scholarly journals The association between midwifery staffing levels and the experiences of mothers on postnatal wards: cross sectional analysis of routine data

2021 ◽  
Author(s):  
Lesley Y Turner ◽  
David Culliford ◽  
Jane E Ball ◽  
Ellen Kitson-Reynolds ◽  
Peter D Griffiths
Keyword(s):  
Postnatal Care ◽  
Routine Data ◽  
Full Time ◽  
Full Time Equivalent ◽  
Cross Sectional ◽  
Negative Experiences ◽  
Staffing Levels ◽  
Post Natal Care ◽  
The Difference ◽  
Sectional Analysis

Background Women have consistently reported lower satisfaction with postnatal care compared with antenatal and labour care. The aim of this research was to examine whether women's experience of inpatient postnatal care in England is associated with variation in midwifery staffing levels. Methods Analysis of data from the National Maternity Survey in 2018 including 17,611 women from 129 organisations. This was linked to hospital midwifery staffing numbers from the National Health Service (NHS) Workforce Statistics and the number of births from Hospital Episode Statistics. A two-level logistic regression model was created to examine the association of midwifery staffing levels and experiences in post-natal care. Results The median full time equivalent midwives per 100 births was 3.55 (interquartile range 3.26 to 3.78). Higher staffing levels were associated with less likelihood of women reporting delay in discharge (adjusted odds ratio [aOR] 0.849, 95% CI 0.753 to 0.959, p=0.008), increased chances of women reporting that staff always helped in a reasonable time aOR1.200 (95% CI 1.052, 1.369, p=0.007) and that they always had the information or explanations they needed aOR 1.150 (95% CI 1.040, 1.271, p=0.006). Women were more likely to report being treated with kindness and understanding with higher staffing, but the difference was small and not statistically significant aOR 1.059 (0.949, 1.181, p=0.306). Conclusions Negative experiences for women on postnatal wards were more likely to occur in trusts with fewer midwives. Low staffing could be contributing to discharge delays and lack of support and information, which may in turn have implications for longer term outcomes for maternal and infant wellbeing.

Firm Characteristics, Relative Efficiency, and Equity Returns

2009 ◽  
Vol 44 (1) ◽  
pp. 213-236 ◽  
Author(s):  
Giao X. Nguyen ◽  
Peggy E. Swanson
Keyword(s):  
Explanatory Power ◽  
Stochastic Frontier ◽  
Efficiency Score ◽  
Equity Returns ◽  
Firm Characteristics ◽  
Stochastic Frontier Approach ◽  
Cross Sectional ◽  
Firm Efficiency ◽  
The Difference ◽  
Sectional Analysis

AbstractThis study uses a stochastic frontier approach to evaluate firm efficiency. The resulting efficiency score, based on firm characteristics, is the input for performance evaluation. The portfolio composed of highly efficient firms significantly underperforms the portfolio composed of inefficient firms even after adjustment for firm characteristics and risk factors, suggesting a required premium for the inefficient firms. The difference in performance between the two portfolios remains for at least five years after the portfolio formation year. In addition, firm efficiency exhibits significant explanatory power for average equity returns in cross-sectional analysis.

scholarly journals Enrollment Strategies, Barriers to Participation, and Reach of a Workplace Intervention Targeting Sedentary Behavior

2018 ◽  
Vol 33 (2) ◽  
pp. 225-236 ◽  
Author(s):  
Sarah L. Mullane ◽  
Sarah A. Rydell ◽  
Miranda L. Larouche ◽  
Meynard John L. Toledo ◽  
Linda H. Feltes ◽  
...  
Keyword(s):  
Sedentary Behavior ◽  
Research Team ◽  
Saint Paul ◽  
Office Workers ◽  
Workplace Intervention ◽  
Full Time ◽  
Cross Sectional ◽  
Negative Experiences ◽  
Participant Engagement ◽  
Participation Barriers

Purpose: To review enrollment strategies, participation barriers, and program reach of a large, 2-year workplace intervention targeting sedentary behavior. Approach: Cross-sectional, retrospective review. Setting: Twenty-four worksites balanced across academic, industry, and government sectors in Minneapolis/Saint Paul (Minnesota) and Phoenix (Arizona) regions. Participants: Full-time (≥30+ h/wk), sedentary office workers. Methods: Reach was calculated as the proportion of eligible employees who enrolled in the intervention ([N enrolled/(proportion of eligible employees × N total employees)] × 100). Mean (1 standard deviation) and median worksite sizes were calculated at each enrollment step. Participation barriers and modifications were recorded by the research team. A survey was sent to a subset of nonparticipants (N = 57), and thematic analyses were conducted to examine reasons for nonparticipation, positive impacts, and negative experiences. Results: Employer reach was 65% (56 worksites invited to participate; 66% eligible of 56 responses; 24 enrolled). Employee reach was 58% (1317 invited to participate, 83% eligible of 906 responses; 632 enrolled). Postrandomization, on average, 59% (15%) of the worksites participated. Eighteen modifications were developed to overcome participant-, context-, and research-related participation barriers. Conclusion: A high proportion of worksites and employees approached to participate in a sedentary behavior reduction intervention engaged in the study. Interventions that provide flexible enrollment, graded participant engagement options, and adopt a participant-centered approach may facilitate workplace intervention success.

The Multinomial, Multiattribute Logit Choice Model

1979 ◽  
Vol 16 (1) ◽  
pp. 124-132 ◽  
Author(s):  
Dennis H. Gensch ◽  
Wilfred W. Recker
Keyword(s):  
Choice Model ◽  
Behavioral Model ◽  
Multinomial Logit ◽  
Choice Modeling ◽  
Cross Sectional ◽  
Individual Level ◽  
Multiattribute Choice ◽  
Regression Approach ◽  
The Difference ◽  
Sectional Analysis

The authors argue that for the cross-sectional multiattribute approach to choice modeling, the multinomial logit is theoretically and empirically superior to the more commonly used regression approach. Other choice methodologies also are discussed briefly in relation to logit. The difference between individual level (where regression is appropriate) and cross-sectional analysis is recognized. Most marketing managers, because of their research goals, will be using a cross-sectional approach. The derivation of the logit from an underlying behavioral model of choice is illustrated. It is this underlying behavioral model of choice that provides logit with several conceptual advantages for modeling a multiattribute choice structure.

scholarly journals Automatic Segmentation of Fiber Cross Sections by Dual Thresholding

2012 ◽  
Vol 7 (1) ◽  
pp. 155892501200700 ◽  
Author(s):  
Yan Wan ◽  
Li Yao ◽  
Bugao Xu
Keyword(s):  
Cross Sections ◽  
Automatic Segmentation ◽  
High Threshold ◽  
Detection Accuracy ◽  
Cross Sectional ◽  
Bisection Algorithm ◽  
Low Threshold ◽  
The Difference ◽  
Thresholding Algorithm ◽  
Sectional Analysis

In a microscopic image, fiber cross sections are often surrounded by borders distinctively darker than their bodies and the background. Fiber borders can be utilized to separate cross-sections properly so that accurate fiber shape and size information can be obtained. Hence, locating correct fiber borders is one of the most critical steps in cross-sectional analysis for fiber characterization and identification. This paper introduces a dual-thresholding algorithm that performs automatic fiber border segmentation from noisy cross-sectional images. The dual thresholds include a low threshold calculated based on the histogram of the difference from the average grayscale, and a high threshold computed by a bisection algorithm. With the low threshold, part of fiber border pixels, regarded as seeds, can be reliably located. The seeds can be further expanded by using the high threshold to form complete borders surrounding individual cross-sections. The experimental results show that the dual-thresholding algorithm can obtain cleaner and more fiber borders than other connectional thresholding algorithms, and improves the detection accuracy from 52.78% and 88.88%.

scholarly journals Using data to strategically deploy staffing resources

2018 ◽  
Vol 39 (3/4) ◽  
pp. 166-171
Author(s):  
Michael Williams
Keyword(s):  
Performance Indicator ◽  
Service Level ◽  
Design Stage ◽  
Full Time ◽  
Service Level Agreements ◽  
Full Time Equivalent ◽  
Content Type ◽  
Staffing Levels ◽  
Staffing Requirement ◽  
Using Data

Purpose The environmentally controlled library warehouse stores ten million collection items and its team of staff provides a delivery service to the students and researchers. Statistics show that the demand for the service was much higher than the forecast at the design stage and, as a result, the operationally intensive environment had bottlenecks and backlogs, which were affecting the service-level agreements. It was clear that the staffing levels were inadequate to meet the demand, so there was a need to capture data to enable evidence-based decision making to restructure and supplement staffing. The paper aims to discuss these issues. Design/methodology/approach Each of the activities undertaken by staff were observed and timed over extended periods, which resulted in detailed measurements for each elemental task. On the basis of known demand for services, the author was able to extrapolate these measurements to model the demand on services and, therefore, the staffing requirement for a whole year. Findings The author was able to provide evidence to show that the levels of staffing were inadequate and two further full-time equivalent staff were required. The data also highlighted specific areas that required higher and lower levels of resourcing than those were currently provided. Originality/value The research was motivated by operational need in an environment where meeting service-level agreements is a key performance indicator. The methods can be applied to many library activities and are especially applicable to repetitive or high-intensity tasks. It is equally valuable in library operations where there is a perception that staffing levels are inadequate but it is not clear how additional staffing should be deployed.

scholarly journals Utilization of postnatal care services in a rural area of Nalgonda district, Telangana state, India

2020 ◽  
Vol 7 (8) ◽  
pp. 3131
Author(s):  
K. Jahnavi ◽  
Abhay Subhashrao Nirgude ◽  
Kondagunta Nagaraj
Keyword(s):  
Postnatal Care ◽  
Skilled Birth Attendant ◽  
Cross Sectional Study ◽  
Postnatal Period ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Care Services ◽  
Factors Influencing ◽  
Post Natal Care ◽  
Geographical Accessibility

Background: Promoting women’s health improves not only individual health but also the health of the family, community and the nation. Less attention was given for postnatal period in developing countries; women and their newborns don’t receive postnatal care services from a skilled birth attendant during the first days after childbirth. The objective was to study utilization of postnatal care services by recently delivered mothers, to study the geographical accessibility factors influencing utilization of postnatal care services and to study healthcare provider factors influencing utilization of post natal care services.Methods: It was a community based cross sectional study conducted in Cherlapally and villages around, which constitute the rural field practice area of Department of SPM, Kamineni Institute of Medical Sciences, Narketpally Telangana from September 2012 to October 2014. A pre-designed and pre-tested questionnaire was used to collect the data. The data was compiled and analyzed using SPSS version 19.Results: Accordingly, 97.9% of the mothers received postnatal care and 2.7% mothers didn’t receive the postnatal care. In the present study post natal advice was received by 67.8%, 82.2% and 55.1% of mothers regarding family planning, breast feeding and baby care respectively. Majority (79.9%) of mothers travelled greater than 5 kms for delivery and only 20.1% of mothers travelled less than 5 kms for delivery.Conclusions: Number of institutional deliveries and deliveries assisted by skilled health personnel were more compared to other studies probably because of awareness created during antenatal visits, maternity benefit scheme and role of ASHA workers.

scholarly journals Does the approved tariff cover the actual cost of global surgical procedures?

2020 ◽  
Author(s):  
Ehsan Zarei ◽  
Maedehalsadadt Hashemi ◽  
Abbas Daneshkohan ◽  
Edris Kakemam
Keyword(s):  
Surgical Procedures ◽  
Cross Sectional Study ◽  
Study Data ◽  
Full Time ◽  
Actual Cost ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Supreme Council ◽  
The Difference

Abstract Background: Following the implementation of the health transformation plan in Iran and the significant increase in medical tariffs, it seems there is still a considerable gap between the actual cost of the Global Surgical procedures (GSPs) and the approved tariffs. The aim of this study was to compare the actual costs of GSPs with approved tariffs in hospitals affiliated to Qazvin University of Medical Sciences in 2016. Methods: In this cross-sectional study, data of 6,126 GSPs performed in three hospitals were extracted from Hospital Information System and approved tariffs were also obtained from the Supreme Council of Health Insurance. The difference between the average actual costs of a GSP and its tariff was considered as the tariff-actual cost gap. Regression test was used to determine the factors affecting the tariff-actual cost gap using SPSS.21. Results: The average actual cost of GPSs was 503 USD while the average tariff was 361 USD, indicating a significant negative gap between the approved tariffs and the actual cost of GPSs. In fact, for each procedure, the hospital suffered an average of 142 USD losses. In 54 of 63 GSPs, the average actual cost was 0.3% to 307.4% higher than the tariff. The highest negative gap was related to the “femoral fracture fixation" with -307.4%. The gap was higher in older patients, females, and patients with a longer stay, orthopedic specialty, and full-time surgeons (p<0.05). Conclusions: The findings of this study showed that tariffs covered only 71.8% of actual costs. It is suggested that in the tariff setting of GSPs, factors such as inflation rate, patient's age, comorbidity, disease severity, and hospital function (teaching or referral center) be considered. In addition, hospital management can also reduce the gap by modifying processes and managing resource consumption, especially medicines and consumables items.

Factors associated with wide variation in clinical litigation rates across acute NHS trusts in England: a cross-sectional analysis

2020 ◽  
Author(s):  
Beverley Griggs ◽  
Tristan Childs ◽  
Jamie Birkinshaw ◽  
Padmanabhan Badrinath
Keyword(s):  
Routine Data ◽  
Organizational Factors ◽  
Hospital Level ◽  
Cross Sectional ◽  
Level Indicator ◽  
Factors Associated ◽  
Cross Sectional Analysis ◽  
The North ◽  
Bed Days ◽  
Sectional Analysis

Abstract Objective Identify organizational factors associated with high clinical litigation rates among acute National Health Service (NHS) trusts in England. Design Cross-sectional analysis using routine data. Setting NHS trusts in England. Participants A total of 235 NHS trusts used the NHS Clinical Negligence Scheme in 2016–17. Ninety-seven trusts (41.3%) with no maternity services, 2 (0.9%) providing specialized services and 3 (1.2%) without clinical negligence claims were excluded. Hence, the remaining 133 trusts (56.6%) were included. Intervention(s) None. Main Outcome Measures Rate of clinical litigation by trust per 100 000 occupied bed days. Results The mean rate of clinical litigation was 25.4 per 100 000 occupied bed days. In univariable analyses, higher values of summary hospital-level mortality indictor, staff sickness, written complaints, patient safety incidents and being in the North of England led to increased clinical litigation rates. Conversely, higher patient admissions, NHS Staff Survey overall engagement score and occupied bed days led to decreased clinical litigation rates. In the multivariable model, factors associated with increased clinical litigation rates were as follows: summary mortality hospital-level indicator (SHMI) (0.9 increase in litigation rate per 0.05 increase in SHMI; P = 0.012); new written complaints (0.62 increase per 50 complaints higher; P &lt; 0.001); located in the North of England compared to London (5.22 higher; P &lt; 0.001). Conversely, a higher number of occupied bed days (−0.64 change per 50 000 days higher; P = 0.007) was associated with lower clinical litigation rates. Conclusions This study identified organizational factors associated with clinical litigation, which will be of interest to clinicians and the NHS. This research also highlights areas for further investigation.

scholarly journals The Size and Scope of Collegiate Athletic Training Facilities and Staffing

2017 ◽  
Vol 52 (8) ◽  
pp. 785-794 ◽  
Author(s):  
Andrew R. Gallucci ◽  
Jeffrey C. Petersen
Keyword(s):  
Athletic Training ◽  
Undergraduate Students ◽  
Cross Sectional Study ◽  
Full Time ◽  
Cross Sectional ◽  
Design Concepts ◽  
Staffing Levels ◽  
Training Facility ◽  
Part Time ◽  
Time Part

Context:  Athletic training facilities have been described in terms of general design concepts and from operational perspectives. However, the size and scope of athletic training facilities, along with staffing at different levels of intercollegiate competition, have not been quantified. Objective:  To define the size and scope of athletic training facilities and staffing levels at various levels of intercollegiate competition. To determine if differences existed in facilities (eg, number of facilities, size of facilities) and staffing (eg, full time, part time) based on the level of intercollegiate competition. Design:  Cross-sectional study. Setting:  Web-based survey. Patients or Other Participants:  Athletic trainers (ATs) who were knowledgeable about the size and scope of athletic training programs. Main Outcome Measure(s):  Athletic training facility size in square footage; the AT's overall facility satisfaction; athletic training facility component spaces, including satellite facilities, game-day facilities, offices, and storage areas; and staffing levels, including full-time ATs, part-time ATs, and undergraduate students. Results:  The survey was completed by 478 ATs (response rate = 38.7%) from all levels of competition. Sample means for facilities were 3124.7 ± 4425 ft2 (290.3 ± 411 m2) for the central athletic training facility, 1013 ± 1521 ft2 (94 ± 141 m2) for satellite athletic training facilities, 1272 ± 1334 ft2 (118 ± 124 m2) for game-day athletic training facilities, 388 ± 575 ft2 (36 ± 53 m2) for athletic training offices, and 424 ± 884 ft2 (39 ± 82 m2) for storage space. Sample staffing means were 3.8 ± 2.5 full-time ATs, 1.6 ± 2.5 part-time ATs, 25 ± 17.6 athletic training students, and 6.8 ± 7.2 work-study students. Division I schools had greater resources in multiple categories (P &lt; .001). Differences among other levels of competition were not as well defined. Expansion or renovation of facilities in recent years was common, and almost half of ATs reported that upgrades have been approved for the near future. Conclusions:  This study provides benchmark descriptive data on athletic training staffing and facilities. The results (1) suggest that the ATs were satisfied with their facilities and (2) highlight the differences in resources among competition levels.

scholarly journals Working in a cold environment, feeling cold at work and chronic pain: a cross-sectional analysis of the Tromsø Study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031248 ◽  
Author(s):  
Erlend Hoftun Farbu ◽  
Morten Skandfer ◽  
Christopher Nielsen ◽  
Tormod Brenn ◽  
Audun Stubhaug ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Pain ◽  
Sex Education ◽  
Missing Values ◽  
Leisure Time Physical Activity ◽  
Leg Pain ◽  
Full Time ◽  
Cold Environment ◽  
Cross Sectional ◽  
Sectional Analysis

AimThe aim of this study was to investigate if working in a cold environment and feeling cold at work are associated with chronic pain (ie, lasting ≥3 months).MethodsWe used data from the sixth survey (2007–2008) of the Tromsø Study. Analyses included 6533 men and women aged 30–67 years who were not retired, not receiving full-time disability benefits and had no missing values. Associations between working in a cold environment, feeling cold at work and self-reported chronic pain were examined with logistic regression adjusted for age, sex, education, body mass index, insomnia, physical activity at work, leisure time physical activity and smoking.Results779 participants reported working in a cold environment ≥25% of the time. This exposure was positively associated with pain at ≥3 sites (OR 1.57; 95% CI 1.23 to 2.01) and with neck, shoulder and leg pain, but not with pain at 1–2 sites. Feeling cold sometimes or often at work was associated with pain at ≥3 sites (OR 1.58; 95% CI 1.22 to 2.07 and OR 3.90; 95% CI 2.04 to 7.45, respectively). Feeling cold often at work was significantly and positively associated with pain at all sites except the hand, foot, stomach and head.ConclusionWorking in a cold environment was significantly associated with chronic pain. The observed association was strongest for pain at musculoskeletal sites and for those who often felt cold at work.

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