1,721,028 research outputs found
IMPLEMENT-CVD Phase 1: Health system factors affecting implementation of fixed-dose combination therapy for hypertension in Kenya
No full textImproving delivery of hospital care in Kenya : understanding how health workers and contexts influence change
Full text linkIntroduction:
Despite considerable efforts directed at developing international evidence based guidelines to improve clinical management, adoption of evidence based practices can be poor in low-income settings including Kenya. Studies in Africa rarely consider the implementation and change processes as influenced by the structural and organizational context in which clinicians are embedded nor how these can influence performance. This thesis builds on existing literature and theory on behavioural change, clinician-managers’ identity construction processes and contextualized leadership processes by examining these and their effect on guideline adoption in the complex contexts of Kenyan county hospitals.
Methods:
Methodologically I explored these issues through qualitative ethnographic approaches using in-depth interviews, focus group discussions and non-participant observations. I analyzed data inductively and deductively borrowing from the grounded theory approach to develop plausible explanations of collated data and observations.
Results:
Early work indicated limited attention to local dissemination of the new guidelines and poor leadership in implementing Evidence Based Medicine (EBM) as key barriers. However, specially introduced ‘study facilitators’ as part of an intervention study emerged as leaders of change often acting as role models, friendly supervisors and peer educators to facilitate EBM implementation. Further work reviewing literature on the roles of clinical mid-level managers (MLMs; department leaders) in improving service delivery emphasized the importance of ‘soft skills’ e.g. building interpersonal relationships, mentoring, coaching and effective communication skills. Subsequent in-depth empiric work on identity transitions of these clinical MLMs indicated that ‘identity work’, drawing on competing professional and managerial institutional logics resulted into ‘willing’, ‘ambivalent’ and ‘reluctant’ hybrids. Distributed leadership by hybrids was undermined by existing hierarchical professional autonomy and cadre delineations between nurses and doctors in the public county hospitals we studied.
Discussion:
The thesis describes both a set of work and a research journey. My initial work was predominantly based on applying the Theory of Planned Behaviour to explain behaviour of front-line health workers. However, it quickly became clear that this provided only a partial understanding of guideline adoption within a hospital overlooking the pivotal role of clinical team leaders / in influencing change. There emerged valuable lessons for current Kenyan leadership and management development programmes which are likely to be transferable to other African health systems. Particular recommendations from this work are the importance of a focus on the soft-skills of those stepping into clinical hybrid manager roles and considering the ‘practical norms’ of Kenyan public hospitals in understanding the gap between desired official institutional norms and health workers actual behavioural practices
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
Full text link“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
Full text linkWe 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
Full text linkWe 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
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe 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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