bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing intensive care admission: a mixed methods study of EM and ICU
Authors: Emerson Philip , Brooks Daniel , Quasim Tara , Puxty Alex , Kinsella John , Lowe David J. 
Published: August 2015

Objectives
Twenty-six percent of ICU patients in the UK are referred directly from the Emergency Department (ED). There is limited literature examining the attitudes or practice of ED/ICU physicians towards referrals from the ED to the ICU. We examined these attitudes through a mixed methods study, designing a model incorporating these attitudes to promote a shared mental model between ED and ICU specialities.

Methods
Individual semistructured interviews were conducted with 11 ED consultants and 11 ICU consultants at two hospitals in the west of Scotland. Interviews were based on 10 ‘case-based vignettes’ representing patients for whom referral from the ED to the ICU is borderline or challenging. Participants were asked to note whether they would refer/accept the patient from the ED to the ICU. The proportions of participants from each speciality choosing to refer or accept patients were compared using a t-test comparing proportions. The reasons behind these decisions were explored during the semistructured interviews.

Results
Twelve factors emerged as influencing the decisions made by the participants. These belonged three core themes: patient factors, clinician factors and resource factors, which were incorporated into a shared mental model. Two cases demonstrated statistically significant differences in referral rates between specialities. There were also clinically significant differences among other cases.

Conclusion
We have described the attitudes of physicians towards ED to ICU referrals in two west of Scotland hospitals, and we have demonstrated that there is a difference in the aspects of the decision-making process. We have developed a model encompassing all factors considered by participants when assessing these difficult referrals. It is hoped that this model will promote shared and more efficient decision-making in the future.
What single-cell stimulation has told us about neural coding
Authors: Doron Guy , Brecht Michael 
Published: August 2015

In recent years, single-cell stimulation experiments have resulted in substantial progress towards directly linking single-cell activity to movement and sensation. Recent advances in electrical recording and stimulation techniques have enabled control of single neuron spiking
in vivo
and have contributed to our understanding of neuronal coding schemes in the brain. Here, we review single neuron stimulation effects in different brain structures and how they vary with artificially inserted spike patterns. We briefly compare single neuron stimulation with other brain stimulation techniques. A key advantage of single neuron stimulation is the precise control of the evoked spiking patterns. Systematically varying spike patterns and measuring evoked movements and sensations enables ‘decoding’ of the single-cell spike patterns and provides insights into the readout mechanisms of sensory and motor cortical spikes.
Leadership development: an applied comparison of Gibbs’ Reflective Cycle and Scharmer’s Theory U
Authors: Potter Christopher 
Published: August 2015

Purpose
– The purpose of this paper is to examine two contrasting leadership development methodologies, Reflective Practice and Scharmer’s Theory U.

Design/methodology/approach
– Gibbs’ Reflective Cycle and Scharmer’s Reflecting Deeply exercise were applied to the same leadership incident on separate days.

Findings
– Reflective Practice provided helpful insights through focusing on one’s thoughts, feelings and motives during the event, as well as the actions of others and the author’s responses to them. The author found that using Scharmer’s Reflecting Deeply exercise enabled a deeper understanding of the incident to emerge, which also provided new and distinct insights.

Research limitations/implications
– The main limitation was the case study nature of this exercise; these findings are merely the result of one person’s experiences.

Practical implications
– To develop rounded leadership skills, leaders can benefit from tapping into all of their resources; these two approaches allow different aspects of one’s intelligence to be accessed, which ought to facilitate greater development.

Social implications
– Many authors cite a current crisis of leadership, not least of all a perceived failure to tackle the environmental challenges we face. By seeking to develop more intelligent and rounded leaders, leadership itself ought to improve which in turn should help society tackle pressing issues.

Originality/value
– To the author’s knowledge, a direct comparison of the leadership development methodologies used in this paper has not been previously described. This paper provides useful insights into the practical application of Reflective Practice and Scharmer’s Theory U, which will help inform others seeking to develop as leaders.
Nationwide Training Limited were chosen by Action for Blind People to design an ILM middle manager leadership and management programme
Authors: Metcalf Andrea 
Published: August 2015

Purpose
– The purpose of this paper is to examine Nationwide Training Limited’s development an ILM middle manager leadership and management programme for Action for Blind People.

Design/methodology/approach
– This paper presents an overview of designing the programme.

Findings
– The programme has received excellent feedback and is oversubscribed for future attendees. There have been a number of internal successes already with a number of appointments to key internal roles from those on the scheme, reinforcing action’s commitment to develop, nurture and retain staff, as well as showing the influence of the programme in terms of helping individuals become ready for more strategic positions within the organisation.

Originality/value
– This paper points to best practice for similar projects.
Delegation – a crucial but sadly neglected management skill
Authors: Rees W. David , Porter Christine 
Published: August 2015

Purpose
– The purpose of this paper is to explain the importance of the concept of delegation, highlighting the lack of attention to it in management textbooks and identifying the key skills involved in effective delegation.

Design/methodology/approach
– The authors use their background as lecturers and authors in management combined with their management and consultancy experience to do a literature search of the topic of management and use their experience to comment on how the understanding and practice of delegation can be improved.

Findings
– As a result of a thorough search through the standard business studies textbooks, the authors found little coverage of the topic of delegation. They found many examples of failures of delegation, sometimes with catastrophic results. Despite the evidence to the contrary, there seems to be a general and highly over-optimistic assumption that an understanding of delegation and good practice can be taken for granted.

Originality/value
– Evidence has been collected about the alarming lack of attention to this critical management skill. The authors have attempted to remedy this by a clear explanation of the skills involved and the potential consequences of neglecting it. The core concepts include accountability, the rationale for delegating authority, associated skills and obstacles and how they can be dealt with; and the overlapping concept of empowerment. Case studies of recent world events illustrating the need for good governance and risk assessment are included.
Becoming “leaderful”: leading forward in turbulent times
Authors: Yeo Roland K. , Gold Jeff , Marquardt Michael J. 
Published: August 2015

Purpose– The purpose of this paper is to offer a practice-based understanding of leadership based on the concept of “leaderful” practice. In supporting this concept, the paper describes the contexts that shape leadership capacity and introduces an integrative framework that further illustrates “leaderful” practice.Design/methodology/approach– The paper draws on prior research conducted by the authors in a variety of industries. Insights were gleaned from both theoretical perspectives and qualitative data drawn from a number of empirical studies.Findings– In order to lead confidently in turbulent times, leaders need to first unlearn the conventional wisdom of leadership. Three contextual enablers contribute to “leaderful” practice, namely problem, action, and experience. Becoming “leaderful” is being mindful of how these three enablers could be harnessed and integrated to facilitate change in meaningful ways.Practical implications– In order to promote “leaderful” practice, both reflective and conversational spaces are imperative. Such spaces help leaders to be mindful of their internal and external contexts, including a keen awareness of self and others in framing references of the past for the future. In doing so, leaders need to be “present” to confront “wicked” problems and take action through collective experience and intelligence.Originality/value– Understanding how leaders think, feel, and act in actual practice helps us understand the genuine characteristics of leadership. The paper introduces a framework of “leaderful” practice with a focus on leading with confidence. It extends current understanding of leadership practice by viewing “leaderful” practice from the perspective of problem, action, and experience.
Depression screening optimization in an academic rural setting
Authors: Aleem Sohaib , Torrey William C , Duncan Mathew S , Hort Shoshana J , Mecchella John N 
Published: August 2015

Purpose
– Primary care plays a critical role in screening and management of depression. The purpose of this paper is to focus on leveraging the electronic health record (EHR) as well as work flow redesign to improve the efficiency and reliability of the process of depression screening in two adult primary care clinics of a rural academic institution in USA.

Design/methodology/approach
– The authors utilized various process improvement tools from lean six sigma methodology including project charter, swim lane process maps, critical to quality tree, process control charts, fishbone diagrams, frequency impact matrix, mistake proofing and monitoring plan in Define-Measure-Analyze-Improve-Control format. Interventions included change in depression screening tool, optimization of data entry in EHR. EHR data entry optimization; follow up of positive screen, staff training and EHR redesign.

Findings
– Depression screening rate for office-based primary care visits improved from 17.0 percent at baseline to 75.9 percent in the post-intervention control phase (p
<
0.001). Follow up of positive depression screen with Patient History Questionnaire-9 data collection remained above 90 percent. Duplication of depression screening increased from 0.6 percent initially to 11.7 percent and then decreased to 4.7 percent after optimization of data entry by patients and flow staff.

Research limitations/implications
– Impact of interventions on clinical outcomes could not be evaluated.

Originality/value
– Successful implementation, sustainability and revision of a process improvement initiative to facilitate screening, follow up and management of depression in primary care requires accounting for voice of the process (performance metrics), system limitations and voice of the customer (staff and patients) to overcome various system, customer and human resource constraints.
Performance improvement CME for quality: challenges inherent to the process
Authors: Vakani Farhan Saeed , O'Beirne Ronan 
Published: August 2015

Purpose
– The purpose of this paper is to discuss the perspective debates upon the real-time challenges for a three-staged Performance Improvement Continuing Medical Education (PI-CME) model, an innovative and potential approach for future CME, to inform providers to think, prepare and to act proactively.

Design/methodology/approach
– In this discussion, the challenges associated for adopting the American Medical Association’s three-staged PI-CME model are reported.

Findings
– Not many institutions in USA are using a three-staged performance improvement model and then customizing it to their own healthcare context for the specific targeted audience. They integrate traditional CME methods with performance and quality initiatives, and linking with CME credits.

Practical implications
– Overall the US health system is interested in a structured PI-CME model with the potential to improve physicians practicing behaviors.

Originality/value
– Knowing the dearth of evidence for applying this structured performance improvement methodology into the design of CME activities, and the lack of clarity on challenges inherent to the process that learners and providers encounter. This paper establishes all-important first step to render the set of challenges for a three-staged PI-CME model.
Healthy work environment – a challenge?
Authors: Jansson von Vultée Pia Hannele 
Published: August 2015

Purpose
– In Sweden, leave due to sickness was high during the 1990s. The Swedish Social Insurance Agency was able to decrease sick days in the period between 2000 and 2010 but sick days are rising again in Sweden, mostly due to psychological problems among women and partly due to their work environment. It is important to find methods to identify poor work settings to prevent absenteeism due to sickness. The paper aims to discuss these issues.

Design/methodology/approach
– The authors created a web questionnaire focusing on the organizational setting and its impact on employee wellbeing – reported as mental energy, work-related exhaustion and work satisfaction. The questionnaire measures good and poor work environment factors to help managers improve organizational settings. The questionnaire was validated qualitatively and quantitatively.

Findings
– It is possible to measure individual wellbeing in an organizational context at an early stage. The authors followed a company undergoing organizational change and identified groups at risk of developing illness.

Practical implications
– Managers uncertain about employee mental status can measure employee wellbeing easily and cost effectively to prevent illness.

Originality/value
– The authors created a method, statistically evaluated, to proactively identify good and poor work environments to promote healthy co-workers.
Client satisfaction determinants in four Kenyan slums
Authors: Wambua Jonesmus Mutua , Mbayaki Regina , Munyao Paul Musya , Kabue Mark Mugo , Mulindi Rose , Change Patrick Mose , Ikamati Rudia , Jahonga Ruth , Ambalu Rachel , Maranga Wamae , Mudany Mildred 
Published: August 2015

Purpose
– In Kenya, gaps exist in health service provision to slum residents, especially service availability and access to quality care. There is also little information on the health status of people living in slums other than in Nairobi. The purpose of this paper is to generate evidence for use in designing interventions to improve health services in four mid-sized slums in Embu, Nyeri and Thika, Kenya.

Design/methodology/approach
– A cross-sectional survey of clients receiving services in health facilities was conducted in the targeted slums. Data were collected through face-to-face interviews. Factor scores were generated using the Rasch model; simple and multivariate logistic regression analyses were done using the R statistical software.

Findings
– Overall, 81 per cent of the 203 participants reported being satisfied with health services. Most clients (89 per cent) reported that health facility staff greeted them warmly; 82 per cent said their consultation was private. The facility type, waiting time and client experience with service providers determined their satisfaction (p
<
0.05).

Practical implications
– Healthcare managers can improve client satisfaction levels by understanding the client flow in their facilities and addressing causes of client dissatisfaction, such as long waiting times, while at the same time promoting facilitating factors.

Originality/value
– The authors use latent variable modelling to compute client satisfaction scores, which were dichotomised into two categories and fitted into a logistic regression model to identify factors that influence client satisfaction. Health facility clients in the four slums are satisfied with services and have confidence the providers will serve them in a friendly and professional manner that promotes respect and quality care. The paper recommend healthcare managers in similar settings carry out client flow analysis and institute remedial measures to address long waiting times. Qualitative studies are recommended to determine the reasons behind the high satisfaction levels reported in this study.
Factors affecting dental service quality
Authors: Bahadori Mohammadkarim , Raadabadi Mehdi , Ravangard Ramin , Baldacchino Donia 
Published: August 2015

Purpose– Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients’ viewpoint.Design/methodology/approach– This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml’s model of service quality which consisted of two parts: the patients’ demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor.Findings– Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality.Practical implications– The Parasuraman and Zeithaml’s model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model.Originality/value– This is a pioneering study that uses Parasuraman and Zeithaml’s model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.
Key performance measures to control maintenance-associated HAIs
Authors: Njuangang Stanley , Liyanage Champika , Akintoye Akintola 
Published: August 2015

Purpose
– The purpose of this paper is to improve overall healthcare maintenance (HM) service performance in NHS infection control (IC). Hence, the authors identify critical success factors (CSFs) and key performance measures in maintenance-associated infections. These infections occur because of the poor performance of HM service in IC.

Design/methodology/approach
– In the first Delphi exercise, complete CSFs and performance measures were presented to the Delphi participants for refinement and modification. Delphi round 1 data were analysed manually and used to refine the rounds 2 and 3 Delphi instruments. In subsequent Delphi rounds, the results were analysed through descriptive statistics.

Findings
– In total, eight CSFs and 53 key performance measures were identified for reducing maintenance-associated infections in hospitals. For example, establishing clear communication between the infection control team (ICT) and HM unit is important for preventing maintenance-associated HAIs. Dust prevention is also identified by the healthcare experts as an important measure to prevent maintenance-associated HAIs in high-risk patient areas.

Originality/value
– The findings provide CSFs and key performance measures for measuring performance in HM in IC. Reducing the rate of maintenance-associated infections will have important socio-economic and health ramifications for hospitals. It will reduce cost and free up additional resources for alternative projects. It will also raise confidence among healthcare users about the quality of services provided by hospitals.
An investigation into independent small business owners’ perception of franchisee relationships
Authors: Perrigot Rozenn , Hussain Dildar , Windsperger Josef 
Published: August 2015

Purpose
– The purpose of this paper is to explore independent small business owners’ perceptions of franchisees relationships with their franchisors, their fellow franchisees within the chain, their employees and their customers.

Design/methodology/approach
– The authors use a qualitative approach and, more specifically, 26 in-depth interviews conducted with independent small business owners from various business sectors.

Findings
– These independent small business owners perceive that franchisees have a dependency-based relationship with their franchisors; a competition-based relationship with their fellow franchisees; a rather complicated relationship with their employees; and a superficial relationship with their customers.

Research limitations/implications
– This study contributes to the franchising literature by presenting an outside-chain view of franchisees’ relationships with their franchisors, other franchisees, employees and customers.

Practical implications
– The findings may have practical implications for franchisors, enabling them to better understand the concerns of independent small business owners as potential franchisee candidates.

Originality/value
– The outside-chain view of franchisees’ relationships is innovative.
Consumer confusion in German food retailing: the moderating role of trust
Authors: Wobker Inga , Eberhardt Tim , Kenning Peter 
Published: August 2015

Purpose
– Due to the rising number of product, service, and shopping possibilities available to consumers, food shopping has become increasingly more complex. As a result, consumers can become confused, and this state of confusion may influence their purchase behaviour (e.g. may cause them to not buy a product) and the personal needs they have in a shopping environment (e.g. certification to signal product quality, salesperson consultation for assistance in decision making, or governmental regulation). However, trust can reduce complexity, and may thereby moderate the influence of consumer confusion for negative outcomes. The purpose of this paper is to identify outcomes of consumer confusion and to investigate the moderating role of broader-scope trust on the negative outcomes of this confusion.

Design/methodology/approach
– A conceptual model was developed to study potential negative outcomes of consumer confusion. In order to assess consumer confusion and the degree of negative outcomes, a telephone survey method for the questionnaire was applied, querying 516 participants who regularly bought food products.

Findings
– The results clearly suggest that consumer confusion evokes various negative outcomes that are of relevance for food retailing. The intensity of the influence of consumer confusion on several of those negative outcomes could be decreased by broader-scope trust. Further, an interaction effect linked to gender was observed.

Originality/value
– To the best of the knowledge, this is the first international journal publication on the moderating role of trust on the outcomes of consumer confusion.