The contribution of professions to the governance of integrated care: Towards a conceptual framework based on case studies from Denmark

2021 ◽  
pp. 135581962110556
Author(s):  
Viola Burau ◽  
Ellen Kuhlmann ◽  
Loni Ledderer
Keyword(s):  
Conceptual Framework ◽  
Integrated Care ◽  
Case Studies ◽  
Good Governance ◽  
Secondary Analysis ◽  
Analytical Framework ◽  
Care Needs ◽  
Adaptive Mechanisms ◽  
Inductive Elements ◽  
Health Policy Implementation

Objective Good governance of integrated care is key to better health care, but we know little about how professions can help make this happen. Our aim is to introduce a conceptual framework to analyse how professions contribute to the governance of integrated care, and to apply the framework to a secondary analysis of selected case studies from Denmark. Methods We developed a framework, which identified the what, how and why of the contribution professions make to the governance of integrated care. We included five qualitative Danish studies, using coordination as an indicator of integrated care. We adopted a thematic approach in our analysis, combining deductive and inductive elements. Results Health professions engage in highly diverse activities, which fall into closely connected clusters of more formal or more informal coordination. Professions apply many different adaptive mechanisms at different levels to fit coordination into local contexts. Professions are driven by interlocking rationales, where a common focus on patients connects organizational and professional concerns. Conclusions Our analytical framework emerges as a useful tool for analysis. The contribution of professions to the governance of integrated care needs greater attention in health policy implementation as it can promote more effective governance of integrated care.

E-inclusion or digital divide: an integrated model of digital inequality

2018 ◽  
Vol 74 (3) ◽  
pp. 552-574 ◽  
Author(s):  
Biyang Yu ◽  
Ana Ndumu ◽  
Lorri M. Mon ◽  
Zhenjia Fan
Keyword(s):  
Conceptual Framework ◽  
Digital Divide ◽  
Migrant Workers ◽  
Secondary Analysis ◽  
Analytical Framework ◽  
Integrative Model ◽  
Cognitive Resources ◽  
Data Set ◽  
Content Type ◽  
Chinese Migrant Workers

Purpose The purpose of this paper is to improve understanding of the societal problem of the deepening digital divide by establishing and testing an integrated conceptual framework for digital divide research. Design/methodology/approach The authors established the integrated conceptual framework after synthesizing the literature, and then tested the framework by conducting a secondary analysis of a 2014-2015 data set comprised of 398 survey responses and nine interviews with Chinese migrant workers. Findings The results showed that Chinese migrant workers were partially e-included in the digital society. However, they encountered material, cognitive, motivational, and social access limitations due to the lack of financial, material, educational, psychological, interpersonal, and cognitive resources, which caused them to experience a digital divide. Findings support the use of the integrative model as a potential analytical framework to understand and address digital inequalities. Originality/value This study first proposed an integrative framework to understand the measurements and causes of the digital divide and then empirically tested its feasibility.

scholarly journals Conclusion: Alternative Theory and Practice of Peacebuilding in Asia

2021 ◽  
pp. 187-196
Author(s):  
Yuji Uesugi ◽  
Anna Deekeling ◽  
Sophie Shiori Umeyama ◽  
Lawrence McDonald-Colbert
Keyword(s):  
Conceptual Framework ◽  
Case Studies ◽  
Social Institutions ◽  
Analytical Framework ◽  
Theory And Practice ◽  
Alternative Theory ◽  
Focal Points ◽  
Practical Application ◽  
China And Japan

AbstractThe concluding chapter summarises the findings of the previous chapters and presents their common assertions. The goal is to evaluate whether the existent gap between hybrid peacebuilding theory and its practice has been successfully closed. Building upon a complexity-informed framework of hybrid emergence, the mid-space actor typology is developed to link between an analytical framework and practical application. This volume has demonstrated that mid-space actors can provide viable focal points for establishing resilient and self-sufficient social institutions from within without dictating the content of such emergences. The case studies of Cambodia and Mindanao were examined to assess the on-the-ground operation of mid-space actors, and the cases of China and Japan illuminated how the conceptual framework of hybridity could improve contemporary peacebuilding models.

scholarly journals Adopt, adapt, or abandon technology-supported person-centred care initiatives: healthcare providers’ beliefs matter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari Dyb ◽  
Gro Rosvold Berntsen ◽  
Lisbeth Kvam
Keyword(s):  
Information Technologies ◽  
Scale Up ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Analytical Framework ◽  
Development Project ◽  
Technology Support ◽  
Care Needs ◽  
Term Care

Abstract Background Technology support and person-centred care are the new mantra for healthcare programmes in Western societies. While few argue with the overarching philosophy of person-centred care or the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual healthcare providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for people with long-term care needs by using the new analytical framework nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) of health and care technologies. We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement, and evaluate technology-supported healthcare programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016–2020). It originates at one of ten work packages in this project. Method The main data consist of ethnographic field observations at the four innovation arenas and 29 interviews with involved healthcare providers. To ensure continuous updates and status on work in the four innovation arenas, we have also participated in a total of six annual network meetings arranged by the project. Results While the NASSS framework is very useful for identifying and communicating challenges with the adoption and spread of technology-supported person-centred care initiatives, we found it less sensitive towards capturing the dedication, enthusiasm, and passion for care transformation that we found among the healthcare providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved healthcare providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached. Conclusion Increased knowledge about healthcare providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement, and evaluate technology-supported healthcare programmes.

An analytical framework of “zero waste construction site”: Two case studies of Shenzhen, China

2021 ◽  
Vol 121 ◽  
pp. 343-353
Author(s):  
Weisheng Lu ◽  
Zhikang Bao ◽  
Wendy M.W. Lee ◽  
Bin Chi ◽  
Jiayuan Wang
Keyword(s):  
Case Studies ◽  
Analytical Framework ◽  
Construction Site ◽  
Zero Waste

scholarly journals Functional difficulties and toileting among older adults in Ghana: evidence from the World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 1

2021 ◽  
pp. 1-23
Author(s):  
Kofi Awuviry-Newton ◽  
Kylie Wales ◽  
Meredith Tavener ◽  
Paul Kowal ◽  
Julie Byles
Keyword(s):  
Older Adults ◽  
Marital Status ◽  
Conceptual Framework ◽  
World Health ◽  
Adult Health ◽  
Care Needs ◽  
Functional Difficulties ◽  
The World ◽  
Health Organization ◽  
Global Ageing

Abstract Ghana's older population is projected to increase in coming decades and as a result will see increasing care needs. Understanding the functional difficulties older adults experience, and the associated factors, will help identify relevant intervention to assist older adults in meeting their care needs. This study aimed to analyse the prevalence of functional difficulties among older adults in Ghana, and examine how the World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) conceptual framework can relate to toileting difficulty to understand the factors that increase older adults’ care needs. Data were for 5,096 adults aged ⩾50 years from the WHO Study on global AGEing and adult health (SAGE) Ghana Wave 1. Difficulties were assessed using self-reported difficulty on 22 functional items, including toileting. Multivariate logistic regression tested associations between toileting and other factors as related to the WHO-ICF conceptual framework. Older adults reported climbing one flight of stairs without resting as a common functional difficulty. Difficulty eating was the item least identified. Toileting difficulty was ranked second among five total activities of daily living difficulties. Age, marital status, self-reported health, memory, bodily pain, short- and far-distance vision, obesity, stroke, chronic lung disease, trust at individual and neighbourhood level, toilet facility type, socialising with co-workers, and public and religious meeting attendance were statistically significantly associated with toileting difficulty in the final parsimonious model. Post-hoc analysis testing interaction revealed that interaction existed between female sex and never married marital status (p = 0.04), and obesity and widowed marital status (p = 0.01), with toileting as the outcome. A significant level of functional difficulty existed among Ghanaian older adults in this sample. Toileting difficulty was associated with factors across different components in the WHO-ICF, emphasising functional, social and environmental factors related to this fundamental human activity.

scholarly journals CASTING THE LIGHT OF THE THEORY OF OPPOSITION ONTO HOHFELD'S FUNDAMENTAL LEGAL CONCEPTS

Legal Theory ◽  
2021 ◽  
pp. 1-34
Author(s):  
João Alberto de Oliveira Lima ◽  
Cristine Griffo ◽  
João Paulo A. Almeida ◽  
Giancarlo Guizzardi ◽  
Marcio Iorio Aranha
Keyword(s):  
Conceptual Framework ◽  
Legal Theory ◽  
Analytical Framework ◽  
The Core ◽  
Recent Developments ◽  
The Law ◽  
Opposition Theory ◽  
Legal Concepts ◽  
Number Of Authors

Abstract At the core of Hohfeld's contribution to legal theory is a conceptual framework for the analysis of the legal positions occupied by agents in intersubjective legal relations. Hohfeld presented a system of eight “fundamental” concepts relying on notions of opposition and correlation. Throughout the years, a number of authors have followed Hohfeld in applying the notion of opposition to analyze legal concepts. Many of these authors have accounted for Hohfeld's theory in direct analogy with the standard deontic hexagon. This paper reviews some of these accounts and extends them employing recent developments from opposition theory. In particular, we are able to extend application of opposition theory to an open conception of the law. We also account for the implications of abandoning the assumption of conflict-freedom and admitting seemingly conflicting legal positions. This enables a fuller analysis of Hohfeld's conceptual analytical framework. We also offer a novel analysis of Hohfeld's power positions.

scholarly journals Impact of Roommates on MDRO Spread in Nursing Homes

2020 ◽  
Vol 41 (S1) ◽  
pp. s66-s67
Author(s):  
Gabrielle M. Gussin ◽  
Ken Kleinman ◽  
Raveena D. Singh ◽  
Raheeb Saavedra ◽  
Lauren Heim ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Multidrug Resistant ◽  
Healthcare Intervention ◽  
Odds Ratios ◽  
Care Needs ◽  
Environmental Cleaning ◽  
The Impact

Background: Addressing the high burden of multidrug-resistant organisms (MDROs) in nursing homes is a public health priority. High interfacility transmission may be attributed to inadequate infection prevention practices, shared living spaces, and frequent care needs. We assessed the contribution of roommates to the likelihood of MDRO carriage in nursing homes. Methods: We performed a secondary analysis of the SHIELD OC (Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, CA) Project, a CDC-funded regional decolonization intervention to reduce MDROs among 38 regional facilities (18 nursing homes, 3 long-term acute-care hospitals, and 17 hospitals). Decolonization in participating nursing homes involved routine chlorhexidine bathing plus nasal iodophor (Monday through Friday, twice daily every other week) from April 2017 through July 2019. MDRO point-prevalence assessments involving all residents at 16 nursing homes conducted at the end of the intervention period were used to determine whether having a roommate was associated with MDRO carriage. Nares, bilateral axilla/groin, and perirectal swabs were processed for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CRE). Generalized linear mixed models assessed the impact of maximum room occupancy on MDRO prevalence when clustering by room and hallway, and adjusting for the following factors: nursing home facility, age, gender, length-of-stay at time of swabbing, bedbound status, known MDRO history, and presence of urinary or gastrointestinal devices. CRE models were not run due to low counts. Results: During the intervention phase, 1,451 residents were sampled across 16 nursing homes. Overall MDRO prevalence was 49%. In multivariable models, we detected a significant increasing association of maximum room occupants and MDRO carriage for MRSA but not other MDROs. For MRSA, the adjusted odds ratios for quadruple-, triple-, and double-occupancy rooms were 3.5, 3.6, and 2.8, respectively, compared to residents in single rooms (P = .013). For VRE, these adjusted odds ratios were 0.3, 0.3, and 0.4, respectively, compared to residents in single rooms (P = NS). For ESBL, the adjusted odds ratios were 0.9, 1.1, and 1.5, respectively, compared to residents in single rooms (P = nonsignificant). Conclusions: Nursing home residents in shared rooms were more likely to harbor MRSA, suggesting MRSA transmission between roommates. Although decolonization was previously shown to reduce MDRO prevalence by 22% in SHIELD nursing homes, this strategy did not appear to prevent all MRSA transmission between roommates. Additional efforts involving high adherence hand hygiene, environmental cleaning, and judicious use of contact precautions are likely needed to reduce transmission between roommates in nursing homes.Funding: NoneDisclosures: Gabrielle M. Gussin, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

scholarly journals Classification and Measurement of the Firms’ Resources and Capabilities Applied to Eco-Innovation Projects from a Resource-Based View Perspective

2018 ◽  
Vol 10 (9) ◽  
pp. 3161 ◽  
Author(s):  
Pilar Portillo-Tarragona ◽  
Sabina Scarpellini ◽  
Jose Moneva ◽  
Jesus Valero-Gil ◽  
Alfonso Aranda-Usón
Keyword(s):  
Natural Resources ◽  
Conceptual Framework ◽  
Case Studies ◽  
Corporate Sustainability ◽  
Policy Makers ◽  
Resource Based View ◽  
Depth Analysis ◽  
Innovation Projects ◽  
Resources And Capabilities

Interest from academics, policy–makers and practitioners in eco-innovation has increased as it enables the optimization of the use of natural resources improving competitiveness and it provides a conceptual framework for corporate sustainability. In this context, this paper provides an in-depth analysis and a wide classification of the specific indicators for the integrated measurement of eco-innovation projects in business from a resource-based view (RBV). The specific metrics were tested to measure the economic-financial and environmental resources and capabilities applied by five Spanish firms to eco-innovation projects, selected as case studies.

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