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

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

The effects of change decomposition on code review -- a controlled experiment

Background: Code review is a cognitively demanding and time-consuming process. Previous qualitative studies hinted at how decomposing change sets into multiple yet internally coherent ones would improve the reviewing process. So far, literature provided no quantitative analysis of this hypothesis. Aims: (1) Quantitatively measure the effects of change decomposition on the outcome of code review (in terms of number of found defects, wrongly reported issues, suggested improvements, time, and understanding); (2) Qualitatively analyze how subjects approach the review and navigate the code, building knowledge and addressing existing issues, in large vs. decomposed changes. Method: Controlled experiment using the pull-based development model involving 28 software developers among professionals and graduate students. Results: Change decomposition leads to fewer wrongly reported issues, influences how subjects approach and conduct the review activity (by increasing context-seeking), yet impacts neither understanding the change rationale nor the number of found defects. Conclusions: Change decomposition reduces the noise for subsequent data analyses but also significantly supports the tasks of the developers in charge of reviewing the changes. As such, commits belonging to different concepts should be separated, adopting this as a best practice in software engineering

Moving Forward as a Family: Crafting a 2-Generation Strategy for Central Texas, PRP 192

United Way for Greater Austin commissioned this policy research project to guide their focus on helping low socioeconomic families achieve greater financial stability through the development of a Two-Generation (2-Gen) strategy for the Central Texas region. Two-Gen programs emphasize the importance of education as a means for better economic outcomes. High-quality early childhood education programs allow children to make critical neural connections during a period of substantial growth and development, ultimately better preparing them for pre-kindergarten programs and academic success in subsequent years. Adults working low-paying jobs encounter barriers to career advancement due to lacking credentials or relevant education. It is not uncommon for parents working long hours for low wages to have at least one child in need of high-quality early childhood education, yet they are unable to enroll their child in such programs due to issues such as cost, transportation, and time away from work. Two-Gen programs seek to resolve the issues complicating this problem of financial instability by providing high-quality educational and training programs for both parents and children, which are even more effective when intentionally coordinated so that the family develops as a single unit in a positive direction. The research consisted of a literature review; a program scan at the local, state, and federal levels; and site visits within Austin, Dallas, and San Antonio, as well as Boston and Miami. Data collected specific to the Central Texas region include a labor market analysis, a needs assessment, and a mapping of current organizational assets. Obtaining and analyzing this data allowed the team to better understand 2-Gen program development, outcomes, impact measurements, and areas for improvement. The research team developed practical applications for the information collected, ultimately contributing to the proposed anti-poverty strategy through the intentional coordination of 2-Gen services by leveraging existing organizational assets to best address the area’s most salient needs. In addition, the team proposed an evaluation strategy involving cost-benefit equations, program evaluation metrics, and a screening tool to predict the likelihood of a program achieving successful outcomes. The report concludes with policy recommendations at the local, state, and federal levels, as well as a summary of the populations affected by financial instability and future directions for this field.United Way for Greater AustinPublic Affair

Improving empathy of physicians through guided reflective writing

Objectives: This study was designed to explore how guided reflective writing could evoke empathy and reflection in a group of practicing physicians. Methods: Total participants recruited included 40 staff physicians at Cleveland Clinic, a tertiary care academic medical center. Twenty physicians (intervention group) were assigned to participate in a 6-session faculty development program introducing narrative medicine and engaging in guided reflective writing. Ten physicians (comparison group 1) received the assigned course reading materials but did not participate in the course sessions. Ten physicians (comparison group 2) neither received the reading materials nor participated in the sessions. Qualitative analysis of the physicians\u27 reflective writings was performed to identify major themes. The Jefferson Scale of Empathy was administered three times during the course. Results: Qualitative analysis of physicians\u27 writings showed themes of both compassionate solidarity and detached concern. Exploration of negative emotions occurred more frequently than positive ones. The most common writing style was case presentation. A total of 36 staff physicians completed the Jefferson Scale of Empathy. Results of statistical analysis suggested an improvement in empathy in the intervention group at the end of the course (p \u3c 0 .05). Conclusions: These results suggest a faculty development program using guided narrative writing can promote reflection and may enhance empathy among practicing physicians. These findings should encourage medical educators to design additional strategies for enhancing reflection and empathic behavior in trainees and specifically practicing physicians who can role model these behaviors to achieve the ultimate goal of improving the quality of patient care