This report will present the preliminary results from an evaluation survey of allied health professionals’ clinical supervision conducted through November 2015. The evaluation was concerned with: a) what is best about the respondents’ supervision; b) what could be improved; c) the respondents’ overall satisfaction and evaluation with their clinical supervision. The purpose of the evaluation was to establish a baseline evaluation in regard to the clinical supervision of allied health professionals regionally across the two District Health Boards.
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A number of strategies were used to encourage completion namely: an introductory email containing the logos of the University of Nottingham, RoSPA and CAPT, that also outlined the way in which the results would be used; addressing the invitation to a named individual, usually the Director of Public Health; a follow-up letter, sent two weeks after the email, including a paper copy of the questionnaire, to non-responders; circulating the questionnaire to contacts in local authorities and health boards from which responses had not yet been received; sending a second follow-up letter and questionnaire, two weeks after the first, again by post, to non-responders; finally, a telephone call one week after the second follow-up. The questionnaire was also promoted through public health networks, including the UK Faculty of Public Health and the Association of Directors of Public Health, and on authors and organisational websites. Research has previously shown these techniques to improve response rates (Edwards et al. 2002; McColl et al. 2001; Edwards et al. 2009).
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The study design and the described procedures have been approved by the National Research Ethics Service Com- mittee North West - Greater Manchester Central (REC reference number: 11/NW/0218). The following local Re- search and Development departments of NHS Trusts and Health Boards after being presented with the aforemen- tioned approval agreed to host the study: the Manchester Mental Health and Social Care Trust Research and Innovation Office, the Greater Manchester West Mental Health NHS Foundation Trust Research and Develop- ment Office, the Pennine Care NHS Foundation Trust Quality Assurance, Research and Innovation Unit, the Lancashire Care NHS Foundation Trust Research Depart- ment, the Cheshire and Wirral Partnership NHS Foun- dation Trust Academic Unit, the Cambridgeshire and Peterborough NHS Foundation Trust Research and De- velopment Department, the Norfolk and Suffolk NHS Foundation Trust Research and Development Office, the UCL/UCLH Joint Research Office, the North Central London Research Consortium, the South London and Maudsley/IoPPN Research and Development Office, the NHS Lothian Academic and Clinical Central Office for Research and Development, the NHS Fife Research and Development Resource Centre and the Birmingham and Solihull Mental Health Foundation NHS Trust Research and Development Department. The Manchester Mental Health and Social Care Trust is the research sponsor and will be responsible for monitoring, audit and pharmacov- igilance of the trial. The trial has the approval of MHRA.
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The focus for this research was on the CDHB for a number of practical reasons. The research was carried out by only one person, expanding this to other hospitals or other District Health Boards was prohibited by time and travel costs. The CDHB is unique in that other DHBs are not likely to operate in the same manner nor have the same managerial challenges. As one of the largest of the 20 DHB’s in New Zealand its scope is greater than most of the others, it is more comprehensive in terms of the number of people it might serve, and because of its status as a “super board”, in the sense that its administration covers far more ground than just Canterbury and incorporates the activities of smaller, regional boards. Due to the size of the Christchurch Hospital campus, and its association with the Otago School of Medicine, all specialist departments found within the South Island of New Zealand are represented within the Christchurch hospital. Because of this many of the Christchurch clinicians also manage outreach clinic in the other South Island DHBs. Expanding the research and interview schedule to other South Island DHBs may have resulted in duplication as well as a greater degree of data saturation.
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In early-2009, and drawing heavily on material and experiences from the NHS – particularly the Leadership Qualities Framework , a government-commissioned working party made several recommendations for clin- ical governance development . These included that: District Health Boards (DHBs) must establish govern- ance structures ensuring a partnership of clinical and corporate management; these Boards and their Chief Executives must enable strong clinical leadership and decision making and promote this throughout the or- ganisation; clinical governance must cover the whole patient journey, with decision making devolved to the appropriate level; and management must identify clinical leaders and support their development. The Minister of Health announced the working party’s recommendations were to become government policy, with implementa- tion by DHBs an immediate priority. In 2010, we therefore sought to measure the extent to which clinical governance was being implemented by surveying public hospital med- ical specialists, a group finely attuned to the nuances of clinical governance and likely to be aware of changes in leadership and organisational structures. From this pro- ject, we developed the CGDI. In 2012, we conducted a follow-up study to investigate progress two years on. This article outlines the methods for the two surveys, results, derivation of the index and implications for utilising it. Methods
It will be important to avoid actual (or perceived) hospital dominance of the new system. For pragmatic reasons the existing infrastructure of hospital manage- ment is being used as the initial basis of the district health boards, and the population of each board approximates to the local catchment of its hospital. A coherent approach to planning, funding, and improv- ing access to non-hospital services—particularly pri- mary health care—will be crucial, as this has been the Achilles’ heel of the system since its creation in 1938. Government’s commitment to developing better primary care 15 and disability support will have to be
With limited information currently available on the use of EPJBs, the exploratory and qualitative research method is appropriate [6-8]. Exploratory research is suitable for the theory-building stage, and aims at formulating more precise questions that future research can answer [2, 9, 10]. Further, case study is suitable for learning more about a little-known, or poorly understood situation . To improve the quality of data and research findings, a multiple-case study with focus group interviews was employed in this study to obtain the primary data from health professionals [12, 13]. Users’ experiences, requirements and feedback on using current patient journey boards are also incorporated in this study. The methodology involved a mixed method approach involving qualitative techniques. A number of brainstroming sessions, focus group interviews and individual interviews were conducted to formalize data collection. Initially, a high level brainstorming session was conducted to understand the technical and user issues. The purpose of this approach was to understand the context. The brainstorming session culminated in developing a user data collection strategy. This was essential to recruit users as they were busy in the wards, and need to be backfilled for the interviews. The individual interviews were mainly with senior administrators to understand the management views, and these were correlated with user views. The focus groups were the main approach for data collection. The size of the focus groups was not uniform and varied between 5 and 10, depending on the site and availability of staff on the day of the focus group interview. The staffs were recruited through ward managers, and a Queensland Health project officer organized the recruitment. The criteria for participation were that the user should have participated either in the manual patient journey board system or in the electronic patient journey board system. Participants recruited for the study were employed at Queensland Health hospital wards, and were well aware of the operational procedures employed in the wards. The focus group questions were almost similar in the sense that the technical questions were identical, and there was a variation in ward specific questions. For example, every wars was provided with a standard view, but ward specific information was populated to cater to specific needs. Therefore, the questions included generic as well as ward specific questions.
A very high proportion of English NHS hospital Trust boards carry out processes that inter- national research indicates may be associated with higher performance (Jha and Epstein 2013, Mannion et al. 2015). All report quality sub-committees (Jha and Epstein 2010) and almost all have explicit objectives related to improving patient safety (Jiang et al. 2008, 2009). All of our case study sites sought to provide strategic assurance by establishing organisational struc- tures and processes for reporting safety-related information throughout the organisation and to the board (Botje et al. 2014, Jiang et al. 2009); making patient safety a strategic priority (Jiang et al. 2008); developing and nurturing an ‘ open and fair culture ’ (Vaughn et al. 2006); and using high level information to ensure compliance with safe practices / standards and external targets (Jha and Epstein 2010). Yet, the degree to which aspirations were fully met was moot, and governance activities remain contingent on board dynamics. Our case study sites exhibited governance behaviours variously related to: agency theory (Chambers and Cornforth 2010), in seeking to measure performance to ensure compliance and hold staff accountable for their actions; stewardship theory (Cornforth and Edwards 1998), in attempting to implement a framework of shared values built on trust; stakeholder theory (Chambers and Cornforth 2010), in managing complex trade-offs between stakeholders, including staff, patients and the public; and resource dependency theory (Zahra and Pearce 1989) in managing internal and external relationships to leverage in ﬂ uence.
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Boards want “tried and tested people most of whom are men,” “experienced members who are known,” who have “the experience of a larger board with more responsibilities.” Experience of “Corporate” private and public organizations” is vital. “Experience at not- for-profit organisations or working part time is discounted.” As “success in the corporate world at Board level is considered compulsory,” most women have a “lack” of such experience and remain on the outside: “Experience…you can't get it if they won’t give you a chance in the first place;” “positions are mainly offered privately to personal contacts. Thus (it is) difficult to get experience to sell myself.” This “lack of experience” at a “higher level of management” for women is “self-fulfilling.”
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Review Methods. We sought studies providing data regarding the association of breastfeeding and occur- rence of childhood leukemia. Studies were identified by using Medline, HHS Blueprint for Action on Breastfeed- ing, US Department of Health and Human Services Of- fice on Women’s Health, Cochrane Database of System- atic Reviews, National Centre for Reviews and Dissemination, reference lists, and national experts. Methodologic quality was evaluated for each study by using criteria from the US Preventive Services Task Force and the National Health Service Centre for Reviews and Dissemination.
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Another factor relevant for selectivity is the video should be task relevant (Burke, 2009; Müller et al., 2009). Videos playing food advertisements can be considered as task relevant, but sometimes news-related videos on DDMB are also played. As videos are placed in a loop, its timing and the number of videos displayed within a loop is central to attract the consumer’s attention when wandering in the store during the beginning, middle, or end of the message. Placement of video boards and display sizes are also factors featured under information display complexity. Burke (2009), Huang, Koster, and Borchers (2008), and Müller et al. (2009) found that if displays were not in the line of sight of the consumer, it would not attract their attention. Displays are also ignored if they are not placed at eye-level (Huang, Koster, & Borchers, 2008). Huang, Koster, and Borchers (2008) found that people are generally more attracted to videos than to animations and text.
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Electronic health records (EHRs) are increasingly being used as a source of clinically relevant patient data for research [1,2], including genome-wide association studies . Often, research ethics boards will not allow data custodians to disclose identifiable health information without patient consent. However, obtaining consent can be challenging and there have been major concerns about the negative impact of obtaining patient consent on the ability to conduct research . Such concerns are re- inforced by the compelling evidence that requiring explicit consent for participation in different forms of health research can have a negative impact on the process and outcomes of the research itself [5-7]. For example, recruitment rates decline significantly when individuals
The value of patient and public involvement (PPI) and empowerment have been recognized and linked with pa- tient experience and quality in health services internationally and in Europe  . Countries have implemented a wide range of patient empowerment measures, including increasing patients’ involvement and participation in care decision-making in England  . National Health Service (NHS) policies have increasingly emphasised patient-centred services and PPI for more than a decade in England. The legal duty to involve and consult the public  and the increasing body of international evidence for involving people in health care and its benefits - have been some of its drivers. The PPI agenda has permeated the World Class Commissioning vision, stating that “to be world class commissioners we need to know the needs and preferences of our local communi- ties, work with our partners on the health and well-being agenda and work with local people to tackle health inequalities”. Specific emphasis was placed on “building continuous and meaningful engagement with patient and public to shape services”, as one of its competencies . Furthermore, the “High Quality Care for All”  called for an NHS “that gives patients and the public more information and choice, works in partnership and has quality of care at its heart.”
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Qualitative methods have been considered essential to public health research for quite some time . They play a critical role in furthering and deepening our understand- ing of the social and broader causes of a problem and in designing public health interventions and implementation mechanisms that are appropriate and acceptable to the tar- get population and therefore likely to be effective. Qualita- tive methods offer particular strengths in the analysis of lay persons’ or professionals’ perceptions on health-related issues, in understanding health-related issues within a bio- graphical perspective, in the handling of complexity of var- iables and their interactions, as well as in the integration of contextual conditions . These reasons also comprise analysis of interactions (e.g. patient-professional, team), organizational issues, power relationships and their ex- pressions in the design, conduct and implementation of a public health intervention. The strength of qualitative ana- lysis is to move beyond the apparent or manifest by elabor- ating latent characteristics or explications through the researchers’ interpretation. However, ‘qualitative’ does not resort to a set of fixed methods or designs. It is an um- brella term for a variety of social research approaches, which are founded – more or less – on the ideas of open- ness, subjectivity, interpretation of meaning and process orientation . The idea of openness relates to various fundamental aspects of research, including the research process and methodological decisions, or the researcher’s stance towards the research subjects and the types of ques- tions asked. For example, in a study of the practice of in- formed consent, researchers had to be sensitive to the idea of different conditions, in which informed consent prior to surgery might even harm the experience of autonomy in patients .
The Health Information and Quality Authority (the Authority) monitors services used by some of the most vulnerable children in the state. Monitoring provides assurance to the public that children are receiving a service that meets the requirements of quality standards. This process also seeks to ensure that the wellbeing, welfare and safety of children is promoted and protected. Monitoring also has an important role in driving continuous improvement so that children have better, safer services. The Authority is authorised by the Minister for Children and Youth Affairs under Section 69 of the Child Care Act, 1991 as amended by Section 26 of the Child Care (Amendment) Act 2011 to inspect foster care services provided by the Child and Family Agency and to report on its findings to the Minister for Children and Youth Affairs. The Authority monitors foster care services against the National Standards for Foster Care, published by the Department of Health and Children in 2003. In order to promote quality and improve safety in the provision of foster care services, the Authority carries out inspections to:
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The temperature of the 0.6-g/cm 3 boards was lower with air injection than without until 3 min. In the 0.7-g/cm 3 boards, the temperature was lower with air injection than without until 6 min. In the 0.8-g/cm 3 boards, the temper- ature was always lower with air injection than without. Although the temperature was lower with air injection than without, IB was higher in the boards manufactured by injecting air than by not injecting air (Fig. 2). The urea– formaldehyde resin did not act sufficiently as a binder under high moisture conditions, even at high temperatures, possibly because high moisture inhibits curing, and causes excessive penetration of resin into the wood particles . Air injection was found to be effective for accelerating the curing of urea–formaldehyde resin by discharging vapor. Effects of the air-injection press on TS
We thank The Immunology Research Fund, Texas Children ’ s Hospital, Houston, TX, USA for the gift of monoclonal antibody reagents for the pilot study. The work was supported by grants from the National Institute of Allergy and Infectious Diseases of the National Institute of Health through the Comprehensive International Program of Research on AIDS Network (U19 AI53741) and 1R01AI075408-0; co-funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health. The views in this report do not necessary reflect the views of the National Institutes of Health or U.S. Department of Health and Human Services.
For Qualitative analysis following are the targeted images, components and circuit boards that project the output as 3D models). Output is in form of 3D models that are labelled and with specifications of components and images. Output is obtained using 2 ways AR classroom mobile application is uses Android Studio for Building and editing application, Unity Platform for development, and Vulforia SDK. For AR laboratory we have projected 3D model using Python and opencv combination for algorithms and using Raspberry pi along with camera and LCD screen as output.
Within the hospital setting, the senior management is made up of a hospital management team that holds ad- ministrative power. This comprises persons in charge of administration, nursing, pharmacy and allied health services and is typically led by the medical superintend- ent. Those in charge of different clinical service units or departments are invariably clinicians and nurses who op- erate without any specific departmental administrators . They are expected to plan and advocate for resources, although they are unlikely to have direct control over a specific departmental budget. Such individuals also supervise teams of front-line workers, either medical or nursing, and contribute directly to service delivery. The lead clinician may have a higher degree in an appropriate medical specialty or, especially in smaller rural hospitals, may still have a general medical qualification. Specialist doctors in leadership roles may have as few as 5 years’ total work experience (including their 3 years training), al- though some will have many more. General medical practitioners in smaller hospitals may have only 1 year of work experience before taking charge of a department. The nurses leading departments tend to have more work experience although very few at this level have any higher training in a specific clinical specialty (for example paedi- atric or surgical nursing). It is such personnel that are the focus of our concern (Figure 1).
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However, participants explained, “it’s actually very diffi- cult to obtain disaggregated data at the regional or local level.” There are gaps in data on SDOH for specific pop- ulations and this is a barrier to action on HE/SDOH. Several respondents echoed that “without better data on risk factors, health behaviours and outcomes, we have very limited baseline data to identify priority popula- tions, and also to monitor the outcomes of our interven- tions with these populations.” Practitioners often relied on their previous practice and experience to identify and take action on priority populations. One participant ex- plained, “priority populations are being identified largely based on … our experience, the relationships we have in our community [and] through community consultations. It’s not as much based on the data, especially for the smaller priority populations, because we just don’t have the data.” However this approach can be problematic “if it looks like you are just picking a population to try and say[- ing] I hope this works.” Practitioners struggled to provide epidemiological data that an SDOH was causing a particu- lar negative health outcome.
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