1,721,020 research outputs found

    Systems modelling and simulation in health service design, delivery and decision making

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    The ever increasing pressures to ensure the most efficient and effective use of limited health service resources will, over time, encourage policy makers to turn to system modelling solutions. Such techniques have been available for decades, but despite ample research which demonstrates potential, their application in health services to date is limited. This article surveys the breadth of approaches available to support delivery and design across many areas and levels of healthcare planning. A case study in emergency stroke care is presented as an exemplar of an impactful application of health system modelling. This is followed by a discussion of the key issues surrounding the application of these methods in health, what barriers need to be overcome to ensure more effective implementation, as well as likely developments in the futur

    Here’s something we prepared earlier: development, use and reuse of a configurable, inter-disciplinary approach for tackling overcrowding in NHS hospitals

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    Overcrowding affects hospital emergency departments (ED) worldwide. Most OR studies addressing overcrowding develop bespoke models to explore potential improvements but ignore the organisational context in which they would be implemented, and few influence practice. There is interest in whether reusable models, for ED crowding and in healthcare generally, could have more impact. We developed a configurable approach for tackling ED overcrowding. A reusable queuing model for exploring drivers of ED performance was augmented by a qualitative approach for exploring the implementation context and a generic framework for assessing the likely compatibility of interventions with a given organisation. At the hospital where the approach was developed it directly informed strategy. We describe reuse of the approach at three hospitals. One project was completed and well-received by hospital management, two were terminated partway when data problems surfaced. The primary contribution of this work is its novelty in considering, alongside quantitative modelling, evidence-based interventions to overcrowding and qualitative assessment of a hospital’s aptitude and capability to adopt different interventions. A secondary contribution is to further the debate on model reuse, particularly by introducing more complex, modelling-centred approaches that acknowledge how models must relate to tangible interventions with reasonable prospects of being adopted locally

    Aiding Infection Prevention and Control Decision-Making using mathematical and simulation-based modelling

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    Hospital-acquired infections (HAIs) pose a significant risk to both staff and patients, potentially complicating patient treatment and causing serious illness that can increase morbidity to those infected and incur substantial costs for the NHS. Consequently, infection prevention and control (IPC) measures are often implemented to reduce transmission within the healthcare system. However, some of these measures can have a negative impact on patient flow through the system. This thesis focuses on the development of models to determine the complex con- sequences of IPC policies and help decision-makers to better assess the potential trade-offs between HAIs and patient flow. Through engagement with relevant stakeholders, a general description of scenarios where IPC policies have a potential impact on patient flow was developed, along with a set of use cases where potential trade-offs between infections and flow occur in practice. A modelling framework was formulated that, together with the problem description, contains all the necessary components to enable the development of models to quantify the consequences of IPC policies. This thesis presents analytical and simulation models to quantify these consequences. A Continuous-time Markov Chain analytical model is used to develop closed-form expressions for the model outputs. A Discrete Event Simulation model is also constructed, which is flexible to altering key model assumptions, enhancing its translatability across institutions. Each model is applied to an example scenario to demonstrate the outputs that the model can provide to assess the impact of different policies. The benefits of developing both models in parallel are discussed, including an analysis of the robustness of the analytical model to altering key model assumptions. Using these models, three methods are developed to aid decision-makers make more informed and reliable decisions. The benefits and limitations of each method are compared, with a particular focus on their likelihood of implementation across different hospitals

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Variations on the Author

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    “Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship

    Appropriate Similarity Measures for Author Cocitation Analysis

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    We provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis

    Dispelling the Myths Behind First-author Citation Counts

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    We conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more sophisticated methods

    Author Index

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    koamabayili/VECTRON-author-checklist: VECTRON author checklist

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    We have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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