Laura Senier, Matthew Kearney and Jason Orne
This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.
Abstract
Purpose
This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.
Methodology/approach
We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program’s capacity. We compare clinic operations to the conceptual models guiding program design.
Findings
Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models.
Research/Policy Implications
Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized.
Originality/Value
There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.
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Amy Hutchison and Beth Beschorner
Children’s emerging conceptions about literacy and its functions are influenced by their experiences with a wide range of written and oral literacies, including the use of digital…
Abstract
Children’s emerging conceptions about literacy and its functions are influenced by their experiences with a wide range of written and oral literacies, including the use of digital technology, in their homes and communities. Now that mobile technologies have become intuitive to use, relatively inexpensive, small and easy to move around and networked, they have provided an entry point for transformations in the creation and sharing of texts – they are changing the way young children ‘do’ literacy. In this chapter, the authors discuss the ways that children learn about multimodal texts; how mobile technology can facilitate the reading, creation and sharing of multimodal texts in preschool and primary classrooms; the literacy skills necessary for reading multimodal texts, and; strategies for planning instruction into which multimodal texts and mobile devices are integrated. Examples of how children may engage in multimodal reading and writing in and out of the classroom are also provided.
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Janet Evans, Simon J. Bevan and John Harrington
Explains the background, context and operation of the Cranfield University Library BIODOC Research Project which explores key issues in the access versus journal holdings debate…
Abstract
Explains the background, context and operation of the Cranfield University Library BIODOC Research Project which explores key issues in the access versus journal holdings debate. Hopes to test whether an access model of provision in certain circumstances provides more cost effective and appropriate information support than the traditional in‐house collection. The project involves the cancellation of all the library journal subscriptions for the Biotechnology Centre and their replacement by the UnCover Reveal current contents service and as document supply from a number of sources. Describes the factors such as rising periodical costs, availability of new electronic document delivery services, increasing use of e‐mail by academics that led to the experiment; and the reasons for the selection of the Biotechnology Centre as an appropriate partner. Describes the project management and everyday operation of the project and the design of the project to include data collection for evaluation. Includes consideration of the issue of copyright.
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SCIENTISTS and sociologists have for some time been gravely disquieted about the impact which modern technology is making upon society; a disquiet which has recently been…
Abstract
SCIENTISTS and sociologists have for some time been gravely disquieted about the impact which modern technology is making upon society; a disquiet which has recently been percolating through wider sections of all communities. Man has always recognized, since the first machine usurped the place of the human hand as the tool of production, that progress does good but brings harm in its wake, although it is not as quickly appreciated.
Explores how the national aspiration of “universal access” to information compares with what is actually happening in practice. Outlines some of the issues which emerge in the…
Abstract
Explores how the national aspiration of “universal access” to information compares with what is actually happening in practice. Outlines some of the issues which emerge in the debate over access versus holdings, and presents some data from Cranfield University to shed some light on it.
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Explores how the national aspiration of “universal access” to information compares with what is actually happening in practice. Outlines some of the issues which emerge in the…
Abstract
Explores how the national aspiration of “universal access” to information compares with what is actually happening in practice. Outlines some of the issues which emerge in the debate over access versus holdings, and presents some data from Cranfield University to shed some light on it.
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Andrew Cox, Peter Godwin and Robin Yeates
This article is a first attempt to define criteria for choosing electronic journal aggregation services. Cost of the licence, relative to its terms and content are considered to…
Abstract
This article is a first attempt to define criteria for choosing electronic journal aggregation services. Cost of the licence, relative to its terms and content are considered to be the key factors. Other factors are considered under the headings of access, features, performance, user interface, administration, company direction. A list of aggregation services is also provided.
Shamsuddin Ahmed and Addas F. Mohammed
Accident emergency hospital (AEH) services require cohesive, collective, uninterrupted streamlined medical diagnostic and satisfactory patient care. Medical service efficiency in…
Abstract
Purpose
Accident emergency hospital (AEH) services require cohesive, collective, uninterrupted streamlined medical diagnostic and satisfactory patient care. Medical service efficiency in AEHs is difficult to quantify due to the clinical complexity involved in treatment involving various units, patient conditions, changes in contemporary medical practices and technological developments. This paper aims to show how to measure efficiency by eliminating waste in AEH system, identify service failure points, identify benchmark medical services, identify patient throughput time and measure treatment time when AEH services are nonstandard. The applications shown in this paper are distinct in particular; we the authors use nontraditional and systems engineering approach to collect data as the traditional data collection is difficult in real-time AEHs.
Design/methodology/approach
The authors show in this study how to measure overall patient treatment time from admission to discharge. Project evaluation and review technique (PERT) captures the inconsistencies involved in measuring treatment time, including measures of variability. The irregular treatment time and complexity involved in the emergency health-care services are usual. The research methodology illustrates how the time function map and service blueprint can improve value-added time in AEHs and benchmark services between similar AEHs.
Findings
The inconsistency in treatment time between AEH in public and private hospital is found to be in ratio of 1:20. The private hospital suggests variety of treatments and long stays for recovery. The PERT computations show that the average time a patient remains in a government AEH is about 10 days. The standard deviation of the AEH treatment time is about 0.043 per cent of the expected patient care time. The inconsistency is not significant as compared to the expected value. In 89.64 per cent of the cases, a patient may be discharged in less than 10 days’ time. The patient on average is discharged in 13 days in a private hospital.
Originality/value
The patient treatment time of an AEH is evaluated with PERT project management approach to account for inconsistencies in treatment time. This research makes new contributions in benchmarking AEH throughput time, identify medical service failure points with service blueprint, measure the efficiency with time function map and collect patient data with nontraditional methods. The inherent inconsistencies in a clinical process are identified by PERT analysis with the variance as a characteristic of the treatment time. Improvement of variability implies cost reduction in AEH system.