453 research outputs found
Predicting university performance in psychology: the role of previous performance and discipline-specific knowledge
Recent initiatives to enhance retention and widen participation ensure it is crucial to understand the factors that predict students' performance during their undergraduate degree. The present research used Structural Equation Modeling (SEM) to test three separate models that examined the extent to which British Psychology students' A-level entry qualifications predicted: (1) their performance in years 1-3 of their Psychology degree, and (2) their overall degree performance. Students' overall A-level entry qualifications positively predicted performance during their first year and overall degree performance, but negatively predicted their performance during their third year. Additionally, and more specifically, students' A-level entry qualifications in Psychology positively predicted performance in the first year only. Such findings have implications for admissions tutors, as well as for students who have not studied Psychology before but who are considering applying to do so at university
The State of Accreditation Readiness in Georgia: A Case Study
Background: Georgia’s public health districts first began exploring the idea of national public health accreditation in 2008 when Cobb & Douglas Public Health included accreditation in their strategic plan. In May 2015, Cobb & Douglas Public Health was the first Georgia public health district to achieve national accreditation status. This article discusses the current state of accreditation readiness in Georgia and explores strengths and barriers to accreditation.
Methods: This study utilized a case study approach in order to examine PHAB accreditation efforts in Georgia within a real life context. Data came from three sources: nine Accreditation Readiness Assessments, a PHAB Pre-Application Technical Assistance Survey, and state-wide Accreditation Readiness Survey.
Results: The Accreditation Readiness Assessments resulted in several lessons learned about common strengths and barriers to accreditation. Strengths included a dedicated staff and supportive Boards of Health. Barriers included accreditation fees and a lack of personnel time. The PHAB Pre-application TA Survey revealed that the majority of those surveyed would recommend TA to other agencies pursuing PHAB accreditation (91%). The Accreditation Readiness Survey revealed that 14 of 18 GA public health districts are either PHAB accredited (1 district), actively pursuing PHAB accreditation (2 districts), or planning to apply (11 districts). This includes 116 of the 159 Georgia counties (73%).
Conclusions: The results of this case study show that 72% of Georgia’s public health districts are engaged in accreditationrelated activities. This includes activities such as accreditation readiness assessment, community health assessment, QI council and plan development, strategic planning, and policy review
Clarifying and Expanding Concepts of Cross-Jurisdictional Sharing: Early Lessons Learned from Conducting QI with Georgia’s Health Districts
Research Objective: Assess the legal and organization cultural foundations for Cross-Jurisdictional Sharing (CJS) in support of local public health accreditation and QI in Georgia.
Data Sets and Sources: Archival data (primarily state statutes), secondary data from previous qualitative comparative research on Deep South public health organization, secondary data from previous surveys, and oral interviews and written communication.
Study Design: Primarily Qualitative design combining ethnographic and participatory research methods.
Analysis: Qualitative Content analysis based on predetermined and emergent themes.
Principal Findings: Georgia’s Health Districts have emerged as major CJS entities that support delivery of essential services and local public health (LPH) QI and LPH accreditation readiness, driven primarily by local organizational leadership and culture that is facilitated through enabling statutes in contrast to more top-down state-mandating statutes, regulations and directives.
Conclusion: Georgia’s use of districts as multi-county public health entities serves as a primary structure for providing local public health services and has become a critical structure to address the looming demands for QI and accreditation, even though the statutes clearly establish the county as the primary local public health entity.
Implications for the Field of PHSSR: This CJS structure to facilitate public health QI and accreditation in Georgia illustrates how agency cultures can emerge from local demands for economies of scale, more than formal policies generated at state level. This is a model that could be very important for advancing CJS in other regions of the country
The State of Accreditation Readiness in Georgia: A Case Study
Background: Georgia’s public health districts first began exploring the idea of national public health accreditation in 2008 when Cobb & Douglas Public Health included accreditation in their strategic plan. In May 2015, Cobb & Douglas Public Health was the first Georgia public health district to achieve national accreditation status. This article discusses the current state of accreditation readiness in Georgia and explores strengths and barriers to accreditation.
Methods: This study utilized a case study approach in order to examine PHAB accreditation efforts in Georgia within a reallife context. Data came from three sources: nine Accreditation Readiness Assessments, a PHAB Pre-Application Technical Assistance Survey, and state-wide Accreditation Readiness Survey.
Results: The Accreditation Readiness Assessments resulted in several lessons learned about common strengths and barriers to accreditation. Strengths included a dedicated staff and supportive Boards of Health. Barriers included accreditation fees and a lack of personnel time. The PHAB Pre-application TA Survey revealed that the majority of those surveyed would recommend TA to other agencies pursuing PHAB accreditation (91%). The Accreditation Readiness Survey revealed that 14 of 18 GA public health districts are either PHAB accredited (1 district), actively pursuing PHAB accreditation (2 districts), or planning to apply (11 districts). This includes 116 of the 159 Georgia counties (73%).
Conclusions: The results of this case study show that 72% of Georgia’s public health districts are engaged in accreditationrelated activities. This includes activities such as accreditation readiness assessment, community health assessment, QI council and plan development, strategic planning, and policy review
Assessing a Quality Improvement Project in a Georgia County Health Department
The study and evaluation of quality improvement among Georgia’s public health systems continues to be a major priority for the Georgia Public Health Practice Based Research Network (GAPH-PBRN). This article focuses on the application and evaluation of a Quality Improvement project in a Georgia County Health Department. The QI team sought to reduce the waiting time in the teen clinic; thereby, increasing the Quality Improvement culture one project at a time in this Health Department. The project revealed that Quality Improvement is a continuous process that requires change and adaptation by employees. This initial Quality Improvement project was the first step in helping to establish Quality Improvement culture in the County Health Department
Extramedullary disease in multiple myeloma: a systematic literature review
Extramedullary involvement (or extramedullary disease, EMD) represents an aggressive form of multiple myeloma (MM), characterized by the ability of a clone and/or subclone to thrive and grow independent of the bone marrow microenvironment. Several different definitions of EMD have been used in the published literature. We advocate that true EMD is restricted to soft-tissue plasmacytomas that arise due to hematogenous spread and have no contact with bony structures. Typical sites of EMD vary according to the phase of MM. At diagnosis, EMD is typically found in skin and soft tissues; at relapse, typical sites involved include liver, kidneys, lymph nodes, central nervous system (CNS), breast, pleura, and pericardium. The reported incidence of EMD varies considerably, and differences in diagnostic approach between studies are likely to contribute to this variability. In patients with newly diagnosed MM, the reported incidence ranges from 0.5% to 4.8%, while in relapsed/refractory MM the reported incidence is 3.4 to 14%. Available data demonstrate that the prognosis is poor, and considerably worse than for MM without soft-tissue plasmacytomas. Among patients with plasmacytomas, those with EMD have poorer outcomes than those with paraskeletal involvement. CNS involvement is rare, but prognosis is even more dismal than for EMD in other locations, particularly if there is leptomeningeal involvement. Available data on treatment outcomes for EMD are derived almost entirely from retrospective studies. Some agents and combinations have shown a degree of efficacy but, as would be expected, this is less than in MM patients with no extramedullary involvement. The paucity of prospective studies makes it difficult to justify strong recommendations for any treatment approach. Prospective data from patients with clearly defined EMD are important for the optimal evaluation of treatment outcomes
Health Districts as Quality Improvement Collaboratives and Multi-Jurisdictional Entities
Research Objective: The Georgia Public Health PBRN assessed the utility of the Multi-county Health District as a structured Quality Improvement Collaborative (QIC), and as multi jurisdictional entities for purposes of meeting standards for accreditation by the Public Health Accreditation Board.
Data Sets and Sources: Data were collected from online surveys followed up with phone interviews or paper surveys to maximize participation. A newly developed clinical care QIC instrument (Schouten et al, 2010) was modified to collect data with a revised focus on QICs for public health. We retained QI culture constructs in the instrument while shifting the focus from healthcare to public health essential services related to accreditation standards.
Study Design: Data was collected from a purposeful sample of local public health key informants in Georgia who were identified by the District Directors’ office as local key informants. Invitations Key informants included county and district staff and county board of health members.
Analysis: Psychometric testing of the QIC assessment instrument included tests for validity and reliability. Census-based and self-reported demographic characteristics were used to compare responses.
Principal Findings: Strong consensus emerged across various constituencies that Districts were critical for local public health to provide essential services. Key opinion leaders from both the rural and non-rural counties agreed that the Districts were important.
Conclusion: Regionalization using Georgia Districts has major potential for supporting QI and meeting quality assurance standards associated with accreditation.
Implications for Field of PHSSR: Accreditation has the potential to substantially clarify and enhance the role of public health in the 21st century. But local public health agencies, based on small municipality or county populations, are unlikely to possess and sustain capacity to meet the challenges of comprehensive essential services. Regionalization of local public health capacity is a critical emerging issue with the launching of public health accreditation
Extramedullary disease in multiple myeloma: a systematic literature review
Extramedullary involvement (or extramedullary disease, EMD) represents an aggressive form of multiple myeloma (MM), characterized by the ability of a clone and/or subclone to thrive and grow independent of the bone marrow microenvironment. Several different definitions of EMD have been used in the published literature. We advocate that true EMD is restricted to soft-tissue plasmacytomas that arise due to hematogenous spread and have no contact with bony structures. Typical sites of EMD vary according to the phase of MM. At diagnosis, EMD is typically found in skin and soft tissues; at relapse, typical sites involved include liver, kidneys, lymph nodes, central nervous system (CNS), breast, pleura, and pericardium. The reported incidence of EMD varies considerably, and differences in diagnostic approach between studies are likely to contribute to this variability. In patients with newly diagnosed MM, the reported incidence ranges from 0.5% to 4.8%, while in relapsed/refractory MM the reported incidence is 3.4 to 14%. Available data demonstrate that the prognosis is poor, and considerably worse than for MM without soft-tissue plasmacytomas. Among patients with plasmacytomas, those with EMD have poorer outcomes than those with paraskeletal involvement. CNS involvement is rare, but prognosis is even more dismal than for EMD in other locations, particularly if there is leptomeningeal involvement. Available data on treatment outcomes for EMD are derived almost entirely from retrospective studies. Some agents and combinations have shown a degree of efficacy but, as would be expected, this is less than in MM patients with no extramedullary involvement. The paucity of prospective studies makes it difficult to justify strong recommendations for any treatment approach. Prospective data from patients with clearly defined EMD are important for the optimal evaluation of treatment outcomes
Foreign policy and political possibility
This article explores the relationship between foreign policy and political possibility in two parts. First, the relationship between foreign policy and political possibility is theorized around three analytical moments: political possibility is linked to the framing of conceivable, communicable and coercive foreign policy. Second, this framework is developed and demonstrated through a brief analysis of Coalition foreign policy in the War on Terror, considering American, British and Australian foreign policy between 2001 and 2003. This analysis dissects distinct and divergent Coalition foreign policies through a linked three-part conceptualization of political possibility. It enables an understanding of how the War on Terror was rendered possible through the construction of foreign policy in thinkable, resonant and ultimately dominant terms. The article concludes by looking to the wider analytical applicability of this particular theorization of the relationship between foreign policy and political possibility
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