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Article
Publication date: 1 October 2005

Rebecca N. Warburton

The purpose of this article is to report preliminary outcome and cost‐benefit results for a patient safety quality improvement program intended to improve outcomes for patients…

678

Abstract

Purpose

The purpose of this article is to report preliminary outcome and cost‐benefit results for a patient safety quality improvement program intended to improve outcomes for patients aged 75 or more visiting the Emergency Department (ED). The program uses the Identification of Seniors at Risk (ISAR) scale to screen, and refers patients at high risk for appropriate intervention.

Design/methodology/approach

The Plan‐Do‐Study‐Act improvement cycle was used as a framework. Simple outcomes have been assessed by comparing patient sub‐groups based on risk status and interventions received. Cost and benefits were assessed based on estimated program outcomes and average costs. Sensitivity analysis was performed to test alternate assumptions.

Findings

The screening tool appears to be accurate, and screening and referral appears to have a positive impact, reducing length of stay, returns to the ED, and subsequent admissions to hospital. However, most results are not statistically significant at the 95 percent level. The value of avoided care exceeds program costs under most assumptions.

Originality/value

Screening and referring all eligible patients has still not been achieved; these are areas for future investigation and improvement. Screening and referral appear to be effective in improving outcomes but because program costs were low, net benefits may have been achieved; however given global budgeting for hospital care improvements in the use of resources (rather than budgetary savings) would be expected. The methods for improvement (the Plan‐Do‐Study‐Act framework; process evaluation; multidisciplinary working group meetings; outcome assessment) are practical and useful for improving quality and safety in a small community hospital with limited resources.

Details

International Journal of Health Care Quality Assurance, vol. 18 no. 6
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 October 2004

Rebecca N. Warburton, Belinda Parke, Wynona Church and Jane McCusker

Reports on the authors' experience with a patient safety quality improvement program, intended to reduce the incidence and severity of adverse outcomes for emergency department…

1382

Abstract

Reports on the authors' experience with a patient safety quality improvement program, intended to reduce the incidence and severity of adverse outcomes for emergency department (ED) patients aged ≥75. The Identification of Seniors at Risk scale was used for screening, and those at high risk were referred for appropriate intervention. The plan‐do‐study‐act improvement cycle was followed, conducting process evaluation to diagnose and correct implementation difficulties. Reports that: implementing an ED screening and referral program is deceptively difficult; process evaluation multidisciplinary working group meetings are an essential improvement tool; screening inclusion criteria had to be adapted to the subject population in order to make efficient use of staff time; the screening questions and process required ongoing assessment, revision, and local adaptation in order to be useful; and high‐risk screening in the ED is critical to a hospital system's ability to anticipate clinical problems; the plan‐do‐study‐act improvement cycle is a practical and useful tool for improving quality and systems in a real care setting.

Details

International Journal of Health Care Quality Assurance, vol. 17 no. 6
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 4 March 2014

Cath Jackson, Kiara Lewis, Mark Conner, Rebecca Lawton and Rosemary R.C. McEachan

The workplace offers an ideal setting for facilitating physical activity and reducing sedentary behaviours. Understanding employees’ current health behaviours is required to…

720

Abstract

Purpose

The workplace offers an ideal setting for facilitating physical activity and reducing sedentary behaviours. Understanding employees’ current health behaviours is required to inform appropriate, tailored, health promotion interventions. The purpose of this paper is to compare the physical activity and sedentary behaviours over 12 months of employees within and across five UK organisations. The paper also explores the association of these health behaviours with objective and self-reported health outcomes; and investigates the association between physical activity and sedentary behaviours.

Design/methodology/approach

Self-reported physical activity and sedentary behaviours were recorded at four time points (baseline, three, six, 12 months). BMI, per cent body fat, waist circumference, blood pressure and resting heart rate were collected in health checks (baseline, 12 months). Well-being and health were collected via questionnaire.

Findings

Low physical activity and high sedentariness were evident. Sitting levels varied by occupational role and organisation. More activity was associated with improved health outcomes; no association was evident for sedentary behaviour. No direct effects of occupational role or organisation on health outcomes emerged after accounting for physical activity/sedentary behaviours. Physical activity and sedentary levels were weakly associated.

Practical implications

The low activity levels are of particular concern as linked to health outcomes for this sample. The weak association between behaviours suggests worksite interventions should target both behaviours.

Originality/value

This study provides insight into both the physical activity and sedentary behaviours of employees of large UK employers across different occupational sectors over 12 months; importantly it is informed by the most recent guidance for these health behaviours.

Details

International Journal of Workplace Health Management, vol. 7 no. 1
Type: Research Article
ISSN: 1753-8351

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Article
Publication date: 3 May 2016

Sergio Altomonte, Brian Logan, Markus Feisst, Peter Rutherford and Robin Wilson

This study aims to explore the opportunities offered by interactive and situated learning (e-learning and m-learning) in support of education for sustainability in disciplines of…

2773

Abstract

Purpose

This study aims to explore the opportunities offered by interactive and situated learning (e-learning and m-learning) in support of education for sustainability in disciplines of the built environment.

Design/methodology/approach

The paper illustrates the development of an online portal and a mobile app aimed at promoting students’ motivation and engagement with sustainability in design, and discusses the outcomes of their testing, investigating users’ acceptance, comparing academic results and analysing feedback.

Findings

The findings add empirical evidence to the view that information and communication technology-enhanced pedagogies can substantially contribute to the agenda of sustainability in higher education, primarily due to their affordance of interactive communication and contextualisation of knowledge, while guaranteeing flexible time and pace of learning.

Research limitations/implications

The study solely focused on the development and testing of e-learning and m-learning tools to foster students’ competence of sustainability in design studio work. The tools trialled were mostly at their prototypical stage and their testing included a relatively short-term evaluation and a narrow, self-selected, user base. However, the approach and findings are felt to be applicable to a much wider range of educational contexts.

Originality/value

Interactive and situated pedagogical methods and tools have the potential to prompt a departure from transmissive educational models, encompassing at once theoretical, experiential and analytic learning processes. This is of value to education for sustainability in disciplines of the built environment due to the requirement to holistically consolidate multi-/inter-/trans-disciplinary knowledge into a coherent design whole.

Details

International Journal of Sustainability in Higher Education, vol. 17 no. 3
Type: Research Article
ISSN: 1467-6370

Keywords

Available. Open Access. Open Access
Article
Publication date: 25 September 2019

Sarah Jayne Briggs, Zoe P. Robinson, Rachel Louise Hadley and Rebecca Laycock Pedersen

This paper aims to explore a single-institution case study of partnership working between students, the University and Students’ Union, through four student-led sustainability…

12172

Abstract

Purpose

This paper aims to explore a single-institution case study of partnership working between students, the University and Students’ Union, through four student-led sustainability projects. The paper analyses the role and value of these partnerships and provides advice for other institutions on effective partnership working between these stakeholders.

Design/methodology/approach

A single case study of partnership working with multiple embedded units of analysis (four projects) is presented based on reflections of practitioners involved in the projects who have different roles within the University and Students’ Union.

Findings

The longevity and effectiveness of student-led projects, and disciplinary-breadth of students engaged, can be enhanced by greater collaboration with, and integration into, University and Students’ Union systems. Partnership working between different stakeholders is key to overcoming challenges and the success of student-led projects, helped by key staff “enablers”. These projects provide myriad learning opportunities for developing change agency skills, even where projects are relatively short-lived and could be seen as failures in terms of longevity.

Research limitations/implications

This analysis is based solely on practitioner reflections, with limited direct quantification or qualitative data on the projects’ impacts on the students themselves.

Originality/value

This paper draws together the experiences and reflections of four practitioners with different roles within the University and Students’ Union across four different projects and provides advice to generate student-led sustainability projects which have longevity and impact for wider student populations and future generations of cohorts.

Details

International Journal of Sustainability in Higher Education, vol. 20 no. 8
Type: Research Article
ISSN: 1467-6370

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Publication date: 25 July 2011

Robert W. Herdt and Rebecca Nelson

The products of transgenic technology have captured the attention of enthusiasts and detractors, but transgenics are just one tool of agricultural biotechnology. Other…

Abstract

The products of transgenic technology have captured the attention of enthusiasts and detractors, but transgenics are just one tool of agricultural biotechnology. Other applications enable scientists to understand biodiversity, to track genes through generations in breeding programs, and to move genes among closely related as well as unrelated organisms. These applications all have the potential to lead to substantial productivity gains.

In this chapter we provide an introduction to basic plant genetic concepts, defining molecular markers, transgenic and cisgenic techniques. We briefly summarize the status of commercialized biotechnology applications to agriculture. We consider the likely future commercialization of products like drought tolerant crops, crops designed to improve human nutrition, pharmaceuticals from transgenic plants, biofuels, and crops for environmental remediation. We identify genomic selection as a potentially powerful new technique and conclude with our reflections on the state of agricultural biotechnology.

Research at universities and other public-sector institutions, largely focused on advancing knowledge, has aroused enormous optimism about the promise of these DNA-based technologies. This in turn has led to large private-sector investments on maize, soybean, canola, and cotton, with wide adoption of the research products in about eight countries. Much has been made of the potential of biotechnology to address food needs in the low-income countries, and China, India, and Brazil have large public DNA-based crop variety development efforts. But other lower income developing countries have little capability to use these tools, even the most straightforward marker applications. Ensuring that these and other applications of biotechnology lead to products that are well adapted to local agriculture requires adaptive research capacity that is lacking in the lowest income, most food-insecure nations. We are less optimistic than many others that private research will fund these needs.

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Article
Publication date: 8 January 2025

Bhanu Balasubramnian and Ken B. Cyree

We examine yield spreads, defined as the difference between the yield to maturity of the risky bank bond and that of a risk-free bond with similar maturity and other…

4

Abstract

Purpose

We examine yield spreads, defined as the difference between the yield to maturity of the risky bank bond and that of a risk-free bond with similar maturity and other characteristics, after controlling for market, liquidity and tax factors. We use senior bonds issued by banks since one of the goals of the Dodd–Frank Act (DFA) is to reduce the possibility of a full-fledged bailout of banks. If markets do not believe that banks will be bailed out, senior bondholders will bear a higher exposure to default risks, and such risk perceptions will be reflected in the yield spread levels.

Design/methodology/approach

We use generalized method of moments (GMM) for parameter estimation with standard errors corrected for autocorrelation and heteroskedasticity using the Newey–West (1987) procedure with five lags.

Findings

Our results indicate a discount of 133 basis points in yield spreads due to the TBTF or too-big-to-fail factor prior to the DFA. However, the market charges a net premium of 36 basis points for the TBTF factor immediately after the DFA (a total change of 169 basis points). We examine commercial banks and noncommercial banks (primarily investment banks and insurance firms) separately. For commercial banks, the discounts observed prior to the DFA changes to a premium after the DFA. For investment banks, the higher premium charged prior to the DFA is reduced after the DFA.

Research limitations/implications

Not all banks issue bonds and not all issued bonds trade in the secondary market frequently.

Practical implications

After the Great Recession, there is a sustained effort across the globe, to remove the possibility of a bailout of very large banks. With systemic risk monitoring, improved capital regulation, stress testing and other regulations on banks and other shadow banking organizations, the question of whether market perceives implicit guarantee of very large financial institutions. We have examined a new security that is not treated as capital.

Social implications

If taxpayer bailouts are avoided, such resources can be used for other developmental purposes. The moral hazard problems of bank manager are also reduced.

Originality/value

We are the first to exclusively examine the senior bonds issued by banks around the enactment of the DFA, 2010.

Details

Managerial Finance, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0307-4358

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Article
Publication date: 8 February 2024

Yara Levtova, Irma Melunovic, Caroline Louise Mead and Jane L. Ireland

This preliminary investigation aims to examine the psychological impact of the COVID-19 pandemic on patients and staff within a high secure service.

79

Abstract

Purpose

This preliminary investigation aims to examine the psychological impact of the COVID-19 pandemic on patients and staff within a high secure service.

Design/methodology/approach

To discern the connection between COVID-19-related distress and multiple factors, the study involved 31 patients and 34 staff who completed assessments evaluating coping strategies, resilience, emotional reactivity, ward atmosphere and work-related aspects.

Findings

Results demonstrated that around a third of staff (31.2%) experienced COVID-19-related distress levels that met the clinical cut-off for possible post-traumatic stress disorder. Emotional reactivity, staff shortages, secondary traumatic stress and coping strategies were all positively correlated with COVID-19-related-distress. Resilience was negatively associated with distress, thus acting as a potential mitigating factor. In comparison, the prevalence of distress among patients was low (3.2%).

Practical implications

The authors postulate that increased staff burdens during the pandemic may have led to long-term distress, while their efforts to maintain minimal service disruption potentially shielded patients from psychological impacts, possibly lead to staff “problem-focused coping burnout”. This highlights the need for in-depth research on the enduring impacts of pandemics, focusing on mechanisms that intensify or alleviate distress. Future studies should focus on identifying effective coping strategies for crisis situations, such as staff shortages, and strategies for post-crisis staff support.

Originality/value

The authors postulate that the added burdens on staff during the pandemic might have contributed to their distress. Nonetheless, staff might have inadvertently safeguarded patients from the pandemic’s psychological ramifications by providing a “service of little disruption”, potentially leading to “problem-focused coping burnout”. These findings underscore the imperative for further research capturing the enduring impacts of pandemics, particularly scrutinising factors that illuminate the mechanisms through which distress is either intensified or alleviated across different groups. An avenue worth exploring is identifying effective coping styles for pandemics.

Details

The Journal of Forensic Practice, vol. 26 no. 1
Type: Research Article
ISSN: 2050-8794

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