Stakeholder views of the development of a clinical quality registry for interventional radiology: a qualitative study

Background Clinical quality registries (CQRs) can likely improve quality in healthcare and research. However, studies indicate that effective use of CQRs is hindered by lack of engagement and interest among stakeholders, as well as factors related to organisational context, registry design and data quality. To fulfil the potential of CQRs, more knowledge on stakeholders’ perceptions of the factors that will facilitate or hamper the development of CQRs is essential to the more appropriate targeting of registry implementation and the subsequent use of the data. The primary aim of this study was to examine factors that can potentially affect the development of a national CQR for interventional radiology in Norway from the perspective of stakeholders. Furthermore, we wanted to identify the intervention functions likely to enable CQR development. Only one such registry, located in Sweden, has been established. To provide a broader context for the Norwegian study, we also sought to investigate experiences with the development of this registry. Methods A qualitative study of ten Norwegian radiologists and radiographers using focus groups was conducted, and an in-depth interview with the initiator of the Swedish registry was carried out. Questions were based on the Capability, Opportunity and Motivation for Behaviour Model and the Theoretical Domains Framework. The participants’ responses were categorised into predefined themes using a deductive process of thematic analysis. Results Knowledge of the rationale used in establishing a CQR, beliefs about the beneficial consequences of a registry for quality improvement and research and an opportunity to learn from a well-developed registry were perceived by the participants as factors facilitating CQR development. The study further identified a range of development barriers related to environmental and resource factors (e.g., a lack of organisational support, time) and individuallevel factors (e.g., role boundaries, resistance to change), as well as several intervention functions likely to be appropriate in targeting these barriers. Conclusion This study provides a deeper understanding of factors that may be involved in the behaviour of stakeholders regarding the development of a CQR. The findings may assist in designing, implementing and evaluating a methodologically rigorous CQR intervention.

The Impact of Resistance to Change on the Implementation of Quality Management System in the Ministry of Education (General Directorate of Education in South Batinah Governorate as a Model)

This study is investigating the reality of resistance to change in the light of Quality Management System (QMS) implementation in the Ministry of Education (South Batinah Directorate as a model of the study). It tries to answer some questions related to the main factors that lead to resistance to change with correlations of gender, years of experience and educational level. The method of collecting data of this study was conducting quantitatively through an electronic questionnaire including 59 participants of directors in different administrative level. The data has been analyzed statistically through SPSS. The result shows that the performance of the employees was impacted through the lack of awareness of the QMS requirements. Although, the all four factors recorded close level of resistance, the cognitive rigidity factor recorded the highest factor that lead to resistance to change. The study results can be generalized to other directorates in the Ministry of Education because the similar work environment. This study can be used to make some very crucial amendments in the future in managing QMS in the organization.

Can Global, Extended, and Repeated Ransomware Attacks Overcome the User's Status Quo Bias and Cause a Switch of System?

Ransomware (RW) attacks’ effectiveness has increased causing far reaching consequences that are not fully understood. The ability to disrupt core services, the global reach, extended duration and the repetition has increased their ability to harm an organization. One aspect that needs to be understood better is the effect on the user. The user in the current environment is exposed to new technologies that might be adopted but there are also habits of using existing systems. The habits have developed over time with trust increasing in the organization in contact directly and the institutions supporting it. This research explores whether the global, extended and repeated RW attacks reduce the trust and inertia sufficiently to change long held habits in using information systems. The model tested measures the effect of the RW attack on the e-commerce status quo to evaluate if it is significant enough to overcome the user’s resistance to change.

Rethinking the “State Security-Human Security” Nexus in the Face of COVID-19

It is the argument of this chapter that the COVID-19 pandemic created a need to problematize how we understand security, especially the contrast between state security and human security. This chapter argues that the pandemic has illustrated the importance of human security as well as the need to understand it as a precondition for, and not as an alternative to, state and international security. However, the study does not argue that the increased importance of human security translates into the protection of all humans. The crude reality that security is always at someone's and something's expense sustains vulnerabilities within societies. The study acknowledges that the changes in the security implications (both material and perceived) do not necessarily or automatically translate to changes in policies. Institutional resistance to change and general political trends among other factors affect the extent to which policies will evolve in a direction that would better meet the security implications of the pandemic.

Academic Aeromobility in the Global Periphery

Academics are part of a small minority that are responsible for disproportionate air travel emissions. Responding to high aviation emissions requires that the complexities of academic air travel practices are understood in specific geographical and institutional contexts. This chapter addresses the work-sociology of academic aeromobility in the context of the global periphery. We report on a programme of interviews conducted prior to COVID-19 with academics at the University of Otago (Aotearoa/New Zealand), where the aeromobility practices of academics are uniquely shaped by extreme geographical distance. Our empirical contribution is presented in the four themes that emerged from our analysis: complex drivers; selective substitution; ‘Don’t weaken me!’ and assorted scalar accountabilities. We then discuss aspects of resistance to change but also avenues of opportunity to reimagine academic air travel practices, which have been accelerated by the COVID-19 pandemic. We specifically address the emergence of a post-COVID ‘new normal’ and conclude with the urgent need for collective action that is coordinated among individual academics, institutions, disciplinary associations and conference organisers. Entrenching the ‘new normal’ will be critical to resolving the unsustainable aeromobilities of academics and institutions that are globally distant.

Conservation agriculture in the southern highlands of Tanzania: learnings from two decades of research for development.

Since its introduction into the Southern Highlands of Tanzania by researchers 25 years ago, Conservation Agriculture (CA) has been well received, researched and the concept proven to be increasing productivity and incomes, enhancing resilience of livelihoods and contributing to reducing greenhouse gas emissions. CA research, as defined by the three interlined principles, was introduced into the Southern Highlands by the Tanzania Agricultural Research Institute (TARI) Uyole, formerly Agricultural Research Institute (ARI) Uyole around 1995. Research results showed a labour saving of up to 70% in CA compared to conventional tillage, yield increases of 26%-100% and 360% for maize and sunflower, respectively, partly attributed to higher moisture content (18%-24%) in CA systems. CA was also found to be much more effective in mitigating dry spells and increasing productivity in maize production in areas where average annual rainfall is less than 770 mm. Economic analysis of maize production showed that profits in CA were three times more than in conventional tillage production at US$526.9 ha-1 and US$ 176.6 ha-1, respectively. Profits were twice as much for beans under CA at US$917.4 ha-1 compared to US$376.3 ha-1 for conventional practice. Studies confirm that 5% of farmers in the Southern Highlands have adopted CA. Increased uptake requires addressing challenges including resistance to change in mindset, inaccessibility of appropriate mechanization and cover crop seeds, traditions of free-range communal grazing of livestock (which makes it difficult for farmers to retain crop residue in their farms) and shortage of investment capital. A holistic value chain approach is recommended in CA interventions, bringing together various stakeholders including scientists, trainers, extension workers, administrators, policy makers, agro-inputs and machinery dealers, machinery service providers, agro-processors and financial institutions. The innovations adaptation set-up brings service providers closer to farmers for co-innovation. Long-term CA programmes are recommended, with farmers being taken through the complete learning cycle in testing CA technologies under their own farm environments. This should be complemented by entrepreneurial CA machinery hire services provision to increase the availability of farm power to smallholders unlikely to have the capital or skills to buy and manage their own machinery. The proof of application of the CA concept in the Southern Highlands has set the stage for further scaling the adoption of CA through support from national policies and programmes.

Evaluation’s Role in Development Projects: Boosting Energy Efficiency in a Traditional Industry in Chad

This chapter illustrates the critical importance of evaluation in development projects. It explores the relevance, processes, and specifics of a project to introduce energy-efficient cook stoves in two traditional industries in Chad. Although Chad benefits from great solar potential given its location and being a Sahelian country, biomass accounted for 94% of the primary energy supply in 2008, and only 2.2% of Chadian households have access to electricity. The beer brewing and meat grilling sectors in particular use enormous quantities of limited and expensive firewood. Locally developed energy-efficient stoves for the two targeted sectors were available, but those technologies had not been commercialized and disseminated into the Chadian market. The project aimed to overcome issues of technology, financing, dissemination, resistance to change, and awareness to introduce and establish use of energy-efficient stoves in micro-scale food processing to achieve environmental and economic benefits, discussing the effectiveness of models introduced and adopted by project beneficiaries with related training. This chapter considers issues related to the project’s financing and sustainability and concludes with lessons provided by the evaluation, including engagement with targeted beneficiaries, awareness of local context, and consideration of size and scale for a demonstration project that can be scaled up in future programs.