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- Fu, Becky Q., et al.
(författare)
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Barriers and Facilitators to Implementing Interventions for Reducing Avoidable Hospital Readmission: Systematic Review of Qualitative Studies
- 2023
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Ingår i: International Journal of Health Policy and Management. - : KERMAN UNIV MEDICAL SCIENCES. - 2322-5939 .- 2322-5939. ; 12, s. 1-17
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Forskningsöversikt (refereegranskat)abstract
- Background: Avoidable hospital readmission is a major problem among health systems. Although there are effective peri-discharge interventions for reducing avoidable hospital readmission, successful implementation is challenging. This systematic review(SR) of qualitative studies aimed to identify barriers and facilitators to implementing peri-discharge interventions from providers and service users perspectives.Methods: We searched four databases for potentially eligible qualitative studies from databases inception to Mar 2020, and updated literature search for studies published between 2020 to Oct 2021. Barriers and facilitators to implementing peri-discharge interventions were identified and mapped onto the Consolidated Framework for Implementation Research(CFIR) constructs. Inductive analysis of the CFIR constructs was performed to yield thematic areas that illustrated the relationship between various facilitators and barriers, generating practical insights to key implementation issues. Results: Thirteen qualitative studies were included in this SR. Key issues were clustered in the CFIR constructs of Design Quality and Complexity of the intervention, strength of Network and Communication, being responsive to Patient Needs with sufficient Resource support, and External Incentives. The three thematic areas were rationality of the interventions, readiness and effort of multidisciplinary implementation teams, and influence of external stakeholders. Common barriers included i) limited resources, ii) poor communication among team members, iii) incompatibility between the new intervention and existing work routine, iv) complicated implementation process, v) low practicality of supporting instruments, and vi) lack of understanding about the content and effectiveness of the new interventions. Common facilitators were i) information sharing via regular meetings on implementation issues, ii) organizational culture that values quality and accountability, iii) financial penalties for hospitals with high avoidable readmissions rates, iv) external support offered via quality improvement programs and community resources, and v) senior leadership support. Conclusions: This study synthesized commonly-presenting barriers and facilitators to implementing peri-discharge interventions among different healthcare organizations. Findings may inform development of implementation strategies in different health systems after appropriate tailoring, based on a consensus-based formative research process.
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- Lang, Justin J., et al.
(författare)
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Top 10 International Priorities for Physical Fitness Research and Surveillance Among Children and Adolescents : A Twin-Panel Delphi Study
- 2023
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Ingår i: Sports Medicine. - New Zealand : Adis International Ltd.. - 0112-1642 .- 1179-2035. ; 53:2, s. 549-564
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Tidskriftsartikel (refereegranskat)abstract
- Background The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts. Objective This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents. Methods Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel. Results There was strong between-panel agreement (panel 1: r(s) = 0.76, p < 0.01; panel 2: r(s) = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) "conduct longitudinal studies to assess changes in fitness and associations with health". This was followed by (ii) "use fitness surveillance to inform decision making", and (iii) "implement regular and consistent international/national fitness surveys using common measures". Conclusions The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.
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- Wang, Lifeng, et al.
(författare)
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Massive MIMO in Spectrum Sharing Networks: Achievable Rate and Power Efficiency
- 2017
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Ingår i: IEEE Systems Journal. - : IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC. - 1932-8184 .- 1937-9234. ; 11:1, s. 20-31
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Tidskriftsartikel (refereegranskat)abstract
- Massive multiple input multiple output (MIMO) is one of the key technologies for fifth generation and can substantially improve energy and spectrum efficiencies. This paper explores the potential benefits of massive MIMO in spectrum sharing networks. We consider a multiuser MIMO primary network, with N-P-antenna primary base station (PBS) andK singleantenna primary users (PUs), and a multiple-input-single-output secondary network, with N-S-antenna secondary base station and a single-antenna secondary user. Using the proposed model, we derive a tight closed-form expression for the lower bound on the average achievable rate, which is applicable to arbitrary system parameters. By performing large-system analysis, we examine the impact of large number of PBS antennas and large number of PUs on the secondary network. It is shown that, when N-P and K grow large, N-S must be proportional to lnK or larger, to enable successful secondary transmission. In addition, we examine the impact of imperfect channel state information on the secondary network. It is shown that the detrimental effect of channel estimation errors is significantly mitigated as N-S grows large.
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