance. Our results suggest that fixing the covariance to a fiducial cosmology can significantly affect the recovered parameter errors and that modelling the cosmological dependence of the variance while keeping the correlation coefficient fixed can alleviate the impact of this effect.

scholarly journals Quality assurance of radiotherapy in the ongoing EORTC 1420 “Best of” trial for early stage oropharyngeal, supraglottic and hypopharyngeal carcinoma: results of the benchmark case procedure

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
J-J Stelmes ◽  
E. Vu ◽  
V. Grégoire ◽  
C. Simon ◽  
E. Clementel ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Early Stage ◽  
Prospective Trial ◽  
Similarity Index ◽  
Phase Iii ◽  
Current Phase ◽  
Hypopharyngeal Carcinoma ◽  
Transoral Surgery ◽  
Swallowing Function ◽  
The Impact

Abstract Introduction The current phase III EORTC 1420 Best-of trial (NCT02984410) compares the swallowing function after transoral surgery versus intensity modulated radiotherapy (RT) in patients with early-stage carcinoma of the oropharynx, supraglottis and hypopharynx. We report the analysis of the Benchmark Case (BC) procedures before patient recruitment with special attention to dysphagia/aspiration related structures (DARS). Materials and methods Submitted RT volumes and plans from participating centers were analyzed and compared against the gold-standard expert delineations and dose distributions. Descriptive analysis of protocol deviations was conducted. Mean Sorensen-Dice similarity index (mDSI) and Hausdorff distance (mHD) were applied to evaluate the inter-observer variability (IOV). Results 65% (23/35) of the institutions needed more than one submission to achieve Quality assurance (RTQA) clearance. OAR volume delineations were the cause for rejection in 53% (40/76) of cases. IOV could be improved in 5 out of 12 OARs by more than 10 mm after resubmission (mHD). Despite this, final IOV for critical OARs in delineation remained significant among DARS by choosing an aleatory threshold of 0.7 (mDSI) and 15 mm (mHD). Conclusions This is to our knowledge the largest BC analysis among Head and neck RTQA programs performed in the framework of a prospective trial. Benchmarking identified non-common OARs and target delineations errors as the main source of deviations and IOV could be reduced in a significant number of cases after this process. Due to the substantial resources involved with benchmarking, future benchmark analyses should assess fully the impact on patients’ clinical outcome.

scholarly journals Measuring capability wellbeing in adults at different stages of life for use in economic evaluation of health and care interventions: a qualitative investigation in people requiring kidney care

2021 ◽  
Author(s):  
Paul Mark Mitchell ◽  
Samantha Husbands ◽  
Sabina Sanghera ◽  
Fergus John Caskey ◽  
Jemima Scott ◽  
...  
Keyword(s):  
Life Stage ◽  
Structured Interview ◽  
Health Conditions ◽  
Economic Evaluations ◽  
Qualitative Investigation ◽  
Key Factors ◽  
Younger Adults ◽  
Patient Groups ◽  
The Life Course ◽  
The Impact

Abstract Purpose Capability wellbeing measures, such as the ICECAP measures, have been proposed for use in economic evaluations to capture broader outcomes of health and care interventions. The ICECAP measures have been developed to reflect capabilities at different stages of life. Some patient groups include patients of different ages and at different stages of life, so it is not always apparent which ICECAP measure is most relevant. This study explores the impact of age and life stage on completion, where both ICECAP-A and ICECAP-O were completed by the same patient. Methods A think-aloud study, and an associated semi-structured interview were conducted with people receiving kidney care as a renal outpatient, kidney transplant outpatient, or through receiving facility-based haemodialysis. Qualitative analysis focused on (1) differences in responses across measures by individuals, where attributes had conceptual overlap, (2) key factors in self-reported capability levels, and (3) measure preference. Results Thirty participants were included in the study, with a mix of older and younger adults. Attributes with similar wording across measures produced similar responses compared to attributes where wording differed. Age and health were key factors for self-reported capability levels. ICECAP-A was slightly preferred overall, including by older adults. Conclusion This study suggests use of ICECAP-A in patients with certain chronic health conditions that include a mix of adults across the life course. This study highlights the importance of considering the stage of life when using capability measures and in economic evaluations of health and care interventions more generally.

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