12508 research outputs found
Sort by
The impact of hospital command centre on patient flow and data quality: findings from the UK NHS
Get PDFYesIn the last six years, hospitals in developed countries have been trialling the use of command centres for improving organisational efficiency and patient care. However, the impact of these Command Centres has not been systematically studied in the past.
Methods: It is a retrospective population based study. Participants were patients who visited Bradford Royal Infirmary Hospital, accident and emergency (A&E) department, between Jan 01, 2018 and August 31, 2021. Outcomes were patient flow (measured as A&E waiting time, length of stay and clinician seen time)and data quality (measured by the proportion of missing treatment and assessment dates and valid transition between A&E care stages).Interrupted time-series segmented regression and process mining were used for analysis.
Results: A&E transition time from patient arrival to assessment by a clinician marginally improved during the intervention period; there was a decrease of 0.9 minutes (95% CI: 0.35 to 1.4), 3 minutes (95% CI: 2.4 to 3.5), 9.7 minutes (95% CI: 8.4 to 11.0) and 3.1 minutes (95% CI: 2.7 to 3.5) during ‘patient flow program’, ‘command centre display roll-in’, ‘command centre activation’ and ‘hospital wide training program’, respectively. However, the transition time from patient treatment until conclusion of consultation showed an increase of 11.5 minutes (95% CI: 9.2 to 13.9), 12.3 minutes (95% CI: 8.7 to 15.9), 53.4 minutes (95% CI: 48.1 to 58.7) and 50.2 minutes (95% CI: 47.5 to 52.9) for the respective four post-intervention periods. Further, length of stay was not significantly impacted; the change was -8.8hrs (95% CI: -17.6 to 0.08), -8.9hrs (95% CI: -18.6 to 0.65), -1.67hrs (95% CI: -10.3 to 6.9) and -0.54hrs (95% CI: -13.9 to 12.8) during the four respective post intervention periods. It was a similar pattern for the waiting and clinician seen times. Data quality as measured by the proportion of missing dates of records was generally poor (treatment date=42.7% and clinician seen date=23.4%) and did not significantly improve during the intervention periods.
Conclusion: The findings of the study suggest that a command centre package that includes process change and software technology does not appear to have consistent positive impact on patient safety and data quality based on the indicators and data we used. Therefore, hospitals considering introducing a Command Centre should not assume there will be benefits in patient flow and data quality.This project is funded by the National Institute for Health Research Health Service and Delivery Research Programme (NIHR129483)
The Duality Impact of Artificial Intelligence against Countering and Preventing Violent Extremism: What Law Got to do with it?
No full textNoIn the past decade, information technology and the Internet have helped fuel radicalisation and violent extremism (VE), which have transcended from the real world to cyberspace. The emergence of new technologies such as Artificial Intelligence (AI) has also paved the way for insurgents to spread their propaganda using such disruptive technologies. The duality of AI proved that while such new technology can bring vast improvements to various sectors, it also has the potential to facilitate extremist behaviours and activities. Terrorist and violent rebels have shifted their ways to use technologies such as AI to spread radical ideology and propaganda, recruit new members, organize financial support and operational tactics and manage online communities. Similarly, AI is seen as a holy grail especially in predictive analytics in the race to prevent and counter-terrorist activities. This research employs qualitative methodology, in which the primary data was collected through semi-structured interviews. The sampling method in this research is purposive sampling and the qualitative data analysis was conducted through thematic and content analysis, in which the observations and the interview transcripts from the semi-structured interviews were examined. The primary data were triangulated with data obtained from the stakeholders. The findings revealed that while the use of AI facilitates enforcers in predicting extremist activities, detecting misinformation and countering extremist narratives, such technology has also aided terrorists and extremists in spreading mass information via automatise chatbots and coordinating information and attacks. The use of AI is said to be a double-edged sword where it serves the aims of a nation’s cybersecurity strategies, but at the same time aid extremists in fulfilling their radical goals. The legal landscape governing AI is still scarce and challenges such as duality call for a specific legal guideline or legislation to aid in the effective governing of such crime
The human rights to water and sanitation
No full textNoThe human right to water offers a strong legal tool for empowering millions of people living without safe drinking water around the world by creating legal obligations and standards for universal access to safe drinking water. The human right to sanitation creates legal obligations and standards for progressive improvement of access for the bil lions of people living without a basic level of sanitation services and the millions depending on open defecation. Both rights have evolved through closely linked processes at the international level, with implications for water and sanitation governance processes at the national level. This chapter analyses the co-evolution of the human rights to water and sanitation and the legal foundations of the rights at the international level, while highlighting the relationship between the rights and discussing the unique developments which each right has experienced. The chapter also considers the implementation chal- lenges and justiciability issues that will shape the future development of both rights at the international and national levels
Differences of corruption types in selected Western and central-eastern health systems during the COVID-19 pandemic: a rapid review
Get PDFYesTo identify, describe, and classify the cases of health corruption present in selected Western [the Netherlands and the United Kingdom (UK)] and Central-Eastern European (Poland and Slovakia) countries during the COVID-19 pandemic.
A rapid review of the literature was conducted, evaluating data from 11 March 2020 to 15 April 2021. Information sources included MEDLINE via WoS, IBSS via ProQuest, Scopus, and gray literature.
Thirteen cases were identified across the four countries. The primary type of health corruption in Western European countries was procurement corruption, while misuse of (high) level positions was the most prevalent in Central-Eastern European countries. Actors from central governments were most involved in cases. The rule of law and anti-corruption watchdogs reported most cases in the United Kingdom and the Netherlands, while the media reported cases in Poland and Slovakia.
The differences in types of corruption in WE and CEE countries emphasize the need to contextualize the approach to tackle corruption. Thus, further research in preventing and tackling corruption is a vital and necessary undertaking despite the inherent of conducting health corruption research
Food Waste Reduction through Food Sharing Initiatives: The lived Experiences of Restaurants and Food Bank Employees in Riyadh
Get PDFToday’s world is characterised by considerable inconsistency. In some parts of the world people are living in starvation and malnutrition, while in some other parts of the same world, about 1.3 billion tons of food is wasted every year. We do not know enough about what contributes to food waste. However, there seems to be an emergent pattern of behaviour around sharing food. This hermeneutic phenomenological research will explore how food sharing might reduce food waste in a cultural and community-based society like Saudi Arabia through the lived experiences of restaurants and food bank employees.
Research data were collected through a face-to-face semi-structured interview method from 15 participants from selected restaurants and food bank in Riyadh. Using the theory of planned behaviour (TPB) as the theoretical lens, a conceptual framework was proposed to elicit underlying behavioural and cultural factors impeding food waste reduction and the inefficiency of food sharing. Using Paul Colaizzi’s approach, the collected interview data were reviewed, analysed, and seventeen themes were elicited for further discussion.
The findings suggest that culture through an affluent way of life and the show-off lifestyle of hosts continue to contribute to more food wastage. The strictly business nature of restaurants operation leads to edible food fit for human consumption ending up in the garbage. The revised conceptual framework provides insight into the factors hindering food waste reduction and food sharing. With supporting regulations and policies, food leftovers can either be distributed to people in need or put to an alternative use
Sustainable development, capabilities, hegemonic forces and social risks: extending the capability approach to promote resilience against social inequalities
No full textYesThe capability approach (CA), while originally regarded as a ‘thin’ framework relating to an individual’s ‘States’, has been progressively deployed in wider spaces of social welfare and policy development. In general, the CA centralises an individual’s (or group’s) functionings, and the freedom to achieve those functionings. One under-researched area is the expression of capabilities when constraints are imposed hegemonically, that is, when an individual (or group) appears to consent to having their choices limited because of some underlying sociocultural ideology. Hegemonic forces are particularly relevant to the application of the CA against the UN’s sustainable development goals (SDGs); specifically, reduced inequalities (Goal 10) under its 2030 Agenda for Sustainable Development, since it is generally under large-scale policy regime shifts that sociocultural inequalities are broken and renewed. New, less transparent hegemonies often emerge within policy changes that seek to address inequalities, and they typically embody a mitigating reaction to social risks emanating from policy change. The chapter is fundamentally a theoretical and conceptual paper, approached from an interdisciplinary context, and draws on concepts such as sustainable development, capability approach, and freedom in analysing hegemonic forces with respect to reducing inequalities
A low-cost and hand-hold PCR microdevice based on water-cooling technology
Get PDFYesPolymerase chain reaction (PCR) has become a powerful tool for detecting various diseases due to its high sensitivity and specificity. However, the long thermocycling time and the bulky system have limited the application of PCR devices in Point-of-care testing. Herein, we have proposed an efficient, low-cost, and hand-hold PCR microdevice, mainly including a control module based on water-cooling technology and an amplification module fabricated by 3D printing. The whole device is tiny and can be easily hand-held with a size of about 110 mm × 100 mm × 40 mm and a weight of about 300 g at a low cost of about $170.83. Based on the water-cooling technology, the device can efficiently perform 30 thermal cycles within 46 min at a heating/cooling rate of 4.0/8.1 ℃/s. To test our instrument, plasmid DNA dilutions were amplified with this device; the results demonstrate successful nucleic acid amplification of the
Meta-evaluation of a whole systems programme, ActEarly: A study protocol
Get PDFYesLiving in an area with high levels of child poverty predisposes children to poorer mental and physical health. ActEarly is a 5-year research programme that comprises a large number of interventions (>20) with citizen science and co-production embedded. It aims to improve the health and well-being of children and families living in two areas of the UK with high levels of deprivation; Bradford in West Yorkshire, and the London Borough of Tower Hamlets. This protocol outlines the meta-evaluation (an evaluation of evaluations) of the ActEarly programme from a systems perspective, where individual interventions are viewed as events in the wider policy system across the two geographical areas. It includes investigating the programme's impact on early life health and well-being outcomes, interdisciplinary prevention research collaboration and capacity building, and local and national decision making.
The ActEarly meta-evaluation will follow and adapt the five iterative stages of the 'Evaluation of Programmes in Complex Adaptive Systems' (ENCOMPASS) framework for evaluation of public health programmes in complex adaptive systems. Theory-based and mixed-methods approaches will be used to investigate the fidelity of the ActEarly research programme, and whether, why and how ActEarly contributes to changes in the policy system, and whether alternative explanations can be ruled out. Ripple effects and systems mapping will be used to explore the relationships between interventions and their outcomes, and the degree to which the ActEarly programme encouraged interdisciplinary and prevention research collaboration as intended. A computer simulation model ("LifeSim") will also be used to evaluate the scale of the potential long-term benefits of cross-sectoral action to tackle the financial, educational and health disadvantages faced by children in Bradford and Tower Hamlets. Together, these approaches will be used to evaluate ActEarly's dynamic programme outputs at different system levels and measure the programme's system changes on early life health and well-being.
This meta-evaluation protocol presents our plans for using and adapting the ENCOMPASS framework to evaluate the system-wide impact of the early life health and well-being programme, ActEarly. Due to the collaborative and non-linear nature of the work, we reserve the option to change and query some of our evaluation choices based on the feedback we receive from stakeholders to ensure that our evaluation remains relevant and fit for purpose.This work was supported by the UK Prevention Research Partnership (MR/S037527/1), which is funded by the British Heart Foundation, Cancer Research UK, Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Health and Social Care Research and Development Division (Welsh Government), Medical Research Council, National Institute for Health Research, Natural Environment Research Council, Public Health Agency (Northern Ireland), The Health Foundation and Wellcome
Mapping the barriers of big data process in construction: The perspective of construction professionals
Get PDFYesThis study identifies, maps and thematizes the barriers to the big data process in the construction industry from the perspective of construction professionals. Australian construction professionals with varying experiences in the big data process were interviewed. Qualitative data analysis identified forty barriers in the big data process and five themes: people, knowledge, technology, data, and environment. The barriers were further mapped, with some transcending more than one stage in the big data process. Many of the barriers have not been empirically identified in previous studies. By implication, mapping the barriers across the big data process enables professionals/construction firms to visualize the potential lapses before and/or during implementation. Therefore, the study offers professionals/construction firms strategic insights and operational perspectives for planning and deploying big data processes
A Narrative Study Carried Out With Older Women With Dementia Who Live Alone: Storytelling About Their Living Arrangements and Wishes For The Future
No full textThis study sets out to explore the significance of gender as an element in the experience of older women living alone at the time of a diagnosis of dementia. It places particular emphasis on power, voice and in/visibility in both research practice and co-production.
Older women who live alone may experience difficulties after diagnosis in adapting to their environments. There is not a clear picture of support networks, such as the roles within broader families, neighbours or friends and access to services. Fewer studies focus on women and dementia from a gendered perspective and more on dementia and caregivers. As such, questions about gender, dementia and ageing are not being raised as interrelated and the voices of these women are silent.
The study was informed by feminist theory and the concept of intersectionality which become the principal way to theorise the relations between systems of oppression and privilege. This provided a lens with which to expose and examine gendered assumptions within dementia.
The design was a qualitative study, and the approach was narrative research. The approach that was taken to collect the data was storytelling, which was analysed by re-storying the stories, and developing themes, in a chronology order.
The thesis also discusses my positionality as a Black British female researcher, including experiences of racism, both within the academia and in the research field