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The purpose of this paper is to outline the development of an evidence-based training and support course for caregivers of children with foetal alcohol spectrum disorder (FASD) in New Zealand, and a brief evaluation undertaken. The seven-week caregiver training course takes an empowerment and advocacy orientation, and the aim is to assist caregivers who are caring for children with, or suspected to have FASD, develop greater resilience and strategies to help their families live successfully with impairments in a disabling society.

A total of 13 parents and caregivers received a seven times two-hour weekly group programme of talks, exercises and case study discussions focused on the following objectives: an increased knowledge of FASD; an increased knowledge of successful strategies and interventions that can be used to help families; and having an opportunity to foster strong peer-support relationships with others who share the lived experience of FASD. A brief interview-based evaluation was undertaken to ascertain caregivers’ views of the course, its benefits and limitations.

Caregivers valued both the content and process of the training course. They highlighted that strength of the training was the delivery by experienced, professionally trained caregivers of children with FASD. They valued the opportunity to spend time with peers in similar circumstances who understood the challenges of parenting a child with FASD.

A short evidence-based specialist training course for parents and caregivers with an empowerment and peer-support orientation is beneficial to parenting children with FASD.

Although SAP R/3 has become widely utilised as a means to change IT systems and business processes, not all organizations embarking on its implementation have achieved their intended results. However, leading practices have demonstrated that success is essentially conditional on managing adequately the complex context of implementation, which necessitates organizational changes across various key areas related to strategy, business processes, IT, structure, culture, and management systems. This paper describes a proposed model presenting the implementation of SAP R/3 from an integrative and holistic perspective. The model is developed based on reported experiences of several best practice organizations. The central theme of the paper argues that at the heart of effective SAP R/3 implementation, a fully balanced perspective has to be taken. On the other hand, the exclusive focus on technical aspects, at the cost of change management elements, has proved to be far from successful.

Full text of a document is a rich source of information that can be used to provide meaningful topics. The purpose of this paper is to demonstrate how to use citation context (CC) in the full text to identify the cited topics and citing topics efficiently and effectively by employing automatic text analysis algorithms.

The authors present two novel topic models, Citation-Context-LDA (CC-LDA) and Citation-Context-Reference-LDA (CCRef-LDA). CC is leveraged to extract the citing text from the full text, which makes it possible to discover topics with accuracy. CC-LDA incorporates CC, citing text, and their latent relationship, while CCRef-LDA incorporates CC, citing text, their latent relationship and reference information in CC. Collapsed Gibbs sampling is used to achieve an approximate estimation. The capacity of CC-LDA to simultaneously learn cited topics and citing topics together with their links is investigated. Moreover, a topic influence measure method based on CC-LDA is proposed and applied to create links between the two-level topics. In addition, the capacity of CCRef-LDA to discover topic influential references is also investigated.

The results indicate CC-LDA and CCRef-LDA achieve improved or comparable performance in terms of both perplexity and symmetric Kullback–Leibler (sKL) divergence. Moreover, CC-LDA is effective in discovering the cited topics and citing topics with topic influence, and CCRef-LDA is able to find the cited topic influential references.

The automatic method provides novel knowledge for cited topics and citing topics discovery. Topic influence learnt by our model can link two-level topics and create a semantic topic network. The method can also use topic specificity as a feature to rank references.

The purpose of this paper is to explore the supply-side factors that determines the quality of global healthcare services from medical tourism healthcare providers’ (MTHP) perspective, which provide value-in-medical-travel to foreign patients/medical tourists, who travel to India for medical treatment/surgery.

The thematic content analysis of in-depth interviews with 15 senior MTHP, from 15 private hospitals in India was undertaken, to generate the themes, and identify the supply-side factors necessary for sustainable medical tourism management.

The findings conclude that MTHP ranked in ascending order, less waiting-time for surgery, healthcare quality and accreditation, staff/surgeon’s expertise, healthcare information, hospital facilities and services, patient-safety, travel-risk, surgical costs and holiday opportunity as essential factors for providing sustainable quality and value-in-medical-travel to patients.

Many private hospital spokespersons declined to be interviewed due to confidentiality and privacy policy

The findings are generalised in case of global private hospitals treating foreign patients. Policy implications suggest that private hospitals in developing countries need to focus on providing value-in-medical-travel, such as accreditation quality of healthcare, no waiting-time, patient-safety, qualified and experienced medical and non-medical staff, hospital facilities and post-surgery care with positive healthcare outcomes.

Medical-tour facilitators, hotels and tourism sites need to collaborate with agencies to provide inclusive built environment, first-aid and wheelchair access, to medical tourists, having financial and legal implications for business.

There is little qualitative empirical research on the views of MTHP, regarding management of essential supply-side factors that provide value-in-medical-travel to attract medical tourists to India.

医疗保健提供者对印度医疗旅行价值的看法

本文的目的是从医疗旅游医疗保健提供者的角度探讨决定全球医疗服务质量的供应方因素, 这些因素可为前往印度求医的外国患者/医疗游客提供医疗旅行的价值治疗/手术.

对印度15家私立医院的15家高级医疗旅游保健提供者（MTHP）进行了深度访谈, 对主题内容进行了分析, 以生成主题并确定可持续医疗旅游管理所必需的供应方因素。

研究结果得出结论, MTHP以升序排列的顺序是：手术等待时间, 医疗质量和认证, 工作人员/外科医生的专业知识, 医疗保健信息, 医院设施和服务, 患者安全, 旅行风险, 手术费用和度假时间机会是为患者提供医疗旅行可持续质量和价值的重要因素。

由于医院的机密性和隐私权政策, 许多私立医院发言人拒绝接受采访。

如果全球私立医院为外国医疗游客提供治疗, 那么研究结果将得到概括。政策含义表明, 发展中国家的私立医院需要集中精力提供医疗旅行价值, 例如无需等待时间的医疗保健认证质量和患者安全, 合格和经验丰富的医务人员和非医务人员, 医院设施和后期医疗服务。具有积极医疗效果的手术护理。

旅馆, 医疗旅行促进者和旅游景点需要与机构合作, 为医疗游客提供紧急急救和轮椅通道, 这对企业有财务和法律影响。

关于MTHP观点的定性实证研究很少, 涉及对提供医疗旅行价值以吸引医疗游客前往印度的基本供应方因素的管理。

印度, 医疗旅游, 全球化 等待时间, 患者安全, 认证质量

研究论文

Perspectiva del valor de los proveedores del cuidado de la salud en viajes con propositos medicos a la India

El propósito de esta investigación es explorar los factores que del lado de la oferta determinan la calidad de los servicios globales de salud desde el punto de vista del proveedor, el cual agrega valor al viaje con propósitos médicos a pacientes/turistas médicos quienes viajan a la India para tratamientos médicos ó cirugía.

El análisis de contenido temático de las detalladas entrevistas, con-15 proveedores experimentados de asistencia sanitaria de turismo medico, en-15 hospitales de la India, fué realizado para generar los temas é identificar los factores que del lado de la oferta son necesarios para la gestión sostenible del turismo médico.

Los hallazgos concluyen que proveedores experimentados de turismo ranquearon en orden ascendente la reducción en tiempos de espera para cirugías, acreditación de la calidad del cuidado de la salud, experticia del personal no médico y de cirugía, información del cuidado de la salud, servicios é instalaciones de los hospitales, seguridad del paciente, riesgos de viaje, costos de cirugías, y oportunidades vacacionales, como factores esenciales para proveer calidad sostenible y valor en los viajes con propósitos médicos a los pacientes.

Muchos representates de los hospitales privados se rehusaron a ser entrevistados debido las políticas de privacidad y confidencialidad del hospitales.

Los hallazgos son generalizables en el caso de hospitales privados globales que tratan a turistas médicos extranjeros. Las implicaciones políticas sugieren que los hospitales privados en los países en vía de desarrollo necesitan enfocarse en agregar valor al viaje médico, por medios como la calidad de acreditación de la atención médica, reduccion de tiempos de espera y la seguridad del paciente, personal médico y no médico calificado y experimentado, instalaciones hospitalarias y servicios posoperatorios con resultados sanitarios positivos.

Los hoteles, los facilitadores de toures médicos y los sitios de turismo necesitan colaborar con las agencias para proveer primeros auxilios de emergencia y acceso en silla de ruedas a los turistas médicos, teniendo esto implicaciones financieras y legales para los negocios.

Existe poca investigación empírica cualitativa sobre los puntos-de vista-de (MTHP) proveedores de asistencia sanitaria de turismo médico con respecto a la gestión de los factores esenciales del lado de la oferta que agregan valor al turismo con fiines médicos para atraer turistas médicos a la India.

India, globalización, turismo médico, tiempo-de-espera, calidad, seguridad-del- paciente

Trabajo de investigación

This study aims to extend the understanding of the role of authentic leadership in encouraging subordinates to become internal whistleblowers. The current study aims to seek whether authentic leadership can encourage internal whistleblowing (IW) through employee controlled motivation for IW and moral courage.

The samples of this study were 221 employees working at 26 government organizations in one of the provinces located on Sumatera Island, Indonesia. Based on the cross-sectional survey method, this study used partial least square-structural equation modeling analysis with SmartPLS 3 software to test the hypotheses.

The result revealed that employee controlled motivation for whistleblowing and moral courage significantly mediates the effect of authentic leadership toward IW. This result also indicates that the two mediating variables in this study fully mediate the effect of authentic leadership toward IW.

This study highlights the critical role played by leaders in encouraging subordinates to IW in the workplace. The role of an authentic leader will have positively affected enhancing IW by employees, which has significant implications for the organization that particularly in manage organization wrongdoing in terms of eliminating or preventing unethical practice.

Theoretically, the current study extends the understanding of the mechanism underlying the relationship between authentic leadership and IW. This study proposes employee controlled motivation for IW and moral courage as the new mediator variables to explain how and why authentic leadership may encourage IW. Empirically, the current study chooses the Indonesian Government as a context that rarely conducts in the prior study.

To address the safety concerns generated by truck crashes occurred in big cities, this paper analyzes the zip code tabulation area (ZCTA)-based truck crash frequency across four temporal intervals – morning (6:00–10:00), mid-day (10:00–15:00), afternoon (15:00–19:00), and night (19:00–6:00) in New York City in 2010. A multivariate conditional autoregressive count model is used to recognize both spatial and temporal dependences. The results prove the presence of spatial and temporal dependencies for truck crashes that occurred in neighboring areas. Built environment attributes such as various types of business establishment density and traffic volume for different types of vehicles, which are important factors to consider for crashes occurred in an urban setting, are also examined in the study.

The disparities of COVID-19 vaccination rates between the rural and urban areas have become apparent during this pandemic. There is a need to understand the root causes of vaccine hesitancy demonstrated by the rural population to increase coverage and to contain the disease spread throughout the United States. This study aimed to explore other factors influencing vaccine hesitancy among rural dwellers besides the geography-related barriers such as poor health care access and individuals having no or suboptimal insurance coverage.

By reviewing existing data and literature about vaccination, health literacy, and behaviors, and prevailing ideologies, we discuss the potential causes of vaccine hesitancy in rural areas that could create barriers for successful public health efforts related to vaccine coverage and provide suggestions to ameliorate the situation.

Geography-related barriers, health literacy, and preconceived notions are key determinants of adopting healthy behaviors and complying with public health authorities' recommendations among rural individuals during a public-health crisis. We argue that ideology, which is much deeper than preconception or misconception on vaccination, should be incorporated as a key factor to redefine the term “vulnerable populations” in public health research.

The limitation of our study is that we have not found an effective way to encourage the populations who hold conservative religious and political ideologies to join the efforts for public health. Even though geography-related barriers may strongly impact the rural dwellers in achieving optimal health, the various forms of ideologies they have toward certain health behaviors cannot be discounted to understand and address vaccine-related disparities in rural areas. There is a need to redefine the term “vulnerable population” particularly as it relates to rural areas in the United States. During large-scale public health disasters, scholars and public health authorities should consider the ideologies of individuals, in addition to other factors such as race/ethnicity, area of residence (rural vs. urban), and socioeconomic factors influencing the existing vulnerabilities and health disparities.