Patients’ and health professionals’ views and experiences of atrial fibrillation and oral-anticoagulant therapy:a qualitative meta-synthesis

Objective - Atrial fibrillation (AF) patients are prescribed oral-anticoagulant (OAC) therapy, often warfarin, to reduce stroke risk. We explored existing qualitative evidence about patients’ and health professionals’ experiences of OAC therapy. Methods - Systematic searches of eight bibliographic databases were conducted. Quality was appraised using the Critical Appraisal Skills Programme tool and data from ten studies were synthesised qualitatively. Results - Four third-order constructs, emerged from the final step in the analysis process: (1) diagnosing AF and the communication of information, (2) deciding on OAC therapy, (3) challenges revolving around patient issues, and (4) healthcare challenges. Synthesis uncovered perspectives that could not be achieved through individual studies. Conclusion - Physicians’ and patients’ experiences present a dichotomy of opinion on decision-making, which requires further exploration and changes in practice. Outcomes of workload pressure on both health professionals and patients should be investigated. The need for on-going support and education to patients and physicians is critical to achieve best practice and treatment adherence. Practice implications - Such research could encourage health professionals to understand and attend better to the needs and concerns of the patient. Additionally these findings can be used to inform researchers and healthcare providers in developing educational interventions with both patients and health professionals.

Real options in multinational decision-making:managerial awareness and risk implications

This paper addresses the theme of real options decision-making in multinational corporations (MNCs) and stresses the role of real options attention and managerial learning in company performance. Using a sample of 278 large MNCs with categorised degrees of managerial real options awareness, we examine the risk implications of switching options in multinational operations, and explore the extent to which the real options logic can be classified as “best practice” in decision-making and risk management. Our results reveal that MNCs which have high managerial awareness about their real options are able to reduce their downside risk through multinationality, organisational slack and other firm characteristics. This finding does not apply fully to MNCs without evidence of such an awareness. Also, although real options awareness does not systematically guarantee lower downside risk from operations, supplementary results indicate that MNCs with evidence of significant investment in the acquisition of real options knowledge tend to outperform competitors that are unaware of their real options. This suggests that if real options are explored and exploited appropriately, real options decision-making can result into superior performance for MNCs in the long-term.

The importance of team-working in knowledge transfer partnerships

Research capacity can be built by collaboration between industry and universities, and Knowledge Transfer Partnerships (KTPs) are an ideal way to do this. While good collaboration and team-work has been recognised as crucial for success, projects tend to be evaluated on outcomes and not collaboration effectiveness. This paper discusses best practice for how a KTP project team might work together effectively.

The experience of delivering case award research in a public sector setting

The CASE Award PhD is a relatively new approach to completing academic research degrees, aligning the ideals of comprehensive research training and cross-collaboration between academics and organisations. As the initial wave of CASE funded PhD research begins to near completion, and indeed become evident through the publication of results, now is an appropriate time to begin the evaluation process of how to successfully deliver a CASE PhD, and to analyse the best practice approaches of completing a CASE Award with an organisation. This article intends to offer a picture into the CASE PhD process, with a focus on methods of communication to successfully implement this kind of research in collaboration with an organisation.

Is there a global model of learning organizations? An empirical, cross-nation study

This paper develops and tests a learning organization model derived from HRM and dynamic capability literatures in order to ascertain the model's applicability across divergent global contexts. We define a learning organization as one capable of achieving on-going strategic renewal, arguing based on dynamic capability theory that the model has three necessary antecedents: HRM focus, developmental orientation and customer-facing remit. Drawing on a sample comprising nearly 6000 organizations across 15 countries, we show that learning organizations exhibit higher performance than their less learning-inclined counterparts. We also demonstrate that innovation fully mediates the relationship between our conceptualization of the learning organization and organizational performance in 11 of the 15 countries we examined. It is the first time in our knowledge that these questions have been tested in a major, cross-global study, and our work contributes to both HRM and dynamic capability literatures, especially where the focus is the applicability of best practice parameters across national boundaries.

Data envelopment analysis model for the appraisal and relative performance evaluation of nurses at an intensive care unit

The appraisal and relative performance evaluation of nurses are very important and beneficial for both nurses and employers in an era of clinical governance, increased accountability and high standards of health care services. They enhance and consolidate the knowledge and practical skills of nurses by identification of training and career development plans as well as improvement in health care quality services, increase in job satisfaction and use of cost-effective resources. In this paper, a data envelopment analysis (DEA) model is proposed for the appraisal and relative performance evaluation of nurses. The model is validated on thirty-two nurses working at an Intensive Care Unit (ICU) at one of the most recognized hospitals in Lebanon. The DEA was able to classify nurses into efficient and inefficient ones. The set of efficient nurses was used to establish an internal best practice benchmark to project career development plans for improving the performance of other inefficient nurses. The DEA result confirmed the ranking of some nurses and highlighted injustice in other cases that were produced by the currently practiced appraisal system. Further, the DEA model is shown to be an effective talent management and motivational tool as it can provide clear managerial plans related to promoting, training and development activities from the perspective of nurses, hence increasing their satisfaction, motivation and acceptance of appraisal results. Due to such features, the model is currently being considered for implementation at ICU. Finally, the ratio of the number DEA units to the number of input/output measures is revisited with new suggested values on its upper and lower limits depending on the type of DEA models and the desired number of efficient units from a managerial perspective.

Public and private hospital services reform:an investigation in Iranian hospitals

This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani province of Iran by making use of DEA approach in order to recognize and suggest the best practice standards. In other words, its aim was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. It is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial and national levels.

The atypical bilingual courtroom:an exploratory study of the interactional dynamics in interpreter-mediated trials in Hong Kong

This study investigates the communication process in the atypical bilingual Hong Kong courtroom, where, unlike in most other jurisdictions, interpreting services are routinely provided for the linguistic majority instead of the linguistic minority and the interpreter usually has to work with court actors who share his/her bilingual knowledge. It sets out to explore how the unique nature of the bilingual Hong Kong courtroom impacts on interactional dynamics in communicative process in the courtroom and potentially on the administration of justice, using authentic recordings of nine criminal trials from three court levels, supplemented by a survey administered to court interpreters. It compares the participant roles of different court actors in different court settings, monolingual and bilingual, using Goffman’s (1981) participation framework and Bell’s (1984) audience design as the conceptual framework. It is found that the notion of recipientship in the atypical bilingual Hong Kong courtroom is complicated by the presence of other bilinguals, which inevitably changes the interactional dynamics and impacts on the power of court interpreter as these bilinguals take on more participant roles in the process. The findings of this study show that the power of court actors is realised in the participant role(s) they and the other co-present court actors take on or are capable of playing. The findings also indicate that a change in the participant role of a court actor has an impact on the participation status other actors, which may in turn hamper the administration of justice. It is also found that the notion of power asymmetry in the courtroom has an effect on the footings adopted by the interpreter and thus on his/her neutrality. This thesis identifies training needs and makes recommendations for best practice in the courtroom and for institutional administrative practice.

Managing students' option choices with technology

This poster outlines the system which the Business School Undergraduate Programme has developed to manage the choice of options by students studying on its programmes. This involves the production of a networked computer package which presents students with the options available to them and leads them through the process of choosing their options on-line. The reasons for developing this system are outlined and the advantages which it has brought to the administration of large numbers of students are discussed.

Form follows function:model-driven engineering for clinical trials

We argue that, for certain constrained domains, elaborate model transformation technologies-implemented from scratch in general-purpose programming languages-are unnecessary for model-driven engineering; instead, lightweight configuration of commercial off-the-shelf productivity tools suffices. In particular, in the CancerGrid project, we have been developing model-driven techniques for the generation of software tools to support clinical trials. A domain metamodel captures the community's best practice in trial design. A scientist authors a trial protocol, modelling their trial by instantiating the metamodel; customized software artifacts to support trial execution are generated automatically from the scientist's model. The metamodel is expressed as an XML Schema, in such a way that it can be instantiated by completing a form to generate a conformant XML document. The same process works at a second level for trial execution: among the artifacts generated from the protocol are models of the data to be collected, and the clinician conducting the trial instantiates such models in reporting observations-again by completing a form to create a conformant XML document, representing the data gathered during that observation. Simple standard form management tools are all that is needed. Our approach is applicable to a wide variety of information-modelling domains: not just clinical trials, but also electronic public sector computing, customer relationship management, document workflow, and so on. © 2012 Springer-Verlag.

A framework for assessing business-incubation input, process and output performance:proceedings of the RENT XXVII Conference, 20-22 November 2013, Vilnius, Lithuania

With business incubators deemed as a potent infrastructural element for entrepreneurship development, business incubation management practice and performance have received widespread attention. However, despite this surge of interest, scholars have questioned the extent to which business incubation delivers added value. Thus, there is a growing awareness among researchers, practitioners and policy makers of the need for more rigorous evaluation of the business incubation output performance. Aligned to this is an increasing demand for benchmarking business incubation input/process performance and highlighting best practice. This paper offers a business incubation assessment framework, which considers input/process and output performance domains with relevant indicators. This tool adds value on different levels. It has been developed in collaboration with practitioners and industry experts and therefore it would be relevant and useful to business incubation managers. Once a large enough database of completed questionnaires has been populated on an online platform managed by a coordinating mechanism, such as a business incubation membership association, business incubator managers can reflect on their practices by using this assessment framework to learn their relative position vis-à-vis their peers against each domain. This will enable them to align with best practice in this field. Beyond implications for business incubation management practice, this performance assessment framework would also be useful to researchers and policy makers concerned with business incubation management practice and impact. Future large-scale research could test for construct validity and reliability. Also, discriminant analysis could help link input and process indicators with output measures.

Design and designing:a critical introduction

Design and Designing provides a broad and critical understanding of what is essentially a practical subject. Designing today is less a craft and more a part of the knowledge economy. It's all about knowing how to acquire knowledge and how to apply it creatively. Design and Designing covers the design process, modelling and drawing, working with clients, production and consumption, sustainability, professional practice and design futures. Chapters are written by expert teachers and practitioners from around the globe, each presenting an accessible and engaging overview of their field of design. Every chapter is highly illustrated with a combination of images and information boxes, which extend or highlight key material. Each section concludes with a design project, a hands-on activity for the reader. Design and Designing covers the full spectrum of design types, from graphic communication to product design, from fashion to games design, setting every type in its aesthetic, ethical and social contexts. With this essential book, readers will learn from today's best practice and best thinking in design, they will develop a critical sense, and become the designers of tomorrow.

Optimal design for correlated processes with input-dependent noise

Optimal design for parameter estimation in Gaussian process regression models with input-dependent noise is examined. The motivation stems from the area of computer experiments, where computationally demanding simulators are approximated using Gaussian process emulators to act as statistical surrogates. In the case of stochastic simulators, which produce a random output for a given set of model inputs, repeated evaluations are useful, supporting the use of replicate observations in the experimental design. The findings are also applicable to the wider context of experimental design for Gaussian process regression and kriging. Designs are proposed with the aim of minimising the variance of the Gaussian process parameter estimates. A heteroscedastic Gaussian process model is presented which allows for an experimental design technique based on an extension of Fisher information to heteroscedastic models. It is empirically shown that the error of the approximation of the parameter variance by the inverse of the Fisher information is reduced as the number of replicated points is increased. Through a series of simulation experiments on both synthetic data and a systems biology stochastic simulator, optimal designs with replicate observations are shown to outperform space-filling designs both with and without replicate observations. Guidance is provided on best practice for optimal experimental design for stochastic response models. © 2013 Elsevier Inc. All rights reserved.

Productivity growth and efficiency measurements in fuzzy environments with an application to health care

Health care organizations must continuously improve their productivity to sustain long-term growth and profitability. Sustainable productivity performance is mostly assumed to be a natural outcome of successful health care management. Data envelopment analysis (DEA) is a popular mathematical programming method for comparing the inputs and outputs of a set of homogenous decision making units (DMUs) by evaluating their relative efficiency. The Malmquist productivity index (MPI) is widely used for productivity analysis by relying on constructing a best practice frontier and calculating the relative performance of a DMU for different time periods. The conventional DEA requires accurate and crisp data to calculate the MPI. However, the real-world data are often imprecise and vague. In this study, the authors propose a novel productivity measurement approach in fuzzy environments with MPI. An application of the proposed approach in health care is presented to demonstrate the simplicity and efficacy of the procedures and algorithms in a hospital efficiency study conducted for a State Office of Inspector General in the United States. © 2012, IGI Global.

Online-questionaire design guidelines

As a new medium for questionnaire delivery, the internet has the potential to revolutionize the survey process. Online (web-based) questionnaires provide several advantages over traditional survey methods in terms of cost, speed, appearance, flexibility, functionality, and usability. Designers of online-questionnaires are faced with a plethora of design tools to assist in the development of their electronic questionnaires. Little, if any, support is incorporated, however, within these tools to guide online-questionnaire designers according to best practice. In essence, an online-questionnaire combines questionnaire-based survey functionality with that of a webpage/site. As such, the design of an online-questionnaire should incorporate principles from both contributing fields. Drawing on existing guidelines for paper-based questionnaire design, website design (paying particular attention to issues of accessibility and usability), and existing but scarce guidelines for electronic surveys, we have derived a comprehensive set of guidelines for the design of online-questionnaires. This article introduces this comprehensive set of guidelines – as a practical reference guide – for the design of online-questionnaires.