Medicine and Health Sciences Commons^™

Ssrn As An Initial Revolution In Academic Knowledge Aggregation And Dissemination, David Bray, Sascha Vitzthum, Benn Konsynski

Sascha Vitzthum

Within this paper we consider our results of using the Social Science Research Network (SSRN) over a period of 18 months to distribute our working papers to the research community. Our experiences have been quite positive, with SSRN serving as a platform both to inform our colleagues about our research as well as inform us about related research (through email and telephoned conversations of colleagues who discovered our paper on SSRN). We then discuss potential future directions for SSRN to consider, and how SSRN might well represent an initial revolution in 21st century academic knowledge aggregation and dissemination. Our paper …

Towards Self-Organizing, Smart Business Networks: Let’S Create ‘Life’ From Inert Information, David Bray, Benn Konsynski

David A. Bray

We review three different theories that can inform how researchers can determine the performance of smart business networks, to include: (1) the Theory of Evolution, (2) the Knowledge-Based Theory of the Firm, and (3) research insights into computers and cognition. We suggest that each of these theories demonstrate that to be generally perceived as smart, an organism needs to be self-organizing, communicative, and tool-making. Consequentially, to determine the performance of a smart business network, we suggest that researchers need to determine the degree to which it is self-organizing, communicative, and tool-making. We then relate these findings to the Internet and …

Rules Of Engagement: Residents' Perceptions Of The In-Training Evaluation Process, Christopher Watling, Cynthia Kenyon, Elaine Zibrowski, Valerie Schulz, Mark Goldszmidt, Indu Singh, Heather Maddocks, Lorelei Lingard

Lorelei Lingard

BACKGROUND: In-training evaluation reports (ITERs) often fall short of their goals of promoting resident learning and development. Efforts to address this problem through faculty development and assessment-instrument modification have been disappointing. The authors explored residents' experiences and perceptions of the ITER process to gain insight into why the process succeeds or fails.

METHOD: Using a grounded theory approach, semistructured interviews were conducted with 20 residents. Constant comparative analysis for emergent themes was conducted.

RESULTS: All residents identified aspects of "engagement" in the ITER process as the dominant influence on the success of ITERs. Both external (evaluator-driven, such as evaluator credibility) …

Interprofessional Communication And Medical Error: A Reframing Of Research Questions And Approaches, Lara Varpio, Pippa Hall, Lorelei Lingard, Catherine Schryer

Lorelei Lingard

Progress toward understanding the links between interprofessional communication and issues of medical error has been slow. Recent research proposes that this delay may result from overlooking the complexities involved in interprofessional care. Medical education initiatives in this domain tend to simplify the complexities of team membership fluidity, rotation, and use of communication tools. A new theoretically informed research approach is required to take into account these complexities. To generate such an approach, we review two theories from the social sciences: Activity Theory and Knotworking. Using these perspectives, we propose that research into interprofessional communication and medical error can develop better …

Point-Of-Care Assessment Of Medical Trainee Competence For Independent Clinical Work, Tara Kennedy, Glenn Regehr, G. Baker, Lorelei Lingard

Lorelei Lingard

BACKGROUND: Clinical supervisors make frequent assessments of medical trainees' competence so they can provide appropriate opportunities for trainees to experience clinical independence. This study explored context-specific assessments of trainees' competence for independent clinical work.

METHOD: In Phase One, 88 teaching team members from internal and emergency medicine were observed during clinical activities (216 hours), and 65 participants completed brief interviews. In Phase Two, 36 in-depth interviews were conducted using video vignettes. Data collection and analysis employed grounded theory methodology.

RESULTS: Supervisors' assessments of trainee trustworthiness for independent clinical work involved consideration of four dimensions: knowledge/skill, discernment of limitations, truthfulness, and …

Response: Hiv Testing For Whole Populations, Daniel Halperin, Malcolm Potts, Doug Kirby, Jeff Klausner, Richard Wamai, Ann Swidler, Elliot Marseille, Norman Hearst

Richard G. Wamai

No abstract provided.

Grounded Theory, Mixed Methods, And Action Research, Lorelei Lingard, Mathieu Albert, Wendy Levinson

Lorelei Lingard

No abstract provided.

Critically Appraising Qualitative Research, Ayelet Kuper, Lorelei Lingard, Wendy Levinson

Lorelei Lingard

No abstract provided.

Doctors As Patients: A Systematic Review Of Doctors' Health Access And The Barriers They Experience, Margaret Kay, Geoffrey Mitchell, Alexandra Clavarino, Jenny Doust

Jenny Doust

Background The need to improve doctors' access to health care by reducing the barriers they experience has been regularly described in the literature, yet the barriers experienced are not well defined, despite the volume of expert opinion in this area. Aim To define what is known about doctors' access to health care from the data within the current literature.Design of study A systematic review of studies of doctors' health access.Method A systematic search of MEDLINE® and CINAHL, supplemented by citation searches and searches of the grey literature, identified both quantitative and qualitative studies. Two reviewers used specific criteria for inclusion …

Know When To Rock The Boat: How Faculty Rationalize Students' Behaviors, Shiphra Ginsburg, Lorelei Lingard, Glenn Regehr, Kathryn Underwood

Lorelei Lingard

BACKGROUND: When faculty evaluate medical students' professionalism, they make judgments based on the observation of behaviors. However, we lack an understanding of why they feel certain behaviors are appropriate (or not).

OBJECTIVE: To explore faculty's reasoning around potential student behaviors in professionally challenging situations.

DESIGN: Guided interviews with faculty who were asked to respond to 5 videotaped scenarios depicting students in professionally challenging situations.

SUBJECTS: Purposive sample of 30 attending Internists and surgeons.

APPROACH: Transcripts were analyzed using modified grounded theory to search for emerging themes and to attempt to validate a previous framework based on student responses.

RESULTS: Faculty's …

Biomedical Scientists' Perception Of The Social Sciences In Health Research, Mathieu Albert, Suzanne Laberge, Brian Hodges, Glenn Regehr, Lorelei Lingard

Lorelei Lingard

The growing interest in interdisciplinary research within the Canadian health sciences sector has been manifested by initiatives aimed at increasing the involvement of the social sciences in this sector. Drawing on Bourdieu's concept of field and Knorr-Cetina's concept of epistemic culture, this study explores the extent to which it is possible for the social sciences to integrate into, and thrive in, a field in which the experimental paradigm occupies a hegemonic position. Thirty-one semi-structured interviews were conducted to explore biomedical scientists' receptiveness toward the social sciences in general and to qualitative research in particular. We found that these respondents exhibited …

Catalyzing And Sustaining Communities Of Collaboration Around Interprofessional Care: An Evaluation Of Four Educational Programs, Eileen Egan-Lee, Elisa Hollenberg, Dale Dematteo, Stasey Tobin, Ivy Oandasan, Mary-Agnes Beduz, Debbie Kwan, Karen Leslie, Jacques Lee, Maria Tassone, Jane Merkley, Lorelei Lingard, Lynne Sinclair, Mandy Lowe, Danny Nashman, Cate Creede, Doreen Day, Ivan Silver, Scott Reeves

Lorelei Lingard

No abstract provided.

Reassessing Hiv Prevention, Malcolm Potts, Daniel Halperin, Douglas Kirby, Ann Swidler, Elliot Marseille, Jeffrey Klausner, Norman Hearst, Richard Wamai, James Kahn, Julia Walsh

Richard G. Wamai

No abstract provided.

Seriously Working Together: Integrated Governance Models To Achieve Sustainable Partnerships Between Health Care Organisations, Claire Jackson, Caroline Nicholson, Jenny Doust, Lily Cheung, John O'Donnell

Jenny Doust

Objective: To identify sustainable governance arrangements for health care organisations undertaking integrated health service delivery based on best available evidence. Method: Systematic review of the literature (1990–2006), supported by key informant interviews as an integrative process. Results: 16 studies met our selection criteria. All described enablers of and barriers to delivering integrated health services. We identified three models for integrated health care governance with a demonstrated ability to be sustained in the medium term. Common themes that emerged as the logical starting point for more ambitious integrated governance arrangements regionally were: the need for a clear separation between governance and …

Experts Call For Rethinking Aids Money, Richard Wamai

Richard G. Wamai

No abstract provided.

Determinants Of Malnutrition In Senegal: Individual, Household, Community Variables, And Their Interaction, Sebastian Linnemayr, Harold Alderman, Abdoulaye Ka

Sebastian Linnemayr

The relationship between poverty and nutrition is a two-sided one: on the one hand, economic growth (which is generally associated with an eradication of poverty) leads to reduced malnutrition. On the other hand, nutrition is one of the key ingredients for human capital formation, which in turn represents one of the fundamental factors of growth. There are numerous studies that show the correlates of malnutrition using both household- and community-level variables. However, few of these studies allow for the potential endogeneity of community infrastructure or indicate their interplay with characteristics of the mother. The current study considers the socio-economic determinants …

Effectiveness Of A Community-Based Intervention To Improve Nutrition In Young Children In Senegal: A Difference In Difference Analysis, Harold Alderman, Biram Ndiaye, Sebastian Linnemayr, Abdoulaye Ka, Claudia Rokx, Khadidiatou Dieng, Menno Mulder-Sibanda

Sebastian Linnemayr

There are few studies of community growth promotion as a means of addressing malnutrition that are based on longitudinal analysis of large-scale programmes with adequate controls to construct a counterfactual. The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006. The project, designed to extend nutrition and growth promotion intervention into rural areas through non-governmental organisation service providers, significantly lowered the risk of a child having a weight more than 2 sd …

The Rhetoric Of Patient Voice: Reported Talk With Patients In Referral And Consultation Letters, Marlee Spafford, Catherine Schryer, Lorelei Lingard

Lorelei Lingard

Referral and consultation letters are written to enable the exchange of patient information and facilitate the trajectory of patients through the healthcare system. Yet, these letters, written about yet apart from patients, also sustain and constrain professional relationships and influence attitudes towards patients. We analysed 35 optometry referral letters and 35 corresponding ophthalmology consultation letters for reported 'patient voice' coded as 'experience' or 'agenda' and we interviewed 15 letter writers (eight optometry students, six optometrists, and one community ophthalmologist). There were 80 instances of reported 'patient voice' in 35 letters. The majority (68%) of the instances occurred in referral letters, …

Is Male Circumcision As Good As The Hiv Vaccine We’Ve Been Waiting For?, Jeffrey Klausner, Richard Wamai, Kasonde Bowa, Kawango Agot, Jesse Kagimba, Daniel Halperin

Richard G. Wamai

No abstract provided.

The Physical Activity Levels Of Preschool-Aged Children: A Systematic Review, Patricia Tucker

Trish Tucker

No abstract provided.

Male Circumcision Is An Efficacious, Lasting And Cost-Effective Strategy For Combating Hiv In High-Prevalence Aids Epidemics: Time To Move Beyond Debating The Science, Richard Wamai

Richard G. Wamai

Letter to the editor, from R.G. Wamai + 43 co-authors

Stemming The Global Obesity Epidemic: What Can We Learn From Data About Social And Economic Trends?, Roland Sturm

Roland Sturm

No abstract provided.