Lack Of Partnerships Research Articles

Understanding Patient, Provider, and System Factors Related to Medicaid Readmissions

Efforts on reducing hospital readmissions, which are intended to improve quality and reduce costs, tend to focus on elderly Medicare beneficiaries without recognition of another high-risk population--adult nonmaternal Medicaid patients. This study was undertaken to understand the complexity of Medicaid readmission issues at the patient, provider, and system levels. Multiple qualitative methods, including site visits to nine safety-net hospitals, patient/family/caregiver inter views, and semistructured interviews with health plans and state Medicaid agencies, were used in 2012 and 2013 to obtain information on patient, provider, and system issues related to Medicaid readmissions; strategies considered or currently used to address those issues; and any perceived financial, regulatory or, other policy factors inhibiting or facilitating readmission reduction efforts. Significant risk factors for Medicaid readmissions included financial stress, high prevalence of mental health and substance abuse disorders, medication nonadherence, and housing instability. Lacking awareness on Medicaid patients' high risk, a sufficient business case, and proven strategies for reducing readmissions were primary barriers for providers. Major hurdles at the system level included shortage of primary care and mental health providers, lack of coordination among providers, lack of partnerships between health plans and providers, and limited data capacity for realtime monitoring of readmissions. The intertwining of behavioral, socioeconomic, and health factors; the difficulty of accessing appropriate care in the outpatient setting; the lack of clear financial incentives for health care providers to reduce readmissions; and the fragmentation of the current health care system warrant greater attention and more concerted efforts from all stakeholders to reduce Medicaid readmissions.

Knowledge translation: translating research into policy and practice

This paper provides a theoretical-reflective study of knowledge translation concepts and their implementation processes for using research evidence in policy and practice. The process of translating research into practice is iterative and dynamic, with fluid boundaries between knowledge creation and action development. Knowledge translation focuses on co-creating knowledge with stakeholders and sharing that knowledge to ensure uptake of relevant research to facilitate informed decisions and changes in policy, practice, and health services delivery. In Brazil, many challenges exist in implementing knowledge translation: lack of awareness, lack of partnerships between researchers and knowledge-users, and low research budgets. An emphasis on knowledge translation has the potential to positively impact health outcomes. Future research in Brazil is needed to study approaches to improve the uptake of research results in the Brazilian context.

Contribution of Gold-ecorated Lodges to Poverty Reduction among Local Residents in Maasai Mara and Amboseli Protected Areas, Kenya

Poverty is the most pressing challenge facing humankind in the 21st century. In response, various options are being pursued to address it; key among them being ecotourism. While some scholars emphasize the potential of ecotourism in alleviating poverty, existing statistics reveal that majority of people living adjacent to wildlife protected areas continue to suffer from the absence of fundamental opportunities to lead decent lives. This study, therefore, was conducted around Basecamp Maasai Mara and Elephant Pepper Camp in Maasai Mara National Reserve (MMNR) as well as Campi ya Kanzi in Amboseli National Park (ANP), Kenya to investigate the contribution of gold-ecorated lodges to poverty reduction. Specifically, the study assessed eco-lodges’ contribution towards local community access to financial resources, basic needs, governance, empowerment and equality as a measure of their contribution to poverty reduction. The study adopted survey design using structured questionnaires and focus group discussion in data collection. The target population included households adjacent to the three eco-lodges. Through simple random sampling, a sample size of 384 households was generated and participated in the questionnaire survey. To generate focus group, purposive sampling was used to recruit key informants who included area chiefs, managers of the eco-lodges, members of cultural manyattas and chairmen of group ranches for interviews and focus group discussions. Majority of the local community indicated that eco-lodges had greatly contributed to education and healthcare. However, majority of the respondents indicated that eco-lodges had not addressed access to financial resources like access to credit and supply of locally produced agricultural produce; inadequate and skewed financial sharing mechanisms; limited access, ownership and control of their once communal land; lack of technical and legal know-how; access to clean water and adequate shelter. Moreover, lack of partnerships with other stakeholders, inequality in sharing ecotourism benefits, discrimination against women, disunity and mistrust, and lack of government support were identified as the main constraints hindering poverty reduction efforts. The study recommends a need for an ecotourism policy that will not only establish fair and sustainable economic partnerships between private investors and local community, but also ensure community cohesion and enhanced socio-economic welfare. Kenya’s National eco-labeling regulators should also put more emphasis on socio-economic benefits of such eco-lodges to the local community besides environmental conservation efforts they foster.

Product development process in small and medium clothing companies: focus on relations with suppliers, retailers and final client

The purpose of this article is to identify and analyse the product development process (PDP) at small and medium size manufacturing companies in the clothing and textile sector. It focuses on company relations with suppliers, retailers and final clients. Methodologically, the study was conducted by means of multiple case studies at five small and medium size clothing manufacturing companies in Southern Brazil. It found a lack of partnerships with suppliers; a lack of participation of final clients in PDP; the organisation of the sector in functional teams; and the centralisation of decisions and actions of the PDP sectors among the owners.

Privatização dos serviços desaneamento: uma análise qualitativa à luz do caso de Cachoeiro de Itapemirim (ES)

O artigo analisa os argumentos utilizados para justificar e para contrapor os discursos de autores e instituições nacionais e internacionais favoráveis ao controle privado dos serviços de saneamento. A partir de dados coletados sobre a experiência de Cachoeiro de Itapemirim (ES), conclui que o Estado foi incapaz de prover à população serviços de qualidade, mas a concessão também não foi uma solução plenamente satisfatória para os usuários, pois apresentou muitos dos problemas recorrentes em outros locais, segundo relatado na literatura, como a fraca participação popular e a ausência de parcerias entre os diversos órgãos responsáveis pelo saneamento naquele município. A priorização de determinadas áreas, em detrimento de outras, bem como os aumentos praticados nos valores das tarifas cobradas, são outros pontos negativos levantados. Por fim, sugere como alternativa, a busca por um modelo de gestão menos discriminatório, pautado principalmente por um forte e efetivo controle social das decisões.

Mental Health and the Development Agenda in Sub-Saharan Africa

This article synthesizes the views of participants in two roundtables that were convened in Nairobi (March 2007) and London (July 2008) to identify key challenges to the prioritization of mental health in Africa and possible solutions. Participants included leading development experts and policy makers from head and country offices of international donors, national directors of mental health for several African countries, key mental health and public health professionals, epidemiologists, and an international nongovernmental organization. The challenges they identified to mainstreaming mental health include lack of understanding of the contribution of mental disorders to morbidity and mortality, competition for limited resources within health reform efforts, poor distribution of interventions and lack of inclusion of mental health among core generic health indicators, lack of economic research evidence, lack of a strategic approach to human resources planning, lack of partnerships with the social development sector, and mental health professionals' need for public health skills to effectively conduct national advocacy. Potential solutions include further investment in economic research, better strategic identification of the levers and entry points for integrating mental health into health sector reform plans, more vigorous engagement of mental health professionals in general health sector reforms, strengthening the linkage between mental health and social development, and intensive resource mobilization. In summary, partnerships, underpinned by collaborative training, research, and mutual dialogue with other health and nonhealth sectors, are needed.

The world of outreach

PurposeThe purpose of this paper is to report on the outreach activities of the Fine Arts Library at Ohio State University.Design/methodology/approachOutreach at Ohio State is intended to have global impact, but successful outreach is often hampered by lack of partnerships, funding restrictions, and a monolithic approach to the patron. The paper reflects on each of these issues and discusses the strategies used by the Fine Arts Library to conduct outreach with user‐focus and budgets in mind.FindingsThe paper finds that there are techniques for outreach that involve small outputs of funds but have larger impacts. Moving past a “one size fits all” philosophy for outreach allows the Fine Arts Library to connect with the patrons it is best able to serve.Originality/valueWhile the phrase “think globally, act locally” is well‐known, it can often be forgotten in libraries, where the goal to reach as many people as possible is very important. This paper suggests that the returns on the local investment are incredibly important to the global missions of libraries.

Corporate Community Involvement in European and US Cities

We aim to identify the implications of corporate citizenship in general, and of collaboration between public and private actors in particular, for the development of cities. We analyse the changing behaviour of proactive firms in the field of community involvement, the spatial dimension of corporate citizenship, the added value of cross-sector partnerships, and the barriers to partnerships. We conclude that the trend of corporate community involvement provides new opportunities for the development of partnerships between proactive corporate citizens, city government, and other (public or private) organisations. However, the results suggest that the actual number of such partnerships is lower than expected. This lack of partnerships can be explained by looking at the internal organisation of companies and their potential partners, and the barriers in the coalition-forming process itself.

Beyond Technology Dissemination: Reinventing Agricultural Extension

This paper examines the challenges in reforming agricultural extension in India to meet the complex and heterogeneous demands of agricultural and rural development. While extension can and should play a much wider role in engaging with these issues, its performance remains restricted to the traditional one of technology dissemination. Fresh theoretical perspectives on the nature of innovation and appropriate institutional reform are opening up new vistas for extension. But the implementation of many of these necessary changes is hampered by outmoded understanding of its role and function, lack of partnerships among the different actors, limited expertise and lack of an explicit agenda on institutional learning.

The uneven diffusion of telemedicine services in Australia.

The diffusion of telemedicine services in Australia over the last four years has been uneven. Some of the major barriers to the adoption of telemedicine relate to the nature of the industry, including its immaturity, the limited telecommunications infrastructure, the lack of appropriate dialogue between vendors and buyers about solutions required, and the lack of partnerships in the industry. Remuneration is only one barrier. There are, of course, other substantial organizational, financial and attitudinal barriers to the adoption of telemedicine. Further development of telemedicine in Australia will require detailed assessment of these matters.