scholarly journals Responding To Vulnerable Patients With Multimorbidity: An Interprofessional Team Approach

2021 ◽  
Author(s):  
Judith B. Brown ◽  
Sonja M. Reichert ◽  
Pauline Boeckxstaens ◽  
Moira Stewart ◽  
Martin Fortin
Keyword(s):  
Healthcare System ◽  
Decision Makers ◽  
Policy Implications ◽  
Team Approach ◽  
Health Issues ◽  
Complex Needs ◽  
Adoption And Implementation ◽  
Vulnerable Patients ◽  
Contextual Understanding ◽  
New Ideas

Abstract Background People with multimorbidity, who may be more vulnerable, often require care by an interprofessional primary healthcare (PHC) team that can tailor their approach to address the multiple and complex needs of this population. This study explored how the needs of vulnerable patients experiencing multimorbidity receive care by innovative interprofessional PHC teams during a one-hour consultation, outside of usual care. Methods This was a descriptive qualitative study. Forty-eight interviews were conducted with 20 allied healthcare professionals: (e.g., social work, pharmacy); 19 physicians (e.g., psychiatry, internal medicine, family medicine); and 9 decision makers. The thematic analysis was both iterative and interpretative using an individual and team approach to identify the main themes and exemplar quotations for illustration. Results Participants described patients with multimorbidity who were vulnerable as those experiencing major challenges accessing and navigating the healthcare system. Mental health issues were a major contributor to being vulnerable and often linked to common social determinants of health. Cultural factors were identified as potentially causing patients to be vulnerable. Participants articulated how the collaborative nature of the team generated new ideas and facilitated creative recommendations designed to meet the specific needs of each patient. Conclusions This one-time consultation went beyond the assessment of a patient’s multimorbidity by including a psycho-social-contextual understanding of vulnerability within the healthcare system. Findings may have important clinical and policy implications in the adoption and implementation of this approach and further assist vulnerable patients with multimorbidity.

The Role of Psilocybin-Assisted Psychotherapy to Support Patients With Cancer: A Critical Scoping Review of the Research

2021 ◽  
pp. 089801012110390
Author(s):  
Rebecca H. Lehto ◽  
Megan Miller ◽  
Jessica Sender
Keyword(s):  
Mental Health ◽  
Health Issues ◽  
Mushroom Species ◽  
Patients With Cancer ◽  
Existential Suffering ◽  
Vulnerable Patients ◽  
Scoping Literature Review ◽  
Life Threatening ◽  
Self Transcendence

Treatments for addressing psychiatric mental health issues in vulnerable patients with cancer are established. Yet, many patients persist with unrelenting psychological difficulties despite intervention. There is growing interest in the role of psilocybin-assisted psychotherapy for managing treatment-resistant mental health challenges in patients with cancer. Psilocybin is a naturally occurring compound derived from certain mushroom species that can induce entheogenic experiences or an altered state of consciousness. Reed's Self-Transcendence Theory provides a holistic lens to examine existential concerns and mental health in individuals who perceive their illness as potentially life threatening, such as those with cancer. This scoping literature review used Arksey and O’Malley's template to evaluate research examining psilocybin-assisted psychotherapy for patients with cancer. Eight articles met inclusion/exclusion criteria (four quantitative, two mixed methods, and two qualitative). Review findings indicated that the majority of patient experiences were positive, centering on themes of death acceptance, reflection, and broadened spirituality. Although psilocybin-assisted psychotherapy is in early stages of clinical testing, it thus shows promise for carefully screened patients with cancer who have persistent existential suffering. It will be critical for investigators to tailor this emerging intervention to select patients and for clinicians to be engaged in assessment of outcomes and efficacy.

scholarly journals Duration of low-wage employment: a study based on a survival model

2018 ◽  
Vol 45 (2) ◽  
pp. 286-299
Author(s):  
Francisco Silva ◽  
José Vieira ◽  
António Pimenta ◽  
João Teixeira
Keyword(s):  
Survival Analysis ◽  
Training Programs ◽  
Decision Makers ◽  
Policy Implications ◽  
Asian Origin ◽  
Content Type ◽  
Level Of Education ◽  
Industry Affiliation ◽  
The Individual ◽  
Low Pay

Purpose The purpose of this paper is to investigate low-wage retention using a survival analysis approach. Design/methodology/approach Variables explaining low-wage retention take into account the characteristics of the employee, such as education, age, tenure with the company, gender and nationality, and the characteristics of the job and the company such as industry affiliation, number of employees, age of the company and location. Findings Female workers and workers with low level of education, older ones, those with more seniority in the company and those of Asian origin remain longer in a low-wage situation. Also, workers in smaller and older companies located outside the Lisbon region are more likely to stay in a low-wage situation. Practical implications The policy implications are clear. Education plays a prominent role: the higher the level of education of the individual, the higher the probability of him/her leaving low pay. Training programs may help employees in Portugal to leave the low-wage situation. Furthermore, policies must address the different mobility rates of different nationalities and different activities. Training programs are more urgent for hotels and restaurants and transports and communication. The findings also indicate that those initially working in younger firms and larger firms have a higher probability of leaving the low-wage situation. This is a stimulus for decision makers to stimulate employment in the younger firms or in the larger firms. Originality/value Despite low-wage retention being a well-known field of research, to our knowledge this is the first research paper using survival analysis to explain the duration of a low-wage situation.

HARNESSING HEURISTICS FOR ECONOMIC POLICY

2018 ◽  
Vol 34 (2) ◽  
pp. 135-163
Author(s):  
Ramzi Mabsout ◽  
Jana G. Mourad
Keyword(s):  
Economic Policy ◽  
21St Century ◽  
Decision Makers ◽  
Policy Implications ◽  
Evidence Based ◽  
Fast And Frugal Heuristics ◽  
Changing Environments ◽  
Effective Decision ◽  
Biases And Heuristics ◽  
Behavioural Sciences

Abstract:The effectiveness of heuristics has received contradicting interpretations in the behavioural sciences. We study the policy implications of two programmes that dispute the effectiveness of heuristics – the biases and heuristics and the fast and frugal heuristics programmes. While the first blames heuristics for most errors in judgement, the second posits heuristics as simple mental algorithms that work well in a range of environments. We argue that the fast and frugal programme is less paternalistic insofar as it models humans as effective decision-makers in a range of environments. However, in the rapidly changing environments of the 21st century, both are needed to inform evidence-based policies.

Policymaking to Enhance Customer Loyalty by E-CRM

2019 ◽  
pp. 135-159
Author(s):  
Maysam Saifi
Keyword(s):  
System Dynamics ◽  
Customer Loyalty ◽  
Dynamic Models ◽  
Banking Industry ◽  
Relationship Management ◽  
Decision Makers ◽  
Policy Implications ◽  
Customer Relationship ◽  
Causal Loop ◽  
Major Decision

This chapter is about using the methodology of system dynamics for the analysis of the effect of electronic customer relationship management (e-CRM) on customer loyalty in the banking industry. For this purpose, after reviewing the existing theoretical literature, a research model including factors describing e-CRM in the bank based on the system dynamics approach is determined. Afterward, according to views of two major decision makers of one of the branches of the Iranian Tejarat Bank, causal loop diagrams and dynamic models of the system are defined that make it possible to describe trends of the past, present, and future of the e-CRM and customer loyalty in the bank. After verifying the validity of the model with the test of model structure, the test of model behavior, and test of policy implications, policies are described and explained.

Enhancing Student Involvement in a Technologically Connected World

2020 ◽  
pp. 17-34
Author(s):  
Joyce B. Boone
Keyword(s):  
Online Learning ◽  
Online Education ◽  
Student Involvement ◽  
Decision Makers ◽  
Transactional Distance ◽  
Political Climate ◽  
Theoretical Perspectives ◽  
Educational Environments ◽  
New Ideas ◽  
Education Administrators

In the multi-faceted domain of adult online education, administrators, researchers, and practitioners have an opportunity to assist adults who bring unique experiences, talents, challenges, and needs to the online learning environment. The purpose of this chapter is to refresh the reader's awareness about two theories: student involvement and transactional distance. It is the hope of the author that a heightened understanding of these theories will spark new ideas, research, and practices, facilitating successful outcomes. Taken individually or paired as theoretical or conceptual frameworks, these theories are seminal to both adult and distance education domains. Researchers, decision-makers, and practitioners are encouraged to objectively observe their educational environments through the lenses of these two theoretical perspectives and consider what is working and what is not working in the context of today's rapidly changing cultural, socio-political climate.

Key Considerations for the Adoption and Implementation of Knowledge Management in Healthcare Operations

2010 ◽  
pp. 125-142 ◽  
Author(s):  
Nilmini Wickramasinghe ◽  
Elie Geisler
Keyword(s):  
Knowledge Management ◽  
Healthcare System ◽  
Healthcare Costs ◽  
Cost Effective ◽  
Healthcare Setting ◽  
Healthcare Systems ◽  
Healthcare Operations ◽  
Healthcare Settings ◽  
Adoption And Implementation ◽  
The U.S

The importance of knowledge management (KM) to organizations in today’s competitive environment is being recognized as paramount and significant. This is particularly evident for healthcare both globally and in the U.S. The U.S. healthcare system is facing numerous challenges in trying to deliver cost effective, high quality treatments and is turning to KM techniques and technologies for solutions in an attempt to achieve this goal. While the challenges facing the U.S. healthcare are not dissimilar to those facing healthcare systems in other nations, the U.S. healthcare system leads the field with healthcare costs more than 15% of GDP and rising exponentially. What is becoming of particular interest when trying to find a solution is the adoption and implementation of KM and associated KM technologies in the healthcare setting, an arena that has to date been notoriously slow to adopt technologies and new approaches for the practice management side of healthcare. We examine this issue by studying the barriers encountered in the adoption and implementation of specific KM technologies in healthcare settings. We then develop a model based on empirical data and using this model draw some conclusions and implications for orthopaedics.

scholarly journals Young health leaders shape their future policies

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
K Gatialová
Keyword(s):  
Health Policy ◽  
European Commission ◽  
Decision Makers ◽  
Health Policies ◽  
Policy Recommendations ◽  
Health Issues ◽  
Next Generation ◽  
Young Professionals ◽  
European Health

Abstract The European Health Parliament (EHP) is a movement connecting and empowering the next generation of European health leaders to rethink EU health policies. The initiative connects promising young professionals and challenges them to develop solutions for European health policy that are both innovative and actionable. The EHP answers Europe’s need for fresh ideas in health and believes that the solutions required must come from young European health leaders who influence the policies that will ultimately concern their generation as they become senior decision-makers. Participants work together for six months to develop policy recommendations that address today’s most pressing European health issues which are picked in cooperation with the European Commission.

scholarly journals Built Environment Correlates of the Propensity of Walking and Cycling

2020 ◽  
Vol 12 (20) ◽  
pp. 8752
Author(s):  
Longzhu Xiao ◽  
Linchuan Yang ◽  
Jixiang Liu ◽  
Hongtai Yang
Keyword(s):  
Built Environment ◽  
Traffic Congestion ◽  
Central Business District ◽  
Decision Makers ◽  
Policy Implications ◽  
Research Attention ◽  
Bus Stop ◽  
Intersection Density ◽  
Business District ◽  
Public Health Promotion

Walking and cycling are not only frequently-used modes of transport but also popular physical activities. They are beneficial to traffic congestion mitigation, air pollution reduction, and public health promotion. Hence, examining and comparing the built environment correlates of the propensity of walking and cycling is of great interest to urban practitioners and decision-makers and has attracted extensive research attention. However, existing studies mainly look into the two modes separately or consider them as an integral (i.e., active travel), and few compare built environment correlates of their propensity in a single study, especially in the developing world context. Thus, this study, taking Xiamen, China, as a case, examines the built environment correlates of the propensity of walking and cycling simultaneously and compares the results wherever feasible. It found (1) built environment correlates of the propensity of walking and cycling differ with each other largely in direction and magnitude; (2) land use mix, intersection density, and bus stop density are positively associated with walking propensity, while the distance to the CBD (Central Business District) is a negative correlate; (3) as for cycling propensity, only distance to CBD is a positive correlate, and job density, intersection density, and bus stop density are all negative correlates. The findings of this study have rich policy implications for walking and cycling promotion interventions.

Person-centered medicine from a complex adaptive systems perspective

2014 ◽  
Vol 2 (1) ◽  
pp. 85 ◽  
Author(s):  
Joachim Sturmberg
Keyword(s):  
Medical Care ◽  
Healthcare System ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Health Issues ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Health And Illness ◽  
Complex Adaptive ◽  
Illness And Disease

Miles and Mezzich have proposed person-centered medicine as the way forward to overcome the rapidly escalating crisis of dehuminisation of medical care and the healthcare system at large. The crisis in medical care is caused by a Zeitgeist characterised by 2 themes – conquering disease and profit maximising activities. Overcoming this crisis requires a change of the prevailing worldview and its reductionist thinking about discrete diseases to a worldview that recognises the complexities arising from the interconnections and interdependencies between all facets of a person’s life – his health and illness and disease trajectories. As Kant said: each man has his particular way of being in good health.This paper presents 5 themes that argue for a complexity based framework to achieve a person/patient-centered understanding of health and healthcare: (1) health, illness and disease are complex adaptive states that impact personhood; (2) healthcare must grow health; (3) healing results from personal sense-making and must be fostered; (4) complex adaptive systems thinking allows an exploration and understanding of personal and community health issues and (5) person/patient-centeredness results in an effective and efficient healthcare system.A person/patient-centered focus, the person/patient at the centre of concern, will result in a seamlessly integrated healthcare system. Such a system will show great diversity between communities, each having emerged as a result of best adaptation to local circumstances. Such a system will have substantial benefits – for the person (in terms of staying healthy) / patient (in terms of regaining his health), the community and the economy.

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