Context-related Aspects Research Articles

Acceptance factors of digitalization in hospitals: a mixed-methods study

IntroductionHospitals have identified IT as a suitable mean to cope with various challenges. However, the heterogenous progress regarding digitalization cannot solely be attributed to a lack of investment. Potentially underlying socio-technical causes should be further investigated. The aim of this work is to identify factors that affect the human acceptance of digitalization in hospitals. The goal is to validate practical relevance with affected professional stakeholders as well as quantify the magnitude of the impact.MethodsThe Mixed-Methods (MM) approach according to the APA Mixed Methods Article Reporting Standard (MMARS) was based on a structured literature analysis (PRISMA-ScR), expert interviews (COREQ), and a web-based survey (CHERRIES). The survey queries acceptance factors related to digitalization in hospitals. By means of a statistical analysis, correlations with the dependent variable acceptance, effect sizes and variances are investigated.ResultsA total of N = 258 hospital professionals participated in the survey, with n = 155 (60.1%) female respondents, and a large share (n = 106, 41.1%) of participants from the field of nursing. Six of the 22 queried factors show a significant impact on acceptance (P < .05). The predictors competence and perceived benefit seem to exert the greatest influence. A multiple linear regression with R2 = .68 (corrected R2 = .63) shows a high goodness of fit. The predictors thus statistically influence the criterion acceptance (F22, 193 = 13.32, p < .001).ConclusionsThe factors contributing to human acceptance of digitalization-related change processes in hospitals were divided into subject-, object- and context-related aspects. The factors skill, education, affinity for digitalization, future of the workplace, participation as well as the perceived benefit were identified as significant influence factors on acceptance of digitalization in hospitals.

The role of leisure-time physical activity in youth for lifelong activity—a latent profile analysis with retrospective life course data

Considering the positive health effects of leisure-time physical activity (LTPA), youth is an important life stage to promote lifelong LTPA. However, the stability of LTPA over the life course is low, and specific predictors of LTPA in youth for lifelong activity have some shortcomings, e.g. neglecting the interacting factors of LTPA within individuals. Therefore, from a person-oriented approach, patterns of LTPA behaviour in youth considering time- and context-related aspects and their relationships with lifelong LTPA were investigated. Life course data from n = 1519 Swiss inhabitants aged between 25 and 76 years were recorded retrospectively using a validated questionnaire (CATI method). Latent profile analyses were used to find the optimal profile solution and for the association with lifelong LTPA auxiliary conditional effect models (controlled for age) were applied. Six distinct patterns emerged. Overall, mostly inactive youth are also the least active in adulthood, whereas several other patterns are associated with a mainly continuous LTPA throughout adulthood. More precisely, multiple constellations in youth occurred to be physically active in at least 80% of the years in adulthood: (1) early starters regarding LTPA in a rather self-organised setting but not with many different LTPAs; (2) late entrants with a variety of different activities and organisational settings; or (3) a high expression in every variable investigated. Consequently, there is not just one type of LTPA behaviour in youth linked to lifelong activity, which indicates that certain aspects of LTPA in youth can be compensated by each other. Implications for LTPA promotion can be derived.

Evidence-based development of new qualification models for public health practice and science

Abstract The Public Health Service (PHS) needs a sufficient and well-trained workforce to fulfill core public health activities. Given the multitude of complex challenges, from often short-term crisis management to long-term health promotion, a better integration of science and practice in the PHS is essential. In Germany, there is a lack of systematically established cooperations and integrated training concepts. However, both are essential to ensure continuous knowledge transfer between science and practice. In the EvidenzÖGD study, representatives from practice, teaching and science jointly develop and pilot new qualification models to qualify public health professionals for work at the interface of practice and science. Based on a systematic analysis of existing collaborations and qualification models, 23 expert interviews were conducted to identify qualification approaches that will enable future public health professionals to work at the interface between science and practice. In a stakeholder workshop planned for July 2022, a multistage decision-making process based on strategic orientation mapping will be conducted to prioritize the identified approaches and generate ideas for new qualification models. In total 17 papers were analyzed and inductively coded according to three main categories. In addition to (1) context-related aspects, such as credentialing, recruitment strategies and resources, also (2) content-related aspects, such as training forms and didactical concepts were extracted. Furthermore, criteria relevant for the further development and continuation of the models (3) could be identified. By strengthening the scientific nature of practice in PHS and anchoring PHS-relevant topics in academia, the EvidenzÖGD project contributes to a sustainable strengthening of evidence-informed approaches in PHS practice. The evidence-informed, participatory development of a tailored qualification model is intended to promote the pilot of the model, which is due in 2023. Key messages • Integrated qualification models support the strengthening of evidence-based approaches in the public health service (ÖGD) and promote the integration of ÖGD-relevant issues in science. • Participatory approaches with explicit consideration of the perspective of young health professionals ensures that new qualification approaches meet the needs and requirements of future generations.

Pilot approach to analyzing patient and citizen involvement in health technology assessment in four diverse low- and middle-income countries.

In low- and middle-income countries (LMICs) striving to achieve universal health coverage, the involvement of different stakeholders in formal or informal ways in health technology assessment (HTA) must be culturally and socially relevant and acceptable. Challenges may be different from those seen in high-income countries. In this article, we aimed to pilot a questionnaire for uncovering the context-related aspects of patient and citizen involvement (PCI) in LMICs, collecting experiences encountered with PCI, and identifying opportunities for patients and citizens toward contributing to local decision- and policy-making processes related to health technologies. Through a collaborative, international multi-stakeholder initiative, a questionnaire was developed for describing each LMIC's healthcare system context and the emergence of opportunities for PCI relating to HTA. The questionnaire was piloted in the first set of countries (Brazil, Indonesia, Nigeria, and South Africa). The questionnaire was successfully applied across four diverse LMICs, which are at different stages of using HTA to inform decision making. Only in Brazil, formal ways of PCI have been defined. In the other countries, there is informal influence that is contingent upon the engagement level of patient and citizen advocacy groups (PCAGs), usually strongest in areas such as HIV/AIDS, TB, oncology, or rare diseases. The questionnaire can be used to analyze the options for patients and citizens to participate in HTA or healthcare decision making. It will be rolled out to more LMICs to describe the requirements and opportunities for PCI in the context of LMICs and to identify possible routes and methodologies for devising a more systematic and formalized PCI in LMICs.

A proposal of hygienic and sanitary standards for the new Building Code in Italy.

The traditional emphasis of Public Health on the type and quality of housing today merges with other wider determinants of health such as: the neighbourhood, the community and the "place" where a home is located, but also the policies that make access to a healthy home within everyone's reach. At the neighbourhood scale, context-related aspects heavily influence the internal quality and real usability of the buildings themselves, with particular reference to factors such as the quality of the site, the relationship between the building and the context, the presence and quality of the greenery and open spaces surrounding the building, as well as all measures that make it possible to reduce the building's impact on the environment, to protect it against environmental pollution, and to manage the building in an integrated manner for maintenance purposes. Creating healthy living environments means referring to the different dimensions mentioned above, and this not only requires the attention of Public Health operators, but also implies an integration of vision and objectives among various professional skills and competences that puts health at the center of all policies. This proposal, which starts from the analysis of existing local hygiene regulations and scientific literature, aims to take stock of a number of areas considered fundamental for the assessment of building hygiene aspects, with particular reference to the eco-sustainability of buildings and adaptation to climate change. The aspects identified can be considered as a starting point for the preparation of integrated building and hygiene regulations based on documented effective practices for the protection of Public Health.

Risk indicator taxonomy for supervision of clinical trials on medicinal products

Aim: To facilitate a risk-based approach for the supervision of clinical trials on medicinal products, we identified and categorized indicators that may present an elevated safety and/or ethical risk for participants, and/or for data integrity. The indicators are relevant for all stakeholders including participants, regulatory bodies, health care inspectorates, sponsors and trial sites.Methods: The sources of indicators included Medline (using the search terms risk-based/-triggered/-driven oversight/monitoring/inspection), relevant documents from websites of regulatory authorities in Europe, North America and Australia, and results of a brainstorm session organized for experts working in the field. Indicators were classified according to risk area (safety and ethical, data integrity, or both).Results: In total, we identified 69 risk indicators that were categorized into six branch-levels of the taxonomy. We visualized the taxonomy in a tree structure to clearly distinguish individual indicators. In addition to readily detectable risk indicators, more context-related aspects determine the final impact of the trial and constitute further components in risk assessment. Context-related aspects include potential high media attention, consequences for the reputation of medical research, and the socioeconomic situation in the geographic region and have to be considered on a case-by-case basis.Conclusions: We identified a wide array of risk indicators for clinical trials on medicinal products and we used a tree structure to incorporate the indicators identified to clearly distinguish individual indicators and to enable efficient use of the indicators. The overview of indicators may facilitate multiple stakeholders in developing structured risk assessment (identification and analysis) for supervising clinical trials on medicinal products. Stakeholders can interpret and prioritize the indicators from their own perspective.

Innovation forecast: Un-avoidable and context dependent

In order to mobilize the necessary resources for innovation forecasts are unavoidable. However, a forecast is never a neutral or objective assessment. Given an interdependent business landscape, there are at least two major context-related aspects that affect an innovation forecast. First, the actor that makes the forecast is embedded into a specific context. Secondly, the potential innovation stems from a specific environment, and will during the innovation journey be related to other environments in a producing and a using setting, and thus to other investments in place. In this paper we examine the development of one innovation and the forecasts made by three different economic actors. There is an interesting variation in the forecasts that can be explained as a variation of contexts of the actors. The contexts influence the way that the forecasts are done and especially in terms of what the context of the innovation is assumed to be. The empirical findings suggest that the results of the innovation forecast are highly dependent on the actors' abstraction of the business landscape which in turn is affected by the contexts of the actors.

Can biodiversity monitoring schemes provide indicators for ecosystem services?

Recently, the science and policy agenda on biodiversity moved to include ecosystem services assessments and it is recognised that for determining the effectiveness and progress of policy frameworks monitoring is crucial.Within European monitoring schemes, data is collected following different sampling protocols for a range of biodiversity or context related aspects; from EU-wide general land cover mapping to red list species within Annex I habitats. In this paper, we analysed field instructions of seven monitoring schemes on the extent to which they can provide data on the provision of ecosystem services and what additional information may be needed for future monitoring of ecosystem services.We compared seven monitoring schemes (i.e. CORINE Land Cover, Land Use Cover Area Survey (LUCAS), European Biodiversity Observation Network (EBONE), biodiversity monitoring on organic and low-input farming systems (BioBio), National Inventory of the Landscape of Sweden (NILS) and Pan-European Common Birds Monitoring (PECBM) and UK Butterfly monitoring (UK-BM)) by scoring the quality of recorded parameters and the adequacy of sampling protocols for ecosystem service monitoring.All the examined schemes were able to provide some parameters on ecosystem services, but the quality of the parameters on average did not exceed the level of qualitative data. Additionally, the divergence between the sampling designs of the schemes and the spatial characteristics of ecosystem services reduced the potential monitoring value of all schemes. Monitoring schemes including a range of sampling methods, scales and included the recording of data on habitats, such as EBONE, BioBio and NILS, provided the best data on the provision of ecosystem services.We conclude that improvement of the monitoring of ecosystem services is hindered by several knowledge gaps: (1) a robust definition and conceptual framework of ecosystem services; (2) the linkage between biodiversity and ecosystem services; and (3) the interpretation of monitoring data.In addition to ecosystem service monitoring, biodiversity monitoring unremittingly remains very important, at least to identify trade-offs between the management for services and the resulting biodiversity status.

Determinants of ERP implementation knowledge transfer

Our study examined the determinants of ERP knowledge transfer from implementation consultants (ICs) to key users (KUs), and vice versa. An integrated model was developed, positing that knowledge transfer was influenced by the knowledge-, source-, recipient-, and transfer context-related aspects. Data to test this model were collected from 85 ERP-implementation projects of firms that were mainly located in Zhejiang province, China. The results of the analysis demonstrated that all four aspects had a significant influence on ERP knowledge transfer. Furthermore, the results revealed the mediator role of the transfer activities and arduous relationship between ICs and KUs. The influence on knowledge transfer from the source’s willingness to transfer and the recipient’s willingness to accept knowledge was fully mediated by transfer activities, whereas the influence on knowledge transfer from the recipient’s ability to absorb knowledge was only partially mediated by transfer activities. The influence on knowledge transfer from the communication capability (including encoding and decoding competence) was fully mediated by arduous relationship.

Physical Exercise Interventions to Improve Disability and Return to Work in Low Back Pain: Current Insights and Opportunities for Improvement

There is a body of literature that indicates that physical exercise interventions, with a primary focus on improvement of functioning instead of pain relief, might be effective to stimulate return to work and improve function in workers who are absent from work due to low back pain (LBP). Successful application and implementation of these interventions however, depends on multiple factors that need to be addressed carefully in clinical practice as well as research. Descriptive literature review, to identify an overview of current knowledge with respect to the safety, content- and context-related aspects of physical exercise interventions, issues relating to timing, the influence of treatment confidence and patient expectations, and the process of changing provider and employer behavior. Physical exercises are not associated with an increased risk for recurrences. The effects of interventions may vary depending on content-related factors (i.e., type of exercises, dosage, frequency, skills of the healthcare providers, etc.) and contextual factors (i.e., treatment setting, compensation system, etc.). Treatment confidence and patients' expectations also significantly influence outcomes of physical exercise interventions. Timing is also important; interventions targeting return to work, applied during the acute phase of work absenteeism, compete with a high rate of spontaneous recovery and may therefore be inefficient. Despite numerous studies, more quantitative and qualitative investigations are needed to further clarify the requirements for a successful application and implementation of physical exercise interventions for disabled workers with low back pain.