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Article
Publication date: 22 January 2024

Matthew David Phillips, Rhian Parham, Katrina Hunt and Jake Camp

Autism spectrum conditions (ASC) and borderline personality disorder (BPD) have overlapping symptom profiles. Dialectical behaviour therapy (DBT) is an established treatment for…

Abstract

Purpose

Autism spectrum conditions (ASC) and borderline personality disorder (BPD) have overlapping symptom profiles. Dialectical behaviour therapy (DBT) is an established treatment for self-harm and BPD, but little research has investigated the outcomes of DBT for ASC populations. This exploratory service evaluation aims to investigate the outcomes of a comprehensive DBT programme for adolescents with a diagnosis of emerging BPD and a co-occurring ASC diagnosis as compared to those without an ASC diagnosis.

Design/methodology/approach

Differences from the start to end of treatment in the frequency of self-harming behaviours, BPD symptoms, emotion dysregulation, depression, anxiety, the number of A&E attendances and inpatient bed days, education and work status, and treatment non-completion rates were analysed for those with an ASC diagnosis, and compared between those with an ASC diagnosis and those without.

Findings

Significant medium to large reductions in self-harming behaviours, BPD symptoms, emotion dysregulation and inpatient bed days were found for those with an ASC diagnosis by the end of treatment. There were no significant differences between those with an ASC and those without in any outcome or in non-completion rates. These findings indicate that DBT may be a useful treatment model for those with an ASC diagnosis, though all results are preliminary and require replication.

Originality/value

To the best of the authors’ knowledge, this is the first study to report the outcomes of a comprehensive DBT programme for adolescents with an ASC diagnosis, and to compare the changes in outcomes between those with a diagnosis and those without.

Details

Advances in Autism, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-3868

Keywords

Book part
Publication date: 7 February 2024

Clair Reynolds Kueny, Alex Price and Casey Canfield

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower…

Abstract

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

Details

Research and Theory to Foster Change in the Face of Grand Health Care Challenges
Type: Book
ISBN: 978-1-83797-655-3

Keywords

Article
Publication date: 13 February 2023

Justin Jahn and Sabine Bohnet-Joschko

This study aims to explore the rise of virtual specialty care startups and understand how the ventures leverage digital services to create a new market space. Given the high level…

Abstract

Purpose

This study aims to explore the rise of virtual specialty care startups and understand how the ventures leverage digital services to create a new market space. Given the high level of competition in an established industry like health care, the authors investigate the business models and competitive strategies of leading virtual specialty care startups with unicorn status (i.e. emerging, current and exited unicorns).

Design/methodology/approach

The authors performed an analysis of Crunchbase data to examine whether rising virtual care ventures target specialty care. They focused on companies from the USA, Europe and Asia-Pacific. The identified virtual specialty care ventures were investigated in-depth via a multiple case study. By reviewing corporate websites, Crunchbase data and media coverage, the authors analyzed the ventures’ business models and competitive strategies.

Findings

This study demonstrates that even in established and highly competitive markets such as health care, managers and entrepreneurs can still leverage digital services to unlock new market spaces. The data analysis reveals that virtual care startups target the field of specialty care. They create a new market space by focusing on fast access to services, personalization, measurable outcomes and affordability. The majority of investigated companies pursues a platform-based business model approach.

Originality/value

In the context of an established industry like health care, this study gives insights into a new generation of virtual specialty care ventures. By investigating the ventures’ business models and competitive strategies, the authors advance a young field of research.

Article
Publication date: 3 July 2023

Jacqueline Deuling, Jenell Lynn-Senter Wittmer, Kimberly Wilson and Adrian Thomas

This study aims to provide a psychometrically sound measure intended to capture perceived/experienced sexism in the workplace, the perceived/experienced sexism scale (PESS). PESS…

Abstract

Purpose

This study aims to provide a psychometrically sound measure intended to capture perceived/experienced sexism in the workplace, the perceived/experienced sexism scale (PESS). PESS is used to consider the effects of perceived experiences of benevolent and hostile sexism at work, as well their relationships with perceived organizational support and the job attitudes of job satisfaction and turnover intentions.

Design/methodology/approach

This study revised the Ambivalent Sexism Inventory (Glick and Fiske, 1996) to create and validate the PESS. Amazon Mechanical Turk was used to collect two samples (220 and 183) of perceptions of female employees.

Findings

Results suggest perceived organizational support and trust perceptions mediate the relationships between perceptions of sexism and organizational outcomes of job satisfaction and turnover intentions.

Originality/value

Existing measures of sexism are intended to identify and measure sexism by examining perpetrators’ actions or thoughts. However, researchers must make assumptions as to the effect such sexist acts or behaviors has on the target. Thus, this study provides a measure of sexism from the perspective of the target.

Details

Gender in Management: An International Journal , vol. 39 no. 1
Type: Research Article
ISSN: 1754-2413

Keywords

Open Access
Article
Publication date: 13 February 2024

Felipa de Mello-Sampayo

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these…

Abstract

Purpose

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.

Design/methodology/approach

This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.

Findings

Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.

Practical implications

This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.

Social implications

Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.

Originality/value

The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.

Details

Journal of Economic Studies, vol. 51 no. 9
Type: Research Article
ISSN: 0144-3585

Keywords

Article
Publication date: 20 July 2023

Osayi Precious Emokpae, Christopher Osamudiamen Emokaro and Nneji Ifeyinwa Umeokeke

This study assessed the heterogeneous impact of the Anchor Borrower Program (ABP) on the welfare distribution of rice farming households in Nigeria.

Abstract

Purpose

This study assessed the heterogeneous impact of the Anchor Borrower Program (ABP) on the welfare distribution of rice farming households in Nigeria.

Design/methodology/approach

Self-selection bias and treatment endogeneity were accounted for by employing the Instrumental Variable Quantile Regression (IVQR) model. The estimates obtained from the IVQR model were further compared with those from the conventional quantile regression, and quantile regression using Propensity Score Matching. This was to highlight the extent to which endogeneity bias has been purged from the treatment, in order to establish a consistent causal link between participation in the ABP and the welfare of a cross-section of rice farming households.

Findings

ABP farmers had significantly higher rice yields across all quantiles of the yield distribution under treatment exogeneity assumption, and in only two quantiles upon controlling for observable confounders. However, this yield gain did not translate to higher Per capita Consumption Expenditure (PCE). The estimates of the more robust IVQR model provided further evidence that the rice yield and PCE of ABP farmers are not statistically different from that of non-ABP farmers across all quantiles of the welfare distribution.

Social implications

The negligible impact of ABP was relatively higher for lower-yielding households. Thus, implying that, although the ABP is a pro-poor development intervention, the program has not been sufficiently implemented to significantly improve the welfare of the dominant resource-poor farming households in Nigeria.

Originality/value

This study assessed the impact of ABP beyond the conventional potential mean outcome framework by accounting for heterogeneity in treatment effect.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-02-2023-0083

Details

International Journal of Social Economics, vol. 51 no. 1
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 9 February 2024

Jackson Lord and Rachel Sabin-Farrell

The transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM…

Abstract

Purpose

The transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM is applied through the University of Rhode Island Change Assessment (URICA). Investigating the utility of the URICA is needed to improve patient care and outcomes. This study aims to assess whether the URICA scores relate to patient outcomes; patient attendance; practitioner ratings of patient readiness, appropriateness, insight, motivation and potential for improvement; and to explore practitioner’s perspectives on the URICA.

Design/methodology/approach

Correlational methods were used to assess the relationship between the URICA and therapeutic outcome, attendance and practitioner-rated areas. Content analysis was used to analyse practitioner qualitative data.

Findings

The URICA did not correlate with either therapeutic outcome or attendance. A significant negative correlation was found between the URICA and practitioner-rated appropriateness of the referral. This means practitioners perceived individuals with lower URICA scores to be a more appropriate referral, despite the score indicating a reduced readiness to change. Qualitative categories included positive views, negative views, ambivalence and changes to measure and process. To conclude, the URICA does not explain a patient’s outcome or attendance. The URICA may not be appropriate to use in its current format in mental health services; therefore, assessing the TTM verbally may be more helpful.

Originality/value

This study provides research into suitability of using the URICA to assess the TTM and its applicability to attendance and outcome in psychological therapies.

Details

Mental Health Review Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1361-9322

Keywords

Open Access
Article
Publication date: 18 March 2024

Alesandra de Araújo Benevides, Alan Oliveira Sousa, Daniel Tomaz de Sousa and Francisca Zilania Mariano

Adolescent pregnancy stands as a societal challenge, compelling young individuals to prematurely discontinue their education. Conversely, an expansion of high school education can…

Abstract

Purpose

Adolescent pregnancy stands as a societal challenge, compelling young individuals to prematurely discontinue their education. Conversely, an expansion of high school education can potentially diminish rates of adolescent pregnancy, given that educational attainment stands as the foremost risk factor influencing sexual initiation, the use of contraceptive methods during initial sexual encounters and fertility. The aim of this paper is to analyze the impact of the implementation of the public educational policy introducing full-time schools (FTS) for high schools in the state of Ceará, Brazil, on early pregnancy rates.

Design/methodology/approach

Using the difference-in-differences method with multiple time periods, we measured the average effect of this staggered treatment on the treated municipalities.

Findings

The main result indicates a reduction of 0.849 percentage points in the teenage pregnancy rate. Concerning dynamic effects, the establishment of FTS in treated municipalities results in a 1.183–1.953 percentage point decrease in teenage pregnancy rates, depending on the timing of exposure. We explored heterogeneous effects within socioeconomically vulnerable municipalities, yet discerned no impact on this group. Rigorous tests confirm the robustness of the results.

Originality/value

This paper aims to contribute to: (1) the consolidation of research on the subject, given the absence of such research in Brazil to the best of our knowledge; (2) the advancement and analysis of evidence-based public policy and (3) the utilization of novel longitudinal data and methodology to evaluate adolescent pregnancy rates.

Details

EconomiA, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1517-7580

Keywords

Article
Publication date: 17 January 2024

Wendy Nieto-Gutiérrez, Aleksandar Cvetković-Vega, María E. Cáceres-Távara and Christian Ponce-Torres

The prison population is seldom studied and often overlooked in many countries despite their vulnerability to long-term illness. This study aims to explore the factors associated…

Abstract

Purpose

The prison population is seldom studied and often overlooked in many countries despite their vulnerability to long-term illness. This study aims to explore the factors associated with the non-treatment for long-term illnesses among incarcerated individuals.

Design/methodology/approach

This study is a cross-sectional analysis. The authors conducted a secondary data analysis using information collected in the Peruvian census of incarcerated individuals. The study population consisted of incarcerated individuals diagnosed with a long-term illness. To evaluate the factors associated with non-treatment, the authors used a Poisson regression model.

Findings

The authors included 12,512 incarcerated individuals (age: 40.9 ± 13.1 years), and 39% of them did not receive treatment for their long-term illness. The authors observed that non-treatment was statistically associated with gender, age, having children, use of the Spanish language, sexual identity, judicial situation, penitentiary location, discrimination inside the penitentiary and health insurance before incarceration. However, only having children (prevalence ratio [PR]: 1.11, confidence interval [CI]95% 1.03–1.19), using the Spanish language (PR: 1.15, CI95%: 1.01–1.31), being in a penitentiary not in Lima (PR: 1.11, CI95%: 1.06–1.17) and perceiving discrimination inside the penitentiary (PR: 1.12, CI95% 1.06–1.18) increased the prevalence of non-treatment.

Originality/value

Identifying the factors associated with non-treatment will allow us to implement measures for prioritizing groups and developing strategies for the evaluation, close follow-up of their health and management of comorbidities.

Details

International Journal of Prison Health, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2977-0254

Keywords

Article
Publication date: 23 January 2024

Rachael M. Rimmer, Rachel D. Woodham, Sharon Cahill and Cynthia H.Y. Fu

The purpose of this paper was to gain a qualitative view of the participant experience of using home-based transcranial direct current stimulation (tDCS). Acceptability impacts…

Abstract

Purpose

The purpose of this paper was to gain a qualitative view of the participant experience of using home-based transcranial direct current stimulation (tDCS). Acceptability impacts patient preference, treatment adherence and outcomes. However, acceptability is usually assessed by rates of attrition, while multifaceted constructs are not reflected or given meaningful interpretations. tDCS is a novel non-invasive brain stimulation that is a potential treatment for major depressive disorder (MDD). Most studies have provided tDCS in a research centre. As tDCS is portable, the authors developed a home-based treatment protocol that was associated with clinical improvements that were maintained in the long term.

Design/methodology/approach

The authors examined the acceptability of home-based tDCS treatment in MDD through questionnaires and individual interviews at three timepoints: baseline, at a six-week course of treatment, and at six-month follow-up. Twenty-six participants (19 women) with MDD in a current depressive episode of at least moderate severity were enrolled. tDCS was provided in a bifrontal montage with real-time remote supervision by video conference at each session. A thematic analysis was conducted of the individual interviews.

Findings

Thematic analysis revealed four main themes: effectiveness, side effects, time commitment and support, feeling held and contained. The themes reflected the high acceptability of tDCS treatment, whereas the theme of feeling contained might be specific to this protocol.

Originality/value

Qualitative analysis methods and individual interviews generated novel insights into the acceptability of tDCS as a potential treatment for MDD. Feelings of containment might be specific to the present protocol, which consisted of real-time supervision at each session. Meaningful interpretation can provide context to a complex construct, which will aid in understanding and clinical applications.

Details

Mental Health Review Journal, vol. 29 no. 1
Type: Research Article
ISSN: 1361-9322

Keywords

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