Peter Bliss, Peter A. Trott and Peter R. Blake
Objectives: The cost‐effectiveness of routine cervical cytology during follow‐up after treatment for carcinoma of cervix is examined. Subjects: All patients having routine…
Abstract
Objectives: The cost‐effectiveness of routine cervical cytology during follow‐up after treatment for carcinoma of cervix is examined. Subjects: All patients having routine follow‐up smears during the financial year 1993–1994. A total of 212 patients generated 311 smears, 96 had an intact cervix and 116 had surgical removal as part of their treatment. Ninety‐one patients with intact cervices and 109 without were evaluable. Results: Nine recurrences were detected, in every case this was expected, based on clinical findings. In two of these the smear was reported as normal. Two hundred and thirty smears were from entirely asymptomatic patients. Conclusions: Limiting cervical smears to those who are symptomatic, or where an abnormality is found on examination, would save approximately £3500 per year. This cost needs to be set beside the possibility of detecting an asymptomatic recurrence at an early stage; as reported by others. This suggests that the impact of this strategy is limited. A randomized trial with prospective economic assessment would be the only way to evaluate the cost‐effectiveness of routine cervical smears in the follow‐up of patients treated for cancer of cervix.
Wouter Keijser, Jacco Smits, Lisanne Penterman and Celeste Wilderom
This paper aims to systematically review the literature on roles of physicians in virtual teams (VTs) delivering healthcare for effective “physician e-leadership” (PeL) and…
Abstract
Purpose
This paper aims to systematically review the literature on roles of physicians in virtual teams (VTs) delivering healthcare for effective “physician e-leadership” (PeL) and implementation of e-health.
Design/methodology/approach
The analyzed studies were retrieved with explicit keywords and criteria, including snowball sampling. They were synthesized with existing theoretical models on VT research, healthcare team competencies and medical leadership.
Findings
Six domains for further PeL inquiry are delineated: resources, task processes, socio-emotional processes, leadership in VTs, virtual physician-patient relationship and change management. We show that, to date, PeL studies on socio-technical dynamics and their consequences on e-health are found underrepresented in the health literature; i.e. no single empirical, theoretic or conceptual study with a focus on PeL in virtual healthcare work was identified.
Research limitations/implications
E-health practices could benefit from organization-behavioral type of research for discerning effective physicians’ roles and inter-professional relations and their (so far) seemingly modest but potent impact on e-health developments.
Practical implications
Although best practices in e-health care have already been identified, this paper shows that physicians’ roles in e-health initiatives have not yet received any in-depth study. This raises questions such as are physicians not yet sufficiently involved in e-health? If so, what (dis)advantages may this have for current e-health investments and how can they best become involved in (leading) e-health applications’ design and implementation in the field?
Originality/value
If effective medical leadership is being deployed, e-health effectiveness may be enhanced; this new proposition needs urgent empirical scrutiny.
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Pádraig Cotter, Eirini Papasileka, Mario Eugster, Varsha Chauhan, Eshia Garcha, Marie Kunkler, Michelle Brooks, Iulia Otvos, Abberaame Srithar, Irene Pujol, Christina Sarafi and Tom Hughes
The purpose of this study is to outline a process-oriented psychology informed view of the impact of ever-increasing acuity within an adult inpatient system and conceptualise how…
Abstract
Purpose
The purpose of this study is to outline a process-oriented psychology informed view of the impact of ever-increasing acuity within an adult inpatient system and conceptualise how an integrated therapies team (ITT) can work with the chaos that this brings.
Design/methodology/approach
A reflective scientist-practitioner based approach was used over a two-year period.
Findings
Several factors lead to “chaos” in an inpatient unit, including societal inequality, the trauma and adversity it creates and the impact of this at a systemic, interpersonal and intrapersonal level. Chaos is one means of coping and can dominate inpatient working, whereas understanding the underlying distress is often marginalised. Developing an ITT can support working with chaos. The ITT holds the therapeutic perspective for the wider multi-disciplinary team (MDT) and therapeutic and facilitation skills are central to how it operates. Processing the chaos and working with the underlying distress is its overarching function.
Practical implications
Developing an ITT offers a robust structure for evolving inpatient MDT working to cope with increasing acuity in a psychologically informed way.
Social implications
The chaos in question is often viewed as patients’ issue but from a collectivist perspective it is something that all members of society are responsible for.
Originality/value
To the best of the authors’ knowledge, this is the first paper to conceptualise the chaos on an inpatient ward as a process needed by the system as a way of coping and propose the addition of an ITT to inpatient working.
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Dimitris Alimisis and Emmanouil Zoulias
– The aim of this research is the development of a problem-based curriculum for robotic surgical training and its evaluation.
Abstract
Purpose
The aim of this research is the development of a problem-based curriculum for robotic surgical training and its evaluation.
Design/methodology/approach
First, the aim and objectives of the curriculum are defined and the background learning theories that guide our work are introduced. The methodology for designing the simulator-based training is presented and finally the output of this work is reported, that is the SAFROS training paradigm, resulted as a balanced synthesis of behavioural and constructivist learning theories.
Findings
The evaluation of basic skills tasks of the curriculum revealed a high acceptance among the trainees.
Research limitations/implications
Within this paper, a first implementation and evaluation of the basic skills tasks is described. Further cooperation between pedagogues and software engineers is required in order to put in practice the whole curriculum. Then, further training experiments with surgeons are necessary to check the validity of the whole curriculum. The authors also need to establish proficiency criteria that can come from the achievements of expert surgeons using the simulator and the robot and use them as final goals to be achieved by trainees in future courses. In the field of subjective evaluation, a possible future extension might be a bigger number of questions. Moreover, the innovative method of text mining in its application to opinion mining decisions can be further applied.
Originality/value
In this paper, an innovative approach for the development of a simulator-based curriculum for robotic surgical training is presented and first evaluation results based on ratings from trainees are also presented. The value of this paper is relevant to medical trainers and curriculum designers.
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This study aims to perform a systematic review of the dialectics and telematics strategy for regulating religion during the COVID-19 pandemic. The study also analyzes some…
Abstract
Purpose
This study aims to perform a systematic review of the dialectics and telematics strategy for regulating religion during the COVID-19 pandemic. The study also analyzes some important issues related to religions, state, and society.
Design/methodology/approach
A critical literature review was performed to complete this study, using media, institutional, national, and international reports, as well as recent and previous studies during the COVID-19 pandemic.
Findings
Religion was one of the social entities that had a crucial effect on the COVID-19 pandemic. The new system in the form of social distancing affects its performance. Furthermore, the response of religion in Indonesia is unique when its status is considered as the largest Islamic country in the world. Therefore, this study attempts to analyze and demonstrate the dynamics of relationships between actors, religion, and state in the process and strategy of religious regulation.
Research limitations/implications
This study was carried out using a single methodological approach.
Practical implications
This study provides input to both religion and the state (government) in building a synergy of constructive responses to the effects of the COVID-19 pandemic.
Social implications
It provides input to society in understanding the critical intersection between religion, state, and society.
Originality/value
This may be the first academic study that analyzes the problems of the process of regulating religion in the context of COVID-19.
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This paper aims to identify the effectiveness, student perceptions and impacts of integrating comics into the English as a foreign language (EFL) writing curriculum for…
Abstract
Purpose
This paper aims to identify the effectiveness, student perceptions and impacts of integrating comics into the English as a foreign language (EFL) writing curriculum for undergraduate Ecuadorian polytechnic students.
Design/methodology/approach
This research followed a mixed method design to obtain quantitative information through a researcher-made survey and paired T-test, which would be corroborated by the qualitative data obtained from semistructured interviews.
Findings
From the descriptive and T-test results and the interview answers, it is concluded that students have a favorable view of the effectiveness of using comics to improve their writing skills. They also expressed their engagement and motivation to work with comics.
Research limitations/implications
First, the research sample, comprised of 109 students, may restrict the generalizability of the findings beyond the specific context of this study. This constraint suggests caution in extrapolating these findings to broader student cohorts, emphasizing the need for larger-scale studies to validate the robustness and applicability of the outcomes. Second, the study’s focus solely on students from a polytechnic state university introduces a potential limitation concerning the diversity and representativeness of the participant pool. Consequently, the findings might be limited in their applicability and may not fully encompass students’ varied responses and attitudes from other educational backgrounds.
Practical implications
The scaffolding afforded by comics aligns with genre-based literacy perspectives, valuing instruction in textual genres and social purposes. From a practical pedagogical point of view, this paper’s results suggest the potential of comic narratives and storyboarding. Comics writing could be added to classroom activities to vibrantly aboard brainstorming, drafting and peer reviewing before dealing with higher-stakes assignments. Legitimizing alternative mediums like comics for academic writing tasks has social implications for promoting literacies in a multimedia world.
Social implications
Writing comics nurtures multiliteracies aligned with participatory digital cultures by expanding traditional linguistic-centric norms. This multimodal composing can potentially increase access and representation and amplify voices across identities and cultures.
Originality/value
Although the paper addresses a topic that is not entirely novel in research, its originality lies in its focus on data originating from Ecuador, where specific cultural nuances and educational contexts may influence the effectiveness of using comics to enhance EFL writing skills. Thus, it fills a gap in the existing literature on this subject.