Learning and leading in the experience age

A focus on experiences of care helps health systems realize the very transformations they look to achieve. This is because patient experience allows patients, families and carers to define value, enabling healthcare organizations to focus on what matters to them and not simply what is the matter with them. This is what we mean by an ‘experience age’, one in which clear connections are made between the things patients value and the clinical outcomes we look to achieve: where links are drawn between experience, clinical effectiveness, safety and cost in order to provide the very best care for all patients. Central to the experience age is ensuring our health systems: (1) are accountable for the whole patient experience and thus able to act sooner to keep people well and out of hospital, (2) work to establish new relationships with patients, families and carers in which patients, carers and staff work together to establish what matters and how care can be delivered and (3) make stronger connections between patient and staff experience. In committing to these efforts, the global dialogue on patient experience will become even more important, as we recognise that despite differences in design and operation, the challenges our health systems face and the focus on what matters most to patients are shared

Seeing the big PICTURE: A framework for improving the communication of requirements within the Business-IT relationship

The relationship between the business and IT departments in the context of the organisation has been characterised as highly divisive. Contributing problems appear to revolve around the failure to adequately communicate and understand the required information for the alignment of business and IT strategies and infrastructures. This study takes a communication-based view on the concept of alignment, in terms of the relationship between the retail business and IT within a major high street UK bank. A research framework (PICTURE) is used to provide insight into this relationship and guide the analysis of interviews with 29 individuals on mid-high management level for their thematic content. The paper highlights the lessons that can be derived from the study of the BIT relationship and how possible improvements could be made

Communication issues in requirements elicitation: A content analysis of stakeholder experiences

The gathering of stakeholder requirements comprises an early, but continuous and highly critical stage in system development. This phase in development is subject to a large degree of error, influenced by key factors rooted in communication problems. This pilot study builds upon an existing theory-based categorisation of these problems through presentation of a four-dimensional framework on communication. Its structure is validated through a content analysis of interview data, from which themes emerge, that can be assigned to the dimensional categories, highlighting any problematic areas. The paper concludes with a discussion on the utilisation of the framework for requirements elicitation exercises

Individual and joint trajectories of change in bone, lean mass and physical performance in older men.

BackgroundDeclines in bone, muscle and physical performance are associated with adverse health outcomes in older adults. However, few studies have described concurrent age-related patterns of change in these factors. The purpose of this study was to characterize change in four properties of muscle, physical performance, and bone in a prospective cohort study of older men.MethodsUsing repeated longitudinal data from up to four visits across 6.9 years from up to 4681 men (mean age at baseline 72.7 yrs. ±5.3) participating in the Osteoporotic Fractures in Men (MrOS) Study, we used group-based trajectory models (PROC TRAJ in SAS) to identify age-related patterns of change in four properties of muscle, physical performance, and bone: total hip bone mineral (BMD) density (g/m2) and appendicular lean mass/ht2 (kg/m2), by DXA; grip strength (kg), by hand dynamometry; and walking speed (m/s), by usual walking pace over 6 m. We also described joint trajectories in all pair-wise combinations of these measures. Mean posterior probabilities of placement in each trajectory (or joint membership in latent groups) were used to assess internal reliability of the model. The number of trajectories for each individual factor was limited to three, to ensure that the pair-wise determination of joint trajectories would yield a tractable number of groups as well as model fit considerations.ResultsThe patterns of change identified were generally similar for all measures, with three district groups declining over time at roughly similar rates; joint trajectories revealed similar patterns with no cross-over or convergence between groups. Mean posterior probabilities for all trajectories were similar and consistently above 0.8 indicating reasonable model fit to the data.ConclusionsOur description of trajectories of change with age in bone mineral density, grip strength, walking speed and appendicular lean mass found that groups identified by these methods appeared to have little crossover or convergence of change with age, even when considering joint trajectories of change in these factors

The Politics of Participatory Performance: Capitalism and Identity

This thesis is located within the discourse of contemporary, participatory performance. It offers a cultural materialist reading of the relationship between neoliberal capitalism and identity, and its adjunct community, to consider the extent to which participatory performance might challenge the individualistic aspects of the neoliberal ideology. The thesis questions what it means to participate in capitalist democracy in the contemporary moment, interrogates how one might exercise participatory agency both within and outside the theatre space and contemplates the function of participatory performance in a period of democratic discontent. I argue that the case-studies contribute to creating communities of individuals thinking about how to develop capitalist democracy in a more egalitarian direction. The thesis primarily employs close performance analysis of nine case-studies that all occurred in the period 2013-2014. These analyses occur across three chapters that each address a differing form of participation. Chapter One considers the significance of the re-presentation of performer acts of participation within demarcated theatre spaces, challenging the concept of the successfully, aspiring neoliberal identity. Chapter Two focuses on acts of audience participation invited within conventional theatre auditoriums to defamiliarise one’s motivations for acting or not. And Chapter Three centres on immersive performance experiences in which the audience member becomes the art object, inviting them to recognise their indebtedness to others. The thread that coheres this broad cross-section of participatory performance practices is their desire to use the act of participation and the platform of performance to reconceive of what it means to do politics by using artistic and cultural means. Collectively, the case-studies advocate the need for continued co-operation with others and the on-going co-creation of meaning, which eliminates knowing, outcome and end-result, to challenge instrumental understandings of political progress. The thesis conclusion asserts this point by considering the shared theatrical techniques employed across the case-studies that destabilise binary modes of thinking to enhance their ethico-political potential. It also reflects on this argument in light of the election of a majority Conservative (neoliberal) government in 2015.AHRC via University of Exete

Generalized Cut Polytopes for Binary Hierarchical Models

Marginal polytopes are important geometric objects that arise in statistics as the polytopes underlying hierarchical log-linear models. These polytopes can be used to answer geometric questions about these models, such as determining the existence of maximum likelihood estimates or the normality of the associated semigroup. Cut polytopes of graphs have been useful in analyzing binary marginal polytopes in the case where the simplicial complex underlying the hierarchical model is a graph. We introduce a generalized cut polytope that is isomorphic to the binary marginal polytope of an arbitrary simplicial complex via a generalized covariance map. This polytope is full dimensional in its ambient space and has a natural switching operation among its facets that can be used to deduce symmetries between the facets of the correlation and binary marginal polytopes. We find complete H-representations of the generalized cut polytope for some important families of simplicial complexes. We also compute the volume of these polytopes in some instances.Comment: 28 pages, 4 figure

A Case Study of the Benefits of the Science Learning Partnerships in Early Years and Primary Education in England

This paper charts the recent history of the STEM Learning UK contracts with local Science Learning Partnerships (SLPs) and identifies what leadership has been made available to support the Early Years and Primary school sector. A case study approach is taken using ‘Super SLP’ hubs in England. Curriculum Hubs exist in core subject areas such as maths, English, science and computing. They have recently been expanded to include Behaviour Hubs. This forms the current DfE strategy of Teaching School Hubs (TSHs), i.e., to offer system support and a full career-length support for all stages of teacher-career and leadership development. This paper charts the changes to the Early Years (EY) and Primary teacher support networks, in science particularly, and examines what they provide and how this can be improved, and discusses, through session evaluation and feedback, what teachers have appreciated the most.</jats:p