Bridging Systems to Implement HIV/STI Programming Within the Juvenile Justice System: Strengths and Challenges of a Local Change Team Approach

Justice-involved youth are at risk for HIV/STIs but do not access services. The complex challenges of improving the delivery of health-related services within juvenile justice (JJ) settings warrant exploration of strategies to close this service gap. This study describes the successes and challenges of utilizing a local change team (LCT) strategy comprising JJ and health agency staff to implement HIV/STI programming in JJ settings, across six counties in six states in the U.S. Five focus groups comprising n = 28 JJ and health agency staff who served as LCT members were conducted. Results demonstrated the structured nature of the collaborative process and strength of commitment among LCT members were necessary for successful implementation of HIV/STI programming. The use of LCTs comprising membership of JJ and (behavioral) health systems has broader applicability to other health and behavioral health issues faced by youth on probation that JJ staff may feel ill equipped to address.

Quality Improvement Initiatives in Reforming Patient Support Groups—Three-Year Outcomes

Background: Little has been done regarding the research on quality and quantity of patient support groups (PSGs) and how they can be improved. Here, we present three-year experiences of a quality improvement (QI) program of our PSGs. Methods: We launched earlier on a three-year project to improve our PSGs, including the number and quality of curricula. Data were collected on the number of PSGs, curricula, and participants. Results: In the first year, we organized relevant resources of our hospital and established a standard protocol for applying financial support and reporting the results. In the second year, we elected “the best patient” to promote sense of honor and better peer supports. In the third year, we surveyed through questionnaires participants’ health literacy to improve their feedback. Competitions and exhibitions of achievements were held each year to share results of every PSG. Finally, we had increased the volume of participation of patients and family over these three years (3968, 5401 (+35.5%) and 5963 (+50.3%)). Participation of staff also increased significantly (489 and 551 (+12.7%)). Furthermore, more interdisciplinary curricula were generated, with fewer doctors (38.2% to 29%), but greater numbers of the following: nurses (4.9% to 17.4%), nurse practitioners (0.4% to 14.5%), medical laboratory scientists (2.5% to 16.3%), social workers (4.7% to 41.7%), and teachers from outside (0% to 1.8%). Conclusion: In this first study on QI efforts on PSGs, we enlisted a core change team, drew a stakeholder map, and selected an improvement framework with good results.

Beyond positivism: Toward a pluralistic approach to studying “real” teams

To conduct sound research on organizational teams while overcoming the difficulties inherent in studying teams in situ, it is essential for researchers to consider all possible methodologies at their disposal. However, in the science of teams, published research is primarily driven by a positivist paradigm and quantitative methodology. This research offers an important perspective but fails to capitalize on the wide array of paradigms and methodologies outside of this perspective. Accordingly, we advocate for a pluralistic approach to studying real-world teams that utilizes qualitative methodologies to complement and enhance quantitative findings. We summarize philosophical assumptions, research paradigms, and qualitative methodologies not commonly used in research on teams. We then highlight existing qualitative research within several exemplar topic areas (team conflict, membership change, team adaptation, shared leadership, and inclusion in teams) and offer propositions for how qualitative methodologies can be used to develop a better understanding of real teams in organizations.

Scientists and Planners Face Challenge of Rising Seas

NASA Sea Level Change Team Meeting; Annapolis, Maryland, 11–13 March 2019

“You Can’t Just Erase History”: Coping With Team Identity Threat

Team identification has frequently been associated with positive outcomes; however, team identification is also associated with negative outcomes such as identity threat. Team identity threat has been studied from the perspective that fans enduring identity threat employ emotion-focused coping rather than problem-focused coping strategies because they lack the authority to change team-related stressors. In this study, the author examined fan reaction to team identity threat, wherein fans ultimately used both problem-focused coping and emotion-focused coping strategies. The particular instance examined involved fans of a National Collegiate Athletic Association men’s basketball team reacting to an identity threat caused by program scandal. Through the use of unobtrusive digital observation, fan reaction was analyzed via comments from three online sources. The study highlights how fans used problem-focused coping to preserve identity meaning, creating their own reality in the process. Theoretical and managerial implications of the research are discussed.

Fortran 2018 coarray enhancements

Teams allow separate sets of images to execute independently. An important design objective is that, given code that has been developed and tested on all images, it should be possible to run the code on a team without making changes. This requires that if a team has n images, the image indices within the team run from 1 to n. Teams are formed by partitioning an existing team into parts, starting with the team of all the images. New teams are executed within change team constructs. Most execution will be within the team, but direct access to data in ancestor and sibling teams is allowed. The number of images may be huge, making the probability of one failing significant. Facilities are therefore provided to allow the programmer to recover the computation after a failure. All these features are explained, together with events and new collective and atomic intrinsic procedures.

Using Boundary Objects to Facilitate Culture Change and Integrate a Global Top Management Team

As business anthropologists, we are often called upon to work on organizational change initiatives as members of a change team. This article is the story of one organizational change initiative involving a global top management team in a healthcare division of a large multinational firm and the research that was used as the basis for implementing change in the top management team and subsequently in the division as a whole. Specifically, the article focuses on how the change team, of which I was a part, communicated the research results to the top management team and to employees of the company by presenting the results in a map that became a boundary object, that facilitating translation across diverse groups, joint sensemaking, and local action in the change process.

Developing, Implementing, and Evaluating a Multimedia Patient Decision Aid Program to Reform the Informed Consent Process of a Peripherally Inserted Central Venous Catheter Procedure: Protocol for Quality Improvement (Preprint)

BACKGROUND Informed consent has considerable clinical, ethical, and legal implications for patient safety and liability. Little information is available about the use of multimedia patient decision aids (PtDA) in the consent process for therapeutic invasive procedures such as the peripherally inserted central venous catheter (PICC). In addition, none of the available studies have designed their multimedia PtDAs based on the Agency for Healthcare Research and Quality’s (AHRQ) comprehensive guide for informed consent. OBJECTIVE This paper describes a patient-centered, systematic, multidisciplinary approach to develop, implement, and alpha test a multimedia PtDA to reform the informed consent process of a PICC for patients in 10 acute and intensive care units. METHODS The development, implementation, and evaluation processes of the PtDA followed the phases in the Multimedia Production Framework: preproduction, production, and postproduction. Within this framework, we applied the criteria for judging the quality of PtDAs, the AHRQ’s Health Literacy Universal Precautions Toolkit, and the AHRQ’s Patient Education Materials Assessment Tool Guide. The methodology was guided by the Interprofessional Shared Decision-Making Model and the AHRQ’s Making Informed Consent an Informed Choice guide. In the preproduction phase, we (1) reviewed the current consent form; (2) observed 18 consent processes; (3) surveyed the vascular access team (N=6 nurses) about their perception of the current process; (4) surveyed 30 patients for knowledge recall and retention, overall satisfaction, and attitude toward using a multimedia PtDA; and (5) wrote and reviewed the script for the multimedia program. The production phase focused on filming the PtDA in English and Spanish languages. The postproduction phase included integrating the multimedia programs into the care processes, developing a modified workflow for the consent process, and alpha testing of the English and Spanish PtDAs by (1) a group of 5 patients for clarity and understandability of the information; (2) nurses using the AHRQ’s Patient Education Materials Assessment Tool Audio and Video; and (3) by the multidisciplinary change team. RESULTS Based on the alpha testing, patients indicated that the content was easy to follow and read; nurses provided positive feedback, and their comments were mainly related to the changes in the workflow in the consent process of the PICC after using the PtDA; and the multidisciplinary change team suggested edits related to changing a few scenes. The final multimedia program consisted of 7 min and 37 s demonstrating detailed information about the PICC. CONCLUSIONS A systematic development of PtDAs for nonurgent invasive procedures may eliminate many limitations of the conventional consent process by ensuring comprehensive, standardized, and easy-to-comprehend information and providing sufficient time for the patients to reflect on the information. To be effective, PtDAs should follow a systematic, patient-centered, evidence-based, and rigorous approach in the development, implementation, and evaluation processes. INTERNATIONAL REGISTERED REPOR RR1-10.2196/10709