It’s a Relationship: A Qualitative Exploration of the Challenges to Interorganizational Collaborative Relationships

Interorganizational collaboration is increasingly used to address social issues, but it can fail when the underlying relationships become damaged. This study explores the qualities, characteristics, and processes that can fracture collaborative relationships and the consequences of failing to correct these fractures. Using a qualitative design, interview data were collected from 19 executive directors of Canadian human service organizations. The findings highlight several challenges to collaboration and show the importance of exploring negative outcomes of inaction. An additional aim of this study is to provide strategies for building and nurturing collaborative relationships

Exploring the Nature of Collaboration Between Organizations Assisting Persons Experiencing Poverty in the Region of Waterloo, Ontario

The current study was designed to examine the experiences of organizations assisting individuals who are economically vulnerable in Waterloo Region through interorganizational collaboration. Several questions were explored in order to gain a deeper understanding of the definition of collaboration, for whom collaboration is useful, how often and with whom organizations collaborate, techniques used during collaboration, and whether collaboration should be increased and improved. Twenty Executive Directors from organizations most strongly involved in the assistance of those experiencing poverty were asked to participate in face-to-face interviews where they were asked questions based on the above mentioned questions. Qualitative analysis of the interviews demonstrated that all participants had experience with inter-organizational collaboration and overall, collaboration was believed to be an important way to resolve complex social issues like poverty. All participants offered information regarding collaboration that was placed into five main themes: definition, capacity to address social issues, quantity of collaboration, reasons and recommendations for, and challenges of aggrandized collaboration, the process, and relationship building. It was found that participants fell into one of three categories in terms of their overall feeling about collaboration: enthusiastic collaborators are those who seek, promote and use collaboration often; ambivalent collaborators are those who frequently collaborate and like collaboration, but would also be willing to address poverty without engaging in collaborative efforts; resistant collaborators are those who will use collaboration if necessary but do not actively seek to collaborate and encourage other ways to address social issues. Regardless of feelings toward collaboration, overall, it was felt to be a useful way to help address societal challenges such as poverty

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien\u2013Dindo Grades III\u2013V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49\u20132.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46\u20130.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease

Body mass index and complications following major gastrointestinal surgery: a prospective, international cohort study and meta-analysis.

AIM: Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data. METHODS: This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. RESULTS: This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46-0.75, P < 0.001) compared to normal weight patients. CONCLUSIONS: In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease