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Purpose Theoretically, a health system has been described in terms of integration being the coordination of health services and collaboration amongst provider organizations. The components of an integrated health system remain inconclusive. Although senior healthcare executives establish structures and designs which facilitate the delivery of integrated care, their perspectives of a health system have not been explored. The purpose of this paper is to present senior healthcare executives’ perspectives of a health system which, when combined, form a model for developing an integrated health system. Design/methodology/approach Using a qualitative methodology and a multi-case study design, 11 presidents and 4 senior vice presidents of major healthcare organizations or systems in Ontario Canada were selected from a target population of 246 senior healthcare executives to engage in 1 h interviews each. Critical case sampling was applied in the selection of the study sample. Interviews were conducted between December 2017 and February 2018. Findings Senior healthcare executives expressed four distinct perspectives of a health system: systems, institutional, clinical and governance. When combined, the four perspectives form an original research-based concept or model for an integrated health system. Originality/value This paper conveys results of personal interviews with senior healthcare executives and presents a proposed model for an integrated health system based on their four distinct perspectives of a health system.

PurposeThe purpose of this paper is to combine previous research on deaf suspects with the findings from data gathered from law enforcement personnel nationwide to gain an understanding of the common practices of US law enforcement when arresting, interrogating and communicating with deaf suspects.Design/methodology/approachIn light of the limited amount of research available on handling deaf suspects, a two-part sampling approach was used. Using critical case sampling, the author surveyed law enforcement via open-ended surveys designed to solicit information about their involvement with deaf suspects and any related questions and concerns. Guided by the Wave 1 data, Wave 2 surveys were administered to law enforcement nationwide (using expert sampling).FindingsAn analysis of the two waves of data collected was used to assemble the list of current practices.Originality/valueThis study combines previous research on deaf suspects, which has been published largely through the framework of deaf studies, with the insight of practitioners to identify a list of current practices used by US law enforcement when handling deaf suspects.

Background Optimizing intraoperative education is critical for development of autonomous residents. Faculty decisions concerning intraoperative entrustment determine the degree to which a resident gains intraoperative responsibility. Accordingly, residents exhibit entrustable behaviors that further faculty entrustment in the operating room. Little empiric evidence exists evaluating how the sex of a resident influences faculty-resident decisions of entrustment. Studies involving perception-based measurements of autonomy report inequities for women residents. We sought to assess faculty behaviors in entrustment in relation to resident sex using OpTrust, a third-party objective measurement tool. Methods From September 2015 to June 2017 at the University of Michigan, surgical cases were observed and entrustment behaviors were rated using OpTrust. Critical case sampling was used to generate variation in operation type, case difficulty, faculty-resident pairings, faculty experience, and the level of the resident's training. Independent sample t-tests were conducted to compare faculty entrustment scores, as well as resident entrustability scores. Results A total of 56 faculty and 73 residents were observed across 223 surgical cases from 4 surgical specialties: general, plastic, thoracic, and vascular. There was no difference in faculty entrustment or entrustability scores between women and men (2.54 vs 2.35, P = .117 and 2.32 vs 2.22, P = .393, respectively). Conclusion Using OpTrust scores, we found that a resident's sex does not appear to influence faculty entrustment in the OR. Faculty entrustment scores for women and men residents are similar across cases. This observation suggests that during the intraoperative interaction, faculty are not extending entrustment or opportunities for autonomy differently to women or men. Future research is needed to identify and measure perioperative elements that inform resident autonomy, which may contribute to inequities for women residents.

Mathematical literacy is generally viewed as embedded in mathematical modelling and the applications of mathematics. It is therefore not unreasonable to expect that the development of mathematical modelling competencies should be accorded priority in mathematical literacy. In South Africa, mathematical literacy is examined through a nationally set examination at the end of 12 years of schooling. Schemes of marking of five consecutive examinations for mathematical literacy were analysed to ascertain the prioritisation of mathematical modelling competencies in these examinations. It was found that more than 80% of marks were awarded to mathematical calculations and that the formulation of a problem statement and the validation of a model did not appear in any of the schemes of marking. The implications of these results are discussed.

Background: Self-management may help cancer survivors to better deal with challenges to their physical, functional, social, and psychological wellbeing presented by cancer and its treatment. Nonetheless, little is known about how people integrate cancer self management practices into their daily lives. The aim of this study was to describe and characterise the processes through which head and neck cancer (HNC) survivors attempt to integrate self-management into their daily lives following primary treatment. Methods: Using a purposeful critical case sampling method, 27 HNC survivors were identified through four designated cancer centres in Ireland and participated in face-to-face semi-structured interviews. Interviews were audio-recorded, transcribed and analysed using thematic analysis. Results: Six themes describing HNC survivors’ attempts to integrate self-management into their lives following treatment were identified: grappling with having to self-manage, trying out self-management strategies, becoming an expert self-manager, struggling to integrate self-management strategies into daily life, avoiding recommended self-management and interpreting self-management. Conclusions: This is the first study to describe HNC survivors’ attempts to integrate self-management into their daily lives following primary treatment. The findings indicate that HNC survivors exhibit highly individualised approaches to self-management integration and abandon self-management strategies that fail to meet their own specific needs. Implications for Survivors: Survivors may benefit from skills training and structured support to assist their transition between in patient care and having to self-manage after primary treatment, and/or ongoing support to deal with persistent and recurring challenges such as eating difficulties and fear of recurrence.

During the rapid development of gambling business, the number of pathological gamblers is increasing as well. The problem of pathological gambling is just as important as alcoholism or drug addiction. However, there is a lack of information and research of this topicin Lithuania. The aim of work: to investigate and analyse the factors that increase or reduce involvement in gambling. Research questions: 1) What factors increase involvement in gambling? 2) What factors reduce involvement in gambling? Critical case sampling was used for selection of the participants. Subjects were required to a) have experience of involvement in gambling for at least one year; b) have experience of negative impact of gambling on quality of life; c) have at least 6 months of gambling abstinence. Five individuals participated in the research; all of them were males who live in Vilnius. Age of the participants varied from 19 to 45. Semi-structured interviews were used to collect data. Interviews were recorded and transcribed verbatim. The matic analysis of the data led to the identification of four major the matic categories: psychological factors; social relations; material well being; quality of life. There search results show that negatyve childhood experience, gambling friends, escaping from various troubles, disputes in family and high financial needs can increase involvement in gambling. Factors that reduce involvement in gambling are: feeling support of social environment, proper evaluation of financial position, awareness of one‘s own addiction to gambling and desire to change life.

The purpose of this chapter is to investigate and explore the five year partnership between University College London (UCL) and Nazarbayev University (NU) in Astana, Kazakhstan. Now that the partnership has ended, there are many valuable lessons that have been learned. This chapter will report on interviews with key members of staff from both UCL and NU revealing their reflections about what went well, the most important lessons that have been learned. The goal of the study is to explore the expertise and experiences of those involved in the UCL/NU partnership in order to provide a record and contribute to the scholarly body of work on Higher Education partnerships. Critical case sampling (purposeful sampling) was employed to select staff members from UCL and NU who were involved in key roles in the establishment and running of the foundation program. It was necessary to include only those staff who had both a key role, and were involved throughout the entirety of the project. Subsequently a small sample of four participants representing both UCL and NU were involved in semi structured interviews. In order to ensure confidentiality, the initials of these individuals have been changed. The interviews revealed a series of key recommendations when entering into transnational higher education partnerships. These are the importance of cultural understanding, patience and flexibility.

Scant explicit guidance currently exists on how to teach mixed research courses. Thus, the purpose of this mixed research study was to compare and to contrast pedagogical approaches used by instructors in mixed research courses, as well as the learning experiences of students enrolled in a mixed research course. This investigation involved the use of a fully mixed concurrent dominant status design and a mixed sampling design that involved a combination of concurrent, identical, sequential, nested, and multilevel sampling. The teacher participants were eight instructors of mixed research courses from institutions around the United States who were purposively selected via critical case sampling such that they represented first generation instructors of mixed research courses. These participants were interviewed either face-to-face or remotely (e.g., via Skype). The student participants were 48 doctoral students enrolled in one of three sections of a doctoral-level mixed research course taught by one of the teacher participants who provided both quantitative (e.g., number of research methodology courses taken) and qualitative (e.g., mixed methodological dissertation research proposals, reflexive journals) data. Among the numerous findings emerging from the instructor interview data was the emergence of a three-dimensional model for categorizing and organizing pedagogical approaches used in mixed research courses. For the student participants, the number of prior research methodology courses was positively related to the quality of mixed methodological dissertation research proposals. Further, the vast majority of students (91.7%) reported positive course experiences and expressed positive perceptions about mixed research. Implications are discussed.

This research attempted to explore to what level children’s right to participation was realized at a primary school which is highly qualified in terms of children’s rights in Turkey. The study was designed as a case study. The study group of the research was chosen via critical case sampling. The data were gathered through observations, interviews and document analysis. The data were analyzed by conducting content and descriptive analysis. In the research, children’s right to participation related 15 different contexts, of which three were laws, were determined at the primary school which is highly qualified in terms of children’s rights. It was revealed that the realization level of children’s right to participation changed in different classrooms based on teachers’ attitudes and beliefs. The results of the research demonstrated that there was a difference in children’s right to participation at the primary school which is highly qualified in terms of children’s rights ranging from the level at which children were not involved to the level at which children participated in decision-making processes.

The purpose of this study was to investigate Effective Children’s Rights Education (ECRE) from the perspectives of classroom teachers who are experts in children’s rights education (TECR). The data were collected through focus group interview method in this research designed as a case study. The sample of the study consists of six qualified primary school teachers for children’s rights education selected by critical case sampling method. The data were interpreted with the help of content analysis method. Five different understandings have been proposed related to effective children’s rights education. In the light of these understandings, detailed information has been obtained in reference to proposed ways for the administration of effective children’s rights education and where and with whom the process should take place. Furthermore, information has been obtained about the arrangements that TECR have made at class and school levels for an effective children’s rights education. The research is important in terms of providing information on the insights into ECRE and its practices at schools in Turkey.

Forty-nine injured workers were selected from a study population of 3,041 injured workers using a critical case sampling technique, to explore characteristics of workplaces and worker perceptions and attributions related to return to work status following workplace injury. The only significant differences between those who returned and those who did not return to work were satisfaction with pre-injury pay and provision of training in occupational health and safety procedures. From the in-depth structured interviews of 49 injured workers, 5 workers who failed to return to work were selected for detailed case study to further explicate the factors which contributed to unsuccessful rehabilitation. Worker characteristics, the timing and meaning of the injury to individual workers, and conflicting and unstated agendas in the occupational rehabilitation process, were all identified as critical factors which impact on return to work outcomes.

Purpose: The purpose of this narrative inauiry is to describe the story about the physical education teacher’s first experience of the head teacher role, and then to interpret the educational meaning in the story. Methods: Using the critical case sampling, the department head, ‘Chum’, a study participant who was first time appointed the head teacher as a 15year-veteran physical education teacher was selected. Performing the unstructured interview five times with the participant, the documentary data such as his journal, note, and teaching note was collected. The collected data was analyzed in-depth, going through the steps like viewing widely, viewing deeply, talking, and talking again. Results: As the head teacher for the first time, the study participant experienced total four kinds of role performance such as educator, administrator, problem-solver, and connector. Conclusion: The educational meaning of this role performance experiece is to pursue the overall contents and form of school physical education as a newly-appointed head teacher, and also to build multi-perspectives as a middle manage considering both viewpoints of a teacher and a manager.