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- Aronsson, Håkan, 1961-, et al.
(author)
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Managing health care decisions and improvement through simulation modeling
- 2011
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In: Quality Management in Health Care. - : Wolters Kluwer. - 1063-8628 .- 1550-5154. ; 20:1, s. 15-29
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Journal article (peer-reviewed)abstract
- Simulation modeling is a way to test changes in a computerized environment to give ideas for improvements before implementation. This article reviews research literature on simulation modeling as support for health care decision making. The aim is to investigate the experience and potential value of such decision support and quality of articles retrieved. A literature search was conducted, and the selection criteria yielded 59 articles derived from diverse applications and methods. Most met the stated research-quality criteria. This review identified how simulation can facilitate decision making and that it may induce learning. Furthermore, simulation offers immediate feedback about proposed changes, allows analysis of scenarios, and promotes communication on building a shared system view and understanding of how a complex system works. However, only 14 of the 59 articles reported on implementation experiences, including how decision making was supported. On the basis of these articles, we proposed steps essential for the success of simulation projects, not just in the computer, but also in clinical reality. We also presented a novel concept combining simulation modeling with the established plan-do-study-act cycle for improvement. Future scientific inquiries concerning implementation, impact, and the value for health care management are needed to realize the full potential of simulation modeling.
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| 2. |
- Mandere, Nicodemus, et al.
(author)
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Assessing the contribution of alternative agriculture to poverty reduction and employment creation: A case study of sugar beet cultivation in Kenya
- 2011
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In: African Journal of Agricultural Research. - 1991-637X. ; 6:2, s. 440-450
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Journal article (peer-reviewed)abstract
- In Kenya, the government is promoting high-value and drought resistant crop varieties in an effort to reduce poverty in rural areas. Sugar beet is one such crop. This study was conducted with two objectives: 1) to assess the opportunities and challenges for sugar beet cultivation and adoption in the Nyandarua district of Kenya and 2) to assess whether sugar beet adoption can offer an opportunity for escaping poverty for smallholder farmers in the district. The factors favoring sugar beet cultivation and adoption in the district include: adequate land area suitable for sugar beet cultivation and the high sugar beet yield that can be attained per unit suitable land area, farmers' awareness of the positive aspects of sugar beet cultivation, and the willingness of many farmers to grow the sugar beet crop. Notwithstanding these favorable conditions, some socio-economic factors-mainly the affordability of sugar beet production and possible lack of appropriate farming technologies, will present challenges to widespread sugar beet adoption, particularly to those farmers in the low-and medium-income categories. The sugar beet profit analysis showed that depending on the market price, sugar beet can potentially increase household net income. However, since the majority of households are in the low-and medium-income categories, for sugar beet to pull the smallholder farmers out of poverty, interventions from government and other stakeholders is of vital necessity. The impact of sugar beet adoption and cultivation will vary from household to household. Those households within the high-income category who can raise the required start up capital are likely to benefit, while the low-and medium-income households may not, which is true for any new crop with high start up costs. Alternative agriculture alone is therefore not a sufficient strategy to address the problems of poverty and unemployment. Any successful strategy to address these issues must be broad-based, and include alternative agriculture and other growth and development strategies. Provision for the entire necessary infrastructure should precede or accompany all of these strategies in order to optimize implementation benefits.
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