Papers by Sandra Buttigieg
JMIR Mental Health
Background The COVID-19 pandemic brought digital practices and engagement to the forefront of soc... more Background The COVID-19 pandemic brought digital practices and engagement to the forefront of society, which were based on behavioral changes associated with adhering to different government mandates. Further behavioral changes included transitioning from working in the office to working from home, with the use of various social media and communication platforms to maintain a level of social connectedness, especially given that many people who were living in different types of communities, such as rural, urban, and city spaces, were socially isolated from friends, family members, and community groups. Although there is a growing body of research exploring how technology is being used by people, there is limited information and insight about the digital practices employed across different age cohorts living in different physical spaces and residing in different countries. Objective This paper presents the findings from an international multisite study exploring the impact of social m...
Indoor and Built Environment, 2019
The World Health Organization (WHO) strives to assist and inspire cities to become more ‘age-frie... more The World Health Organization (WHO) strives to assist and inspire cities to become more ‘age-friendly’ through the Global Age-Friendly Cities Guide. An age-friendly city offers a supportive environment that enables residents to grow older actively within their families, neighbourhoods and civil society, and offers extensive opportunities for their participation in the community. In the attempts to make cities age-friendly, ageism may interact with these developments. The goal of this study was to investigate the extent to which features of age-friendly cities, both facilitators and hindrances, are visible in the city scape of the Dutch municipalities of The Hague and Zoetermeer and whether or not ageism is manifested explicitly or implicitly. A qualitative photoproduction study based on the Checklist of Essential Features of Age-Friendly Cities was conducted in five neighbourhoods. Both municipalities have a large number of visual age-friendly features, which are manifested in five ...
Healthcare professionals and resource planners can use healthcare delivery process mining to ensu... more Healthcare professionals and resource planners can use healthcare delivery process mining to ensure the optimal utilisation of scarce healthcare resources when developing policies. Within hospitals, patients' Length of Stay (LOS) and volume of admitted patients, in terms of number and characteristics (age, gender, and social deter-minants), are significant factors determining daily resource requirements. In this study, we used Coxian phase-type Distribution (C-PHD) based Phase-Type Survival (PTS) trees for analysing how covariates such as admission date, gender, age, district, and admissions source influence the admission rate and LOS distribution. PTS trees. This study used a two-year data set (2011-2012) of patients admitted to the Emergency Department at Mater Dei Hospital to generate models and an independent one-year data set (2013) of patients admitted to the Emergency Department at Mater Dei Hospital to evaluate. The PTS tree effectively clusters patients based on their L...
Corporate Social Responsibility and Environmental Management, 2011
ABSTRACTThe debate concerning corporate social responsibility (CSR) is shifting from public relat... more ABSTRACTThe debate concerning corporate social responsibility (CSR) is shifting from public relations, reputation management, and cause marketing to issues of competitive advantage and good corporate governance. The need for and benefits of proactive and transparent communication about CSR are widely acknowledged. This study uses the case study approach to examine the practice and communication of CSR in emerging economies with a focus on India. This empirical study analyses the CSR and governance themes of Reliance Industries Limited (RIL), the largest private company from India for CSR communication. The study finds that the company lacks an inclusive and strategic approach to CSR communication. Based on the findings, we develop a participatory ‘top‐down’ and ‘inside‐out’ approach to management of CSR communication by corporates in emerging economies in Asia. Despite some limitations, this study is expected to serve as a pointer to the effectiveness of CSR communication by the Ind...
The past several decades have seen a shift in patient care towards digitalisation, which has ushe... more The past several decades have seen a shift in patient care towards digitalisation, which has ushered in a new era of health care delivery and improved sustainability and resilience of health systems, with positive impacts on both internal and external stakeholders. This study’s aim was to understand the role of digital virtual consultations in improving internal and external stakeholders’ health, as well as wellbeing among hospital doctors. A qualitative research approach was used with semi-structured online interviews administered to hospital doctors. The interviews showed that the doctors viewed digital virtual consultations as supplementary to in-person consultations, and as tools to reduce obstacles related to distance and time. If the necessary infrastructure and technology were in place, doctors would be willing to use these options. Implementing these technologies would improve the medical profession’s flexibility on the one hand; but it might affect doctors’ work–life balanc...
BMJ Open, 2022
ObjectiveTo explore the relationships between leader support, staff influence over decisions, wor... more ObjectiveTo explore the relationships between leader support, staff influence over decisions, work pressure and patient satisfaction.DesignA cross-sectional study of large National Health Service (NHS) datasets in England in 2010.Setting and participants158 NHS acute hospital trusts in England (n=63 156) from all staff groups.Primary and secondary outcome measuresSurvey data measuring leader support, staff influence over decision making, staff work pressure and objective outcome data measuring patient satisfaction.ResultsMultilevel serial mediation analysis showed a significantly positive association between leader support and staff influence over decisions (B=0.74, SE=0.07, p<0.01). Furthermore, staff influence over decisions showed a negative association with staff work pressure (B=−0.84, SE=0.41, p<0.05) which in turn was negatively linked to patient satisfaction (B=−17.50, SE=4.34, p<0.01). Serial mediation showed a positive indirect effect of leader support on patient ...
Challenges calling for integrated approaches to health, such as the One Health (OH) approach, typ... more Challenges calling for integrated approaches to health, such as the One Health (OH) approach, typically arise from the intertwined spheres of humans and animals, and the ecosystems constituting their environment. Initiatives addressing such wicked problems commonly consist of complex structures and dynamics. The Network for Evaluation of One Health (NEOH) proposes an evaluation framework anchored in systems theory to address the intrinsic complexity of OH initiatives and regards them as subsystems of the context within which they operate. Typically, they intend to influence a system with a view to improve human, animal, and environmental health. The NEOH evaluation framework consists of four overarching elements, namely: (1) the definition of the OH initiative and its context; (2) the description of its theory of change with an assessment of expected and unexpected outcomes; (3) the process evaluation of operational and supporting infrastructures (the 'OHness'); and (4) an assessment of the association(s) between the process evaluation and the outcomes produced. It relies on a mixed-methods approach by combining a descriptive and qualitative assessment with a semi-quantitative scoring for the evaluation of the degree and structural balance of 'OH-ness' (summarised in an OH-index and OH-ratio, respectively) and conventional metrics for different outcomes in a multi-criteria-decision analysis. We provide the methodology for all elements, including ready-to-use Microsoft Excel spread-sheets for the assessment of the 'OH-ness' (Element 3) and further helpful worksheets as electronic supplements. Element 4 connects the results from the assessment of the 'OH-ness' to the methods and metrics described in Chapters 4 to 6 in this handbook. Finally, we offer some guidance on how to produce recommendations based on the results. The presented approach helps researchers, practitioners, policy makers and evaluators to conceptualise and conduct evaluations of integrated approaches to health and enables comparison and learning across different OH activities, thereby facilitating decisions on strategy and resource allocation. Examples of the application of this framework have been described in eight case studies, published in a dedicated Frontiers Research Topic (https://www.frontiersin.org/researchtopics/5479).
243) [4]. Several scholars entered the debate. Indeed, Iversen and colleagues [5] presented the c... more 243) [4]. Several scholars entered the debate. Indeed, Iversen and colleagues [5] presented the core aspects of ageism namely: “Ageism is defined as negative or positive stereotypes, prejudice and/or discrimination against (or to the advantage of) elderly people on the basis of their chronological age or on the basis of a perception of them as being ‘old’ or ‘elderly’. Ageism can be implicit or explicit and can be expressed on a micro-, mesoor macro-level” (p. 4). The key dimensions defined by Iverson and colleagues are the three classical components (cognitive-stereotypes, affective-prejudice, behavioraldiscrimination); the positive/negative aspect (positive ageism, negative ageism), the conscious/unconscious aspect (explicit ageism, implicit ageism); and the levels at which ageism can manifest (microlevel ageism, meso-level ageism, macro-level ageism). More recently, Levy and Macdonald [6] urged for a deeper understanding of ageism by moving beyond the negative aspect and includin...
Health Services Management Research, 2019
Introduction: Awareness of sexual health in Malta-a small European Union member state started to ... more Introduction: Awareness of sexual health in Malta-a small European Union member state started to gain momentum in the new millennium. Taboos and norms about sexuality pose strong barriers for the provision of information, and reproductive health services. A major contributor is the strong influence of the Roman Catholic Church, which holds fast to its prohibitions of sexual behaviours, albeit counterbalanced by the liberal standpoint adopted by the State in recent years. Methods: Survey data were collected from 269 students aged 16-21 (response rate 89.7%) in a state post-secondary school. The sample was selected through convenience sampling within the school grounds. Results: Women were more knowledgeable in relation to available services and risks when compared to men. No geographical differences were found. School was the most common source for information, while health professionals, namely general practitioners were considered trusted resources for their needs. Confidentiality was deemed to be the most requested and crucial feature of sexual health services. Conclusions: Three important multisectoral needs emerged, namely adequate dissemination system of sexual health information, scientifically based sexual health education for professionals in contact with young people, and well-designed and accessible sexual health services. Implications for management include updating health sexual education and promotion strategies, as well as designing better services. Young people should be able to make informed choices regarding their sexual health, in line with contemporary needs.
I would like to thank the Senate of the University of Malta for granting me the privilege and the... more I would like to thank the Senate of the University of Malta for granting me the privilege and the honour to deliver the following oration on this solemn occasion. Today, graduands from various disciplines within well-established Faculties of our University, namely the Faculties of Engineering, Information and Communication Technology, Medicine and Surgery, Science, as well as the Institute of Health Care will be receiving their hard-earned degree. The multidisciplinary gathering is ample evidence of the rich diversity which the University of Malta enjoys, and on which it can capitalise both academically and professionally. Indeed, it is this diversity that has influenced my choice as regards the theme for this oration, in which I will be focusing on interdisciplinarity and team working in academia and professional practice. The philosopher Roland Barthes views interdisciplinarity as a transformative process which brings together distinct disciplines and results in new ideas and new ...
Journal of Clinical Epidemiology
Objectives: This systematic review aimed to identify the characteristics and application of citat... more Objectives: This systematic review aimed to identify the characteristics and application of citation analyses in evaluating the justification, design, and placement of the research results of clinical health studies in the context of earlier similar studies. Study Design and Setting: We searched MEDLINE (Ovid), Embase (Ovid), and the Cochrane Methodology Register for metaresearch studies. We included meta-research studies assessing whether researchers used earlier similar studies and/or systematic reviews Systematic review registration number https://osf.io/8759p/. Disclosure: D.P. and B.N. included the studies and extracted data. All authors contributed to the idea, validation of data, and risk of bias assessment and have read and approved the final manuscript.
CABI Reviews, 2017
The current fragmented framework of health governance for humans, animals and environment, togeth... more The current fragmented framework of health governance for humans, animals and environment, together with the conventional linear approach to solving current health problems, is failing to meet today's health challenges and is proving unsustainable. Advances in healthcare depend increasingly on intensive interventions, technological developments and expensive pharmaceuticals. The disconnect grows between human health, animal health and environmental and ecosystems health. Human development gains have come with often unrecognized negative externalities affecting ecosystems. Deterioration in biodiversity and ecosystem services threatens to reverse the health gains of the last century. A paradigm shift is urgently required to de-sectoralize human, animal, plant and ecosystem health and to take a more integrated approach to health, One Health (OH). The Sustainable Development Goals (SDGs) offer a framework and unique opportunity for this. Through analysing individual SDGs, we argue t...
Algorithms
The problem of hospital patients’ delayed discharge or ‘bed blocking’ has long been a challenge f... more The problem of hospital patients’ delayed discharge or ‘bed blocking’ has long been a challenge for healthcare managers and policymakers. It negatively affects the hospital performance metrics and has other severe consequences for the healthcare system, such as affecting patients’ health. In our previous work, we proposed the phase-type survival tree (PHTST)-based analysis to cluster patients into clinically meaningful patient groups and an extension of this approach to examine the relationship between the length of stay in hospitals and the destination on discharge. This paper describes how PHTST-based clustering can be used for modelling delayed discharge and its effects in a stroke care unit, especially the extra beds required, additional cost, and bed blocking. The PHTST length of stay distribution of each group of patients (each PHTST node) is modelled separately as a finite state continuous-time Markov chain using Coxian-phase-type distributions. Delayed discharge patients wai...
Frontiers in Sociology, 2020
Drawn from the stress process model, the pandemic has imposed substantial stress to individual ec... more Drawn from the stress process model, the pandemic has imposed substantial stress to individual economic and mental well-being and has brought unprecedented disruptions to social life. In light of social distancing measures, and in particular physical distancing because of lockdown policies, the use of digital technologies has been regarded as the alternative to maintain economic and social activities. This paper aims to describe the design and implementation of an online survey created as an urgent, international response to the COVID-19 pandemic. The online survey described here responds to the need of understanding the effects of the pandemic on social interactions/relations and to provide findings on the extent to which digital technology is being utilized by citizens across different communities and countries around the world. It also aims to analyze the association of use of digital technologies with psychological well-being and levels of loneliness. The data will be based on the ongoing survey (comprised of several existing and validated instruments on digital use, psychological well-being and loneliness), open for 3 months after roll out (ends September) across 11 countries
Supplemental material, HSM871003 Supplementary Material for Healthcare supply chain management: A... more Supplemental material, HSM871003 Supplementary Material for Healthcare supply chain management: Application in the Maltese Healthcare System by Sandra C Buttigieg, Frank Bezzina, Andrew Xuereb and Prasanta K Dey in Health Services Management Research
Journal of Health Organization and Management, 2022
Purpose The purpose of this paper is to identify and analyse the readmission risk prediction tool... more Purpose The purpose of this paper is to identify and analyse the readmission risk prediction tools reported in the literature and their benefits when it comes to healthcare organisations and management.Design/methodology/approach Readmission risk prediction is a growing topic of interest with the aim of identifying patients in particular those suffering from chronic diseases such as congestive heart failure, chronic obstructive pulmonary disease and diabetes, who are at risk of readmission. Several models have been developed with different levels of predictive ability. A structured and extensive literature search of several databases was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis strategy, and this yielded a total of 48,984 records.Findings Forty-three articles were selected for full-text and extensive review after following the screening process and according to the eligibility criteria. About 34 unique readmission risk prediction models ...
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Papers by Sandra Buttigieg