The Current Understanding of Precision Medicine and Personalised Medicine in Selected Research Disciplines: Study Protocol of a Systematic Concept Analysis

Introduction. The terms "precision medicine" and "personalised medicine" have become key terms in health-related research, and in science-related public communication. However, the application of these two concepts and their interpretation in various disciplines are heterogeneous, which also affects research translation and public awareness. This leads to confusion regarding the use and distinction of the two concepts. Methods and analysis. Our study aims at using Rodger's concept analysis method to systematically examine and distinguish the current understanding of the concepts "precision medicine" and "personalised medicine" in clinical medicine, biomedicine (incorporating genomics and bioinformatics), health services research; physics, chemistry, engineering; machine learning, and artificial intelligence, and to identify their respective attributes (clusters of characteristics) and surrogate and related terms. We will analyse similarities and differences in definitions in the respective disciplines and across different (sub)disciplines. The analysis procedure will include (1) a concept identification, (2) a setting, sample, and data source selection, (3) data collection, (4) data analysis and data summary, (5) identification of examples, and (6) identification of implications for further concept development. Ethics and dissemination. Following ethical and research standards, we will comprehensively report the methodology for a systematic analysis following Roger's[1] concept analysis method. Our systematic concept analysis will contribute to the clarification of the two concepts and distinction in their application in given settings and circumstances. Such a broader concept analysis will contribute to non-systematic syntheses of the concepts, or occasional systematic reviews on one of the concepts that have been published in specific disciplines, in order to facilitate interdisciplinary communication, translational medical research, and implementation science.

What Counts as Evidence in Child Welfare Research?

In this commentary, we respond to Barth, R. P., Berrick, J. D., Garcia, A. R., Drake, B., Jonson-Reid, M., Gyouroko, J. R., and Greeson, J. K. P. (2021). Research to consider while effectively re-designing child welfare services. Research on Social Work Practice. https://doi.org/10.1177/10497315211050000 and critique their premise that Western-based research with population-level administrative data is the best and only valid evidence on which to base child welfare policy and practice changes. We offer an alternative viewpoint on what forms of evidence should be brought to bear as we consider re-envisioning the child welfare system, highlighting the importance of lived experience and the need to consider the evidence regarding all marginalized racial and ethnic groups. We argue that evidence should represent the perspectives of those with lived experience and that collaborative child welfare research can strengthen the validity of analyses and interpretations. We hold that Barth et al. ask and answer the wrong questions. We press for deeper critical reflection, a more nuanced intersectional lens, and urgent action to address structural and institutional racism in the child welfare system.

Promoting organizational vision integration among hospital employees

Background The concept of organizational vision has been little explored in the health-care services research literature. To address this knowledge gap in the literature, the present study examines the factors that may promote organizational vision integration (OVI), which refers to the employees’ use of organizational vision as a guiding framework in their work. The roles of organizational commitment (OC), leadership autonomy support (LAS), and organizational culture in relation to hospital employees’ OVI are examined. Methods Hospital employees were surveyed. Partial least-squares structural equation modeling was performed using SmartPLS 3 software to test the proposed hypotheses statistically. A bootstrapping test was used to identify the mediating effects. Results The main findings show that: (i) OC is the most powerful factor in promoting employees’ OVI (β = 0.26), while organizational culture (represented by the concept of internal market-oriented culture) and LAS showed significantly less and almost equal impact (β = 0.16 and β = 0.15, respectively). In total, OC, organizational culture and LAS explain 25% of the variance in the concept of OVI. (ii) LAS and organizational culture both significantly contribute to employees’ OC (β = 0.35 and β = 0.29, respectively) and in total explain nearly 40% (R2 = 0.38) of the variance in the concept of OC. (iii) The relationships between organizational culture, LAS, and OVI are mediated through OC, and (iv) LAS mediates the relationship between organizational culture and OVI, and that between organizational culture and OC. Conclusions To promote hospital employees’ OVI effectively, hospital managers should focus particularly on their employees’ OC. Specifically, they should strengthen their employees’ OC through building a strong employee-focused organizational culture and ensuring that leaders practice LAS. This contributes to promoting hospital employees’ OVI.

Improving Child Development Screening: Implications for Professional Practice and Patient Equity

Introduction and Objectives: A pediatric group with 25 clinics and 150 providers used multifaceted approaches to implement workflow processes and an electronic health record (EHR) flowsheet to improve child developmental screening. The key outcome was developmental screening done for every patient during 3 periods between ages 8 and 36 months. Identification of developmental concerns was the secondary study outcome. Screening rates and referrals were hypothesized to be optimized for children regardless of demographic backgrounds. Methods: During preventive visits, developmental screens targeted patients in age groups 8 to 12, 13 to 24, and 25 to 36 months. EHRs were analyzed for screening documentation, results, and referrals by patient demographics. Fifteen pediatric professionals were interviewed about their qualitative experiences. Quality improvement interventions included appointing clinic champions, training staff about the screening process and responsibilities, using a standardized tool, employing plan-do-study-act cycles, posting EHR prompts, providing financial incentives, and monitoring screening rates using control charts. Results: Within 25 months, screening rates improved from 60% to >95% within the 3 preventive visit age groups for a total of more than 30 000 children. Professionals valued the team process improvements. Children enrolled in Medicaid, black children, and those living in lower income zip codes had lower screening rates than privately insured, white children, and those living in higher income areas. Ages and Stages Questionnaire 3rd edition results were significantly different by gender, race/ethnicity, insurance, and income categories across all groups. Referral rates varied by race/ethnicity and zip code of residence. Conclusions: This project resulted in an effective and efficient process to improve child developmental screening that was valued by pediatric professionals. Analyses of patient demographics revealed disparities in services for the most vulnerable families. Ongoing quality improvement, health services research, and advocacy offer hope to improve health equity.

THE POLISH SAFETY MODEL FOR CHILD AND YOUTH TOURISM – LEGAL ASPECTS

Purpose. Analysis of the legal solutions adopted in Poland relating to the ensuring safe practice of various forms of tourism during the school year when the school acts as a tour operator and in the period free from classes, when recreation is organised by entities conducting economic activity. Method. The implemented methods is critical analysis of legal acts and literature on the subject. Results. In the study, the necessity is shown to modify the adopted legal solutions in order to clarify the responsibilities of the school headmaster, in terms of ensuring the safety of school trip participants by teachers, depending on the type of tourist activity, especially in relation to active tourism. On the other hand, the recreation of children and adolescents is based on the provision of appropriate staff with the appropriate authorisation, and on the control activities of state bodies and relevant services. Research and conclusion limitations. Analysis of specific legal regulations and selected general regulations, which indirectly relate to the safety of organizing activities when it comes to children and youth tourism. Practical implications. In the research, it has been shown that the school principal, as the entity responsible for ensuring the safety of students during events and excursions organised by the school, has to rely on too general provisions of the legislation, especially with reference to the number of teachers in relation to the number of students under their direct care, without taking into account the particular form of excursion within the framework of active tourism. Originality. The article is an attempt to synthesize the problem of the model of safety adopted in Poland for school tourism and recreation of children and adolescents in the period free from classes. Type of work. In the article, the results of theoretical research are presented.

Quantifying the Benefits and Ecosystem Services Provided by Green Roofs—A Review

Water-sensitive urban design (WSUD) has been widely used in cities to mitigate the negative consequences of urbanization and climate change. One of the WSUD strategies that is becoming popular is green roofs (GR) which offer a wide range of ecosystem services. Research on this WSUD strategy has been continuously increasing in terms of both quantity and quality. This paper presents a comprehensive review quantifying the benefits of GRs in papers published since 2010. More precisely, this review aims to provide up-to-date information about each GR benefit and how they have improved over the last decade. In agreement with previous reviews, extensive GRs were considerably researched, as compared to very limited studies on intensive and semi-intensive GRs. Each GR ecosystem service was specifically quantified, and an imbalance of GR research focus was identified, wherein urban heat- and runoff-related benefits were outstandingly popular when compared to other benefits. The results also highlight the recent introduction of hybrid GRs, which demonstrated improvements in GR performance. Furthermore, limitations of GRs, obstacles to their uptake, and inconsistent research findings were also identified in this review. Accordingly, opportunities for future research were pointed out in this review. This paper also recommends future studies to improve upon well-known GR benefits by exploring and applying more innovative GR construction techniques and materials. At the same time, further studies need to be undertaken on inadequately studied GR benefits, such as reduced noise and air pollution. In spite of the existence of reliable modelling tools, their application to study the effects of large-scale implementations of GRs has been restricted. Insufficient information from such research is likely to restrict large-scale implementations of GRs. As a result, further studies are required to transform the GR concept into one of the widely accepted and implemented WSUD strategies.

Discrete event simulation applied to single queue management: a case study at a bank agency

Capacity and queue management are currently used in financial institutions. With decreasing bank units due to internet services, research in this field has focused on improving to utilize their employees efficiently and achieve service excellence. In developing countries like Brazil, the customer has become more bank-accounted due to government and labor requirements, such as the wage credit became mandatory in the wage account. The paper's aim is motivated by a real-life case study to simulate discrete events to improve queue management at a Brazilian bank branch with the Arena software simulation environment. The simulation model was designed, tested, and applied considering the Discrete Event Simulation (DES) replication for queuing strategies on a real-world banking scenario. The arrival and service times were collected from 115 customers in Ferraz de Vasconcelos/SP city. It was performed in version 15.10 (2018) of the Arena software, with processor Intel core i3 CPU dual-core 3.07 GHz and 8GB of RAM. The results indicate that the bank agency should consider providing 9 to 11 operators to attend customers considering the arrival and service rate.