framework approach
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2022 ◽  
Vol 14 (2) ◽  
pp. 756
Author(s):  
Rocío Rodríguez-Rivero ◽  
Isabel Ortiz-Marcos

When working with international development projects (IDPs), the use of the logical framework approach (LFA) prevails as the most important tool to plan and manage these projects. This paper presents how the methodology has been enriched, including risk management (LFRMA logical framework with risk management approach), proposing an original contribution, tested with professionals that will improve the effectiveness of IDPs by increasing their success rate and their sustainability. The steps followed to design the methodology (problem statement (literature review, interview with experts, questionnaire for professionals. and statistical analysis), case study analysis (eight case studies in Colombia, interviews with IDPs managers, focus groups, questionnaire for participants, qualitative analysis, and fuzzy analysis) and design of LFRMA (focus group with experts)) and the methodology itself (how to introduce risk management during all the life cycle through the methodology steps) are presented. Conclusions answer the research questions: can the effectiveness and sustainability of IDPs be improved? Can risk management help to improve IDPs effectiveness? Would it be useful to introduce risk management into the LFA? The LFRMA methodology consists of two fields of application, the first at the organization level and the second at the project level.


Spinal Cord ◽  
2022 ◽  
Author(s):  
Vera-Ellen M. Lucci ◽  
Rhyann C. McKay ◽  
Christopher B. McBride ◽  
Maureen S. McGrath ◽  
Rhonda Willms ◽  
...  

Abstract Background Improvement to autonomic processes such as bladder, bowel and sexual function are prioritised by individuals with spinal cord injury (SCI). Bowel care is associated with high levels of dissatisfaction and decreased quality of life. Despite dissatisfaction, 71% of individuals have not changed their bowel care routine for at least 5 years, highlighting a disconnect between dissatisfaction with bowel care and changing routines to optimise bowel care. Objective Using an integrated knowledge translation approach, we aimed to explore the barriers and facilitators to making changes to bowel care in individuals with SCI. Methods Our approach was guided by the Behaviour Change Wheel and used the Theoretical Domains Framework (TDF). Semi-structured interviews were conducted with individuals with SCI (n = 13, mean age 48.6 ± 13.1 years) and transcribed verbatim (duration 31.9 ± 7.1 min). Barriers and facilitators were extracted, deductively coded using TDF domains and inductively analysed for themes within domains. Results Changing bowel care after SCI was heavily influenced by four TDF domains: environmental context and resources (workplace flexibility, opportunity or circumstance, and access to resources); beliefs about consequences; social influences (perceived support and peer mentorship); and knowledge (knowledge of physiological processes and bowel care options). All intervention functions and policy categories were considered viable intervention options, with human (61%) and digital (33%) platforms preferred. Conclusions Modifying bowel care is a multi-factorial behaviour. These findings will support the systematic development and implementation of future interventions to both enable individuals with SCI to change their bowel care and to facilitate the optimisation of bowel care approaches.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Sebastian Vermeersch ◽  
Rémy P. Demeester ◽  
Nathalie Ausselet ◽  
Steven Callens ◽  
Paul De Munter ◽  
...  

Abstract Background HIV patients face considerable acute and chronic healthcare needs and battling the HIV epidemic remains of the utmost importance. By focusing on health outcomes in relation to the cost of care, value-based healthcare (VBHC) proposes a strategy to optimize quality of care and cost-efficiency. Its implementation may provide an answer to the increasing pressure to optimize spending in healthcare while improving patient outcomes. This paper describes a pragmatic value-based healthcare framework for HIV care. Methods A value-based HIV healthcare framework was developed during a series of roundtable discussions bringing together 16 clinical stakeholder representatives from the Belgian HIV reference centers and 2 VBHC specialists. Each round of discussions was focused on a central question translating a concept or idea to the next level of practical implementation: 1) how can VBHC principles be translated into value-based HIV care drivers; 2) how can these value-based HIV care divers be translated into value-based care objectives and activities; and 3) how can value-based HIV care objectives and activities be translated into value-based care indicators. Value drivers were linked to concrete objectives and activities using a logical framework approach. Finally, specific, measurable, and acceptable structure, process and outcomes indicators were defined to complement the framework. Results Our framework identifies 4 core value areas where HIV care would benefit most from improvements: Prevention, improvement of the cascade of care, providing patient-centered HIV care and sustaining a state-of-the-art HIV disease management context. These 4 core value areas were translated into 12 actionable core value objectives. For each objective, example activities were proposed. Indicators are suggested for each level of the framework (outcome indicators for value areas and objectives, process indicators for suggested activities). Conclusions This framework approach outlines how to define a patient- and public health centered value-based HIV care paradigm. It proposes how to translate core value drivers to practical objectives and activities and suggests defining indicators that can be used to track and improve the framework’s implementation in practice.


Author(s):  
Pallapu Himavanth Reddy

Abstract: Cloud computing provides customers with storage as a service, allowing data to be stored, managed, and cached remotely. Users can also access it online. A major concern for users is the integrity of the data stored in the cloud, as it is possible for external invaders or criminals to attack, repair, or destroy the data stored in the cloud. Data auditing is a trending concept that involves hiring a third-party auditor to perform a data integrity test (TPA). The main purpose of this project is to provide a safe and effective testing system that combines features such as data integrity, confidentiality, and privacy protection. The cloud server is only used to store encrypted data blocks in the proposed system. It is not subject to any additional computer verification. TPA and the data owner are in charge of all the functions of the scheme. A variety of materials are used to evaluate the proposed audit process. The proposed solution meets all the processes while minimizing the load on cloud servers. Data dynamics actions such as data review, deletion, and installation will be performed in the future. Keywords: Cloud storage; Third Party Auditor; Public Auditing; Privacy Preserving; Integrity;


2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Hajara I. Maizare ◽  
Fatimah I. Tsiga-Ahmed ◽  
Abubakar M. Jibo ◽  
Aishatu L. Adamu ◽  
Rabiu I. Jalo ◽  
...  

Adverse Events Following Immunisation (AEFI) contribute to child morbidity and mortality as they often lead to low uptake of vaccines with consequent persistence of vaccine-preventable diseases. It is essential to assess the prevalence of AEFIs in northern Nigeria, where misconceptions about immunisation exist. This study assessed the prevalence and pattern of AEFI among children less than 24 months after attending immunisation clinics in Kano, Nigeria. Using a mixed-methods design, adapted intervieweradministered questionnaires were assigned to a cross-section of 384 mother-baby pairs who presented to the immunisation clinics of selected primary healthcare centres (PHCs) within metropolitan Kano. This was followed by six sessions of focus group discussion with a sub-sample of the mothers. Logistic regression and the framework approach were used to analyse the data. The prevalence of AEFI was (43.5%, n=164), and most cases (72.4%, n=273) were mild. Fever was the most common type of AEFI reported (66.5%, n=109) and was higher among infants less than three months (44.5%, n=73). Age of the index child was the only significant predictor of AEFI (OR:0.18, 95% CI: 0.10-0.35). Our study shows that AEFI was common among children less than 24 months old in Kano. We recommend sensitisation and health education of caregivers using valuable communication strategies and sufficient training of immunisation service providers on professional ways to deliver these vaccines safely.


2021 ◽  
Vol 08 (12) ◽  
pp. 289-293
Author(s):  
Sheraz Khan ◽  
◽  
Islam Nabi ◽  
Rafi Ullah ◽  
Majid Ullah ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055215
Author(s):  
Jennifer Broom ◽  
Alex Broom ◽  
Katherine Kenny ◽  
Jeffrey J. Post ◽  
Pamela Konecny

ObjectivesDespite escalating antimicrobial resistance (AMR), implementing effective antimicrobial optimisation within healthcare settings has been hampered by institutional impediments. This study sought to examine, from a hospital management and governance perspective, why healthcare providers may find it challenging to enact changes needed to address rising AMR.DesignSemistructured qualitative interviews around their experiences of antimicrobial stewardship (AMS) and responsiveness to the requirement for optimisation. Data were analysed using the framework approach.SettingTwo metropolitan tertiary-referral hospitals in Australia.ParticipantsTwenty hospital managers and executives from the organisational level of department head and above, spanning a range of professional backgrounds and in both clinical and non-clinical roles, and different professional streams were represented.ResultsThematic analysis demonstrated three key domains which managers and executives describe, and which might function to delimit institutional responsiveness to present and future AMR solutions. First, the primacy of ‘political’ priorities. AMR was perceived as a secondary priority, overshadowed by political priorities determined beyond the hospital by state health departments/ministries and election cycles. Second, the limits of accreditation as a mechanism for change. Hospital accreditation processes and regulatory structures were not sufficient to induce efficacious AMS. Third, a culture of acute problem ‘solving’ rather than future proofing. A culture of reactivity was described across government and healthcare institutions, precluding longer term objectives, like addressing the AMR crisis.ConclusionThere are dynamics between political and health service institutions, as well as enduring governance norms, that may significantly shape capacity to enact AMS and respond to AMR. Until these issues are addressed, and the field moves beyond individual behaviour modification models, antimicrobial misuse will likely continue, and stewardship is likely to have a limited impact.


2021 ◽  
pp. 769-777
Author(s):  
A. Balachandra ◽  
B. R. Kiran ◽  
B. S. Ramya ◽  
N. Madhu

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260617
Author(s):  
E. Bradshaw ◽  
K. Whale ◽  
A. Burston ◽  
V. Wylde ◽  
R. Gooberman-Hill

Background Patient and public involvement work (PPI) is essential to good research practice. Existing research indicates that PPI offers benefits to research design, conduct, communication, and implementation of findings. Understanding how PPI works and its value helps to provide information about best practice and highlight areas for further development. This study used a values-based approach to reporting PPI at a Research Unit focused on musculoskeletal conditions within a UK medical school. Methods The study was conducted between October 2019 and January 2020 using Gradinger’s value system framework as a theoretical basis. The framework comprises three value systems each containing five clusters. All PPI members and researchers who had attended PPI groups were invited to participate. Participants completed a structured questionnaire based on the value system framework; PPI members also provided further information through telephone interviews. Data were deductively analysed using a framework approach with data mapped onto value systems. Results Twelve PPI members and 17 researchers took part. Views about PPI activity mapped onto all three value systems. PPI members felt empowered to provide their views, and that their opinions were valued by researchers. It was important to PPI members that they were able to ‘give back’ and to do something positive with their experiences. Researchers would have liked the groups to be more representative of the wider population, patients highlighted that groups could include more younger members. Researchers recognised the value of PPI, and the study highlighted areas where researchers members might benefit from further awareness. Conclusions Three areas for development were identified: (i) facilitating researcher engagement in training about the value and importance of PPI in research; (ii) support for researchers to reflect on the role that PPI plays in transparency of healthcare research; (iii) work to further explore and address aspects of diversity and inclusion in PPI.


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