Health Diagnosis of Communities of Practices (CoPs)

The purpose of this study is to provide a multi-level framework to diagnose the structural healthiness of CoPs and present a new metric, Bottleneck Impact Score (BIS), to measure the seriousness of bottlenecks in knowledge sharing activities among CoPs members. After analyzing knowledge sharing activities of 4,414 members from 59 CoPs, we confirm that while only a small number of CoP members actively engage in both transferring and receiving knowledge, most experts are not core players and they are reluctant to share their knowledge with others. We also find that only few CoPs can be classified as knowledge “sharing” community while most of CoPs suffer from inactive participation of employees with high expertise and are diagnosed as having at least one of master-apprenticeship and knowledge drain bottlenecks. Interestingly, we also find that CoPs members in field division such as Iron&Steel, Rolling, and Maintenance department more actively participate in knowledge sharing than CoPs members in Staff department. Finally, BISs are used to measure and compare the seriousness of six different types of bottlenecks in CoPs and departments

How can malaria rapid diagnostic tests achieve their potential? A qualitative study of a trial at health facilities in Ghana.

BACKGROUND: Rapid diagnostic tests (RDTs) for malaria are at the early stages of introduction across malaria endemic countries. This is central to efforts to decrease malaria overdiagnosis and the consequent overuse of valuable anti-malarials and underdiagnosis of alternative causes of fever. Evidence of the effect of introducing RDTs on the overprescription of anti-malarials is mixed. A recent trial in rural health facilities in Ghana reduced overprescription of anti-malarials, but found that 45.5% patients who tested negative with RDTs were still prescribed an anti-malarial. METHODS: A qualitative study of this trial was conducted, using in-depth interviews with a purposive sample of health workers involved in the trial, ranging from those who continued to prescribe anti-malarials to most patients with negative RDT results to those who largely restricted anti-malarials to patients with positive RDT results. Interviews explored the experiences of using RDTs and their results amongst trial participants. RESULTS: Meanings of RDTs were constructed by health workers through participation with the tests themselves as well as through interactions with colleagues, patients and the research team. These different modes of participation with the tests and their results led to a change in practice for some health workers, and reinforced existing practice for others. Many of the characteristics of RDTs were found to be inherently conducive to change, but the limited support from purveyors, lack of system antecedents for change and limited system readiness for change were apparent in the analysis. CONCLUSIONS: When introduced with a limited supporting package, RDTs were variously interpreted and used, reflecting how health workers had learnt how to use RDT results through participation. To build confidence of health workers in the face of negative RDT results, a supporting package should include local preparation for the innovation; unambiguous guidelines; training in alternative causes of disease; regular support for health workers to meet as communities of practice; interventions that address negotiation of health worker-patient relationships and encourage self-reflection of practice; feedback systems for results of quality control of RDTs; feedback systems of the results of their practice with RDTs; and RDT augmentation such as a technical and/or clinical troubleshooting resource

Emerging communities of child-healthcare practice in the management of long-term conditions such as chronic kidney disease: Qualitative study of parents' accounts

Background: Parents of children and young people with long-term conditions who need to deliver clinical care to their child at home with remote support from hospital-based professionals, often search the internet for care-giving information. However, there is little evidence that the information available online was developed and evaluated with parents or that it acknowledges the communities of practice that exist as parents and healthcare professionals share responsibility for condition management. Methods. The data reported here are part of a wider study that developed and tested a condition-specific, online parent information and support application with children and young people with chronic-kidney disease, parents and professionals. Semi-structured interviews were conducted with 19 fathers and 24 mothers who had recently tested the novel application. Data were analysed using Framework Analysis and the Communities of Practice concept. Results: Evolving communities of child-healthcare practice were identified comprising three components and several sub components: (1) Experiencing (parents making sense of clinical tasks) through Normalising care, Normalising illness, Acceptance & action, Gaining strength from the affected child and Building relationships to formalise a routine; (2) Doing (Parents executing tasks according to their individual skills) illustrated by Developing coping strategies, Importance of parents' efficacy of care and Fear of the child's health failing; and (3) Belonging/Becoming (Parents defining task and group members' worth and creating a personal identity within the community) consisting of Information sharing, Negotiation with health professionals and Achieving expertise in care. Parents also recalled factors affecting the development of their respective communities of healthcare practice; these included Service transition, Poor parent social life, Psycho-social affects, Family chronic illness, Difficulty in learning new procedures, Shielding and avoidance, and Language and cultural barriers. Health care professionals will benefit from using the communities of child-healthcare practice model when they support parents of children with chronic kidney disease. Conclusions: Understanding some of the factors that may influence the development of communities of child-healthcare practice will help professionals to tailor information and support for parents learning to manage their child's healthcare. Our results are potentially transferrable to professionals managing the care of children and young people with other long-term conditions. © 2014 Carolan et al.; licensee BioMed Central Ltd

Bridging the gap between police and citizens: what we know, what we've done, and what can be done

Master's Project (M.A.) University of Alaska Fairbanks, 2017There is a long history of distrust between police and citizens and there have been no meaningful and sustained steps to correct this situation. Death and injuries are sustained by citizens and police, but still there has not been a real attempt to prevent this occurring because there is no trust between police and citizens and this lack of trust has created a rift or gap between police and citizens and this projects aim is to address the gap. Research into what causing damage and finding a way to repair the damaged relationship between police and citizens by way of finding approaches that tend to lead to trust between groups of people. Communication, a better ethics base for police, training and education, restorative justice, media, and the studying of social theories will help find a way to repair the damage. A collaboration of all of the aforementioned categories will tend to help bridge the gap between police and citizens. It is believed that by addressing the issues and the roots of the problems between police and citizens, a new relationship built on trust will emerge. By having a more trusting relationship there will be less harm caused to police and citizens

Assessing New York City's Youth Gun Violence Crisis: Crews - Volume II - CompStat for Violence Prevention Programs: Collecting Program Specific Data to Manage Performance and Inform Policy

The success or failure of community strategies to address the youth gun violence crisis is often attributed in part to how well the problem is understood and diagnosed. With support from The New York Community Trust, the Crime Commission has undertaken an analysis of youth gun violence and crew activity -- violent turf rivalries among less-organized, smaller and normally younger groups than traditional gangs -- in select New York City communities. Our initial findings from available data, existing research and interviews with stakeholders are presented in a series of papers titled, "Assessing New York City's Youth Gun Violence Crisis: Crews.

A one health approach to strengthening antimicrobial stewardship in Wakiso District, Uganda

Antimicrobial stewardship (AMS), as one of the global strategies to promote responsible use of antimicrobials to prevent antimicrobial resistance (AMR), remains poor in many low-and middle-income countries (LMICs). We implemented a project aimed at strengthening AMS in Wakiso district, Uganda using a One Health approach. A total of 86 health practitioners (HPs), including animal health workers, and 227 community health workers (CHWs) participated in training workshops, and over 300 pupils from primary schools were sensitized on AMR, AMS, and infection prevention and control (IPC). We further established two multidisciplinary online communities of practice (CoPs) for health professionals and students, with a current membership of 321 and 162, respectively. In addition, a Medicine and Therapeutics Committee (MTC) was set up at Entebbe Regional Referral Hospital. The project evaluation, conducted three months after training, revealed that the majority of the HPs (92.2%) and CHWs (90.3%) reported enhanced practices, including improved hand washing (57.3% and 81.0%, respectively). In addition, 51.5% of the HPs reported a reduction in the quantity of unnecessary antibiotics given per patient. This project demonstrates that AMS interventions using a One Health approach can promote understanding of the prudent use of antimicrobials and improve practices at health facilities and in communities

Media Coverage of Law Enforcement Use of Force and Disability

Disability intersects with other factors such as race, class, gender, and sexuality, to magnify degrees of marginalization and increase the risk of violence. When the media ignores or mishandles a major factor, as we contend they generally do with disability, it becomes harder to effect change.This white paper focuses on the three years of media coverage of police violence and disability since the death of a young man with Down syndrome, named Ethan Saylor, in January 2013. After reviewing media coverage of eight selected cases of police violence against individuals with disabilities, the paper reveals the following patterns in the overall data:? Disability goes unmentioned or is listed as an attribute without context.? An impairment is used to evoke pity or sympathy for the victim.? A medical condition or "mental illness" is used to blame victims for their deaths.? In rare instances, we have identified thoughtful examinations of disability from within its social context that reveal the intersecting forces that lead to dangerous use-of-force incidents. Such stories point the way to better models for policing in the future. We conclude by proposing best practices for reporting on disability and police violence

Inspiring inclusion in your classroom and beyond

This article reflects upon teachers’ engagement in a Leadership for Inclusion Community of Practice (LIn-CoP), which utilised the Participatory Action Learning Action Research (PALAR) strategy. The study explored if and how engagement could support teachers to develop and exercise leadership for inclusion, using Grudnoff, Haigh, Cochran-Smith, Eil and Ludlow (2017) six facets for equity. Data were drawn from seven early career elementary teachers in the Republic of Ireland over a three-year period. The teachers sought successfully to: 1) develop six facets of equity and, 2) overcome barriers to applying their learning in their contexts. Analysis unveiled many examples of inclusive practices for promoting equity, thus narrowing the values practice gap related to inclusion. The findings also highlight for researchers and professional learning facilitators the potential of the PALAR LIn-CoP model for applying teacher learning in situated environments, in the face of organisational barriers

Collaborative Crop Research Program

For over 30 years, The McKnight Foundation's Collaborative Crop Research Program (CCRP) has explored solutions for sustainable local food systems through agricultural research. The program grew out of the Foundation's Plant Biology Program, which was founded in 1983, and reflects the Foundation's long-time commitment to place-based grantmaking and learning from those working on the ground. In 2014, the Foundation engaged The Philanthropic Initiative (TPI) to develop a historic overview of the CCRP to capture its origins and evolution over the last 30 years. To develop this narrative, TPI interviewed past and current Board members, staff, consultants and grantees who had been involved at various stages in the lifespan of the program, and reviewed existing documents, reports and meeting notes.The report that follows is to serve as part of the "institutional memory" of The McKnight Foundation's Collaborative Crop Research Program. Its heavy reliance on individual recollections may detract from its precision, but such reflections bring to life the program's three decades of commitment, collaboration, and adaptation in an effort to contribute to a world where all have access to nutritious food that is sustainably produced by local people. While not an evaluative document, key moments of influence and impacts are noted along the way

Developing and testing a strategy to enhance a palliative approach and care continuity for people who have dementia: Study overview and protocol

Background: Typically, dementia involves progressive cognitive and functional deterioration, leading to death. A palliative approach recognizes the inevitable health decline, focusing on quality of life. The approach is holistic, proactive, supports the client and the family, and can be provided by the client’s usual care team. In the last months of life, distressing symptoms, support needs, and care transitions may escalate. This project trialed a strategy intended to support a consistent, high quality, palliative approach for people with dementia drawing close to death. The strategy was to implement two communities of practice, drawn primarily from service provider organizations across care sectors, supporting them to address practice change. Communities comprised practitioners and other health professionals with a passionate commitment to dementia palliative care and the capacity to drive practice enhancement within partnering organizations. Project aims were to document: (i) changes driven by the communities of practice; (ii) changes in staff/practitioner characteristics during the study (knowledge of a palliative approach and dementia; confidence delivering palliative care; views on death and dying, palliative care, and a palliative approach for dementia); (iii) outcomes from perspectives of family carers, care providers, and community of practice members; (iv) the extent to which changes enhanced practice and care continuity; and (v) barriers to and facilitators of successful community of practice implementation. Methods/design: This action research project was implemented over 14 months in 2010/11 in metropolitan Perth, Western Australia and regional Launceston, Tasmania. Each state based community of practice worked with the researchers to scope existing practice and its outcomes. The research team compiled a report of existing practice recommendations and resources. Findings of these two steps informed community of practice action plans and development of additional resources. Change implementation was recorded and explored in interviews, comparisons being made with practice recommendations. Changes in staff/practitioner characteristics were evaluated using survey data. Findings from semi structured interviews and survey administration established outcomes from perspectives of family carers, care providers, and community of practice members. Consideration of processes and outcomes, across the two state based settings, informed identification of barriers and facilitators. Community of practice reflections also informed study recommendations