12508 research outputs found
Sort by
Design and evaluation of an interactive quality dashboard for national clinical audit data: a realist evaluation
Get PDFYesNational audits aim to reduce variations in quality by stimulating quality improvement. However, varying provider engagement with audit data means that this is not being realised.
The aim of the study was to develop and evaluate a quality dashboard (i.e. QualDash) to support clinical teams' and managers' use of national audit data.
Design: The study was a realist evaluation and biography of artefacts study.
Setting: The study involved five NHS acute trusts.
Methods and results: In phase 1, we developed a theory of national audits through interviews. Data use was supported by data access, audit staff skilled to produce data visualisations, data timeliness and quality, and the importance of perceived metrics. Data were mainly used by clinical teams. Organisational-level staff questioned the legitimacy of national audits. In phase 2, QualDash was co-designed and the QualDash theory was developed. QualDash provides interactive customisable visualisations to enable the exploration of relationships between variables. Locating QualDash on site servers gave users control of data upload frequency. In phase 3, we developed an adoption strategy through focus groups. ‘Champions', awareness-raising through e-bulletins and demonstrations, and quick reference tools were agreed. In phase 4, we tested the QualDash theory using a mixed-methods evaluation. Constraints on use were metric configurations that did not match users' expectations, affecting champions' willingness to promote QualDash, and limited computing resources. Easy customisability supported use. The greatest use was where data use was previously constrained. In these contexts, report preparation time was reduced and efforts to improve data quality were supported, although the interrupted time series analysis did not show improved data quality. Twenty-three questionnaires were returned, revealing positive perceptions of ease of use and usefulness. In phase 5, the feasibility of conducting a cluster randomised controlled trial of QualDash was assessed. Interviews were undertaken to understand how QualDash could be revised to support a region-wide Gold Command. Requirements included multiple real-time data sources and functionality to help to identify priorities.
Conclusions: Audits seeking to widen engagement may find the following strategies beneficial: involving a range of professional groups in choosing metrics; real-time reporting; presenting ‘headline' metrics important to organisational-level staff; using routinely collected clinical data to populate data fields; and dashboards that help staff to explore and report audit data. Those designing dashboards may find it beneficial to include the following: ‘at a glance' visualisation of key metrics; visualisations configured in line with existing visualisations that teams use, with clear labelling; functionality that supports the creation of reports and presentations; the ability to explore relationships between variables and drill down to look at subgroups; and low requirements for computing resources. Organisations introducing a dashboard may find the following strategies beneficial: clinical champion to promote use; testing with real data by audit staff; establishing routines for integrating use into work practices; involving audit staff in adoption activities; and allowing customisation.
Limitations: The COVID-19 pandemic stopped phase 4 data collection, limiting our ability to further test and refine the QualDash theory. Questionnaire results should be treated with caution because of the small, possibly biased, sample. Control sites for the interrupted time series analysis were not possible because of research and development delays. One intervention site did not submit data. Limited uptake meant that assessing the impact on more measures was not appropriate.
Future work: The extent to which national audit dashboards are used and the strategies national audits use to encourage uptake, a realist review of the impact of dashboards, and rigorous evaluations of the impact of dashboards and the effectiveness of adoption strategies should be explored.
Study registration: This study is registered as ISRCTN18289782.This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 12. See the NIHR Journals Library website for further project information
Extended Entropy Maximisation and Queueing Systems with Heavy-Tailed Distributions
Get PDFNumerous studies on Queueing systems, such as Internet traffic flows, have shown to be bursty, self-similar and/or long-range dependent, because of the heavy (long) tails for the various distributions of interest, including intermittent intervals and queue lengths. Other studies have addressed vacation in no-customers’ queueing system or when the server fails. These patterns are important for capacity planning, performance prediction, and optimization of networks and have a negative impact on their effective functioning. Heavy-tailed distributions have been commonly used by telecommunication engineers to create workloads for simulation studies, which, regrettably, may show peculiar queueing characteristics. To cost-effectively examine the impacts of different network patterns on heavy- tailed queues, new and reliable analytical approaches need to be developed. It is decided to establish a brand-new analytical framework based on optimizing entropy functionals, such as those of Shannon, Rényi, Tsallis, and others that have been suggested within statistical physics and information theory, subject to suitable linear and non-linear system constraints. In both discrete and continuous time domains, new heavy tail analytic performance distributions will be developed, with a focus on those exhibiting the power law behaviour seen in many Internet scenarios.
The exposition of two major revolutionary approaches, namely the unification of information geometry and classical queueing systems and unifying information length theory with transient queueing systems. After conclusions, open problems arising from this thesis and limitations are introduced as future work
Effectual Endeavors of Silk Protein Sericin against Isoproterenol Induced Cardiac Toxicity and Hypertrophy in Wistar Rats
No full textYesThe silkworm cocoon has been used in the treatment of various ailments in different Asian countries. This research was designed to evaluate the effect of sericin on myocardial necrosis and hypertrophy in isoproterenol-challenged rats. The rats were administered with sericin (500 and 1000 mg/kg, p.o.) for 28 days, followed by administration of isoprenaline (85 mg/kg, s.c.) on the 29th and 30th days. The cardioprotective activity was assessed by various physical, enzymatic, and histopathological parameters along with apoptotic marker expression. The cardioprotective effect showed that pre-treatment of rats with sericin significantly increased the non-enzymatic antioxidants marker in serum and heart tissue (glutathione, vitamin E, and vitamin C). The results were the same in enzymatic antioxidant marker, mitochondrial enzymes, and protein. The grading of heart, heart/body weight ratio, gross morphology, cardiac markers, oxidative stress markers in serum and heart tissue, glucose, serum lipid profiling and Lysosomal hydrolases, heart apoptotic markers such as MHC expression by western blot, apoptosis by flow cytometry, total myocardial collagen content, fibrosis estimation, myocyte size were significantly decreased when compared with isoproterenol (ISG) group however histopathological studies showed normal architecture of heart in both control and treated rats. The pharmacological study reflects that sericin on both doses i.e., 500 mg/kg and 1000 mg/kg have potent cardioprotective action against the experimental model which was confirmed by various physical, biochemical, and histopathological parameters evaluated further research is required to examine the molecular mechanism of cardioprotective effect of sericin.King Saud University, Riyadh, Saudi Arabia (RSP-2021/357
Building social capital in cruise travel via social network sites
No full textYesThe purpose of this study is to investigate what type of Facebook posts
help cruise lines build bridging and bonding social capital. The study
applies the Chi-Square Automatic Interaction Detection (CHAID) method
to identify which types of posts establish bridging and bonding social
capital. The analysis is conducted on an international cruise line’s official
Facebook posts posted between 1 January 2018 and 1 January 2020
before the Covid-19 pandemic. The results highlight that media type,
embedding passenger motivation, and a ship image help establish both
bridging and bonding social capital, while content type helps establish
bridging social capital. The paper is original because it helps
understand how cruise lines can improve bonding and bridging social
capital via social media. The paper also enhances understanding of
social capital theory in the travel industry by investigating the
relationship between Facebook post types and social capital in cruise
shipping
A critical realist exploration of the mother’s subjective experience of her relationship with her baby. The importance of recognising and supporting reciprocity in infant care and the barriers to achieving this
Get PDFResearch emphasises the importance of the mother-infant relationship for infants’ well-being. To benefit interventions, the current research, using a critical realist lens, investigates an area that research has neglected, which is the subjective experience of the mother-infant relationship, including experiences of moments of connection. Bourdieu’s ‘thinking tools’ enables exploration of mechanisms that may affect the mother-infant relationship. How the study’s results can inform health visiting practice is considered.
Six mothers were interviewed, four of whom participated in a video of their mother-infant interaction. Two focus groups, each with six health visitors, discussed their practice in the context of supporting the mother-infant relationship. Interpretative phenomenological analysis and thematic analysis were employed.
This research indicated a high arousal state, referred to as Vigilantia, was experienced by mothers and infants. Vigilantia appeared to support mothers’ drive to make sense of their young infants but also seemed associated with mothers’ reliance on a discourse of the ‘traditional baby’, which stressed instrumental care and omitted the relational infant. The mothers found it difficult to make sense of the “bizarre” relational connection they felt for their infants. Health visitors described obstacles to supporting the mother-infant relationship associated with their service’s design and their role. Health visitors also seemed to identify with some mothers and in doing so could overlook the infants.
Neoliberal values discount the relational and these values affect the experience of the mother-infant relationship. Ideas for improving practice are suggested, as well as acknowledgment of the need for social structural changes
Mystalk Alert: A Response to Cyberstalking in Malaysia
Get PDFYesThe Internet has become a vital part of our daily lives in the last two decades. However, as a
double-edged sword, such reliance has increased the chance of being targeted by various
cybercrimes, including cyberstalking. Furthermore, when the crime transcends into the real
world, it can result in rape and even murder. Hence, the MYStalk Alert application aims at
helping and facilitating the victims of stalking and victims of harassment generally to
understand, cope, and document their experience on the crime for a compelling trail of evidence
in the criminal justice process. This Application aims to remedy the circumstances by giving
access to users to the features that make it easy to document the evidence and provides them
with available information on the crime and the legal landscape of stalking in Malaysia.
Furthermore, MYStalk Alert also focused on the user’s physical and psychological by
providing self-assessment and tips for the wellbeing including mental health test under the
feature of victims’ support. The Application is a first of its kind in Malaysia and aims to support
victims of stalking in getting the justice they deserved. The preliminary findings revealed
contradictory views on the effective response of the criminal justice system towards
cyberstalking, which explains the under-reporting of such crime. Significantly, the findings
illustrate that the current Malaysian legal framework on cyberstalking is deficient in protecting
cyberstalking victims, which calls for an urgent need for a review in the Malaysian laws.This work was supported by research grant FRGS/1/2019/SSI10/UITM/02/2 by the Research Management Centre, UiTM Shah Alam, Selangor, Malaysia
Recent Development in Sexual Harassment Law in Malaysia: Whither the Victim's Protection?
Get PDFYesBefore 2012, there was no law on sexual harassment in Malaysia. However, when the
Employment Act 1955 was amended in 2012, employers must inquire into sexual harassment
complaints, failing which a criminal penalty will be imposed. Unfortunately, the new law did
not allow a complainant to claim damages from the harasser or the employer. After more
than two decades of campaigns by women's rights groups and NGOs, the Anti-Sexual
Harassment Bill 2021 (hereinafter 'the ASHB 2021') was finally enacted and passed in July this
year. Given the novelty and absence of any academic research, this paper seeks to examine
the provisions of the Bill critically to understand its scope, coverage and broader implications
for sexual harassment victims. The paper employs a qualitative research methodology,
adopting a doctrinal approach and content analysis of the primary source, the ASHB 2021,
that would provide a deeper understanding of the legislation. The authors contend that
despite being regarded as a victim-centric law, the Bill is half-baked and inadequate to protect
sexual harassment victims due to its failure to include significant provisions on the sexual
harassment definition, the protection against victimisation and employers' obligations to
prevent and address such conduct.The authors would like to express their gratitude to the Faculty of Law, Universiti Teknologi MARA (UiTM) Shah Alam, Selangor, Malaysia, which facilitated the writing and publication workshop and funded this paper
The Impact of Allied Health Professionals on the Primary and Secondary Prevention of Obesity in Young Children: A Scoping Review
Get PDFYesAllied Health Professionals (AHPs) have the capacity to promote healthy
behaviours in young children through routine ‘contact points’, as well as structured weight
management programmes. This scoping review aims to evaluate the impact of AHPs in the
prevention of obesity in young children.
Methods: Databases were searched for relevant evidence between 1st January 2000 and 17th
January 2022. Eligibility criteria included primary evidence (including, but not limited to;
randomised controlled trials, observational studies, service evaluations) evaluating the
impact of AHPs on the primary and secondary prevention of obesity in young children (mean
age under five years old).
Results: AHP related interventions typically demonstrated improvements in outcomes such
as nutritional behaviour (e.g., lower sweetened drink intake), with some reductions in screen
time. However, changes in weight outcomes (e.g., Body Mass Index (BMI) z score, BMI) in
response to an AHP intervention were inconsistent. There was insufficient data to determine
moderating effects, however tentative evidence suggests that those with a lower
socioeconomic status or living in an underprivileged area may be more likely to lose weight
following an AHP intervention. There was no evidence identified evaluating how AHPs use
routine ‘contact points’ in the prevention of obesity in young children.
Conclusion: AHP interventions could be effective in optimising weight and nutritional
outcomes in young children. However, more research is required to determine how routine
AHP contact points, across the range of professional groups may be used in the prevention
of obesity in young children
Curious Travellers: Using web-scraped and crowd-sourced imagery in support of heritage under threat
Get PDFYesDesigned as a pragmatic approach that anticipates change to cultural heritage, this chapter discusses responses that encompass records for tangible cultural heritage (monuments, sites and landscapes) and the narratives that see the impact upon them. The Curious Travellers project provides a mechanism for digitally documenting heritage sites that have been destroyed or are under immediate threat from unsympathetic development, neglect, natural disasters, conflict and cultural vandalism. The project created and tested data-mining and crowd-sourced workflows that enable the accurate digital documentation and 3D visualisation of buildings, archaeological sites, monuments and heritage at risk. When combined with donated content, image data are used to recreate 3D models of endangered and lost monuments and heritage sites using a combination of open-source and proprietary methods. These models are queried against contextual information, helping to place and interrogate structures with relevant site and landscape data for the surrounding environment. Geospatial records such as aerial imagery and 3D mobile mapping laser scan data serve as a framework for adding new content and testing accuracy. In preserving time-event records, image metadata offers important information on visitor habits and conservation pressures, which can be used to inform measures for site management.The Curious Travellers project was funded as a component of the AHRC Digital Transformations Theme Large Grant ‘Fragmented Heritage’ (AH/L00688X/1). AHRC Follow-on funding has seen this approach contribute to the BReaTHe project (AH/S005951/1) which seeks to Build Resilience Through Heritage for displaced communities and with a contribution to the BA Cities and Infrastructures Scheme project, ‘Reducing Disaster Risk to Life and Livelihoods by evaluating the seismic performance of retrofitted interventions within Kathmandu’s UNESCO World Heritage Site during the 2015 Earthquake’, with Durham University (KF1\100109)
Getting the measure of brochs: using survey records old and new to investigate Shetland's Iron Age archaeology
No full textNoBrochs are monumental Iron Age (c.400–200 BC) drystone towers or roundhouses. They are only found in Scotland, particularly the Atlantic north and west. Whilst the structural layout of brochs has long been debated, few measured surveys have been conducted. Three significant broch sites form the tentative World Heritage site of “Mousa, Old Scatness and Jarlshof: the Zenith of Iron Age Shetland” (UNESCO in Mousa, Old Scatness and Jarlshof: the zenith of Iron Age Shetland, UNESCO (2019) Mousa, Old Scatness and Jarlshof: the zenith of Iron Age Shetland. http://whc.unesco.org/en/tentativelists/5677. Accessed 9 Aug 2019). All three sites have undergone new surveys as part of a collaborative doctoral partnership research project. This chapter presents a diachronic perspective using digital documentation techniques to detect stone displacement and weathering at the site of Old Scatness using historic imagery, including photographs from the Old Scatness excavations (1995–2006) and regular condition monitoring undertaken by Shetland Amenity Trust to undertake retrospective digital structure-from-motion (SfM) photogrammetry. Whilst point clouds and 3D meshes were successfully generated from low-resolution digital images, analogue film transparencies without metadata could not produce accurate geospatial data without manually trying to extant reference data. It was possible to detect displacements in stonework over time by comparing two meshes together and measuring the distances between vertex point pairs. The reliability and accuracy of these results were dependent on how well pairs of meshes could be aligned