bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flexible, Capable, Adaptable: A Dynamic Allied Health Workforce
Authors: May Kerry , McAlinden Fiona , Splawa-Neyman Michael , O'Rourke Michelle , Sturgess Tamica 
Published: February 2019

Objective: The Allied Health Executive at a major Metropolitan Health Service was experiencing an increasing number of flexible work requests and was keen to ensure that local and legislative requirements were met, our highly skilled and specialist staff were supported to remain in the workforce as their life outside work changed and the operational demands of a bed-based service delivery model were not negatively impacted.
Design: A root cause analysis was completed identifying three main contributing factors for the current, adhoc approach to flexible work requests. Current and past flexible work participants were surveyed, along with their managers and the Nurse Unit Managers of the clinical work areas. A literature review and environmental scan regarding frameworks for decision making for and supporting flexible work requests was undertaken.
Findings: There was a lack of consistent information as to how to establish and manage a flexible work request. There had been an historical view that flexible work requests were difficult to operationalise and there were missed experiences with flexible work arrangements for the people involved, their managers and their colleagues.
Outcome measures: The combined data was then utilised to develop a framework to support decision-making around whether a role could operate as a flexible work arrangement. A framework on how to best support the staff considering and entering into these arrangements to ensure all the benefits of a flexible work arrangement are realised and many of the challenges minimised was also developed.
Conclusion: Flexible work arrangements should be considered in appropriate circumstances, and will have the best opportunity for success when supported by a consistent, evidenced-based framework.
Abbreviations: EFT – Equivalent Full Time; RCA – Root Cause Analysis.
Introduction of the Community Rehabilitation Northern Queensland Service
Authors: Mervin Merehau Cindy , Barker Ruth , Stealey Cindy , Comans Tracy 
Published: February 2019

Objective: To analyse trends in length of hospital stay before and after the implementation of the Community Rehabilitation Northern Queensland Service (CRNQ) in Townsville, Australia.
Design: Retrospective analysis of collected administrative data provided by the data custodian Townsville Hospital Health Service District.
Setting: All patients discharged from the Townsville hospital between 1 July 2008 and 30 June 2013 for whom the Australian Refined Diagnosis Related Groups were stroke (B70), degenerative nervous system disorders (B67) or rehabilitation (Z60).
Main outcome measures: Average length of stay and total number of inpatient episodes coded stroke, degenerative nervous system disorders or rehabilitation.
Results: Length of stay for the selected diagnosis related groups was consistently ranging from 23 days to 25 days for the period 2008-2012. In the first year of full operational capacity of CRNQ (2012-13), there was an average reduction of six days in length of stay. The major reductions in length of stay occurred in patients admitted for rehabilitation care.
Conclusions: This study adds additional evidence that earlier discharge can be facilitated for patients with neurological conditions living outside metropolitan areas when appropriate rehabilitation services are available in the community.
Abbreviations: AR-DRG – Australian Refined Diagnosis Related Groups; CRNQ – Community Rehabilitation Northern Queensland Service.
Mainstreaming Human Immunodeficiency Virus (HIV) Insurance in India: Opportunities and Challenges
Authors: Trivedi Mayur , Raman A. Venkat 
Published: February 2019

Millions of Indians fall into poverty because of the private high Out of Pocket pattern of health financing, due to the absence of insurance coverage. Conditions like HIV and AIDS also influence poverty due to a lifelongtreatment requirement. Access to insurance coverage (commercial or voluntary) has been denied to People Living with HIV (PLHIV) through various clauses. However lately, there have been certain experiments on inclusion of HIV into new or existing schemes. This paper provides a systematic review of coverage, managerial and financial systems of selected cases of HIV insurance pilots in India with an objective to explore its sustainability and ability to be replicated.
A cross-sectional descriptive analysis of existing literature and in-depth case studies of relevant health insurance schemes were used for the review. Data was compiled using qualitative data collection tools such as in-depth interviews with officials. The schemes were analysed using two frameworks viz. managerial ability and coverage ability. The managerial ability was analysed through a Strength-Weakness-Opportunity-Threat(SWOT) analysis. The coverage ability was analysed through three dimensions viz. a) breadth b) depth and c) height. In India, there are two types of insurance policies vis-à-vis HIV coverage. These were categorised as HIV-specific and HIV-sensitive policies.
Of the seven pilot schemes reviewed, the small-scale health insurance schemes show limited success owing to smaller pool and limited managerial capabilities. The large schemes offer avenues for mainstreaming butpose issues of governance as well as marketing among PLHIVs. The findings of the research identify a specific set of issues and challenges for sustainability and replication from three perspectives viz. a) market, b) cost recovery and sustainability and c) equitable coverage.
Abbreviations: AIDS – Acquired Immune Deficient Syndrome; ART - Anti-retroviral Therapy; BPL – Below Poverty Line; FF-HIP – Freedom Foundation Health Insurance Policy; HIV – Human Immunodeficiency Virus; IRDA – Insurance Regulatory and Development Authority; NGO – Non Government Organisation; PLHIV – People Living with HIV; OI – Opportunistic Infections; OOP – Out of Pocket; RSBY – Rashtriya Swasthya Bima Yojana; STI – Sexually Transmitted Infection; SWOT – Strengths, Weaknesses, Opportunities, Threats; UHC – Universal Health Coverage; UNDP – United Nations Development Program.
Cost of Waiting on an Orthopaedic Waiting List: a scoping review
Authors: Morris Joanne , Twizeyemariya Asterie , Grimmer Karen 
Published: February 2019

Background: Approximately 30% Australians suffer from arthritis and other musculoskeletal disorders. From 2003-2033 there is a predicted 223% increase in expenditure on health management of musculoskeletal disorders. There is evidence of increasing prevalence of orthopaedic complaints, in longer waiting lists for specialist consultations in public hospital outpatient clinics. Little is known about the costs and ramifications of waiting for orthopaedic consultations.
Aim: Establish what is known about the direct and indirect costs of being placed on a waiting list for an orthopaedic consultation.
Method: Patient and Outcome search strategy of Medline, Embase, Pubmed, NHS Economic evaluation database (NHS-EED) from each database inception date. Handsearching of reference lists of included papers alsooccurred. A realist synthesis framework underpinned the review, using a ubiquitous patient journey to map available literature on the impact of waiting. Hierarchy of evidence was reported using NHMRC criteria andarticles critically appraised using either the PEDRo or CASP criteria (relevant to the design). A purpose-built data extraction instrument was developed.
Results: We identified 786 studies, of which 139 were relevant, including a systematic review (Hoogeboom et al) with 15 included articles which were added to the list of eligible papers (and the review itself deleted), leaving 153 included articles; 17 were relevant to the review. Fourteen papers reported on quality of life and four reported on costs, two of these papers reported on both and all were of low to moderate quality. The research was not based on a comprehensive understanding of the stages of waiting, and there were inconclusive outcomes for quality of life and cost.
Conclusion: There is scant evidence of the impact on quality of life and costs of waiting for orthopaedic outpatient appointments. Future research should aim for improved methodological quality and use patientfocused quality of life measures, and validated measures of cost.
Abbreviations: NHMRC – National Health and Medical Research Council; PROMS – Patient Related Outcome Measures; QoL – Quality of Life; WOMAC – Western Ontario and McMaster Universities Osteoarthritis Index; YLD – Years Lived With Disability
Health Workers’ Perspectives on Infrastructure to Support Maternal Health Services in Rural Areas of Vietnam
Authors: Nguyen Thi Hoai Thu , McDonald Fiona , Wilson Andrew 
Published: February 2019

Background: One common governance issue faced by developing countries is the establishment and maintenance of infrastructure to support the delivery of primary health services. This qualitative study explores the perspective of maternal health workers on how infrastructure impacts the provision of maternity services in rural areas in Vietnam.
Methods: Forty-one health workers and health managers at the commune, district and provincial levels of the Vietnamese public health system were interviewed. Questions focused on the impact of various organisational factors, including the impact of infrastructure on the performance of the health workforce, which provides publicly funded primary care. All interviews were recorded, transcribed and coded for thematic analysis.
Findings: Participants noted that infrastructure directly affected their ability to perform certain tasks and could both directly and indirectly negatively impact their motivation. In general, participants noted a lack of investment in infrastructure for the provision of primary care services in rural areas. They identified that there were deficits in the availability of utilities and the adequacy of facilities.
Conclusion: This research contributes to understanding the barriers to the provision of primary care in developing countries and in particular. The current inadequacy of facility buildings and inadequacy of clean water supply are issues for health workers in meeting the technical requirements of the standards as set out in the National Guidelines on reproductive health, and lead to safety concerns for the quality of maternal health services provided in commune health centres and District Health Centres.
Abbreviations: CHC – Commune Health Centres; DHC – District Health Centre; HW – Health Worker.
Recipe for Success: localism and bounded rationality in lobbying for radiation therapy services in North West Tasmania
Authors: West Sancia , Shannon Elizabeth , Crisp Elaine , Barnett Tony 
Published: February 2019

Objective: Describes where bounded rationality and localism are evident in the debate over the introduction of radiation therapy services in North West Tasmania and how this affected the delivery of the message fromeach side.
Design: Semi-structured interviews with stakeholders and patients/family over an eight month period in 2016 are contrasted with viewpoints identified via document analysis.Setting: North West Tasmania.
Main Outcome Measures: The mechanisms for policy change and the policy beliefs of each side are examined with the intention of understanding how bounded rationality and a sense of localism can combine to effectpolicy change.
Results: In the instance of radiation therapy services in North West Tasmania, a policy debate was originally waged between medical professionals and policy makers opposed to a local service on one side and a handful of policy actors advocating for a local service on the other. Those in favour of a local radiation therapy service harnessed a sense of localism to project the perception of widespread community support for the proposal and secured funding commitments during the 2010 Federal Election campaign.
Conclusions: There is evidence of bounded rationality from both the stakeholder and patient groups, as well as a strong sentiment of localism expressed by patients and community advocates. Through understanding this particular case, health service managers can determine how to better time and target messages to the general public and to policy makers during periods of proposed changes to health services.
A Comparison of Three Payment Systems for Public Paediatric Dental Services
Authors: Conquest Jennifer Hanthorn , Skinner John , Kruger Estie , Tennant Marc 
Published: February 2019

Objective: This study investigated the delivery of paediatric (0-17 years) government dental services in New South Wales (NSW), Australia through public dental clinics and the commissioned payments models of Fee-for-Service and Capped-Fee.
Method: De-identified patient data from government provided dental care and the commissioned services was sourced from NSW Oral Health Data Warehouse for evaluation and interpretation using descriptive analysis during the period 1 January 2012 to 31 December 2013.
Result: The breakdown of dental care provided the associated cost analysis for the study’s cohort that resulted in both years, more than 50 percent dental services offered to paediatric patients were preventive care in all payment systems. The most common preventive items offered were fluoride treatment, dietary advice, oral health education and fissure sealants.
Conclusion: There was little difference in the mix of dental care provided between study years and age groups through the three payment systems in NSW. The difference between the government services and those provided via the Fee-for-Service and Capitation payment systems was negligible.
This has important implications for the delivery of dental care to public dental care, particularly when patients may not live close to a public dental clinic and also with the interest nationally in giving patients greater choice.
Service Navigators in the Workforce: an ethical framework for practice
Authors: Donovan Jennifer , Hampson Ralph , Connolly Marie 
Published: February 2019

Aim and Context: This paper explores the current growth of service navigators in complex health and human services and details the development of the Service Navigation Relational Autonomy Framework as a guide to assist practitioners and managers implementing this role.
Approach: The framework was developed using a research into action process. The three-stage process included knowledge inquiry: bringing together existing knowledge in practice fields and research; knowledge synthesis:debate and exchange of practitioner insights and messages from research; and knowledge framework: framework creation based on the key elements of evidence-informed best practice. Main findings: The framework centres on four practice domains: reinforcing ethical practices; fostering self-determination; supporting transitions and wellbeing; and mobilising service systems. It incorporates the concept of relational autonomy as a foundation for navigator practice by recognising the nature of relationships and power dynamics in the provision of care, and the central importance of self-determination. Conclusions: A navigation framework is critical for practice guidance and to ensure service navigators and organisations have the capacity to meet the needs of service users and their families. The framework presented in this paper seeks to encourage debate about service navigation, its implementation, and its future in health and human service organisations.
How Are Continuous Quality Improvement (CQI) Approaches Used in Evaluating Management Development Programs? a literature review
Authors: Onnis Leigh-ann , Hakendorf Marcia , Tsey Komla 
Published: February 2019

Aim: The aim of the review was to examine the characteristics of studies that use CQI approaches to evaluate management development programs; and to synthesise the findings to understand how CQI approaches are being used to evaluate the effectiveness of management development programs.
Method: A scoping review of the literature was conducted in a manner consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The matches were screened by title and abstract using the inclusion criteria, leading to a full paper review of 48 papers. Of these, the 14 papers found to meet the inclusion criteria for the scoping review were independently reviewed and analysed by two of the authors.
Findings: The review revealed the ways in which CQI approaches were used in evaluating management development programs highlighting the role of context, pre-determined competencies and participatory CQI approaches. Participatory CQI approaches including on-the-job application of learning provided opportunities for participants to learn through CQI activities associated with action learning and CQI feedback cycles.
Conclusions: The authors concluded that evaluations using participatory CQI approaches are better positioned to report more comprehensively on the benefits of management development programs when they include the competencies required to be successful in the context within which the manager is working. Future directions for research in this area include an examination of the microsystem context to determine whether the required management competencies associated with remoteness differ from other contexts.
META-ANALISIS PENGARUH MODEL PEMBELAJARAN ROLE PLAYING TERHADAP HASIL BELAJAR IPS
Authors: Kristin Firosalia 
Published: February 2019

Tujuan penelitian ini untuk menganalisis kembali penggunaan model pembelajaran role playing dalam meningkatkan hasil belajar IPS. Metode yang digunakan dalam penelitian ini adalah meta analisis. Penelitian diawali dengan merumuskan masalah penelitian, menelusuri hasil penelitian yang relevan untuk dianalisis. Data dikumpulkan dengan menelusuri jurnal elektronik melalui Google Scholar dengan kata kunci “hasil belajar”, “bermain peran”, “pembelajaran IPS SD”. Dari penelusuran itu diperoleh 86 artikel tetapi yang relevan hanya 12 artikel dari jurnal. Data dianalisis dengan menggunakan analisis deskriptif kualitatif. Berdasarkan hasil analisis model pembelajaran role playing mampu meningkatkan hasil belajar siswa mulai dari yang terendah 1,65% sampai yang tertinggi 64,32% dengan rata-rata 23,32%.
MODEL MANAJEMEN MUTU TERPADU BERBASIS MULTIPLE INTELEGENCE PADA SEKOLAH DASAR UNGGULAN DI KABUPATEN JEPARA
Authors: Setiardi Dicky , Munir Muhammad Misbahul 
Published: February 2019

This research is a study of qualitative descriptive. It was carried out at the Jepara Bumi Kartini Primary School. The instrument technique used to collect the data is by interviewing, observing and documentation. The prominent resources is headschool respon, teachers, employees,committee, and the organization of management in primary school of Unggulan Terpadu Bumi Kartini, that collected by essay document, video record/audio tape/MP3 and documetation. The data analysis was carried out at the preliminary study stage, data development and validation stages.The results of the study showed that the application of integrated quality management based on multiple intellegence in the Primary School of Unggulan Bumi Kartini of Jepara Kartini was more aim towards mathematical logical intelligence. Several efforts can be done to implement integreted quality management based on multiple intellegence in other intelligences is by synergizing in the form of good management governance including the availability of human resources, availability of facilities and infrastructure, a conducive environment, updated curriculum, as well as the role of school committees and society participation in implementing integrated quality management based on multiple intellegence, so as to improve the quality of students who will ultimately create excellent schools.
Palanga’s Modern Architecture on the Way to Heritage
Authors: Nekrošius Liutauras , Riaubienė Edita 
Published: February 2019

Abstract
This paper discusses particular aspects of the development of cultural identity through diverse, multi-layered architectural heritage and argues that by combining architectural expertise with community engagement the inclusive modernist heritage collection can be created. The research is based on the case of Palanga resort. The paper focuses on the issue of creating a list of cultural heritage of Palanga town as a coherent and continuous architectural collection and discusses the approaches to be used in engaging communities into the process of heritage making.
Considering the post-colonial society and its multiple relationship with the built environment of that time in Lithuania, the changed needs and requirements, and today’s high commercial interest, it is essential to find effective ways for the protection and further development of heritage of the recent past.
Air temperature anomalies in experimental forests in Rogów in 1924–2015
Authors: Chojnacka-Ożga Longina , Ożga Wojciech 
Published: February 2019

Abstract
Meteorological measurements, that aim to monitor weather and climate conditions to aid research in changing forest ecosystems, have been conducted in the Warsaw University of Life Sciences’ experimental forests in Rogów since 1924. Based on the long-term air temperature measurements, it can be demonstrated that in the years 1924–2015, anomalously cold months have occurred less often (ca. 3.2%) than anomalously warm months (ca. 4.5%). During the last 20 years, only two anomalously cold months were recorded (November 1998, December 2010), whereas anomalously warm months occurred frequently (May 2002, July 1999, 2002, 2006, 2010, 2012, 2014, August 2002, 2015, September 1999, 2006, October 2000, 2001). We hypothesised that the more frequent anomalously warm months would constitute a trend in increasing the air temperature for particular months between 1924–2015, but surprisingly, a statistically significant trend was observed for all winter (XII–II) and spring months (III–IV) as well as the end of summer (VIII).
Spatial variability of CO2 fluxes from meadow and forest soils in western part of Wzniesienia Łódzkie (Łódź Hills)
Authors: Wroński Krzysztof Tadeusz 
Published: February 2019

Abstract
For this study, the rate of soil respiration was estimated based on monthly measurements of 20 research points representing different types of plant communities. Meadows were found to have the highest rates of soil respiration, whereas rates measured in forests were lower. However, the seasonality of leaf and pine needle decomposition caused large variation in the CO2 fluxes from forest soils. Furthermore, the carbon content at both, the soil surface and 5 cm below ground, affected spatial differentiation of soil respiration in summer and autumn, while the carbon content at 5 cm below ground also affects the spatial variability of annual CO2 fluxes from the soil. Amazingly, however, results of research indicate that the carbon content throughout the whole humus layer does not impact soil respiration. It was also observed that changes in relief affected rates of soil respiration due to differences in sunlight exposure and the history of land use, which can markedly reduce the impact of the carbon content at 5 cm below ground on soil respiration.