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BACKGROUND: Traumatic injury remains the leading cause of death, with more than five million deaths every year. Little is known about the comparative effectiveness in reducing mortality of trauma care systems at different stages of development. The objective of this study was to review the literature and examine differences in mortality associated with different stages of trauma system development. METHOD: A systematic review of peer-reviewed population-based studies retrieved from MEDLINE, EMBASE, and CINAHL. Additional studies were identified from references of articles, through database searching, and author lists. Articles written in English and published between 2000 and 2020 were included. Selection of studies, data extraction, and quality assessment of the included studies were performed by two independent reviewers. The results were reported as odds ratio (OR) with 95 % confidence intervals (CI). RESULTS: A total of 52 studies with a combined 1,106,431 traumatic injury patients were included for quantitative analysis. The overall mortality rate was 6.77% (n = 74,930). When patients were treated in a non-trauma centre compared to a trauma centre, the pooled statistical odds of mortality were reduced (OR 0.74 [95% CI 0.69-0.79]; p < 0.001). When patients were treated in a non-trauma system compared to a trauma system the odds of mortality rates increased (OR 1.17 [95% CI 1.10-1.24]; p < 0.001). When patients were treated in a post-implementation/initial system compared to a mature system, odds of mortality were significantly higher (OR 1.46 [95% CI 1.37-1.55]; p < 0.001). CONCLUSION: The present study highlights that the survival of traumatic injured patients varies according to the stage of trauma system development in which the patient was treated. The analysis indicates a significant reduction in mortality following the introduction of the trauma system which is further enhanced as the system matures. These results provide evidence to support efforts to, firstly, implement trauma systems in countries currently without and, secondly, to enhance existing systems by investing in system development. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019142842 .

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Multiple studies have been done for the identification of pairwise distant kinship and several targeted panels have been constructed. For most of such constructions, pedigree analysis was applied to evaluate the system effectiveness of a certain panel. However, such analyses were hard to be compared to each other and could be affected by many factors, such as sample size and sampling randomness. A new indicator named predicted area under ROC curve (AUCP), where ROC curve stood for receiver operating characteristic curve, was derived applying binomial distribution theory and analyzed with simulated and real cases in this study. After comparing between the values of AUCPs and results of pedigree analyses with different loci sets and kinship types, the ability of these two methods evaluating the system effectiveness was proved to be close to each other. The implementation of AUCP was much easier than pedigree analysis, because a secondary sampling or simulation was not needed. Therefore, AUCP can be a better indicator for panels targeted to pairwise distant kinship identification and we are recommending it as an indicator calculated by default for such panels.

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We describe an effort to improve the care of Medicaid and uninsured individuals through a three-way partnership between a Medicaid managed care insurer, front-line providers, and an academic university. The project provided annual funding over eleven years, for research, pilot programs, and demonstration projects. Projects were provider-driven in design and methods. The Medicaid-managed care insurer-funded proposals were vetted by a neutral university team experienced in grant writing and community-based research and scored by a community-based review panel. The grant program ran from 2007 to 2018, funding 41 projects, totaling USD 2,097,842. The partnership of an insurer, a university, and frontline providers was not only viable and sustainable for over a decade, but also flexible, free of project selection issues, and well-received by all stakeholders. Funded providers worked in both urban and rural settings and included hospitals, community non-profits, outpatient clinics, academic and community health partnerships, and public health agencies. The projects generally reflected common issues in the Medicaid and uninsured population needs, such as childhood obesity, and they were consistent with the targeted goals of the program. Broad health foci included child and/or maternal health, chronic conditions, mental health, preventive health, screening, system effectiveness, special populations including refugees, Latinos, and rural individuals, and substance use disorders. Details of the awarded grantee goals, the grants management process, and lessons learned from the partnership are presented. The partnership triad model was effective and stable, with each partner adding unique value. The use of the academic institution to administrate the program provided an arms-length relationship between the insurer and the providers in project selection and allowed assistance to less experienced researchers in community settings.

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Inter-organizational information systems are critical in the modern business world, as a large portion of economic activities are done through inter-organizational collaborations. One such important collaboration is social innovation/entrepreneurship, which involves multiple parties from diverse areas cooperating in major tasks. Against such a backdrop, exploring beneficial factors for organizational members to actively develop and/or make good use of a management information system (MIS) for collaborative performance has become a vital research question. This conceptual paper argues that positive psychology is critical to encourage members to volunteer to construct an MIS that facilitates social innovation effectiveness. Specifically, we discuss the four dimensions of psychological capital (i.e., hope, optimism, self-efficacy, and resilience) on effective inter-organizational MIS attributes (e.g., connectivity), and on the consequences of social innovation. At the core of this discussion, we believe that a positive psychological foundation is a driver for staff effort to contribute to a better MIS, which could benefit social innovation success. This research contributes by offering inspiration for future studies to link the micro- and macro-level aspects of social innovation and entrepreneurship phenomena.

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BACKGROUND: Child Protective Services (CPS) systems have not historically conducted system effectiveness research. More information is needed about the long-term outcomes of children and families served by the systems. OBJECTIVE: To investigate how workers within CPS systems in Colorado and the Netherlands measure and perceive the effectiveness of their CPS system. PARTICIPANTS AND SETTING: CPS administrators and workers in Colorado and the Netherlands from August 2015 through May 2016. At both sites, interviewees included front line employees with deep knowledge of daily mechanics and processes, as well as experts and thought leaders who possessed historical memory and perspective about their site's CPS system. METHODS: In-depth, semi-structured interviews were conducted with 77 participants. In Colorado (n = 36), 8 participants were state experts and 28 held county-level roles. In the Netherlands (n = 41), 17 participants were national experts and 24 worked at Veilig Thuis agencies. RESULTS: Participants in both sites reported that they did not know if their system had empirical evidence to support its effectiveness, and had difficulty identifying how they would measure the effectiveness of their system. CONCLUSIONS: Both systems lack the ability to collect data on the quality of their services and the longitudinal outcomes for the children and families they serve. Measures of good outcomes must be developed. Without longitudinal outcome data, CPS systems cannot assess the effectiveness of their practice. CPS systems might partner with the healthcare system, where the infrastructure and culture are already in place to look at quality and longitudinal outcomes.

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Objective To derive and empirical validate probability of exclusion in grand-parental double single-parentage cases (PEGDS). Methods Firstly, an exact definition of PEGDSwas established, and PEGDSformula was derived based on the definition. Then the values of formula were calculated in 19 STR loci. Secondly, the simulation values of PEGDSwere counted through multi-group simulation experiments in 19 STR loci. Finally PEGDSformula was empirically validated by correlation method between the values of formula and simulation. Results PEGDSformula was all in accord with the simulation experiments. Cumulative probability of exclusion in grand-parental double single-parentage cases (CPEGDS) in AGCU EX20 system was 1-3.10310×10-9. The system effectiveness in grand-parental double single-parentage cases was a little more than trio cases, and was far more than duo cases. Conclusion PEGDSformula in this paper could be applied to grand-parental double single-parentage cases.

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Facing a severe population health crisis due to noncommunicable diseases, Ukraine and other former Soviet republics and Eastern European countries have a pressing need for more effective health systems. Policies to enhance health system effectiveness should consider the perspectives of different stakeholder groups, including providers as well as patients. In addition, policies that directly target the quality of clinical care should be based on objective performance measures. In 2009 and 2010 we conducted a coordinated series of household and facility-level surveys to capture the perspectives of Ukrainian household members, outpatient clinic patients, and physicians regarding the country's health system overall, as well as the quality, access, and affordability of health care. We objectively measured the quality of care for heart failure and chronic obstructive pulmonary disease using CPV(®) vignettes. There was broad agreement among household respondents (79%) and physicians (95%) that Ukraine's health system should be reformed. CPV(®) results indicate that the quality of care for common noncommunicable diseases is poor in all regions of the country and in hospitals as well as polyclinics. However, perspectives about the quality of care differ, with household respondents seeing quality as a serious concern, clinic patients having more positive perceptions, and physicians not viewing quality as a reform priority. All stakeholder groups viewed affordability as a problem. These findings have several implications for policies to enhance health system effectiveness. The shared desire for health system reform among all stakeholder groups provides a basis for action in Ukraine. Improving quality, strengthening primary care, and enhancing affordability should be major goals of new health policies. Policies to improve quality directly, such as pay-for-performance, would be mutually reinforcing with purchasing reforms such as transparent payment mechanisms. Such policies would align the incentives of physicians with the desires of the population they serve.

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The elimination of new HIV infections in infants and children is part of a broader global commitment by the United Nations. Prevention of Mother to Child transmission (PMTCT) programmes have prevented 350,000 new HIV infections with the use of antiretroviral therapy (ARVs) for pregnant women who are HIV infected, and the majority of these gains were in sub-Saharan Africa. Coverage of PMTCT programmes throughout Africa is variable resulting in many women not having access to the appropriate interventions in the antenatal care setting to prevent vertical transmission. The global elimination target requires a 90% reduction of new child infections and to decrease MTCT to <5% which potentially can be achieved utilising the four pronged approach proposed by the World Health Organization. Family planning messages and provision of contraception methods to avoid unplanned pregnancies are shown to be more effective than HIV Counselling and Testing [HCT] and single dose Nevirapine in averting transmission of perinatal HIV infection. Child survival goes beyond HIV-free survival and safe breastfeeding prevents 13% of deaths under 5 years of age rendering it essential to reduce under-5 mortality. Health systems strengthening to deliver more complex regimens either for prevention purposes or the mothers own health is an important part of a broader continuum of interventions which will depend on the effective delivery of current treatment modalities, development of new prevention interventions including a vaccine, and include prevention of unplanned pregnancies and primary prevention of HIV infections in the mother.

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