Multidimensional evaluation of managed relocation.
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ABSTRACT:
SUBMITTER: Richardson DM
PROVIDER: S-EPMC2694035 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ImportanceTrust is a core component of social cohesion, facilitating cooperation and collective action in the face of adversity and enabling survivors to remain resilient. Residential stability is an important prerequisite of developing trusting relations among community members. However, little is known about whether the movement of internally displaced persons (IDPs) after a disaster might change community relations.ObjectiveWe explored perceived changes in trust within 1 community directly impacted by the 2011 Great East Japan Earthquake and Tsunami.Design, setting, and participantsThis prospective cohort study examined survey data from 3594 residents of Iwanuma City, Japan, aged 65 years or older. Data were obtained from the Iwanuma Study-part of the Japan Gerontological Evaluation Study, a nationwide cohort study established in 2010-approximately 7 months before the disaster. All Iwanuma City residents age 65 years or older (8576 residents) were eligible to participate in 2010. The response rate was 59.0% (5058 residents). A follow-up survey was conducted in 2013, approximately 2.5 years after the disaster. Of the 4380 remaining participants who answered the baseline survey, 3594 were recontacted (follow-up rate, 82.1%). Data analysis was performed from July 1, 2019, to January 9, 2020.ExposuresThe number of temporarily relocated Iwanuma City survivors within 100 m and 250 m of a nonrelocated resident's home address.Main outcomes and measuresPerceived changes in particularized trust (ie, trusting people from the same community) and generalized trust (trusting people from other communities) measured on a 5-point Likert scale.ResultsAmong 3250 nonrelocated residents (1808 [55.6%] women; mean [SD] age, 76.5 [6.2] years) of Iwanuma City included in the analytic sample, multivariable-adjusted multinomial logistic regression analyses found that each standard deviation increase in the influx of internally displaced persons (1 SD = 11 IDPs) within 250 m of a resident's home address was associated with higher odds of a decrease in the resident's particularized and generalized trust (odds ratio, 1.17; 95% CI, 1.04-1.32).Conclusions and relevanceThe influx of IDPs in the host community appeared to be associated with an erosion of trust among locals. To avoid the erosion of social cohesion after a disaster, it may be crucial to provide opportunities for social interaction between old and new residents of communities.
| S-EPMC7645695 | biostudies-literature
Project description:BackgroundConsistent evidence suggests that children's palliative care is not equitable and managed clinical networks (MCNs) have been recommended as a solution. This study explored the perspectives of health professionals involved in the development of a children's palliative care MCN, with an aim to identify barriers and enablers of successful implementation.MethodsThematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the MCN or in the delivery of children's palliative care (September 2019-March 2020).ResultsThe study explored health professionals' perceptions of the MCN features that had helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded MCN co-ordinator, committed individuals who lead the MCN, and a governance structure that fosters collaboration. However, the MCN's development was impeded by cross-cutting barriers including limited funding for the MCN and children's palliative care more generally, no shared technology, lack of standards and evidence base for children's palliative care, and shortage of palliative care staff. These barriers impacted on the MCN's ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified.ConclusionsKey features of children's palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network's success.
| S-EPMC7824916 | biostudies-literature
Project description:BACKGROUND:Telehealth initiatives have bloomed around the globe, but their integration and diffusion remain challenging because of the complex issues they raise. Available evidence around telehealth usually deals with its expected effects and benefits, but its unintended consequences (UCs) and influencing factors are little documented. This study aims to explore, describe and analyze multidimensional UCs that have been associated with the use of telehealth. METHODS:We performed a secondary analysis of the evaluations of 10 telehealth projects conducted over a 22-year period in the province of Quebec (Canada). All material was subjected to a qualitative thematic-pragmatic content analysis with triangulation of methodologies and data sources. We used the conceptual model of the UCs of health information technologies proposed by Bloomrosen et al to structure our analysis. RESULTS:Four major findings emerged from our analysis. First, telehealth utilization requires many adjustments, changes and negotiations often underestimated in the planning and initial phases of the projects. Second, telehealth may result in the emergence of new services corridors that disturb existing ones and involve several adjustments for organizations, such as additional investments and resources, but also the risk of fragmentation of services and the need to balance between standardization of practices and local innovation. Third, telehealth may accentuate power relations between stakeholders. Fourth, it may lead to significant changes in the responsibilities of each actor in the supply chain of services. Finally, current legislative and regulatory frameworks appear ill-adapted to many of the new realities brought by telehealth. CONCLUSION:This study provides a first attempt for an overview of the UCs associated with the use of telehealth. Future research-evaluation studies should be more sensitive to the multidimensional and interdependent factors that influence telehealth implementation and utilization as well as its impacts, intended or unintended, at all levels. Thus, a consideration of potential UCs should inform telehealth projects, from their planning until their scaling-up.
| S-EPMC6600023 | biostudies-literature
Project description:BACKGROUND:Large scale and individual genetic studies have suggested numerous susceptible genes for depression in the past decade without conclusive results. There is a strong need to review and integrate multi-dimensional data for follow up validation. The present study aimed to apply prioritization procedures to build-up an evidence-based candidate genes dataset for depression. METHODS:Depression candidate genes were collected in human and animal studies across various data resources. Each gene was scored according to its magnitude of evidence related to depression and was multiplied by a source-specific weight to form a combined score measure. All genes were evaluated through a prioritization system to obtain an optimal weight matrix to rank their relative importance with depression using the combined scores. The resulting candidate gene list for depression (DEPgenes) was further evaluated by a genome-wide association (GWA) dataset and microarray gene expression in human tissues. RESULTS:A total of 5,055 candidate genes (4,850 genes from human and 387 genes from animal studies with 182 being overlapped) were included from seven data sources. Through the prioritization procedures, we identified 169 DEPgenes, which exhibited high chance to be associated with depression in GWA dataset (Wilcoxon rank-sum test, p?=?0.00005). Additionally, the DEPgenes had a higher percentage to express in human brain or nerve related tissues than non-DEPgenes, supporting the neurotransmitter and neuroplasticity theories in depression. CONCLUSIONS:With comprehensive data collection and curation and an application of integrative approach, we successfully generated DEPgenes through an effective gene prioritization system. The prioritized DEPgenes are promising for future biological experiments or replication efforts to discover the underlying molecular mechanisms for depression.
| S-EPMC3071871 | biostudies-literature
Project description:BACKGROUND AND AIMS: One of the best-known performance planning and evaluation techniques utilising both monetary and non-monetary data is the Balanced Scorecard (BSC). This is a means of rationalising the global activity of a business in the attempt to create value, and to translate the company vision into a set of tactical objectives and measurable strategies. The aim of this study was to implement and evaluate the use of BSC in two departments of the St. Anna University Hospital, Ferrara: the Analysis Laboratory and Digestive Endoscopy operating units (OU). MATERIALS AND METHODS: With the collaboration of the health workers involved, a precise methodological programme was pursued: Definition of the strategic map from 4 perspectives, according to Kaplan and Norton, Definition of the Key Performance Areas (KPA), or macro-objectives, Identification of the cause-effect relationships between KPAs, Identification of the sub-objectives of each KPA, Definition of the Key Performance Indicators (KPI), Definition of the weight/importance of each objective in the global evaluation. RESULTS: The information gathered permitted the definition of macro- and sub-objectives for each perspective, as well as determining the relevant indicators, standards, weights, frequency of detection and means of acquisition. Strategic maps showing the cause/effect relationships in each OU were created, as were 'evaluation panels', which describe the global performance of each department. For each perspective, the fundamental data were summarised in one table. Evaluation of each perspective yielded a positive result for the majority of the objectives, and the global result (including all 4 perspectives) was found to be satisfactory. DISCUSSION-CONCLUSION: The Balanced Scorecard was implemented in the abovementioned OUs of St. Anna University Hospital, Ferrara, after the health workers themselves realised the need for change.In our research the employees were pleased to be evaluated, not only for the financial outcomes, but also for the satisfaction of improving internal procedure, relationships with the community and their own growth/learning. BSC is an ideal point of contact between the financial and clinical dimensions of management. However, difficulties in its application were faced, among these, at least in the initial phase, the lack of information systems able to drive it, and the complexity of the research for specific indicators needed to be overcome. The time factor (on average, at least two years are required) and the availability of technological resources were also limiting factors.The rapid diffusion of BSC among the principal international profit and non-profit organisations is testament to its great potential. This project could be seen as a preparatory phase in the strategical analysis of a subsequent business plan.
| S-EPMC2759901 | biostudies-other
Project description:Apis mellifera strain:Managed Transcriptome or Gene expression
| PRJNA689223 | ENA
Project description:The current study contributes to previous work on measuring the social phenotype in Autism Spectrum Disorder (ASD) by validating a multidimensional test of social competence developed for use with individuals with and without ASD. The "Multidimensional Social Competence Scale" (MSCS) was previously validated as a parent-rating scale with youth 11-18 years with ASD without intellectual disability and typically developing adolescents of comparable age. The current study presents a validation of a self-report version of the MSCS in a non-clinical young adult population (N = 1178, males = 360, females = 817, age range = 17-25 years). The MSCS consists of seven domains that represent social competence: social motivation, social inferencing, demonstrating empathic concern, social knowledge, verbal conversation skills, nonverbal sending skills, and emotion regulation. These domains are theorized to be indicative of the higher-order construct of social competence. A second higher-order theorization of the MSCS structure posits that 3 of these factors are indicative of social responsiveness, and the remaining 4 factors are indicative of social understanding and emotion regulation. Our findings indicated support for each of the theorized multidimensional factor structures. Reliability, optimal scoring, convergent and discriminant validity of the measure, as well as implications for future research are discussed.
| S-EPMC6214554 | biostudies-literature
Project description:The linear composite direction represents, theoretically, where the unidimensional scale would lie within a multidimensional latent space. Using compensatory multidimensional IRT, the linear composite can be derived from the structure of the items and the latent distribution. The purpose of this study was to evaluate the validity of the linear composite conjecture and examine how well a fitted unidimensional IRT model approximates the linear composite direction in a multidimensional latent space. Simulation experiment results overall show that the fitted unidimensional IRT model sufficiently approximates linear composite direction when correlation between bivariate latent variables is positive. When the correlation between bivariate latent variables is negative, instability occurs when the fitted unidimensional IRT model is used to approximate linear composite direction. A real data experiment was also conducted using 20 items from a multiple-choice mathematics test from American College Testing.
| S-EPMC9265490 | biostudies-literature
Project description:The cleavage of nuclear proteins by caspases promotes nuclear breakdown and, therefore, plays a key role in apoptosis execution. However, the detailed molecular mechanisms of these events remain unclear. To get more insights into the mechanisms of nuclear events during apoptosis we set up a rapid fractionation protocol for the separation of the cytoplasmic and nuclear fractions of cells undergoing cisplatin-induced apoptosis. Importantly, nuclear accumulation of effector caspase-3 as well as initiator caspase-2, -8 and -9 was observed using the developed protocol and immunofluorescence microscopy. The detection of caspases and their cleavage products in the nucleus occurred within the same time interval after cisplatin treatment and took place shortly before nuclear fragmentation. The entry of initiator caspases to the nucleus was independent of caspase-3. Given that all three initiator caspases had catalytic activity in the nuclei, our findings indicate that initiator caspases might participate in the proteolysis of nuclear components during apoptosis, promoting its disintegration and apoptotic cell death.
| S-EPMC6093910 | biostudies-literature
Project description:BackgroundIn today's dynamic health-care system, organizations such as hospitals are required to improve their performance for multiple stakeholders and deliver an integrated care that means to work effectively, be innovative and organize efficiently. Achieved goals and levels of quality can be successfully measured by a multidimensional approach like Balanced Scorecard (BSC). The aim of the study was to verify the opportunity to introduce BSC framework to measure performance in St. Anna University Hospital of Ferrara, applying it to the Clinical Laboratory Operative Unit in order to compare over time performance results and achievements of assigned targets.MethodsIn the first experience with BSC we distinguished four perspectives, according to Kaplan and Norton, identified Key Performance Areas and Key Performance Indicators, set standards and weights for each objective, collected data for all indicators, recognized cause-and-effect relationships in a strategic map. One year later we proceeded with the next data collection and analysed the preservation of framework aptitude to measure Operative Unit performance. In addition, we verified the ability to underline links between strategic actions belonging to different perspectives in producing outcomes changes.ResultsThe BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the specific perspective contribution to overall performance enhancement. After time results comparison was possible depending on the selection of feasible and appropriate key performance indicators, which was occasionally limited by data collection problems.ConclusionsThe first use of BSC to compare performance at Operative Unit level, in course of time, suggested this framework can be successfully adopted for results measuring and revealing effective health factors, allowing health-care quality improvements.
| S-EPMC3118336 | biostudies-literature