Outcomes Advanced Workbook Pdf ((HOT))
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83 Match 1-6 with a-f to make work collocations. 1 work-life a management 2 time b break 3 action с balance 4 job d satisfaction 5 to-do e plan 6 rest f list E Write an information sheet ( words) with the title M anaging your time effectively. Include information and advice either for colleagues at your workplace or for students at your school or college. Lis t e n in g С Complete the sentences with the collocations in exercise B. 1 Practical...s might include lists of aims, schedule overviews and summaries of the key outcomes required. 2 If your work does not provide you with any..., it may be time to find a new one. 3 Take a regular...to relax. 4 When there is so much pressure to work long hours, it becomes difficult to maintain a good...and then your personal life suffers. 5 Prioritising the most urgent projects is an example of effective..., enabling you to meet your deadlines faster and more effectively. 6 I ticked off three items on m y...this morning. Language note verb + -ing or verb + infinitive Some verbs, such as stop, try, remember, forget, regret and come, have a different meaning depending on whether they are followed by an -ing form or an infinitive. % 14.1 Listen to the first part of a speech. Who is speaking? a a company director b a university lecturer с a business advisor Listen again. Tick (/) the good reasons for going into business and put a cross (X) by the bad reasons, according to the speaker. 1 making more money... 2 pursuing a passion... 3 being your own boss... 4 supplementing a less fulfilling job... 5 fulfilling a need in the market place... 6 showing you can start again after failure... 7 spending more time with your family... С % 14.2 Listen to the second part of the speech and complete the list. Write exactly what you hear, using one word in each gap. D Choose the correct forms in the pairs of sentences. 1 a Stop constantly to check / checking your s, b When you're tired, stop to have / having a break. 2 a Reduce interruptions. This may mean to put / putting a 'Do not disturb' sign on your desk, b Decide what you mean to do / doing in the morning and stick to the plan. 3 a Whatever you do, try not to leave / leaving important tasks until the last minute, b If you suffer from insomnia, try to read / reading a book instead of watch ing TV. 4 a We regret to inform / informing staff that some redundancies will be necessary, b Many people regret not to spend / spending enough time with their families. 5 a Remember to eat / eating healthily. b I remember once to get / getting extremely anxious about getting all my work done. Reasons why businesses fail not having enough management knowledge, especially about finance and how to deal with difficult1... having unrealistic expectations of the amount o f 2... which is required not recognising problems to do with location such as accessibility and nearness to 3... not providing an online 4... and not promoting 5... strongly enough not focusing on 6... rather than short-term business 14 BUSINESS \D 3 13
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A realist review methodology was used that is outlined in full in Appendix 1 (available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.160177/-/DC1). Broadly, multiple databases (e.g., Medline, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Embase, ISI Web of Knowledge) were searched using the following search terms: Social near determinant* AND health OR Health near/2 *equit* OR disparit*, Health* worker* OR Health* professional* OR Health* provider* OR primary health care OR community health worker* and training* or education* or capacity strengthening OR capacity building. Additional searches of selected relevant websites were conducted, including those of the Canadian Task Force on Preventive Health Care, US Preventive Services Task Force, UK National Institute for Health and Care Excellence, National Guideline Clearinghouse and the Guide to Community Preventive Services. Grey literature was identified by Google searches, scanning reference lists, key informant discussions and postings on Internet listserves relating to health equity. This search identified almost 500 documents that were scanned for relevance, and a total of 71 documents were retained. Because this is a relatively new area of scientific inquiry that examines a variety of complex interventions impacting multiple health and social outcomes, a qualitative synthesis of the findings is presented that can be used as a framework for action on social determinants in clinical practice. With the exception of some clinical practice guidelines, most of the evidence on the effectiveness of physician intervention in social determinants is from smaller-scale observational studies and a few randomized controlled studies, as well as a growing number of qualitative and mixed-methods studies that are able to better assess the complexity involved and the role of context in influencing outcomes. Most publications pertain to low-resource settings within high-income country contexts, such as inner city neighbourhoods with high rates of poverty.
In designing engagements, several studies pointed to the importance of clarifying the objectives, roles, and expectations of the engagement for patients/carers [40,41,42,43,44,45]. Approaches that gave users specific roles or engaged them in a formal structure such as a steering committee [45] or that enabled patients to set the agenda, develop shared mission and purpose statements and participate in all/most stages of the planning, administration, and evaluation made participants feel comfortable with the team and process, maintained patient involvement throughout the course of the process, and improved the quality of outcomes [41, 45,46,47,48,49,50]. These techniques occurred in mental health, HIV, and pediatric service settings where patients were engaged to improve access to, and quality of, care or promote a culture change in the development and delivery of services.
Engaging patients can also change the culture of staff and care settings. The experiences reported in these articles included shifts in organizational culture promoting further patient participation in service design and delivery, [40, 63, 75] achieving collaboration and mutual learning, [42, 47, 76, 77] and sharing or neutralizing power among patients and providers or staff, [52] as well as developing new competencies and negotiating for service changes [39, 59] (Table 4). Interestingly, these outcomes tended to arise in mental health settings and from co-design engagements (Table 5). Further analysis of the methods used in these studies revealed key enabling factors including creating deliberative spaces to share experiences, including external facilitation; broadening power and control to include users, values, and beliefs exercises; conducting user/staff/provider training; and implementing a top-down approach from the local authority (Table 5).
Ultimately, the effectiveness of any patient engagement should be judged by its impact on patient care. There is a growing body of literature that indicates that engaging patients can lead to improved effectiveness, efficiency, quality of care [28,29,30,31], health outcomes, and cost-effective health service utilization [27, 83, 84]. The outcomes reported in our review spanned beyond improved care to include enhanced governance and informed policies and organizational planning, which illustrates the breadth of quality of care initiatives that might be sought through patient engagement. However, drawing causal associations between engaging patients in health services improvement and health outcomes is difficult. Furthermore, it remains unclear whether these improvements translate into sustained or improved quality of care beyond local settings at a system level. Indeed, one study found a lack of evidence that patient involvement leads to the implementation of patient-centered care [85]. Some evaluative tools are emerging [86], yet more studies are needed that assess the conditions on which these tools and strategies can sustain the quality of care systemically.
Our review builds upon previous reviews in this field by providing insight into the associations between quality improvement methods and the varying system-level outcomes they yield. Indeed, our review echoes previous research indicating that patient engagement can lead to a multiplicity of health services outcomes with sufficient role definition, training, and alignment of patient-provider expectations but that the quality of the reporting has been poor and the full impact of patient engagement is not fully understood [87,88,89]. Previous reviews have been limited to specific countries [87], care settings (e.g., mental health [89]), hospitals [90], or study design (e.g., qualitative studies [88]). In this way, our review provides a comprehensive perspective of optimal strategies used internationally, across care settings and using multiple methodologies to engage patients, caregivers, and relatives in quality of care improvement initiatives. Our review also provides novel insights into how the level of engagement influences the outcomes, namely, discrete products (e.g., development of tools and documents) largely derived from low-level engagement (consultative unidirectional feedback), whereas care process or structural outcomes (e.g., improved governance, care or services) mainly derived from high-level engagement (co-design or partnership strategies). If the benefits of engaging patients in the design or delivery of health care are to be realized at an organization or system level, then effective strategies and the contextual factors enabling their outcomes need to be identified so that learning can be generalized. Importantly, our review provides guidance on the effective strategies and contextual factors that enable patient engagement including techniques to enhance the design, recruitment, involvement, and leadership action, and those aimed to create a receptive context. 2b1af7f3a8