scholarly journals Improving methadone access for rural communities in the USA: lessons learned from COVID-19 adaptations and international models of care

2021 ◽  
Author(s):  
Lister ◽  
Lister
Keyword(s):  
Rural Communities ◽  
Models Of Care ◽  
Lessons Learned ◽  
The Usa

scholarly journals Conceptualization and Realization of a National Trail in a Small Island-Nation: The Commonwealth of Dominica’s Experience

2021 ◽  
Vol 2 (1) ◽  
pp. 79-94
Author(s):  
Colmore S. Christian
Keyword(s):  
Rural Communities ◽  
Socioeconomic Development ◽  
Research Question ◽  
Strong Support ◽  
Lessons Learned ◽  
Small Island ◽  
Implementation Challenges ◽  
Face To Face ◽  
Research Themes ◽  
Socioeconomic Benefits

The island-nation of Dominica, 790 km2 in area, is located approximately 1126.5 km Southeast of Florida, USA. In the mid-1990s, Dominica embarked on developing the 183.5 km Waitukubuli National Trail (WNT), the first and only national trail model in the Eastern Caribbean. The 14-segment WNT, officially opened in May 2013, passes through some of the island’s most diverse landscapes. WNT was designed to link as many rural communities as possible and promote ecotourism and community socioeconomic development. Rehabilitation work continues on the WNT and the rest of Dominica, following the devastation caused by Hurricane Maria of 2017. This article, based primarily on a limited questionnaire survey, selected interviews, and literature review, explored the research question ‘What were the challenges faced by a small-island nation in the development of a National Trail? Five specific research objectives focused on the conceptualization, implementation challenges, partnerships fostered, national and sub-regional significance, and future outlook of the Trail were considered. Questionnaire respondents identified the island’s topography and negotiations with private landowners as significant trail construction challenges. A 100% of survey respondents anticipate that reliable funding to support timely maintenance would likely be a critical future issue. Some respondents identified marketing, public engagement, and visitor safety as potential issues. Face-to-face interviews found strong support for the WNT. The interviewees were confident that Dominica would realize sustainable socioeconomic benefits from the Trail. The article concludes with lessons learned and proposes strategies and research themes to ensure the Trail’s sustainability.

Reflecting or ruminating: listening to the regrets of life science leaders

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Helen Mary Meldrum
Keyword(s):  
Chief Executive Officers ◽  
Life Science ◽  
Negative Emotion ◽  
Chief Executive ◽  
Positive Influence ◽  
Lessons Learned ◽  
Business Leaders ◽  
Content Type ◽  
The Usa ◽  
Executive Officers

PurposeThe overwhelming frequency of failure in trying to bring a safe and effective biotech, pharmaceutical or medical device product to market is truly astounding. This research synthesizes industry leaders' insights on lessons learned from reflecting on professional disappointments.Design/methodology/approachThis research used a qualitative approach to learning from the Chief Executive Officers (CEOs), Chief Scientific Officers (CSOs) and Chief Medical Officers (CMOs) of the most successful life science firms in the USA. A total of 45 industry leaders were interviewed regarding their lingering regrets about their career misadventures.FindingsRegrets were unavoidable because there were opportunity costs for every choice each leader made. Commentary about wisdom gained comprised themes regarding valuable time lost, strategies that could have been enacted, products that failed and essential personnel who were not managed optimally. Contrary to expectations, there was little mention of money that was squandered.Originality/valueNot felt as a solely negative emotion, regrets were recognized by these leaders as a potentially positive influence on their future decisions. Not felt as a solely negative emotion, regret was recognized by these leaders as a potentially positive influence on their future decisions. This exploratory study suggests that learning from retrospective and anticipated regrets benefits life science leaders in gaining clarity of thought regarding their current business challenges. Because prior research on the value of psychological regrets has mostly relied on limited samples, this inquiry contributes a new vantage point by examining a unique population of senior business leaders, thus providing broader applicability to the organizational literature.

Managing the Digital Disruption Associated with COVID-19-Driven Rapid Digital Transformation in Brisbane, Australia

2021 ◽  
Vol 12 (05) ◽  
pp. 1135-1143
Author(s):  
Amalie Dyda ◽  
Magid Fahim ◽  
Jon Fraser ◽  
Marianne Kirrane ◽  
Ides Wong ◽  
...  
Keyword(s):  
Care Delivery ◽  
Digital Health ◽  
Clinical Care ◽  
Models Of Care ◽  
Digital Transformation ◽  
Lessons Learned ◽  
Digital Data ◽  
Routine Practice ◽  
Action Research Project ◽  
Digital Disruption

Abstract Background The COVID-19 pandemic has forced rapid digital transformation of many health systems. These innovations are now entering the literature, but there is little focus on the resulting disruption. Objective We describe the implementation of digital innovations during the COVID-19 response of Australia's largest health service, Metro North (in Brisbane, Queensland), the challenges of the subsequent digital disruption, how these were managed, and lessons learned. Methods Prior to the COVID-19 pandemic, the Australian state of Queensland created the Queensland Digital Clinical Charter, which provides guidance for the development of digital health programs. The guidelines utilize three horizons: digitizing workflows, leveraging digital data to transform clinical care, and reimagining new and innovative models of care. The technical response to COVID-19 in Metro North is described across these horizons. The rapid digital response caused significant disruption to health care delivery; management of the disruption and the outcomes are detailed. This is a participatory action research project, with members of the research team assisting with leading the implementation project informing the case report content. Results Several digital innovations were introduced across Metro North during the COVID-19 response. This resulted in significant disruption creating digital hypervigilance, digital deceleration, data discordance, and postdigital “depression.” Successful management of the digital disruption minimized the negative effects of rapid digital transformation, and contributed to the effective management of the pandemic in Queensland. Conclusion The rapid digital transformation in Metro North during COVID-19 was successful in several aspects; however, ongoing challenges remain. These include the need to improve data sharing and increase interoperability. Importantly, the innovations need to be evaluated to ensure that Metro North can capitalize on these changes and incorporate them into long-term routine practice. Moving forward, it will be essential to manage not only the pandemic, but increasingly, the resultant digital disruption.

Implementing a Geohazard Integrity Management Program: Statistics and Lessons Learned Over 15 Years

2014 ◽  
Author(s):  
Alex J. Baumgard ◽  
Tara L. Coultish ◽  
Gerry W. Ferris
Keyword(s):  
Management System ◽  
Management Program ◽  
Lessons Learned ◽  
Proactive Approach ◽  
Oil Pipelines ◽  
Pipeline Networks ◽  
The Usa ◽  
Integrity Management ◽  
Pipeline Failures ◽  
Program Challenges

Over the last 15 years, BGC Engineering Inc. has developed and implemented a geohazards Integrity Management Program (IMP) with 12 major pipeline operators (consisting of gas and oil pipelines and of both gathering and transmission systems). Over this time, the program has been applied to the assessment of approximately 13,500 individual hydrotechnical and geotechnical geohazard sites spanning approximately 63,000 km of operating pipelines in Canada and the USA. Hydrotechnical (watercourse) and geotechnical (slope) hazards are the primary types of geohazards that have directly contributed to pipeline failures in Canada. As with all IMPs, the core objectives of a geohazard management system are to ensure a proactive approach that is repeatable and defensible. In order to meet these objectives, the program allows for varying levels of intensity of inspection and a recommended timescale for completion of actions to manage the identified geohazards in accordance with the degree of hazard that the site poses to the pipeline. In this way, the sites are managed in a proactive manner while remaining flexible to accommodate the most current conditions at each site. This paper will provide a background to the key components of the program related specifically to existing operating pipeline systems, present pertinent statistics on the occurrence of various types of geohazards based on the large dataset of inspections, and discuss some of the lessons learned in the form of program results and program challenges from implementing a geohazard integrity management system for a dozen operators with different ages of systems, complexity of pipeline networks, and in varied geographic settings.

It’s more than money: policy options to secure medical specialist workforce for regional centres

2017 ◽  
Vol 41 (6) ◽  
pp. 698 ◽  
Author(s):  
Jennifer May ◽  
Judi Walker ◽  
Mathew McGrail ◽  
Fran Rolley
Keyword(s):  
Rural Communities ◽  
Local Governments ◽  
Medical Training ◽  
Critical Mass ◽  
Models Of Care ◽  
Hub And Spoke ◽  
Recruitment And Retention ◽  
Modifiable Factors ◽  
State And Local

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of ‘regional’ hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills sets. Workforce policy needs to address modifiable factors with four groups, namely commonwealth and state governments, specialist medical colleges and local communities, all needing to align their activities for achievement of long-term medical workforce outcomes. What are the implications for practitioners? Modifiable factors affecting recruitment and retention must be addressed to support specialist models of care in regional centres. Modifiable factors relate to maintenance of a critical mass of practitioners, training a fit-for-purpose workforce and coordinated effort between stakeholders. Although remuneration is important, the decision to stay relates primarily to non-financial factors.

scholarly journals MIGRACIÓN Y CAMBIO SOCIOCULTURAL EN DOS COMUNIDADES RURALES DEL DEPARTAMENTO DE CHALATENANGO, EL SALVADOR

2013 ◽  
Vol 8 (15) ◽  
pp. 143
Author(s):  
Patricia Castro Fuentes
Keyword(s):  
Rural Communities ◽  
El Salvador ◽  
Everyday Life ◽  
Cultural Dynamics ◽  
Sociocultural Change ◽  
Cultural Hybridization ◽  
The Everyday ◽  
Gender And Migration ◽  
The Usa ◽  
And Migration

Este artículo presenta resultados de la investigación «Género y migración: Recomposición Familiar», que fue llevada a cabo en los municipios de Comalapa y Concepción Quezaltepeque del Departamento de Chalatenango, en El Salvador; cuyo trabajo de campo se realizó entre 2009 y 2010. De esa investigación se ha retomado el análisis del fenómeno migratorio que experimenta El Salvador desde la perspectiva de la hibridación cultural, y se centra en la vida cotidiana de los municipios antes mencionados con la intención de comparar las dinámicas culturales que se establecen en ambos, tomando en cuenta que en el primero las personas migran hacia EUA y en el segundo mayoritariamente a Italia.   MIGRATION AND SOCIOCULTURAL CHANGE IN TWO RURAL COMMUNITIES FROM CHALATENANGO, EL SALVADORABSTRACTThis article presents results from the piece of research titled «Gender and Migration: Family Recomposition.» This study was conducted in the municipalities of Comalapa and Concepción Quezaltepeque in Chalatenango, El Salvador. Fieldwork was carried out between 2009 and 2010. The analysis of the migration phenomenon experienced in El Salvador has been taken from this piece of research. This analysis was made from a cultural hybridization perspective and focuses on the everyday life in the aforementioned municipalities. The intention is to compare the cultural dynamics established between the two, taking into consideration that in the former, people migrate to the USA, whereas in the latter they mostly migrate to Italy.

The African American Tobacco Control Leadership Council: Advocating for a menthol cigarette ban in San Francisco, California

2021 ◽  
pp. tobaccocontrol-2020-056215
Author(s):  
Sarah D Mills ◽  
Carol O McGruder ◽  
Valerie B Yerger
Keyword(s):  
African American ◽  
Tobacco Control ◽  
San Francisco ◽  
Community Support ◽  
Control Policy ◽  
Tobacco Product ◽  
Lessons Learned ◽  
Menthol Cigarette ◽  
The Usa ◽  
Product Sales

The African American Tobacco Control Leadership Council (AATCLC) is an advocacy group that works to inform the direction of tobacco control policy and priorities in the USA. This article narrates the AATCLC’s work advocating for a comprehensive, flavoured tobacco product sales ban in San Francisco, California. Recommendations for tobacco control advocates and lessons learned from their work are provided. The article concludes by discussing conditions necessary to enact the policy. These include having a dedicated advocacy team, community support, a policy sponsor, and clear and repeated messaging that is responsive to community concerns.

BIM Based Design Management of a Building Project Collaboratively Designed With a Foreign Design Firm in China

2019 ◽  
pp. 902-927
Author(s):  
Algan Tezel ◽  
Zeeshan Aziz ◽  
Chuxiong Jiang
Keyword(s):  
Building Design ◽  
Lessons Learned ◽  
Design Management ◽  
Construction Market ◽  
Stakeholder Perspectives ◽  
Building Information ◽  
The Usa ◽  
Complex Building ◽  
Design Firms ◽  
Building Project

In parallel with China's growing construction market, there has been an influx of foreign architectural and engineering design firms into the Chinese construction market. Those firms generally form partnerships with local Chinese firms or institutions to overcome various complications in the country. Adding to the complexity, relatively recent technologies such as Building Information Modelling (BIM) also started to play a role in those collaborative project design management efforts in China. This paper presents an in-depth case study of a complex building design project collaboratively executed using BIM by a foreign design firm from the USA and local Chinese firm in China. The project was analysed from different design management and stakeholder perspectives. Some of the findings confirm the pervious accounts from the literature. New insights and the key lessons learned for BIM based design management in this context are also presented.

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