Health systems research in fragile and conflict affected states: a qualitative study of associated challenges.

BACKGROUND: High quality health systems research (HSR) in fragile and conflict-affected states (FCAS) is essential to guiding the policies and programmes that will improve access to health services and, ultimately, health outcomes. Yet, conducting HSR in FCAS is challenging. An understanding of these challenges is essential to tackling them and to supporting research conducted in these complex environments. Led by the Thematic Working Group on Health Systems in FCAS, the primary aim of this study was to develop a research agenda on HSR in FCAS. The secondary aim was to identify the challenges associated with conducting HSR in these contexts. This paper presents these challenges. METHODS: Guided by a purposely-selected steering group, this qualitative study collected respondents' perspectives through an online survey (n = 61) and a group discussion at the Third Global Symposium on HSR in September 2014 (n = 11). Respondents with knowledge and/or experience of HSR in FCAS were intentionally recruited. RESULTS: Of those ever involved in HSR in FCAS (45/61, 75%), almost all (98%) experienced challenges in conducting their research. Challenges fall under three broad thematic areas: (1) lack of appropriate support; (2) complex local research environment, including access constraints, weak local research capacity, collaboration challenges and lack of trust in the research process; and (3) limited research application, including rapidly outdated findings and lack of engagement with the research process and results. CONCLUSIONS: This study shows that those familiar with HSR in FCAS face many challenges in gaining support for and in conducting and applying high-quality research. There is a need for more sustainable support, including commitment to and long-term funding of HSR in FCAS; investment in capacity building within FCAS to meet the challenges related to implementation of research in these complex environments; relationship and trust building among stakeholders involved in HSR, particularly between local and international researchers and between researchers and participants; and innovative and flexible approaches to research design and implementation in these insecure and rapidly changing contexts

Adaptation of WASH Services Delivery to Climate Change and Other Sources of Risk and Uncertainty

This report urges WASH sector practitioners to take more seriously the threat of climate change and the consequences it could have on their work. By considering climate change within a risk and uncertainty framework, the field can use the multitude of approaches laid out here to adequately protect itself against a range of direct and indirect impacts. Eleven methods and tools for this specific type of risk management are described, including practical advice on how to implement them successfully

Using the Internet to improve university education: Problem-oriented web-based learning and the MUNICS environment

Up to this point, university education has largely remained unaffected by the developments of novel approaches to web-based learning. The paper presents a principled approach to the design of problem-oriented, web-based learning at the university level. The principles include providing authentic contexts with multimedia, supporting collaborative knowledge construction, making thinking visible with dynamic visualisation, quick access to content resources via Information and Communication Technologies (ICT), and flexible support by tele-tutoring. These principles are used in the Munich Net-based Learning In Computer Science (MUNICS) learning environment, which is designed to support students of computer science to apply their factual knowledge from the lectures to complex real-world problems. For example, students can model the knowledge management in an educational organisation with a graphical simulation tool. Some more general findings from a formative evaluation study with the MUNICS prototype are reported and discussed. E.g., the students' ignorance of the additional content resources is discussed in the light of the well-known finding of insufficient use of help systems in software applicationsBislang wurden neuere Ansätze zum web-basierten Lernen in nur geringem Maße zur Verbesserung des Universitätsstudiums genutzt. Es werden theoretisch begründete Prinzipien für die Gestaltung problemorientierter, web-basierter Lernumgebungen an der Universität formuliert. Zu diesen Prinzipien gehören die Nutzung von Multimedia-Technologien für die Realisierung authentischer Problemkontexte, die Unterstützung der gemeinsamen Wissenskonstruktion, die dynamische Visualisierung, der schnelle Zugang zu weiterführenden Wissensressourcen mit Hilfe von Informations- und Kommunikationstechnologien sowie die flexible Unterstützung durch Teletutoring. Diese Prinzipien wurden bei der Gestaltung der MUNICS Lernumgebung umgesetzt. MUNICS soll Studierende der Informatik bei der Wissensanwendung im Kontext komplexer praktischer Problemstellungen unterstützen. So können die Studierenden u.a. das Wissensmanagement in einer Bildungsorganisation mit Hilfe eines graphischen Simulationswerkzeugs modellieren. Es werden Ergebnisse einer formativen Evaluationsstudie berichtet und diskutiert. Beispielsweise wird die in der Studie festgestellte Ignoranz der Studierenden gegenüber den weiterführenden Wissensressourcen vor dem Hintergrund des häufig berichteten Befunds der unzureichenden Nutzung von Hilfesystemen beleuchte

Multidisciplinary group performance—measuring integration intensity in the context of the North West London Integrated Care Pilot

Introduction: Multidisciplinary Group meetings (MDGs) are seen as key facilitators of integration, moving from individual to multidisciplinary decision-making, and from a focus on individual patients to a focus on patient groups. We have developed a method for coding MDG transcripts to identify whether they are or are not vehicles for delivering the anticipated efficiency improvements across various providers and apply it to a test case in the North West London Integrated Care Pilot. Methods: We defined ‘integrating’ as the process within the MDG meeting that enables or promotes an improved collaboration, improved understanding, and improved awareness of self and others within the local healthcare economy such that efficiency improvements could be identified and action taken. Utterances within the MDGs are coded according to three distinct domains grounded in concepts from communication, group decision-making, and integrated care literatures—the Valence, the Focus, and the Level. Standardized weighted integrative intensity scores are calculated across ten time deciles in the Case Discussion providing a graphical representation of its integrative intensity. Results: Intra- and Inter-rater reliability of the coding scheme was very good as measured by the Prevalence and Bias-adjusted Kappa Score. Standardized Weighted Integrative Intensity graph mirrored closely the verbatim transcript and is a convenient representation of complex communication dynamics. Trend in integrative intensity can be calculated and the characteristics of the MDG can be pragmatically described. Conclusion: This is a novel and potentially useful method for researchers, managers and practitioners to better understand MDG dynamics and to identify whether participants are integrating. The degree to which participants use MDG meetings to develop an integrated way of working is likely to require management, leadership and shared values

Design for safety: theoretical framework of the safety aspect of BIM system to determine the safety index

Despite the safety improvement drive that has been implemented in the construction industry in Singapore for many years, the industry continues to report the highest number of workplace fatalities, compared to other industries. The purpose of this paper is to discuss the theoretical framework of the safety aspect of a proposed BIM System to determine a Safety Index. An online questionnaire survey was conducted to ascertain the current workplace safety and health situation in the construction industry and explore how BIM can be used to improve safety performance in the industry. A safety hazard library was developed based on the main contributors to fatal accidents in the construction industry, determined from the formal records and existing literature, and a series of discussions with representatives from the Workplace Safety and Health Institute (WSH Institute) in Singapore. The results from the survey suggested that the majority of the firms have implemented the necessary policies, programmes and procedures on Workplace Safety and Health (WSH) practices. However, BIM is still not widely applied or explored beyond the mandatory requirement that building plans should be submitted to the authorities for approval in BIM format. This paper presents a discussion of the safety aspect of the Intelligent Productivity and Safety System (IPASS) developed in the study. IPASS is an intelligent system incorporating the buildable design concept, theory on the detection, prevention and control of hazards, and the Construction Safety Audit Scoring System (ConSASS). The system is based on the premise that safety should be considered at the design stage, and BIM can be an effective tool to facilitate the efforts to enhance safety performance. IPASS allows users to analyse and monitor key aspects of the safety performance of the project before the project starts and as the project progresses

Claim your space: re-placing spaces to better meet the needs of the net generation

The challenge for the Reid Library at The University of Western Australia was the transformation of a 1960s building into a welcoming space with services and facilities appropriate for a more technologically demanding generation. A key issue was how to balance the continuing need for access to physical collections with the rapidly expanding demand for new kinds of learning spaces and facilities oriented towards on-line and collaborative learning and research. This paper outlines the approach taken to identify client needs (both physical and virtual), define and propose new service models, and transform learning spaces while maintaining access to physical collections

AGENT: Alumni growth and engagement across new technologies

The AGENT project aims to use social networking technologies (LinkedIn and Facebook) to support the development of undergraduates’ employability and career development. The focus of the project is on e-mentoring by alumni to provide a ‘bridge’ between individuals whose social ties and connections are weakened by time and distance, whilst at the same time capitalising on the learning opportunities afforded by the widening of social networks. Social networking sites (SNSs) have been shown to provide students with the tools to make connections, build relationships and support personal development. From a social capital perspective, SNSs can support ‘weak ties’ by allowing students to grow a social network from which to draw resources in the form of information, knowledge, advice and expertise that an institution’s alumni can provide. Alumni are a key resource for building professional networking communities that can provide offline as well as online support to students. We report on an on-going JISC project –AGENT (Alumni Growth and Engagement across New Technologies) that explores how Web 2.0 technologies engage alumni, create the sense of belonging, develop more effective and mutually-beneficial alumni-student connections and associated positive social capital outcomes.Joint Information Systems Committee (JISC) 2011-201

Maximising Social Interactions and Effectiveness within Distance Learning Courses: Cases from Construction

Advanced Internet technologies have revolutionised the delivery of distance learning education. As a result, the physical proximity between learners and the learning providers has become less important. However, whilst the pervasiveness of these technological developments has reached unprecedented levels, critics argue that the student learning experience is still not as effective as conventional face-to-face delivery. In this regard, surveys of distance learning courses reveal that there is often a lack of social interaction attributed to this method of delivery, which tends to leave learners feeling isolated due to a lack of engagement, direction, guidance and support by the tutor. This paper defines and conceptualises this phenomenon by investigating the extent to which distance-learning programmes provide the social interactions of an equivalent traditional classroom setting. In this respect, two distance learning case studies were investigated, covering the UK and Slovenian markets respectively. Research findings identified that delivery success is strongly dependent on the particular context to which the specific distance learning course is designed, structured and augmented. It is therefore recommended that designers of distance learning courses should balance the tensions and nuances associated with commercial viability and pedagogic effectiveness