Establishing links between organizational climate, employee well-being and historical patient outcomes

This research undertaken in collaboration with Queensland Health analysed the links between dimensions of workplace climate/employee well-being contained in a number of Queensland Health databases, including the Patient Satisfaction Survey, the Clinical Incident database, the compliments and complaints database, the Variable Life Adjusted Display (VLAD) Database and the Better Workplaces Staff Opinion Survey database. Queensland Health sought to identify in what ways workplace climate is related to patient outcomes using existing datasets collected within the Queensland Health Centre for Healthcare Improvement. The process of establishing links involved matching aggregated data for specific facilities (where possible), or failing that, larger facilities (e.g. Hospital), or the Health Service District. Once the datasets had been matched on location or facility, correlations were calculated between the aggregated scores. The results demonstrated links between the data sets. These links showed that a better workplace climate is associated with greater reported numbers of clinical incidents, especially “no harm” clinical incidents. There was also a link between workplace climate and patient compliments/complaints which show that unsolicited compliments received from patients and their families are clearly related to a number of positive aspects of workplace climate (workplace morale, role clarity, and appraisal and recognition) and individual morale. The results linking workplace climate and patient satisfaction showed that there is a strong positive relationship between overall patient satisfaction and role clarity, and a negative relationship between overall patient satisfaction and both workplace distress and excessive work demands. While these results relate to historical data and therefore should not be construed to reflect the current state of operation within Queensland Health, they are still indicative of some very important relationships. This is the first study to demonstrate that more positive clinical management practices, better perceptions of the workplace climate and better employee well-being are a reflection of a better incident reporting and learning culture in a health care organization, ultimately resulting in improved patient outcomes

Validation of the English and Chinese versions of the Quick-FLIC quality of life questionnaire.

A useful measure of quality of life should be easy and quick to complete. Recently, we reported the development and validation of a shortened Chinese version of the Functional Living Index-Cancer (FLIC), which we called the Quick-FLIC. In the present study of 327 English-speaking and 221 Chinese-speaking cancer patients, we validated the English version of the Quick-FLIC and further assessed the Chinese version. The 11 Quick-FLIC items were administered alongside the 11 remaining items of the full FLIC, but there appeared to be little context effect. Validity of the English version of the Quick-FLIC was attested by its strong correlation with two other measures of quality of life, and its ability to detect differences between patients with different performance status and treatment status (each P<0.001). Its internal consistency (alpha=0.86) and test-retest reliability (intraclass correlation=0.76) were also satisfactory. The measure was responsive to changes in performance status (P<0.001). The Chinese version showed similar characteristics. The Quick-FLIC behaved in ways that are highly comparable with the FLIC, even though the Quick-FLIC comprised only 11 items whereas the FLIC comprised 22. Further research is required to see whether the use of shorter instruments can improve data quality and response rates, but the fact that shorter instruments place less burden on the patients is itself inherently important

Patient-Related Barriers to Timely Dialysis Access Preparation: A Qualitative Study of the Perspectives of Patients, Family Members, and Health Care Providers

Rational & Objective A key aspect of smooth transition to dialysis is the timely creation of a permanent access. Despite early referral to kidney care, initiation onto dialysis is still suboptimal for many patients, which has clinical and cost implications. This study aimed to explore perspectives of various stakeholders on barriers to timely access creation. Study Design Qualitative study. Setting & Participants Semi-structured interviews with 96 participants (response rate, 67%), including patients with stage 4 chronic kidney disease (n = 30), new hemodialysis patients with (n = 18) and without (n = 20) permanent access (arteriovenous fistula), family members (n = 19), and kidney health care providers (n = 9). Analytical Approach Thematic analysis. Results Patients reported differential levels of behavioral activation toward access creation: avoidance/denial, wait and see, or active intention. 6 core themes were identified: (1) lack of symptoms, (2) dialysis fear and practical concerns (exaggerated fear, pain, cost, lifestyle disruptions, work-related concerns, burdening their families), (3) evaluating value against costs/risks of access creation (benefits, threat of operation, viability, prompt for early initiation), (4) preference for alternatives, (5) social influences (hearsay, family involvement, experiences of others), and (6) health care provider interactions (mistrust, interpersonal tension, lack of clarity on information). Themes were common to all groups, whereas nuanced perspectives of family members and health care providers were noted in some subthemes. Limitations Response bias. Conclusions Individual, interpersonal, and psychosocial factors compromise dialysis preparation and contribute to suboptimal dialysis initiation. Our findings support the need for interventions to improve patient and family engagement and address emotional concerns and misperceptions about preparing for dialysis

Effect of disbonds on the fatigue endurance of composite scarf joints

The certification of scarf repairs requires that the repair is capable of handling flight loads in the presence of disbonds. This paper presents a study of the fatigue disbond growth behaviour of scarf joints. By determining the strain energy release rates of a disbond in a scarf joint subjected to a unit load, a predictive model based on linear elastic fracture mechanics is presented, which is shown to correlate well with experimental results. This method offers a promising technique for predicting the fatigue life of composite scarf joints with disbonds

Skeleton and fractal scaling in complex networks

We find that the fractal scaling in a class of scale-free networks originates from the underlying tree structure called skeleton, a special type of spanning tree based on the edge betweenness centrality. The fractal skeleton has the property of the critical branching tree. The original fractal networks are viewed as a fractal skeleton dressed with local shortcuts. An in-silico model with both the fractal scaling and the scale-invariance properties is also constructed. The framework of fractal networks is useful in understanding the utility and the redundancy in networked systems.Comment: 4 pages, 2 figures, final version published in PR

Differentiating the effects of negative state on optimism and the implicit perception of everyday injury risk

To date no research has examined the effects of negative state on the perception of everyday injury risk. Instead, studies have focussed more broadly on the relationship between mood and self- reported optimism. The present study had two aims. Firstly, to assess the effect of incidental anxiety on implicit injury risk perception using a modified Implicit Association Test (IAT). Secondly, it sought to compare any effect with that on a conventional measure of risk perception (optimism). In line with previous research, anxious participants perceived more risk (were less optimistic). In contrast, there was no significant correlation between anxiety and the implicit perception of everyday injury risk. Theoretical and practical implications are discussed

Fairness Beyond Disparate Treatment & Disparate Impact: Learning Classification without Disparate Mistreatment

Automated data-driven decision making systems are increasingly being used to assist, or even replace humans in many settings. These systems function by learning from historical decisions, often taken by humans. In order to maximize the utility of these systems (or, classifiers), their training involves minimizing the errors (or, misclassifications) over the given historical data. However, it is quite possible that the optimally trained classifier makes decisions for people belonging to different social groups with different misclassification rates (e.g., misclassification rates for females are higher than for males), thereby placing these groups at an unfair disadvantage. To account for and avoid such unfairness, in this paper, we introduce a new notion of unfairness, disparate mistreatment, which is defined in terms of misclassification rates. We then propose intuitive measures of disparate mistreatment for decision boundary-based classifiers, which can be easily incorporated into their formulation as convex-concave constraints. Experiments on synthetic as well as real world datasets show that our methodology is effective at avoiding disparate mistreatment, often at a small cost in terms of accuracy.Comment: To appear in Proceedings of the 26th International World Wide Web Conference (WWW), 2017. Code available at: https://github.com/mbilalzafar/fair-classificatio

Speed and spin differences between the old celluloid versus new plastic table tennis balls and the effect on the kinematic responses of elite versus sub-elite players

This study measured 1) the speed and spin differences between the old celluloid versus new plastic table tennis balls at pre ball-table impact and post ball-table impact when projected with topspin at 7.56 m.s-1, and investigated 2) the effect this has on the kinematic responses of 5 elite versus 5 sub-elite players’ forehand topspin in response to topspin and backspin. Plastic balls were lower in both speed and spin at pre and post ball-table impact compared with celluloid balls but the magnitude of change in speed and spin for each ball material differed. During flight before impact, plastic balls lost 3.98% more speed and 1.24% more spin than celluloid balls. Post ball-table impact, plastic balls showed a greater speed increment (0.69%) and smaller spin decrement (0.19%) than celluloid balls. Differences in players’ kinematic responses to the different ball materials were found only when players returned backspin shots. Players supinated their rackets more by 2.23% at ball-racket contact and produced 3.37% less ball spin when returning plastic compared with celluloid balls; an indication of an early adaptation to the lower spin rate of plastic balls. The lack of differences in kinematic response to topspin may be due to the similar changes in speed and spin of both types of balls at ball-table impact. It is not known if a higher initial ball projection velocity would evoke differences in movement responses from the players post ball-table impact but could be explored in future studies