The golden ticket: gaining in-person access to relatives in long-term care homes during the Covid-19 pandemic

Context: Governments made emergency declarations to restrict the presence of family carers in long-term care homes (LTCHs) as part of infection control measures during the pandemic. Within Canada, two visitor statuses were created: ‘essential’ to the health of the resident and ‘non-essential’ or ‘social visitor’, who were subject to additional restrictions. Objective: This study explored family carers’ experiences navigating in-person access to their relatives in LTCH during the pandemic. Methods: Using interpretive description, a sample of 14 family carers (nine daughters, five spouses) living in British Columbia, Canada, participated in in-depth interviews via video call about their experiences between March 2020 and June 2021. Findings: Analyses illustrated variability in carers’ visitor status across families and over time. Two key themes were identified: 1) “Fighting a Losing Battle” describes how reductionist attitudes and policies minimized the role of caregiving and resulted in traumatic disruptions in familial relationships; 2) “Who’s In and Who’s Out” captures inequities in how visitor status policies were applied. Limitations: Restrictions on conducting research during the pandemic resulted in a smaller sample of family carer participants. Implications: Findings highlight the patchwork implementation of visitor policies over the initial 17 months of the pandemic and the precarious space family carers continue to occupy within the LTC sector. Future research should focus on formalising support for family presence during public health emergencies

Determinants of voluntary audit and voluntary full accounts in micro- and non-micro small companies in the UK

This is an Author's Accepted Manuscript of an article published in Accounting and Business Research, 42(4), 441 - 468, 2012, copyright Taylor & Francis, available online at: http://www.tandfonline.com/10.1080/00014788.2012.667969.This study investigates the link between the auditing and filing choices made by a sample of 592 small private companies, which includes 419 micro-companies. It examines decisions made in connection with the 2006 accounts following UK's adoption of the maximum EU size thresholds in 2004, and the impact of the proposed Directive on the annual accounts of micro-companies. The research extends the model of cost, management and agency factors associated with voluntary audit, and develops a complementary model for voluntary full accounts. The results show the benefits of placing full audited accounts on public record that outweigh the costs for a significant proportion of companies. In non-micro small companies, voluntary audit is determined by cost and agency factors, whereas in micro-companies it is driven by cost, management and agency factors. In both groups, the predictors of voluntary full accounts include management and agency factors, and choosing voluntary audit is one of the key factors. The study provides models that can be tested in other jurisdictions to provide evidence of the needs of micro-companies, and the discussion of the methodological challenges for small company researchers in the UK makes further contribution to the literature

InSAR-Based Mapping to Support Decision-Making after an Earthquake

It has long been recognized that earthquakes change the stress in the upper crust around the fault rupture and can influence the behaviour of neighbouring faults and volcanoes. Rapid estimates of these stress changes can provide the authorities managing the post-disaster situation with valuable data to identify and monitor potential threads and to update the estimates of seismic and volcanic hazard in a region. Here we propose a methodology to evaluate the potential influence of an earthquake on nearby faults and volcanoes and create easy-to-understand maps for decision-making support after large earthquakes. We apply this methodology to the Mw 7.8, 2016 Ecuador earthquake. Using Sentinel-1 Interferometric Synthetic Aperture Radar (InSAR) and continuous GPS data, we measure the coseismic ground deformation and estimate the distribution of slip over the fault rupture. We also build an alternative source model using the Global Centroid Moment Tensor (CMT) solution. Then we use these models to evaluate changes of static stress on the surrounding faults and volcanoes and produce maps of potentially activated faults and volcanoes. We found, in general, good agreement between our maps and the seismic and volcanic events that occurred after the Pedernales earthquake. We discuss the potential and limitations of the methodology.This work is supported by the European Commission, Directorate-General Humanitarian Aid and Civil Protection (ECHO) under the SAFETY (Sentinel for Geohazards regional monitoring and forecasting) project (ECHO/SUB/2015/718679/Prev02) and by the Spanish Ministry of Economy and Competitiveness under INTERGEOSIMA (CGL2013-47412) and ACTIVESTEP (CGL2017-83931-C3), QUAKESTEP (1-P) + 3GEO(2-P) + GEOACTIVA (3-P) projects

Developing Product Label Information to Support Evidence-Informed Use of Vaccines in Pregnancy

Background: Product labelling information describing the use of vaccines in pregnancy continues to contain cautionary language even after clinical and epidemiological evidence of safety becomes available. This language raises safety concerns among healthcare providers who may hesitate to recommend vaccines during pregnancy. Purpose: To develop clear evidence-based language about vaccine safety and effectiveness in pregnancy for inclusion in vaccine product labels. Methods: We conducted a three-stage consensus-methods project with stakeholders, including: healthcare providers, vaccine regulators, industry representatives, and experts in public health, communication, law, ethics, and social sciences. Using qualitative and quantitative methods, we held a nominal group technique (NGT) meeting, followed by a Delphi survey, and then a consensus workshop with a subset of Delphi participants. We developed a methodological tool to analyse data for consensus. Principal results: Stakeholders (N = 14) at the NGT meeting drafted product label statements for evaluation in the Delphi survey. Survey participants (N = 41) provided feedback on statements for five hypothetical vaccines. Workshop participants (N = 27) initiated discussions that demonstrated a lack of awareness that the regulatory purpose of product labels is to provide a scientific summary of product-specific preclinical and clinical trial data. Each stage of this project built on earlier stages until we achieved strong consensus on the language, structure, and types of data that stakeholders wanted to include in inactivated influenza vaccine (IIV) and tetanus-diphtheria-acellular pertussis (Tdap) vaccine product labels in Canada. Conclusions: The revised statements for IIV and Tdap aligned with workshop participants’ goals that the product label be evidence-based, with a consistent structure and language that is easily understood by healthcare providers. Emergent methods uncovered stakeholder concerns about the regulatory purpose, content, and evidence used in product labels. Involving healthcare providers in the development and regular updating of product information could prevent interpretations of that information that contribute to vaccine hesitancy

Development, implementation and evaluation of the digital transformation of renal services in Wales: the journey from local to national

Background Treatment for people with kidney disease is often associated with complicated combinations of medicines. Logistical challenges with traditiona paper-based prescribing means that these patients are particularly susceptible to medication-relation errors and harm. Aim To improve the quality of care that people with kidney disease receive across Wales through a Value-Based digital transformation programme. Setting Renal units within the National Welsh Renal Clinical Network (WRCN). Development A novel Electronic Prescribing & Medicines Administration (EPMA) system, integrated into a patient care record and linked to a patient portal was developed in South West Wales (SWW) region of the WRCN, enabled by the Welsh Government (WG) Efficiency Through Technology Fund. National upscale was enabled through the WG Transformation Fund. Implementation EPMA was designed and rolled out initially in SWW region of the WRCN (2018). A dedicated delivery team used the blueprint to finalise and implement a strategy for successful national roll-out eventually across all Wales (completed 2021). Evaluation A multi-factorial approach was employed, as both the technology itself and the healthcare system within which it would be introduced, were complex. Continuous cycles of action research involving informal and formal qualitative interviews with service-users ensured that EPMA was accessible and optimally engaging to all target stakeholders (patients and staff). Results confirmed that EPMA was successful in improving the quality of care that people with kidney disease receive across Wales, contributed to Value-Based outcomes, and put people who deliver and access care at the heart of transformation. Conclusion Key findings of this study align directly with the national design principles to drive change and transformation, put forward by the WG in their plan for Health and Social Care: prevention and early intervention; safety; independence; voice; seamless care

Project manager-to-project allocations in practice: an empirical study of the decision-making practices of a multi-project based organization

Empirical studies that examine how managers make project manager-to-project (PM2P) allocation decisions in multi-project settings are currently limited. Such decisions are crucial to organizational success. An empirical study of the PM2P practice, conducted in the context of Botswana, revealed ineffective processes in terms of optimality in decision-making. A conceptual model to guide effective PM2P practices was developed. The focus of this study is on deploying the model as a lens to study the PM2P practices of a large organization, with a view to identify and illustrate strengths and weaknesses. A case study was undertaken in the mining industry, where core activities in terms of projects are underground mineral explorations at identified geographical regions. A semi-structured interview protocol was used to collect data from 15 informants, using an enumeration. Integrated analysis of both data types (using univariate descriptive analysis for the quantitative data, content and thematic analysis for the qualitative data) revealed strengths in PM2P practices, demonstrated by informants’ recognition of some important criteria to be considered. The key weaknesses were exemplified by a lack of effective management tools and techniques to match project managers to projects. The findings provide a novel perspective through which improvements in working practices can be made

The BEST site on the internet: An online resource for beginning and establishing successful teachers

Beginning teachers face enormous challenges in their first year of teaching. High attrition rates of teachers within the first five years attest to the difficulties inherent in commencing professional life as a teacher. This paper describes the design, development and evaluation of a website designed to relieve many of the problems of professional isolation encountered by beginning teachers. The website allows new teachers, and preservice teachers on school practice, to communicate with each other and expert teacher mentors through discussion boards, and provides access to a range of resources including lesson plans, annotated lists of useful websites, weblogs, wikis and frequently asked questions. The paper describes the theoretical foundations of the approach, the features of the site in detail and the plan for effectiveness evaluation of the site

The design of an online community of practice for beginning teachers

Beginning teachers face enormous challenges in their first year of teaching. High attrition rates of teachers within the first five years attest to the difficulties inherent in commencing professional life as a teacher. This paper describes the design of a Web site developed to overcome many of the problems of professional isolation encountered by beginning teachers. The Web site allows new teachers to access curriculum resources that are dynamically updated through RSS feeds, to communicate with each other and expert teacher mentors through discussion boards, and to reflect on practice through weblogs. The paper describes the theoretical foundations of the approach, the features of the site in detail, and the plan for evaluation of the site