Why and when social support predicts older adults’ pain-related disability

Pain-related social support has been shown to be directly associated with pain-related disability, depending on whether it promotes functional autonomy or dependence. However, previous studies mostly relied on cross-sectional methods, precluding conclusions on the temporal relationship between pain-related social support and disability. Also, research on the behavioral and psychological processes that account for such a relationship is scarce. Therefore, this study aimed at investigating the following longitudinally: (1) direct effects of social support for functional autonomy/dependence on pain-related disability, (2) mediating role of physical functioning, pain-related self-efficacy, and fear, and (3) whether pain duration and pain intensity moderate such mediating processes. A total of 168 older adults (Mage = 78.3; SDage = 8.7) participated in a 3-month prospective design, with 3 moments of measurement, with a 6-week lag between them. Participants completed the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Brief Pain Inventory, the 36-SF Health Survey, behavioral tasks from the Senior Fitness Test, the Pain Self-Efficacy Questionnaire, and the Tampa Scale for Kinesiophobia. Moderated mediation analyses showed that formal social support for functional dependence (T1) predicted an increase in pain-related disability (T3), that was mediated by self-reported physical functioning (T2) and by pain-related self-efficacy (T2) at short to moderate pain duration and at low to moderate pain intensity, but not at higher levels. Findings emphasized that social support for functional dependence is a risk factor for pain-related disability and uncovered the “why” and “when” of this relationship. Implications for the design of social support interventions aiming at promoting older adults' healthy aging despite chronic pain are drawn.info:eu-repo/semantics/acceptedVersio

Temporal inabilities and decision-making capacity in depression

We report on an interview-based study of decision-making capacity in two classes of patients suffering from depression. Developing a method of second-person hermeneutic phenomenology, we articulate the distinctive combination of temporal agility and temporal inability characteristic of the experience of severely depressed patients. We argue that a cluster of decision-specific temporal abilities is a critical element of decision-making capacity, and we show that loss of these abilities is a risk factor distinguishing severely depressed patients from mildly/moderately depressed patients. We explore the legal and clinical consequences of this result

Crafting A Human Resource Strategy To Foster Organizational Agility: A Case Study

A decade ago, the CEO of Albert Einstein Healthcare Network (AEHN), anticipating a tumultuous and largely unpredictable period in its industry, undertook to convert this organization from one that was basically stable and complacent to one that was agile, “nimble, and change-hardy”. This case study briefly addresses AEHN’s approaches to business strategy and organization design, but focuses primarily on the human resource strategy that emerged over time to foster the successful attainment of organizational agility. Although exploratory, the study suggests a number of lessons for those who are, or will be, studying or trying to create and sustain this promising new organizational paradigm

Event-Cloud Platform to Support Decision- Making in Emergency Management

The challenge of this paper is to underline the capability of an Event-Cloud Platform to support efficiently an emergency situation. We chose to focus on a nuclear crisis use case. The proposed approach consists in modeling the business processes of crisis response on the one hand, and in supporting the orchestration and execution of these processes by using an Event-Cloud Platform on the other hand. This paper shows how the use of Event-Cloud techniques can support crisis management stakeholders by automatizing non-value added tasks and by directing decision- makers on what really requires their capabilities of choice. If Event-Cloud technology is a very interesting and topical subject, very few research works have considered this to improve emergency management. This paper tries to fill this gap by considering and applying these technologies on a nuclear crisis use-case

Digital Technologies as antecedents to Process Integration and Dynamic Capabilities in Healthcare: An Empirical Investigation

Healthcare has been in focus over the past decade due to its criticality and continuous revolution. In this digital era, with the advent of various technologies, healthcare is undergoing a massive transformation. This study attempts to analyze the impacts of three major digital technologies which are being adopted in the healthcare sector which are electronic medical records (EMR), enterprise resource planning (ERP) and internet-of-things (IoT) enabled medical wearables in the hospital context. Focusing towards analyzing the impact of these technologies towards process-integration and further towards dynamic capabilities like quality, agility and responsiveness; the study framework is well-grounded by two theoretical-underpinnings - Cybernetic Control theory and Dynamic Capability theory. Questionnaire has been finalized through extant literature review and focused-group-discussion. Empirical investigation has been done with a sample of 154 hospital respondents from four major metro cities from the private tertiary-care hospitals in India. The empirical analysis of the framework is carried out by exploratory-factor-analysis, confirmatory-factor-analysis and structural-equation-modelling. The study outcomes highlight linkages both from technologies to process-integration and further towards dynamic capabilities. This study uniformly analyzes the impacts of the aforementioned digital technologies across Indian private hospitals thereby providing the hospital managers with a framework, influencing superior dynamic capabilities and achieving a competitive edge

Non-Technical Individual Skills are Weakly Connected to the Maturity of Agile Practices

Context: Existing knowledge in agile software development suggests that individual competency (e.g. skills) is a critical success factor for agile projects. While assuming that technical skills are important for every kind of software development project, many researchers suggest that non-technical individual skills are especially important in agile software development. Objective: In this paper, we investigate whether non-technical individual skills can predict the use of agile practices. Method: Through creating a set of multiple linear regression models using a total of 113 participants from agile teams in six software development organizations from The Netherlands and Brazil, we analyzed the predictive power of non-technical individual skills in relation to agile practices. Results: The results show that there is surprisingly low power in using non-technical individual skills to predict (i.e. explain variance in) the mature use of agile practices in software development. Conclusions: Therefore, we conclude that looking at non-technical individual skills is not the optimal level of analysis when trying to understand, and explain, the mature use of agile practices in the software development context. We argue that it is more important to focus on the non-technical skills as a team-level capacity instead of assuring that all individuals possess such skills when understanding the use of the agile practices.Comment: 18 pages, 1 figur

Integrated Clinical Pathways: A Model-based Holistic Method

Against the background of increasing multidisciplinarity as well as the focus on quality, transparency and economic efficiency of medical services, clinical pathways (CPs) have been established as a promising tool at the organizational level in recent years. They are primarily intended to ensure an adequate description of the care processes and to manage the balance between best treatment practice and economic viability. CPs standardize the internal care services by explicating the institution-specific knowledge with regard to recommendations for action, service portfolio, organizational structures, infrastructure, etc. of a specific service provider. The development of hospital information systems (HIS) has so far been characterized by an evolutionary development of modules in the field of laboratory, radiology, nursing and picture archiving systems as well as in the area of administrative systems. As one result of this development, the HIS usually comprises a heterogeneous network of software systems of different types and manufacturers. However, the actual control of patients by means of evidence-based processes and integration of CPs into HIS was not addressed until the recent years, when HIS manufacturers started developing modules for CP modeling and workflow support. The objective of this thesis is to provide a holistic methodical support for the description of clinical pathways and their integration into a hospital information system to finally improve the compliance of daily care to standard process definitions. Therefore, conceptual models provide an adequate mean to describe and communicate complex matters in a comprehensible form as well as to configure IT systems due to their semi-formal nature. Hence, a first research thread investigates the question, how clinical pathways can be described adequately using conceptual models. This results in an iterative design of adequate modeling languages for clinical pathways. A second research thread further investigates the question, how conceptual models of clinical pathways can be used to configure process-oriented application systems in health care. This thread therefore describes the design of a model-based method, that enables a consecutive transformation of CPs into technical (workflow) specifications, based on the principles of the Model-Driven Architecture.:A. Synopsis of the Doctoral Dissertation B. Agility in Medical Treatment Processes C. Domain Specific Modeling Language - CPmod D. BPMN4CP - Version 1.0 E. BPMN4CP - Version 2.0 F. BPMN4CP - Version 2.1 G. MDA in Health Care IS Development H. Transforming Clinical Pathways into Care Workflows I. CDA Templates - Utilizing the MediCUB