A co-designed social media intervention to satisfy information needs and improve outcomes in patients with chronic kidney disease : a longitudinal study

Background The number of people living with a long-term condition is increasing worldwide. Social media offers opportunities for patients to exchange information and experiences with others with the same condition, potentially leading to better self-management and improved patient outcomes, at minimal costs to health service providers. Objective This paper describes how an online network with a range of social media platforms was created, with the help of a group of patients with chronic kidney disease, and specialist professionals. The project evaluation considered whether information needs and health-related and social outcomes were met. Methods Longitudinal in-depth evaluation of the creation of the moderated network; observation of the use of the platforms; self-efficacy surveys (baseline and 6 months); semistructured interviews (at baseline and 6 months). Results 15 patients and professionals participated in the co-design of the network (hub), initially launched with 50 patients. Several platforms were needed to engage patients at different levels, and encourage generation of information, with the support of moderators. 14 separate patients participated in the evaluation. Satisfaction of information needs through social engagement improved self-efficacy (in 13 participants) with better self-care and management of illness. Social outcomes included seeking employment and an increase in social capital. Conclusion: An online network (hub) with several social media platforms helped patients with chronic kidney disease to manage their condition. Careful design with users resulted in a sustainable network with wider applicability across health and social care

Virginia: Baseline Report - State Level Field Network Study of the Implementation of the Affordable Care Act

This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.By and large, Virginia opponents of the Affordable Care Act have been able to thwart full implementation at the state level. This can be seen in Virginia's decision to default to a federally facilitated marketplace and refusal to close the coverage gap. Having control of the executive branch and legislature until 2014 allowed lawmakers to minimize the impacts of the ACA, implementing only what was legally required of them and ignoring calls from advocates for low-income people who called for fuller implementation.There remains the possibility for significant changes, including the structure and functioning of the marketplace as well as closing the coverage gap that would alter the state and national policy landscape. There remains serious debate about if and how Virginia will close the coverage gap. If Virginia moved forward, nearly 400,000 Virginians could get access to quality, affordable health care. Moreover, some advocates have asserted that Virginia could be the linchpin in opening up the South to Medicaid expansion

Michigan: Baseline Report - State Level Field Network Study of the Implementation of the Affordable Care Act

This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.Michigan has taken a mixed approach to implementing the Patient Protection and Affordable Care Act (ACA). It very nearly became the first state led entirely by Republicans to create a health insurance exchange as part of the ACA. Instead, Michigan was one of the more than thirty states to default to a federally run exchange. The state decided to adopt the Medicaid expansion, but with a delayed start date of April 2014

Pennsylvania: Base Line Report - State Level Field Network Study of the Implementation of the Affordable Care Act

This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.Although the ACA will no doubt have real financial consequences for insurers, hospitals, and health care providers, at this early stage in implementation, it is difficult to calculate precise gains and losses. For example, the Hospital Association of Pennsylvania supported the ACA, believing, in part, that reform was necessary to reduce current levels of uncompensated care and to reduce reliance on emergency care for patients who put off treatment for as long as possible to avoid out-of-pocket costs. The association agreed to significant cuts in Medicare and Medicaid to support the bill's passage. However, because cost savings from universal coverage have not yet been realized, hospitals reported cutting staff in April 2014 to offset the loss of Medicaid and Medicare funding. Safety net hospitals, which are required to serve all populations, seem especially affected, as many of their patients who fall into the Medicaid coverage gap are still showing up in emergency rooms without insurance

Data-driven modeling of systemic delay propagation under severe meteorological conditions

The upsetting consequences of weather conditions are well known to any person involved in air transportation. Still the quantification of how these disturbances affect delay propagation and the effectiveness of managers and pilots interventions to prevent possible large-scale system failures needs further attention. In this work, we employ an agent-based data-driven model developed using real flight performance registers for the entire US airport network and focus on the events occurring on October 27 2010 in the United States. A major storm complex that was later called the 2010 Superstorm took place that day. Our model correctly reproduces the evolution of the delay-spreading dynamics. By considering different intervention measures, we can even improve the model predictions getting closer to the real delay data. Our model can thus be of help to managers as a tool to assess different intervention measures in order to diminish the impact of disruptive conditions in the air transport system.Comment: 9 pages, 5 figures. Tenth USA/Europe Air Traffic Management Research and Development Seminar (ATM2013

Evaluation of the Community Leadership Project 2.0

Social Policy Research Associates (SPR), the contracted evaluator for CLP, began work partway through the first phase of CLP and has continued its role for CLP 2.0. SPR's overall goals for the evaluation are to: (1) inform improvements in CLP 2.0 implementation; (2) share lessons with the philanthropic field on effective capacity-building strategies for small organizations working in low-income communities and communities of color; and (3) assess the impact of CLP 2.0 on community grantees. This report focuses specifically on the launching of CLP 2.0 and on community grantees' characteristics and capacity levels at baseline

Integrating Behavioral Health & Primary Care in New Hampshire: A Path Forward to Sustainable Practice & Payment Transformation

New Hampshire residents face challenges with behavioral and physical health conditions and the interplay between them. National studies show the costs and the burden of illness from behavioral health conditions and co-occurring chronic health conditions that are not adequately treated in either primary care or behavioral health settings. Bringing primary health and behavioral health care together in integrated care settings can improve outcomes for both behavioral and physical health conditions. Primary care integrated behavioral health works in conjunction with specialty behavioral health providers, expanding capacity, improving access, and jointly managing the care of patients with higher levels of acuity In its work to improve the health of NH residents and create effective and cost-effective systems of care, the NH Citizens Health Initiative (Initiative) created the NH Behavioral Health Integration Learning Collaborative (BHI Learning Collaborative) in November of 2015, as a project of its Accountable Care Learning Network (NHACLN). Bringing together more than 60 organizations, including providers of all types and sizes, all of the state’s community mental health centers, all of the major private and public insurers, and government and other stakeholders, the BHI Learning Collaborative built on earlier work of a NHACLN Workgroup focused on improving care for depression and co-occurring chronic illness. The BHI Learning Collaborative design is based on the core NHACLN philosophy of “shared data and shared learning” and the importance of transparency and open conversation across all stakeholder groups. The first year of the BHI Learning Collaborative programming included shared learning on evidence-based practice for integrated behavioral health in primary care, shared data from the NH Comprehensive Healthcare Information System (NHCHIS), and work to develop sustainable payment models to replace inadequate Fee-for-Service (FFS) revenues. Provider members joined either a Project Implementation Track working on quality improvement projects to improve their levels of integration or a Listen and Learn Track for those just learning about Behavioral Health Integration (BHI). Providers in the Project Implementation Track completed a self-assessment of levels of BHI in their practice settings and committed to submit EHR-based clinical process and outcomes data to track performance on specified measures. All providers received access to unblinded NHACLN Primary Care and Behavioral Health attributed claims data from the NHCHIS for provider organizations in the NH BHI Learning Collaborative. Following up on prior work focused on developing a sustainable model for integrating care for depression and co-occurring chronic illness in primary care settings, the BHI Learning Collaborative engaged consulting experts and participants in understanding challenges in Health Information Technology and Exchange (HIT/HIE), privacy and confidentiality, and workforce adequacy. The BHI Learning Collaborative identified a sustainable payment model for integrated care of depression in primary care. In the process of vetting the payment model, the BHI Learning Collaborative also identified and explored challenges in payment for Substance Use Disorder Screening, Brief Intervention and Referral to Treatment (SBIRT). New Hampshire’s residents will benefit from a health care system where primary care and behavioral health are integrated to support the care of the whole person. New Hampshire’s current opiate epidemic accentuates the need for better screening for behavioral health issues, prevention, and treatment referral integrated into primary care. New Hampshire providers and payers are poised to move towards greater integration of behavioral health and primary care and the Initiative looks forward to continuing to support progress in supporting a path to sustainable integrated behavioral and primary care

A Systematic Review of Blockchain Literature in Logistics and Supply Chain Management: Identifying Research Questions and Future Directions

Potential blockchain applications in logistics and supply chain (LSCM) have gained increasing attention within both academia and industry. However, as a field in its infancy, blockchain research often lacks theoretical foundations, and it is not clear which and to what extent organizational theories are used to investigate blockchain technology in the field of LSCM. In response, based upon a systematic literature review, this paper: (a) identifies the most relevant organizational theories used in blockchain literature in the context of LSCM; and (b) examines the content of the identified organizational theories to formulate relevant research questions for investigating blockchain technology in LSCM. Our results show that blockchain literature in LSCM is based around six organizational theories, namely: agency theory, information theory, institutional theory, network theory, the resource-based view and transaction cost analysis. We also present how these theories can be used to examine specific blockchain problems by identifying blockchain-specific research questions that are worthy of investigation

Understanding construction delay analysis and the role of pre-construction programming

Copyright © 2013, American Society of Civil Engineers. This is the author's accepted manuscript. The final published article is available from the link below.Modern construction projects commonly suffer from delay in their completions. The resolution of time and cost claims consequently flowing from such delays continues to remain a difficult undertaking for all project parties. A common approach often relied on by contractors and their employers (or their representatives) to resolve this matter involves applying various delay analysis techniques, which are all based on construction programs originally developed for managing the project. However, evidence from literature suggests that the reliability of these techniques in ensuring successful claims resolution are often undermined by the nature and quality of the underlying program used. As part of a wider research carried out on delay and disruption analysis in practice, this paper reports on an aspect of the study aimed at exploring preconstruction stage programming issues that affect delay claims resolutions. This aspect is based on an in-depth interview with experienced construction planning engineers in the United Kingdom, conducted after an initial large-scale survey on delay and disruption techniques usage. Summary of key findings and conclusions include: (1) most contractors prefer to use linked bar chart format for their baseline programs over conventional critical path method (CPM) networks; (2) baseline programs are developed using planning software packages. Some of these pose difficulties when employed for most delay analysis techniques, except for simpler ones; (3) manpower loading graphs are not commonly developed as part of the main deliverables during preconstruction stage planning. As a result, most programs are not subjected to resource loading and leveling for them to accurately reflect planned resource usage on site. This practice has detrimental effects on the reliability of baseline programs in their use for resolving delay claims; and (4) baseline program development involves many different experts within construction organizations as expected, but with very little involvement of the employer or its representative. Active client involvement is however quite important as it would facilitate quick program approval/acceptance before construction, a necessary requirement for early delay claims settlement, which otherwise are often left unresolved long after the delaying events with the potential of generating into expensive disputes. The study results provide a better understanding of the key issues that need attention if improvements are to be made in delay claim resolutions. Additional research focusing on the testing of these results using a much larger sample and rigorous statistical analysis for generalization purposes would be helpful in advancing the limited knowledge of this subject matter