Oliver J. Old and Timothy Rogers
Inguinal hernias are a common problem amongst neonates, and a potential source of significant morbidity through incarceration of the hernia. Expedited surgical repair can prevent…
Abstract
Purpose
Inguinal hernias are a common problem amongst neonates, and a potential source of significant morbidity through incarceration of the hernia. Expedited surgical repair can prevent incarceration and reduce complications. The department at Bristol Children's Hospital aimed to minimise waiting times for surgery thereby reducing incarceration and complication rates. This paper aims to examine how this was done.
Design/methodology/approach
Bristol Children's Hospital provides local and regional (tertiary referral) services. Retrospective audit of waiting times from referral to surgery was performed against the departmental standard of four weeks. Data were collected on frequency of incarceration and any complications. Following service restructure, second cycle audit was performed to assess the impact of change.
Findings
First cycle audit (n=74) found median waiting time 20 days, (Mean 28.4 days, Range 0‐138 days). A total of 28 per cent of patients waited longer than the target four weeks from referral. Incarceration occurred in 13 per cent of patients awaiting surgery. Two patients (2.7 per cent) experienced complications. Following service restructuring second cycle audit (n=28) found waiting times were significantly reduced (median two days, mean 7.0, p<0.0001). Only 7 per cent of patients waited over four weeks for surgery. There were no incarcerations or complications.
Practical implications
This study demonstrates a successful model of service for management of neonatal inguinal hernias which could be adopted at children's hospitals throughout the UK.
Originality/value
This study highlights a successful audit process, in which the extent of a problem is quantified and analysed, strategies for improvement are identified and implemented, and second cycle audit confirms the impact of change and an improved service.
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Yuzhuo Cai and Yohannes Mehari
Institutional theory has arguably become a popular and powerful explanatory tool for studying various organisational issues, including those in the context of higher education…
Abstract
Institutional theory has arguably become a popular and powerful explanatory tool for studying various organisational issues, including those in the context of higher education. However, little is known about the efforts of higher education researchers in tracing the development of organisational institutionalism and applying the theory in their research for a better understanding of the nature of universities and colleges. The purpose of this chapter is thus to fill the gaps by analysing nine leading higher education journals. The results indicate that the application of institutional theory in higher education research is dominated by the concepts of new institutionalism developed in the 1970s and 1980s. In spite of a growing tendency to utilise the recently developed insights of institutional theory in higher education studies, the full potential of institutional theory has not been fully exploited by higher education researchers. We therefore propose some directions for further institutional analysis in higher education studies.
Recent growth of concern relating to ‘elder abuse’ concurrent with recognition of the importance of user involvement has suggested a link between these two developments. Here…
Abstract
Recent growth of concern relating to ‘elder abuse’ concurrent with recognition of the importance of user involvement has suggested a link between these two developments. Here, however, Phil Slater argues that generalised principles cannot generate blueprints for implementation. A concrete illustration of the general arguments is offered.
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The Bureau of Economics in the Federal Trade Commission has a three-part role in the Agency and the strength of its functions changed over time depending on the preferences and…
Abstract
The Bureau of Economics in the Federal Trade Commission has a three-part role in the Agency and the strength of its functions changed over time depending on the preferences and ideology of the FTC’s leaders, developments in the field of economics, and the tenor of the times. The over-riding current role is to provide well considered, unbiased economic advice regarding antitrust and consumer protection law enforcement cases to the legal staff and the Commission. The second role, which long ago was primary, is to provide reports on investigations of various industries to the public and public officials. This role was more recently called research or “policy R&D”. A third role is to advocate for competition and markets both domestically and internationally. As a practical matter, the provision of economic advice to the FTC and to the legal staff has required that the economists wear “two hats,” helping the legal staff investigate cases and provide evidence to support law enforcement cases while also providing advice to the legal bureaus and to the Commission on which cases to pursue (thus providing “a second set of eyes” to evaluate cases). There is sometimes a tension in those functions because building a case is not the same as evaluating a case. Economists and the Bureau of Economics have provided such services to the FTC for over 100 years proving that a sub-organization can survive while playing roles that sometimes conflict. Such a life is not, however, always easy or fun.
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Nobody concerned with political economy can neglect the history of economic doctrines. Structural changes in the economy and society influence economic thinking and, conversely…
Abstract
Nobody concerned with political economy can neglect the history of economic doctrines. Structural changes in the economy and society influence economic thinking and, conversely, innovative thought structures and attitudes have almost always forced economic institutions and modes of behaviour to adjust. We learn from the history of economic doctrines how a particular theory emerged and whether, and in which environment, it could take root. We can see how a school evolves out of a common methodological perception and similar techniques of analysis, and how it has to establish itself. The interaction between unresolved problems on the one hand, and the search for better solutions or explanations on the other, leads to a change in paradigma and to the formation of new lines of reasoning. As long as the real world is subject to progress and change scientific search for explanation must out of necessity continue.
Stephanie Grace Prost, Cynthia Golembeski, Vyjeyanthi S. Periyakoil, Jalayne Arias, Andrea K. Knittel, Jessica Ballin, Heather D. Oliver and Nguyen-Toan Tran
The targeted use of standardized outcome measures (SOMs) of mental health in research with older adults who are incarcerated promotes a common language that enables…
Abstract
Purpose
The targeted use of standardized outcome measures (SOMs) of mental health in research with older adults who are incarcerated promotes a common language that enables interdisciplinary dialogue, contributes to the identification of disparities and supports data harmonization and subsequent synthesis. This paper aims to provide researchers with rationale for using “gold-standard” measures used in research with community-dwelling older adults, reporting associated study sample psychometric indexes, and detailing alterations in the approach or measure.
Design/methodology/approach
The authors highlight the mental health of older adults who are incarcerated. They also discuss the benefits of SOMs in practice and research and then identify gold-standard measures of mental health used in research with community-dwelling older adults and measures used in research with older adults who are incarcerated. Finally, the authors provide several recommendations related to the use of SOMs of mental health in research with this population.
Findings
Depression, anxiety and post-traumatic stress disorder are common among older adults who are incarcerated. Researchers have used a variety of measures to capture these mental health problems, some parallel to those used with community-dwelling samples. However, a more targeted use of SOMs of mental health in research with this population will contribute to important strides in this burgeoning field.
Originality/value
This review offers several practical recommendations related to SOMs of mental health in research with older adults who are incarcerated to contribute to a rigorous evidence base and thus inform practice and potentially improve the health and well-being of this population.
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Contemporary literature reveals that, to date, the poultry livestock sector has not received sufficient research attention. This particular industry suffers from unstructured…
Abstract
Contemporary literature reveals that, to date, the poultry livestock sector has not received sufficient research attention. This particular industry suffers from unstructured supply chain practices, lack of awareness of the implications of the sustainability concept and failure to recycle poultry wastes. The current research thus attempts to develop an integrated supply chain model in the context of poultry industry in Bangladesh. The study considers both sustainability and supply chain issues in order to incorporate them in the poultry supply chain. By placing the forward and reverse supply chains in a single framework, existing problems can be resolved to gain economic, social and environmental benefits, which will be more sustainable than the present practices.
The theoretical underpinning of this research is ‘sustainability’ and the ‘supply chain processes’ in order to examine possible improvements in the poultry production process along with waste management. The research adopts the positivist paradigm and ‘design science’ methods with the support of system dynamics (SD) and the case study methods. Initially, a mental model is developed followed by the causal loop diagram based on in-depth interviews, focus group discussions and observation techniques. The causal model helps to understand the linkages between the associated variables for each issue. Finally, the causal loop diagram is transformed into a stock and flow (quantitative) model, which is a prerequisite for SD-based simulation modelling. A decision support system (DSS) is then developed to analyse the complex decision-making process along the supply chains.
The findings reveal that integration of the supply chain can bring economic, social and environmental sustainability along with a structured production process. It is also observed that the poultry industry can apply the model outcomes in the real-life practices with minor adjustments. This present research has both theoretical and practical implications. The proposed model’s unique characteristics in mitigating the existing problems are supported by the sustainability and supply chain theories. As for practical implications, the poultry industry in Bangladesh can follow the proposed supply chain structure (as par the research model) and test various policies via simulation prior to its application. Positive outcomes of the simulation study may provide enough confidence to implement the desired changes within the industry and their supply chain networks.
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With this number the Library Review enters on its ninth year, and we send greetings to readers at home and abroad. Though the magazine was started just about the time when the…
Abstract
With this number the Library Review enters on its ninth year, and we send greetings to readers at home and abroad. Though the magazine was started just about the time when the depression struck the world, its success was immediate, and we are glad to say that its circulation has increased steadily every year. This is an eminently satisfactory claim to be able to make considering the times through which we have passed.
While some libraries have done their best over the years to inform the public as to what they are doing and can do as regards helping readers, others seem to move along without…
Abstract
While some libraries have done their best over the years to inform the public as to what they are doing and can do as regards helping readers, others seem to move along without making any special effort to publicise their facilities. In the old days modesty was a virtue, but now it is its own reward. Government departments, which used to shun the limelight, now employ public relations officers in large numbers, and professional bodies and big business houses constantly seek publicity. Times have changed, and the battle is to the strong; and it is unfortunately generally felt that the institution or service that does not speak for itself has little to speak about. It may frankly be said that if a service is in a position to enlarge its sphere of influence and esteem it should do so to the utmost of its endeavour. But it will be granted that if its publicity is not justified by performance, there will likely be an unhappy reaction.