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1. Management of information technology and quality performance in health care facilities

Author

James A. Rodger, David Paper, and Parag C. Pendharkar

Subjects
Information management, HRHIS, Knowledge management, business.industry, Data management, media_common.quotation_subject, Information technology, Health care, Information technology management, Quality (business), Marketing, business, Quality policy, media_common
Abstract

The objective of this research was to investigate the moderating effect of information technology (1T) infrastructure on the relationship between health care information management and quality performance within health care departments. The variables that were measured included both management and customer perceptions of quality, management of health care information (MOHCI), and IT infrastructure. This research focused on the determinants of departmental quality. The study conceptualized and developed measures for quality, MOHCI, and IT infrastructure variables. A significant relationship was observed between the management of health care information and quality performance. IT infrastructure exhibited a direct, rather than a moderating, effect on quality performance. The research also found/ that significant differences exist between customer and manager perceptions of quality.

Published
1999

2. An empirical study for measuring operating room quality performance attributes

Author

David Paper, James A. Rodger, and Parag C. Pendharka

Subjects
Marketing, Information Systems and Management, business.industry, Strategy and Management, media_common.quotation_subject, Operating room management, Quality performance, Computer Science Applications, Empirical research, Management of Technology and Innovation, Health care, Operations management, Quality (business), business, media_common
Abstract

Rising health care costs and customer dissatisfaction with services has prompted many hospital administrators to begin scrutinizing their operations. The initial challenge for administrators is to identify the critical processes of the hospital. Since the main purpose of a hospital is to improve the health of its patients, one of its core processes involves the procedures of the operating room (OR). Focusing on OR processes should prove to be one important lever for improving the overall quality of hospital services.

Published
1998

3. End-user perceptions of quality and information technology in health care

Author

James A. Rodger, David Paper, and Parag C. Pendharkar

Subjects
Marketing, Hospital information system, Multivariate statistics, Information Systems and Management, Knowledge management, business.industry, Computer science, End user, Strategy and Management, media_common.quotation_subject, Information technology, Regression analysis, Computer Science Applications, Scheduling (computing), Management of Technology and Innovation, Perception, Health care, business, media_common
Abstract

The results of a field study investigating the impact of the extent of use, staff scheduling, and the adoption of quality control mechanisms (QCM) on end-user perceptions of information technology (IT) in a health care environment are presented. A multivariate model was developed and tested using multiple regression analysis on 47 hospital information system (HIS) end-users. Three specific hypotheses are proposed and tested. Data analyses indicate that end user perceptions depend on two factors: the end-user usage of IT, and the adoption of formal quality control mechanisms. Based on the research results, several suggestions are made to improve the likelihood of successful IT implementation in the health care industry.

Published
1996

4. Becoming a partner in your healthcare

Author

R. Paper

Subjects
Receipt, Service (business), medicine.medical_specialty, business.industry, media_common.quotation_subject, Control (management), Hematology, General Medicine, Haemophilia, medicine.disease, Intimidation, Quality of life (healthcare), Nursing, Feeling, Health care, medicine, business, Psychiatry, Genetics (clinical), media_common
Abstract

Chronic disorders such as haemophilia and von Willebrand disease can rob people of a feeling of control over their lives. Added to this is often a feeling of confusion or intimidation when dealing with the healthcare system. People may begin to feel like victims of their disorders and of the healthcare system. The healthcare system defines people who are in receipt of care as patients. The word patient comes from the Latin word patiens, which means to suffer, endure, allow, permit or undergo. Even the term implies a sense of victimization. People who become partners in their care and view the receipt and delivery of healthcare as a service wherein they are the consumer and the doctor or clinician is the provider, will feel more in control and will likely have better outcomes than people who assume the more traditional role of 'patient'.

Published
2002

5. Interdisciplinary Research in Artificial Intelligence: Challenges and Opportunities

Author

Remy Kusters, Dusan Misevic, Hugues Berry, Antoine Cully, Yann Le Cunff, Loic Dandoy, Natalia Díaz-Rodríguez, Marion Ficher, Jonathan Grizou, Alice Othmani, Themis Palpanas, Matthieu Komorowski, Patrick Loiseau, Clément Moulin Frier, Santino Nanini, Daniele Quercia, Michele Sebag, Françoise Soulié Fogelman, Sofiane Taleb, Liubov Tupikina, Vaibhav Sahu, Jill-Jênn Vie, Fatima Wehbi, Centre de Recherche Interdisciplinaire / Center for Research and Interdisciplinarity [Paris, France] (CRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Artificial Evolution and Computational Biology (BEAGLE), Laboratoire d'InfoRmatique en Image et Systèmes d'information (LIRIS), Université Lumière - Lyon 2 (UL2)-École Centrale de Lyon (ECL), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Université Lumière - Lyon 2 (UL2)-École Centrale de Lyon (ECL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Inria Grenoble - Rhône-Alpes, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Imperial College London, Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Flowing Epigenetic Robots and Systems (Flowers), Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), École Nationale Supérieure de Techniques Avancées (ENSTA Paris), Laboratoire Images, Signaux et Systèmes Intelligents (LISSI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Universitaire de France (IUF), Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche (M.E.N.E.S.R.), Performance analysis and optimization of LARge Infrastructures and Systems (POLARIS), Inria Grenoble - Rhône-Alpes, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Grenoble (LIG), Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Nokia Bell Labs [Cambridge], TAckling the Underspecified (TAU), Inria Saclay - Ile de France, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire de Recherche en Informatique (LRI), CentraleSupélec-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-CentraleSupélec-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Hub France IA, Nokia Bell Labs [Paris-Saclay], Scool (Scool), Inria Lille - Nord Europe, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche en Informatique, Signal et Automatique de Lille - UMR 9189 (CRIStAL), Centrale Lille-Université de Lille-Centre National de la Recherche Scientifique (CNRS)-Centrale Lille-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Thanks to the Bettencourt Schueller Foundation long term partnership, the workshop that gave rise to this paper was partially supported by the funding from CRI Research Collaboratory, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Inria Grenoble - Rhône-Alpes, Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'InfoRmatique en Image et Systèmes d'information (LIRIS), Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-École Centrale de Lyon (ECL), Université de Lyon-Université Lumière - Lyon 2 (UL2)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-École Centrale de Lyon (ECL), Université de Lyon-Université Lumière - Lyon 2 (UL2), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Unité d'Informatique et d'Ingénierie des Systèmes (U2IS), École Nationale Supérieure de Techniques Avancées (ENSTA Paris)-École Nationale Supérieure de Techniques Avancées (ENSTA Paris), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Big Data, 0301 basic medicine, [SCCO.COMP]Cognitive science/Computer science, [INFO.INFO-NE]Computer Science [cs]/Neural and Evolutionary Computing [cs.NE], [INFO.INFO-AI]Computer Science [cs]/Artificial Intelligence [cs.AI], 03 medical and health sciences, 0302 clinical medicine, Political science, Health care, Computer Science (miscellaneous), auditability, education, lcsh:T58.5-58.64, Ai education, business.industry, lcsh:Information technology, interdisciplinary science, Precision medicine, artificial intelligence, Transparency (behavior), ethics, Variety (cybernetics), 030104 developmental biology, [INFO.INFO-MA]Computer Science [cs]/Multiagent Systems [cs.MA], Perspective, Artificial intelligence, business, interpretability, 030217 neurology & neurosurgery, Information Systems
Abstract

The use of artificial intelligence (AI) in a variety of research fields is speeding up multiple digital revolutions, from shifting paradigms in healthcare, precision medicine and wearable sensing, to public services and education offered to the masses around the world, to future cities made optimally efficient by autonomous driving. When a revolution happens, the consequences are not obvious straight away, and to date, there is no uniformly adapted framework to guide AI research to ensure a sustainable societal transition. To answer this need, here we analyze three key challenges to interdisciplinary AI research, and deliver three broad conclusions: 1) future development of AI should not only impact other scientific domains but should also take inspiration and benefit from other fields of science, 2) AI research must be accompanied by decision explainability, dataset bias transparency as well as development of evaluation methodologies and creation of regulatory agencies to ensure responsibility, and 3) AI education should receive more attention, efforts and innovation from the educational and scientific communities. Our analysis is of interest not only to AI practitioners but also to other researchers and the general public as it offers ways to guide the emerging collaborations and interactions toward the most fruitful outcomes.

Published
2020

6. Corporate Governance and Social Impact of Non‐Profits: Evidence from a Randomized Program in Healthcare in the Democratic Republic of Congo

Author

Bertrand Quelin, Caroline Flammer, Marieke Huysentruyt, Anicet Fangwa, Groupement de Recherche et d'Etudes en Gestion à HEC (GREGH), Ecole des Hautes Etudes Commerciales (HEC Paris)-Centre National de la Recherche Scientifique (CNRS), and HEC Research Paper Series

Subjects
Sustainable Development Goals (SDGs), History, Polymers and Plastics, corporate governance, Developing country, Context (language use), Audit, JEL: D - Microeconomics/D.D6 - Welfare Economics, JEL: A - General Economics and Teaching/A.A1 - General Economics, Industrial and Manufacturing Engineering, randomized experiment, JEL: G - Financial Economics/G.G3 - Corporate Finance and Governance, JEL: F - International Economics/F.F6 - Economic Impacts of Globalization/F.F6.F63 - Economic Development, JEL: I - Health, Education, and Welfare/I.I1 - Health, Health care, Business and International Management, health care economics and organizations, JEL: D - Microeconomics/D.D1 - Household Behavior and Family Economics, JEL: Q - Agricultural and Natural Resource Economics • Environmental and Ecological Economics/Q.Q0 - General/Q.Q0.Q01 - Sustainable Development, JEL: D - Microeconomics/D.D2 - Production and Organizations, Public economics, JEL: D - Microeconomics/D.D8 - Information, Knowledge, and Uncertainty, business.industry, Corporate governance, healthcare, developing countries, Incentive, non-profit organizations, Scale (social sciences), JEL: O - Economic Development, Innovation, Technological Change, and Growth, social impact, Corporate social responsibility, [SHS.GESTION]Humanities and Social Sciences/Business administration, Business
Abstract

How can non-profit organizations improve their governance to increase their social impact? This study examines the effectiveness of a bundle of governance mechanisms (consisting of pro-social incentives and auditing) in the context of a randomized governance program conducted in the Democratic Republic of Congo's healthcare sector. Within the program, a set of health centers were randomly assigned to a governance treatment while others were not. We find that the governance treatment leads to i) higher operating efficiency and ii) improvements in social performance (measured by a reduction in the occurrence of stillbirths and neonatal deaths). Furthermore, we find that funding is not a substitute for governance—health centers that only receive funding increase their scale, but do not show improvements in operating efficiency nor social performance. Overall, our results suggest that corporate governance plays an important role in achieving the non-profits' objectives and increasing the social impact of the funds invested.

Published
2020

7. Risk factors for bronchiolitis hospitalization in infants: A French nationwide retrospective cohort study over four consecutive seasons (2009-2013)

Author

Jean-Christophe Rozé, Jean-Michel Hascoet, Jean-François Magny, Pierre-Henri Jarreau, Brigitte Fauroux, Elie Saliba, Michaël Schwarzinger, Sommeil-Vigilance-Fatigue et Santé Publique (VIFASOM (URP_7330)), Institut de Recherche Biomédicale des Armées (IRBA)-Université Paris Cité (UPCité), Unité Pédiatrique de Ventilation Non Invasive et de Sommeil [CHU Necker Enfants-Malades], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Maternité Régionale Adolphe Pinard [Nancy], Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Université Paris Cité (UPCité), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier universitaire de Nantes (CHU Nantes), Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Translational Health Economics Network [Paris] (THEN), Sorbonne Université (SU), The present study was supported by AbbVie France. Translational Health Economics (THEN) was responsible for data collection, preparation, and validation with external sources of information. THEN received payment from AbbVie for these activities. Writing charges were funded by AbbVie France, and AbbVie approved the decision to submit the paper for publication, but the corresponding author was ultimately responsible for submitting the manuscript for publication., HASCOET, JEAN-MICHEL, Service d'assistance respiratoire et sommeil de l'enfant [CHU Necker], Sommeil-Vigilance-Fatigue et Santé Publique (VIFASOM - EA 7330), Institut de Recherche Biomédicale des Armées (IRBA)-Université de Paris (UP), Regional Maternity [Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL), Université de Paris (UP), Department of Neonatal Medicine of Port-Royal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Cochin [AP-HP], Neonatal Intensive Care Unit of Port-Royal [Paris], Department of Neonatology [Paris], Department of Neonatology [Nantes], Department of Neonatology [Tours], Hôpital Gatien de Clocheville [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Université Paris Diderot - Paris 7 (UPD7), Université Sorbonne Paris Cité (USPC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)

Subjects
Male, Pediatrics, Pulmonology, Epidemiology, Physiology, Cell Transplantation, Comorbidity, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Families, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine and Health Sciences, Morphogenesis, Blood and Lymphatic System Procedures, Birth Weight, 030212 general & internal medicine, Children, education.field_of_study, Multidisciplinary, Congenital Heart Defects, Hospitals, 3. Good health, Hospitalization, Physiological Parameters, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Bronchiolitis, Medicine, Female, France, Seasons, Infants, Research Article, medicine.medical_specialty, Down syndrome, Science, Population, Cardiology, Surgical and Invasive Medical Procedures, 03 medical and health sciences, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, 030225 pediatrics, Internal medicine, Congenital Disorders, medicine, Humans, Birth Defects, education, Transplantation, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Omphalocele, business.industry, Body Weight, Infant, Biology and Life Sciences, Retrospective cohort study, medicine.disease, Health Care, Bronchopulmonary dysplasia, Age Groups, Health Care Facilities, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Medical Risk Factors, People and Places, Respiratory Infections, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Population Groupings, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Developmental Biology, Stem Cell Transplantation
Abstract

International audience; Objectives: Large studies are needed to update risk factors of bronchiolitis hospitalization. We performed a nationwide analysis of hospitalization rates for bronchiolitis over four consecutive bronchiolitis seasons to identify underlying medical disorders at risk of bronchiolitis hospitalization and assess their frequency.Methods: Data were retrieved from the French National Hospital Discharge database. Of all infants discharged alive from maternity wards from January 2008 to December 2013 in France (N = 3,884,791), we identified four consecutive cohorts at risk of bronchiolitis during the seasons of 2009–2010 to 2012–2013. The main outcome was bronchiolitis hospitalization during a season. Individual risk factors were collected.Results: Among infants, 6.0% were preterm and 2.0% had ≥1 chronic condition including 0.2% bronchopulmonary dysplasia (BPD) and 0.2% hemodynamically significant congenital heart disease (HS-CHD). Bronchiolitis hospitalization rates varied between seasons (min: 1.26% in 2010–2011; max: 1.48% in 2012–2013; p

Published
2020

8. Structured peer-led diabetes self-management and support in a low-income country: The ST2EP randomised controlled trial in Mali

Author

Assa Traoré Sidibé, Stéphane Besançon, Cyril Ferdynus, Xavier Debussche, Hélène Delisle, Laetitia Huiart, Maryvette Balcou-Debussche, CHU Sud Saint Pierre [Ile de la Réunion], Centre d'Investigation Clinique de La Réunion - INSERM (CIC 1410), Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), ONG Santé Diabète, Institut Coopératif Austral de Recherche en Éducation (ICARE), Université de La Réunion (UR), Réseau des universités pour l'éducation à la santé (Réseau UNIRéS), Université Blaise Pascal - Clermont-Ferrand 2 (UBP), CRSN/Faculté de médecine Université de Montréal, Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hopital Universitaire, This work was supported by the Bridges programme of the International Diabetes Federation. BRIDGES (Bringing Research in Diabetes to Global Environments and Systems) is a programme initiated by the International Diabetes Federation, and supported by an educational grant from Lilly Diabetes, https://www.idf.org/our-activities/epidemiology-research/bridges.html. The NGO Santé Diabète received the funding (https://santediabete.org/en, Director: SB). The funders were not involved in the study design, in the collection, analysis and interpretation of the data, as well as in the writing of the report and in the decision to submit the paper or preparation of the manuscript for publication. The authors were independent from study funders., and Univ, Réunion

Subjects
Male, Psychological intervention, lcsh:Medicine, Social Sciences, Type 2 diabetes, Human learning, Mali, Biochemistry, Vascular Medicine, law.invention, Geographical Locations, 0302 clinical medicine, Endocrinology, Learning and Memory, Diabetes mellitus, Randomized controlled trial, law, Health care, Outcome Assessment, Health Care, Medicine and Health Sciences, Diabetes diagnosis and management, Psychology, 030212 general & internal medicine, lcsh:Science, 2. Zero hunger, Multidisciplinary, Middle Aged, 3. Good health, Health education and awareness, Blood pressure, Female, Research Article, Adult, medicine.medical_specialty, Waist, HbA1c, Patients, Endocrine Disorders, 030209 endocrinology & metabolism, Peer Group, 03 medical and health sciences, Patient Education as Topic, medicine, Learning, Humans, Hemoglobin, Developing Countries, Glycated Hemoglobin, Biology and life sciences, business.industry, Self-Management, lcsh:R, Cognitive Psychology, Proteins, Peer group, medicine.disease, Diagnostic medicine, Health Care, Self Care, Diabetes Mellitus, Type 2, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Metabolic Disorders, People and Places, Africa, Physical therapy, Cognitive Science, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Patient education, Neuroscience
Abstract

Objectives Our objective was to evaluate the effectiveness of peer-led self-management education in improving glycaemic control in patients with type 2 diabetes in a low-income country (Mali). Methods We conducted an open-label randomised controlled trial. A total of 151 adults (76% women, mean age 52.5) with type 2 diabetes (HbA1c≥8%), treated in the diabetes consultation units of two secondary health centres in Bamako, were allocated to peer-led structured patient education (n = 76) or conventional care alone (n = 75). The intervention group received 1 year of culturally tailored structured patient education (3 courses of 4 sessions) delivered in the community by five trained peer educators. Both groups underwent conventional diabetes monitoring and follow-up. Primary outcome was the mean absolute change in HbA1c from baseline to 12 months. Results 177 education sessions were delivered to the intervention group. Patient attrition was 8%. From baseline to 12 months, the decrease in HbA1c levels was 1.05% (SD = 2.0; CI95%: 1.54;-0.56) in the intervention group compared with 0.15% (SD = 1.7; CI95%: -0.56; 0.26) in the control group, p = 0.006. Mean BMI change was -1.65 kg/m2 (SD = 2.5; CI95%: -2.25; -1.06) in the intervention group and +0.05 kg/m2 (SD = 3.2; CI95%: -0.71; 0.81) in the control group, p = 0.0005. Mean waist circumference decreased by 3.34 cm (SD = 9.3; CI95%: -5.56;-1.13) in the intervention group and increased by 2.65 cm (SD = 10.3; CI95%: 0.20; 5.09) in the control group, p = 0.0003. Conclusions Peer-led structured patient education delivered over 1 year to patients with poorly controlled type 2 diabetes in Mali yielded substantial improvements in glycaemic control and anthropometric parameters. This is of importance for the scaling up of efficient interventions in low-resource settings in the future. Trial registration ClinicalTrials.gov NCT01485913

Published
2018

9. Avoiding a 'big' baby : local perceptions and social responses toward childbirth-related complications in Menabe, Madagascar

Author

Elliot Rakotomanana, Dolorès Pourette, Carole Pierlovisi, Ranjatiana Randriantsara, Chiarella Mattern, Centre population et développement (CEPED - UMR_D 196), Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5), Université Paris Descartes - Paris 5 (UPD5), Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche Médicale (INSERM), Muséum national d'Histoire naturelle (MNHN), Université d'Antananarivo, Unité d'Epidémiologie [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), The study 'Reproductive health, therapeutic pathways, and healthcare uptake in the Morondava-Menabe region' was founded by Louvain Cooperation and the Pasteur Institute of Madagascar. The 'Study on sociocultural determinants of stunting' was founded by the United States Agency for International Development. We wish to express our gratitude to them., The authors would like to thank Amber Cripps, Astrid Knoblauch, Chris Gordon, Yandé Thiaw and the three reviewers of the paper., and We also thank the NGOs FAFED and FANOITRA. We would like to thank all those who participated in the studies, the fokontany presidents, healthcare professionals, reninjazas and traditional practitioners, and obviously all the women and men who shared their experience with us.

Subjects
Adult, Maternal mortality, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Health (social science), Pregnant women's care pathways, Local knowledge, [SHS.ANTHRO-BIO]Humanities and Social Sciences/Biological anthropology, Mothers, Social issues, 03 medical and health sciences, 0302 clinical medicine, History and Philosophy of Science, Health facility, Nursing, Pregnancy, Health care, medicine, Madagascar, Childbirth, Humans, 030212 general & internal medicine, Qualitative Research, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, 030219 obstetrics & reproductive medicine, [SHS.SOCIO]Humanities and Social Sciences/Sociology, business.industry, Public health, Focus Groups, Delivery, Obstetric, Focus group, Pregnancy Complications, Spouse, Anthropological approach, Childbirth-related complications, Female, Perception, Traditional birth attendant, Psychology, business
Abstract

International audience; In Madagascar, a country where over 60% of deliveries are not attended by a healthcare professional, late or inadequate responses to complications during childbirth account for a great number of maternal deaths. In this article, we analyse local perceptions of birth-related risks and strategies used to avoid these risks or manage complications of childbirth. We conduct this analysis in light of the social meanings of childbirth and the social expectations placed upon women in a context of socioeconomic vulnerability and a challenged public health system. We conducted two separate studies in the district of Morondava (Menabe region) in June 2014 and March 2015, comprising semi-directive interviews with 111 people (59 mothers, 18 members of their immediate en-tourage and 34 institutional or healthcare stakeholders), and eight focus groups discussions-two with community leaders, and six with fathers. The results show that the social pressure exerted on women to give birth without complications leads them to practices aimed at avoiding a "big" baby including dietary restrictions, physical activity, and refusal of iron supplementation intake. During pregnancy, women are usually accompanied by a traditional birth attendant or matron (reninjaza). Further, they use the public health system by attending antenatal consultations. However, women are reluctant to deliver in a health facility, where the practices of health professionals are in discordance with the social realities of women and local beliefs around childbirth. If complications arise, they are explained by social causes. The parturient woman is only taken to a healthcare facility after carrying out rituals and if the problems do not resolve themselves. These findings support recommendations to reduce the cultural distance between health workers and childbearing women, strengthen the collaborations with reninjazas, and inform women and their decision makers (mother, reninjaza, spouse) about nutrition during pregnancy and signs of complications.

Published
2018

10. Public Policy to Promote Entrepreneurship: A Call to Arms

Author

Thomas B. Astebro, Zoltan J. Acs, David B. Audretsch, David Robinson, Max Planck Institute of Economics, Max-Planck-Gesellschaft, Joseph L. Rotman School of Management, University of Toronto, Indiana University [Bloomington], Indiana University System, Air Force Institute of Technology, HEC Paris Research Paper Series, and Haldemann, Antoine

Subjects
Entrepreneurship, Labour economics, Economics and Econometrics, HD28 Management. Industrial Management, media_common.quotation_subject, public policy, Immigration, Business, Management and Accounting(all), Public policy, Social Welfare, entrepreneurship, 0502 economics and business, Health care, Economics, Western world, Market reform, 050207 economics, media_common, Market failure, ComputingMilieux_THECOMPUTINGPROFESSION, business.industry, 05 social sciences, 1. No poverty, General Business, Management and Accounting, 8. Economic growth, JEL: L - Industrial Organization/L.L2 - Firm Objectives, Organization, and Behavior/L.L2.L26 - Entrepreneurship, [SHS.GESTION]Humanities and Social Sciences/Business administration, [SHS.GESTION] Humanities and Social Sciences/Business administration, business, 050203 business & management
Abstract

We debate the motivation for and effectiveness of public policies to encourage individuals to become entrepreneurs. Reviewing established evidence we find that most western world policies do not greatly reduce or solve any market failures but instead waste taxpayers’ money, encourage those already intent on becoming entrepreneurs, and mostly generate one-employee businesses with low growth intentions and a lack of interest in innovating. Most policy initiatives that would have the effect of promoting valuable entrepreneurship would not be recognizable as such, because they would primarily address other market failures: a central-payer healthcare would remove health-care related distortions affecting employment choices; greater STEM education would produce more engineers of which some start valuable new firms; and labor market reform to encourage hiring immigrants in jobs they have been educated for would reduce inefficient allocation of talent to entrepreneurship.

Published
2016

11. Multiple vulnerabilities and maternal healthcare in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000, 2006, and 2011

Author

Chul Ou Lee, Hoang Van Minh, Vu Duy Kien, Tran Thi Huong, Luu Ngoc Hoat, Juhwan Oh, Kim Bao Giang, You Seon Nam, and This paper was written as part of collaborative project on strengthening health system in Viet Nam which is being implemented by Hanoi Medical University, University of Medicine and Pharmacy of Ho Chi Minh City, Viet Nam and LEE Jong-wook Center for Globa

Subjects
Rural Population, Program evaluation, inequality, Ethnic group, 0302 clinical medicine, Pregnancy, Surveys and Questionnaires, Health care, Ethnicity, Medicine, 030212 general & internal medicine, Socioeconomics, media_common, education.field_of_study, Multiple Indicator Cluster Surveys, lcsh:Public aspects of medicine, Health Policy, healthcare, Public Health, Global Health, Social Medicine and Epidemiology, multiple socioeconomic vulnerabilities, Vietnam, Female, Original Article, Public Health, 0305 other medical science, Adult, Inequality, media_common.quotation_subject, Population, Developing country, 03 medical and health sciences, Environmental health, Humans, Maternal Health Services, Healthcare Disparities, education, Socioeconomic status, 030505 public health, skilled antenatal care, business.industry, Public Health, Environmental and Occupational Health, skilled delivery, inequity, lcsh:RA1-1270, Patient Acceptance of Health Care, Delivery, Obstetric, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Cross-Sectional Studies, Socioeconomic Factors, Special Issue: Millennium Development Goals in Vietnam: the Progress and Social Determinants, business
Abstract

Background: Knowledge of the aggregate effects of multiple socioeconomic vulnerabilities is important for shedding light on the determinants of growing health inequalities and inequities in maternal healthcare.Objective: This paper describes patterns of inequity in maternal healthcare utilization and analyzes associations between inequity and multiple socioeconomic vulnerabilities among women in Vietnam.Design: This is a repeated cross-sectional study using data from the Vietnam Multiple Indicator Cluster Surveys 2000, 2006, and 2011. Two maternal healthcare indicators were selected: (1) skilled antenatal care and (2) skilled delivery care. Four types of socioeconomic vulnerabilities – low education, ethnic minority, poverty, and rural location – were assessed both as separate explanatory variables and as composite indicators (combinations of three and four vulnerabilities). Pairwise comparisons and adjusted odds ratios were used to assess socioeconomic inequities in maternal healthcare.Results: In all three surveys, there were increases across the survey years in both the proportions of women who received antenatal care by skilled staff (68.6% in 2000, 90.8% in 2006, and 93.7% in 2011) and the proportions of women who gave birth with assistance from skilled staff (69.9% in 2000, 87.7% in 2006, and 92.9% in 2011). The receipt of antenatal care by skilled staff and birth assistance from skilled health personnel were less common among vulnerable women, especially those with multiple vulnerabilities.Conclusions: Even though Vietnam has improved its coverage of maternal healthcare on average, policies should target maternal healthcare utilization among women with multiple socioeconomic vulnerabilities. Both multisectoral social policies and health policies are needed to tackle multiple vulnerabilities more effectively by identifying those who are poor, less educated, live in rural areas, and belong to ethnic minority groups.Keywords: healthcare; skilled antenatal care; skilled delivery; multiple socioeconomic vulnerabilities; inequity; inequality(Published: 29 February 2016)Citation: Glob Health Action 2016, 9: 29386 - http://dx.doi.org/10.3402/gha.v9.29386This paper is part of the Special Issue: Millennium Development Goals in Vietnam: the Progress and Social Determinants. More papers from this issue can be found at www.globalhealthaction.net

Published
2016