Search results

Estimation of (in)efficiency became a popular practice that witnessed applications in virtually any sector of the economy over the last few decades. Many different models were deployed for such endeavors, with Stochastic Frontier Analysis (SFA) models dominating the econometric literature. Among the most popular variants of SFA are Aigner, Lovell, and Schmidt (1977), which launched the literature, and Kumbhakar, Ghosh, and McGuckin (1991), which pioneered the branch taking account of the (in)efficiency term via the so-called environmental variables or determinants of inefficiency. Focusing on these two prominent approaches in SFA, the goal of this chapter is to try to understand the production inefficiency of public hospitals in Queensland. While doing so, a recognized yet often overlooked phenomenon emerges where possible dramatic differences (and consequently very different policy implications) can be derived from different models, even within one paradigm of SFA models. This emphasizes the importance of exploring many alternative models, and scrutinizing their assumptions, before drawing policy implications, especially when such implications may substantially affect people’s lives, as is the case in the hospital sector.

The promulgation of group purchasing organizations (GPOs) into the healthcare (HC) sector is an invaluable procurement strategy to manage the suppliers effectively. This study aims to identify and prioritize the factors of integrating GPOs into the HC sector on the perspectives of the developing countries such as India.

The factors are identified from current literature exploration, experts’ support and experience surveys. The factors are scrutinized and shortlisted using the Delphi technique and analysed further using the best-worst model method.

The findings of the study highlight the cost reduction, fair distribution of savings and healthcare supply chain (HCSC) data standardization among others to be the most prioritized drivers. The consulting services provided by GPOs including training and development as a result of high competitiveness in the HC market has been prioritized the least.

The study bears some important implications for decision and policymakers. The managers should consider factors, namely, cost reduction, fair distribution of savings and HCSC data standardization on a priority basis that acts as motivation for the HC providers to join the GPOs.

The study provides valuable insights for HC providers to participate in the GPOs for cost savings and enhance the performances.

The Covid-19 pandemic generated significant changes in the operating methods of hospital logistics departments. The objective of this research is to understand how these changes took place, what collaboration mechanisms were developed with clinical authorities and, to what extent, logistics and clinical care activities should be decoupled to maximize each area's contribution?

The case study is selected to investigate practices implemented during the COVID-19 pandemic in hospitals in Canada. The pandemic presented an opportunity to contrast practices implemented in response to this crisis with those historically used in this environment.

The strategy of decoupling logistical tasks of an operational nature from clinical activities is well-founded and helps free clinical staff from tasks for which they are not trained. However, the decoupling of operational tasks should be combined with an integration of the clinical information flow to the logistics hub players. With this clinical information, the logistics hub can generate its full potential enabling better inventory management decisions to be made.

The concept of decoupling is studied to identify configurations that offer the best benefits for clinical staff.

This purpose of this study was to assess dietary diversity among women of reproductive age (WRA) and the associations between consumption of a diversified diet and overweight/obesity statuses in Ekiti State, Nigeria.

Cross-sectional study of 207 WRA from six local government areas in Ekiti State, Nigeria, was done. A validated interviewer-administered questionnaire was used to collect data on sociodemographic characteristics, dietary intake and anthropometry. Dietary intake was assessed with 24-h dietary recall to calculate the Minimum Dietary Diversity Score for Women (MDD-W). Data were analyzed using descriptive statistics, Spearman rank correlation and Chi square test at α_0.05.

Majority of the participants (65.2%) were aged between 19 and 34 years, 58.5% were married and 49.8% had high school as their highest level of education. Mean MDD-W and body mass index (BMI) were 3.8 ± 0.9 and 25.46 ± 6.4 kg/m², respectively. All participants (100%) consumed foods from the “grains, white roots and tubers” group and majority also from the “meat and poultry” group (79.7%) but ranked low in the consumption of foods from other food groups. Many were overweight (34.8%), obese (14.0%) and a few (1.9%) had morbid obesity. MDD-W was significantly associated with marital status (X² = 7.7, P = 0.022) and BMI (X² = 11.4, P = 0.023) and had a weak positive correlation with BMI (r = 0.189, P = 0.007).

Study shows that both undernutrition and overweight/obesity coexist in the population, indicating a case of double burden of malnutrition (DBM) at a population level. However, further studies may be needed to investigate the extent of DBM at individual levels. Although there was a positive correlation between MDD-W and BMI, it cannot be used to predict causality. Study further reveals that the micronutrient intake of the WRA population in Ekiti is inadequate. Considering the importance of the 10 food groups highlighted in MDD_W to nutrition and health, the promotion of the consumption of foods from these food groups with more attention to the micronutrient-rich ones needs to be heightened.

Diet of participants was not diverse enough, indicating micronutrient inadequacy. Promotion of the consumption of a diverse diet, particularly from the food groups rich in micronutrient, needs to be heightened, while food groups high in calorie should be minimally consumed to forestall DBM.

This paper aims to examine the association between the dietary inflammatory index, the consumption of Enteral Nutrition Supplemented with probiotics with certain serum inflammation markers and gastrointestinal complications among individuals diagnosed with COVID-19.

This cross-sectional investigation involved 100 COVID-19 patients who were admitted to intensive care units in hospitals. These patients were administered two different types of Enteral Nutrition, so the dietary inflammatory index (DII), gastrointestinal complications and some serum inflammation markers have been compared between two groups.

The mean DII scores in all patients were significantly pro-inflammatory (probiotic formula 2.81 ± 0.01 vs usual formula group 2.93 ± 0.14 p = 0.19). The probiotic formula consumption had an inverse association with High-sensitivity C-reactive Protein concentration (coef = −3.19, 95% CI −1.25, −5.14 p = 0.001) and lead to a reduction of 2.14 mm/h in the serum level of Erythrocyte sedimentation rate compared to normal formula. The incidence of diarrhea, abdominal pain and vomiting in probiotic formula patients was respectively 94%, 14% and 86% less than in usual formula patients (p = 0.05).

In this cross-sectional study for the first time, the authors found that probiotic formula consumption was inversely associated with serum inflammation markers and gastrointestinal complications incidence. The high DII leads to more gastrointestinal complications incidence and inflammation markers. More studies are needed to prove this relationship.

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

Violence toward frontline health-care workers (HCWs) from patients and visitors is a pervasive issue that ranges from verbal and psychological abuse to physical assault. The emergence of the COVID-19 pandemic has led to increased reports of escalated verbal workplace aggressions (VWPAs); however, most studies have been conducted internationally. Studies based in the USA have focused on physical violence experienced by nurses and paramedics in emergency situations. The purpose of this study is to learn about the experiences of different levels of frontline HCWs with VWPA from patients and visitors and discover ways to address this issue.

This qualitative descriptive study asked registered nurses, licensed practical nurses and patient care technicians from one health-care system about their experiences with patient and visitor VWPA using an anonymous, voluntary open-ended survey and in-person interviews. In all, 31 participants completed the survey and 2 were interviewed. Data were analyzed using content analysis.

Three themes emerged from the data: the experience, moving through and moving forward. Frontline HCWs described experiences of VWPA, indicating its forms, frequency and conditions. They used coping, along with personal and professional measures, to manage and move through the situation. Moving forward was captured as suggestions for the future and conveyed hope for a perfect state.

The experiences of frontline HCWs offered insight into how they perceive and cope with difficult encounters. Recommendations relate to not only implementing interventions that support frontline HCWs but also creating a culture where aggression is not tolerated and addressing perpetrator behavior is a priority.

The lean startup approach (LSA) is extensively utilized by early-stage entrepreneurs, with “pivot” serving as a key pillar. However, there is a research gap concerning the boundary conditions impacting LSA and pivot decisions, especially when addressing societal challenges, as in the context of transformational entrepreneurship. In this regard, the healthcare sector, further compounded by a lack of research on startups and scale-ups, presents an embraced opportunity to provide multiple contributions for both theory and practice.

The present investigation employs a grounded approach to explore the experiences of the co-founders of a fast-growing Italian e-health startup. A narrative strategy was employed to organize conditions and evolving strategic action/interactions into three different pivoting phases of the startup – before the pivot, its enactment and aftermath – with primary and secondary data collected over a period of one year.

Pivoting in digital healthcare unfolded as a liminal experience marked by factors such as high regulation, multiple stakeholders, technological and symbolic ambivalence, resource-intensive demands and institutional actors acting as pathway pioneers, leading to an information overload and unforeseeable uncertainty to manage. These factors challenge entrepreneurs' ability to attain optimal distinctiveness, presenting the paradoxical need for vertical flexibility for scaling up.

By uniquely illuminating the sector’s constraints on entrepreneurial phenomena, this study provides a valuable guide for entrepreneurs and institutional actors in addressing societal challenges.

This study introduces a process model of transformational information crafting when pivoting, highlighting the role of entrepreneurs' transformational stance and platform-mediated solutions as engines behind strategies involving information breaking and transition, preceding knowledge-driven integration strategies.

Web users rely heavily on online content make decisions without assessing the veracity of the content. The online content comprising text, image, video or audio may be tampered with to influence public opinion. Since the consumers of online information (misinformation) tend to trust the content when the image(s) supplement the text, image manipulation software is increasingly being used to forge the images. To address the crucial problem of image manipulation, this study focusses on developing a deep-learning-based image forgery detection framework.

The proposed deep-learning-based framework aims to detect images forged using copy-move and splicing techniques. The image transformation technique aids the identification of relevant features for the network to train effectively. After that, the pre-trained customized convolutional neural network is used to train on the public benchmark datasets, and the performance is evaluated on the test dataset using various parameters.

The comparative analysis of image transformation techniques and experiments conducted on benchmark datasets from a variety of socio-cultural domains establishes the effectiveness and viability of the proposed framework. These findings affirm the potential applicability of proposed framework in real-time image forgery detection.

This study bears implications for several important aspects of research on image forgery detection. First this research adds to recent discussion on feature extraction and learning for image forgery detection. While prior research on image forgery detection, hand-crafted the features, the proposed solution contributes to stream of literature that automatically learns the features and classify the images. Second, this research contributes to ongoing effort in curtailing the spread of misinformation using images. The extant literature on spread of misinformation has prominently focussed on textual data shared over social media platforms. The study addresses the call for greater emphasis on the development of robust image transformation techniques.

This study carries important practical implications for various domains such as forensic sciences, media and journalism where image data is increasingly being used to make inferences. The integration of image forgery detection tools can be helpful in determining the credibility of the article or post before it is shared over the Internet. The content shared over the Internet by the users has become an important component of news reporting. The framework proposed in this paper can be further extended and trained on more annotated real-world data so as to function as a tool for fact-checkers.

In the current scenario wherein most of the image forgery detection studies attempt to assess whether the image is real or forged in an offline mode, it is crucial to identify any trending or potential forged image as early as possible. By learning from historical data, the proposed framework can aid in early prediction of forged images to detect the newly emerging forged images even before they occur. In summary, the proposed framework has a potential to mitigate physical spreading and psychological impact of forged images on social media.

This study focusses on copy-move and splicing techniques while integrating transfer learning concepts to classify forged images with high accuracy. The synergistic use of hitherto little explored image transformation techniques and customized convolutional neural network helps design a robust image forgery detection framework. Experiments and findings establish that the proposed framework accurately classifies forged images, thus mitigating the negative socio-cultural spread of misinformation.