Organizational Characteristics Research Articles

Проблемы формирования гитарного оркестра в свете истории и практики становления и развития исторических форм коллективного музицирования

The purpose of the study is to substantiate the fact that such standardized forms as the symphony orchestra and the orchestra of Russian folk instruments have become important points for the creation of a guitar orchestra but not an expanded group of guitarists. The article presents the parameters of the formation of symphony orchestras, which were also the basis of the guitar orchestra; describes the historical forms of collective music making, starting with the Neapolitan orchestra, in which the guitar played an exclusively accompanying role for a long time; the influence of the mandolin on the functioning of the guitar in the orchestra is shown; the specific organizational characteristics of amateur guitar playing and professional guitar orchestra are determined. As a result, the author comes to the conclusion that today the repertoire for a guitar orchestra is limited and, as a rule, is represented by arrangements of those few works that were written specifically for a hypothetical guitar orchestra.

Efficiency of investment activity in the dairy subcomplex

The article presents the results related to the evaluation of the effectiveness of investment activities in the dairy subcomplex. It is established that investments are an important component of the economic development of the dairy subcomplex, the effectiveness of which depends on a set of factors of the macro- and microeconomic environment, its organizational and economic characteristics, the investment strategy of enterprises, objects and sources of investment, the period for which capital is invested, the certainty of its future effect and the associated risk level. It was found out that in the conditions of low competitiveness of dairy subcomplex enterprises, there is a need to use effective investment projects, which significantly strengthened the role of investment efficiency analysis as a tool within which it is possible to justify, evaluate and select priority investment projects. It is determined that the task of analyzing the effectiveness of investments is the calculation of profits and cash flows, the assessment of their effectiveness, the identification of the influence of uncertainty factors on their profitability, the selection of optimal investment projects. It is advisable to organize the analysis of the effectiveness of investments in the following areas: the definition of subjects and objects of analysis; the choice of organizational forms of analysis, depending on the organizational structure and the distribution of responsibilities between individual performers; the preparation of the analysis program and its information support; analytical data processing, design and generalization of the analysis results. The proposed methodological approach to the analysis of investment efficiency takes into account the conditions of an unstable market environment (variable macroeconomic conditions, insufficient supply of dairy raw materials, uncertainty about wholesale purchase and sale prices), makes it possible to determine the effectiveness of investments, conduct risk analysis by simulation and predict data for risk analysis using regression methods.

Barriers and facilitators to use of buprenorphine in state-licensed specialty substance use treatment programs: A survey of program leadership

IntroductionMedications for opioid use disorder (MOUD), including buprenorphine, reduce overdose risk and improve outcomes for individuals with opioid use disorder (OUD). However, historically, most non-opioid treatment program (non-OTP) specialty substance use treatment programs have not offered buprenorphine. Understanding barriers to offering buprenorphine in specialty substance use treatment settings is critical for expanding access to buprenorphine. This study aims to examine program-level attitudinal, financial, and regulatory factors that influence clients' access to buprenorphine in state-licensed non-OTP specialty substance use treatment programs. MethodsWe surveyed leadership from state-licensed non-OTP specialty substance use treatment programs in New Jersey about organizational characteristics, including medications provided on- and off-site and percentage of OUD clients receiving any type of MOUD, and perceived attitudinal, financial, and regulatory barriers and facilitators to buprenorphine. The study estimated prevalence of barriers and compared high MOUD reach (n = 36, 35 %) and low MOUD reach (n = 66, 65 %) programs. ResultsMost responding organizations offered at least one type of MOUD either on- or off-site (n = 80, 78 %). However, 71 % of organizations stated that fewer than a quarter of their clients with OUD use any type of MOUD. Endorsement of attitudinal, financial, and institutional barriers to buprenorphine were similar among high and low MOUD reach programs. The most frequently endorsed government actions suggested to increase use of buprenorphine were facilitating access to long-acting buprenorphine (n = 95, 96 %), education and stigma reduction for clients and families (n = 95, 95 %), and financial assistance to clients to pay for medications (n = 90, 90 %). ConclusionsAlthough non-OTP specialty substance use programs often offer clients access to MOUD, including buprenorphine, most OUD clients do not actually receive MOUD. Buprenorphine uptake in these settings may require increased financial support for programs and clients, more robust education and training for providers, and efforts to reduce the stigma associated with medication among clients and their families.

Correlates of perceived shared decision making with parents of children with special healthcare needs: Findings from the PART-CHILD study

ObjectiveTo assess the extent of perceived shared decision making (SDM) with parents of pediatric patients and to examine its association with characteristics of patients, professionals, and healthcare facilities. MethodsParents of pediatric patients (n = 4383) were recruited in 15 social pediatric centers in Germany and provided information on perceived SDM (binary CollaboRATEpediatric score: optimal versus suboptimal extent of SDM), child age and sex, type of impairment, appointment, and healthcare professional present at the appointment. Organizational characteristics were assessed in a cross-sectional survey of staff at the study sites. ResultsOverall, 58.4% of parents reported an optimal extent of SDM. The optimal extent of SDM was more likely reported by parents of girls (OR=1.27, p < 0.001) and children with physical (as opposed to cognitive and combined) impairments (OR=1.30, p = 0.006), and after appointments attended by allied health professionals (OR=1.28, p = 0.004). In addition, parents in facilities receiving financing in addition to compensation by statutory health insurance funds were less likely to report an optimal extent of perceived SDM. ConclusionWhile SDM with parents was mostly related to individual characteristics of children and professionals at appointments, organizational characteristics seemed less relevant in our study. Practice implicationsStaff should be made aware of lower SDM with parents of boys, older children, and those with cognitive impairments, and trained to improve the SDM in these groups.

Macaque Brainnetome Atlas: A multifaceted brain map with parcellation, connection, and histology

The rhesus macaque (Macaca mulatta) is a crucial experimental animal that shares many genetic, brain organizational, and behavioral characteristics with humans. A macaque brain atlas is fundamental to biomedical and evolutionary research. However, even though connectivity is vital for understanding brain functions, a connectivity-based whole-brain atlas of the macaque has not previously been made. In this study, we created a new whole-brain map, the Macaque Brainnetome Atlas (MacBNA), based on the anatomical connectivity profiles provided by high angular and spatial resolution ex vivo diffusion MRI data. The new atlas consists of 248 cortical and 56 subcortical regions as well as their structural and functional connections. The parcellation and the diffusion-based tractography were evaluated with invasive neuronal-tracing and Nissl-stained images. As a demonstrative application, the structural connectivity divergence between macaque and human brains was mapped using the Brainnetome atlases of those two species to uncover the genetic underpinnings of the evolutionary changes in brain structure. The resulting resource includes: (1) the thoroughly delineated Macaque Brainnetome Atlas (MacBNA), (2) regional connectivity profiles, (3) the postmortem high-resolution macaque diffusion and T2-weighted MRI dataset (Brainnetome-8), and (4) multi-contrast MRI, neuronal-tracing, and histological images collected from a single macaque. MacBNA can serve as a common reference frame for mapping multifaceted features across modalities and spatial scales and for integrative investigation and characterization of brain organization and function. Therefore, it will enrich the collaborative resource platform for nonhuman primates and facilitate translational and comparative neuroscience research.

Содержание и значение некоторых основных элементов криминалистической характеристики организации незаконной миграции

The article covers the content of key elements of the criminalistic characteristics of organization of illegal migration and the meaning of such elements for the investigation (Art. 322.1 of the Criminal Code of the Russian Federation). The author arrives at a justified conclusion that knowledge of special aspects of such elements gives a criminal case investigator an opportunity to evaluate correctly the investigative situation at hand, develop and implement an algorithm of investigative and other procedural actions aimed at collection and recording of evidence of the committed crime.

Foreign Sponsorship of Armed Groups and Civil War

Abstracts Under what conditions do armed groups escalate their campaigns to civil war? Existing research suggests foreign states’ material support is critical to explaining armed groups' conduct during civil war and, thereby, war intensification, duration, and outcomes. Thus far, little attention has been paid to understanding whether and how foreign support influences whether armed groups fight civil wars in the first place, largely due to data limitations. Armed group-level datasets have included only those already engaged in significant civil war violence, which introduces selection bias that precludes investigating factors that influence which groups fight civil wars. Leveraging the new Armed Groups Dataset (AGD), which measures characteristics of armed groups engaged in lower-level violence, we conduct a preliminary empirical investigation into the explanatory role of foreign sponsorship in group-level variation in civil war. While foreign sponsorship and civil war are correlated, there is little evidence that sponsorship has substantial independent explanatory value in predicting civil war. Rather, the evidence is consistent with claims that armed groups’ organizational characteristics account for both access to foreign sponsorship and, independently, their likelihood of escalating civil war.

Dapagliflozin prevents kidney podocytes pyroptosis via miR-155-5p/HO-1/NLRP3 axis modulation

Diabetic nephropathy (DN) is a significant clinical microvascular complication associated with diabetes mellitus (DM), and end-stage diabetes giving rise to kidney failure is developing into the major etiological factor of chronic kidney failure. Dapagliflozin is reported to limit podocyte damage in DM, which has proven to protect against renal failure. Mounting evidence has demonstrated that pyroptosis is associated with DM progression. Nevertheless, whether pyroptosis causes DN and the underlying molecular pathways remain obscure. In this study, we aimed to explore the antipyroptotic attributes of dapagliflozin and elucidate the underlying mechanisms of kidney damage in diabetes. In vivo, experiments were conducted in streptozotocin (STZ)-induced type 2 diabetic mice, which were administered dapagliflozin via gavage for 6 weeks. Subsequently, the specific organizational characteristics and expression of pyroptosis-related genes were evaluated. Intragastric dapagliflozin administration markedly reduced renal tissue injury. Meanwhile, dapagliflozin also attenuated the expression level of pyroptosis associated genes, including ASC, cleaved Caspase-1, GSDMD N-termini, NLRP3, IL-18, and IL-1β in renal tissue of dapagliflozin-treated animals. Similar antipyroptotic effects were observed in palmitic acid (PA)-treated mouse podocytes. We also found that heme oxygenase 1 (HO-1) enhanced the protection of mouse podocyte clone 5 cells (MPC5). Moreover, miR-155-5p inhibition increased pyroptosis in PA-treated MPC5 cells, suggesting that miR-155-5p acts as an endogenous stimulator that increases HO-1 expression and reduces pyroptosis. Hence, our findings imply that dapagliflozin inhibits podocyte pyroptosis via the miR-155-5p/HO-1/NLRP3 axis in DM. Furthermore, dapagliflozin substitution may be regarded as an effective strategy for preventing pyroptosis in the kidney, including a therapeutic option for treating pyroptosis-related DN.

Analysis of the Factors Affecting the Business Sustainability of Agricultural Cooperatives in Northern Mindanao

Cooperatives serve as cornerstones in the region's agricultural sector, supporting livelihoods, food security, and economic development. In examining the complex dynamics of agricultural cooperatives in Northern Mindanao, this analysis investigates the multifaceted factors that affect their business sustainability, shedding light on crucial determinants driving the region's agricultural cooperative landscape. The study used a descriptive correlational research design and used survey in gathering primary data. Findings revealed that the majority of the cooperatives have been operating for 21 years and above, more have members from 15 to 150, the majority have 1 to 9 employees, and the majority are micro-cooperatives. The results indicating an average mean distribution of management of cooperatives described as strongly affecting business sustainability, shed light on the critical role of effective management practices in ensuring the long-term viability of agricultural cooperatives. The study concluded that Management of Cooperatives is significantly correlated to Business Sustainability: People means are considered weak and positive relationships between the variables tested, and Profit means are described as strong. The Enterprise Characteristics are significantly correlated to Business Sustainability, People means are described as moderate and positive relationships between the variables tested, and Profit means are described as moderate. Implications: emphasize the need for cooperatives to strategically leverage their organizational characteristics to enhance business sustainability through targeted interventions in areas such as human resource management, innovation adoption, and value chain integration.

Factors Associated with Nursing Professionalism: Insights from Tertiary Care Center in India

BackgroundProfessionalism among nurses plays a critical role in ensuring patient safety and quality care and involves delivering competent, safe, and ethical care while also working with clients, families, communities, and healthcare teams.Aims and objectivesTo assess the level of nursing professionalism and the factors affecting professionalism among nurses working at a tertiary care center in India.MethodsA descriptive cross-sectional study was conducted from October 2022 to March 2023 using a total enumeration sampling technique. Following institutional ethics committee approval, standardized tools were administered consisting of Nursing Professionalism Scale and socio-demographic, personal, and organizational characteristics.ResultsA total of 270 nurses participated, with a response rate of 93.7%. The mean age of the participants was 27.33 ± 2.75 years, with the majority being female (82.6%) and belonged to the age group of 23–27 years (59.6%). More than half of the nurses exhibited high professionalism (53%), with the highest and lowest median scores for professional responsibility (29.0) and valuing human beings (13.0) respectively. Multivariate regression analysis demonstrated that, compared with their counterparts, nurses with a graduate nursing qualification (AOR = 4.77, 95% CI = 1.16–19.68), up-to-date training (AOR = 4.13, 95% CI = 1.88–9.06), and adequate career opportunity (AOR = 33.91, 95% CI = 14.48–79.39) had significant associations with high nursing professionalism.Conclusion/Implications for practiceThe majority of the nurses had high professionalism, particularly in the domains of professional responsibility and management. Hospitals and healthcare institutions can use these findings to develop policies and prioritize opportunities for nurses to attend conferences and workshops to enhance their professional values, ultimately leading to improved patient care outcomes.Patient and public contributionNo patient or public contribution.

Capacity sizing method of virtual power plants based on game theory

AbstractIn the context of a low‐carbon economy, considering the output uncertainties of the renewable energy sources and the fluctuation of electrical price, the cost–benefit analysis is proposed for multi‐investor virtual power plant (VPP) under different risk preferences, and multi‐investor VPP capacity sizing problem is researched. First, the structural organization and flexible regulation characteristics of multi‐investor VPPs are analyzed. Second, integrated model and cost–benefit analysis indexes of VPP are built. Third, an optimal capacity sizing model of multi‐investor VPP is established, aiming at income maximization. Game theory is used to configure the distributed generators in the VPP under various cooperative modes and noncooperative modes of multiple investors. Fourth, according to the installed proportion of each distributed generator and the risk preference coefficient of each investor, the income allocation correction model based on the improved Shapley value method is proposed to stabilize the optimal VPP alliance. Finally, the demonstration project in the animation industry park of Sino‐Singapore Tianjin Eco‐City is employed as representative scenarios, which is used to validate the effectiveness of the proposed model. The results prove that the method proposed in this paper can guide knowledge for the investors with different risk preferences when planning the optimal capacity of multiple distributed generators in the VPP.

Group prenatal care successes, challenges, and frameworks for scaling up: a case study in adopting health care innovations

BackgroundGroup prenatal care enhances quality of care, improves outcomes, and lowers costs. However, this healthcare innovation is not widely available. Using a case-study approach, our objectives were to (1) examine organizational characteristics that support implementation of Expect With Me group prenatal care and (2) identify key factors influencing adoption and sustainability.MethodsWe studied five clinical sites implementing group prenatal care, collecting qualitative data including focus group discussions with clinicians (n = 4 focus groups, 41 clinicians), key informant interviews (n = 9), and administrative data. We utilized a comparative qualitative case-study approach to characterize clinical sites and explain organizational traits that fostered implementation success. We characterized adopting and non-adopting (unable to sustain group prenatal care) sites in terms of fit for five criteria specified in the Framework for Transformational Change: (1) impetus to transform, (2) leadership commitment to quality, (3) improvement initiatives that engage staff, (4) alignment to achieve organization-wide goals, and (5) integration.ResultsTwo sites were classified as adopters and three as non-adopters based on duration, frequency, and consistency of group prenatal care implementation. Adopters had better fit with the five criteria for transformational change. Adopting organizations were more successful implementing group prenatal care due to alignment between organizational goals and resources, dedicated healthcare providers coordinating group care, space for group prenatal care sessions, and strong commitment from organization leadership.ConclusionsAdopting sites were more likely to integrate group prenatal care when stakeholders achieved alignment across staff on organizational change goals, leadership buy-in, and committed institutional support and dedicated resources to sustain it.Trial registrationThe Expect With Me intervention’s design and hypotheses were preregistered: https://clinicaltrials.gov/study/NCT02169024. Date: June 19, 2014.

Entrepreneurial Bricolage and Innovation in Sport for Development and Peace Organizations

Many sport for development and peace organizations operate with limited resources and in low-resource environments. While resource constraints impede some organizations, others demonstrate an adaptive behavior, known as bricolage, to repurpose and flexibly engage existing resources to accomplish their goals. In this study, we ask what distinguishes organizations that engage in bricolage from others. We specifically test whether sport for development and peace nonprofits that engage in bricolage are more likely to engage in social innovation, and we test those findings against organizational size, age, and characteristics of organizations’ operating environments. Using data from an international sample of 161 sport for development and peace nonprofits, we find that organizations employing greater levels of bricolage also demonstrate significantly higher levels of innovation, except for process-focused innovations, which are significantly associated with environmental turbulence. Organizational size itself does not appear to influence the use of bricolage or the relationship between bricolage and innovation.

Strategien des Entlassmanagements in deutschen Allgemeinkrankenhäusern

ZusammenfassungHintergrundSektorenübergreifende Übergänge aus der stationären Versorgung sind mit Risiken für die Patientensicherheit verbunden. Im Jahr 2017 wurde der Rahmenvertrag über das Entlassmanagement rechtlich verankert. Zur Umsetzung von Maßnahmen zur Gewährleistung sicherer Übergänge von Patient:innen nach stationärer Behandlung fehlen in Deutschland bisher empirische Daten. Ziel dieser Studie ist ein Überblick über die von deutschen Allgemeinkrankenhäusern umgesetzten Strategien des Entlassmanagements.MethodeZwischen März und Mai 2022 wurden in einer deutschlandweiten Befragung konkrete Strategien des Entlassmanagements sowie strukturelle und organisationsbezogene Merkmale von 401 Allgemeinkrankenhäusern erfasst und im Anschluss deskriptive Statistiken und Gruppenvergleiche durchgeführt.Ergebnisse7 von 9 erfragten Strategien wurden in > 95 % der Häuser umgesetzt. Die Evaluation der Entlassungsplanung wurde nur in 61 % der Häuser umgesetzt, die systematische Dokumentation, Analyse und Evaluation der Wiederaufnahme in 54 %. Häuser mit einer höheren Anzahl Planbetten berichteten signifikant seltener über „frühzeitige Kontaktaufnahme mit Nachversorgenden“ und „Organisation des nahtlosen Übergangs in die Anschlussversorgung“.DiskussionEin Großteil der Strategien im Entlassmanagement aus der stationären Behandlung wird in deutschen Allgemeinkrankenhäusern umgesetzt. Allerdings werden Maßnahmen zur Evaluation und systematischen Analyse von Entlassungsprozessen sowie Wiederaufnahmen von Patient:innen nur teilweise umgesetzt. Diese sind jedoch notwendig, um Entlassungsprozesse und Verbesserungspotenziale systematisch zu bewerten.

The problems of counteraction to HIV-infection and its prevention in places of imprisonment

The article considers the problem of organizing prevention and treatment of HIV-infection in suspected, accused and convicted persons in places of deprivation of liberty. The HIV-infected individuals in places of deprivation of liberty are in situation of increased risk that creates objective necessity for in-depth study of this phenomenon. The purpose of the study was to determine specific characteristics of organization of support of HIV-infected individuals, to identify ways of contamination and its main risk factors among both suspected, accused and convicted persons and penitentiary institution personnel. The study provided sorting out of main aspects that resulting in convicts' refusal to receive drugs and treatment. The corresponding recommendations for optimizing general and particular prevention of these negative phenomena were developed. The conclusion was made that it is possible to apply complex methods to motivate convicted HIV patients for treatment. Some of these methods can include such medical social psychological measures of organizational managerial character as training of specialists; participation of HIV patients in comprehensive preventive programs; group support of convicted HIV patients; positive reinforcement application; individual approach.

Measuring value in health care: lessons from accountable care organizations.

Accountable care organizations (ACOs) were created to promote health care value by improving health outcomes while curbing health care expenditures. Although a decade has passed, the value of care delivered by ACOs is yet to be fully understood. We proposed a novel measure of health care value using data envelopment analysis and examined its association with ACO organizational characteristics and social determinants of health (SDOH). We observed that the value of care delivered by ACOs stagnated in recent years, which may be partially attributed to challenges in care continuity and coordination across providers. ACOs that were solely led by physicians and included more participating entities exhibited lower value, highlighting the role of coordination across ACO networks. Furthermore, SDOH factors, such as economic well-being, healthy food consumption, and access to health resources, were significant predictors of ACO value. Our findings suggest a "skinny in scale, broad in scope" approach for ACOs to improve the value of care. Health care policy should also incentivize ACOs to work with local communities and enhance care coordination of vulnerable patient populations across siloed and disparate care delivery systems.

Characteristics of Primary Morbidity in the Population of the Far Eastern Federal District (Retrospective Analysis)

Background. The peculiarities of the economic and geographical position of the Far Eastern Federal District determine climatic, socio-biological and medical and organizational characteristics that affect the leading criteria for population health. A relevant and priority direction for the development of the macro-region is the study of the main indicators of population health, reflecting the organizational and economic potential of the region, as well as the preservation and promotion of public health based on the formation of a healthy lifestyle and increasing the availability and quality of medical care. Aims — study and analyse the primary morbidity of the adult population in the Far Eastern Federal District. Methods. A retrospective analytical study was carried out. An analysis of the dynamics of primary morbidity by rate of increase (decrease) and a comparative analysis of average annual primary morbidity, including major classes of diseases diagnosed for the first time in life, in the adult population in the macro-region as a whole and in its 11 constituent entities is given. I–IV, VI–XIV, XVII, XIX classes of diseases were taken into account according to the International Classification of Diseases of the 10th revision. Results. The Far Eastern Federal District ranked 5th in descending order by primary morbidity among other Russian macroregions throughout the study period. There was variability in the primary morbidity ranking among the constituent entities of the district. The dynamics of primary morbidity showed a moderate upward trend in 2017, followed by two years of stable trend, and in 2020 there was a moderate downward trend. The prevalence of disease in patients diagnosed for the first time in the population of the other federal districts of the country was characterised by individual variability. At the same time, in most macro-regions a moderate to pronounced decrease in primary morbidity was found in 2020 (rate of increase (decrease) morbidity: from –2.3 to –7.2%), except for the Central Federal District (rate of increase (decrease) morbidity: –0.1%) and the Urals Federal District (rate of increase (decrease) morbidity: –0.2%), where this indicator remained stable. Conclusions. In the Far Eastern Federal District, characteristic variability in the level, dynamics and structure of primary morbidity among the population has been identified. A general pattern with all-Russian indicators was revealed, consisting in a decrease in incidence in most classes of diseases in 2020, except for X Respiratory disease, in which stability remained. The revealed features of the rank distribution of primary morbidity by classes of diseases in the subjects of the district will make it possible to be based on the principle of targeted distribution of funds when planning the volume of medical care to the population.

A Deeper Look at the Boy Scouts of America "Perversion" Files: Structural Factors Related to Access and Abuse.

The Boy Scouts of America's (BSA's) Ineligible Volunteer (IV) files, commonly called the "perversion files," is a unique data set allowing researchers to examine organizational characteristics that allow for child sexual victimization. Despite the uniqueness of this data set, few researchers have examined it. The researchers examined a random sample of cases from the IV files of scout leaders who molested scouts. A situational crime theoretical model was employed as had been used in studies on the Catholic Church sexual abuse scandal, proving effective. The researchers examined randomly selected from 1980 to 1999. Of initially examined 400 randomly selected cases, only 140 held retrievable data. The majority of the 140 cases did not have scouting victims, which resulted in a reduction to 48 cases. Beyond the several scouting forms, many files contained public domain information, including newspaper articles, police reports, criminal justice records, and/or records of civil litigation. Through both the scouting documents and the public domain records, the researchers identified six BSA-specific characteristics that allowed motivated adult leaders to molest their victims. These characteristics included (a) weak or inefficient incident reporting system, (b) failure to collect and review pertinent information, (c) organizationally legitimate reasons for one-on-one contact, (d) volunteer imbalance, (e) legitimate reasons for separation from protective adults, and (f) social status as a prophylactic defense. These structural characteristics are explored through descriptive statistics and specific case studies illustrating the phenomena. When the history of the IV files came to light through litigation, the BSA was forced to reconcile its past actions and develop new preventive measures. The Boy Scouts of America implemented various actions to protect the youth. Many of these protections specifically address structural characteristics.

Health-care organization characteristics in cancer care delivery: an integrated conceptual framework with content validation.

Context can influence cancer-related outcomes. For example, health-care organization characteristics, including ownership, leadership, and culture, can affect care access, communication, and patient outcomes. Health-care organization characteristics and other contextual factors can also influence whether and how clinical discoveries reduce cancer incidence, morbidity, and mortality. Importantly, policy, market, and technology changes are transforming health-care organization design, culture, and operations across the cancer continuum. Consequently, research is essential to examine when, for whom, and how organizational characteristics influence person-level, organization-level, and population-level cancer outcomes. Understanding organizational characteristics-the structures, processes, and other features of entities involved in health care delivery-and their dynamics is an important yet understudied area of care delivery research across the cancer continuum. Research incorporating organizational characteristics is critical to address health inequities, test care delivery models, adapt interventions, and strengthen implementation. The field lacks conceptual grounding, however, to help researchers identify germane organizational characteristics. We propose a framework identifying organizational characteristics relevant for cancer care delivery research based on conceptual work in health services, organizational behavior, and management science and refined using a systematic review and key informant input. The proposed framework is a tool for organizing existing research and enhancing future cancer care delivery research. Following a 2012 Journal of the National Cancer Institute monograph, this work complements National Cancer Institute efforts to stimulate research addressing the relationship between cancer outcomes and contextual factors at the patient, provider, team, delivery organization, community, and health policy levels.

Turnover Rates and Factors Associated With Turnover: A Longitudinal Analysis of the Retention Period of Clinical Nurses in Korea Using National Data.

Many countries, including Korea, are struggling with a nursing workforce shortage. This study aimed to identify the actual turnover rate of Korean clinical nurses and the factors affecting the turnover rate, considering the time required for nurses to gain experience at their current medical institution. This longitudinal study followed up on a cohort consisting of all 107,682 nurses from January 1, 2017 to July 30, 2020. Differences in the distribution of retention and turnover according to the medical institutions' and nurses' characteristics were analyzed using the chi-square test. The hazard ratios (HRs) for turnover in each analysis interval were analyzed using multilevel Cox proportional-hazards analysis. The mean turnover rate was 10.0% within 1 year and 33.4% within 3.5 years. Several organizational characteristics (the type and ownership of the hospital, its location, and the bed-to-nurse ratio) and individual characteristics (gender, age, and clinical experience) were found to be associated with turnover risk. Among these factors, compared to hospitals with a bed-to-nurse ratio in general wards of 6.0 or more, those with a ratio of 3.5-3.9 had an HR for 1-year turnover of 0.81 (95% confidence interval [CI] = 0.67-0.98), and those with a ratio of 2.5-2.9 had an HR for 3.5-year turnover of 0.77 (95% CI = 0.66-0.90). The bed-to-nurse ratio is a condition that can be modified through collaboration between government policy-makers and medical institutions. To reduce nurse turnover and retain experienced nurses, appropriate staffing should be implemented.