Assessing and changing medical practice culture.

PubMed

Hills, Laura

2011-01-01

Your medical practice has an existing culture that manifests itself daily in literally hundreds of ways. Some aspects of your culture likely support your practice's growth; others may be impeding your progress. This article describes the characteristics of medical practice culture and provides numerous examples of how culture influences behavior. It describes how culture is expressed in a medical practice through objects and artifacts, language, emotions, interactions, practice management systems, and daily work habits. It offers three techniques for assessing an existing medical practice culture and a checklist for conducting culture observations. This article also provides guidelines for identifying a desired medical practice culture and explores why changing culture is so difficult. It describes five reasons employees are likely to resist culture change and provides 12 fundamental changes that will enable a practice to improve its culture. Finally, this article explores how medical practice cultures are formed and perpetuated and provides more than a dozen questions to ask employees in a culture survey.

Job Realities of Primary School Principals in Greece: Similarities and Variations in a Highly Centralized System

ERIC Educational Resources Information Center

Dimopoulos, Kostas; Dalkavouki, Katerina; Koulaidis, Vasilis

2015-01-01

This study aims at investigating primary school principals' work on a daily basis in order to understand the ways in which the centralized educational system affects their practices. Four typical cases of principals were selected and asked to keep daily records for a period of four months. Data from logs were complemented with data collected…

Making Democracy Work and Grow: Practical Suggestions for Students, Teachers, Administrators, and Other Community Leaders. Bulletin, 1948, No. 10

ERIC Educational Resources Information Center

Boie, Mildred Louise, Comp.

1948-01-01

Democracy is more than a creed or a doctrine. It must be a continuing force in the daily thinking, working, and living of all our citizens. American schools and colleges can strengthen democracy by practicing it--by showing concretely the basic advantages it offers to human beings. It is in the homes and in the schools, in home towns and local…

The content of the work of clinical nurse specialists described by use of daily activity diaries.

PubMed

Oddsdóttir, Elín Jakobína; Sveinsdóttir, Herdís

2011-05-01

Evaluate the usefulness of the role of clinical nurse specialists and the content of their work by mapping their activities. The clinical work of advanced practice nursing differs in different countries, and a clear picture is lacking on what exactly advanced practice nurses do. Prospective exploratory study. The setting of the study was the largest hospital in Iceland where over half of the country's active nursing workforce are employed, including the only clinical nurse specialists. Of 19 clinical nurse specialists working at the hospital, 15 participated. Data were collected over seven days with a structured activity diary that lists 65 activities, classified into six roles and three domains. In 17 instances, the 'role activities' and 'domain activities' overlap and form 17 categories of practice. The clinical nurse specialists coded their activities at 15-minutes interval and could code up to four activities simultaneously. Daily, the clinical nurse specialists evaluated their clinical nurse specialist background. The roles that occupied the greatest proportion of the clinical nurse specialists' time were education, expert practice and 'other' activities, while the smallest proportions were in counselling, research and practice development. The domain they worked in most was the institutional domain, followed by the client/family domain and the clinical outcome management domain. All of the clinical nurse specialists reported working on two activities simultaneously, 11 of them on three activities and six on four activities. They self-assessed their background as clinical nurse specialists as being very useful. The activity diary is a useful tool for assessing the content of practice. Clinical nurse specialists spend too much time on activities related to the institution. Nurse managers are advised to provide clinical nurse specialists with ample time to develop the direct practice role in the client/family domain. The development of advanced nursing practice requires that clinical nurse specialists take an active and visible part in direct patient care. © 2011 Blackwell Publishing Ltd.

Teacher Education as Academic Work: The Affordances of a Materialist Analysis

ERIC Educational Resources Information Center

Nuttall, Joce; Brennan, Marie

2016-01-01

In this paper we make an argument for paying close attention to the materiality of practice in understanding the work of teacher educators; specifically, the meanings of artefacts used by teacher educators in the course of their daily work. We locate this analysis within a dialectical materialist understanding of the development of human activity,…

"How Can I Help?": Practicing Familial Support through Simulation

ERIC Educational Resources Information Center

Coughlin, April B.; Dotger, Benjamin H.

2016-01-01

Teachers face numerous challenges in daily practice, including situations that involve the health, safety, and well-being of students and families. When harassment and physical abuse impact K-12 students, these situations pose unexpected challenges to novice teachers working to support their students. In this article, the authors report on a study…

Improved quality and more attractive work by applying EBM in disability evaluations: a qualitative survey.

PubMed

Hoving, Jan L; Kok, Rob; Ketelaar, Sarah M; Smits, Paul B A; van Dijk, Frank J H; Verbeek, Jos H

2016-02-29

The uptake of evidence in practice by physicians, even if they are trained in the systematic method of evidence-based medicine (EBM), remains difficult to improve. The aim of this study was to explore perceptions and experiences of physicians doing disability evaluations regarding motivators and preconditions for the implementation of EBM in daily practice. This qualitative study was nested in a cluster randomized controlled trial (Trial registration NTR1767; 20-apr-2009) evaluating the effects of training in EBM. The 45 physicians that participated received a comprehensive 6-months training program in EBM of which the last course day included audio-recorded interviews in groups. During these interviews participating physicians discussed perceptions and experiences regarding EBM application in daily practice. In an iterative process we searched for common motivators or preconditions for the implementation of EBM. Three main concepts or themes emerged after analyzing the transcriptions of the discussions: 1) improved quality of physicians' actions, such as clients benefiting from the application of EBM; 2) improved work attractiveness of physicians; and 3) preconditions that have to be met in order to work in an evidence-based manner including professional competence, facilitating material conditions and organizational support and demands. Physicians trained in EBM are motivated to use EBM because they perceive it as a factor improving the quality of their work and making their work more attractive. In addition to personal investments and gains, organizational support should further facilitate the uptake of evidence in practice.

Clinical Guidelines and Implementation into Daily Dental Practice.

PubMed

Guncu, Guliz Nigar; Nemli, Secil Karakoca; Carrilho, Eunice; Yamalık, Nermin; Volodina, Elena; Melo, Paulo; Margvelashvili, Vladimer; Rossi, Alessandra

2018-01-31

The purpose of this study is to assess the extent of the familiarity, attitude and perceptions of dental professionals regarding clinical dental guidelines and their implementation into daily dental practice. For this purpose, a questionnaire which was developed by the members of the World Dental Federation, European Regional Organization Working Group - 'Relation Between Dental Practitioner and Universities', was implemented by the National Dental Associations of six European Regional Organization-zone countries (Georgian Stomatological Association - Georgia, Associazione Nazionale Dentisti Italiani - Italy, Portuguese Dental Association - Portugal, Russian Dental Association - Russia, Swiss Dental Association - Switzerland, and Turkish Dental Association - Turkey. The questionnaire was filled by a total of 910 dental professionals who are members of one of these national dental associations and who voluntarily wanted to participate to this survey. Most of the survey participants were familiar with clinical dental guidelines (68%), claimed that they implemented them into daily practice (61.7%), and generally acknowledged their benefits (81.8%). Many participants believed that clinical dental guidelines could help to improve the clinical treatment plan (50.6 %) and the accuracy of diagnosis (39.4%); which increased with age and years of practice (p < 0.05). The most frequently perceived barrier to the effective implementation of clinical dental guidelines was expressed as 'lack of awareness', while participants suggested a role for national dental associations in spreading clinical dental guidelines. A better understanding of the perceptions and attitudes of dentists towards clinical dental guidelines and the potential impact of factors affecting such perceptions and attitudes may be of particular importance for attempts aiming at overcoming the barriers for effective implementation of clinical dental guidelines into daily practice. Despite a significant familiarity and a common positive attitude, dental professionals are likely to have different perceptions towards clinical dental guidelines, especially regarding their effective implementation into daily practice, benefits and barriers.

The practical epistemologies of the classroom: A study of laboratory work

NASA Astrophysics Data System (ADS)

Wickman, Per-Olof

2004-05-01

The practical epistemologies of university students during laboratory work in chemistry are analyzed to enhance understanding of how teaching practices interact with learners. The purpose is to develop a theoretical framework of learning as action that can be used by educational researchers to examine meaning-making, but also by teachers in close association with their daily work to understand the course learning takes in their own classrooms. Here this framework is adopted to demonstrate how the sequence of learning may affect the subject content learnt. It is also demonstrated how learning can be understood in terms of habits, and how observations of such habits could be used by a teacher to inform her/his teaching. The theory of practical epistemologies is based on the later Wittgenstein, pragmatics, and sociocultural approaches identifying learning with talk, action, and habits situated in practices.

Gathering, strategizing, motivating and celebrating: the team huddle in a teaching general practice.

PubMed

Walsh, Allyn; Moore, Ainsley; Everson, Jennifer; DeCaire, Katharine

2018-03-01

To understand how implementing a daily team huddle affected the function of a complex interprofessional team including learners. A qualitative descriptive study using semi-structured interviews in focus groups. An academic general practice teaching practice. All members of one interprofessional team, including nurses, general practitioners, junior doctors, and support staff. Focus group interviews using semi-structured guidance were transcribed and the results analysed using qualitative content analysis. Four interrelated themes were identified: communication and knowledge sharing; efficiency of care; relationship and team building; and shared responsibility for team function. The implementation of the daily team huddle was seen by participants to enhance the collaboration within the team and to contribute to work life enjoyment. Participants perceived that problems were anticipated and solved quickly. Clinical updates and information about patients benefited the team including learners. Junior doctors quickly understood the scope of practice of other team members, but some felt reluctant to offer clinical opinions. The implementation of a daily team huddle was viewed as worthwhile by this large interprofessional general practice team. The delivery of patient care was more efficient, knowledge was readily distributed, and problem solving was shared across the team, including junior doctors.

The American Association for Thoracic Surgery 2016 ethics forum: Working virtues in surgical practice.

PubMed

Churchill, Larry R

2017-05-01

Moral virtues are the complement to ethical principles. They constitute the elements of character that drive habits and daily routines. Certain virtues are especially important in surgery, shaping surgical practice even when no big decisions are at hand. Eight virtues are described and the work they do is explored: trustworthiness, equanimity, empathy, advocacy, compassion, courage, humility, and hope. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Themes at the Intersections of Theory and Practice in Online and Blended Education

ERIC Educational Resources Information Center

Lukenchuk, Antonina

2016-01-01

This is a reflexive account of my experiences teaching online and blended doctoral research methodology courses and seminars. Vacillating between skepticism and affirmation, my thoughts mirror the many issues that arise from my daily professional practice and from what I have discovered in my quest to better understand the nature and workings of…

Practical Solutions to Practically Every Problem: The Early Childhood Teacher's Manual.

ERIC Educational Resources Information Center

Saifer, Steffen

This book is designed to help early childhood teachers deal with common problems that arise in all aspects of their work. Part one addresses daily dilemmas such as schedule planning, meal and nap times, art, and outdoor play. Part two covers classroom concerns such as the physical environment, curriculum, individual student needs, field trips,…

Organisation of workplace learning: a case study of paediatric residents' and consultants' beliefs and practices.

PubMed

Skipper, Mads; Nøhr, Susanne Backman; Jacobsen, Tine Klitgaard; Musaeus, Peter

2016-08-01

Several studies have examined how doctors learn in the workplace, but research is needed linking workplace learning with the organisation of doctors' daily work. This study examined residents' and consultants' attitudes and beliefs regarding workplace learning and contextual and organisational factors influencing the organisation and planning of medical specialist training. An explorative case study in three paediatric departments in Denmark including 9 days of field observations and focus group interviews with 9 consultants responsible for medical education and 16 residents. The study aimed to identify factors in work organisation facilitating and hindering residents' learning. Data were coded through an iterative process guided by thematic analysis. Findings illustrate three main themes: (1) Learning beliefs about patient care and apprenticeship learning as inseparable in medical practice. Beliefs about training and patient care expressed in terms of training versus production caused a potential conflict. (2) Learning context. Continuity over time in tasks and care for patients is important, but continuity is challenged by the organisation of daily work routines. (3) Organisational culture and regulations were found to be encouraging as well inhibiting to a successful organisation of the work in regards to learning. Our findings stress the importance of consultants' and residents' beliefs about workplace learning as these agents handle the potential conflict between patient care and training of health professionals. The structuring of daily work tasks is a key factor in workplace learning as is an understanding of underlying relations and organisational culture in the clinical departments.

Sleep and organizational citizenship behavior: the mediating role of job satisfaction.

PubMed

Barnes, Christopher M; Ghumman, Sonia; Scott, Brent A

2013-01-01

We examine sleep as an important factor beyond the work domain that is relevant to organizational citizenship behavior. In a field study of 87 employees from a variety of organizations, an objective measure of sleep quantity predicted organizational citizenship behavior directed toward organizations but not organizational citizenship behavior directed toward individuals. Additionally, job satisfaction mediated this relationship. In a second field study of 85 working college students, we found that natural variation in daily sleep over the course of a work week predicted daily variance in organizational citizenship behavior directed toward both individuals and organizations, and that job satisfaction mediated these relationships. Based on these findings, we discuss theoretical and practical implications of sleep-deprived employees.

A Novel Approach for Collaborative Pair Programming

ERIC Educational Resources Information Center

Goel, Sanjay; Kathuria, Vanshi

2010-01-01

The majority of an engineer's time in the software industry is spent working with other programmers. Agile methods of software development like eXtreme Programming strongly rely upon practices like daily meetings and pair programming. Hence, the need to learn the skill of working collaboratively is of primary importance for software developers.…

5 CFR 610.123 - Travel on official time.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Travel on official time. 610.123 Section... DUTY Weekly and Daily Scheduling of Work Work Schedules § 610.123 Travel on official time. Insofar as practicable travel during nonduty hours shall not be required of an employee. When it is essential that this...

5 CFR 610.123 - Travel on official time.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Travel on official time. 610.123 Section... DUTY Weekly and Daily Scheduling of Work Work Schedules § 610.123 Travel on official time. Insofar as practicable travel during nonduty hours shall not be required of an employee. When it is essential that this...

5 CFR 610.123 - Travel on official time.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Travel on official time. 610.123 Section... DUTY Weekly and Daily Scheduling of Work Work Schedules § 610.123 Travel on official time. Insofar as practicable travel during nonduty hours shall not be required of an employee. When it is essential that this...

5 CFR 610.123 - Travel on official time.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Travel on official time. 610.123 Section... DUTY Weekly and Daily Scheduling of Work Work Schedules § 610.123 Travel on official time. Insofar as practicable travel during nonduty hours shall not be required of an employee. When it is essential that this...

5 CFR 610.123 - Travel on official time.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Travel on official time. 610.123 Section... DUTY Weekly and Daily Scheduling of Work Work Schedules § 610.123 Travel on official time. Insofar as practicable travel during nonduty hours shall not be required of an employee. When it is essential that this...

Systematic Quality Development Work in a Swedish Leisure-Time Centre

ERIC Educational Resources Information Center

Lager, Karin; Sheridan, Sonja; Gustafsson, Jan

2016-01-01

There is increasing activity in the area of quality issues in education in Europe. Diverse discourses of policy for quality are encountered in daily practice. This article explores systematic quality development work in a Swedish educational setting: the leisure-time centre. By following 2 teachers' enactments of policy in planning, organising,…

Is prevention of acute pesticide poisoning effective and efficient, with Locally Adapted Personal Protective Equipment? A randomized crossover study among farmers in Chitwan, Nepal.

PubMed

Varma, Anshu; Neupane, Dinesh; Ellekilde Bonde, Jens Peter; Jørs, Erik

2016-07-26

Farmers' risk of pesticide poisoning can be reduced with personal protective equipment but in low-income countries farmers' use of such equipment is limited. To examine the effectiveness and efficiency of Locally Adapted Personal Protective Equipment to reduce organophosphate exposure among farmers. In a crossover study, 45 male farmers from Chitwan, Nepal, were randomly allocated to work as usual applying organophosphate pesticides wearing Locally Adapted Personal Protective Equipment or Daily Practice Clothing. For seven days before each experiment, each farmer abstained from using pesticides. Before and after organophosphate application, an interview surveys and blood tests were carried out, and analyzed with paired t-test, frequencies and percentages. The difference between follow-up mean for acute organophosphate poisoning symptoms in the two groups was 0.13 [95% CI -0.22;0.49] and for plasma cholinesterase (U/ml) -0.03 [95% CI -0.11;0.06]. The difference between follow-up mean minus baseline mean for acute organophosphate poisoning symptoms in the two groups was 0.29 [95% CI -0.26;0.84] and for plasma cholinesterase (U/ml) -0.01 [95% CI --0.08;0.06]. Wearing the Locally Adapted Personal Protective Equipment versus Daily Practice Clothing gave the following results, respectively: comfort 75.6% versus 100%, sense of heat 64.4% versus 31.3%, other problems 44.4% versus 33.3%, likeability 95.6% versus 77.8%. We cannot support the expectation that our farmers in Chitwan, Nepal working with Locally Adapted Personal Protective Equipment would have fewer acute organophosphate poisoning symptoms, higher plasma cholinesterase (U/mL) and find it more efficient to work with the equipment than farmers working with their Daily Practice Clothing. Based on the farmers' working behavior, compounds used, intensity and exposure duration we conclude that Locally Adapted Personal Protective Equipment does not provide additional protection during usual work practices. However, our Locally Adapted Personal Protective Equipment might offer protection from (certain) accidental overexposure. Trial Registration NCT02137317.

Preventing Heat-Related Illness or Death of Outdoor Workers

MedlinePlus

... attention to workers who show signs of heat-related illness „ „ Evaluating work practices continually to reduce ex- ertion and environmental heat stress „ „ Monitoring weather reports daily and reschedul- ing jobs ...

Design of a Workstation by a Cognitive Approach

PubMed Central

Jaspers, MWM; Steen, T.; Geelen, M.; van den Bos, C.

2001-01-01

To ensure ultimate acceptance of computer systems that are easy to use, provide the desired functionality and fits into users work practices requires the use of improved methods for system design and evaluation. Both designing and evaluating workstations that link up smoothly with daily routine of physicians' work requires a thorough understanding of their working practices. The application of methods from cognitive science may contribute to a thorough understanding of the activities involved in medical information processing. We used cognitive task analysis in designing a physicians' workstation, which seems a promising method to ensure that the system meets the user needs.

[Work in medicine: some issues concerning professional autonomy].

PubMed

Schraiber, L B

1995-01-01

The author analyzes several issues pertaining to medical practice as related to the technical autonomy characterizing professional activity in this field. She points to the coexistente of a scientific side and an empirical/pragmatic side of medicine, the latter known as the medical art. The article also discusses the complexity of medical command of technological rationality which presides over the practical use of scientific knowledge. The author defines work in medicine as a "tensive structure" and examines its consequences for self-representation by physicians, their daily work, and themselves as agents of professional labor and subjects of action.

Effects of workplace intervention on affective well-being in employees' children.

PubMed

Lawson, Katie M; Davis, Kelly D; McHale, Susan M; Almeida, David M; Kelly, Erin L; King, Rosalind B

2016-05-01

Using a group-randomized field experimental design, this study tested whether a workplace intervention-designed to reduce work-family conflict-buffered against potential age-related decreases in the affective well-being of employees' children. Daily diary data were collected from 9- to 17-year-old children of parents working in an information technology division of a U.S. Fortune 500 company prior to and 12 months after the implementation of the Support-Transform-Achieve-Results (STAR) workplace intervention. Youth (62 with parents in the STAR group, 41 in the usual-practice group) participated in 8 consecutive nightly phone calls, during which they reported on their daily stressors and affect. Well-being was indexed by positive and negative affect and affective reactivity to daily stressful events. The randomized workplace intervention increased youth positive affect and buffered youth from age-related increases in negative affect and affective reactivity to daily stressors. Future research should test specific conditions of parents' work that may penetrate family life and affect youth well-being. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Effectiveness of Work, Activities of Daily Living, Education, and Sleep Interventions for People With Autism Spectrum Disorder: A Systematic Review.

PubMed

Weaver, Lindy L

2015-01-01

To examine interventions addressing work, activities of daily living (ADLs), instrumental activities of daily living (IADLs), education, and sleep for people with autism spectrum disorder. A total of 23 studies were identified, and 9 work-, 11 ADL/IADL-, and 3 education-related interventions were examined. No sleep studies were identified. Use of mobile and tablet technologies for vocational skills was supported. Support for ADL/IADL intervention is variable, with indications that Cognitive Orientation to Occupational Performance, sensory integration, and contextual interventions may increase occupational performance. Preliminary evidence suggests that daily yoga and brief exercise may improve classroom performance and behavior; group physical activities may assist with school readiness variables. Evidence for using technologies for IADLs was limited, as was evidence determining effective interventions for feeding and eating issues. Studies investigating interventions related to sleep are lacking. More studies are needed in all areas, presenting opportunities for the expansion of science-driven occupational therapy practice and research for people with ASD. Copyright © 2015 by the American Occupational Therapy Association, Inc.

Calvin Won't Sit Down! The Daily Behavior Report Card: A Practical Technique to Change Student Behavior and Increase School-Home Communication

ERIC Educational Resources Information Center

Mires, Carolyn B.; Lee, David L.

2017-01-01

Calvin is a student who will not stay in his seat. He calls out constantly. Calvin does not complete his class work, and his homework is rarely returned. Do you have a student like Calvin? Does he fail to turn in homework, or act disrespectfully toward teachers and peers? Easy to implement, the Daily Behavior Report Card is an empirically based…

Longing for a Better World: Hope in Professional Practices

ERIC Educational Resources Information Center

Erwich, René; van der Stoep, Jan

2017-01-01

Christians are called to be a witness to the coming of the Kingdom of God and to cultivate practices in which peace and justice may flourish. In order to serve God in their daily work, Christians are faced with situations that cause both hope and despair. In this article, we explore what the concept of hope means for the education of Christian…

How to Address Citizens' Practices and Policies on Sustainability? A Consultative Tool for Brokering Policy-Related Knowledge between the Worlds of Policymaking and Everyday

ERIC Educational Resources Information Center

Espluga, Josep; Konrad, Wilfried; Mays, Claire; Oltra, Christian; Poumadére, Marc; Prades, Ana

2016-01-01

An innovative investigative approach (STAVE), combining elements of research, engagement and brokerage, was used to uncover policy assumptions and daily experiences related to energy use practices. Exploratory work within three policymaker institutions and eight reconvened focus groups were carried out in three different European countries…

Embodied practice: claiming the body's experience, agency, and knowledge for social work.

PubMed

Tangenberg, Kathleen M; Kemp, Susan

2002-01-01

Although social work practice typically is concerned with physical conditions and experiences such as poverty, addiction, and violence, relatively little attention has been given to the body in professional literature. Emphasizing both physical and sociocultural dimensions of the body, this article argues for an invigorated, more complex understanding of the body in social work theory, practice, and research. Drawing from scholarship in the humanities, social sciences, and social work, a framework involving three dimensions of the body is proposed for integration with accepted ecological practice models. The nature and implications of three primary dimensions of the body for multiple domains of social work practice are explored, citing examples from narratives of mothers living with HIV disease: (1) the experiencing body, focused on the physicality of daily life; (2) the body of power, focused on the physicality of oppression and marginality, typically based on race or ethnicity, socioeconomic status, gender, sexual orientation, age, disability, physical appearance, and illness; and (3) the client body, reflecting the bodily experiences of those identified as clients who participate in relationships with social workers.

Benefits of transformational behaviors for leaders: A daily investigation of leader behaviors and need fulfillment.

PubMed

Lanaj, Klodiana; Johnson, Russell E; Lee, Stephanie M

2016-02-01

Although a large body of work has examined the benefits of transformational leadership, this work has predominantly focused on recipients of such behaviors. Recent research and theory, however, suggest that there are also benefits for those performing behaviors reflective of transformational leadership. Across 2 experience-sampling studies, we investigate the effects of such behaviors on actors' daily affective states. Drawing from affective events theory and self-determination theory we hypothesize and find that engaging in behaviors reflective of transformational leadership is associated with improvement in actors' daily affect, more so than engaging in behaviors reflective of transactional, consideration, initiating structure, and participative leadership. Behaviors reflective of transformational leadership improved actors' affect in part by fulfilling their daily needs. Furthermore, extraversion and neuroticism moderated these effects such that extraverts benefitted less whereas neurotics benefitted more from these behaviors in terms of affective changes. We consider the theoretical and practical implications of these findings and offer directions for future research. (c) 2016 APA, all rights reserved).

Daily micro-breaks and job performance: General work engagement as a cross-level moderator.

PubMed

Kim, Sooyeol; Park, YoungAh; Headrick, Lucille

2018-03-29

Despite the growing research on work recovery and its well-being outcomes, surprisingly little attention has been paid to at-work recovery and its job performance outcomes. The current study extends the work recovery literature by examining day-level relationships between prototypical microbreaks and job performance as mediated by state positive affect. Furthermore, general work engagement is tested as a cross-level moderator weakening the indirect effects of microbreaks on job performance via positive affect. Using multisource experience sampling method, the authors collected two daily surveys from 71 call center employees and obtained objective records of daily sales performance for two consecutive weeks (n = 632). Multilevel path analysis results showed that relaxation, socialization, and cognitive microbreaks were related to increased positive affect at work which, in turn, predicted greater sales performance. However, breaks for nutrition-intake (having snacks and drinks) did not show significant effects. Importantly, microbreaks had significant indirect effects on job performance via positive affect only for workers who had lower general work engagement, whereas the indirect effects did not exist for workers who had higher general work engagement. Furthermore, Bayesian multilevel analyses confirmed the results. Theoretical and practical implications, limitations, and future research directions are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Daily Practices of Successful Principals

ERIC Educational Resources Information Center

Brock, Barbara L.; Grady, Marilyn L.

2011-01-01

While many books outline the attributes of successful school leaders, few describe how those traits manifest in daily practice. "The Daily Practices of Successful Principals" goes beyond the outward picture of excellence and provides a compendium of daily practices used by successful principals in various settings. Written by former administrators…

Good enough practices in scientific computing.

PubMed

Wilson, Greg; Bryan, Jennifer; Cranston, Karen; Kitzes, Justin; Nederbragt, Lex; Teal, Tracy K

2017-06-01

Computers are now essential in all branches of science, but most researchers are never taught the equivalent of basic lab skills for research computing. As a result, data can get lost, analyses can take much longer than necessary, and researchers are limited in how effectively they can work with software and data. Computing workflows need to follow the same practices as lab projects and notebooks, with organized data, documented steps, and the project structured for reproducibility, but researchers new to computing often don't know where to start. This paper presents a set of good computing practices that every researcher can adopt, regardless of their current level of computational skill. These practices, which encompass data management, programming, collaborating with colleagues, organizing projects, tracking work, and writing manuscripts, are drawn from a wide variety of published sources from our daily lives and from our work with volunteer organizations that have delivered workshops to over 11,000 people since 2010.

Web-GIS based information management system to Bureau of Law Enforcement for Urban Managementenforcement for urban management

NASA Astrophysics Data System (ADS)

Sun, Hai; Wang, Cheng; Ren, Bo

2007-06-01

Daily works of Law Enforcement Bureau are crucial in the urban management. However, with the development of the city, the information and data which are relative to Law Enforcement Bureau's daily work are increasing and updating. The increasing data result in that some traditional work is limited and inefficient in daily work. Analyzing the demands and obstacles of Law Enforcement Bureau, the paper proposes a new method to solve these problems. A web-GIS based information management system was produced for Bureau of Law Enforcement for Urban Management of Foshan. First part of the paper provides an overview of the system. Second part introduces the architecture of system and data organization. In the third part, the paper describes the design and implement of functional modules detailedly. In the end, this paper is concluded and proposes some strategic recommendations for the further development of the system. This paper focuses on the architecture and implementation of the system, solves the developing issues based on ArcServer, and introduces a new concept to the local government to solve the current problems. Practical application of this system showed that it played very important role in the Law Enforcement Bureau's work.

The relationship between nurse practice environment, nurse work characteristics, burnout and job outcome and quality of nursing care: a cross-sectional survey.

PubMed

Van Bogaert, Peter; Kowalski, Christoph; Weeks, Susan Mace; Van Heusden, Danny; Clarke, Sean P

2013-12-01

To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment. Acute care hospitals face daily challenges to their efforts to achieve nurse workforce stability, safety, and quality of care. A body of knowledge shows a favourably rated nurse practice environment as an important condition for better nurse and patient outcome variables; however, further research initiatives are imperative for a clear understanding to support and guide the practice community. Cross-sectional survey. Grounded on previous empirical findings, a structural equation model designed with valid measurement instruments was tested. The study population was registered acute care nurses (N=1201) in two independent hospitals and one hospital group with six hospitals in Belgium. Nurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care. Analyses were consistent with features of nurses' work characteristics including perceived workload, decision latitude, and social capital, as well as three dimension of burnout playing mediating roles between nurse practice environment and outcomes. A revised model adjusted using various fit measures explained 52% and 47% of job outcomes and nurse-assessed quality of care, respectively. The study refines understanding of the relationship between aspects of nursing practice in order to achieve favourable nursing outcomes and offers important concepts for managers to track in their daily work. The findings of this study indicate that it is important for clinicians and leaders to consider how nurses are involved in decision-making about care processes and tracking outcomes of care and whether they are able to work with physicians, superiors, peers, and subordinates in a trusting environment based on shared values. The involvement of nurse managers at the unit level is especially critical because of associations with nurse work characteristics such as decision latitude and social capital and outcome variables. Further practice and research initiatives to support nurses' involvement in decision-making process and interdisciplinary teamwork are recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

A RCT Comparing Daily Mindfulness Meditations, Biofeedback Exercises, and Daily Physical Exercise on Attention Control, Executive Functioning, Mindful Awareness, Self-Compassion, and Worrying in Stressed Young Adults.

PubMed

de Bruin, Esther I; van der Zwan, J Esi; Bögels, Susan M

2016-01-01

Our Western society is characterized by multitasking, competition, and constant time pressure. Negative effects of stress for the individual (anxiety, depression, somatic complaints) and for organizations and society (costs due to work absence) are very high. Thus, time-efficient self-help interventions to address these issues are necessary. This study assessed the effects of daily mindfulness meditations (MM) versus daily heart rate variability biofeedback (HRV-BF) and daily physical exercise (PE) on attention control, executive functioning, mindful awareness, self-compassion, and worrying. Young adults ( n  = 75, age range 18 to 40) with elevated stress levels were randomized to MM, HRV-BF, or PE, and measurements were taken at pre-test, post-test, and follow-up. Interventions in all three groups were self-guided and lasted for 5 weeks. Generalized estimating equation analyses showed that overall, all three interventions were effective and did not differ from each other. However, practice time differed between groups, with participants in the PE group practicing much more than participants in the other two groups. Therefore, additional analyses were carried out in two subsamples. The optimal dose sample included only those participants who practiced for at least 70 % of the total prescribed time. In the equal dose sample, home practice intensity was equal for all three groups. Again, the effects of the three interventions did not differ. In conclusion, MM, HRV-BF, and PE are all effective self-help methods to improve attention control, executive functioning, mindful awareness, self-compassion, and worrying, and mindfulness meditation was not found to be more effective than HRV-biofeedback or physical exercise for these cognitive processes.

Integrating Puppet and Gitolite to provide a novel solution for scalable system management at the MPPMU Tier2 centre

NASA Astrophysics Data System (ADS)

Delle Fratte, C.; Kennedy, J. A.; Kluth, S.; Mazzaferro, L.

2015-12-01

In a grid computing infrastructure tasks such as continuous upgrades, services installations and software deployments are part of an admins daily work. In such an environment tools to help with the management, provisioning and monitoring of the deployed systems and services have become crucial. As experiments such as the LHC increase in scale, the computing infrastructure also becomes larger and more complex. Moreover, today's admins increasingly work within teams that share responsibilities and tasks. Such a scaled up situation requires tools that not only simplify the workload on administrators but also enable them to work seamlessly in teams. In this paper will be presented our experience from managing the Max Planck Institute Tier2 using Puppet and Gitolite in a cooperative way to help the system administrator in their daily work. In addition to describing the Puppet-Gitolite system, best practices and customizations will also be shown.

Learning to doctor: tinkering with visibility in residency training.

PubMed

Wallenburg, Iris; Bont, Antoinette; Heineman, Maas-Jan; Scheele, Fedde; Meurs, Pauline

2013-05-01

Medical doctors in teaching hospitals aim to serve the two central goals of patient care and medical training. Whereas patient care asks for experience, expertise and close supervision, medical training requires space to practise and the 'invisibility' of medical residents. Yet current reforms in postgraduate medical training point to an increasing emphasis on the measurable visibility of residents. Drawing on an ethnographic study of gynaecology training in The Netherlands, this article demonstrates that in daily clinical routines multiple practices of residents' visibility (visibilities) coexist. The article lists four visibilities: staging residents, negotiating supervision, playing the invisibility game and filming surgical operations. The article shows how attending physicians and medical residents tinker with these visibilities in daily clinical work to provide good care while enacting learning space, highlighting the increasing importance of visualising technologies in clinical work. Moreover, the article contributes to traditional sociological accounts on medical education, shifting the focus from medical education as a social institution to the practices of medical training itself. Such a focus on practice helps to gain an understanding of how the current reform challenges clinicians' educational activities. © 2012 The Authors. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

[The importance of symbolic interactionism in nursing practice].

PubMed

Dupas, G; de Oliveira, I; Costa, T N

1997-08-01

The nurse should combine, in their daily practice, technical abilities with a profound comprehension of the main object oh their work, the human being. Symbolic Interactionism is an approach which enables the nursery professional to understand patients by the meaning they value their living experiences. The use of qualitative methods in nursery research is essential because it studies the humans beings and their relationship with the environment, allowing the understanding of the living experiences. These kind of approaches should be even more applied in nursery practice as they open new ways for professional knowledge and enrich practical skills.

Outcome of parent-physician communication skills training for pediatric residents.

PubMed

Nikendei, Christoph; Bosse, Hans Martin; Hoffmann, Katja; Möltner, Andreas; Hancke, Rabea; Conrad, Corinna; Huwendiek, Soeren; Hoffmann, Georg F; Herzog, Wolfgang; Jünger, Jana; Schultz, Jobst-Hendrik

2011-01-01

communication skills represent an essential component of clinical competence. In the field of pediatrics, communication between physicians and patients' parents is characterized by particular difficulties. To investigate the effects of a parent-physician communication skills training program on OSCE performance and self-efficacy in a group control design. parallel to their daily work in the outpatient department, intervention-group experienced clinicians in practice (n=14) participated in a communication training with standardized parents. Control-group physicians (n=14) did not receive any training beyond their daily work. Performance was assessed by independent video ratings of an OSCE. Both groups rated their self-efficacy prior to and following training. regarding OSCE performance, the intervention group demonstrated superior skills in building relationships with parents (p<.024) and tended to perform better in exploring parents' problems (p<.081). The communication training program led to significant improvement in self-efficacy with respect to the specific training objectives in the intervention group (p<.046). even in physicians with considerable experience, structured communication training with standardized parents leads to significant improvement in OSCE performance and self-efficacy. PRACTISE IMPLICATIONS: briefness and tight structure make the presented communication training program applicable even for experienced physicians in daily clinical practice. 2010 Elsevier Ireland Ltd. All rights reserved.

Interviewing Children: Reporter Guide

ERIC Educational Resources Information Center

Carr, Sarah

2012-01-01

Interviewing children is a critical element of the education reporter's daily work. However, practices for gaining access and avoiding harm and embarrassment vary widely depending on the news organization and individual reporter in question. This document aims to provide journalists with broad guidelines, but it stops short of advocating for the…

"Grey" Areas and "Organized Chaos" in Emergency Response

ERIC Educational Resources Information Center

Taber, Nancy; Plumb, Donovan; Jolemore, Shawn

2008-01-01

Purpose: The purpose of this research is to explore the interaction between organizational policies and daily work practices of paramedics and firefighters within two emergency response organizations. Design/methodology/approach: Data were collected in a case study consisting of interviews, focus groups, and observations. The theoretical grounding…

Design Principles Guide Educators in Choosing and Using Curriculum Materials. Research Review

ERIC Educational Resources Information Center

Foster, Elizabeth

2018-01-01

Engaging with materials can shape the teaching experience, teachers' practices and mindsets, and, ultimately, students' learning experiences. This issue of "Learning Professional" looks at an area of emerging interest: curriculum materials and the role they play in the daily work of educators and leaders. Educators, researchers, and…

Micro-Cycle Teaching Experiments as a Vehicle for Professional Development

ERIC Educational Resources Information Center

Billings, Esther M. H.; Kasmer, Lisa

2015-01-01

This study used design experiments, specifically micro-cycle teaching experiments (MTE) as a catalyst for practice-based professional development. The MTE incorporated research-based characteristics of effective professional development: it was embedded in the teachers' daily work of planning and enacting lessons, co-constructed with the…

Tips and Tidbits: A Book for Family Day Care Providers.

ERIC Educational Resources Information Center

Gonzalez-Mena, Janet

This book provides practical information and advice designed to help family day care providers solve problems they confront in their daily work with children. The book is organized into 7 sections. Part I, "Effective Ways to Change Unacceptable Behavior," offers recommendations about discipline, alternatives to punishment, modeling, and…

Secrets of Successful Homeschooling

ERIC Educational Resources Information Center

Rivero, Lisa

2011-01-01

Parents who homeschool gifted children often find the daily practice of home education very different from what they had imagined. Gifted children are complex in both personality and learning styles. Parents who say that homeschooling works well for their gifted children have learned from others or discovered on their own several secrets that make…

School Counseling Principles: Ethics and Law

ERIC Educational Resources Information Center

Stone, Carolyn

2006-01-01

This practical guide will sensitize the professional school counselor to legal and ethical issues involved in working with minors in school settings. Using a case study approach and more than 100 cases representing school counselors daily dilemmas, chapters help the reader connect the reality of school counseling to critical federal and state…

How Data Use for Accountability Undermines Equitable Science Education

ERIC Educational Resources Information Center

Braaten, Melissa; Bradford, Chris; Kirchgasler, Kathryn L.; Barocas, Sadie Fox

2017-01-01

Purpose: When school leaders advance strategic plans focused on improving educational equity through data-driven decision making, how do policies-as-practiced unfold in the daily work of science teachers? The paper aims to discuss this issue. Design/methodology/approach: This ethnographic study examines how data-centric accountability and…

Supervisors Need Support, Too

ERIC Educational Resources Information Center

Martin, James G.

2017-01-01

In recent years, there has been an increasing focus on professional learning structures for teaching and finding ways to embed this learning into the daily work of teachers. This is premised on the understanding that one-shot professional development yields little transfer or change of practice to ultimately impact student learning. But how has…

"I Can Do Better": Exploring Purposeful Improvement in Daily Clinical Work

ERIC Educational Resources Information Center

Mylopoulos, Maria; Farhat, Walid

2015-01-01

Clinicians' purposeful improvement of practice is vital to maintaining excellence in patient care. This activity is understood as a core competency of adaptive expertise. As part of a broader program of research exploring adaptive expertise in healthcare, this study explored purposeful improvement in paediatric minimally invasive surgery. A…

So You Think You Want to Save the World

PubMed Central

Bodnar, Benjamin E.

2011-01-01

There is increasing interest among both medical and other professional communities in becoming involved in global health, development, and other charitable work. There has also been a proliferation of opportunities in the field. Nonetheless, it is still difficult to find practical information on the daily realities of development work or advice on the difficulties inherent to this type of work. This article is intended for individuals who are interested in becoming involved in global health and development work. Through a discussion that touches on development economics, the history, psychology, and current state of development aid, the common conflicts, as well as the rewards of development work, this article aims to prepare the interested individual for the experience of global health and development work. The article also provides practical suggestions and references for those searching for an opportunity in the field, with an emphasis on global health opportunities. PMID:21966040

So you think you want to save the world.

PubMed

Bodnar, Benjamin E

2011-09-01

There is increasing interest among both medical and other professional communities in becoming involved in global health, development, and other charitable work. There has also been a proliferation of opportunities in the field. Nonetheless, it is still difficult to find practical information on the daily realities of development work or advice on the difficulties inherent to this type of work. This article is intended for individuals who are interested in becoming involved in global health and development work. Through a discussion that touches on development economics, the history, psychology, and current state of development aid, the common conflicts, as well as the rewards of development work, this article aims to prepare the interested individual for the experience of global health and development work. The article also provides practical suggestions and references for those searching for an opportunity in the field, with an emphasis on global health opportunities. Copyright © 2011.

Prevention and management of foot problems in diabetes: A Summary Guidance for Daily Practice 2015, based on the IWGDF guidance documents.

PubMed

Schaper, N C; Van Netten, J J; Apelqvist, J; Lipsky, B A; Bakker, K

2017-02-01

Foot problems complicating diabetes are a source of major patient suffering and societal costs. To prevent, or at least reduce, the adverse effects of foot problems in diabetes, the International Working Group on the Diabetic Foot (IWGDF; www.iwgdf.org) was founded in 1996, consisting of experts from almost all the disciplines involved in the care of patients with diabetes and foot problems. An important output of the IWGDF is the international consensus guidance, continuously updated since 1999. To date, the publications have been translated into 26 languages, and more than 100,000 copies have been distributed globally. The "Summary Guidance for Daily Practice" summarises the essentials of prevention and management of foot problems in persons with diabetes for clinicians who work with these patients on a daily basis. This guidance is the result of a long and careful process that started with the empaneling in 2013 of five working groups consisting of 49 international experts. These experts performed seven targeted systematic reviews to provide the evidence supporting the five chapters of the IWGDF Guidance on prevention; footwear and offloading; diagnosis, prognosis and management of peripheral artery disease; diagnosis and management of foot infections; interventions to enhance healing. In total almost 80,000 studies were detected by our literature review. After review of the title and abstract the reviewers of the different working groups selected only studies that fulfilled a minimal set of quality criteria and ended up with 429 articles for complete quality analysis. The GRADE system was used to translate the evidence from the studies into recommendations for daily clinical practice. The rating of each recommendation takes into account both the strength and the quality of the evidence. The IWGDF Guidance 2015 makes a total of 77 recommendations on prevention and management of foot problems in diabetes. These recommendations were condensed by the editorial board into this "Summary Guidance". Encouraging and aiding clinicians to follow the evidence-based recommendations of the IWGDF Guidance 2015, and in particular the principles outlined in the "Summary Guidance", will likely result in a worldwide reduction in, and better outcomes of, foot problems in persons with diabetes, helping to reduce the morbidity and mortality associated with this major health problem. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Antibiotic stewardship: does it work in hospital practice? A review of the evidence base.

PubMed

Hulscher, M E J L; Prins, J M

2017-11-01

Guidelines for developing and implementing stewardship programmes include recommendations on appropriate antibiotic use to guide the stewardship team's choice of potential stewardship objectives. They also include recommendations on behavioural change interventions to guide the team's choice of potential interventions to ensure that professionals actually use antibiotics appropriately in daily practice. To summarize the evidence base of both appropriate antibiotic use recommendations (the 'what') and behavioural change interventions (the 'how') in hospital practice. Published systematic reviews/Medline. The literature shows low-quality evidence of the positive effects of appropriate antibiotic use in hospital patients. The literature shows that any behavioural change intervention might work to ensure that professionals actually perform appropriate antibiotic use recommendations in daily practice. Although effects were overall positive, there were large differences in improvement between studies that tested similar change interventions. The literature showed a clear need for studies that apply appropriate study designs- (randomized) controlled designs-to test the effectiveness of appropriate antibiotic use on achieving meaningful outcomes. Most current studies used designs prone to confounding by indication. In the process of selecting behavioural change interventions that might work best in a chosen setting, much should be learned from behavioural sciences. The challenge for stewardship teams lies in selecting change interventions on the careful assessment of barriers and facilitators, and on a theoretical base while linking determinants to change interventions. Future studies should apply more robust designs and evaluations when assessing behavioural change interventions. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Predictors for half-year outcome of impairment in daily life for back pain patients referred for physiotherapy: a prospective observational study.

PubMed

Karstens, Sven; Hermann, Katja; Froböse, Ingo; Weiler, Stephan W

2013-01-01

From observational studies, there is only sparse information available on the predictors of development of impairment in daily life for patients receiving physiotherapy. Therefore, our aim was to identify factors which predict impairment in daily life for patients with back pain 6 months after receiving physiotherapy. We conducted a prospective cohort study with 6-month follow-up. Patients were enrolled for treatment in private physiotherapy practices. Patients with a first physiotherapy referral because of thoracic or low back pain, aged 18 to 65 years were included. Primary outcome impairment was measured utilising the 16-item version of the Musculoskeletal Function Assessment Questionnaire. Therapy was documented on a standardized form. Baseline scores for impairment in daily life, symptom characteristics, sociodemographic and psychosocial factors, physical activity, nicotine consumption, intake of analgesics, comorbidity and delivered primary therapy approach were investigated as possible predictors. Univariate and multiple linear regression analyses were performed. A total of 792 patients participated in the study (59% female, mean age 44.4 (SD 11.4), with 6-month follow-up results available from 391 patients. In univariate analysis 17 variables reached significance. In multiple linear regression identified predictors were: impairment in daily life before therapy, mental disorders, duration of the complaints, self-prognosis on work ability, rheumatoid arthritis, age, form of stress at work and physical activity. The variables explain 34% of variance (adjusted R(2), p<0.001). With minimal information available from observational studies on the predictors of development of back problems for physiotherapy patients, this study adds new knowledge for forming appropriate referral guidelines. Impairment in daily life before therapy, mental disorder as comorbidity and the duration of the complaints can be named as outstanding factors. The results of this study can be used to facilitate comparison of patient therapy goals with the prognosis in everyday practice.

The art and science of political advocacy.

PubMed

Kosiorowski, Donna

2014-01-01

School nurses throughout the nation, individually and collectively, work to bring about change for the school nursing profession and to safeguard the health of children and the public. School nurses practice amidst education reform, health care reform, changes in society, and medical and technological advancements. School nurses must be active in decisions that affect their daily practice by involvement in the local, state, and federal political process. School nurses must craft the art and develop the science of political advocacy.

The Standard of Care: Legal History and Definitions: the Bad and Good News

PubMed Central

Moffett, Peter; Moore, Gregory

2011-01-01

The true meaning of the term “the standard of care” is a frequent topic of discussion among emergency physicians as they evaluate and perform care on patients. This article, using legal cases and dictums, reviews the legal history and definitions of the standard of care. The goal is to provide the working physician with a practical and useful model of the standard of care to help guide daily practice. PMID:21691483

Engaging social work practitioners in research: challenges and opportunities.

PubMed

Gitterman, Alex

2014-10-01

Contemporary emphasis on measuring and evaluating observable, behavioral outcomes reflects a major change in the profession toward greater empirical basis for social work practice. This intellectual and methodological shift has created a gap between practitioners and researchers. While social work practitioners definitely should be more knowledgeable and receptive to interventions that have proven to be effective in helping people, social work academics must pay more attention to the realities of social work practitioners who struggle daily with expanding caseloads, ever-increasing time pressures to help clients whose lives are embedded in poverty, unemployment, oppression, racism, homelessness, and violence.

Work happiness among teachers: a day reconstruction study on the role of self-concordance.

PubMed

Tadić, Maja; Bakker, Arnold B; Oerlemans, Wido G M

2013-12-01

Self-concordant work motivation arises from one's authentic choices, personal values, and interests. In the present study, we investigated whether self-concordant motivation may fluctuate from one work-related task to the next. On the basis of self-determination theory, we hypothesized that momentary self-concordance buffers the negative impact of momentary work demands on momentary happiness. We developed a modified version of the day reconstruction method to investigate self-concordance, work demands, and happiness during specific work-related tasks on a within-person and within-day level. In total, 132 teachers completed a daily diary on three consecutive work days as well as a background questionnaire. The daily diary resulted in 792 reported work activities and activity-related work demands, self-concordance, and happiness scores. Multilevel analysis showed that-for most work activities-state self-concordant motivation buffered the negative association of work demands with happiness. These findings add to the literature on motivation and well-being by showing that the levels of self-concordance and happiness experienced by employees vary significantly on a within-day level and show a predictable pattern. We discuss theoretical and practical implications of the findings to increase employees' well-being. © 2013.

Using knowledge as the basis for evidence-based practice in primary care nurses.

PubMed

Bennasar-Veny, M; Gonzalez-Torrente, S; De Pedro-Gomez, J; Morales-Asencio, J M; Pericas-Beltran, J

2016-06-01

The aim of this study was to explore the perception of primary care nurses regarding the need and use of knowledge from research, as a basis for evidence-based practice in their workplace. Additionally, the study aimed to determine which factors might hinder or enable implementation into daily practice. Evidence-based practice involves integrating best results in research with clinical experience, which enables us to provide a higher quality of care, as well as to optimize the care given. International studies show that nurses feel that there are still many barriers that hinder their doing research and incorporating new findings into clinical practice; although in the field of primary care, few studies have been carried out. This descriptive qualitative study design used focus groups to collect data. This study was carried out in Spanish primary care centres. Forty-six registered nurses took part in this study and were divided into five focus groups. Three significant themes emerged: awareness of the need to use research, nurses as knowledge-generation agents and motivation to use research despite barriers. A limited number of participants and a convenience sample were used. Nurses recognize that professional health care must be based on evidence obtained from daily work - both originated by their colleagues and by themselves - and they are willing to work on it although they perceive a lack of competence for this purpose and demand support from their institutions. Primary care institutions should empower nursing coordinators as leaders of evidence-based practice and implicate clinical nurses from the beginning on the implementation of guidelines. © 2016 International Council of Nurses.

Eating out in Spain: Motivations, sociability and consumer contexts.

PubMed

Díaz-Méndez, Cecilia; García-Espejo, Isabel

2017-12-01

Eating out is a consumer practice which is difficult to define. The study of this practice has traditionally been based on the work/leisure dichotomy. However, in Spain this is not so clear. If we analyse profiles, motivations, places and relationships, we discover an eating-out food model which is specific to Spain and in which food is not limited by this dual link with work and leisure. Eating linked to work does not respond only to instrumental needs. Leisure eating is not always a choice based on preference. Both contain a strong element of sociability which acts as a motivator and are linked to the familisme of Spanish society, whilst at the same time de-routinizing daily life, both at home and at work. This study is based on a national survey carried out in 2014 and helps to understand this consumer practice and those elements which are specific to Spain. Copyright © 2017 Elsevier Ltd. All rights reserved.

Why measure patient satisfaction?

PubMed

Riskind, Patty; Fossey, Leslie; Brill, Kari

2011-01-01

A practice that consistently and continuously measures patient perceptions will be more efficient and effective in its daily operations. With pay-for-performance requirements on the horizon and consumer rating sites already publicizing impressions from physician encounters, a practice needs to know how it is performing through the eyes of the patients. Azalea Orthopedics has used patient feedback to coach its physicians on better patient communication. The Orthopaedic Institute has used patient satisfaction results to reduce wait times and measure the return on investment from its marketing efforts. Patient survey results that are put to work can enhance the efficiency and effectiveness of practice operations as well as position the practice for increased profitability.

Chest radiography practice in critically ill patients: a postal survey in the Netherlands

PubMed Central

Graat, Marleen E; Hendrikse, Karin A; Spronk, Peter E; Korevaar, Johanna C; Stoker, Jaap; Schultz, Marcus J

2006-01-01

Background To ascertain current chest radiography practice in intensive care units (ICUs) in the Netherlands. Methods Postal survey: a questionnaire was sent to all ICUs with > 5 beds suitable for mechanical ventilation; pediatric ICUs were excluded. When an ICU performed daily-routine chest radiographs in any group of patients it was considered to be a "daily-routine chest radiography" ICU. Results From the number of ICUs responding, 63% practice a daily-routine strategy, in which chest radiographs are obtained on a daily basis without any specific reason. A daily-routine chest radiography strategy is practiced less frequently in university-affiliated ICUs (50%) as compared to other ICUs (68%), as well as in larger ICUs (> 20 beds, 50%) as compared to smaller ICUs (< 20 beds, 65%) (P > 0.05). Remarkably, physicians that practice a daily-routine strategy consider daily-routine radiographs helpful in guiding daily practice in less than 30% of all performed radiographs. Chest radiographs are considered essential for verification of the position of invasive devices (81%) and for diagnosing pneumothorax, pneumonia or acute respiratory distress syndrome (82%, 74% and 69%, respectively). On demand chest radiographs are obtained after introduction of thoracic drains, central venous lines and endotracheal tubes in 98%, 84% and 75% of responding ICUs, respectively. Chest films are also obtained in case of ventilatory deterioration (49% of responding ICUs), and after cardiopulmonary resuscitation (59%), tracheotomy (58%) and mini-tracheotomy (23%). Conclusion There is notable lack of consensus on chest radiography practice in the Netherlands. This survey suggests that a large number of intensivists may doubt the value of daily-routine chest radiography, but still practice a daily-routine strategy. PMID:16848892

Understanding suffering and giving compassion: the reach of socially engaged Buddhism into China.

PubMed

Kuah-Pearce, Khun Eng

2014-01-01

This paper will explore the social engagement of Buddhists through their active voluntary works - works that result in the development of a religious philanthropic culture. Through three case examples, this paper will examine how the sangha and individual Buddhists understand social suffering and compassion and attempt to integrate their understanding of Buddhist virtues and values in their daily life where the performance of voluntary works is seen as Buddhist spiritualism. In this process, the individuals seek to understand the key principles of Buddhism that are of direct relevance to their daily existence and their quest to be a compassionate self. Foremost are two notions of yebao (karma) and gan-en (gratitude) and how through compassionate practices and gratitude for those who accepted compassionate acts, they would be rewarded with good karma. Here, pursuing compassionate acts and the alleviation of social suffering is the pursuit of this-worldly spiritualism.

Designing and Piloting a Leadership Daily Practice Log: Using Logs to Study the Practice of Leadership

ERIC Educational Resources Information Center

Spillane, James P.; Zuberi, Anita

2009-01-01

Purpose: This article aims to validate the Leadership Daily Practice (LDP) log, an instrument for conducting research on leadership in schools. Research Design: Using a combination of data sources--namely, a daily practice log, observations, and open-ended cognitive interviews--the authors evaluate the validity of the LDP log. Participants: Formal…

Supporting Fourth-Grade Students' Word Identification Using Application Software

ERIC Educational Resources Information Center

Moser, Gary P.; Morrison, Timothy G.; Wilcox, Brad

2017-01-01

A quasi-experimental study examined effects of a 10-week word structure intervention with fourth-grade students. During daily 10-15-minute practice periods, students worked individually with mobile apps focused on specific aspects of word identification. Pre- and post-treatment assessments showed no differences in rate and accuracy of oral reading…

Saxon Math. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2013

2013-01-01

"Saxon Math," published by Houghton Mifflin Harcourt, is a core curriculum for students in grades K-5. A distinguishing feature of the curriculum is its use of an incremental approach for instruction and assessment. This approach limits the amount of new math content delivered to students each day and allows time for daily practice. New…

Saxon Math. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2016

2016-01-01

"Saxon Math" is a core curriculum for students in grades K-12 that uses an incremental approach to instruction and assessment. This approach limits the amount of new math content delivered to students each day and allows time for daily practice. New concepts are introduced gradually and integrated with previously introduced content so…

Job Satisfaction for Child and Youth Care Workers.

ERIC Educational Resources Information Center

Krueger, Mark A.

Job satisfaction, which can be defined as a feeling of fulfillment or pleasure associated with one's work, comes from many personal sources but can be nourished by supportive agency practices, daily interactions, and long-term goals. Job satisfaction is important for child and youth care workers because (1) job satisfaction and competence are…

Between Grownups & Kids: Conference Proceedings (Austin, Texas, August 27, 1977).

ERIC Educational Resources Information Center

Evans, Joyce, Comp.

Presented are proceedings of a conference designed to increase awareness, knowledge, and feelings of competency of adults who work with children, with particular emphasis on the positive aspects of child rearing and practical suggestions for daily activities and interactions. In the keynote address titled "How to Drive Your Child Sane," A. Ginott…

Taming the Saxophone

ERIC Educational Resources Information Center

Murphy, Sean

2013-01-01

The saxophone section of a wind ensemble can easily be one of the most frustrating to work with when it comes to producing a clear, characteristic tone. Sometimes, the road to an improved sound can be a long path of daily diligence and practice; however, there are many quicker solutions that will drastically improve a student's tone. This article…

Organisation of Workplace Learning: A Case Study of Paediatric Residents' and Consultants' Beliefs and Practices

ERIC Educational Resources Information Center

Skipper, Mads; Nøhr, Susanne Backman; Jacobsen, Tine Klitgaard; Musaeus, Peter

2016-01-01

Several studies have examined how doctors learn in the workplace, but research is needed linking workplace learning with the organisation of doctors' daily work. This study examined residents' and consultants' attitudes and beliefs regarding workplace learning and contextual and organisational factors influencing the organisation and planning of…

"It makes us really look inferior to outsiders": Coping with psychosocial experiences associated with the lack of access to safe water and sanitation.

PubMed

Bisung, Elijah; Elliott, Susan J

2017-11-09

This paper explores daily experiences and coping resources related to the lack of access to safe water and adequate sanitation in Usoma, a lakeshore community in Western Kenya. A qualitative approach that involved 10 focus group discussions and 9 key informant interviews with community leaders, volunteers and professionals was used to explore the research objectives. Data were collected from June to August 2013. Daily practices and experiences around water and sanitation, such as water collection, open defecation and shared toilets, were a major concern to residents. In the absence of safe water, residents used social networks and support, financial resources and the nearby Lake Victoria as coping resources. Findings from this study are important for mobilizing resources in vulnerable settings as a first step towards designing community-based interventions. For public health practice, practitioners must work with - and collaborate across - sectors to enhance and strengthen social networks and cohesion, and protect the natural environment while working toward addressing water-related challenges in deprived settings.

Relational responsibilities in responsive evaluation.

PubMed

Visse, Merel; Abma, Tineke A; Widdershoven, Guy A M

2012-02-01

This article explores how we can enhance our understanding of the moral responsibilities in daily, plural practices of responsive evaluation. It introduces an interpretive framework for understanding the moral aspects of evaluation practice. The framework supports responsive evaluators to better understand and handle their moral responsibilities. A case is introduced to illustrate our argument. Responsive evaluation contributes to the design and implementation of policy by working with stakeholders and coordinating the evaluation process as a relationally responsible practice. Responsive evaluation entails a democratic process in which the evaluator fosters and enters a partnership with stakeholders. The responsibilities of an evaluator generally involve issues such as 'confidentiality', 'accountability' and 'privacy'. The responsive evaluator has specific responsibilities, for example to include stakeholders and vulnerable groups and to foster an ongoing dialogue. In addition, responsive evaluation involves a relational responsibility, which becomes present in daily situations in which stakeholders express expectations and voice demands. In our everyday work as evaluators, it is difficult to respond to all these demands at the same time. In addition, this article demonstrates that novice evaluators experience challenges concerning over- and underidenfitication with stakeholders. Guidelines and quality criteria on how to act are helpful, but need interpretation and application to the unique situation at hand. Copyright © 2011 Elsevier Ltd. All rights reserved.

Playing Chemical Plant Environmental Protection Games with Historical Monitoring Data.

PubMed

Zhu, Zhengqiu; Chen, Bin; Reniers, Genserik; Zhang, Laobing; Qiu, Sihang; Qiu, Xiaogang

2017-09-29

The chemical industry is very important for the world economy and this industrial sector represents a substantial income source for developing countries. However, existing regulations on controlling atmospheric pollutants, and the enforcement of these regulations, often are insufficient in such countries. As a result, the deterioration of surrounding ecosystems and a quality decrease of the atmospheric environment can be observed. Previous works in this domain fail to generate executable and pragmatic solutions for inspection agencies due to practical challenges. In addressing these challenges, we introduce a so-called Chemical Plant Environment Protection Game (CPEP) to generate reasonable schedules of high-accuracy air quality monitoring stations (i.e., daily management plans) for inspection agencies. First, so-called Stackelberg Security Games (SSGs) in conjunction with source estimation methods are applied into this research. Second, high-accuracy air quality monitoring stations as well as gas sensor modules are modeled in the CPEP game. Third, simplified data analysis on the regularly discharging of chemical plants is utilized to construct the CPEP game. Finally, an illustrative case study is used to investigate the effectiveness of the CPEP game, and a realistic case study is conducted to illustrate how the models and algorithms being proposed in this paper, work in daily practice. Results show that playing a CPEP game can reduce operational costs of high-accuracy air quality monitoring stations. Moreover, evidence suggests that playing the game leads to more compliance from the chemical plants towards the inspection agencies. Therefore, the CPEP game is able to assist the environmental protection authorities in daily management work and reduce the potential risks of gaseous pollutants dispersion incidents.

Open Hearts Build Lives: Positive Emotions, Induced Through Loving-Kindness Meditation, Build Consequential Personal Resources

PubMed Central

Fredrickson, Barbara L.; Cohn, Michael A.; Coffey, Kimberly A.; Pek, Jolynn; Finkel, Sandra M.

2011-01-01

B. L. Fredrickson’s (1998, 2001) broaden-and-build theory of positive emotions asserts that people’s daily experiences of positive emotions compound over time to build a variety of consequential personal resources. The authors tested this build hypothesis in a field experiment with working adults (n = 139), half of whom were randomly-assigned to begin a practice of loving-kindness meditation. Results showed that this meditation practice produced increases over time in daily experiences of positive emotions, which, in turn, produced increases in a wide range of personal resources (e.g., increased mindfulness, purpose in life, social support, decreased illness symptoms). In turn, these increments in personal resources predicted increased life satisfaction and reduced depressive symptoms. Discussion centers on how positive emotions are the mechanism of change for the type of mind-training practice studied here and how loving-kindness meditation is an intervention strategy that produces positive emotions in a way that outpaces the hedonic treadmill effect. PMID:18954193

Using time management to achieve balance.

PubMed

Schroeder, R E

1998-01-01

A recent MGMA survey showed work-life balance as the number one issue facing group practice managers. This article explains techniques from the field of time management that will enable group practice managers to gain control of their schedules, reduce time pressures and stress and increase productivity. The article covers: goal setting, daily lists, handling paperwork, delegating and limiting involvement, socializing, communicating, overachieving, planning, writing, telephone calling, attending meetings, reading, financial planning, developing a philosophy, involving family, evaluating skills and teaching time management to employees.

A modified Delphi method toward multidisciplinary consensus on functional convalescence recommendations after abdominal surgery.

PubMed

van Vliet, Daphne C R; van der Meij, Eva; Bouwsma, Esther V A; Vonk Noordegraaf, Antonie; van den Heuvel, Baukje; Meijerink, Wilhelmus J H J; van Baal, W Marchien; Huirne, Judith A F; Anema, Johannes R

2016-12-01

Evidence-based information on the resumption of daily activities following uncomplicated abdominal surgery is scarce and not yet standardized in medical guidelines. As a consequence, convalescence recommendations are generally not provided after surgery, leading to patients' insecurity, needlessly delayed recovery and prolonged sick leave. The aim of this study was to generate consensus-based multidisciplinary convalescence recommendations, including advice on return to work, applicable for both patients and physicians. Using a modified Delphi method among a multidisciplinary panel of 13 experts consisting of surgeons, occupational physicians and general practitioners, detailed recommendations were developed for graded resumption of 34 activities after uncomplicated laparoscopic cholecystectomy, laparoscopic and open appendectomy, laparoscopic and open colectomy and laparoscopic and open inguinal hernia repair. A sample of occupational physicians, general practitioners and surgeons assessed the recommendations on feasibility in daily practice. The response of this group of care providers was discussed with the experts in the final Delphi questionnaire round. Out of initially 56 activities, the expert panel selected 34 relevant activities for which convalescence recommendations were developed. After four Delphi rounds, consensus was reached for all of the 34 activities for all the surgical procedures. A sample of occupational physicians, general practitioners and surgeons regarded the recommendations as feasible in daily practice. Multidisciplinary convalescence recommendations regarding uncomplicated laparoscopic cholecystectomy, appendectomy (laparoscopic, open), colectomy (laparoscopic, open) and inguinal hernia repair (laparoscopic, open) were developed by a modified Delphi procedure. Further research is required to evaluate whether these recommendations are realistic and effective in daily practice.

The development and validation of the Instructional Practices Log in Science: a measure of K-5 science instruction

NASA Astrophysics Data System (ADS)

Adams, Elizabeth L.; Carrier, Sarah J.; Minogue, James; Porter, Stephen R.; McEachin, Andrew; Walkowiak, Temple A.; Zulli, Rebecca A.

2017-02-01

The Instructional Practices Log in Science (IPL-S) is a daily teacher log developed for K-5 teachers to self-report their science instruction. The items on the IPL-S are grouped into scales measuring five dimensions of science instruction: Low-level Sense-making, High-level Sense-making, Communication, Integrated Practices, and Basic Practices. As part of the current validation study, 206 elementary teachers completed 4137 daily log entries. The purpose of this paper is to provide evidence of validity for the IPL-S's scales, including (a) support for the theoretical framework; (b) cognitive interviews with logging teachers; (c) item descriptive statistics; (d) comparisons of 28 pairs of teacher and rater logs; and (e) an examination of the internal structure of the IPL-S. We present evidence to describe the extent to which the items and the scales are completed accurately by teachers and differentiate various types of science instructional strategies employed by teachers. Finally, we point to several practical implications of our work and potential uses for the IPL-S. Overall, results provide neutral to positive support for the validity of the groupings of items or scales.

Beliefs and implementation of evidence-based practice among community health nurses: A cross-sectional descriptive study.

PubMed

Pereira, Filipa; Pellaux, Victoria; Verloo, Henk

2018-03-08

To describe beliefs about evidence-based practice and record levels of implementation among community health nurses working independently and in community healthcare centres in the canton of Valais, Switzerland. In many settings, evidence-based practice is considered a key means of delivering better and secure health care. However, there is a paucity of published studies on the implementation of evidence-based practice in community health care. Cross-sectional descriptive study (n = 100). Beliefs about evidence-based practice and levels of implementation were measured using validated scales developed by Melnyk et al. (Worldviews on Evidence-Based Nursing, 5, 2008, 208). Information on respondents' sociodemographic and professional characteristics was collected. Data were analysed using descriptive and inferential statistics. The final response rate was 32.3% (n = 100). More than half of respondents had previously heard about evidence-based practice; most believed in the value of using evidence to guide their practice and were prepared to improve their skills to be able to do so. However, the rate of implementation of evidence-based practice in daily practice in the 8 weeks before the survey was poor. Statistically significant positive associations were found between beliefs about evidence-based practice and how respondents had heard about it and between implementation rates and whether they had heard about evidence-based practice and how they had done so. Evidence-based practices requiring scientific knowledge and skills were implemented less frequently. Greater professional community healthcare experience and management roles did not increase implementation of evidence-based practice. The systematic implementation of evidence-based practice by community health nurses working independently and in healthcare centres in Valais was rare, despite their positive beliefs about it. These results revealed the level of implementation of evidence-based practice by nurses in community healthcare settings in Valais. Further research is required to better understand their needs and expectations and to develop suitable strategies that will allow the integration of evidence-based practice into nurses' daily practice. © 2018 The Authors Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

The impact of social context on self-management in women living with HIV.

PubMed

Webel, Allison R; Cuca, Yvette; Okonsky, Jennifer G; Asher, Alice K; Kaihura, Alphoncina; Salata, Robert A

2013-06-01

HIV self-management is central to the health of people living with HIV and is comprised of the daily tasks individuals employ to manage their illness. Women living with HIV are confronted with social context vulnerabilities that impede their ability to conduct HIV self-management behaviors, including demanding social roles, poverty, homelessness, decreased social capital, and limited access to health care. We examined the relationship between these vulnerabilities and HIV self-management in a cross-sectional secondary analysis of 260 women living with HIV from two U.S. sites. All social context variables were assessed using validated self-report scales. HIV Self-Management was assessed using the HIV Self-Management Scale that measures daily health practices, HIV social support, and the chronic nature of HIV. Data were analyzed using appropriate descriptive statistics and multivariable regression. Mean age was 46 years and 65% of participants were African-American. Results indicated that social context variables, particularly social capital, significantly predicted all domains of HIV self-management including daily health practices (F = 5.40, adjusted R(2) = 0.27, p < 0.01), HIV social support (F = 4.50, adjusted R(2) = 0.22, p < 0.01), and accepting the chronic nature of HIV (F = 5.57, adjusted R(2) = 0.27, p < 0.01). We found evidence to support the influence of the traditional social roles of mother and employee on the daily health practices and the chronic nature of HIV domains of HIV self-management. Our data support the idea that women's social context influences their HIV self-management behavior. While social context has been previously identified as important, our data provide new evidence on which aspects of social context might be important targets of self-management interventions for women living with HIV. Working to improve social capital and to incorporate social roles into the daily health practices of women living with HIV may improve the health of this population. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Impact of Social Context on Self-Management in Women Living with HIV

PubMed Central

Webel, Allison R.; Cuca, Yvette; Okonsky, Jennifer G.; Asher, Alice K.; Kaihura, Alphoncina; Salata, Robert A.

2013-01-01

HIV self-management is central to the health of people living with HIV and is comprised of the daily tasks individuals employ to manage their illness. Women living with HIV are confronted with social context vulnerabilities that impede their ability to conduct HIV self-management behaviors, including demanding social roles, poverty, homelessness, decreased social capital, and limited access to health care. We examined the relationship between these vulnerabilities and HIV self-management in a cross-sectional secondary analysis of 260 women living with HIV from two U.S. sites. All social context variables were assessed using validated self-report scales. HIV Self-Management was assessed using the HIV Self-Management Scale that measures daily health practices, HIV social support, and the chronic nature of HIV. Data were analyzed using appropriate descriptive statistics and multivariable regression. Mean age was 46 years and 65% of participants were African-American. Results indicated that social context variables, particularly social capital, significantly predicated all domains of HIV self-management including daily health practices (F=5.40, adjusted R2=0.27, p<0.01), HIV social support (F=4.50, adjusted R2=0.22, p<0.01), and accepting the chronic nature of HIV (F=5.57, adjusted R2=0.27, p<0.01). We found evidence to support the influence of the traditional social roles of mother and employee on the daily health practices and the chronic nature of HIV domains of HIV self-management. Our data support the idea that women’s social context influences their HIV self-management behavior. While social context has been previously identified as important, our data provide new evidence on which aspects of social context might be important targets of self-management interventions for women living with HIV. Working to improve social capital and to incorporate social roles into the daily health practices of women living with HIV may improve the health of this population. PMID:23631790

[The regulation of labor relations and human resources management in nursing].

PubMed

de Freitas, Genival Fernandes; Fugulin, Fernanda Maria Togeiro; Fernandes, Maria de Fátima Prado

2006-09-01

This paper is aimed at discoursing on the regulation of labor relations in Nursing and at giving subsidies to the nurse's managerial practice concerning the rights and obligations of employees and employers based on the Brazilian Labor Law and the Federal Constitution. It emphasizes some regulations that are not clear enough and give rise to doubts and conflicts on the nurse's daily professional activities, such as working hours, resting periods in and between journeys, extra pay for overtime work, weekly paid rest and changes in work schedule. The adequacy of nursing practice to legal rules should allow nurses to get more knowledge, resulting in more confidence and safer actions. By having professional and patient's rights respected, occasional juridical problems inherent to labor rights and obligations will be reduced.

What is the impact of a national postgraduate medical specialist education reform on the daily clinical training 3.5 years after implementation? A questionnaire survey.

PubMed

Mortensen, Lene; Malling, Bente; Ringsted, Charlotte; Rubak, Sune

2010-06-18

Many countries have recently reformed their postgraduate medical education (PGME). New pedagogic initiatives and blueprints have been introduced to improve quality and effectiveness of the education. Yet it is unknown whether these changes improved the daily clinical training. The purpose was to examine the impact of a national PGME reform on the daily clinical training practice. The Danish reform included change of content and format of specialist education in line with outcome-based education using the CanMEDS framework. We performed a questionnaire survey among all hospital doctors in the North Denmark Region. The questionnaire included items on educational appraisal meetings, individual learning plans, incorporating training issues into work routines, supervision and feedback, and interpersonal acquaintance. Data were collected before start and 31/2 years later. Mean score values were compared, and response variables were analysed by multiple regression to explore the relation between the ratings and seniority, type of hospital, type of specialty, and effect of attendance to courses in learning and teaching among respondents. Response rates were 2105/2817 (75%) and 1888/3284 (58%), respectively. We found limited impact on clinical training practice and learning environment. Variances in ratings were hardly affected by type of hospital, whereas belonging to the laboratory specialities compared to other specialties was related to higher ratings concerning all aspects. The impact on daily clinical training practice of a national PGME reform was limited after 31/2 years. Future initiatives must focus on changing the pedagogical competences of the doctors participating in daily clinical training and on implementation strategies for changing educational culture.

Streets, strolls and spots: sex work, drug use and social space in Detroit.

PubMed

Draus, Paul; Roddy, Juliette; Asabigi, Kanzoni

2015-05-01

In this paper, we explore social spaces related to street sex work and illicit drug use in Detroit. We consider these spaces as assemblages (Duff, 2011, 2013; Latour, 2005) that reflect the larger moral geography (Hubbard, 2012) of the city and fulfill specific functions in the daily lives of drug using sex workers. We draw on thirty-one in-depth qualitative interviews with former street sex workers who were recruited through a court-based treatment and recovery program, as well as ethnographic field notes from drug treatment and law enforcement settings. Our interview findings reveal highly organized and routine activities that exist in a relatively stable, symbiotic relationship with law enforcement practices, employment and commuter patterns, and built environments. While the daily life of street sex work involves a good deal of individual agency in terms of moving between spaces and negotiating terms of exchange, daily trajectories were also circumscribed by economics, illicit substance use, and the objective risks of the street and the police. We consider the implications of these results for future policy directed at harm reduction in the street setting. Copyright © 2015 Elsevier B.V. All rights reserved.

Implementing AORN recommended practices for prevention of transmissible infections.

PubMed

Patrick, Marcia R; Hicks, Rodney W

2013-12-01

Preventing infection in the perioperative setting is a critical element of patient and health care worker safety. This article reviews the recommendations in the AORN "Recommended practices for prevention of transmissible infections in the perioperative practice setting." The recommended practices are intended to help perioperative nurses implement standard and transmission-based precautions (ie, contact, droplet, airborne), including use of personal protective equipment as well as interventions to prevent surgical site infections and exposure to bloodborne pathogens. Additional recommendations cover vaccination programs and how to manage personnel who require work restrictions. Hospital and ambulatory patient scenarios are included to help perioperative nurses apply the recommendations in daily practice. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Starting learning in medical practice: an evaluation of a new Introductory Clerkship.

PubMed

Jacobs, J C G; Bolhuis, S; Bulte, J A; Laan, R; Holdrinet, R S G

2005-08-01

The transition from undergraduate medical education to learning in clinical clerkships can be difficult for students. Learning in clinical practice requires awareness of learning opportunities and goals, active elaboration and reflection. Staff should provide students with guidance to learn from their experiences. A new Introductory Clerkship was designed to facilitate the start of goal-oriented, active and reflective work-based learning. This four-week clerkship is a result of the cooperation of six major specialties in the university hospital. The innovations included explicitly formulated goals, a description of the student's activities in daily practice and of the staff's role, group meetings, a logbook, a halfway formative interview and a final summative interview. The aim of this study was to investigate to what extent the innovations of the new Introductory Clerkship were implemented and how students and residents valued them. Two questionnaires were constructed: one was administered to students (n = 54) and the other to residents (n = 27). Students considered participation in daily practice very instructive, although more observations of history taking and physical examination are wanted. The interviews and group meetings promote students' learning. Use of the logbook needs improvement. Residents perceived a shortage of time and would appreciate more participation of staff members, as well as a better preparation for supervising tasks. Overall, the study demonstrates that it is possible to introduce innovations in clinical clerkships to improve the learning environment of work-based learning.

Late Immersion Foundation Document: Teachers and Administrators

ERIC Educational Resources Information Center

Alberta Education, 2010

2010-01-01

The aim of this document is to give teachers and administrators the contextual and pedagogical tools for the late immersion program. It acts as a guide for beginning and experienced teachers who need to update their knowledge regarding this program and its details. For many working in this area, it also confirms their daily practices as well as…

Estimating fuel consumption for the upper coastal plain of South Carolina

Treesearch

S.L. Goodrick; D. Shea; J. Blake

2010-01-01

Recent changes in air quality regulations present a potential obstacle to continued use of prescribed fire as a land management tool. towering of the acceptable daily concentration of particulate matter from 6510 35 jig/m' will bring much closer scrutiny of prescribed burning practices from the air quality community. To work within this narrow window, land...

Classroom Labels That Young Children Can Use: Enhancing Biliteracy Development in a Dual Language Classroom

ERIC Educational Resources Information Center

Salinas-Gonzalez, Irasema; Arreguin-Anderson, Maria G.; Alanís, Iliana

2015-01-01

This article focuses on biliteracy development of English and Spanish through the practical strategy of systematically labeling the classroom within the context of daily classroom activities and providing children with various opportunities to use the words throughout the day. Using the foundational work related to classroom labels from Pinnell…

Fostering sustainable operations in a natural resource management agency: insights from the field

Treesearch

Patricia L. Winter; Shawn M. Burn

2010-01-01

Sustainable operations (SO; operating in an environmentally, economically, and socially sustainable manner) is consistent with the environmental stewardship mission of natural resource management organizations. This study sought to examine SO practices in the daily work lives of US Forest Service employees, including those primarily stationed in the office and in the...

An Evaluation of a School-Based Teenage Pregnancy Prevention Program Using a Logic Model Framework

ERIC Educational Resources Information Center

Hulton, Linda J.

2007-01-01

Teenage pregnancy and the subsequent social morbidities associated with unintended pregnancies are complex issues facing school nurses in their daily work. In contemporary practice, school nurses are being held to higher standards of accountability and being asked to demonstrate the effective outcomes of their interventions. The purpose of this…

Teachers' Use of ICTs in Public Language Education: Evidence from Second Language Secondary-School Classrooms

ERIC Educational Resources Information Center

Izquierdo, Jesús; de-la-Cruz-Villegas, Verónika; Aquino-Zúñiga, Silvia-Patricia; Sandoval-Caraveo, María-del-Carmen; García-Martínez, Verónica

2017-01-01

Worldwide, curricular changes and financial investments are currently underway to promote the integration of technology in public education and English language learning at a young age. This study examines the ICTs that have become part of the daily instructional practices and educational settings of teachers of English who work with young…

An Examination of K-5 Principal Time and Tasks to Improve Leadership Practice

ERIC Educational Resources Information Center

Van Vooren, Carol

2018-01-01

This study highlights the high rates of attrition among school leaders that result from increased demands on school principals. This article reports on a unique university and school district partnership that worked together in action-based, community-engaged research to address the time allocation and tasks in the daily life of principals. The…

Ethical Dilemmas: A Model to Understand Teacher Practice

ERIC Educational Resources Information Center

Ehrich, Lisa Catherine; Kimber, Megan; Millwater, Jan; Cranston, Neil

2011-01-01

Over recent decades, the field of ethics has been the focus of increasing attention in teaching. This is not surprising given that teaching is a moral activity that is heavily values-laden. Because of this, teachers face ethical dilemmas in the course of their daily work. This paper presents an ethical decision-making model that helps to explain…

Bilinguals’ Working Memory (WM) Advantage and Their Dual Language Practices

PubMed Central

Yang, Eunju

2017-01-01

The present study investigates a possible working memory (WM) difference between monolingual and bilingual groups and explores the relationship between their WM advantage and language practices. A mixed methods design was employed for the study. To measure participants’ WM, auditory and visual digit span tasks were conducted on the different language groups: 20 Korean near-monolinguals, and 40 Korean–English bilinguals with two different levels of second language (L2) proficiency. Bilinguals’ daily language practices were explored through semi-structured interviews with eight bilinguals. The convergence of the findings from both tests and interview data suggests that knowing two languages does not guarantee bilingual WM advantages over monolinguals, but the advantage might be linked to bilinguals’ unique L2 use environment where they need to hold incoming L2 information while decoding it. PMID:28718840

Interprofessional learning at work: what spatial theory can tell us about workplace learning in an acute care ward.

PubMed

Gregory, Linda Rosemary; Hopwood, Nick; Boud, David

2014-05-01

It is widely recognized that every workplace potentially provides a rich source of learning. Studies focusing on health care contexts have shown that social interaction within and between professions is crucial in enabling professionals to learn through work, address problems and cope with challenges of clinical practice. While hospital environments are beginning to be understood in spatial terms, the links between space and interprofessional learning at work have not been explored. This paper draws on Lefebvre's tri-partite theoretical framework of perceived, conceived and lived space to enrich understandings of interprofessional learning on an acute care ward in an Australian teaching hospital. Qualitative analysis was undertaken using data from observations of Registered Nurses at work and semi-structured interviews linked to observed events. The paper focuses on a ward round, the medical workroom and the Registrar's room, comparing and contrasting the intended (conceived), practiced (perceived) and pedagogically experienced (lived) spatial dimensions. The paper concludes that spatial theory has much to offer understandings of interprofessional learning in work, and the features of work environments and daily practices that produce spaces that enable or constrain learning.

Meanings of sex, concepts of risk and sexual practices among migrant coal miners in Quang Ninh, Vietnam.

PubMed

Van Tuan, Ta

2010-08-01

The study explores the meanings of sex among migrant coal miners in Vietnam and identifies contextual factors influencing engagement in unsafe sexual practices. Findings reveal that sex carries a number of social meanings in the lives of migrant miners: sex is relaxation and reward for their risk and hard work; access to sex is an incentive for miners to continue working in the mine; sex strengthens identity and social networks; sex helps miners to affirm manhood, group membership and masculinity; and sex workers are confidants with whom they can share their problems. Facing accidents at work on a daily basis, miners are less inclined to worry about the long-term risks of HIV infection. In addition, being excluded from access to relevant information, miners feel distant from HIV infection. Findings suggest that interventions on sexual behaviour and practices should be sensitive to the concepts of risk and meanings of sex among migrant groups such as coal miners.

Unproven diagnostic procedures in IgE-mediated allergic diseases.

PubMed

Niggemann, B; Grüber, C

2004-08-01

A considerable body of literature on therapeutic aspects of complementary and alternative medicine has been published in recent years, but little is known on diagnostic procedures. This short review lists complementary and alternative diagnostic procedures for the diagnosis of allergic diseases and presents an assessment of their usefulness for the daily practice. The review of the literature revealed that neither the determination of specific immunoglobulin G-antibodies in serum, the hair-analysis, the cytotoxic test, kinesiology, iridology, or electrodermal testing represent useful tests for the daily practice. To date, no complementary or alternative diagnostic procedure can be recommended as a meaningful element in the diagnostic work-up of allergic diseases. This is especially true for food allergy: properly performed oral food challenges still represent the gold standard for implementing specific diets in food allergic individuals. Ineffective diagnostic approaches may be costly for the consumer and delay appropriate therapy.

Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors

PubMed Central

Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik

2014-01-01

Aim: To explore the mechanisms through which nurse practice environment dimensions, such as nurse–physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Background: Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Design: Cross-sectional survey. Method: Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Results: Nurse practice environment dimensions predicted nurses’ ratings of job outcome variables as well as quality of care. Features of nurses’ work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. Conclusion: The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses’ perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services. PMID:25431563

Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors.

PubMed

Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik

2014-01-01

To explore the mechanisms through which nurse practice environment dimensions, such as nurse-physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Cross-sectional survey. Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Nurse practice environment dimensions predicted nurses' ratings of job outcome variables as well as quality of care. Features of nurses' work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses' perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services.

Nursing in an imperfect world: Storytelling as preparation for mental health nursing practice.

PubMed

Treloar, Anna; McMillan, Margaret; Stone, Teresa

2017-06-01

Storytelling is a valuable adjunctive method of preparing undergraduate mental health nursing students for practice. To explore the possibilities of this method of teaching, 100 stories were collected from experienced nurses working in mental health and analysed using a case study methodology. The aim was to explore the purpose of clinical anecdotes told by experienced nurses working in mental health settings to undergraduates and new recruits, with an ancillary purpose of looking at the implications of these anecdotes for the exploration of contemporary mental health practice and education. A framework for student discussion of stories is provided. The insights gained illuminate not only the history of mental health nursing and the daily activities of nurses working in mental health, but also some of the deep-level skills developed and used by these nurses as they work in the complexity and ambiguity of an imperfect world where the job requires managing the unexpected every shift, and where there might not always be a textbook-perfect solution to clinical situations. © 2016 Australian College of Mental Health Nurses Inc.

Playing Chemical Plant Environmental Protection Games with Historical Monitoring Data

PubMed Central

Reniers, Genserik; Zhang, Laobing; Qiu, Xiaogang

2017-01-01

The chemical industry is very important for the world economy and this industrial sector represents a substantial income source for developing countries. However, existing regulations on controlling atmospheric pollutants, and the enforcement of these regulations, often are insufficient in such countries. As a result, the deterioration of surrounding ecosystems and a quality decrease of the atmospheric environment can be observed. Previous works in this domain fail to generate executable and pragmatic solutions for inspection agencies due to practical challenges. In addressing these challenges, we introduce a so-called Chemical Plant Environment Protection Game (CPEP) to generate reasonable schedules of high-accuracy air quality monitoring stations (i.e., daily management plans) for inspection agencies. First, so-called Stackelberg Security Games (SSGs) in conjunction with source estimation methods are applied into this research. Second, high-accuracy air quality monitoring stations as well as gas sensor modules are modeled in the CPEP game. Third, simplified data analysis on the regularly discharging of chemical plants is utilized to construct the CPEP game. Finally, an illustrative case study is used to investigate the effectiveness of the CPEP game, and a realistic case study is conducted to illustrate how the models and algorithms being proposed in this paper, work in daily practice. Results show that playing a CPEP game can reduce operational costs of high-accuracy air quality monitoring stations. Moreover, evidence suggests that playing the game leads to more compliance from the chemical plants towards the inspection agencies. Therefore, the CPEP game is able to assist the environmental protection authorities in daily management work and reduce the potential risks of gaseous pollutants dispersion incidents. PMID:28961188

A patient workflow management system built on guidelines.

PubMed Central

Dazzi, L.; Fassino, C.; Saracco, R.; Quaglini, S.; Stefanelli, M.

1997-01-01

To provide high quality, shared, and distributed medical care, clinical and organizational issues need to be integrated. This work describes a methodology for developing a Patient Workflow Management System, based on a detailed model of both the medical work process and the organizational structure. We assume that the medical work process is represented through clinical practice guidelines, and that an ontological description of the organization is available. Thus, we developed tools 1) for acquiring the medical knowledge contained into a guideline, 2) to translate the derived formalized guideline into a computational formalism, precisely a Petri Net, 3) to maintain different representation levels. The high level representation guarantees that the Patient Workflow follows the guideline prescriptions, while the low level takes into account the specific organization characteristics and allow allocating resources for managing a specific patient in daily practice. PMID:9357606

Sustaining Culture Change: Experiences in the Green House Model.

PubMed

Bowers, Barbara; Nolet, Kimberly; Jacobson, Nora

2016-02-01

To describe conditions that influence how Green House (GH) organizations are sustaining culture change principles and practices in a sample of GH skilled nursing homes. Primary data were collected at 11 skilled nursing GH organizations from 2012 to 2014. These organizations have adopted the comprehensive and prescriptive GH model of culture change. To develop an understanding of sustainability from the perspective of staff who are immersed in GH daily work, grounded theory qualitative methods were used. Data were collected using semi-structured interviews with 166 staff and observation of house meetings and daily operations. Data were analyzed using grounded dimensional analysis. Organizations varied in their ability to sustain GH principles and practices. An organization's approach to problem solving was central to sustaining the model. Key conditions influenced reinforcement or erosion of GH principles and practices. Reinforcing the GH model requires a highly skilled team of staff with the ability to frequently and collaboratively solve both mundane and complex problems in ways that are consistent with the GH model. This raises questions about the type of human resources practices and policy supports that could assist organizations in sustaining culture change. © Health Research and Educational Trust.

User's Satisfaction of Multiple Accounting Record System.

PubMed

Chen, M C; Yu, H C

2016-01-01

The study hospital had developed a multiple account recording system that generates the accounting information of the consumed materials based on daily nursing records. A questionnaire survey was delivered to further investigate the impact of the system. Four concepts of the system were investigated. (1) Supportive and time saving; (2) impact on workflows and job satisfactions; (3) ease of use; and (4) overall satisfactions. The system scored 4.03 out of 5 as the highest for helpfulness for daily practices, 3.98 for decrease the time for recording material consumptions, 3.98 for actually changed the way they work. Users mostly expressed positive attitude towards the system.

Delegation in Correctional Nursing Practice.

PubMed

Tompkins, Frances

2016-07-01

Correctional nurses face daily challenges as a result of their work environment. Common challenges include availability of resources for appropriate care delivery, negotiating with custody staff for access to patients, adherence to scope of practice standards, and working with a varied staffing mix. Professional correctional nurses must consider the educational backgrounds and competency of other nurses and assistive personnel in planning for care delivery. Budgetary constraints and varied staff preparation can be a challenge for the professional nurse. Adequate care planning requires understanding the educational level and competency of licensed and unlicensed staff. Delegation is the process of assessing patient needs and transferring responsibility for care to appropriately educated and competent staff. Correctional nurses can benefit from increased knowledge about delegation. © The Author(s) 2016.

An ethical framework for nursing service administration.

PubMed

Christensen, P J

1988-04-01

Nurses as administrators are responsible for creating an ethical work environment in which nurses' human welfare is promoted. Bureaucratic organizations can dehumanize people, wherein human welfare suffers in the midst of institutional constraints. Amid these conditions nurses' ethical competence cannot develop nor can nurses maintain a sense of personal integrity. Applying concepts from nursing and general ethics to administrative practice provides a basis for developing an ethical framework for management. The proposed framework involves ethical awareness, principled reasoning, moral commitment to the profession and to one another, and primary consideration for human welfare with strategies to promote it. Use of these components when making decisions in daily practice and on a policy level enhances the well-being of nurses working in organizations.

Younger Adults Show Long-Term Effects of Cognitive Training on Broad Cognitive Abilities over 2 Years

ERIC Educational Resources Information Center

Schmiedek, Florian; Lövdén, Martin; Lindenberger, Ulman

2014-01-01

In the COGITO study (Schmiedek, Lövdén, & Lindenberger, 2010), 101 younger adults practiced 12 tests of perceptual speed, working memory, and episodic memory for over 100 daily 1-hr sessions. The intervention resulted in positive transfer to broad cognitive abilities, including reasoning and episodic memory. Here, we examine whether these…

The Knowing-Doing Gap: The Influence of Teacher Feedback in Changing Principal Behavior--A Mixed Methods Study

ERIC Educational Resources Information Center

St. Martin, Kimberly

2010-01-01

This mixed methods study attempted to determine how a system of regular feedback from teachers on principal's work influenced the way in which two principals incorporated the 21 Leadership Responsibilities into their daily practice. Since Principals are the front line of school reform, even when a school commits to an improvement effort that is…

Investigating the Integration of Everyday Phenomena and Practical Work in Physics Teaching in Vietnamese High Schools

ERIC Educational Resources Information Center

Ng, Wan; Nguyen, Van Thanh

2006-01-01

Making science relevant in students' learning is an important aspect of science education. This involves the ability to draw in examples from daily contexts to begin with the learning or to apply concepts learnt into familiar everyday phenomena that students observe and experience around them. Another important aspect of science education is the…

Narratives of Learning: The Personal Portfolio in the Portfolio Approach to Teaching and Learning

ERIC Educational Resources Information Center

Leslie, Paul; Camargo-Borges, Celiane

2017-01-01

This paper will explore how a portfolio approach to teaching and learning can help the educator incorporate unique forms of reflective practice into his or her daily work. By being able to express ideas more clearly to himself, the educator can better promote the relational construction of knowledge in his educational communities. This paper, as…

"And Then We Summarise in English for the Others": The Lived Experience of the Multilingual Workplace

ERIC Educational Resources Information Center

Angouri, Jo; Miglbauer, Marlene

2014-01-01

In multinational corporate companies, multilingualism is often a daily reality for employees and the negotiation of language practices for work and social purposes, a routine. Despite the role of English as a lingua franca, the linguistic ecology of modern workplaces is dynamic, rich and diverse. While English is often used for communication…

Yoga Asanas for the Relief and Prevention of Carpal Tunnel Syndrome.

ERIC Educational Resources Information Center

Beleu, Steve

This collection of yoga asanas (exercises) can help relieve the pain of carpal tunnel syndrome (CTS) and help prevent CTS among people who work on computer terminals. For maximum benefit, the exercises should be practiced daily or on as regular a schedule as possible. They are not intended to replace surgery or a physician's prescribed care. They…

Daily Mindful Responding Mediates the Effect of Meditation Practice on Stress and Mood: The Role of Practice Duration and Adherence.

PubMed

Lacaille, Julien; Sadikaj, Gentiana; Nishioka, Midori; Carrière, Kimberly; Flanders, Joseph; Knäuper, Bärbel

2018-01-01

Although meditation practice is an important component of many mindfulness-based interventions (MBIs), empirical findings of its effects on psychological functioning are mixed and the mechanisms for the effects remain unclear. Responding with mindfulness (i.e., returning one's attention back to a nonjudgmental, present-oriented awareness) is a fundamental skill practiced in meditations. With repeated meditation practice, this skill is thought to become internalized and be applied to one's daily life. We thus hypothesized that the extent to which individuals responded to daily events with mindfulness would mediate the effects of meditation practice (instance, duration, and adherence to instructions) on psychological well-being. Using a daily diary methodology, we tracked the meditation practice, use of mindful responding during the day, and psychological outcomes (perceived stress, negative and positive affect) of 117 mindfulness-based stress reduction program participants. We found that on days when participants meditated, they responded with greater mindfulness to daily events, which accounted for the beneficial effects of meditating on psychological outcomes. Furthermore, findings suggest that on meditation days, longer and more closely adhered meditation practices were independently associated with increases in mindful responding, which in turn were associated with better psychological outcomes. These results suggest that regular, longer, and more closely adhered meditation practice is an important component of MBIs, in part because it leads to responding more mindfully in daily life, which promotes well-being. © 2017 Wiley Periodicals, Inc.

Vaginal Practices among Women at High Risk of HIV Infection in Uganda and Tanzania: Recorded Behaviour from a Daily Pictorial Diary

PubMed Central

Francis, Suzanna C.; Baisley, Kathy; Lees, Shelley S.; Andrew, Bahati; Zalwango, Flavia; Seeley, Janet; Vandepitte, Judith; Ao, Trong T.; van de Wijgert, Janneke; Watson-Jones, Deborah; Kapiga, Saidi; Grosskurth, Heiner; Hayes, Richard J.

2013-01-01

Background Intravaginal practices (IVP) are highly prevalent in sub-Saharan African and have been implicated as risk factors for HIV acquisition. However, types of IVP vary between populations, and detailed information on IVP among women at risk for HIV in different populations is needed. We investigated IVP among women who practice transactional sex in two populations: semi-urban, facility workers in Tanzania who engage in opportunistic sex work; and urban, self-identified sex workers and bar workers in Uganda. The aim of the study was to describe and compare IVP using a daily pictorial diary. Methodology/Principal Findings Two hundred women were recruited from a HIV prevention intervention feasibility study in Kampala, Uganda and in North-West Tanzania. Women were given diaries to record IVP daily for six weeks. Baseline data showed that Ugandan participants had more lifetime partners and transactional sex than Tanzanian participants. Results from the diary showed that 96% of Tanzanian participants and 100% of Ugandan participants reported intravaginal cleansing during the six week study period. The most common types of cleansing were with water only or water and soap. In both countries, intravaginal insertion (e.g. with herbs) was less common than cleansing, but insertion was practiced by more participants in Uganda (46%) than in Tanzania (10%). In Uganda, participants also reported more frequent sex, and more insertion related to sex. In both populations, cleansing was more often reported on days with reported sex and during menstruation, and in Uganda, when participants experienced vaginal discomfort. Participants were more likely to cleanse after sex if they reported no condom use. Conclusions While intravaginal cleansing was commonly practiced in both cohorts, there was higher frequency of cleansing and insertion in Uganda. Differences in IVP were likely to reflect differences in sexual behaviour between populations, and may warrant different approaches to interventions targeting IVP. Vaginal practices among women at high risk in Uganda and Tanzania: recorded behaviour from a daily pictorial diary. PMID:23555618

Integrating Occupational Therapy Specific Assessments in Practice: Exploring Practitioner Experiences

PubMed Central

Nakamura, Mio; Asaba, Akie; Kottorp, Anders

2017-01-01

Background Occupational therapists sometimes find it challenging to integrate client-centered and occupational therapy specific assessments in practice. The aim of this study was to explore the use of occupational therapy specific assessments such as the Assessment of Motor and Process Skills (AMPS) among occupational therapists in Sweden and Japan. Methods Interviews and qualitative thematic analyses were utilized. Findings Four themes are reported: (1) use it or lose it, (2) simply no space until after hours, (3) biggest barriers can be colleagues, and (4) being more specific: communication. Conclusion In keeping with previous studies, occupational therapists often find it challenging to implement client-centered and occupation-based assessment tools into practice. However, more work is needed to understand how best practices can be incorporated into a changing occupational therapy daily practice. PMID:29333112

"The law has no feeling for poor folks like us!" Everyday responses to legal compulsion in England's working-class communities, 1871-1904.

PubMed

Auerbach, Sascha

2012-01-01

During the late Victorian period, the role of the state increased dramatically in England's working-class urban communities. New laws on labor, health, and education, enforced by a growing bureaucracy of elected and appointed officials, extended the reach of public authority into daily life on an unprecedented scale. Everyday negotiations between these officials and working-class men and women, I argue, were key moments for determining the practical impact of new social welfare policies. This was particularly true in the contestation over children's compulsory school attendance, as I demonstrate through a close examination of the daily encounters between parents and education officials. Despite the growing size and authority of the Victorian state, working-class parents effectively mitigated the impact of the compulsory education laws on their families. They were able to do so because the categories that governed the level of enforcement—age, household economic status, health, and labor—were themselves determined through daily dialogues between parents and education officials. Parents' familiarity with the law and with the dynamics of the public education bureaucracy were key factors in these negotiations, as were internal fractures within the Victorian state itself. Working-class parents, and mothers in particular, also countered officials' moral policy justifications with their own discourse of right and wrong, which focused on the legitimacy of parental authority, an insistence on just treatment, and the elevation of household needs over the laws' requirements.

The principle of respect for autonomy--concordant with the experience of oncology physicians and molecular biologists in their daily work?

PubMed

Ebbesen, Mette; Pedersen, Birthe D

2008-03-26

This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work. This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. We found that that molecular biologists consider the principle of respect for autonomy as a negative obligation, where the informed consent of patients or research subjects should be respected. Furthermore, molecular biologists believe that very sick patients are constraint by the circumstances to a certain choice. However, in contrast to molecular biologists, oncology physicians experience the principle of respect for autonomy as a positive obligation, where the physician in dialogue with the patient performs a medical prognosis based on the patient's wishes and ideas, mutual understanding and respect. Oncology physicians believe that they have a positive obligation to adjust to the level of the patient when providing information making sure that the patient understands. Oncology physicians experience situations where the principle of respect for autonomy does not apply because the patient is in a difficult situation. In this study we explore the moral views and attitudes of oncology physicians and molecular biologists and compare these views with bioethical theories of the American bioethicists Tom L. Beauchamp & James F. Childress and the Danish philosophers Jakob Rendtorff & Peter Kemp. This study shows that essential parts of the two bioethical theories are reflected in the daily work of Danish oncology physicians and Danish molecular biologists. However, the study also explores dimensions where the theories can be developed further to be concordant with biomedical practice. The hope is that this study enhances the understanding of the principle of respect for autonomy and the way it is practiced.

The Practice of Hatha Yoga for the Treatment of Pain Associated with Endometriosis.

PubMed

Gonçalves, Andrea Vasconcelos; Barros, Nelson Filice; Bahamondes, Luis

2017-01-01

The aim of this study was to compare chronic pelvic pain, menstrual patterns, and quality of life (QoL) in two groups of women with endometriosis: those who did and those who did not participate in a specific 8-week yoga intervention. This was a randomized controlled trial. It was conducted at the University of Campinas Medical School, Campinas, SP, Brazil. Forty women were randomly divided into two groups: an intervention group of women who practiced yoga (n = 28), and a control group of women who did not practice yoga (n = 12). Participants attended 90-min scheduled yoga sessions twice a week for 8 weeks. Additionally, an Endometriosis Health Profile (EHP)-30 questionnaire was applied to evaluate women's QoL at admission and 2 months later upon completion of the yoga program. Menstrual and daily pain patterns were evaluated through a daily calendar (visual analog scale). The degree of daily pain was significantly lower among the women who practiced yoga compared with the non-yoga group (p = 0.0007). There was an improvement of QoL in both groups between baseline and the end of the study evaluation. In relation to EHP-30 domains, pain (p = 0.0046), impotence (p = 0.0006), well-being (p = 0.0009), and image (p = 0.0087) from the central questionnaire, and work (p = 0.0027) and treatment (p = 0.0245) from the modular questionnaire were significantly different between the study groups over time. There was no significant difference between the two groups regarding the diary of menstrual patterns (p = 0.96). Yoga practice was associated with a reduction in levels of chronic pelvic pain and an improvement in QoL in women with endometriosis.

Need for better analgesic treatment after tonsillectomy in ear, nose and throat practices.

PubMed

Kamarauskas, Audrius; Dahl, Mads Ronald; Hlidarsdottir, Tinna; Mainz, Jan; Ovesen, Therese

2013-05-01

The objective of this study was to investigate patient-reported outcomes on quality (PRO) of outpatient tonsillectomy in Danish ear, nose and throat practices in terms of indicators, standards and prognostic factors. Patients filled in a post-operative questionnaire three weeks after tonsillectomy. The questions were focused on the preoperative information about the procedure. Unscheduled contacts to Danish health care after the tonsillectomy and number of days absent from work/school were reported. A pain score was indicated daily during the first 14 post-operative days. A total of 89% of the 614 enrolled patients returned the questionnaire. 30% were dissatisfied with the information they had been afforded about post-operative complications and risks and 23% had unscheduled contacts to Danish health care. The daily pain score and absence from work/school were significantly higher among adults (> 15 years) than among children. The pain score correlated significantly with absence from work/school, unscheduled contacts and short observation time. PRO was significantly influenced by the length of the observation time before discharge, and a higher pain score was associated with a lower satisfaction with preoperative information about complications/risks. Most patients/parents are satisfied with outpatient tonsillectomy. However, the post-operative pain control needs revision, the preoperative information should be intensified and the observation of the patients before discharge should be extended. not relevant. not relevant.

The Interest of Performing "On-Demand Chest X-rays" after Lung Resection by Minimally Invasive Surgery.

PubMed

Haddad, Laura; Bubenheim, Michael; Bernard, Alain; Melki, Jean; Peillon, Christophe; Baste, Jean-Marc

2017-10-01

Background  There is a lack of consensus in hospital centers regarding costly daily routine chest X-rays after lung resection by minimally invasive surgery. Indeed, there is no evidence that performing daily chest X-rays prevents postoperative complications. Our objective was to compare chest X-rays performed on demand when there was clinical suspicion of postoperative complications and chest X-rays performed systematically in daily routine practice. Methods  This prospective single-center study compared 55 patients who had on-demand chest X-rays and patients in the literature who had daily routine chest X-rays. Our primary evaluation criterion was length of hospitalization. Results  The length of hospitalization was 5.3 ± 3.3 days for patients who had on-demand X-rays, compared with 4 to 9.7 days for patients who had daily routine X-rays. Time to chest tube removal (4.34 days), overall complication rate (27.2%), reoperation rate (3.6%), and mortality rate (1.8%) were comparable to those in the literature. On average, our patients only had 1.22 ± 1.8 on-demand X-rays, compared with 3.3 X-rays if daily routine protocol had been applied. Patients with complications had more X-rays (3.4 ± 1.8) than patients without complications (0.4 ± 0.7). Conclusion  On-demand chest X-rays do not seem to delay the diagnosis of postoperative complications or increase morbidity-mortality rates. Performing on-demand chest X-rays could not only simplify surgical practice but also have a positive impact on health care expenses. However, a broader randomized study is warranted to validate this work and ultimately lead to national consensus. Georg Thieme Verlag KG Stuttgart · New York.

Translating knowledge into best practice care bundles: a pragmatic strategy for EBP implementation via moving postprocedural pain management nursing guidelines into clinical practice.

PubMed

Saunders, Hannele

2015-07-01

To describe quantitative and qualitative best evidence as sources for practical interventions usable in daily care delivery in order to integrate best evidence into clinical decision-making at local practice settings. To illustrate the development, implementation and evaluation of a pain management nursing care bundle based on a clinical practice guideline via a real-world clinical exemplar. Successful implementation of evidence-based practice requires consistent integration of best evidence into daily clinical decision-making. Best evidence comprises high-quality knowledge summarised in systematic reviews and translated into guidelines. However, consistent integration of guidelines into care delivery remains challenging, partly due to guidelines not being in a usable form for daily practice or relevant for the local context. A position paper with a clinical exemplar of a nurse-led, evidence-based quality improvement project to design, implement and evaluate a pain management care bundle translated from a national nursing guideline. A pragmatic approach to integrating guidelines into daily practice is presented. Best evidence from a national nursing guideline was translated into a pain management care bundle and integrated into daily practice in 15 medical-surgical (med-surg) units of nine hospitals of a large university hospital system in Finland. Translation of best evidence from guidelines into usable form as care bundles adapted to the local setting may increase implementation and uptake of guidelines and improve quality and consistency of care delivery. A pragmatic approach to translating a nursing guideline into a pain management care bundle to incorporate best evidence into daily practice may help achieve more consistent and equitable integration of guidelines into care delivery, and better quality of pain management and patient outcomes. © 2015 John Wiley & Sons Ltd.

Productive and counterproductive job crafting: A daily diary study.

PubMed

Demerouti, Evangelia; Bakker, Arnold B; Halbesleben, Jonathon R B

2015-10-01

The present study aims to uncover the way daily job crafting influences daily job performance (i.e., task performance, altruism, and counterproductive work behavior). Job crafting was conceptualized as "seeking resources," "seeking challenges," and "reducing demands" and viewed as strategies individuals use to optimize their job characteristics. We hypothesized that daily job crafting relates to daily job demands and resources (work pressure and autonomy), which consequently relate to daily work engagement and exhaustion and ultimately to job performance. A sample of 95 employees filled in a quantitative diary for 5 consecutive working days (n occasions = 475). We predicted and found that daily seeking resources was positively associated with daily task performance because daily autonomy and work engagement increased. In contrast, daily reducing demands was detrimental for daily task performance and altruism, because employees lower their daily workload and consequently their engagement and exhaustion, respectively. Only daily seeking challenges was positively (rather than negatively) associated with daily counterproductive behavior. We conclude that employee job crafting can have both beneficial and detrimental effects on job performance. (c) 2015 APA, all rights reserved).

What is analysis?

PubMed

Astrachan, G D

2000-07-01

This paper attempts to discern a ground for doing depth psychological work in times of disappearance, loss and the absence of the gods. Through the poetry of Friedrich Hölderlin, and to a lesser extent, Rainer Maria Rilke, it seeks to discover the significance of fragmentation and conflagration in the manifestations of both psyche and the post-industrial landscape we inhabit. What does the 'death of god' mean for our notions of symbol and self and for the practice of psychotherapy and psychoanalysis? How do we understand our daily clinical work in the context of ruin, holocaust and despair?

Teacher Blogs and Education Policy in a Publicly Private World: Filling the Gap between Policy and Practice

ERIC Educational Resources Information Center

Greene, Kiersten

2017-01-01

K-12 teachers who write about their daily work on blogs and other social media platforms share local knowledge and wisdom from the immediate view of the classroom. These first-hand retellings of everyday classroom life offer a unique critique of educational policy from the teachers' perspective. Reporting on the analysis of 14 public-facing blogs…

Eating routines: Embedded, value based, modifiable, and reflective

PubMed Central

Jastran, Margaret; Bisogni, Carole A.; Sobal, Jeffery; Blake, Christine; Devine, Carol M.

2009-01-01

Eating routines are a compelling issue because recurring eating behaviors influence nutrition and health. As non-traditional and individualized eating patterns have become more common, new ways of thinking about routine eating practices are needed. This study sought to gain conceptual understanding of working adults' eating routines. Forty-two purposively sampled US adults reported food intake and contextual details about eating episodes in qualitative 24-hour dietary recalls conducted over 7 consecutive days. Using the constant comparative method, researchers analyzed interview transcripts for recurrent ways of eating that were either explicitly reported by study participants as “routines” or emergent in the data. Participants' eating routines included repetition in food consumption as well as eating context, and also involved sequences of eating episodes. Eating routines were embedded in daily schedules for work, family, and recreation. Participants maintained purposeful routines that helped balance tension between demands and values, but they modified routines as circumstances changed. Participants monitored and reflected upon their eating practices and tended to assess their practices in light of their personal identities. These findings provide conceptual insights for food choice researchers and present a perspective from which practitioners who work with individuals seeking to adopt healthful eating practices might usefully approach their tasks. PMID:18835305

The daily digital practice as a form of self-care: Using photography for everyday well-being.

PubMed

Brewster, Liz; Cox, Andrew M

2018-04-01

Interest in the connection between involvement in digital communities and well-being has increased as these communities become more commonplace. Specific models of interaction that affect well-being have emerged; here, we examine one of those models, termed 'digital daily practice'. Digital daily practices involve a commitment to doing one thing - exercise, photography and writing - every day and sharing it online. Participants in these practices agree that they provide an unexpected benefit of improving well-being. This article makes an in-depth examination of one digital daily practice, photo-a-day, using a practice theory framework to understand the affordances it offers for well-being. We engage with the literature on well-being and self-care, critiquing its presentation of well-being as an individual trait. We present data from an ethnographic study including interviews and observations to highlight how photo-a-day as a practice functions as self-care and how communities are formed around it. Photo-a-day is not a simple and uncomplicated practice; rather it is the complex affordances and variance within the practice that relate it to well-being. We conclude that this practice has multi-faceted benefits for improving well-being.

Gender, Emotion Work, and Relationship Quality: A Daily Diary Study

PubMed Central

Curran, Melissa A.; McDaniel, Brandon T.; Pollitt, Amanda M.; Totenhagen, Casey J.

2015-01-01

We use the gender relations perspective from feminist theorizing to investigate how gender and daily emotion work predict daily relationship quality in 74 couples (148 individuals in dating, cohabiting, or married relationships) primarily from the southwest U.S. Emotion work is characterized by activities that enhance others’ emotional well-being. We examined emotion work two ways: trait (individuals’ average levels) and state (individuals’ daily fluctuations). We examined actor and partner effects of emotion work and tested for gender differences. As outcome variables, we included six types of daily relationship quality: love, commitment, satisfaction, closeness, ambivalence, and conflict. This approach allowed us to predict three aspects of relationship quality: average levels, daily fluctuations, and volatility (overall daily variability across a week). Three patterns emerged. First, emotion work predicted relationship quality in this diverse set of couples. Second, gender differences were minimal for fixed effects: Trait and state emotion work predicted higher average scores on, and positive daily increases in, individuals’ own positive relationship quality and lower average ambivalence. Third, gender differences were more robust for volatility: For partner effects, having a partner who reported higher average emotion work predicted lower volatility in love, satisfaction, and closeness for women versus greater volatility in love and commitment for men. Neither gender nor emotion work predicted average levels, daily fluctuations, or volatility in conflict. We discuss implications and future directions pertaining to the unique role of gender in understanding the associations between daily emotion work and volatility in daily relationship quality for relational partners. PMID:26508808

Gender, Emotion Work, and Relationship Quality: A Daily Diary Study.

PubMed

Curran, Melissa A; McDaniel, Brandon T; Pollitt, Amanda M; Totenhagen, Casey J

2015-08-01

We use the gender relations perspective from feminist theorizing to investigate how gender and daily emotion work predict daily relationship quality in 74 couples (148 individuals in dating, cohabiting, or married relationships) primarily from the southwest U.S. Emotion work is characterized by activities that enhance others' emotional well-being. We examined emotion work two ways: trait (individuals' average levels) and state (individuals' daily fluctuations). We examined actor and partner effects of emotion work and tested for gender differences. As outcome variables, we included six types of daily relationship quality: love, commitment, satisfaction, closeness, ambivalence, and conflict. This approach allowed us to predict three aspects of relationship quality: average levels, daily fluctuations, and volatility (overall daily variability across a week). Three patterns emerged. First, emotion work predicted relationship quality in this diverse set of couples. Second, gender differences were minimal for fixed effects: Trait and state emotion work predicted higher average scores on, and positive daily increases in, individuals' own positive relationship quality and lower average ambivalence. Third, gender differences were more robust for volatility: For partner effects, having a partner who reported higher average emotion work predicted lower volatility in love, satisfaction, and closeness for women versus greater volatility in love and commitment for men. Neither gender nor emotion work predicted average levels, daily fluctuations, or volatility in conflict. We discuss implications and future directions pertaining to the unique role of gender in understanding the associations between daily emotion work and volatility in daily relationship quality for relational partners.

Building clinical and organizational resilience to reconcile safety threats, tensions and trade-offs: insights from theory and evidence.

PubMed

Jeffs, Lianne; Tregunno, Deborah; MacMillan, Kathleen; Espin, Sherry

2009-01-01

Healthcare delivery settings are complex adaptive and tightly coupled, interrelated systems. Within the larger healthcare system, a key subsystem is the "clinical microsystem" level. It is at this level that clinicians are faced with high levels of uncertainty in their daily work - uncertainty that impacts the quality and safety of care that patients receive. The first aim of this paper is to enhance healthcare leaders' understanding of what is currently known about safety threats and strategies to manage the inherent tensions and trade-offs that occur in everyday practice. The second aim is to inform strategies that build clinical and organizational resilience through a multi-level framework derived from the collective theoretical and empirical work. Together, this information can strengthen safety practices throughout healthcare organizations.

Improving health sector travel.

PubMed

Hurdle, David; Davis, Adrian

2004-10-01

Preventing ill health and obesity and building more physical activity into our daily lives have never been so high on the agenda, and the way we travel can help. Many workplaces and schools are drawing up travel plans, with the aims usually to minimise car use and encourage healthier and more environmentally friendly travel. The Transport White Paper of 1998 advocated travel plans and singled out hospitals for action. Travel plans continue to be a focus within the latest Transport White Paper, launched in July 2004. This article covers various prompts to the health sector to implement travel plans. It addresses issues and concerns facing NHS Trusts, the practical things Trusts can do, and the increasing amount of good practice available. Finally, it demonstrates that travel plans can work, and are working, in the health sector.

Promoting Mental Health and Preventing Mental Illness in General Practice.

PubMed

Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

2016-01-01

This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development.

Time to pay attention: attentional performance time-stamped prefrontal cholinergic activation, diurnality and performance

PubMed Central

Paolone, Giovanna; Lee, Theresa M.; Sarter, Martin

2012-01-01

Although the impairments in cognitive performance that result from shifting or disrupting daily rhythms have been demonstrated, the neuronal mechanisms that optimize fixed time daily performance are poorly understood. We previously demonstrated that daily practice of a sustained attention task (SAT) evokes a diurnal activity pattern in rats. Here we report that SAT practice at a fixed time produced practice time-stamped increases in prefrontal cholinergic neurotransmission that persisted after SAT practice was terminated and in a different environment. SAT time-stamped cholinergic activation occurred irrespective of whether the SAT was practiced during the light or dark phase or in constant light conditions. In contrast, prior daily practice of an operant schedule of reinforcement, albeit generating more rewards and lever presses per session than the SAT, neither activated the cholinergic system nor affected the animals' nocturnal activity pattern. Likewise, food-restricted animals exhibited strong food anticipatory activity (FAA) and attenuated activity during the dark period but FAA was not associated with increases in prefrontal cholinergic activity. Removal of cholinergic neurons impaired SAT performance and facilitated the reemergence of nocturnality. Shifting SAT practice away from a fixed time resulted in significantly lower performance. In conclusion, these experiments demonstrated that fixed time, daily practice of a task assessing attention generates a precisely practice time-stamped activation of the cortical cholinergic input system. Time-stamped cholinergic activation benefits fixed time performance and, if practiced during the light phase, contributes to a diurnal activity pattern. PMID:22933795

Time to pay attention: attentional performance time-stamped prefrontal cholinergic activation, diurnality, and performance.

PubMed

Paolone, Giovanna; Lee, Theresa M; Sarter, Martin

2012-08-29

Although the impairments in cognitive performance that result from shifting or disrupting daily rhythms have been demonstrated, the neuronal mechanisms that optimize fixed-time daily performance are poorly understood. We previously demonstrated that daily practice of a sustained attention task (SAT) evokes a diurnal activity pattern in rats. Here, we report that SAT practice at a fixed time produced practice time-stamped increases in prefrontal cholinergic neurotransmission that persisted after SAT practice was terminated and in a different environment. SAT time-stamped cholinergic activation occurred regardless of whether the SAT was practiced during the light or dark phase or in constant-light conditions. In contrast, prior daily practice of an operant schedule of reinforcement, albeit generating more rewards and lever presses per session than the SAT, neither activated the cholinergic system nor affected the animals' nocturnal activity pattern. Likewise, food-restricted animals exhibited strong food anticipatory activity (FAA) and attenuated activity during the dark phase but FAA was not associated with increases in prefrontal cholinergic activity. Removal of cholinergic neurons impaired SAT performance and facilitated the reemergence of nocturnality. Shifting SAT practice away from a fixed time resulted in significantly lower performance. In conclusion, these experiments demonstrated that fixed-time, daily practice of a task assessing attention generates a precisely practice time-stamped activation of the cortical cholinergic input system. Time-stamped cholinergic activation benefits fixed-time performance and, if practiced during the light phase, contributes to a diurnal activity pattern.

Perceiving the moral dimension of practice: insights from Murdoch, Vetlesen, and Aristotle.

PubMed

Scott, P Anne

2006-07-01

This paper situates the moral domain of practice within the context of a particular description of nursing practice - one that sees human interaction at the heart of that practice. Such a description fits not only with professional rhetoric but also with literature from patients and recent empirical work exploring the nature of nursing practice. Martha Levine in her 1977 description of ethics, within the context of nursing practice, indicated that what was important from an ethical perspective was how we interact with each other, with patients and colleagues, on a daily basis. What enables such interaction to display moral sensitivity, insight into patient need, and a focus on the good for the patient? Of relevance when answering this question is the empirical evidence indicating that professional socialization, as a nurse or a doctor, may dull the individual's moral sense. If this is the case, cognizance needs to be taken of such evidence when identifying theoretical approaches from mainstream ethics that may provide insight and value for nurse education. It is suggested that such insight and value can be gained from a consideration of the work of Aristotle, Murdoch, and Vetlesen.

Empowering school social work practices for positive youth development: Hong Kong experience.

PubMed

To, Siu-ming

2007-01-01

Empowerment has become a popular concept in working with adolescents in recent years. It challenges the deficit model of youth work and focuses on creating a facilitative climate in which young people can make maximum use of the opportunity to learn and grow. While many practitioners have adopted the empowerment approach in youth services, however, we know little about the possibilities for empowerment practice in the field of school social work. Based on the findings of a qualitative study conducted in Hong Kong, this paper explores how school social workers engage in different dimensions of empowerment: (1) the personal dimension in regard to how students recapture a sense of competence to meet life challenges and fight for their own benefits; (2) the school and community dimensions in regard to how practitioners collaborate with service users and partners to initiate constructive changes to school policies and strengthen the school-community partnership for student development; and (3) the institutional dimension in regard to how practitioners play the advocacy role in the education sector. The findings provide rich information for other youth workers, especially those who render service in the school setting, as they apply the empowerment approach in daily practice.

From agricultural intensification to conservation: Sediment transport in the Raccoon River, Iowa, 1916-2009

USGS Publications Warehouse

Jones, C.S.; Schilling, K.E.

2011-01-01

Fluvial sediment is a ubiquitous pollutant that negatively aff ects surface water quality and municipal water supply treatment. As part of its routine water supply monitoring, the Des Moines Water Works (DMWW) has been measuring turbidity daily in the Raccoon River since 1916. For this study, we calibrated daily turbidity readings to modern total suspended solid (TSS) concentrations to develop an estimation of daily sediment concentrations in the river from 1916 to 2009. Our objectives were to evaluate longterm TSS patterns and trends, and relate these to changes in climate, land use, and agricultural practices that occurred during the 93-yr monitoring period. Results showed that while TSS concentrations and estimated sediment loads varied greatly from year to year, TSS concentrations were much greater in the early 20th century despite drier conditions and less discharge, and declined throughout the century. Against a backdrop of increasing discharge in the Raccoon River and widespread agricultural adaptations by farmers, sediment loads increased and peaked in the early 1970s, and then have slowly declined or remained steady throughout the 1980s to present. With annual sediment load concentrated during extreme events in the spring and early summer, continued sediment reductions in the Raccoon River watershed should be focused on conservation practices to reduce rainfall impacts and sediment mobilization. Overall, results from this study suggest that eff orts to reduce sediment load from the watershed appear to be working. ?? 2011 by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America.

Engagement and practical wisdom in clinical practice: a phenomenological study.

PubMed

Saraga, Michael; Boudreau, Donald; Fuks, Abraham

2018-05-08

In order to understand the lived experiences of physicians in clinical practice, we interviewed eleven expert, respected clinicians using a phenomenological interpretative methodology. We identified the essence of clinical practice as engagement. Engagement accounts for the daily routine of clinical work, as well as the necessity for the clinician to sometimes trespass common boundaries or limits. Personally engaged in the clinical situation, the clinician is able to create a space/time bubble within which the clinical encounter can unfold. Engagement provides an account of clinical practice as a unitary lived experience. This stands in stark contrast to the prevailing notion, referred to as a dual discourse, that describes medicine as the addition of humanism to science. Drawing on Aristotle's notion of phronesis and Sartre's definition of the situation, we illustrate how this novel perspective entwines clinical practice, the person of the clinician, and the clinician's situation.

[Some considerations about nurses' use of non traditional therapies in psychiatric nursing care].

PubMed

Andrade, Rubia Laine de Paula; Pedrão, Luiz Jorge

2005-01-01

In this work, a revision of the literature was carried out to identify articles that described non traditional therapeutic modalities psychiatric nurses can use in their daily practice. The described modalities were Music, Motor Activity, Therapeutic Accompaniment and Yoga. Music is able to reconstruct identities, integrate people, reduce anxiety and provide the construction of positive self-esteem. Motor Activity increases self-esteem, reduces inactivity and increases the participation of the psychiatric patient in other activities. In Therapeutic Accompaniment, nurses follow patients in daily routine with a view to their reintegration in the different situations they have to face. Yoga allows for improved memory, reduces emotional tension, depression, anxiety and irritability, and promotes relaxation and a greater feeling of self-control. All activities should be integrated in a global therapeutic plan for each user and be part of daily service programming.

Staff Nurses’ Perceptions and Experiences about Structural Empowerment: A Qualitative Phenomenological Study

PubMed Central

Van Bogaert, Peter; Peremans, Lieve; Diltour, Nadine; Van heusden, Danny; Dilles, Tinne; Van Rompaey, Bart; Havens, Donna Sullivan

2016-01-01

The aim of the study reported in this article was to investigate staff nurses’ perceptions and experiences about structural empowerment and perceptions regarding the extent to which structural empowerment supports safe quality patient care. To address the complex needs of patients, staff nurse involvement in clinical and organizational decision-making processes within interdisciplinary care settings is crucial. A qualitative study was conducted using individual semi-structured interviews of 11 staff nurses assigned to medical or surgical units in a 600-bed university hospital in Belgium. During the study period, the hospital was going through an organizational transformation process to move from a classic hierarchical and departmental organizational structure to one that was flat and interdisciplinary. Staff nurses reported experiencing structural empowerment and they were willing to be involved in decision-making processes primarily about patient care within the context of their practice unit. However, participants were not always fully aware of the challenges and the effect of empowerment on their daily practice, the quality of care and patient safety. Ongoing hospital change initiatives supported staff nurses’ involvement in decision-making processes for certain matters but for some decisions, a classic hierarchical and departmental process still remained. Nurses perceived relatively high work demands and at times viewed empowerment as presenting additional. Staff nurses recognized the opportunities structural empowerment provided within their daily practice. Nurse managers and unit climate were seen as crucial for success while lack of time and perceived work demands were viewed as barriers to empowerment. PMID:27035457

Staff Nurses' Perceptions and Experiences about Structural Empowerment: A Qualitative Phenomenological Study.

PubMed

Van Bogaert, Peter; Peremans, Lieve; Diltour, Nadine; Van heusden, Danny; Dilles, Tinne; Van Rompaey, Bart; Havens, Donna Sullivan

2016-01-01

The aim of the study reported in this article was to investigate staff nurses' perceptions and experiences about structural empowerment and perceptions regarding the extent to which structural empowerment supports safe quality patient care. To address the complex needs of patients, staff nurse involvement in clinical and organizational decision-making processes within interdisciplinary care settings is crucial. A qualitative study was conducted using individual semi-structured interviews of 11 staff nurses assigned to medical or surgical units in a 600-bed university hospital in Belgium. During the study period, the hospital was going through an organizational transformation process to move from a classic hierarchical and departmental organizational structure to one that was flat and interdisciplinary. Staff nurses reported experiencing structural empowerment and they were willing to be involved in decision-making processes primarily about patient care within the context of their practice unit. However, participants were not always fully aware of the challenges and the effect of empowerment on their daily practice, the quality of care and patient safety. Ongoing hospital change initiatives supported staff nurses' involvement in decision-making processes for certain matters but for some decisions, a classic hierarchical and departmental process still remained. Nurses perceived relatively high work demands and at times viewed empowerment as presenting additional. Staff nurses recognized the opportunities structural empowerment provided within their daily practice. Nurse managers and unit climate were seen as crucial for success while lack of time and perceived work demands were viewed as barriers to empowerment.

Managing barriers to empathy in the clinical encounter: a qualitative interview study with GPs.

PubMed

Derksen, Frans Awm; Olde Hartman, Tim C; Bensing, Jozien M; Lagro-Janssen, Antoine Lm

2016-12-01

Current daily general practice has become increasingly technical and somatically oriented (where attention to patients' feelings is decreased) due to an increase in protocol-based guidelines. Priorities in GP-patient communication have shifted from a focus on listening and empathy to task-oriented communication. To explore what barriers GPs experience when applying empathy in daily practice, and how these barriers are managed. Thirty Dutch GPs with sufficient heterogeneity in sex, age, type of practice, and rural or urban setting were interviewed. The consolidated criteria for reporting qualitative research (COREQ) were applied. The verbatim transcripts were then analysed. According to participating GPs, the current emphasis on protocol-driven care can be a significant barrier to genuineness in communication. Other potential barriers mentioned were time pressures and constraints, and dealing with patients displaying 'unruly behaviour' or those with personality disorders. GPs indicated that it can be difficult to balance emotional involvement and professional distance. Longer consulting times, smaller practice populations, and efficient practice organisation were described as practical solutions. In order to focus on a patient-as-person approach, GPs strongly suggested that deviating from guidelines should be possible when necessary as an element of good-quality care. Joining intercollegiate counselling groups was also discussed. In addition to practical solutions for barriers to behaving empathically, GPs indicated that they needed more freedom to balance working with protocols and guidelines, as well as a patient-as-person and patient-as-partner approach. This balance is necessary to remain connected with patients and to deliver care that is truly personal. © British Journal of General Practice 2016.

Addressing holistic health and work empowerment through a body-mind-spirit intervention program among helping professionals in continuous education: A pilot study.

PubMed

Ho, Rainbow T H; Sing, Cheuk Yan; Wong, Venus P Y

2016-01-01

To examine the effectiveness of a body-mind-spirit (BMS) intervention program in improving the holistic well-being and work empowerment among helping professionals in continuous education. Forty-four helping professionals, who were in their first-year part-time postgraduate study, participated in the present study. All participants attended a 3-day BMS intervention program which emphasized a holistic approach to health and well-being. Ratings on their levels of physical distress, daily functioning, affect, spirituality, and psychological empowerment at work were compared before and immediately after the intervention. Participants reported significantly lower levels of negative affect and physical distress, and were less spiritually disoriented after the intervention. Enhanced levels of daily functioning, positive affect, spiritual resilience, and tranquility were also reported. Results also suggested that participants were empowered at work, and specifically felt more able to make an impact on work outcomes. The 3-day BMS intervention program produced a positive and measurable effect on participants' holistic well-being and empowerment at work. Educators in related fields could incorporate holistic practices into the curriculum to better prepare the future practitioners, leading to better outcomes both to the professionals themselves and their clients or patients.

The timing of maternal depressive symptoms and mothers' parenting practices with young children: implications for pediatric practice.

PubMed

McLearn, Kathryn Taaffe; Minkovitz, Cynthia S; Strobino, Donna M; Marks, Elisabeth; Hou, William

2006-07-01

The prevalence of maternal depressive symptoms and its associated consequences on parental behaviors, child health, and development are well documented. Researchers have called for additional work to investigate the effects of the timing of maternal depressive symptoms at various stages in the development of the young child on the emergence of developmentally appropriate parenting practices. For clinicians, data are limited about when or how often to screen for maternal depressive symptoms or how to target anticipatory guidance to address parental needs. We sought to determine whether concurrent maternal depressive symptoms have a greater effect than earlier depressive symptoms on the emergence of maternal parenting practices at 30 to 33 months in 3 important domains of child safety, development, and discipline. Secondary analyses from the Healthy Steps National Evaluation were conducted for this study. Data sources included a self-administered enrollment questionnaire and computer-assisted telephone interviews with the mother when the Healthy Steps children were 2 to 4 and 30 to 33 months of age. The 30- to 33-month interview provided information about 4 safety practices (ie, always uses car seat, has electric outlet covers, has safety latches on cabinets, and lowered temperature on the water heater), 6 child development practices (ie, talks daily to child while working, plays daily with child, reads daily to child, limits child television and video watching to <2 hours a day, follows > or = 3 daily routines, and being more nurturing), and 3 discipline practices (ie, uses more reasoning, uses more harsh punishment, and ever slapped child on the face or spanked the child with an object). The parenting practices were selected based on evidence of their importance for child health and development, near complete data, and sample variability. The discipline practices were constructed from the Parental Response to Misbehavior Scale. Maternal depressive symptoms were assessed using a 14-item modified version of the Center for Epidemiologic Studies-Depression Scale. Multiple logistic regression models estimated the effect of depressive symptoms on parenting practices, adjusted for baseline demographic characteristics, Healthy Steps participation, and site. No significant interactions were found when testing analytic models with dummy variables for depressive symptoms at 2 to 4 months only, 30 to 33 months only, and at both times; reported models do not include interaction terms. We report main effects of depressive symptoms at 2 to 4 and 30 to 33 months when both are included in the model. Of 5565 families, 3412 mothers (61%) completed 2- to 4- and 30- to 33-month interviews and provided Center for Epidemiologic Studies-Depression Scale data at both times. Mothers with depressive symptoms at 2 to 4 months had reduced odds of using car seats, lowering the water heater temperature, and playing with the child at 30 to 33 months. Mothers with concurrent depressive symptoms had reduced odds of using electric outlet covers, using safety latches, talking with the child, limiting television or video watching, following daily routines, and being more nurturing. Mothers with concurrent depressive symptoms had increased odds of using harsh punishment and of slapping the child on the face or spanking with an object. The study findings suggest that concurrent maternal depressive symptoms have stronger relations than earlier depressive symptoms, with mothers not initiating recommended age-appropriate safety and child development practices and also using harsh discipline practices for toddlers. Our findings, however, also suggest that for parenting practices that are likely to be established early in the life of the child, it may be reasonable that mothers with early depressive symptoms may continue to affect use of those practices by mothers. The results of our study underscore the importance of clinicians screening for maternal depressive symptoms during the toddler period, as well as the early postpartum period, because these symptoms can appear later independent of earlier screening results. Providing periodic depressive symptom screening of the mothers of young patients has the potential to improve clinician capacity to provide timely and tailored anticipatory guidance about important parenting practices, as well as to make appropriate referrals.

Demand-based provision of housing, welfare and care services to elderly clients: from policy to daily practice through operations management.

PubMed

de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

2009-03-01

Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the daily routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation's policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes.

"Are We hurting ourselves?" What is the prevalence of back pain in anesthesia providers?

PubMed

Anson, Jonathan A; Mets, Elbert J; Vaida, Sonia J; King, Tonya S; Ochoa, Tim; Gordin, Vitaly

2016-11-01

Back injuries are a highly reported category of occupational injury in the health care setting. The daily clinical activities of an anesthesia provider, including lifting, pushing stretchers, transferring patients, and bending for procedures, are risk factors for developing low back pain. The purpose of this study is to investigate the prevalence of work related low back pain in anesthesia providers. We conducted a cross-sectional survey study of anesthesia providers at an academic institution. The target population included all 141 clinical anesthesia providers employed by the Penn State Milton S. Hershey Medical Center Department of Anesthesia. A survey study was conducted using the Oswestry Disability Index (ODI), a validated scoring system for low back pain. Additional questions related to the daily activities of clinical anesthesia practice were also asked. The survey instrument underwent pretesting and clinical sensibility testing to ensure validity and consistent interpretation. The primary self-reported measures were the prevalence of low back pain in anesthesia providers and an assessment of disability based on the ODI. Secondary functional measures included the impact of low back pain on work flow. Nearly half (46.6%) of respondents suffer from low back pain attributed to clinical practice. In this subset of respondents, 70.1% reported not having back pain prior to their anesthesia training. Of those with low back pain, 44% alter their work flow, and 9.8% reported missing at least one day of work. Six providers (5.3%) required surgical intervention. Using the ODI score interpretation guidelines, 46% of respondents had a "mild disability" and 2% had a "moderate disability." Respondents reporting feeling "burned out" from their job had a significantly higher average ODI score compared to those who did not (6.8 vs 3.3, respectively; P=.01). Nearly half of all anesthesia providers sampled suffer from low back pain subjectively attributed to their clinical practice. This leads to changes in work flow and missed days of work. The results of this study suggest a deficiency in the effectiveness of anesthesia training programs in teaching proper techniques to prevent musculoskeletal injuries. Copyright © 2016 Elsevier Inc. All rights reserved.

Visual impairment, coping strategies and impact on daily life: a qualitative study among working-age UK ex-service personnel.

PubMed

Stevelink, Sharon A M; Malcolm, Estelle M; Fear, Nicola T

2015-11-12

Sustaining a visual impairment may have a substantial impact on various life domains such as work, interpersonal relations, mobility and social and mental well-being. How to adjust to the loss of vision and its consequences might be a challenge for the visually impaired person. The purpose of the current study was to explore how younger male ex-Service personnel cope with becoming visually impaired and how this affects their daily life. Semi-structured interviews with 30 visually impaired male ex-Service personnel, all under the age of 55, were conducted. All participants are members of the charity organisation Blind Veterans UK. Interviews were analysed thematically. Younger ex-Service personnel applied a number of different strategies to overcome their loss of vision and its associated consequences. Coping strategies varied from learning new skills, goal setting, integrating the use of low vision aids in their daily routine, to social withdrawal and substance misuse. Vision loss affected on all aspects of daily life and ex-Service personnel experienced an on-going struggle to accept and adjust to becoming visually impaired. Health care professionals, family and friends of the person with the visual impairment need to be aware that coping with a visual impairment is a continuous struggle; even after a considerable amount of time has passed, needs for emotional, social, practical and physical support may still be present.

[Health coaching as a part of integration into the job market--evaluation of a qualification concept].

PubMed

Heinmüller, M; Liel, K; Angerer, P; Gündel, H; Geldermann, B; Gottwald, M; Kimil, A; Limm, H

2014-03-01

The aim of this study is to develop, implement and evaluate an education programme enabling the pedagogic staff of employment promotion agencies to integrate health promotion approaches und activities in vocational training programmes. The evaluation of the education programme is based on Kirkpatrick's 4 levels training evaluation model. Besides the participants' verbal end of session feedback, a standardised questionnaire was used at the end of the education programme and after 3 months practical experience. Process evaluation included the implementation level of the methods learned. From a total of 71 participants, 56 completed the first and 31 the second questionnaire (return rate 79% and 44%, respectively). The participants' mean age was 42 years, 80% were female. Only 22% of them integrated health topics systematically into their daily work. A 3-day basic training followed by case conferences during practical work was developed to transfer knowledge and practical competence in person-to-person talks and group activities (so called FIT-counselling and FIT-group). For 96% of participants, their expectations regarding the education programme were met completely or predominantly. 91% indicated a rise in motivation to work as health coach. When rating the training material, 96% judged it helpful for implementation/transfer. Many participants marked the education programme as being too short and wished more time for the topic of "mental health" and exchange of experiences. The follow-up after 3 months on-the-job training revealed that 84 and 97%, respectively, found FIT-counselling and FIT-groups helpful for their daily work. In all employment promotion agencies FIT-counselling and FIT-groups were implemented. Our results affirm the need for and prove the acceptance of education programmes enabling the pedagogic staff of job-training programmes to deliver health coaching. Periodic case conferences take into account the participants' request for more exchange of experiences, facilitate implementation and contribute to quality and sustainability. Further development of the education programme is ongoing. © Georg Thieme Verlag KG Stuttgart · New York.

Knowledge, Attitudes, Behaviors and Noise Exposure of Baristas

PubMed Central

Pursley, Alyssa J.; Saunders, Gabrielle H.

2016-01-01

Objective To examine the daily noise exposure of baristas working in cafés, and to measure their knowledge, attitudes and behaviors regarding hearing conservation and perceptions of noise in their work environment. Design Fifteen baristas from six cafés in Portland completed the Knowledge, Attitudes and Behaviors questionnaire, a sound disturbance survey, and a structured interview to document perceptions of noise in the work environment. To measure daily noise exposure, a subset of eight participants wore a personal dosimeter for three different work shifts. Study Sample 11 females and 4 males aged between 19 and 36 years old (mean: 26.3, SD: 4.6) recruited from independently owned cafés in the Portland metro area. Results Dosimetry measurements revealed Leq measurements between 71 dBA and 83 dBA, with noise doses ranging from 4% to 74%, indicating that baristas are not exposed to sound levels above the regulatory criterion. Questionnaire results indicated that baristas have low awareness about the hazards of noise, are not opposed to hearing conservation, and rarely use hearing protection when engaged in noisy activities. Conclusions Baristas here lacked the pertinent education and motivation to commit to invaluable hearing conservation practices. PMID:26795371

Proactive and integrated primary care for frail older people: design and methodological challenges of the Utrecht primary care PROactive frailty intervention trial (U-PROFIT).

PubMed

Bleijenberg, Nienke; Drubbel, Irene; Ten Dam, Valerie H; Numans, Mattijs E; Schuurmans, Marieke J; de Wit, Niek J

2012-04-25

Currently, primary care for frail older people is reactive, time consuming and does not meet patients' needs. A transition is needed towards proactive and integrated care, so that daily functioning and a good quality of life can be preserved. To work towards these goals, two interventions were developed to enhance the care of frail older patients in general practice: a screening and monitoring intervention using routine healthcare data (U-PRIM) and a nurse-led multidisciplinary intervention program (U-CARE). The U-PROFIT trial was designed to evaluate the effectiveness of these interventions. The aim of this paper is to describe the U-PROFIT trial design and to discuss methodological issues and challenges. The effectiveness of U-PRIM and U-CARE is being tested in a three-armed, cluster randomized trial in 58 general practices in the Netherlands, with approximately 5000 elderly individuals expected to participate. The primary outcome is the effect on activities of daily living as measured with the Katz ADL index. Secondary outcomes are quality of life, mortality, nursing home admission, emergency department and out-of-hours General Practice (GP), surgery visits, and caregiver burden. In a large, pragmatic trial conducted in daily clinical practice with frail older patients, several challenges and methodological issues will occur. Recruitment and retention of patients and feasibility of the interventions are important issues. To enable broad generalizability of results, careful choices of the design and outcome measures are required. Taking this into account, the U-PROFIT trial aims to provide robust evidence for a structured and integrated approach to provide care for frail older people in primary care. NTR2288.

A stock-and-flow simulation model of the US blood supply.

PubMed

Simonetti, Arianna; Forshee, Richard A; Anderson, Steven A; Walderhaug, Mark

2014-03-01

Lack of reporting requirements for the amount of blood stored in blood banks and hospitals poses challenges to effectively monitor the US blood supply. Effective strategies to minimize collection and donation disruptions in the supply require an understanding of the daily amount of blood available in the system. A stock-and-flow simulation model of the US blood supply was developed to obtain estimates of the daily on-hand availability of blood, with uncertainty and by ABO/Rh type. The model simulated potential impact on supply of using different blood management practices for transfusion: first in-first out (FIFO), using the oldest stored red blood cell units first; non-FIFO likely oldest, preferentially selecting older blood; and non-FIFO likely newest, preferentially selecting younger blood. Simulation results showed higher estimates of the steady-state of the blood supply level for FIFO (1,630,000 units, 95% prediction interval [PI] 1,610,000-1,650,000) than non-FIFO scenarios (likely oldest, 1,530,000 units, 95% PI 1,500,000-1,550,000; and likely newest, 1,190,000 units, 95% PI 1,160,000-1,220,000), either for overall blood or by blood types. To our knowledge, this model represents a first attempt to evaluate the impact of different blood management practices on daily availability and distribution of blood in the US blood supply. The average storage time before blood is being issued was influenced by blood management practices, for preferences of blood that is younger and also that use specific blood types. The model also suggests which practice could best approximate the current blood management system and may serve as useful tool for blood management. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Awareness of food nutritive value and eating practices among Nigerian bank workers: Implications for nutritional counseling and education.

PubMed

Eze, Ngozi M; Maduabum, Felicia O; Onyeke, Nkechi G; Anyaegunam, Ngozi J; Ayogu, Chinwe A; Ezeanwu, Bibian Amaka; Eseadi, Chiedu

2017-03-01

Adequate nutrition is an important aspect of a healthy lifestyle for all individuals, including bank staff. The objective of this study was to investigate the awareness of food nutritive value and eating practices among bank workers in Lagos State, Nigeria.The study adopted a cross-sectional descriptive survey design. A purposive sample of 250 bank workers took part in the study. Means and Student t tests were employed for data analysis.Results showed that bank workers were aware of the nutritive value of foods, and that eating practices commonly adopted included skipping breakfast, eating breakfast at work, buying food at work from the bank canteen, eating in between meals, buying snacks as lunch, and consuming soft drinks daily, among others. There were no significant differences between male and female bank workers in mean responses on food nutritive value or in eating practices adopted.Good eating habits will help bank workers not only to improve their nutritional well-being, but also to prevent nutrition-related diseases. The implications for nutritional counseling and education are discussed in the context of these findings.

Awareness of food nutritive value and eating practices among Nigerian bank workers

PubMed Central

Eze, Ngozi M.; Maduabum, Felicia O.; Onyeke, Nkechi G.; Anyaegunam, Ngozi J.; Ayogu, Chinwe A.; Ezeanwu, Bibian Amaka; Eseadi, Chiedu

2017-01-01

Abstract Adequate nutrition is an important aspect of a healthy lifestyle for all individuals, including bank staff. The objective of this study was to investigate the awareness of food nutritive value and eating practices among bank workers in Lagos State, Nigeria. The study adopted a cross-sectional descriptive survey design. A purposive sample of 250 bank workers took part in the study. Means and Student t tests were employed for data analysis. Results showed that bank workers were aware of the nutritive value of foods, and that eating practices commonly adopted included skipping breakfast, eating breakfast at work, buying food at work from the bank canteen, eating in between meals, buying snacks as lunch, and consuming soft drinks daily, among others. There were no significant differences between male and female bank workers in mean responses on food nutritive value or in eating practices adopted. Good eating habits will help bank workers not only to improve their nutritional well-being, but also to prevent nutrition-related diseases. The implications for nutritional counseling and education are discussed in the context of these findings. PMID:28272248

[Techniques of mediation. Chemistry as a combination of work, teaching and research: the case of J. F. A. Göttling].

PubMed

Frercks, Jan

2008-01-01

Atypical career of a chemist in Germany around 1800 consisted of being trained as an apothecary, followed by an occupation as a professor at a university or another institution of higher education. These conditions deeply influenced the concept and the practice of chemistry as a science. Johann Friedrich August Göttling is an intriguing example for merging education and daily duties of teaching with the self-image of a scientific chemist. He linked chemical teaching, work, and research by using different hybrid media, such as the Almanach oder Taschenbuch für Scheidekünstler und Apotheker, a stove specifically designed for the narrow student's room, portable laboratories, a pharmaceutical boarding school and textbooks. This allowed him to practice three different forms of chemistry as a science. A "socio-epistemological diagram" of German chemistry around 1800 shows that these forms neatly corresponded to the then predominant three-level epistemology. In particular, the concept of a chemical fact served to link pharmaceutical practice with teaching practice, while granting only the chemistry done by professors the status of a science.

[Teacher education in health sciences: from prescribing to form].

PubMed

Schwartzman, Gisela; Roni, Carolina; Eder, María L

2013-01-01

From the Pedagogical Advisory of Italian Hospital's University Institute is a need to develop training processes regarding teaching practices that promote changes in regular teaching proposals. Teachers "in training", involved in counseling under the Teacher Education Program, in most cases have a career in the practice of teaching. That's why it is intended to recover their experiences and, at the same time, conduct them to a critical analysis towards improving their daily work. In this paper we review, and consider the perspective of those who have been trained under this system, the principles supporting the pedagogical counseling approach: the dialectical relationship between theory and practice, the reflection on action, and interventions redefinitions towards maintaining and reviewing its educational purposes.

Clinical Practice Informs Secure Messaging Benefits and Best Practices.

PubMed

Haun, Jolie N; Hathaway, Wendy; Chavez, Margeaux; Antinori, Nicole; Vetter, Brian; Miller, Brian K; Martin, Tracey L; Kendziora, Lisa; Nazi, Kim M; Melillo, Christine

2017-10-01

Background Clinical care team members in Department of Veterans' Affairs (VA) facilities nationwide are working to integrate the use of Secure Messaging (SM) into care delivery and identify innovative uses. Identifying best practices for proactive use of SM is a key factor in its successful implementation and sustained use by VA clinical care team members and veterans. Objectives A collaborative project solicited input from VA clinical care teams about their local practices using SM to provide access to proactive patient-centered care for veterans and enhance workflow. Methods This project implemented a single-item cross-sectional qualitative electronic survey via internal e-mail to local coordinators in all 23 Veterans Integrated Service Networks (VISNs). Content analysis was used to manage descriptive data responses. Descriptive statistics described sample characteristics. Results VA clinical care team members across 15 of 23 VISNs responded to the questionnaire. Content analysis of 171 responses produced two global domains: (1) benefits of SM and (2) SM best practices. Benefits of SM use emphasize enhanced and efficient communication and increased access to care. Care team members incorporate SM into their daily clinical practices, using it to provide services before, during, and after clinical encounters as a best practice. SM users suggest improvements in veteran care, clinical team workflow, and efficient use of health resources. Clinical team members invested in the successful implementation of SM integrate SM into their daily practices to provide meaningful and useful veteran-centered care and improve workflow. Conclusion VA clinical care team members can use SM proactively to create an integrated SM culture. With adequate knowledge and motivation to proactively use this technology, all clinical team members within the VA system can replicate best practices shared by other clinical care teams to generate meaningful and useful interactions with SM to enrich veterans' health care experience.

[The micropolitics of desire: the clinic of the individual in the mental health institution].

PubMed

Rinaldi, Doris Luz

2015-02-01

The scope of this article is to discuss clinical practice issues in public mental health institutions, their predicaments and potential conditions, focusing especially on the practice "among others" of the psycho analyst in this clinic. The mental health field is a field in permanent revitalization, marked by the heterogeneity and plurality of guidelines, permeated by tensions between old models of care, new political objectives to redeem the minimum rights of a population traditionally excluded from social coexistence and proposals for a new clinical practice that concentrates on the individual. Based on clinical perceptions, I intend to approach the clinical treatment of the individual in a mental health institution, as well as the challenges of working in a team, bearing in mind the impositions of mental health policy arounnd which the services are structured. Our proposal is to think of the clinic as the micro politics of desire that sustains the daily work of monitoring the course of treatment for each individual.

Introducing practice-based learning and improvement ACGME core competencies into a family medicine residency curriculum.

PubMed

Coleman, Mary Thoesen; Nasraty, Soraya; Ostapchuk, Michael; Wheeler, Stephen; Looney, Stephen; Rhodes, Sandra

2003-05-01

The Accreditation Council for Graduate Medical Education (ACGME) recommends integrating improvement activities into residency training. A curricular change was designed at the Department of Family and Community Medicine, University of Louisville, to address selected ACGME competencies by incorporating practice-based improvement activities into the routine clinical work of family medicine residents. Teams of residents, faculty, and office staff completed clinical improvement projects at three ambulatory care training sites. Residents were given academic credit for participation in team meetings. After 6 months, residents presented results to faculty, medical students, other residents, and staff from all three training sites. Residents, staff, and faculty were recognized for their participation. Resident teams demonstrated ACGME competencies in practice-based improvement: Chart audits indicated improvement in clinical projects; quality improvement tools demonstrated analysis of root causes and understanding of the process; plan-do-study-act cycle worksheets demonstrated the change process. Improvement activities that affect patient care and demonstrate selected ACGME competencies can be successfully incorporated into the daily work of family medicine residents.

Drawbacks of proactivity: Effects of daily proactivity on daily salivary cortisol and subjective well-being.

PubMed

Fay, Doris; Hüttges, Annett

2017-10-01

The benefit of proactive work behaviors for performance-related outcomes has been well established. However, this approach to studying proactivity has not yet acknowledged its potential implications for the actor's well-being. Drawing on the fact that resources at work are limited and that the workplace is a social system characterized by interdependencies, we proposed that daily proactivity could have a negative effect on daily well-being. We furthermore proposed that this effect should be mediated by work overload and negative affect. We conducted a daily diary study (N = 72) to test the potential negative effects of proactivity on daily well-being. Data was collected across 3 consecutive work days. During several daily measurement occasions, participants reported proactivity, work overload, negative affect, and fatigue. They also provided 4 saliva samples per day, from which cortisol was assayed. Based on the 4 samples, a measure of daily cortisol output was produced. Multilevel analyses showed that daily proactivity was positively associated with higher daily cortisol output. The positive association of daily proactivity with bedtime fatigue was marginally significant. There was no support for a mediating effect of work overload and negative affect. Implications for theory-building on the proactivity-well-being link are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Effect of Daily Work on Student's Memorization Ability in Piano Education

ERIC Educational Resources Information Center

Toptas, Baris

2016-01-01

It is very important for a student to study regularly so that the results of effective training given by the teacher can be positive. It is an inevitable fact that daily and regular work will bring success to students. Therefore, daily work is highly important in music education. Daily work in instrumental education, which is a part of music…

Promoting Mental Health and Preventing Mental Illness in General Practice

PubMed Central

Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

2016-01-01

Abstract This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert ‘Think Tank’ convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your ‘cluster’ of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development. PMID:28250821

Primary care nursing role and care coordination: an observational study of nursing work in a community health center.

PubMed

Anderson, Daren R; St Hilaire, Daniel; Flinter, Margaret

2012-05-31

Care coordination is a core element of the Patient-Centered Medical Home and requires an effective, well educated nursing staff. A greater understanding of roles and tasks currently being carried out by nurses in primary care is needed to help practices determine how best to implement care coordination and transform into PCMHs. We conducted an observational study of primary care nursing in a Community Health Center by creating a classification schema for nursing responsibilities, directly observing and tracking nurses' work, and categorizing their activities. Ten nurses in eight different practice sites were observed for a total of 61 hours. The vast majority of nursing time was spent in vaccine and medication administration; telephone work; and charting and paper work, while only 15% of their time was spent in activity that was classified broadly as care coordination. Care coordination work appeared to be subsumed by other daily tasks, many of which could have been accomplished by other, lesser trained members of the health care team. Practices looking to implement care coordination need a detailed look at work flow, task assignments, and a critical assessment of staffing, adhering to the principal of each team member working to the highest level of his or her education and license. Care coordination represents a distinct responsibility that requires dedicated nursing time, separate from the day to day tasks in a busy practice. To fully support these new functions, reimbursement models are needed that support such non visit-based work and provide incentives to coordinate and manage complex cases, achieve improved clinical outcomes and enhance efficiency of the health system. This article describes our study methods, data collection, and analysis, results, and discussion about reorganizing nursing roles to promote care coordination.

What's new in paediatric dentistry?

NASA Astrophysics Data System (ADS)

Vitale, M. C.

2016-03-01

Since the early 80's, the use of laser has been introduced in the daily dental practice and the technological development has also provided over time to optimize its use. Various types of lasers with different wavelengths have been developed for use in a handy, easy and ergonomic manner. In daily paediatric dentistry, laser could be a very useful medical device which can completely replace the traditional high hand-piece and bur to realize a "micro-invasive" dentistry and a "clean" surgery, without bleeding and sutures. According to the international literature and in the light of recent researches, this work could give an overview on assisted laser therapy in paediatric dentistry, highlighting advantages and disadvantages of this new technology and pointing out the high compliance of the young patient.

Delegation and supervision of healthcare assistants' work in the daily management of uncertainty and the unexpected in clinical practice: invisible learning among newly qualified nurses.

PubMed

Allan, Helen T; Magnusson, Carin; Evans, Karen; Ball, Elaine; Westwood, Sue; Curtis, Kathy; Horton, Khim; Johnson, Martin

2016-12-01

The invisibility of nursing work has been discussed in the international literature but not in relation to learning clinical skills. Evans and Guile's (Practice-based education: Perspectives and strategies, Rotterdam: Sense, 2012) theory of recontextualisation is used to explore the ways in which invisible or unplanned and unrecognised learning takes place as newly qualified nurses learn to delegate to and supervise the work of the healthcare assistant. In the British context, delegation and supervision are thought of as skills which are learnt "on the job." We suggest that learning "on-the-job" is the invisible construction of knowledge in clinical practice and that delegation is a particularly telling area of nursing practice which illustrates invisible learning. Using an ethnographic case study approach in three hospital sites in England from 2011 to 2014, we undertook participant observation, interviews with newly qualified nurses, ward managers and healthcare assistants. We discuss the invisible ways newly qualified nurses learn in the practice environment and present the invisible steps to learning which encompass the embodied, affective and social, as much as the cognitive components to learning. We argue that there is a need for greater understanding of the "invisible learning" which occurs as newly qualified nurses learn to delegate and supervise. © 2016 John Wiley & Sons Ltd.

Rewinding Forward: What James A. Wallace's 1980 Essay "The Philosophy of University Housing" Tells Us about Where We've Been, Where We Are, and Where We're Heading

ERIC Educational Resources Information Center

Shushok, Frank, Jr.; Manz, Jonathan W.

2012-01-01

Why do we do what we do? Why is what we do important? What are the best practices to ensure that our "why" is accomplished? These are questions of philosophy--a topic of immense importance since the "why" behind the work influences everything about the "how" and "what" of daily affairs in the world of…

The principle of respect for autonomy – Concordant with the experience of oncology physicians and molecular biologists in their daily work?

PubMed Central

Ebbesen, Mette; Pedersen, Birthe D

2008-01-01

Background This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work. Methods This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. Results We found that that molecular biologists consider the principle of respect for autonomy as a negative obligation, where the informed consent of patients or research subjects should be respected. Furthermore, molecular biologists believe that very sick patients are constraint by the circumstances to a certain choice. However, in contrast to molecular biologists, oncology physicians experience the principle of respect for autonomy as a positive obligation, where the physician in dialogue with the patient performs a medical prognosis based on the patient's wishes and ideas, mutual understanding and respect. Oncology physicians believe that they have a positive obligation to adjust to the level of the patient when providing information making sure that the patient understands. Oncology physicians experience situations where the principle of respect for autonomy does not apply because the patient is in a difficult situation. Conclusion In this study we explore the moral views and attitudes of oncology physicians and molecular biologists and compare these views with bioethical theories of the American bioethicists Tom L. Beauchamp & James F. Childress and the Danish philosophers Jakob Rendtorff & Peter Kemp. This study shows that essential parts of the two bioethical theories are reflected in the daily work of Danish oncology physicians and Danish molecular biologists. However, the study also explores dimensions where the theories can be developed further to be concordant with biomedical practice. The hope is that this study enhances the understanding of the principle of respect for autonomy and the way it is practiced. PMID:18366749

[Health community agent: subject of the buccal health practice in Alagoinhas, Bahia state].

PubMed

Rodrigues, Ana Aurea Alécio de Oliveira; Santos, Adriano Maia Dos; Assis, Marluce Maria Araújo

2010-05-01

This study about the work of micro politics was carried out by the Buccal Health Team (ESB) in the Family Health Program (PSF) of Alagoinhas, Bahia State, and has as central theoretical purpose the specific and singular forms in the practice of daily work, using the technologies (hard, light-hard and light). The methodological trajectory is based on the historical-social current in view of a dialectic approach of qualitative nature. The techniques of data collection used were: semi structured interview, observation of the work process and documental analysis. The analysis of the data was oriented by the hermeneutics-dialectics, allowing to compare the different levels of analysis, articulating the theoretical with the empirical evidence. The results reveal that the Family Health Teams are multidisciplinary, but have still not developed an interdisciplinary work, hence occurring juxtaposition of skills. Each unit plans their work process according to the singularities of the social subjects, implementing different characteristics in how to welcome, inform, attend and refer. An effort in changing the work process can be perceived in the perspective of amplified clinic with the health community agent standing out as a social/collective subject.

New quality regulations versus established nursing home practice: a qualitative study.

PubMed

Sandvoll, Anne Marie; Kristoffersen, Kjell; Hauge, Solveig

2012-06-07

Western governments have initiated reforms to improve the quality of care for nursing home residents. Most of these reforms encompass the use of regulations and national quality indicators. In the Norwegian context, these regulations comprise two pages of text that are easy to read and understand. They focus particularly on residents' rights to plan their day-to-day life in nursing homes. However, the research literature indicates that the implementation of the new regulations, particularly if they aim to change nursing practice, is extremely challenging. The aim of this study was to further explore and describe nursing practice to gain a deeper understanding of why it is so hard to implement the new regulations. For this qualitative study, an ethnographic design was chosen to explore and describe nursing practice. Fieldwork was conducted in two nursing homes. In total, 45 nurses and nursing aides were included in participant observation, and 10 were interviewed at the end of the field study. Findings indicate that the staff knew little about the new quality regulations, and that the quality of their work was guided by other factors rooted in their nursing practice. Further analyses revealed that the staff appeared to be committed to daily routines and also that they always seemed to know what to do. Having routines and always knowing what to do mutually strengthen and enhance each other, and together they form a powerful force that makes daily nursing care a taken-for-granted activity. New regulations are challenging to implement because nursing practices are so strongly embedded. Improving practice requires systematic and deeply rooted practical change in everyday action and thinking.

Allergic rhinitis and its impact on work productivity in primary care practice and a comparison with other common diseases: The Cross-sectional study to evAluate work Productivity in allergic Rhinitis compared with other common dIseases (CAPRI) study

PubMed Central

de la Hoz Caballer, Belén; Rodríguez, Mercedes; Fraj, Juan; Cerecedo, Inmaculada; Antolín-Amérigo, Darío

2012-01-01

Background: Allergic rhinitis (AR) is a highly prevalent allergic disease and also counts among the 10 most frequent reasons for medical consultation. Its impact on quality of life (QoL) and work productivity has been established but comparisons with other diseases are rare in the literature. The aim of this study was to evaluate the impact of AR in health-related QoL (HRQoL) and work productivity in primary care patients, compared with other prevalent diseases such as hypertension, diabetes mellitus (DM) type II, and symptomatic depression. Methods: Six hundred sixteen patients were included in a multicenter cross-sectional observational study. A generic HRQoL questionnaire, 36-item Short Form, and a specific questionnaire, “Work Productivity and Activity Impairment” were handed out to measure QoL and work productivity impact of the diseases. To assess clinical severity with a comparable scale between diseases Clinical Global Impression (CGI) had been used. Results: Symptomatic depression was found to produce the greatest impairment on work productivity with a decrease of 59.5%, with significant differences compared with AR, hypertension, and DM type II (p < 0.05). Symptomatic depression was found to produce the highest negative impact on daily activities with a statistically significant reduction of 59.4% (p < 0.05) compared with AR (26.6% decrease), hypertension (8.8% decrease), and DM (16.7% decrease) patients. Differences between AR and DM or hypertension were also significant (p < 0.05). Restriction on daily activities for AR was 27.8%, which is significantly higher (p < 0.05) than hypertension (19.8% decrease) but not DM (25.7% decrease). Depression had the highest impairment on daily activities (59.4%), compared with the remaining three groups (p < 0.05). Conclusion: AR impairs work productivity in a greater magnitude than hypertension and DM type II. PMID:23168153

Allergic rhinitis and its impact on work productivity in primary care practice and a comparison with other common diseases: the Cross-sectional study to evAluate work Productivity in allergic Rhinitis compared with other common dIseases (CAPRI) study.

PubMed

de la Hoz Caballer, Belén; Rodríguez, Mercedes; Fraj, Juan; Cerecedo, Inmaculada; Antolín-Amérigo, Darío; Colás, Carlos

2012-01-01

Allergic rhinitis (AR) is a highly prevalent allergic disease and also counts among the 10 most frequent reasons for medical consultation. Its impact on quality of life (QoL) and work productivity has been established but comparisons with other diseases are rare in the literature. The aim of this study was to evaluate the impact of AR in health-related QoL (HRQoL) and work productivity in primary care patients, compared with other prevalent diseases such as hypertension, diabetes mellitus (DM) type II, and symptomatic depression. Six hundred sixteen patients were included in a multicenter cross-sectional observational study. A generic HRQoL questionnaire, 36-item Short Form, and a specific questionnaire, "Work Productivity and Activity Impairment" were handed out to measure QoL and work productivity impact of the diseases. To assess clinical severity with a comparable scale between diseases Clinical Global Impression (CGI) had been used. Symptomatic depression was found to produce the greatest impairment on work productivity with a decrease of 59.5%, with significant differences compared with AR, hypertension, and DM type II (p < 0.05). Symptomatic depression was found to produce the highest negative impact on daily activities with a statistically significant reduction of 59.4% (p < 0.05) compared with AR (26.6% decrease), hypertension (8.8% decrease), and DM (16.7% decrease) patients. Differences between AR and DM or hypertension were also significant (p < 0.05). Restriction on daily activities for AR was 27.8%, which is significantly higher (p < 0.05) than hypertension (19.8% decrease) but not DM (25.7% decrease). Depression had the highest impairment on daily activities (59.4%), compared with the remaining three groups (p < 0.05). AR impairs work productivity in a greater magnitude than hypertension and DM type II.

Composition, production rate and characterization of Greek dental solid waste.

PubMed

Mandalidis, Alexandros; Topalidis, Antonios; Voudrias, Evangelos A; Iosifidis, Nikolaos

2018-05-01

The overall objective of this work is to determine the composition, characterization and production rate of Greek dental solid waste (DSW). This information is important to design and cost management systems for DSW, for safety and health considerations and for assessing environmental impact. A total of 141 kg of DSW produced by a total of 2542 patients in 20 dental practices from Xanthi, Greece was collected, manually separated and weighed over a period of four working weeks. The waste was separated in 19 sub fractions, which were classified in 2 major categories, according to Greek regulations: Domestic-type waste comprising 8% and hazardous waste comprising 92% by weight of total DSW. The latter was further classified in infectious waste, toxic waste and mixed type waste (infectious and toxic together), accounting for 88.5%, 3.5% and 0.03% of total DSW by weight, respectively. The overall unit production rates (mean ± standard error of the mean) were 381 ± 15 g/practice/d and 53.3 ± 1.4 g/patient/d for total DSW, 337 ± 14 g/practice/d and 46.6 ± 1.2 g/patient/d for total infectious DSW, 13.4 ± 0.7 g/practice/d and 2.1 ± 0.1 g/patient/d for total toxic DSW and 30.4 ± 2.5 g/practice/d and 4.6 ± 0.4 g/patient/d for domestic-type waste. Daily DSW production was correlated with daily number of patients and regression correlations were produced. DSW was subject to laboratory characterization in terms of bulk density, calorific value, moisture, ash and volatile solids content. Measured calorific values were compared to predictions from empirical models. Copyright © 2018 Elsevier Ltd. All rights reserved.

An ethnographic investigation of junior doctors' capacities to practice interprofessionally in three teaching hospitals.

PubMed

Milne, Jacqueline; Greenfield, David; Braithwaite, Jeffrey

2015-01-01

Collaborative practice among early career staff is at the bedrock of interprofessional care. This study investigated factors influencing the enactment of interprofessional practice by using the day-to-day role of six junior doctors in three teaching hospitals as a gateway to understand the various professions' interactive behaviours. The contextual framework used for the study was Strauss' theory of negotiated order. Ethnographic techniques were applied to observe the actions and interactions of participants on typical working days in their hospital environments. Field notes were created and thematic analysis was applied to the data. Three themes explored were culture, communication, and collaboration. Issues identified highlight the bounded organisational and professional cultures within which junior doctors work, and systemic problems in interprofessional interaction and communication in the wards of hospitals. There are indications that early career doctors are interprofessional isolates. The constraints of short training terms and pressure from multi-faceted demands on junior doctors can interfere with the establishment of meaningful relationships with nurses and other health professionals. The realisation of sustained interprofessional practice is, therefore, practically and structurally difficult. Enabling factors supporting the sharing of expertise are outweighed by barriers associated with professional and hospital organisational cultures, poor interprofessional communication, and the pressure of competing individual task demands in the course of daily practice.

The Pocketable Electronic Devices in Radiation Oncology (PEDRO) Project: How the Use of Tools in Medical Decision Making is Changing?

PubMed

De Bari, Berardino; Franco, Pierfrancesco; Niyazi, Maximilian; Cornetto, Andrea Peruzzo; Qvortrup, Camilla; Martin, Arturo Navarro; Cacicedo, Jon; Fernandez, Gonçalo; Louro, Luís Vasco; Lestrade, Laëtitia; Ciammella, Patrizia; Greto, Daniela; Checkrine, Tarik; Youssef, Elkholti; Filippi, Andrea Riccardo; Poulsen, Laurids Østergaard; Alongi, Filippo

2016-04-01

To analyze the impact of mobile electronic devices (MEDs) and apps in the daily clinical activity of young radiation or clinical oncologists in 5 Western European countries (Italy, Germany, Spain, Portugal, and Denmark). A web-based questionnaire was sent to 462 young (≤40 years) members of the national radiation or clinical oncology associations of the countries involved in the study. The 15 items investigated diffusion of MEDs (smartphones and/or tablets), their impact on daily clinical activity, and the differences perceived by participants along time. A total of 386 (83.5%) of the 462 correctly filled questionnaires were statistically evaluated. Up to 65% of respondents declared to use an electronic device during their clinical activity. Conversely, 72% considered low to moderate impact of smartphones/tables on their daily practice. The daily use significantly increased from 2009 to 2012: users reporting a use ≥6 times/d raised from 5% to 39.9%. Professional needs fulfillment was declared by less than 68% of respondents and compliance to apps indications by 66%. Significant differences were seen among the countries, in particular concerning the feeling of usefulness of MEDs in the daily clinical life. The perception of the need of a comprehensive Web site containing a variety of applications (apps) for clinical use significantly differed among countries in 2009, while it was comparable in 2012. This survey showed a large diffusion of MEDs in young professionals working in radiation oncology. Looking at these data, it is important to verify the consistency of information found within apps, in order to avoid potential errors eventually detrimental for patients. "Quality assurance" criteria should be specifically developed for medical apps and a comprehensive Web site gathering all reliable applications and tools might be useful for daily clinical practice. © The Author(s) 2015.

Improving Your Daily Practice: A Guide for Effective School Leadership

ERIC Educational Resources Information Center

Berkey, Timothy B.

2009-01-01

This book will show principals how they can change daily practices to invest more time in the improvement of teaching and learning. It redirects leadership to effective practices in instructional leadership. Contents include an Introduction and the following chapters: (1) Why Change the Way I Lead?; (2) The Path to Effective School Leadership; (3)…

The power of presence: the role of mindfulness at work for daily levels and change trajectories of psychological detachment and sleep quality.

PubMed

Hülsheger, Ute R; Lang, Jonas W B; Depenbrock, Franziska; Fehrmann, Carmen; Zijlstra, Fred R H; Alberts, Hugo J E M

2014-11-01

In this research, we examined the role of mindfulness for recovery from work using a daily diary design (N = 121; 5 days; 3 measurement occasions per day). The first goal of the study was to investigate the relationship of mindfulness with sleep quality and the mediating role of psychological detachment from a day-level perspective. A second goal was to extend the process perspective in recovery research beyond the day level and consider systematic change trajectories in recovery variables over the course of the work week and the role of mindfulness in these trajectories. Results regarding day-level relationships confirmed that mindfulness experienced during work was related to subsequent sleep quality, and this relationship was mediated by psychological detachment from work in the evening. Furthermore, an investigation of the role of mindfulness in recovery change trajectories supported the idea that psychological detachment trajectories increase over the work week for individuals low on mindfulness while there was no systematic mean-level change for individuals high on mindfulness. In contrast, sleep quality followed a linear increase from Monday to Friday for all individuals, irrespective of their levels of trait mindfulness. Practical and theoretical implications for the mindfulness and the recovery literature are discussed in conclusion. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Getting the big picture: the macro-politics of information system development (and failure) in a Canadian hospital.

PubMed

Balka, E

2003-01-01

While recognized that global actors influence health information system design, studies of health informatics have largely focused on micro politics of technology design and implementation. Here a problematic patient care information system (PCIS) is discussed in relation to federal and provincial policies and corporate strategies to demonstrate that our understanding of health informatics can be enhanced by linking micro studies of health informatics to larger macro contexts. Interviews and document study. Although the extent to which federal initiatives influenced (or failed to influence) provincial and hospital initiatives remains debateable, events initiated at one level (the hospital's decision to implement software, initiated at the organizational level) are influenced (perhaps indirectly) by developments in other contexts (federal/macro changes gave an initiative more weight; provincial initiatives such as the Labour Accord altered the industrial relations environment in which system development occurred). Micro-studies of work practice, invaluable in addressing interactions between technologies, users and work practices, often fail to account for the historic reach of global actors, although it is often these historic circumstances that contribute to present-day interactions between user, information system and organization, and that find expression - often indirectly - in daily work practices.

Understanding time use, stress and recovery practices among early career physicians: an exploratory study.

PubMed

Cranley, Nicole M; Cunningham, Christopher J L; Panda, Mukta

2016-01-01

Early career physicians (ECPs) work an average of 80 h per week, and at times may approach 24 continuous hours working. These hours, combined with a stressful work environment, and an inability to physically and psychologically detach from work make ECPs likely to experience burnout and other negative health-related consequences. This study provides insight into the stress and recovery challenges faced by ECPs in a typical hospital environment. Rich qualitative and quantitative data were gathered from participants regarding daily time usage, and recovery practices and needs. ECPs report longer working hours, less leisure time and shorter amounts of sleep than average working adults. ECPs do not participate in many resource-replenishing activities while at work, and when out of work, they tend to participate in more passive than active forms of recovery. Resource-draining activities were identified as requiring much of ECP's nonwork time, further limiting recovery. The prevention of burnout and other negative health consequences among ECPs requires the building of a workplace and educational culture that supports regular resource replenishment. This includes the need for a curriculum of medical education that teaches ECPs to identify the signs of stress and recovery needs, and how to effectively address these needs.

Perceived consequences of ageing with late effects of polio and strategies for managing daily life: a qualitative study.

PubMed

Sjödahl Hammarlund, Catharina; Lexell, Jan; Brogårdh, Christina

2017-08-09

New or increased impairments may develop several decades after an acute poliomyelitis infection. These new symptoms, commonly referred to as late effects of polio (LEoP), are characterised by muscular weakness and fatigue, generalised fatigue, pain at rest or during activities and cold intolerance. Growing older with LEoP may lead to increased activity limitations and participation restrictions, but there is limited knowledge of how these persons perceive the practical and psychological consequences of ageing with LEoP and what strategies they use in daily life. The aim of this qualitative study was therefore to explore how ageing people with LEoP perceive the their situation and what strategies they use for managing daily life. Seven women and seven men (mean age 70 years) were interviewed. They all had a confirmed history of acute poliomyelitis and new impairments after a stable period of at least 15 years. Data were transcribed verbatim and analysed using systematic text condensation. The latent analysis resulted in three categories 'Various consequences of ageing with LEoP', 'Limitations in everyday activities and participation restrictions', and 'Strategies for managing daily life when ageing with LEoP' and 12 subcategories. The new impairments led to decreased physical and mental health. The participants perceived difficulties in performing everyday activities such as managing work, doing chores, partaking in recreational activities and participating in social events, thereby experiencing emotional and psychological distress. They managed to find strategies that mitigated their worries and upheld their self-confidence, for example finding practical solutions, making social comparisons, minimising, and avoidance. Ageing with LEoP affected daily life to a great extent. The participants experienced considerable impact of the new and increased impairments on their life situation. Consequently, their ability to participate in various social activities also became restricted. Social comparisons and practical solutions are strategies that facilitate adaptation and acceptance of the new situation due to LEoP. This emphasises the need to design rehabilitation interventions that focus on coping, empowerment and self-management for people ageing with LEoP.

Family-witnessed resuscitation in emergency departments: doctors' attitudes and practices.

PubMed

Gordon, E D; Kramer, E; Couper, Ian; Brysiewicz, P

2011-09-27

Resuscitation of patients occurs daily in emergency departments. Traditional practice entails family members remaining outside the resuscitation room. We explored the introduction of family witnessed resuscitation (FWR) as it has been shown to allow closure for the family when resuscitation is unsuccessful and helps them to better understand the last moments of life. Attending medical doctors have concerns about this practice, such as traumatisation of family members, increased pressure on the medical team, interference by the family, and potential medico-legal consequences. There was not complete acceptance of the practice of FWR among the sample group. Short-course training such as postgraduate advanced life support and other continued professional development activities should have a positive effect on this practice.The more experienced doctors are and the longer they work in emergency medicine, the more comfortable they appear to be with the concept of FWR and therefore the more likely they are to allow it. Further study and course attendance by doctors has a positive influence on the practice of FWR.

Psychosocial work conditions, social capital, and daily smoking: a population based study.

PubMed

Lindström, M

2004-09-01

To investigate the associations between psychosocial conditions at work, social capital/social participation, and daily smoking. The 2000 public health survey in Scania is a cross sectional postal questionnaire study with a 59% participation rate. A total of 5180 persons aged 18-64 years that belonged to the work force and the unemployed were included in this study. Logistic regression models were used to investigate the associations between psychosocial factors at work/unemployment, social participation, and daily smoking. Psychosocial conditions at work were defined according to the Karasek-Theorell demand-control/decision latitudes into relaxed, active, passive, and jobstrain categories. The multivariate analyses included age, country of origin, education and economic stress. 17.2% proportion of all men and 21.9% of all women were daily smokers. The jobstrain (high demands/low control) and unemployed categories had significantly higher odds ratios of daily smoking among both men and women compared to the relaxed (low demands/high control) reference category. The passive (low demands/low control), jobstrain, and unemployed categories were also significantly associated with low social participation. Low social participation was significantly and positively associated with daily smoking within each of the psychosocial work conditions and unemployed categories. The positive association between low social capital/low social participation and daily smoking is well known. However, both social participation and daily smoking are associated with psychosocial work conditions and unemployment. Psychosocial work conditions and unemployment may affect daily smoking both directly and through a pathway including social participation.

Need satisfaction and employees' recovery state at work: A daily diary study.

PubMed

van Hooff, Madelon L M; Geurts, Sabine A E

2015-07-01

The present study aimed to advance insight in the associations between employees' daily effort expenditure at work and their recovery state during the workday, and specifically focused on the role of daily work-related need satisfaction in this process. We examined (a) if high intrinsic work motivation and low self-control effort act as mediating mechanisms underlying the beneficial role of need satisfaction, and (b) to what extent need satisfaction mitigates the adverse effects of high job demands (work pressure and cognitive demands) on employee recovery. Data were collected by means of a 5-day daily diary study (2 measurements daily: in the morning before work, and at the end of the workday) among 68 participants. Multilevel analyses showed that need satisfaction at work was related to a beneficial recovery state at the end of the workday, and that this association was mediated by high intrinsic work motivation and low self-control effort. Furthermore, need satisfaction attenuated the adverse effects of high work pressure on employee recovery. All in all, this study increased our understanding of employees' daily effort and recovery processes at work, and highlighted the beneficial role of need satisfaction at work. (c) 2015 APA, all rights reserved).

A Practical Guide for Physicians and Health Care Workers to Reduce Their Carbon Footprint in Daily Clinical Work.

PubMed

Storz, Maximilian Andreas

2018-03-12

With Earth Overshoot Day having recently passed, there is no space for complacency regarding taking care of our planet. On August 2, 2017, humanity used nature's resource budget for the entire year. For decades, we have lived far beyond our means by overexploiting natural resources and spewing pollution, such as microplastics and industrial chemicals, into our environment. On the other hand, public awareness of human-induced climate change has also increased since the 1980s. The frequent media coverage about extreme weather conditions and natural disasters, such as Hurricane Irma in 2017, serves as an important reminder that anthropogenic climate change is happening now.Adverse health conditions associated with climate change include an increased prevalence of diseases and disorders. Although we all contribute to this development, as physicians we also have the privileged duty to protect global human health. Therefore, we should make every effort to cut down our own carbon footprint and adapt a more sustainable lifestyle.The aim of this commentary is to provide feasible tips and strategies to effectively reduce one's individual carbon footprint, with a special focus on daily clinical and hospital work. Not only are these strategies easy to implement in daily clinical routine, but most of them are associated with important health benefits.

When lending a hand depletes the will: The daily costs and benefits of helping.

PubMed

Lanaj, Klodiana; Johnson, Russell E; Wang, Mo

2016-08-01

Employees help on a regular daily basis while at work, yet surprisingly little is known about how responding to help requests affects helpers. Although recent theory suggests that helping may come at a cost to the helper, the majority of the helping literature has focused on the benefits of helping. The current study addresses the complex nature of helping by simultaneously considering its costs and benefits for helpers. Using daily diary data across 3 consecutive work weeks, we examine the relationship between responding to help requests, perceived prosocial impact of helping, and helpers' regulatory resources. We find that responding to help requests depletes regulatory resources at an increasing rate, yet perceived prosocial impact of helping can replenish resources. We also find that employees' prosocial motivation moderates these within-person relationships, such that prosocial employees are depleted to a larger extent by responding to help requests, and replenished to a lesser extent by the perceived prosocial impact of helping. Understanding the complex relationship of helping with regulatory resources is important because such resources have downstream effects on helpers' behavior in the workplace. We discuss the implications of our findings for both theory and practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

A Practical Guide for Physicians and Health Care Workers to Reduce Their Carbon Footprint in Daily Clinical Work

PubMed Central

Storz, Maximilian Andreas

2018-01-01

With Earth Overshoot Day having recently passed, there is no space for complacency regarding taking care of our planet. On August 2, 2017, humanity used nature’s resource budget for the entire year. For decades, we have lived far beyond our means by overexploiting natural resources and spewing pollution, such as microplastics and industrial chemicals, into our environment. On the other hand, public awareness of human-induced climate change has also increased since the 1980s. The frequent media coverage about extreme weather conditions and natural disasters, such as Hurricane Irma in 2017, serves as an important reminder that anthropogenic climate change is happening now. Adverse health conditions associated with climate change include an increased prevalence of diseases and disorders. Although we all contribute to this development, as physicians we also have the privileged duty to protect global human health. Therefore, we should make every effort to cut down our own carbon footprint and adapt a more sustainable lifestyle. The aim of this commentary is to provide feasible tips and strategies to effectively reduce one’s individual carbon footprint, with a special focus on daily clinical and hospital work. Not only are these strategies easy to implement in daily clinical routine, but most of them are associated with important health benefits. PMID:29616907

Care, Autonomy, and Gender in Nursing Practice: A Historical Study of Nurses' Experiences.

PubMed

Galbany-Estragués, Paola; Comas-d'Argemir, Dolors

2017-10-01

Care is the essence of the nursing role and is closely related to the concept of professional autonomy. Autonomy is implicated in power relations between doctors and nurses and between men and women. These relationships are closely linked to care practices and the inequality of nursing and medicine. The aim of this study was to analyze nursing discourse regarding the concept of care and its relationship to the concept of autonomy and gender. This is a historical study based on oral interviews that took place between November 2008 and February 2011. We interviewed 19 nursing professionals who currently worked at the Hospital of the Holy Spirit (near Barcelona) or had worked there between 1961 and 2010. Semistructured interviews were recorded, transcribed, and analyzed. We highlight four main themes: "a real nurse"; "more technology, less care"; "the fragility of autonomy"; and "the invisibility of nursing work." These themes show the contradictions in the nursing profession that are based on the concept of care. However, in daily practice, the concept of care varies. Time pressure distances the nursing practice from its theoretical context. Changes in the concept of care are related to transformations in the health system and nursing work. Changes related to the autonomy of nursing are related to changes in the concept of care. In practice, care has a biomedical orientation. Care has become technologized and bureaucratized, which reduces the time that is spent with the patient. In a context in which medical authority predominates, nursing's struggle for autonomy is based on the recognition of the value of care. When care becomes invisible, the autonomy of nursing as a profession is threatened. This conclusion allows reflections about shifts in the concept of care and how they affect clinical practice and the autonomy of the nursing profession.

Impact of daily mood, work hours, and iso-strain variables on self-reported health behaviors.

PubMed

Jones, Fiona; O'Connor, Daryl B; Conner, Mark; McMillan, Brian; Ferguson, Eamonn

2007-11-01

Four hundred and twenty-two employees completed daily diaries measuring positive affect, negative affect, work hours, and health behaviors (snacking, smoking, exercise, alcohol, caffeine consumption) on work days over a 4-week period. In addition, measures of job demands, job control, and social support (iso-strain variables) were completed on 1 occasion. Multilevel random coefficient modeling was used to examine relationships between the job characteristics, daily work variables, and self-reported health behaviors. Results indicated a more important role for within-person daily fluctuations than for between-persons variations in predicting health behaviors. Whereas negative affect was negatively related to health behavior for both men and women, work hours had negative impacts for women only. Iso-strain variables showed few main effects and a modest number of interactions with daily variables (mainly for men). Findings point to the limited impact of stable features of work design compared to the effects of daily work stressors on health behaviors. (c) 2007 APA

The State of the Science on Sensory Factors and Their Impact on Daily Life for Children: A Scoping Review.

PubMed

Dunn, Winnie; Little, Lauren; Dean, Evan; Robertson, Sara; Evans, Benjamin

2016-04-01

The objective of this study was to identify and synthesize research about how sensory factors affect daily life of children. We designed a conceptual model to guide a scoping review of research published from 2005 to October 2014 (10 years). We searched MEDLINE, CINAHL, and PsycINFO and included studies about sensory perception/processing; children, adolescents/young adults; and participation. We excluded studies about animals, adults, and review articles. Our process resulted in 261 articles meeting criteria. Research shows that children with conditions process sensory input differently than peers. Neuroscience evidence supports the relationship between sensory-related behaviors and brain activity. Studies suggest that sensory processing is linked to social participation, cognition, temperament, and participation. Intervention research illustrates the importance of contextually relevant practices. Future work can examine the developmental course of sensory processing aspects of behavior across the general population and focus on interventions that support children's sensory processing as they participate in their daily lives. © The Author(s) 2016.

Parents’ Daily Time With Their Children: A Workplace Intervention

PubMed Central

Lawson, Katie M.; Almeida, David M.; King, Rosalind B.; Hammer, Leslie; Casper, Lynne M.; Okechukwu, Cassandra A.; Hanson, Ginger; McHale, Susan M.

2015-01-01

OBJECTIVES: In the context of a group randomized field trial, we evaluated whether parents who participated in a workplace intervention, designed to increase supervisor support for personal and family life and schedule control, reported significantly more daily time with their children at the 12-month follow-up compared with parents assigned to the Usual Practice group. We also tested whether the intervention effect was moderated by parent gender, child gender, or child age. METHODS: The Support-Transform-Achieve-Results Intervention was delivered in an information technology division of a US Fortune 500 company. Participants included 93 parents (45% mothers) of a randomly selected focal child aged 9 to 17 years (49% daughters) who completed daily telephone diaries at baseline and 12 months after intervention. During evening telephone calls on 8 consecutive days, parents reported how much time they spent with their child that day. RESULTS: Parents in the intervention group exhibited a significant increase in parent-child shared time, 39 minutes per day on average, between baseline and the 12-month follow-up. By contrast, parents in the Usual Practice group averaged 24 fewer minutes with their child per day at the 12-month follow-up. Intervention effects were evident for mothers but not for fathers and for daughters but not sons. CONCLUSIONS: The hypothesis that the intervention would improve parents’ daily time with their children was supported. Future studies should examine how redesigning work can change the quality of parent-child interactions and activities known to be important for youth health and development. PMID:25869371

Parents' daily time with their children: a workplace intervention.

PubMed

Davis, Kelly D; Lawson, Katie M; Almeida, David M; Kelly, Erin L; King, Rosalind B; Hammer, Leslie; Casper, Lynne M; Okechukwu, Cassandra A; Hanson, Ginger; McHale, Susan M

2015-05-01

In the context of a group randomized field trial, we evaluated whether parents who participated in a workplace intervention, designed to increase supervisor support for personal and family life and schedule control, reported significantly more daily time with their children at the 12-month follow-up compared with parents assigned to the Usual Practice group. We also tested whether the intervention effect was moderated by parent gender, child gender, or child age. The Support-Transform-Achieve-Results Intervention was delivered in an information technology division of a US Fortune 500 company. Participants included 93 parents (45% mothers) of a randomly selected focal child aged 9 to 17 years (49% daughters) who completed daily telephone diaries at baseline and 12 months after intervention. During evening telephone calls on 8 consecutive days, parents reported how much time they spent with their child that day. Parents in the intervention group exhibited a significant increase in parent-child shared time, 39 minutes per day on average, between baseline and the 12-month follow-up. By contrast, parents in the Usual Practice group averaged 24 fewer minutes with their child per day at the 12-month follow-up. Intervention effects were evident for mothers but not for fathers and for daughters but not sons. The hypothesis that the intervention would improve parents' daily time with their children was supported. Future studies should examine how redesigning work can change the quality of parent-child interactions and activities known to be important for youth health and development. Copyright © 2015 by the American Academy of Pediatrics.

Meso and micro level workforce challenges in psychiatric rehabilitation.

PubMed

Reifels, Lennart; Pirkis, Jane

2012-01-01

Results of an exploratory study are presented which examined workforce challenges in Australia's most established psychiatric rehabilitation sector. The study had the two-fold aim of investigating workforce challenges at an organizational ("meso") level and at the level of direct-service workers' daily practice ("micro"). Data from 23 key informant interviews conducted with service managers and long-serving staff were analyzed through basic descriptive and thematic analyses. Organizations faced significant annual staff turnover (25.6%), specific staff supply shortages, and challenges in recruiting staff with adequate experience and longevity to match the complexity of client issues. Workers equally encountered challenges in this increasingly complex and rapidly changing field of work. CONCLUSIONS & IMPLICATIONS FOR PRACTICE: Workforce strategies designed to attract/retain experienced staff can improve workforce cohesiveness and sustainability, as can training and support activities aimed at equipping staff to reflect on and operate in dynamic and changing work environments.

How Can Geography and Mobile Phones Contribute to Psychotherapy?

PubMed

Ferrás, Carlos; García, Yolanda; Aguilera, Adrián; Rocha, Álvaro

2017-06-01

Interdisciplinary relationships between Geography and Psychotherapy are an opportunity for innovation. Indeed, scientific works found on bibliographic databases and concerning this theme are scarce. Geographical sub-fields, such as the Geography of Emotions or Psychoanalytical Geography have started to emerge, theorizing about and interpreting feelings, emotions, moods, sufferings, of the chronically ill or diversified social groups and sites. But a less theoretical and more practical approach, in the sense of proposing, predicting and intervening, is lacking; as well as research into the possibilities offered by communication technologies and mobile phones. In the present work, we present the results of a review of the most relevant scientific works published internationally; we reflect on the contributions of Geography and mobile phones to psychosocial therapies and define the orientation and questions that should be posed in future research, from the point of view of geography and regarding psychotherapy. We conclude that the production of georeferenced data via mobile phones concerning the daily lives of people opens great possibilities for cognitive behavioural therapy and mental health. They allow for the development of personalized mood maps that locate the places where a person experiences greater or lesser stress on a daily basis; they allow for a cartography of emotions, a cognitive cartography of the places we access physically or through the Internet, of our feelings and psychosocial experiences. They open the door to the possibility of offering personalized psychotherapy treatments focusing on the ecological-environmental analysis of the places frequented by the person on a daily basis.

Managing barriers to empathy in the clinical encounter: a qualitative interview study with GPs

PubMed Central

Derksen, Frans AWM; Hartman, Tim C olde; Bensing, Jozien M; Lagro-Janssen, Antoine LM

2016-01-01

Background Current daily general practice has become increasingly technical and somatically oriented (where attention to patients’ feelings is decreased) due to an increase in protocol-based guidelines. Priorities in GP–patient communication have shifted from a focus on listening and empathy to task-oriented communication. Aim To explore what barriers GPs experience when applying empathy in daily practice, and how these barriers are managed. Design and setting Thirty Dutch GPs with sufficient heterogeneity in sex, age, type of practice, and rural or urban setting were interviewed. Method The consolidated criteria for reporting qualitative research (COREQ) were applied. The verbatim transcripts were then analysed. Results According to participating GPs, the current emphasis on protocol-driven care can be a significant barrier to genuineness in communication. Other potential barriers mentioned were time pressures and constraints, and dealing with patients displaying ‘unruly behaviour’ or those with personality disorders. GPs indicated that it can be difficult to balance emotional involvement and professional distance. Longer consulting times, smaller practice populations, and efficient practice organisation were described as practical solutions. In order to focus on a patient-as-person approach, GPs strongly suggested that deviating from guidelines should be possible when necessary as an element of good-quality care. Joining intercollegiate counselling groups was also discussed. Conclusion In addition to practical solutions for barriers to behaving empathically, GPs indicated that they needed more freedom to balance working with protocols and guidelines, as well as a patient-as-person and patient-as-partner approach. This balance is necessary to remain connected with patients and to deliver care that is truly personal. PMID:27884917

Empathy: what does it mean for GPs? A qualitative study.

PubMed

Derksen, Frans; Bensing, Jozien; Kuiper, Sascha; van Meerendonk, Milou; Lagro-Janssen, Antoine

2015-02-01

Research has highlighted empathy as an important and effective factor in patient-physician communication. GPs have extensive practical experience with empathy. However, little is known about the personal views of GPs regarding the meaning and application of empathy in daily practice. To explore GP's experiences and the application of empathy in daily practice and to investigate the practical use of empathy. Facts such as preconditions, barriers and facilitating possibilities are described. Qualitative interview study; 30 in-depth interviews were performed between June 2012 and January 2013 with a heterogeneous sample of Dutch GPs. Interviews were recorded and transcribed verbatim; content analysis was performed with the help of ATLAS-ti. Empathy was seen as an important quality-increasing element during the patient-GP consultation. The application of non-verbal and verbal techniques was described. Attention to cues and references to previous consults were reported separately. Required preconditions were: being physically and mentally fit, feeling no time pressure and having an efficient practice organization. Not feeling connected to the patient and strict medical guidelines and protocols were identified as obstacles. A key consideration was the positive contribution of empathy to job satisfaction. The opinions of GPs in this research can be considered as supplementing and strengthening the findings of previous researches. The GPs in this study discussed, in particular, ideas important to the facilitation of empathy. These included: longer consultations, smaller practices, efficient telephonic triage by practice assistants, using intervision to help reflect on their work and drawing financiers' attention to the effectiveness of empathy. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

An examination of occupation-based, client-centered, evidence-based occupational therapy practices in New Hampshire.

PubMed

Mulligan, Shelley; White, Barbara Prudhomme; Arthanat, Sajay

2014-01-01

This study surveyed occupational therapy practitioners to gain a better understanding of the nature of occupational therapy practices in the State of New Hampshire. A questionnaire was developed and distributed to a sample of practitioners working in New Hampshire to gather information regarding the extent to which occupation-based, client-centered, evidence-based services were being provided. Results suggested that practitioners highly value these service delivery attributes. However, day-to-day practice decisions regarding evaluation methods, where to conduct intervention sessions, goal writing, and choices of intervention activities suggest a stronger emphasis on the evaluation and remediation of specific performance skill and body function deficits, rather than on client performance of desired occupations. In light of the findings, the discrepancy between practitioner values and daily clinical practices is discussed, along with the challenges inherent in providing authentic, evidence-based occupational therapy. Copyright 2014, SLACK Incorporated.

Effective Recruitment of Schools for Randomized Clinical Trials: Role of School Nurses.

PubMed

Petosa, R L; Smith, L

2017-01-01

In school settings, nurses lead efforts to improve the student health and well-being to support academic success. Nurses are guided by evidenced-based practice and data to inform care decisions. The randomized controlled trial (RCT) is considered the gold standard of scientific rigor for clinical trials. RCTs are critical to the development of evidence-based health promotion programs in schools. The purpose of this article is to present practical solutions to implementing principles of randomization to RCT trials conducted in school settings. Randomization is a powerful sampling method used to build internal and external validity. The school's daily organization and educational mission provide several barriers to randomization. Based on the authors' experience in conducting school-based RCTs, they offer a host of practical solutions to working with schools to successfully implement randomization procedures. Nurses play a critical role in implementing RCTs in schools to promote rigorous science in support of evidence-based practice.

Premenstrual symptoms and associated morbidity in a family practice setting.

PubMed

Tippy, P K; Falvo, D R; Smaga, S A

1986-01-01

Women at two family practice clinics were given questionnaires to determine the nature, severity, and treatment of symptoms experienced premenstrually; the degree to which symptoms affected activities of daily living; the relationship of selected variables to women's perception of their symptoms; and the degree of physician involvement in discussion and/or treatment of symptoms. From the study group of 219 women, 76% reported symptoms severe enough to interfere with daily activities every month. The activity most affected by symptoms was relationship with family and friends, while work activities were affected least. Women's perception of the degree to which their mothers' activities had been affected by premenstrual symptoms was significantly related to their own incapacitation by them. Fifty-eight percent of women experiencing symptoms took medication for their symptoms, with over-the-counter medication being the most frequent treatment. Only 14% of the total sample had discussed these symptoms with their physician. Sixty-nine percent of the sample believed they had premenstrual syndrome (PMS). There was a significant relationship between women's belief that they had PMS and the degree of incapacitation experienced from their symptoms.

The crossover of daily work engagement: test of an actor-partner interdependence model.

PubMed

Bakker, Arnold B; Xanthopoulou, Despoina

2009-11-01

This study of 62 dyads of employees (N = 124) examined the crossover of work engagement-a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption. We hypothesized that work engagement crosses over from an employee (the actor) to his or her colleague (the partner) on a daily basis. The frequency of daily communication was expected to moderate the crossover of daily work engagement, which in turn would relate to colleagues' daily performance. Participants first filled in a general questionnaire and then completed a diary study over 5 consecutive workdays. The hypotheses were tested with multilevel analyses, using an actor-partner interdependence model. Results confirmed the crossover of daily work engagement, but only on days when employees within a dyad interacted more frequently than usual. Moreover, we found that actor's work engagement (particularly vigor), when frequently communicated, had a positive indirect relationship with partner's performance through partner's work engagement. Finally, results showed that actor's vigor was negatively related to partner's performance when communication was low. However, this negative effect was counteracted when mediated by the vigor of the partner.

Work-time sun behaviours among Canadian outdoor workers: results from the 2006 National Sun Survey.

PubMed

Marrett, Loraine D; Pichora, Erin C; Costa, Michelle L

2010-01-01

The objective of the study was to describe summer work-related sun behaviours among Canadian outdoor workers. Information on time in the sun and sun protection practices at work during the summer of 2006 were collected from 1,337 outdoor workers aged 16-64 years as part of the Second National Sun Survey. Proportions (and 95% confidence intervals) were estimated using procedures appropriate for complex survey designs. Twenty-six percent of all Canadians, 39% of males and 33% of those aged 16-24 years work outdoors during the summer. Although 41% spend four or more hours daily in the sun at work, just over half always or often protect themselves by covering their heads (58%), wearing protective clothing (56%) or wearing sunglasses (54%), and only 29% use sunscreen. Males and those aged 16-24 spend the most work time in the sun but are the least likely to use protection. The prevalence of outdoor work and sun behaviours varies among regions. Study findings confirm the need for strategies to reduce time in the sun and increase the use of sun protection among outdoor workers. In order to be effective, these strategies must include both enhanced workplace policies and practice, and increased individual use of sun protection.

[EEQ in clinical embryology: a starting program].

PubMed

Boyer, Pierre; Brugnon, Florence; Levy, Rachel; Pfeffer, Jérôme; Siest, Jean-Pascal

2014-01-01

Every laboratory including those working in assisted reproductive technologies have to be accredited EN ISO 15189 before 2020. This standardisation includes an external quality evaluation (EQE). In order to work out an EQE tool, we used images extracted from our own database developed during daily practice. We achieved an easily online tool called: "EEQ en embryologie clinique", developed on Biologie prospective web site with ART French biologists Association (Blefco) expertise in evaluation of early human embryonic stages. In 2013, 38 ART laboratories participate to the first program with more than 90% of appropriates results. The present article aims at describing this tool and discussing its limits.

Preferred delivery method and acceptability of Wheat-Soy Blend (WSB++) as a daily complementary food supplement in northwest Bangladesh.

PubMed

Shamim, Abu Ahmed; Hanif, Abu A M; Merrill, Rebecca D; Campbell, Rebecca K; Kumkum, Mehnaz Alam; Shaikh, Saijuddin; de Pee, Saskia; Ahmed, Tahmeed; Parveen, Monira; Mehra, Sucheta; Klemm, Rolf D W; Labrique, Alain B; West, Keith P; Christian, Parul

2015-01-01

Fortified blended foods (FBFs) are widely used to prevent undernutrition in early childhood in food-insecure settings. We field tested enhanced Wheat Soy Blend (WSB++)-a FBF fortified with micronutrients, milk powder, sugar, and oil-in preparation for a complementary food supplement (CFS) trial in rural northwestern Bangladesh. Formative work was conducted to determine the optimal delivery method (cooked vs. not) for this CFS, to examine mothers' child feeding practices with and acceptance of the WSB++, and to identify potential barriers to adherence. Our results suggest WSB++ is an acceptable CFS in rural Bangladesh and the requirement for mothers to cook WSB++ at home is unlikely to be a barrier to its daily use as a CFS in this population.

District nurses' use for an assessment tool in their daily work with elderly patients' medication management.

PubMed

Gusdal, Annelie K; Beckman, Christel; Wahlström, Rolf; Törnkvist, Lena

2011-06-01

To explore the capability of the Safe Medication Assessment (SMA) tool in identifying factors highly related to unsafe medication management among elderly patients and to investigate the district nurses' (DNs) opinions of the SMA's usefulness as a tool in their daily primary healthcare practice. Elderly patients who experience many medical conditions often use multiple drugs. As well as the combined decline in physical and cognitive functions, the elderly are at high risk for medication-related problems. It is essential to develop a screening procedure to distinguish elderly at risk of an unsafe medication management. An explorative study. During a 3-6-month period, 25 voluntary DNs used SMA with 160 patients (consecutively chosen and meeting four specified criteria) in their daily practice. Furthermore, DNs responded to questions regarding SMA's usefulness. The result showed that SMA had the capability to identify factors highly related to unsafe medication management among the elderly included in the study. In 64% of assessments DNs identified areas of new information and in 23% of the assessments DNs intervened. They found SMA to be satisfactory regarding its level of simplicity, relevance, completeness, intelligibility, and time for implementation. SMA alerted the DNs to patients' attitudes about medication and empowered them in identifying elderly patients who had unsafe medication management. SMA was also perceived as a useful assessment tool by the DNs.

Is there competition between breast-feeding and maternal employment?

PubMed

Roe, B; Whittington, L A; Fein, S B; Teisl, M F

1999-05-01

Theory suggests that the decision to return to employment after childbirth and the decision to breast-feed may be jointly determined. We estimate models of simultaneous equations for two different aspects of the relationship between maternal employment and breast-feeding using 1993-1994 data from the U.S. Food and Drug Administration's Infant Feeding Practices Study. We first explore the simultaneous duration of breast-feeding and work leave following childbirth. We find that the duration of leave from work significantly affects the duration of breast-feeding, but the effect of breast-feeding on work leave is insignificant. We also estimate models of the daily hours of work and breast-feedings at infant ages 3 months and 6 months postpartum. At both times, the intensity of work effort significantly affects the intensity of breast-feeding, but the reverse is generally not found. Competition clearly exists between work and breast-feeding for many women in our sample.

[Performance and safety at work].

PubMed

Bentivegna, M

2010-01-01

The evaluative approach of occupational therapy, centred on the person, on an analysis of performance and an assessment of the work environment, can provide important information for planning interventions to increase safety at work. The reliability of work performance is influenced by many factors, some of which are not directly dependent on humans, such as those related to the environment, to materials, to spaces, to places and to the organization of work; others, however, are closely related to human behaviours. For this reason, for the purpose of ensuring prevention of all harmful events, the process of risk evaluation must also include an analysis of the role of human behaviour and functional capacity. In our daily clinical practice, we Occupational Therapists use work to promote the wellbeing and health of people by involving them in activities, with the knowledge that every occupation is perceived by an individual as something particularly personal and significant.

Bureaucratic power in note-writing: authoritative expertise within the state.

PubMed

Mangset, Marte; Asdal, Kristin

2018-02-24

What produces the power of senior civil servants at ministries of finance, positioned at the top of the bureaucratic hierarchy? Max Weber has claimed that a hierarchical organization, meritocratic recruitment and procedural work provide bureaucracies with legitimacy. In particular he insisted on the role of Fachwissen (disciplinary knowledge) obtained through formal education. However, he also argued for the role of Dienstwissen, forms of knowledge and skills stemming from the experience of service in itself. Weber did not elaborate on this concept in detail, and few analysts of governmental expertise have examined this notion. We draw on the practice-turn in sociology, combining the study of governmental expertise with micro-sociological studies of administrative practices. By analysing interviews with 48 senior civil servants at the British, French and Norwegian ministries of finance about their daily practices, this article demonstrates that bureaucratic note-writing and the procedural evaluation of such notes constitute a key form of expertise that yields authority. The study provides an analytical framework for understanding what administrative expertise consists of, how it is integral to procedural work, the forms bureaucratic hierarchies take in practice and how these three dimensions provide authority. © London School of Economics and Political Science 2018.

Psychosocial work conditions, social capital, and daily smoking: a population based study

PubMed Central

Lindstrom, M

2004-01-01

Objective: To investigate the associations between psychosocial conditions at work, social capital/social participation, and daily smoking. Design/setting/participants/measurements: The 2000 public health survey in Scania is a cross sectional postal questionnaire study with a 59% participation rate. A total of 5180 persons aged 18–64 years that belonged to the work force and the unemployed were included in this study. Logistic regression models were used to investigate the associations between psychosocial factors at work/unemployment, social participation, and daily smoking. Psychosocial conditions at work were defined according to the Karasek-Theorell demand–control/decision latitudes into relaxed, active, passive, and jobstrain categories. The multivariate analyses included age, country of origin, education and economic stress. Results: 17.2% proportion of all men and 21.9% of all women were daily smokers. The jobstrain (high demands/low control) and unemployed categories had significantly higher odds ratios of daily smoking among both men and women compared to the relaxed (low demands/high control) reference category. The passive (low demands/low control), jobstrain, and unemployed categories were also significantly associated with low social participation. Low social participation was significantly and positively associated with daily smoking within each of the psychosocial work conditions and unemployed categories. Conclusions: The positive association between low social capital/low social participation and daily smoking is well known. However, both social participation and daily smoking are associated with psychosocial work conditions and unemployment. Psychosocial work conditions and unemployment may affect daily smoking both directly and through a pathway including social participation. PMID:15333886

Workshop V: Cultural Perception and Bias/Science Practice and Ethics

NASA Astrophysics Data System (ADS)

Chuan, Kwek Leong; Lin, Jauyn Grace; Pierron-Bohnes, Veronique; Dawson, Silvina Ponce

2015-12-01

Despite the objectivity of science, the local work environment affects the daily activities of scientists. Differences in cultural perception can affect female scientists in the workplace directly. The pressure currently exerted on researchers, on the other hand, is altering how science is practiced and seems to affect women and men differently. In this paper we summarize the discussions that took place on this topic in Workshop V of the 5th IUPAP International Conference on Women in Physics. We present some of the results of the 2010 Global Survey of Physicists analyzed by region and data from France and Taiwan. We also include the recommendations that were formulated at the end of the workshop.

Beyond Being Present: Learning-Oriented Leadership in the Daily Work of Middle Managers

ERIC Educational Resources Information Center

Döös, Marianne; Johansson, Peter; Wilhelmson, Lena

2015-01-01

Purpose: This paper aims to contribute to the understanding of learning-oriented leadership as being integrated in managers' daily work. The particular focus is on managers' efforts to change how work is carried out through indirect acts of influence. In their daily work, managers influence the organisation's learning conditions in ways that go…

Challenges faced in daily life by persons with type 2 diabetes: A meta-synthesis.

PubMed

Inga-Britt, Lindh; Kerstin, Blomqvist

2018-01-01

Objectives To derive improved understanding of the implicit meanings of challenges in daily life from the perspective of persons with type 2 diabetes. Methods A meta-synthesis was conducted with an interpretive and constructivist approach. Four databases were searched for articles published between 2007 and 2011, producing 37 articles for analysis. Van Deurzen's life world theory was applied as an analytic grid. Results Challenges in daily life with type 2 diabetes could be understood as living in a tension between opposing forces, implying a struggle with inevitable paradoxes: living in the present and for the future, trusting oneself while relying on others, and being normal while feeling changed and different. Discussion This synthesis adds knowledge to previous understanding of living with type 2 diabetes, revealing the complexity of daily life when struggling with a lifelong illness. Person-centred care could be used to understand what challenges diabetes may cause in family and working life and the ambivalent feelings the illness can lead to. Future research is needed to implement and evaluate a person-centred care in practice. Since new qualitative research is continuously added to this topic, metasyntheses should be undertaken regularly.

Care homes and the Mental Capacity Act 2005: Changes in understanding and practice over time.

PubMed

Manthorpe, Jill; Samsi, Kritika

2016-07-01

The Mental Capacity Act 2005 provides the legal framework in England and Wales for the making of decisions in respect of people who have never had or have lost decision-making capacity. As part of a 5-year research program investigating the implementation and adoption of the Mental Capacity Act in dementia practice, we interviewed staff working in different care homes at two time points (32 staff at Time 1 in 2008 and 27 staff at Time 2 in 2012) in South East England. At baseline Time 1, daily practice seemed to resonate with Mental Capacity Act principles of respecting decisions and trying to act in a person's best interests. This paper reports Time 2 findings. We found that few care home staff interviewed specifically reported finding the Mental Capacity Act helpful in crystallizing the legal basis of their work. Most continued to offer illustrations of day-to-day practice in which they paid attention to individual choices, took account of the wishes of residents' families, and tried to act in residents' best interests but referred major decisions to their seniors. This study highlights the potential of referring to specific day-to-day practice in care homes when offering training or scrutinizing practice in dementia care more generally so that the work is set in its legal as well as moral framework. Care home staff in this study reported that advanced planning and pre-specifying preferences were more common among new care home residents, especially those with dementia, indicating that greater understanding of these is required by staff. © The Author(s) 2014.

The Effect of the Transcendental Meditation Technique on Anxiety Level

ERIC Educational Resources Information Center

Dillbeck, Michael C.

1977-01-01

Two weeks of twice-daily practice of the Transcendental Meditation (TM) technique was compared with 2 weeks of twice-daily practice of passive relaxation as a means of reduction of anxiety, as measured by the Trait scale of the State-Trait Anxiety Inventory. (Editor)

Building Power Between Polarities: On the Space-in-Between.

PubMed

Ventres, William B

2016-02-01

In this article, I introduce the concept of the space-in-between. This space-in-between is born of the realization that, between the expression of any two polarities (across dimensions such as emotion, thought, geography, and ideology), there exists a philosophical construct useful for framing thinking about practice, research, and managerial relationships in the health professions. Out of this construct emerge practical considerations useful for structuring the conduct of meaningful interpersonal and intercultural interactions. I describe how the idea of a space-in-between developed out of my medical practice, grew as a result of my experiences in international environments. and has found fulfillment in my ongoing work. I explore the application of a space-in-between in public health, medical anthropology, medical ethics, and global health. I review how, as a result of incorporating this space in their daily work, clinicians, educators, researchers, and managers can grow as leaders by sharing the presence that arises from the space-in-between them and the people in the communities they serve. © The Author(s) 2015.

[Issues of research in medicine].

PubMed

Topić, Elizabeta

2006-01-01

Research in medicine is liable to all rules and standards that apply to research in other natural sciences, since medicine as a science and service fully meets the general definition of science: it is a common, integrated, organized and systematized knowledge of mankind, whereby physician--being more or less aware of doing so-- in his daily activities applies scientific thinking and scientific methods. The procedure of problem solving in scientific work and in medical practice is characterized by many similarities as well as variation. In scientific research, the observation of some phenomenon that cannot be explained by the known facts and theories is followed by making a hypothesis, planning and carrying out experimental investigation resulting in some data. Interpretation of these data then provides evidence to confirm or reject the hypothesis. In medical practice, quite a similar procedure is followed; the initial examination of a patient, when his condition cannot be explained by the data thus obtained, is identical to the observation of a phenomenon which cannot be explained by the known facts; working diagnosis would correspond to making the hypothesis; and experimental investigation would compare to laboratory and other diagnostic studies. The working diagnosis is accepted or rejected depending on these results. Of course, there also are differences in the problem solving procedure between scientific research and daily medical practice. For example, in research a single hypothesis is posed, a single experiment with successive testing and/or repeats is performed, whereas in medical practice several hypotheses are made, multiple studies are concurrently performed to reject current hypotheses and to make new ones. Scientific investigation produces an abundance of systematic data, whereas in medical practice target data are being generated, yet not systematically. Definitive decision making also differs greatly, as in scientific research it only ensues from conclusive evidence, whereas in medical practice definitive decision is made and therapeutic procedures are performed even before reaching final evidence. The general strategy of work and research in medicine can be briefly described by four principles, i.e. good knowledge of one's own work; continuing upgrading of one's own work in collaboration with respective institutions (laboratories, university, and research institutes); implementation of standard, up-to-date and scientific methods most of the time; and publishing work results on a regular basis. This strategy ensures constant progress and treatment quality improvement while allowing due validation and evaluation of the work by the society. Scientific research is based on the pre-existing knowledge of the problem under study, and should be supervised, systematic and planned. Research produces data that may represent some new concepts, or such concepts are developed by further data processing. In research, scientific procedure includes a number of steps that have to be made to reach a new scientific result. This procedure includes (a) thinking about a scientific issue; (b) making a scientific hypothesis, i.e. the main objective of the study; (c) research ethics; (d) determination of sources and mode of data collection; (e) research performance; (f) collection and analysis of all research data; (g) interpretation of results and evidence; and (h) publications. The next section of this chapter brings an example of scientific research in the field of medicine, where the procedures carried out during the research are briefly described; other chapters of this supplement deal with statistical methodology used on processing the data obtained in the study, which is most frequently employed in scientific work in the field of medicine.

Design of a wearable bio-patch for monitoring patient's temperature.

PubMed

Vicente, Jose M; Avila-Navarro, Ernesto; Juan, Carlos G; Garcia, Nicolas; Sabater-Navarro, Jose M

2016-08-01

New communication technologies allow us developing useful and more practical medical applications, in particular for ambulatory monitoring. NFC communication has the advantages of low powering and low influence range area, what makes this technology suitable for health applications. This work presents an explanation of the design process of planar NFC antennas in a wearable biopatch. The problem of optimizing the communication distance is addressed. Design of a biopatch for continuous temperature monitoring and experimental results obtained wearing this biopatch during daily activities are presented.

Impact of estradiol valerate/dienogest on work productivity and activities of daily living in women with heavy menstrual bleeding.

PubMed

Wasiak, Radoslaw; Filonenko, Anna; Vanness, David J; Law, Amy; Jeddi, Mark; Wittrup-Jensen, Kim U; Stull, Donald E; Siak, Steven; Jensen, Jeffrey T

2013-04-01

To quantify the change in work productivity and activities of daily living in North American women with heavy menstrual bleeding (HMB) treated with estradiol valerate/dienogest (E2V/DNG; Qlaira(®)/Natazia(®)) compared to placebo. Women in the United States and Canada, aged 20-53 years with an objective diagnosis of HMB and no recognizable anatomical pathology, were treated with E2V/DNG or placebo for seven cycles (196 days). Main outcome measures included work productivity (i.e., productivity while at work) and activities of daily living measured using a modified Work Productivity and Activity Impairment Questionnaire (mWPAI) on a Likert scale from 0 to 10 (higher values denote higher impairment levels). In both countries, significant improvement was observed between baseline and end of treatment in work productivity and activities of daily living impairment. The improvements in work productivity and activities of daily living with E2V/DNG treatment relative to placebo ranged from 37.2% to 39.2% across both countries. Monthly gains due to E2V/DNG treatment (net of placebo improvement) associated with improvement in work productivity were estimated to be US$80.2 and Can$70.8 (US$58.5) and those associated with improvement in activities of daily living were estimated to be US$84.9 and Can$73.5 (US$60.7). E2V/DNG was shown to have a consistent positive impact on work productivity and activities of daily living in U.S. and Canadian women with HMB. In addition, these improvements in work productivity and activities of daily living were associated with a reduction in HMB-related monetary burden compared to the placebo group.

Low-Income Mothers' Nighttime and Weekend Work: Daily Associations with Child Behavior, Mother-Child Interactions, and Mood

ERIC Educational Resources Information Center

Gassman-Pines, Anna

2011-01-01

This study investigated low-income mothers' daily nighttime and weekend work and family outcomes. Sixty-one mothers of preschool-aged children reported daily on work hours, mood, mother-child interaction, and child behavior for two weeks (N = 724 person-days). Although nighttime and weekend work are both nonstandard schedules, results showed…

Statistics teaching in medical school: opinions of practising doctors.

PubMed

Miles, Susan; Price, Gill M; Swift, Louise; Shepstone, Lee; Leinster, Sam J

2010-11-04

The General Medical Council expects UK medical graduates to gain some statistical knowledge during their undergraduate education; but provides no specific guidance as to amount, content or teaching method. Published work on statistics teaching for medical undergraduates has been dominated by medical statisticians, with little input from the doctors who will actually be using this knowledge and these skills after graduation. Furthermore, doctor's statistical training needs may have changed due to advances in information technology and the increasing importance of evidence-based medicine. Thus there exists a need to investigate the views of practising medical doctors as to the statistical training required for undergraduate medical students, based on their own use of these skills in daily practice. A questionnaire was designed to investigate doctors' views about undergraduate training in statistics and the need for these skills in daily practice, with a view to informing future teaching. The questionnaire was emailed to all clinicians with a link to the University of East Anglia Medical School. Open ended questions were included to elicit doctors' opinions about both their own undergraduate training in statistics and recommendations for the training of current medical students. Content analysis was performed by two of the authors to systematically categorize and describe all the responses provided by participants. 130 doctors responded, including both hospital consultants and general practitioners. The findings indicated that most had not recognised the value of their undergraduate teaching in statistics and probability at the time, but had subsequently found the skills relevant to their career. Suggestions for improving undergraduate teaching in these areas included referring to actual research and ensuring relevance to, and integration with, clinical practice. Grounding the teaching of statistics in the context of real research studies and including examples of typical clinical work may better prepare medical students for their subsequent career.

From painful busyness to emotional immunization: Nurses' experiences of ethical challenges.

PubMed

Storaker, Anne; Nåden, Dagfinn; Sæteren, Berit

2017-08-01

The professional values presented in ethical guidelines of the Norwegian Nurses Organisation and International Council of Nurses describe nurses' professional ethics and the obligations that pertain to good nursing practice. The foundation of all nursing shall be respect for life and the inherent dignity of the individual. Research proposes that nurses lack insight in ethical competence and that ethical issues are rarely discussed on the wards. Furthermore, research has for some time confirmed that nurses experience moral distress in their daily work and that this has become a major problem for the nursing profession. The purpose of this article is to obtain a deeper understanding of the ethical challenges that nurses face in daily practice. The chosen research questions are "What ethical challenges do nurses experience in their daily practice?" We conducted a qualitative interview study using a hermeneutical approach to analyzing data describing nurses' experiences. Ethical considerations: The Norwegian Social Science Data services approved the study. Furthermore, the head of the hospital gave permission to conduct the investigation. The requirement of anonymity and proper data storage in accordance with the World Medical Association Declaration of Helsinki was met. The context for the study comprised three different clinical wards at a university hospital in Norway. Nine qualified nurses were interviewed. The results were obtained through a systematic development beginning with the discovery of busyness as a painful phenomenon that can lead to conflicts in terms of ethical values. Furthermore, the consequences compromising professional principles in nursing care emerged and ended in moral blindness and emotional immunization of the healthcare providers. Emotional immunization occurred as a new dimension involving moral blindness and immunity in relation to being emotionally touched.

Impact of Dry Eye Symptoms and Daily Activities in a Modern Office.

PubMed

van Tilborg, Mirjam M; Murphy, Paul J; Evans, Katharine S

2017-06-01

Modern offices and the use of electronic devices are increasing factors in work-related eye symptoms. However, symptoms of eye fatigue or dry eye sensation can be mixed and confusing. This study surveys the eye symptoms reported during a working day at modern offices to investigate the possible inhibition on daily work activities. Two online digital surveys were sent to three different work locations, by direct e-mail. Survey A consisted of 14 questions that investigated eye symptoms experienced during daily activities at work and the impact on daily activities. Survey B consisted of four general questions, the Dutch Ocular Surface Disease Index, the Work Productivity and Activity Index, and the Illness Perception Questionnaire. A total of 505 participants completed survey A, and 213 completed survey B. The participants reported that a high proportion of their day was spent working on a computer (60%). The majority experienced an air draft (79.1%) and had no adjustable light (81.5%) at their workspace. Dry eye-related symptoms were reported at a significantly higher frequency at work than at home (P < .001). Up to 70% experienced some inhibition of daily activity at work due to eye symptoms, with more than 5% experiencing symptoms most or all of the time. Indoor environment, work environment, and general health were perceived as the main reasons for developing dry eye. Compared with males, females showed a statistically significant higher Ocular Surface Disease Index score (P < .001) and experienced more inhibition and adverse effects on daily life and work productivity. This investigation shows that dry eye symptoms have a negative impact on daily activities at work. These findings suggest that multidisciplinary understanding of the negative impact of dry eye by a range of specialists will be of help in managing work-related dry eye.

Effectiveness of exercise-heat acclimation for preventing heat illness in the workplace.

PubMed

Yamazaki, Fumio

2013-09-01

The incidence of heat-related illness in the workplace is linked to whether or not workers have acclimated to a hot environment. Heat acclimation improves endurance work performance in the heat and thermal comfort at a given work rate. These improvements are achieved by increased sweating and skin blood flow responses, better fluid balance and cardiovascular stability. As a practical means of acclimatizing the body to heat stress, daily aerobic exercise training is recommended since thermoregulatory capacity and blood volume increase with physical fitness. In workers wearing personal protective suits in hot environments, however, little psychophysiological benefit is received from short-term exercise training and/or heat acclimation because of the ineffectiveness of sweating for heat dissipation and the aggravation of thermal discomfort with the accumulation of sweat within the suit. For a manual laborer who works under uncompensable heat stress, better management of the work rate, the work environment and health is required.

Teaching minority children hygiene: investigating hygiene education in kindergartens and homes of ethnic minority children in northern Vietnam.

PubMed

Rheinländer, Thilde; Samuelsen, Helle; Dalsgaard, Anders; Konradsen, Flemming

2015-01-01

Ethnic minority children in Vietnam experience high levels of hygiene- and sanitation-related diseases. Improving hygiene for minority children is therefore vital for improving child health. The study objective was to investigate how kindergarten and home environments influence the learning of hygiene of pre-school ethnic minority children in rural Vietnam. Eight months of ethnographic field studies were conducted among four ethnic minority groups living in highland and lowland communities in northern Vietnam. Data included participant observation in four kindergartens and 20 homes of pre-school children, together with 67 semi-structured interviews with caregivers and five kindergarten staff. Thematic analysis was applied and concepts of social learning provided inputs to the analysis. This study showed that poor living conditions with lack of basic sanitation infrastructures were important barriers for the implementation of safe home child hygiene. Furthermore, the everyday life of highland villages, with parents working away from the households resulted in little daily adult supervision of safe child hygiene practices. While kindergartens were identified as potentially important institutions for improving child hygiene education, essential and well-functioning hygiene infrastructures were lacking. Also, hygiene teaching relied on theoretical and non-practice-based learning styles, which did not facilitate hygiene behaviour change in small children. Minority children were further disadvantaged as teaching was only provided in non-minority language. Kindergartens can be important institutions for the promotion of safe hygiene practices among children, but they must invest in the maintenance of hygiene and sanitation infrastructures and adopt a strong practice-based teaching approach in daily work and in teacher's education. To support highland minority children in particular, teaching styles must take local living conditions and caregiver structures into account and teach in local languages. Creating stronger links between home and institutional learning environments can be vital to support disadvantaged highland families in improving child health.

A model of ergonomics intervention in industry: case study in Japan.

PubMed

Chavalitsakulchai, P; Ohkubo, T; Shahnavaz, H

1994-06-01

This paper presents the results of an ergonomics survey in four different Japanese work places. The survey consisted of two parts. In the first part, the physical and psycho-social problems of the female workers were investigated. Questionnaire techniques were used to assess musculoskeletal disorders in various parts of the body and of psycho-social stress at work as well as in the daily life situation. Furthermore, work posture analysis, task analysis, simple clinical tests and flexibility tests were conducted. In the second part, the ergonomics intervention practices in different types of Japanese work places were examined. Three different questionnaires were developed and used to collect information from representatives of employees, management and responsible governmental agents of the Department of Industrial Safety and Health, Ministry of Labor, with regard to ergonomic interventions at work places. Management, employees, and government representatives expressed desire for cooperation and participation for arrangement of the ergonomics intervention program. A model for appropriate ergonomics intervention in industry is developed with regard to physical and psycho-social problems at work. Factors influencing worker participation and the establishment of a dynamic system of ergonomics intervention at work places are discussed. Practical ways for improving the working conditions of female workers are: (i) cooperation between managers, workers, and government officers is regarded as vital for the ergonomics intervention program, (ii) worker participation, (iii) appropriate training course with regard to ergonomics education, and (iv) managerial support.

Achieving the daily step goal of 10,000 steps: the experience of a Canadian family attached to pedometers.

PubMed

Choi, Bernard C K; Pak, Anita W P; Choi, Jerome C L; Choi, Elaine C L

2007-01-01

Health experts recommend daily step goals of 10,000 steps for adults and 12,000 steps for youths to achieve a healthy active living. This article reports the findings of a Canadian family project to investigate whether the recommended daily step goals are achievable in a real life setting, and suggests ways to increase the daily steps to meet the goal. The family project also provides an example to encourage more Canadians to conduct family projects on healthy living. This is a pilot feasibility study. A Canadian family was recruited for the study, with 4 volunteers (father, mother, son and daughter). Each volunteer was asked to wear a pedometer and to record daily steps for three time periods of each day during a 2-month period. Both minimal routine steps, and additional steps from special non-routine activities, were recorded at work, school and home. The mean number of daily steps from routine minimal daily activities for the family was 6685 steps in a day (16 hr, approx 400 steps/hr). There was thus a mean deficit of 4315 steps per day, or approximately 30,000 steps per week, from the goal (10,000 steps for adults; 12,000 steps for youths). Special activities that were found to effectively increase the steps above the routine level include: walking at brisk pace, grocery shopping, window shopping in a mall, going to an entertainment centre, and attending parties (such as to celebrate the holiday season and birthdays). To increase our daily steps to meet the daily step goal, a new culture is recommended: "get off the chair". By definition, sitting on a chair precludes the opportunity to walk. We encourage people to get off the chair, to go shopping, and to go partying, as a practical and fun way to increase the daily steps. This paper is a call for increased physical activity to meet the daily step goal.

Job Design for Mindful Work: The Boosting Effect of Psychosocial Safety Climate.

PubMed

Lawrie, Emily J; Tuckey, Michelle R; Dollard, Maureen F

2017-12-28

Despite a surge in workplace mindfulness research, virtually nothing is known about how organizations can cultivate everyday mindfulness at work. Using the extended job demands-resources model, we explored daily psychological demands and job control as potential antecedents of daily mindfulness, and the moderating effect of psychosocial safety climate (PSC, which relates to the value organizations place on psychological health at work). We also examined the relationship between mindfulness and learning to augment understanding of the benefits of everyday mindfulness at work. A sample of 57 employees, primarily working in education, health care, and finance, completed a diary for five days within a 2-week period, covering mindfulness, psychological demands, job control, and learning. PSC was measured in a baseline survey, with individual ratings combined with those of up to four colleagues to tap objective (shared) climate. Hierarchical linear modeling showed that daily psychological demands were negatively related to daily mindfulness, and daily job control was positively related to daily mindfulness especially as PSC increased. Additionally, daily mindfulness was positively associated with daily workplace learning. This study is one of the first to identify work-related antecedents to everyday mindfulness. The findings suggest that (a) to support everyday mindfulness at work, jobs must be designed with manageable demands and a variety of tasks that allow for creativity and skill discretion, and (b) the benefits of mindfulness interventions for employee psychological health and well-being may not be sustainable unless employees have influence over when and how they do their work, in the "right" climate. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Let it be and keep on going! Acceptance and daily occupational well-being in relation to negative work events.

PubMed

Kuba, Katharina; Scheibe, Susanne

2017-01-01

[Correction Notice: An Erratum for this article was reported in Vol 22(1) of Journal of Occupational Health Psychology (see record 2016-25216-001). In the article, there were errors in the Participants subsection in the Method section. The last three sentences should read "Job tenure ranged from less than 1 year to 32 years, with an average of 8.83 years (SD 7.80). Participants interacted with clients on average 5.44 hr a day (SD 2.41). The mean working time was 7.36 hr per day (SD 1.91)."] Negative work events can diminish daily occupational well-being, yet the degree to which they do so depends on the way in which people deal with their emotions. The aim of the current study was to examine the role of acceptance in the link between daily negative work events and occupational well-being. We hypothesized that acceptance would be associated with better daily occupational well-being, operationalized as low end-of-day negative emotions and fatigue, and high work engagement. Furthermore, we predicted that acceptance would buffer the adverse impact of negative work events on daily well-being. A microlongitudinal study across 10 work days was carried out with 92 employees of the health care sector, yielding a total of 832 daily observations. As expected, acceptance was associated with lower end-of-day negative emotions and fatigue (though there was no association with work engagement) across the 10-day period. Furthermore, acceptance moderated the effect of negative event occurrence on daily well-being: Highly accepting employees experienced less increase in negative emotions and less reduction in work engagement (though comparable end-of-day fatigue) on days with negative work events, relative to days without negative work events, than did less accepting employees. These findings highlight affective, resource-saving, and motivational benefits of acceptance for daily occupational well-being and demonstrate that acceptance is associated with enhanced resilience to daily negative work events. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Perception about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia

PubMed Central

Zafar, Hamayun; Oluseye, Kamaldeen; Alghadir, Ahmad; Iqbal, Zaheen A.

2015-01-01

[Purpose] To report perceptions about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia. [Subjects and Methods] A 21-item structured questionnaire was used to assess various domains including the demographic and professional characteristics of physical therapists and their perceptions about the importance and use of therapeutic massage in their daily practice. The questionnaire was uploaded online and the web link was sent to 140 members of the Saudi Physical Therapy Association (SPTA). [Results] The overall response rate was 86%. Among the respondents, 31% reported occasional use of therapeutic massage in their clinical practice, and 55% reported to have received formal training for therapeutic massage. Use of therapeutic massage was more common among female physical therapists. [Conclusion] Many physical therapists working in Saudi Arabia consider therapeutic massage to be an important treatment modality, but its use is relatively limited, either due to the time and effort required to dispense it, or the lack of scientific evidence for its efficacy. PMID:26180330

[The hygienic assessment of the organization of the vocational study practice of students training for the job of power-generating unit operator].

PubMed

Shpangenberg, S

1992-01-01

The study is carried out with schoolchildren from the educative and industrial complex of energetics (two classes with total 60 students) at the age of 17-18, from the Technical College of Energetics "V. Pick"--Sofia. They are trained for the profession "operator on power aggregates". The investigation is performed during the educative and industrial practice of the students in the Heat Power Station "Tr. Kostov" and the Heat Power Station "Sofia", as well as in the training shop of the technical college. Studies are made on: the functional adaptation of the organism through the reactivity of the CNS, some analysers, the cardiovascular system and the sympathetic-adrenal system, haemopoiesis; the factors of the educative and industrial environment; working/professional maturity of the students; health status of the adolescents. The results of the examination show low effectiveness of the education and industrial training in the Heat power station or low daily and annual exposure, leading to monotony, hypodynamia especially when working in second shift. It is recommended the education and industrial practice in the secondary special schools and technical colleges to be carried out in training shops, educative and industrial workshops and at standardization of the environmental factors and organization of rational regime of work and rest.

Enacting Firm, Fair and Friendly Practice: A Model for Strengths-Based Child Protection Relationships?

PubMed

Oliver, Carolyn; Charles, Grant

2016-06-01

Strengths-based solution-focused approaches are gaining ground in statutory child protection work, but few studies have asked front line practitioners how they navigate the complex worker-client relationships such approaches require. This paper describes one component of a mixed-methods study in a large Canadian statutory child protection agency in which 225 workers described how they applied the ideas of strengths-based practice in their daily work. Interviews with twenty-four practitioners were analysed using an interpretive description approach. Only four interviewees appeared to successfully enact a version of strengths-based practice that closely mirrored those described by key strengths-based child protection theorists and was fully congruent with their mandated role. They described navigating a shifting balance of collaboration and authority in worker-client relationships based on transparency, impartial judgement, attentiveness to the worker-client interaction and the value that clients were fellow human beings. Their accounts extend current conceptualisations of the worker-client relationship in strengths-based child protection work and are congruent with current understandings of effective mandated relationships. They provide what may be a useful model to help workers understand and navigate relationships in which they must reconcile their own authority and expertise with genuine support for the authority and expertise of their clients.

What to do when trust has been breached in your practice.

PubMed

Hills, Laura

2013-01-01

We've all experienced gossiping, missed deadlines, someone taking credit for another's work, and little white lies. These and other breaches of trust are commonplace. However, they do more damage in the medical practice than many practice managers realize. This article argues that medical practice employees need to trust their managers, patients, doctors, one another, and even the security of their jobs so they are able to focus on their daily tasks and perform well. It defines trust as both a logical and emotional act and describes common breaches of workplace trust. It defines three characteristics of high-trust organizations and illustrates through examples how practice managers can demonstrate their trustworthiness through their actions, not only through their words. This article also offers seven steps for rebuilding trust that has been breached. It offers readers two instruments: a survey tool practice managers can use to assess the trust in their practices and a self-quiz practice managers can take to assess their own trustworthiness. Finally, this article offers research about the impact of trust on the bottom line and 10 truths about trust that medical practice managers can share with their employees.

The daily lives of people with Parkinson's disease.

PubMed

Valcarenghi, Rafaela Vivian; Alvarez, Angela Maria; Santos, Silvana Sidney Costa; Siewert, Josiane Steil; Nunes, Simony Fabíola Lopes; Tomasi, Andrelise Viana Rosa

2018-01-01

To understand the daily lives of people with Parkinson's disease. Qualitative research, using as methodological and theoretical referential the Grounded Theory and Symbolic Interactionism, respectively. The in-depth interview was conducted with 30 people with Parkinson's disease. From data analysis, three themes were selected: Living with the disease - living with the treatment and changes in lifestyle; Modifying of one's job performance - revealing incapacity for work and the need to anticipate retirement and; Living with the stigma - the feeling of prejudice against the disease and the perceived limitations of the health services. Living with a chronic and non-transferable disease encompasses social, physical and cultural effects, along with the personal experiences of each unique individual. This study assists the improvement of care to people with the disease, because the care practice emerges from the interactions between the subjects.

Designing for privacy management in hospitals: Understanding the gap between user activities and IT staff's understandings.

PubMed

Eikey, Elizabeth V; Murphy, Alison R; Reddy, Madhu C; Xu, Heng

2015-12-01

We examined the role of privacy in collaborative clinical work and how it is understood by hospital IT staff. The purpose of our study was to identify the gaps between hospital IT staff members' perceptions of how electronic health record (EHR) users' protect the privacy of patient information and how users actually protect patients' private information in their daily collaborative activities. Since the IT staff play an important role in implementing and maintaining the EHR, any gaps that exist between the IT staff's perceptions of user work practices and the users' actual work practices can result in a number of problems in the configuration, implementation, or customization of the EHR, which can lead to collaboration challenges, interrupted workflow, and privacy breaches. We used qualitative data collection methods for this study. We conducted semi-structured interviews with 20 hospital IT staff members. We also conducted observations of EHR users in the in-patient units of the same hospital. We identified gaps in IT staff's understandings of users' work activities, especially in regards to privacy-compromising workarounds that are used by users and why they are used. We discuss the reasons why this gap may exist between IT staff and users and ways to improve IT staff's understanding of why users perform certain privacy-compromising workarounds. A hospital's IT staff face a daunting task in ensuring users' collaborative work practices are supported by the system while providing effective privacy mechanisms. In order to achieve both goals, the IT staff must have a clear understanding of their users' practices. However, as this study highlights, there may be a mismatch between the IT staff's understandings of how users protect patient privacy and how users actually protect privacy. Copyright © 2015. Published by Elsevier Ireland Ltd.

Learning beyond Graduation: Exploring Newly Qualified Specialists' Entrance into Daily Practice from a Learning Perspective

ERIC Educational Resources Information Center

Cuyvers, Katrien; Donche, Vincent; Van den Bossche, Piet

2016-01-01

The entrance of newly qualified medical specialists into daily practice is considered to be a stressful period in which curriculum support is absent. Although engaging in both personal and professional learning and development activities is recognized fundamental for lifelong professional competence, research on medical professionals' entrance…

Cultural Orientations, Daily Activities, and Adjustment in Mexican American Youth

ERIC Educational Resources Information Center

McHale, Susan M.; Updegraff, Kimberly A.; Kim, Ji-Yeon; Cansler, Emily

2009-01-01

The links between youth's daily activities and adjustment and the role of cultural practices and values in these links were studied in 469 youth from 237 Mexican American families. In home interviews, data on mothers', fathers', and two adolescent-age siblings' cultural practices (language use, social contacts) and values (for familism, for…

Variation in Expert Source Selection According to Different Objectivity Standards

ERIC Educational Resources Information Center

Albaek, Erik

2011-01-01

Several scholars have tried to clarify how journalists handle and implement the abstract objectivity norm in daily practice. Less research attention has been paid to how common abstract professional norms and values, "in casu" the objectivity norm, may systematically vary when interpreted and implemented in daily journalistic practice. Allgaier's…

Quality of life and consequences for daily life of familial adenomatous polyposis (FAP) family members.

PubMed

Douma, K F L; Bleiker, E M A; Vasen, H F A; Gundy, C M; Aaronson, N K

2011-06-01

The study aimed to document the impact of familial adenomatous polyposis (FAP) on health-related quality of life (HRQOL) and several practical aspects of daily life, and to identify factors significantly associated with HRQOL. This study is the first to compare HRQOL between patients with FAP, at-risk individuals and noncarriers. A total of 525 individuals (response rate 64%) from 145 families at high risk for FAP completed a battery of self-report questionnaires assessing generic- and condition-specific HRQOL and the consequences of FAP for daily life. HRQOL was comparable to that of the general Dutch population. Surgically treated patients with FAP had significantly lower scores on several HRQOL domains compared with at-risk individuals, noncarriers and nonsurgically treated patients with FAP. Type of surgery was not significantly associated with HRQOL. Within the surgically treated group, postsurgical complications and comorbidity significantly affected HRQOL. Forty-one percent of patients reported that FAP had affected their working life. Surgically treated patients with FAP have significantly poorer HRQOL than other groups. The type of surgery and age at time of first surgery were not associated with HRQOL but surgical complications and comorbidity were. Patients should be informed of the consequences of FAP for work and other life domains. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

Ergonomic analysis jobs in recovered factories.

PubMed

Cuenca, Gabriela; Zotta, Gastón

2012-01-01

With the advent of the deep economic crisis in Argentina on 2001, the recovery of companies through to the creation of the Cooperatives Working Self-Management or Factories Recovered by its workers was constituted as one of the ways in which the salaried disobeyed the increasing unemployment. When the companies turn into recovered factories they tend to leave of side practices that have been seen like imposed by the previous organization and not understanding them as a primary condition for the execution of his tasks. Safety and ergonomics are two disciplines that are no longer considered relevant to the daily work. Therefore this investigation aims to revalue, undergo semantic to give back to a place in every organization analyzed. This research developed a self-diagnostic tool for working conditions, and the environment, present in the recovered factories.

[The patient's right to information: influence of socio-professional factors in primary care].

PubMed

Pérez-Cárceles, M D; Pereñíguez-Barranco, J E; Osuna-Carrillo de Albornoz, E; Luna-Maldonado, A

2006-02-15

To describe the information provided by primary care doctors to their patients in different phases of the care provision process and to analyse any relationships with socio-professional factors. Descriptive, cross-sectional study based on postal questionnaire. Primary care centres in Murcia, Spain. 227 family physicians. Distribution of a questionnaire which includes: a) socio-professional variables (age, sex, marital status, years in practice, years in present post, work environment, previous training, number of patients on list, number of patients seen daily); b) an evaluation of job satisfaction (Likert scale) related to salary, career choice, immediate superiors and daily surgery; and c) the frequency with which information is provided to patients concerning diagnosis, prognosis, treatment, complementary examinations and personal, professional and family impact. The reply rate was 59%. The percentages of doctors who always provided information concerning diagnosis, prognosis, treatment, complementary examinations and person, professional and family impact was, 23.3%, 7%, 64.3%, 40.5%, and 9.7%, respectively. There was a direct and statistically significant relationship between job satisfaction and the information provided to patients, the doctors feeling most satisfaction providing the most information on the different phases of the care process. On the other hand, there was an inverse and statistically significant relationship between the number of patients on the doctors' lists and the information provided. The degree of fulfillment of the patient's right to information is low. Doctors should realise the practical importance of clinical information in their work. There is a general feeling of discontent amongst family doctors, which has a negative impact on their professional activity. A lighter workload would significantly improve the extent to which doctors provide patients with information and mechanisms should be put in place to improve working conditions to avoid the non-fulfillment of the patient's right to information.

[Anesthetic gases and nurses in operating room].

PubMed

Dosil Caamaño, Alicia; Dosil Caamaño, Susana

2011-04-01

Summary The growing number of women of childbearing age joining the job market and remaining work active during pregnancy determines the importance of preventing the potential hazards of the workplace during pregnancy and while breastfeeding. We must take into account that regular working practices may not be acceptable for women during pregnancy or while breastfeeding. One of the daily risks of operation theatre nurses is exposure to inhaled anaesthetics used during surgery In most cases, nurses are unaware if exposure is permitted during pregnancy or while breastfeeding. In this article, it is intended to publicize these risks, as well as the ways to prevent, taking into account the existing health and safety laws.

[TEIS--a system for public health offices for assessing, presenting, evaluating and communicating data on the quality of drinking water].

PubMed

Henke, A; Overath, H; Heinzke, J

1999-05-01

Monitoring the quality of drinking water is a cardinal task of German Public Health Offices and of the relevant Ministries of Health of the German Federal states ("Länder"). Today this can be tackled on a large scale and economically only with computer assistance. A system has been developed in North Rhine Westphalia on behalf of the Ministry of Health, for data assessment and communication which is suitable for practical work and user friendly. It aims at supporting the Public Health Offices in their daily work and at improving and simplifying the monitoring of drinking water supply systems and of drinking water quality control.

The daily commute from work to home: examining employees' experiences in relation to their recovery status.

PubMed

van Hooff, Madelon L M

2015-04-01

Sufficient recovery after daily effort expenditure at work is important to protect employee health and well-being. However, the role of commuting in the daily effort-recovery process is still not very well understood. The present study aimed to advance insight in this respect by examining if relaxation, detachment, mastery and stressful delays experienced during the commute from work to home affect employees' recovery status after returning home from work and at the end of the evening. Daily job demands were expected to moderate these effects. Serenity and (low) anxiety were included as indicators of employees' recovery status. Data were collected by means of a 5-day daily diary study (three measurements daily) among 76 participants from various industries. Multilevel analyses showed that relaxation was positively and stressful delays were negatively related to employees' recovery status after returning home from work but not to indicators of recovery at the end of the evening. For detachment, similar relations were found but only on days with high job demands. Mastery was not related to employees' recovery status. These findings enhance our insight in the daily effort-recovery cycle and underline the importance of promoting detachment (on demanding workdays) and relaxation on the way home from work. Copyright © 2013 John Wiley & Sons, Ltd.

Selecting relevant and feasible measurement instruments for the revised Dutch clinical practice guideline for physical therapy in patients after stroke.

PubMed

Otterman, Nicoline; Veerbeek, Janne; Schiemanck, Sven; van der Wees, Philip; Nollet, Frans; Kwakkel, Gert

2017-07-01

To select relevant and feasible instruments for the revision of the Dutch clinical practice guideline for physical therapy in patients with stroke. In this implementation study a comprehensive proposal for ICF categories and matching instruments was developed, based on reliability and validity. Relevant instruments were then selected in a consensus round by 11 knowledge brokers who were responsible for the implementation of the selected instruments. The feasibility of the selected instruments was tested by 36 physical therapists at different work settings within stroke services. Finally, instruments that were deemed relevant and feasible were included in the revised guideline. A total of 28 instruments were recommended for inclusion in the revised guideline. Nineteen instruments were retained from the previous guideline. Ten new instruments were tested in clinical practice, seven of which were found feasible. Two more instruments were added after critical appraisal of the set of the measurement instruments. The revised guideline contains 28 relevant and feasible instrument selected and tested in clinical practice by physical therapists. Further education and implementation is needed to integrate instruments in clinical practice. Further research is proposed for developing and implementing a core set of measurement instruments to be used at fixed time points to establish data registries that allow for continuous improvement of rehabilitation for stroke patients. Implications for Rehabilitation The revised Dutch Stroke Physical Therapy Guideline recommends a total of 28 instruments, that are relevant and feasible for clinical practice of physical therapist in the different settings of stroke rehabilitation. The selection of instrument in daily practice should be part of the clinical reasoning process of PTs and be tailored to individual patients' needs and the degree of priority of the affected ICF category. Suggested education strategies for further integration of instruments in of the daily practice of PTs in Stroke Rehabilitation are: 'Training on the job' and 'peer assessment in clinical situations'.

Relationship of Dyadic Closeness with Work-Related Stress: A Daily Diary Study

ERIC Educational Resources Information Center

Lavee, Yoav; Ben-Ari, Adital

2007-01-01

We examined the association between work-related stress of both spouses and daily fluctuations in their affective states and dyadic closeness. Daily diary data from 169 Israeli dual-earner couples were analyzed using multilevel modeling. The findings indicate that work stress has no direct effect on dyadic closeness but rather is mediated by the…

Urinary urgency - translating the evidence base into daily clinical practice.

PubMed

Cardozo, L; Chapple, C R; Dmochowski, R; Fitzgerald, M P; Hanno, P; Michel, M C; Staskin, D; Van Kerrebroeck, P; Wyndaele, J-J; Yamaguchi, O; Yoshida, M

2009-12-01

To consider the currently available knowledge and understanding of the symptom of urgency. Each faculty member reviewed the literature base of a different aspect of urgency and along with their personal clinical experience provided a base of evidence for discussion. This overview summarises relevant published literature and the current clinical experience of the authors. Whilst the mechanisms producing the sensation of urgency are still not fully understood and we are working within a definition that may complicate measurement and treatment, our pressing need is to effectively manage our patients for whom the practical nature of urgency can be all too apparent. Health care professionals have an important role to play today in helping to alleviate the widespread problem of urgency and its consequences.

Navigating the field of temporally framed care in the Danish home care sector.

PubMed

Tufte, Pernille; Dahl, Hanne Marlene

2016-01-01

The organisational and temporal framing of elderly care in Europe has changed in the wake of new public management reforms and standardised care services, the strict measurement of time and work schedules have become central aspects of care work. The article investigates the crafting of care in this framing: how care workers approach the services specified in their rotas and navigate between needs, demands and opportunities in the daily performance of duties. Applying feminist theory on time and anthropological theory on social navigation, it examines the practice of home care work in two Danish municipalities. Data are derived predominantly from participant observation. The article identifies two overarching temporal dilemmas in different home care situations: one where process time prevails over clock time and another where the care workers balance the two. Focusing on how care workers respond to these dilemmas in practice, the article identifies various navigation tactics, including leaving time outside, individualised routinisation, working on different paths simultaneously and postponing tasks. By assessing care workers' performance in the temporal framing of work and focusing on care workers' mediation between different time logics, this study provides an in-depth perspective on the broader feminist literature on the dilemmas of care. © 2015 Foundation for the Sociology of Health & Illness.

Too drained to help: a resource depletion perspective on daily interpersonal citizenship behaviors.

PubMed

Trougakos, John P; Beal, Daniel J; Cheng, Bonnie Hayden; Hideg, Ivona; Zweig, David

2015-01-01

This article explores the role of within-person fluctuations in employees' daily surface acting and subsequent personal energy resources in the performance of organizational citizenship behaviors directed toward other individuals in the workplace (OCBI). Drawing on ego depletion theory (Muraven & Baumeister, 2000), we develop a resource-based model in which surface acting is negatively associated with daily OCBIs through the depletion of resources manifested in end-of-day exhaustion. Further integrating ego depletion theory, we consider the role of employees' baseline personal resource pool, as indicated by chronic exhaustion, as a critical between-person moderator of these within-person relationships. Using an experience-sampling methodology to test this model, we found that surface acting was indirectly related to coworker ratings of OCBI through the experience of exhaustion. We further found that chronic levels of exhaustion exacerbated the influence of surface acting on employees' end-of-day exhaustion. These findings demonstrate the importance of employees' regulatory resource pool for combating depletion and maintaining important work behaviors. Implications for theory and practice are discussed. (c) 2015 APA, all rights reserved.

Standing out and moving up: performance appraisal of cultural minority physicians.

PubMed

Leyerzapf, Hannah; Abma, Tineke A; Steenwijk, Reina R; Croiset, Gerda; Verdonk, Petra

2015-10-01

Despite a growing diversity within society and health care, there seems to be a discrepancy between the number of cultural minority physicians graduating and those in training for specialization (residents) or working as a specialist in Dutch academic hospitals. The purpose of this article is to explore how performance appraisal in daily medical practice is experienced and might affect the influx of cultural minority physicians into specialty training. A critical diversity study was completed in one academic hospital using interviews (N = 27) and focus groups (15 participants) with cultural minority physicians and residents, instructing specialists and executives of medical wards. Data were digitally recorded and transcribed verbatim. A thematic and integral content analysis was performed. In addition to explicit norms on high motivation and excellent performance, implicit norms on professionalism are considered crucial in qualifying for specialty training. Stereotyped imaging on the culture and identity of cultural minority physicians and categorical thinking on diversity seem to underlie daily processes of evaluation and performance appraisal. These are experienced as inhibiting the possibilities to successfully profile for selection into residency and specialist positions. Implicit criteria appear to affect selection processes on medical wards and possibly hinder the influx of cultural minority physicians into residency and making academic hospitals more diverse. Minority and majority physicians, together with the hospital management and medical education should target inclusive norms and practices within clinical practice.

Working at the nexus between public health policy, practice and research. Dynamics of knowledge sharing in the Netherlands

PubMed Central

2012-01-01

Background Joining the domains of practice, research and policy is an important aspect of boosting the quality performance required to tackle complex public health problems. “Joining domains” implies a departure from the linear and technocratic knowledge-translation approach. Integrating the practice, research and policy triangle means knowing its elements, appreciating the barriers, identifying possible cooperation strategies and studying strategy effectiveness under specified conditions. This article examines the dynamic process of developing an Academic Collaborative Centre for Public Health in the Netherlands, with the objective of achieving that the three domains of policy, practice and research become working partners on an equal footing. Method An interpretative hermeneutic approach was used to interpret the phenomenon of collaboration at the nexus between the three domains. The project was explicitly grounded in current organizational culture and routines, applied to nexus action. In the process of examination, we used both quantitative (e.g. records) and qualitative data (e.g., interviews and observations). The data were interpreted using the Actor-Network, Institutional Re-Design and Blurring the Boundaries theories. Results Results show commitment at strategic level. At the tactical level, however, managers were inclined to prioritize daily routine, while the policy domain remained absent. At the operational level, practitioners learned to do PhD research in real-life practice and researchers became acquainted with problems of practice and policy, resulting in new research initiatives. Conclusion We conclude that working at the nexus is an ongoing process of formation and reformation. Strategies based on Institutional Re-Design theories in particular might help to more actively stimulate managers’ involvement to establish mutually supportive networks. PMID:23075375

Working at the nexus between public health policy, practice and research. Dynamics of knowledge sharing in The Netherlands.

PubMed

Jansen, Maria W; De Leeuw, Evelyne; Hoeijmakers, Marjan; De Vries, Nanne K

2012-10-17

Joining the domains of practice, research and policy is an important aspect of boosting the quality performance required to tackle complex public health problems. "Joining domains" implies a departure from the linear and technocratic knowledge-translation approach. Integrating the practice, research and policy triangle means knowing its elements, appreciating the barriers, identifying possible cooperation strategies and studying strategy effectiveness under specified conditions.This article examines the dynamic process of developing an Academic Collaborative Centre for Public Health in the Netherlands, with the objective of achieving that the three domains of policy, practice and research become working partners on an equal footing. An interpretative hermeneutic approach was used to interpret the phenomenon of collaboration at the nexus between the three domains. The project was explicitly grounded in current organizational culture and routines, applied to nexus action. In the process of examination, we used both quantitative (e.g. records) and qualitative data (e.g., interviews and observations). The data were interpreted using the Actor-Network, Institutional Re-Design and Blurring the Boundaries theories. Results show commitment at strategic level. At the tactical level, however, managers were inclined to prioritize daily routine, while the policy domain remained absent. At the operational level, practitioners learned to do PhD research in real-life practice and researchers became acquainted with problems of practice and policy, resulting in new research initiatives. We conclude that working at the nexus is an ongoing process of formation and reformation. Strategies based on Institutional Re-Design theories in particular might help to more actively stimulate managers' involvement to establish mutually supportive networks.

Examining the Influence of a Mobile Learning Intervention on Third Grade Math Achievement

ERIC Educational Resources Information Center

Kiger, Derick; Herro, Dani; Prunty, Deb

2012-01-01

Third grade students at a Midwestern elementary school participated in a 9-week mobile learning intervention (MLI). Two classrooms used Everyday Math and daily practice using flashcards, etc., to learn multiplication. Two other classrooms used Everyday Math and web applications for the iPod touch for daily practice. MLI students outperformed…

A Practical Guide for Day Care Personnel: Let the Sun Shine In.

ERIC Educational Resources Information Center

DeLorey, John L., Jr.; Cahn, Marjorie E.

This handbook of practical guidelines for daily life in day care is addressed to caregivers, teachers, directors, and students who want to provide high quality care for children. Separate sections are devoted to (1) day care as a daily living experience; (2) the parent-caregiver relationship; (3) priorities for health and safety, staff…

Assessing the Utility of a Daily Log for Measuring Principal Leadership Practice

ERIC Educational Resources Information Center

Camburn, Eric M.; Spillane, James P.; Sebastian, James

2010-01-01

Purpose: This study examines the feasibility and utility of a daily log for measuring principal leadership practice. Setting and Sample: The study was conducted in an urban district with approximately 50 principals. Approach: The log was assessed against two criteria: (a) Is it feasible to induce strong cooperation and high response rates among…

Daily Autonomy Supporting or Thwarting and Students' Motivation and Engagement in the High School Science Classroom

ERIC Educational Resources Information Center

Patall, Erika A.; Steingut, Rebecca R.; Vasquez, Ariana C.; Trimble, Scott S.; Pituch, Keenan A.; Freeman, Jen L.

2018-01-01

This diary study provided the first classroom-based empirical test of the relations between student perceptions of high school science teachers' various autonomy supporting and thwarting practices and students' motivation and engagement on a daily basis over the course of an instructional unit. Perceived autonomy supporting practices were…

Intersecting vulnerabilities in professionals and patients in intensive care.

PubMed

Meunier-Beillard, Nicolas; Dargent, Auguste; Ecarnot, Fiona; Rigaud, Jean-Philippe; Andreu, Pascal; Large, Audrey; Quenot, Jean-Pierre

2017-12-01

In the context of healthcare delivery, the vulnerabilities of patients in the intensive care unit (ICU) are intricately linked with those experienced on a daily basis by caregivers in the ICU in a symbiotic relation, whereby patients who are suffering can in turn engender suffering in the caregivers. In the same way, caregivers who are suffering themselves may be a source of suffering for their patients. The vulnerabilities of both patients and caregivers in the ICU are simultaneously constituted through a process that is influenced on the one hand by the healthcare objectives of the ICU, and on the other hand, by the conformity of the patients who are managed in that ICU. The specific challenges of management in high-technology units such as an ICU may have consequences on the practices and work conditions of healthcare professionals. Constructing the patient, collectively redefining the patient's identity, and ascribing the patient to a specific healthcare trajectory enables professionals to circumscribe, contain and fight against the spectrum of extreme vulnerabilities of their patients. Imposing this normative framework is the sole means of guiding these professionals through their daily practices. In spite of this, situations of suffering remain a constitutive feature of the caregiving relation in the ICU.

Implementing evidence-based medicine in general practice: a focus group based study

PubMed Central

Hannes, Karin; Leys, Marcus; Vermeire, Etienne; Aertgeerts, Bert; Buntinx, Frank; Depoorter, Anne-Marie

2005-01-01

Background Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM) in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners) to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. Methods We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful sampling was used to recruit participants. Results A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' individual practice), commercial and consumer organisations on the meso-level (institutions, organisations) and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community). Existing barriers and possible strategies to overcome these barriers were described. Conclusion In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed. PMID:16153300

The Relative Salience of Daily and Enduring Influences on Off-Job Reactions to Work Stress.

PubMed

Calderwood, Charles; Ackerman, Phillip L

2016-12-01

Work stress is an important determinant of employee health and wellness. The occupational health community is recognizing that one contributor to these relationships may be the presence of negative off-job reactivity to work, which we argue involves continued thoughts directed towards work (cognitive reactivity), continued negative mood stemming from work (affective reactivity), and the alteration of post-work behaviours in response to work factors (behavioural reactivity). We explored the relative contributions of daily work stressors, affective traits, and subjective job stress perceptions to negative off-job reactivity. These relationships were evaluated in a study of hospital nurses (n = 75), who completed trait measures and then provided self-assessments of daily work stress and off-job reactions for four work days. The results of several multilevel analyses indicated that a main-effects model best described the data when predicting cognitive, affective, and behavioural reactivity from daily work stressors, affective traits, and subjective job stress perceptions. A series of multilevel dominance analyses revealed that subjective job stress perceptions dominated the prediction of behavioural reactivity, while trait negative affect dominated the prediction of affective reactivity. Theoretical implications and the relative salience of daily and enduring contributors to negative off-job reactivity are discussed. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

29 CFR 778.202 - Premium pay for hours in excess of a daily or weekly standard.

Code of Federal Regulations, 2010 CFR

2010-07-01

... normal or regular working hours. Similarly, where the employee's normal or regular daily or weekly working hours are greater or less than 8 hours and 40 hours respectively and his contract provides for the... excess of his normal or regular daily working hours), his employer may exclude the premium portion of the...

Internet Addiction: A Brief Summary of Research and Practice

PubMed Central

Cash, Hilarie; Rae, Cosette D; Steel, Ann H; Winkler, Alexander

2012-01-01

Problematic computer use is a growing social issue which is being debated worldwide. Internet Addiction Disorder (IAD) ruins lives by causing neurological complications, psychological disturbances, and social problems. Surveys in the United States and Europe have indicated alarming prevalence rates between 1.5 and 8.2% [1]. There are several reviews addressing the definition, classification, assessment, epidemiology, and co-morbidity of IAD [2-5], and some reviews [6-8] addressing the treatment of IAD. The aim of this paper is to give a preferably brief overview of research on IAD and theoretical considerations from a practical perspective based on years of daily work with clients suffering from Internet addiction. Furthermore, with this paper we intend to bring in practical experience in the debate about the eventual inclusion of IAD in the next version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). PMID:23125561

The Impact of New Technologic and Molecular Advances in the Daily Practice of Gastrointestinal and Hepatobiliary Pathology.

PubMed

Xue, Yue; Farris, Alton Brad; Quigley, Brian; Krasinskas, Alyssa

2017-04-01

The practice of anatomic pathology, and of gastrointestinal pathology in particular, has been dramatically transformed in the past decade. In addition to the multitude of diseases, syndromes, and clinical entities encountered in daily clinical practice, the increasing integration of new technologic and molecular advances into the field of gastroenterology is occurring at a fast pace. Application of these advances has challenged pathologists to correlate newer methodologies with existing morphologic criteria, which in many instances still provide the gold standard for diagnosis. This review describes the impact of new technologic and molecular advances on the daily practice of gastrointestinal and hepatobiliary pathology. We discuss new drugs that can affect the gastrointestinal tract and liver, new endoluminal techniques, new molecular tests that are often performed reflexively, new imaging techniques for evaluating hepatocellular carcinoma, and modified approaches to the gross and histologic assessment of tissues that have been exposed to neoadjuvant therapies.

Physician's working hours and patients seen before and after national health insurance: "free" medical care and medical practice.

PubMed

Enterline, P E; McDonald, J C; McDonald, A D; Henderson, V

1975-02-01

Surveys were made of a sample of physicians before and after the introduction of a national health insurance plan in Montreal, Canada. Although the number of physicians in active practice seemed unaffected by the plan, their average working day was reduced 1.5 hours. Declines ranged from 0.3 hours for general internists to 2.7 hours for general surgeons. The average daily volume of services by physicians in the area also declined because of a decline in telephone consultations, and home and hospital visits. Office visits increased sharply. Changes in the type of services were clearly related to the fee schedule adopted by the government, with large declines in services for which payment was probably inadequate in relation to physician's time required. If the fee schedule reflected actual collections prior to the health insurance plan, then gross physician income increased as the result of redirecting services to better paying activities.

Evaluation of an interprofessional educational curriculum pilot course for practitioners working with post-stroke patients.

PubMed

Olaisen, Rho Henry; Mariscal-Hergert, Cheryl; Shaw, Alissa; Macchiavelli, Cecilia; Marsheck, Joanna

2014-03-01

This report describes the design and evaluation of an interprofessional pilot training course aimed at pre-licensure practitioners working with post-stroke patients in community-based settings. The course was developed by community-based practitioners from nine health professions. Course learning activities included traditional methods (lectures) and interactive modules (problem-based learning and exchange-based learning). The study's aim was to assess the program's effectiveness in adapting and incorporating knowledge, skills and self-confidence when delivering tertiary care in therapeutic pool environments; gauge adoption of course principles into practice, and assess overall course satisfaction. Methods of evaluation included conceptual mapping of course format, pre- and post-questionnaires, daily reflection questionnaires, course satisfaction survey and adoption survey, 10 weeks follow-up. Overall, the findings indicate students' knowledge, skills and self-confidence in delivering effective post-stroke care increased following the training. Students reported adopting clinical practices in 10 weeks follow-up. Implications for designing interprofessional curricula are discussed.

Empowering school personnel for positive youth development: the case of Hong Kong school social workers.

PubMed

To, Siu-ming

2009-01-01

While empowerment has become a popular concept in working with adolescents, few attempts have been made to explore the possibilities for empowering school personnel to create an environment in which young people can make maximum use of the opportunity to learn and grow. Based on the field experiences of 15 Hong Kong school social workers, this article examines how practitioners use various strategies to interact with school personnel to generate empowering practices in the school setting: namely, (1) exerting influence on school personnel in daily conversations and interactions; (2) creating an environment conducive to the teacher-student relationship; (3) achieving consensus with school personnel through lobbying and negotiation; and (4) collaborating with school personnel to organize life education and positive youth development programs. The findings provide valuable reference materials to guide other practitioners in applying the empowerment approach in actual practice. It also helps fill the gap in existing literature on empowerment and school social work.

SUNRAYCE 1993: Working safely with lead-acid batteries and photovoltaic power systems

NASA Astrophysics Data System (ADS)

Dephillips, M. P.; Moskowitz, P. D.; Fthenakis, V. M.

1992-11-01

The US Department of Energy (DOE) is sponsoring SUNRAYCE 93 to advance tile technology and use of photovoltaics and electric vehicles. Participants will use cars powered by photovoltaic modules and lead-acid storage batteries. This brochure, prepared for students and faculty participating in this race, outlines the health hazards presented by these electrical systems and gives guidance on strategies for their safe usage. At the outset, it should be noted that working with photovoltaic systems and batteries requires electric vehicle drivers and technicians to have 'hands-on' contact with the car on a daily basis. It is important that no one work near a photovoltaic energy system or battery, either in a vehicle or on the bench, unless they familiarize themselves with the components in use and know and observe safe work practices including the safety precautions described in the manuals provided by the various equipment vendors and this document.

[The epidemiological characteristics and correlated factors of daily hassles for thermal power plant workers].

PubMed

Wu, Hui; Yu, Shan-fa; Zhou, Wen-hui; Gu, Gui-zhen

2012-07-01

This study aimed to investigate the epidemiological characteristics and correlated factors of daily hassles among thermal power plant workers. A mass screening of daily hassles and correlated factors was conducted on 498 workers from a thermal power plant in Zhengzhou in July, 2008. The questionnaires included Daily Hassles Questionnaires, Work Roles Questionnaires, Job Content Questionnaires (Chinese version), Effort-Reward Imbalance (Chinese version), Work Locus of Control Scale and Type A Behavior Scale, with content covering demographic characters and occupational stress correlated factors among subjects. The daily hassles was divided into lower level and higher level according to scores, and the epidemiological characteristics and correlated factors of daily hassles were analyzed. A total of 446 qualified questionnaires were obtained, effective response rate was 89.6% (446/498). For respondents, the age was (36.96 ± 6.49) years old, working length of the current job was (12.05 ± 7.54) years, the daily hassles scores was (9.01 ± 2.50), and the prevalence rate of the higher level of daily hassles was 34.1% (152/446). The multiple non-conditional logistic regression analysis showed 5-14 years' working length of current job (OR = 0.451, 95%CI: 0.225 - 0.904), average income > 3000 yuan(OR = 0.372, 95%CI: 0.202 - 0.684), reward (OR = 0.557, 95%CI: 0.325 - 0.954) and coping strategy (OR = 0.552, 95%CI: 0.330 - 0.925) were negatively correlated with daily hassles, and shift-work (OR = 1.887, 95%CI: 1.108 - 3.215), effort (OR = 2.053, 95%CI: 1.198 - 3.519), psychological demand (OR = 1.797, 95%CI: 1.049 - 3.078), negative affectivity (OR = 3.421, 95%CI: 2.065 - 5.668) were positively correlated with daily hassles. The prevalence rate of the higher level of daily hassles was considerable high for thermal power plant workers. Its negative correlated factors included 5 - 14 years' working length of the current job, average income > 3000 yuan, reward and coping strategy and its positive corelated factors included shift-work, effort, psychological demand and negative affectivity.

[How do residents in urology evaluate their daily routine at work-a survey analysis].

PubMed

Necknig, U; Borowitz, R; Wöhr, M; Leyh, H; Weckermann, D

2018-05-28

The changing conditions in German hospitals is causing a shortage of young people. In order to identify starting point for improvements, the Bavarian association of urologists in collaboration with the German Society of Residents in Urology (GeSRU) conducted an online survey among residents in urology in summer of 2017. A standardised survey composed of 38 questions was distributed to participants through a mailing list of the GeSRU. Most questions were closed-ended; however, some did allow participants to respond by means of an open-ended answer. A total of 218 participants provided a total of 11,764 responses: 58% were female and 42% were male. Over 70% were aged between 31 and 35 years. In all, 29% of participants responded negatively to the question asking whether they feel like their medical studies at university prepared them well for the daily routine in their workplace. Participants particularly demanded a higher degree of practical experience during their studies, as well as more teaching of soft skills. In relation to choosing their specialisation, participants considered the intern year and their clinical traineeships as crucial factors. Participants did express appreciation of their field of specialization in relation to the broad range of available treatments, the opportunity of further specialising, the clientele of patients, the opportunity of working in a small team, innovations, and the high possibilities of opening their own medical practice. On a personal level, participants specifically wished for a more structured plan relating to their further internship, involving regular meetings. They also expressed the wish for more personalised career plans, more flexible work hours, and improved advanced training, both internally and externally. With the aim of making urology even more attractive, participants' wishes and suggestions should be taken into consideration. These, in general, involve a more structured training plan, better working conditions with part-time programmes, and improved surrounding conditions at the workplace, in particular for families.

The effect of a sit-stand workstation intervention on daily sitting, standing and physical activity: protocol for a 12 month workplace randomised control trial.

PubMed

Hall, Jennifer; Mansfield, Louise; Kay, Tess; McConnell, Alison K

2015-02-15

A lack of physical activity and excessive sitting can contribute to poor physical health and wellbeing. The high percentage of the UK adult population in employment, and the prolonged sitting associated with desk-based office-work, make these workplaces an appropriate setting for interventions to reduce sedentary behaviour and increase physical activity. This pilot study aims to determine the effect of an office-based sit-stand workstation intervention, compared with usual desk use, on daily sitting, standing and physical activity, and to examine the factors that underlie sitting, standing and physical activity, within and outside, the workplace. A randomised control trial (RCT) comparing the effects of a sit-stand workstation only and a multi-component sit-stand workstation intervention, with usual desk-based working practice (no sit-stand workstation) will be conducted with office workers across two organisations, over a 12 month period (N = 30). The multicomponent intervention will comprise organisational, environmental and individual elements. Objective data will be collected at baseline, and after 2-weeks, 3-months, 6-months and 12-months of the intervention. Objective measures of sitting, standing, and physical activity will be made concurrently (ActivPAL3™ and ActiGraph (GT3X+)). Activity diaries, ethnographic participant observation, and interviews with participants and key organisational personnel will be used to elicit understanding of the influence of organisational culture on sitting, standing and physical activity behaviour in the workplace. This study will be the first long-term sit-stand workstation intervention study utilising an RCT design, and incorporating a comprehensive process evaluation. The study will generate an understanding of the factors that encourage and restrict successful implementation of sit-stand workstation interventions, and will help inform future occupational wellbeing policy and practice. Other strengths include the objective measurement of physical activity during both work and non-work hours. Clinicaltrials.gov identifier NCT02172599, 22nd June 2014.

A comparison of ethical issues in nursing practice across nursing units.

PubMed

Park, Mihyun; Jeon, Sang Hee; Hong, Hyun-Ja; Cho, Sung-Hyun

2014-08-01

The complexity and variety of ethical issues in nursing is always increasing, and those issues lead to special concerns for nurses because they have critical impacts on nursing practice. The purpose of this study was to gather comprehensive information about ethical issues in nursing practice, comparing the issues in different types of nursing units including general units, oncology units, intensive care units, operating rooms, and outpatient departments. The study used a descriptive research design. Ethics/human rights issues encountered by nurses in their daily nursing practice were identified by using the Ethical Issues Scale. The study sample included 993 staff nurses working in a university hospital in South Korea. This study was approved by the University Institutional Review Board. Completed questionnaires were returned sealed with signed informed consent. The most frequently and disturbingly encountered issues across nursing units were "conflicts in the nurse-physician relationship," "providing care with a possible risk to your health," and "staffing patterns that limit patient access to nursing care." The findings of this study showed that nurses from different nursing units experienced differences in the types or frequency of ethical issues. In particular, intensive care units had the greatest means of all the units in all three component scales including end-of-life treatment issues, patient care issues, and human rights issues. Nurses experienced various ethical challenges in their daily practice. Of the ethical issues, some were distinctively and frequently experienced by nurses in a specific unit. This study suggested that identifying and understanding specific ethical issues faced by nurses in their own areas may be an effective educational approach to motivate nurses and to facilitate nurses' reflection on their experiences. © The Author(s) 2014.

Participatory design of a collaborative clinical trial protocol writing system.

PubMed

Weng, Chunhua; McDonald, David W; Sparks, Dana; McCoy, Jason; Gennari, John H

2007-06-01

To explore concrete approaches to socio-technical design of collaborative healthcare information systems and to design a groupware technology for collaborative clinical trial protocol writing. We conducted "quick and dirty ethnography" through semi-structured interviews, observational studies, and work artifacts analysis to understand the group work for protocol development. We used participatory design through evolutionary prototyping to explore the feature space of a collaborative writing system. Our design strategies include role-based user advocacy, formative evaluation, and change management. Quick and dirty ethnography helped us efficiently understand relevant work practice, and participatory design helped us engage users into design and bring out their tacit work knowledge. Our approach that intertwined both techniques helped achieve a "work-informed and user-oriented" design. This research leads to a collaborative writing system that supports in situ communication, group awareness, and effective work progress tracking. The usability evaluation results have been satisfactory. The system design is being transferred to an organizational tool for daily use.

Work outcomes and their predictors in the Redesigning Daily Occupations (ReDO) rehabilitation programme for women with stress-related disorders.

PubMed

Eklund, Mona; Wästberg, Birgitta A; Erlandsson, Lena-Karin

2013-04-01

Previous research has shown that the Redesigning Daily Occupations programme reduced the degree of sick leave and increased return to work rates among women on sick leave for stress-related disorders when compared with "care as usual". To further investigate the Redesigning Daily Occupations intervention, this study explored changes in the work situation from baseline to a 12-month follow-up in the Redesigning Daily Occupations group compared with the "care as usual" group and analysed any predictors of change. A matched-control design was used and 84 women were recruited. Objective (return to work and sick leave) and subjective work outcomes (perceptions of the worker role and the work environment) were explored. Potential predictors were clinical and demographic variables and an anxiety-depression factor. In both groups, large positive effect sizes from baseline to follow-up were found regarding the objective outcomes, a moderate positive effect size was found for perceived work environment, whereas perceived worker role remained unaffected. Previous work rehabilitation predicted objective work outcomes in both groups. Higher education and older age were predictors of subjective outcomes in the Redesigning Daily Occupations group, whereas a more severe anxiety-depression rating was negative for work environment ratings in the "care as usual" group. Return to work seemed possible without a change in the women's perceptions of the worker role; rather they renegotiated their view of the work environment. The Redesigning Daily Occupations programme was found to be promising, with a positive effect on return to work and sick leave reduction. It seemed more suitable for the higher educated and older women. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

Sculpting the brain

PubMed Central

Garcia-Lopez, Pablo

2012-01-01

Neuroculture, conceived as the reciprocal interaction between neuroscience and different areas of human knowledge is influencing our lives under the prism of the latest neuroscientific discoveries. Simultaneously, neuroculture can create new models of thinking that can significantly impact neuroscientists' daily practice. Especially interesting is the interaction that takes place between neuroscience and the arts. This interaction takes place at different, infinite levels and contexts. I contextualize my work inside this neurocultural framework. Through my artwork, I try to give a more natural vision of the human brain, which could help to develop a more humanistic culture. PMID:22363275

Daily spillover from family to work: A test of the work-home resources model.

PubMed

Du, Danyang; Derks, Daantje; Bakker, Arnold B

2018-04-01

The present study examines a mediated moderation model of the day-level effects of family hassles and family-work spillover (affect and cognition) on the relationship between job resources and employees' flourishing at work. Based on the work-home resources model, the authors hypothesized that demands from one domain (family) induce repetitive thoughts or negative feelings about those problems, so that individuals are not able to function optimally and to make full use of contextual resources in the other domain (work). Multilevel analyses of 108 Chinese working parents' 366 daily surveys revealed that the relationship between morning job resources and afternoon flourishing was significantly positive when previous day family hassles were low; the relationship became nonsignificant when previous day family hassles were high. In addition, as predicted, daily rumination also attenuated the relationship between morning job resources and afternoon flourishing, whereas daily affect did not. Finally, the moderating effect of previous day family hassles was mediated by daily rumination. The findings contribute to spillover theories by revealing the roles of affective and cognitive spillover from family to work. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The usefulness of the surgical knowledge and skills acquired via the university curriculum for doctors' medical practice several years after graduation.

PubMed

Zyluk, Andrzej; Puchalski, Piotr; Szlosser, Zbigniew

2015-01-01

Teaching surgery during university curriculum comprises transferring theoretical knowledge traditionally and simultaneously acquiring manual skills, i.e., suturing, stitch removal, limb immobilization, catheterization, and assisting operations. Observations of doctors several years after graduation led to the reflection that teachers' ideas about surgical knowledge and skills that are useful in daily practice frequently fail to meet the facts of the case. The objective of this study was to determine which part of the surgical knowledge and skills taught via the university surgical curriculum proved to be useful in the daily practice of young doctors. A custom-made questionnaire was designed and mailed to 200 randomly chosen doctors who had graduated from the medical faculty at the authors' university 5 to 6 years previously. The questionnaire comprised 9 items concerning the knowledge and skills that proved to be the most useful in participants' daily practice, regardless of their specialty. A total of 64 completed questionnaires were returned (32% of 200 sent) and were the subject of analysis. The most useful knowledge in daily practice was that acquired from general surgery, followed by oncological and vascular surgery. The most useful was knowledge about the rational interpretation of clinical symptoms and signs acquired from examination of the patient, followed by arriving at an accurate diagnosis through logical analysis, and next developing "oncological sensitivity" to diagnosing neoplasms. The most effective teaching model was specialized outpatient clinic rounds, followed by training manual skills on a model and classical ward-round teaching. The most frequently learned (acquired) manual skills were removal of stitches, rectal examination, and examination of the abdomen. Of these skills, the most useful in daily practice appeared to be removal of stitches, catheterization of the urinary bladder, and wound suturing. Learning and practicing manual skills followed by classical ward-round teaching was considered "skill-/competency-oriented teaching" surgery by all respondents. The results of this study show some discrepancy between the knowledge and skills taught during university surgical curriculum and their actual usefulness in the daily practice of graduates. Awareness of this should have an effect on modification of the curriculum and methods for undergraduate surgery teaching. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Assessment of Histological Remission in Ulcerative Colitis: Discrepancies Between Daily Practice and Expert Opinion.

PubMed

Römkens, Tessa E H; Kranenburg, Pim; Tilburg, Arjan van; Bronkhorst, Carolien; Nagtegaal, Iris D; Drenth, Joost P H; Hoentjen, Frank

2018-03-28

Histological remission [HR] is a potential treatment target in ulcerative colitis [UC]. Limited 'real world' data are available on the reliability of histological scoring when assessing minimal histological inflammation. The aim of this study was to investigate the reliability of UC histological scores in colonic biopsies showing mucosal healing [MH] and limited histological inflammation, and to compare the 'daily practice' histological assessment with expert reviews by gastrointestinal [GI] pathologists. We performed a retrospective single-centre study. Colonic biopsies from UC patients with MH [Mayo score ≤ 1] were included. All biopsies assessed in daily practice were reassessed by three blinded GI pathologists using three histological scores (Geboes score [GS], Riley score [RS], Harpaz [Gupta] Index [HGI]) and a global visual scale [GVS]. We evaluated inter- and intra-observer variation between GI pathologists and correlations between scores including the initial histological assessment using Cronbach's alpha and Spearman rho analysis. In total, 270 biopsies from 39 UC patients were included. The inter-observer concordance for all histological indexes was substantial to almost perfect [GS 0.84; HGI 0.61; GVS 0.74, RS 0.91]. Correlation between the RS and GS was almost perfect [R = 0.86], but we found no correlation between the primary histological assessment and reassessment by GI pathologists. Current UC histological scores reliably assess limited histological inflammation in UC patients. The discrepancy between the initial histological assessment and the reassessment by dedicated GI pathologists suggests a gap between daily practice and academic expertise. This issue may limit the implementation of HR as a treatment target for UC in daily practice.

Green Infrastructure and Watershed-Scale Hydrology in a Mixed Land Cover System

NASA Astrophysics Data System (ADS)

Hoghooghi, N.; Golden, H. E.; Bledsoe, B. P.

2017-12-01

Urbanization results in replacement of pervious areas (e.g., vegetation, topsoil) with impervious surfaces such as roads, roofs, and parking lots, which cause reductions in interception, evapotranspiration, and infiltration, and increases in surface runoff (overland flow) and pollutant loads and concentrations. Research on the effectiveness of different Green Infrastructure (GI), or Low Impact Development (LID), practices to reduce these negative impacts on stream flow and water quality has been mostly focused at the local scale (e.g., plots, small catchments). However, limited research has considered the broader-scale effects of LID, such as how LID practices influence water quantity, nutrient removal, and aquatic ecosystems at watershed scales, particularly in mixed land cover and land use systems. We use the Visualizing Ecosystem Land Management Assessments (VELMA) model to evaluate the effects of different LID practices on daily and long-term watershed-scale hydrology, including infiltration surface runoff. We focus on Shayler Crossing (SHC) watershed, a mixed land cover (61% urban, 24% agriculture, 15% forest) subwatershed of the East Fork Little Miami River watershed, Ohio, United States, with a drainage area of 0.94 km2. The model was calibrated to daily stream flow at the outlet of SHC watershed from 2009 to 2010 and was applied to evaluate diverse distributions (at 25% to 100% implementation levels) and types (e.g., pervious pavement and rain gardens) of LID across the watershed. Results show reduced surface water runoff and higher rates of infiltration concomitant with increasing LID implementation levels; however, this response varies between different LID practices. The highest magnitude response in streamflow at the watershed outlet is evident when a combination of LID practices is applied. The combined scenarios elucidate that the diverse watershed-scale hydrological responses of LID practices depend primarily on the type and extent of the implemented practices. Our work provides a key advancement toward improving current understanding of the effectiveness and efficiencies of LID approaches in mixed land cover watersheds.

Experience of Using Information Systems in Public Health Practice: Findings from a Qualitative Study

PubMed Central

Vest, Joshua R; Issel, L. Michele; Lee, Sean

2014-01-01

Objective Data collection and management by local health departments (LHDs) is a complex endeavor, complicated by system level and organizational factors. The purpose of this study was to describe the processes and use of information systems (IS) utilized for data collection, management, and sharing by LHD employees. Methods We interviewed a purposive sample of 12 staff working in the key public health practice areas of communicable disease control, immunizations, and vital records from three LHDs in different states. Our interview questions addressed job descriptions, daily activities, and the use and perceptions of both data and IS in support of their work. A content analytic approach was used to derive themes and categories common across programmatic areas. Results Local public health involves the use of mix of state-supplied and locally implemented IS supported by paper records. Additionally, each LHD in this study used at least one shadow system to maintain a duplicate set of information. Experiences with IS functionality and the extent to which it supported work varied by programmatic area, but inefficiencies, challenges in generating reports, limited data accessibility, and workarounds were commonly reported. Conclusions Current approaches to data management and sharing do not always support efficient public health practice or allow data to be used for organizational and community decision making. Many of the challenges to effective and efficient public health work were not solely technological. These findings suggest the need for interorganizational collaboration, increasing organizational capacity, workflow redesign, and end user training. PMID:24678380

[The use of an opect optic system in neurosurgical practice].

PubMed

Kalinovskiy, A V; Rzaev, D A; Yoshimitsu, K

2018-01-01

Modern neurosurgical practice is impossible without access to various information sources. The use of MRI and MSCT data during surgery is an integral part of the neurosurgeon's daily practice. Devices capable of managing an image viewer system without direct contact with equipment simplify working in the operating room. To test operation of a non-contact MRI and MSCT image viewer system in the operating room and to evaluate the system effectiveness. An Opect non-contact image management system developed at the Tokyo Women's Medical University was installed in one of the operating rooms of the Novosibirsk Federal Center of Neurosurgery in 2014. In 2015, the Opect system was used by operating surgeons in 73 surgeries performed in the same operating room. The system effectiveness was analyzed based on a survey of surgeons. The non-contact image viewer system occurred to be easy-to-learn for the personnel to operate this system, easy-to-manage it, and easy-to-present visual information during surgery. Application of the Opect system simplifies work with neuroimaging data during surgery. The surgeon can independently view series of relevant MRI and MSCT scans without any assistance.

Quality assurance and the need to evaluate interventions and audit programme outcomes.

PubMed

Zhao, Min; Vaartjes, Ilonca; Klipstein-Grobusch, Kerstin; Kotseva, Kornelia; Jennings, Catriona; Grobbee, Diederick E; Graham, Ian

2017-06-01

Evidence-based clinical guidelines provide standards for the provision of healthcare. However, these guidelines have been poorly implemented in daily practice. Clinical audit is a quality improvement tool to promote quality of care in daily practice and to improve outcomes through the systematic review of care delivery and implementation of changes. A major priority in the management of subjects with cardiovascular disease (CVD) management is secondary prevention by controlling cardiovascular risk factors and providing appropriate medical treatment. Clinical audits can be applied to monitor modifiable risk factors and evaluate quality improvements of CVD management in daily practice. Existing clinical audits have provided an overview of the burden of risk factors in subjects with CVD and reflect real-world risk factor recording and management. However, consistent and representative data from clinic audits are still insufficient to fully monitor quality improvement of CVD management. Data are lacking in particular from low- and middle-income countries, limiting the evaluation of CVD management quality by clinical audit projects in many settings. To support the development of clinical standards, monitor daily practice performance, and improve quality of care in CVD management at national and international levels, more widespread clinical audits are warranted.

The 9 to 5 routine: advancing the understanding of occupational transition for new immigrants.

PubMed

Movsessian, Yeraz

2013-01-01

This paper offers a reflection on temporal routines that underscore daily work life and work transitions. This reflection includes views of a Canadian student who examines work transitions through lived experiences and observation of the Chilean work/home routine. A narrative reflection on lived experience is used to examine 9 to 5 work transitions. There is a blending of work and daily life routines that provide a balance for workers in Chile and there are differences across countries in the valuing of work and daily life routines. Narrative reflections about work and work transitions can highlight differences at the macro level that can yield personal insights into challenges in transitioning into work for new immigrants.

'Once I had money in my pocket, I was every colour under the sun': using 'appearance biographies' to explore the meanings of appearance for people with dementia.

PubMed

Ward, Richard; Campbell, Sarah; Keady, John

2014-08-01

Appearance and the work invested in it by and for people with dementia are a neglected issue within dementia studies. In policy and practice there exists an assumption that the role of supporting a person to manage their appearance is easily assumed by another within caring encounters, only to be subsumed within the daily task-oriented provision of care. This paper reports on interviews conducted as part of the Hair and Care project, which explored questions of appearance and the meanings it holds with people with dementia. The research used 'appearance biographies', a method which allows for a range of topics to be considered about appearance throughout the life course, acting as a conduit for reminiscence and life story work. The paper reports on the key themes and findings from these interviews, discussing them in the context of a wider debate on dementia, self-expression and agency. A key question posed by the authors is whether appearance and the work invested in it are legitimate considerations for dementia care policy and practice. And if so, how should we make sense of this work and what significance should we attach to it? In seeking to answer these questions the authors position the perspectives and experiences of people with dementia as central to their analysis. A narrative framework is suggested as a useful basis on which to understand the work of managing appearance over the life course. The implications for policy and practice are outlined. Copyright © 2014 Elsevier Inc. All rights reserved.

Knowledge Transfer in Health Care Through Digitally Collecting Learning Experiences - Results of Witra Care.

PubMed

Behrends, Marianne; Kupka, Thomas; Schmeer, Regina; Meyenburg-Altwarg, Iris; Marschollek, Michael

2016-01-01

The goal of the project Witra Care was to investigate how far the use of mobile technology is suitable to collect experience-based knowledge of nurses. Nine new employees and seven experienced nurses received for six weeks a mobile phone or a tablet pc with a mobile application that allowed them to collect learning object as pictures, videos, audio files or notes. In Witra Care the nurses created 303 learning objects. They have found the collecting of learning experiences was helpful for their learning processes. The learning objects demonstrate various aspects of daily routines in nursing. The results of Witra Care show that the documentation of learning experiences with mobile devices helps to gather information about the practical knowledge in the daily work of nurses, identifies individual learning needs of the employees and supports them in their personal learning processes.

Using data to improve medical practice by measuring processes and outcomes of care.

PubMed

Nelson, E C; Splaine, M E; Godfrey, M M; Kahn, V; Hess, A; Batalden, P; Plume, S K

2000-12-01

The purpose of this article is to help clinicians expand their use of data to improve medical practice performance and to do improvement research. Clinical practices can be viewed as small, complex organizations (microsystems) that produce services for specific patient populations. These services can be greatly improved by embedding measurement into the flow of daily work in the practice. WHY DO IT?: Four good reasons to build measures into daily medical practice are to (1) diagnose strengths and weaknesses in practice performance; (2) improve and innovate in providing care and services using improvement research; (3) manage patients and the practice; and (4) evaluate changes in results over time. It is helpful to have a "physiological" model of a medical practice to analyze the practice, to manage it, and to improve it. One model views clinical practices as microsystems that are designed to generate desired health outcomes for specific subsets of patients and to use resources efficiently. This article provides case study examples to show what an office-based practice might look like if it were using front-line measurement to improve care and services most of the time and to conduct clinical improvement research some of the time. WHAT ARE THE PRINCIPLES FOR USING DATA TO IMPROVE PROCESSES AND OUTCOMES OF CARE?: Principles reflected in the case study examples--such as "Keep Measurement Simple. Think Big and Start Small" and "More Data Is Not Necessarily Better Data. Seek Usefulness, Not Perfection, in Your Measures"--may help guide the development of data to study and improve practice. HOW CAN A PRACTICE START TO USE DATA TO IMPROVE CARE AND CONDUCT IMPROVEMENT RESEARCH?: Practical challenges are involved in starting to use data for enhancing care and improvement research. To increase the odds for success, it would be wise to use a change management strategy to launch the startup plan. Other recommendations include "Establish a Sense of Urgency. (Survival Is Not Mandatory)" and "Create the Guiding Coalition. (A Small, Devoted Group of People Can Change the World)." Over the long term, we must transform thousands of local practice cultures so that useful data are used every day in countless ways to assist clinicians, support staff, patients, families, and communities.

How nurses and their work environment affect patient experiences of the quality of care: a qualitative study

PubMed Central

2014-01-01

Background Healthcare organisations monitor patient experiences in order to evaluate and improve the quality of care. Because nurses spend a lot of time with patients, they have a major impact on patient experiences. To improve patient experiences of the quality of care, nurses need to know what factors within the nursing work environment are of influence. The main focus of this research was to comprehend the views of Dutch nurses on how their work and their work environment contribute to positive patient experiences. Methods A descriptive qualitative research design was used to collect data. Four focus groups were conducted, one each with 6 or 7 registered nurses in mental health care, hospital care, home care and nursing home care. A total of 26 nurses were recruited through purposeful sampling. The interviews were audiotaped, transcribed and subjected to thematic analysis. Results The nurses mentioned essential elements that they believe would improve patient experiences of the quality of nursing care: clinically competent nurses, collaborative working relationships, autonomous nursing practice, adequate staffing, control over nursing practice, managerial support and patient-centred culture. They also mentioned several inhibiting factors, such as cost-effectiveness policy and transparency goals for external accountability. Nurses feel pressured to increase productivity and report a high administrative workload. They stated that these factors will not improve patient experiences of the quality of nursing care. Conclusions According to participants, a diverse range of elements affect patient experiences of the quality of nursing care. They believe that incorporating these elements into daily nursing practice would result in more positive patient experiences. However, nurses work in a healthcare context in which they have to reconcile cost-efficiency and accountability with their desire to provide nursing care that is based on patient needs and preferences, and they experience a conflict between these two approaches. Nurses must gain autonomy over their own practice in order to improve patient experiences. PMID:24923663

Daily fluctuations in teachers' well-being: a diary study using the Job Demands-Resources model.

PubMed

Simbula, Silvia

2010-10-01

The study tests the dynamic nature of the Job Demands-Resources model with regard to both motivational and health impairment processes. It does so by examining whether daily fluctuations in co-workers' support (i.e., a typical job resource) and daily fluctuations in work/family conflict (i.e., a typical job demand) predict day-levels of job satisfaction and mental health through work engagement and exhaustion, respectively. A total of 61 schoolteachers completed a general questionnaire and a daily survey over a period of five consecutive work days. Multilevel analyses provided evidence for both the above processes. Consistently with the hypotheses, our results showed that day-level work engagement mediated the impact of day-level co-workers' support on day-level job satisfaction and day-level mental health, after general levels of work engagement and outcome variables had been controlled for. Moreover, day-level exhaustion mediated the relationship between day-level work/family conflict and day-level job satisfaction and day-level mental health after general levels of exhaustion and outcome variables had been controlled for. These findings provide new insights into the dynamic psychological processes that determine daily fluctuations in employee well-being. Such insights may be transformed into job redesign strategies and other interventions designed to enhance work-related psychological well-being on a daily level.

Oral health knowledge and practices of dentists practicing in a teaching hospital in Nigeria.

PubMed

Jegede, Akinlolu Tolulope; Oyedele, Titus Ayodeji; Sodipo, Babasola Olufemi; Folayan, Morenike Oluwatoyin

2016-01-01

To assess the oral health practices and knowledge of practicing dentists at a tertiary health institution in Nigeria, and the possible association of age and sex with caries prevention practices. A cross-sectional study was conducted. All practicing dentists in the institution were eligible to participate in the study. A questionnaire that assessed oral health practices and knowledge was administered. Respondents were expected to select the most appropriate responses that reflected their knowledge of oral health practices and caries prevention practices. Questions included assessment of knowledge and practice of tooth brushing, flossing, refined carbohydrate intake, and dental service utilization. Participants' responses were scored and dichotomized to poor and good knowledge, and poor and good practices, using the median scores. Bivariate analysis was conducted to identify factors associated with good and poor oral health practices, and good and poor knowledge. Fifty-two eligible study participants were accessible at the time of questionnaire administration. Only 46 respondents returned the filled questionnaire giving a response rate of 88.5%. The age of respondents ranged between 25 and 48 years. The majority of respondents had good oral health practices (65.2%) and good oral health knowledge (85%). However, few respondents had good caries prevention practices: 39.2% brushed at least twice daily, 45.7% took refined carbohydrate less than once daily, 36.9% used dental floss at least once daily, and 60.9% undertook preventive dental care. The correlation between the dentists' oral health knowledge score and oral health practices score was insignificant (0.90; P = 0.55). A large number of dentists practicing in the tertiary hospital had good oral health practices and good oral health knowledge. However, the proportion of dentists with good caries prevention practices was low.

Theory and practice of clinical ethics support services: narrative and hermeneutical perspectives.

PubMed

Porz, Rouven; Landeweer, Elleke; Widdershoven, Guy

2011-09-01

In this paper we introduce narrative and hermeneutical perspectives to clinical ethics support services (CESS). We propose a threefold consideration of 'theory' and show how it is interwoven with 'practice' as we go along. First, we look at theory in its foundational role: in our case 'narrative ethics' and 'philosophical hermeneutics' provide a theoretical base for clinical ethics by focusing on human identities entangled in stories and on moral understanding as a dialogical process. Second, we consider the role of theoretical notions in helping practitioners to understand their situation in clinical ethics practice, by using notions like 'story', 'responsibility', or 'vulnerability' to make explicit and explain their practical experience. Such theoretical notions help us to interpret clinical situations from an ethical perspective and to foster moral awareness of practitioners. And, thirdly, we examine how new theoretical concepts are developed by interpreting practice, using practice to form and improve our ethical theory. In this paper, we discuss this threefold use of theory in clinical ethics support services by reflecting on our own theoretical assumptions, methodological steps and practical experiences as ethicists, and by providing examples from our daily work. In doing so, we illustrate that theory and practice are interwoven, as theoretical understanding is dependent upon practical experience, and vice-versa. © 2011 Blackwell Publishing Ltd.

Ethical decision-making in hospice care.

PubMed

Walker, Andreas; Breitsameter, Christof

2015-05-01

Hospices are based on a holistic approach which places the physical, psychological, social and spiritual welfare of their patients at the forefront of their work. Furthermore, they draw up their own mission statements which they are at pains to follow and seek to conduct their work in accordance with codes of ethics and standards of care. Our study researched what form the processes and degrees of latitude in decision-making take in practice when questions of an ethical and ethically relevant nature arise. We used a qualitative approach. Data collection and evaluation was based on the methods of grounded theory. The study was reported to the relevant Ethics Commission who had raised no objections following the submission of the study protocol. The study at the hospices was approved by the directors of the hospices and the nursing teams. The rights of the participants were protected by obtaining informed consent. Medication in the prefinal phase and questions affecting the provision of solids and liquids in the end-of-life phase have an ethical dimension. In the context of these two fields, decisions are taken collectively. A nurse's individual (and ethically relevant) leeway in decision-making processes is restricted to the nurse's own style of administering care. The nurse's decision-making often depends to a far greater degree on her ability to adapt her concept of ideal care to fit the practical realities of her work than to any conceptual framework. An adaptive process is necessary for the nurse because she is required to incorporate the four pillars of hospice care - namely, physical, psychological, social and spiritual care - into the practice of her daily work. Ethically relevant decisions are often characterised by nurses adjusting their aspiration levels to the practical conditions with which they are confronted. © The Author(s) 2014.

Moral case deliberation.

PubMed

Tan, Daniel Y B; Ter Meulen, Bastiaan C; Molewijk, Albert; Widdershoven, Guy

2018-06-01

Ethical dilemmas in general are characterised by a choice between two mutually excluding options neither of which is satisfactory, because there always will be a form of moral damage. Within the context of medicine several ethics support services have been developed to support healthcare professionals in dealing with ethical dilemmas, including moral case deliberation. In this article, we describe how moral case deliberation works in daily practice, illustrated with a case example from the neurology ward. The article is meant as an introduction to moral case deliberation according to the dilemma method. We show its relevance to the clinic and the context needed to put it into practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Artificial intelligence--the knowledge base applied to nephrology].

PubMed

Sancipriano, G P

2005-01-01

The idea that efficacy efficiency, and quality in medicine could not be reached without sorting the huge knowledge of medical and nursing science is very common. Engineers and computer scientists have developed medical software with great prospects for success, but currently these software applications are not so useful in clinical practice. The medical doctor and the trained nurse live the 'information age' in many daily activities, but the main benefits are not so widespread in working activities. Artificial intelligence and, particularly, export systems charm health staff because of their potential. The first part of this paper summarizes the characteristics of 'weak artificial intelligence' and of expert systems important in clinical practice. The second part discusses medical doctors' requirements and the current nephrologic knowledge bases available for artificial intelligence development.

Teachers as researchers: a narrative pedagogical approach to transforming a graduate family and health promotion course.

PubMed

Brykczynski, Karen A

2012-01-01

Scholarship of teaching in nursing is illustrated by describing the development, implementation, evaluation, and revision of a family and health promotion course for graduate family nurse practitioner students. A narrative pedagogical approach that combines conventional pedagogy with action research is used. The work, an example of curriculum as dialogue, illustrates how teachers can incorporate research, evaluation, and reflection into their daily teaching practice. Given adequate support, these evaluation and research activities could constitute part of the scholarship of teaching, and, as such, would warrant allocation of time in faculty workloads and formal acknowledgment in annual performance evaluations and promotion and tenure decisions. The importance of increasing the clinical relevance of the scholarship of teaching in a practice discipline such as nursing is also emphasized.

Health promotion, occupational therapy and multiculturalism: lessons from research.

PubMed

Dyck, I

1993-08-01

Principles of occupational therapy practice make the profession an important potential partner in health promotion initiatives for immigrant groups. Health promotion embodies the principles of self-definition of health needs by target groups, and working with a community in initiating and supporting programmes. This paper discusses the implications of an exploratory study of the daily activities of immigrant Indo-Canadian mothers for translating health promotion principles into practice. The research process and an analysis of interviews conducted with the women suggest factors to consider in using a health promotion framework with immigrants who have experienced social and economic dislocation through the immigration process. Discussion of household structure, divisions of labour, childcare strategies, and parenting concerns raises issues requiring particular attention in sharing occupational therapy skills and knowledge with ethnocultural communities.

Community Pharmacists' Perceptions about Pharmaceutical Care of Traditional Medicine Products: A Questionnaire-Based Cross-Sectional Study in Guangzhou, China

PubMed Central

Chen, Xi; Ung, Carolina Oi Lam; Hu, Hao; Liu, Xiaodan; Zhao, Jing; Hu, Yuanjia; Li, Peng; Yang, Qing

2016-01-01

This study aimed to investigate community pharmacists' perceived responsibility, practice behaviors, knowledge, perceived barriers, and improvement measures towards provision of pharmaceutical care in relation to traditional medicine (TM) products in Guangzhou, China. A self-completion questionnaire was used to survey licensed pharmacists working at community pharmacies. This study found that the community pharmacists in Guangzhou, China, were involved in the provision of TM products during their daily practice but only provided pharmaceutical care in this area with a passive attitude. Extrinsic barriers such as lack of scientific evidence for the safety and efficacy of TM products and unclear definition of their roles and responsibilities were highlighted while intrinsic factors such as insufficient TM knowledge were identified. PMID:27066101

Transmission of vocational skills between experienced and new hospital workers.

PubMed

Thébault, Jeanne; Gaudart, Corinne; Cloutier, Esther; Volkoff, Serge

2012-01-01

This article presents the results of a study currently underway looking at the transmission of vocational skills between health care workers in a French hospital. The aim was to show that health care workers, in addition to their work with patients, also have to incorporate the transmission of vocational skills into their daily activities. Thirteen transmission situations were observed and analyzed by means of an activity-focused ergonomic work analysis, with the aim of reporting on this "invisible work". The population studied was composed of nurses and the nursing assistants from three different units in one hospital. The results show that the work required to integrate and supervise new staff members is left to the discretion of health care workers. This means they are constantly required to arbitrate on both an individual and collective basis between providing health care for patients and supporting new members of staff. The content of the transmission goes beyond the prescribed tasks and technical knowledge, as staff members also pass on their professional strategies (individual and collective), rules of practice and ethical considerations. Supervising students also offers experienced workers the opportunity to share their professional practices. This study highlights the issues arising from this transmission activity for the experienced workers, new workers, patients and the hospital.

The Daily Disciplines of Leadership: How To Improve Student Achievement, Staff Motivation, and Personal Organization. The Jossey-Bass Education Series.

ERIC Educational Resources Information Center

Reeves, Douglas B.

This guide is intended to be a practical primer to help education leaders meet the daily challenges of school leadership. It shows how to include leadership in an integrated system of educational accountability, teaching, and curriculum for student achievement; how to do away with ineffective, obsolete, and unnecessary practices; and how to…

Students discussing their mathematical ideas: the role of the teacher

NASA Astrophysics Data System (ADS)

Pijls, Monique; Dekker, Rijkje

2011-12-01

This article adds to current research on enhancing student discourse in mathematics teaching specifically in secondary schools but with equal relevance to elementary schools. Three mathematics teachers in secondary education were confronted with the question of how to encourage students to discuss their work with each other in the daily practice of their mathematical lessons. In response to this question the teachers devised three different approaches to encourage student discourse. One of the teachers chose to experiment with another setting to perform mathematical tasks that involved students working together on a group test. The second teacher experimented with a new kind of help when students were working on their maths tasks and asked for assistance. The third created a new setting in which the teacher (temporarily) did not provide mathematical hints and the students had to solve their own problems. The three teachers were very motivated, but they all had difficulties in not giving explanations themselves when supporting their students in their collaborative mathematical learning. They found that temporarily diminishing their product help stimulated discussion between students. It also became clear that the process of teacher reflection and follow-up discussions with the researcher/observers promoted changes of practice.

Working practices and success of infection prevention and control teams: a scoping study.

PubMed

Hale, R; Powell, T; Drey, N S; Gould, D J

2015-02-01

Little research has been undertaken on how infection prevention and control (IPC) teams operate and how their effectiveness is assessed. This review aimed to explore how IPC teams embed IPC throughout hospitals, balance outbreak management with strategic aspects of IPC work (e.g. education), and how IPC team performance is measured. A scoping exercise was performed combining literature searches, evidence synthesis, and intelligence from expert advisers. Eleven publications were identified. One paper quantified how IPC nurses spend their time, two described daily activities of IPC teams, five described initiatives to embed IPC across organizations following legislation since 1999 in the UK or changes in the delivery of healthcare, and three explored the contribution of IPC intermediaries (link nurses and champions). Eight publications reported research findings. The others reported how IPC teams are embedding IPC practice in UK hospitals. In conclusion, there is scope for research to explore different models of IPC team-working and effectiveness, and cost-effectiveness. Other topics that need addressing are the willingness and ability of ward staff to assume increased responsibility for IPC and the effectiveness of intermediaries. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

The significance of routines in nursing practice.

PubMed

Rytterström, Patrik; Unosson, Mitra; Arman, Maria

2011-12-01

The aim of this study was to illuminate the significance of routines in nursing practice. Clinical nursing is performed under the guidance of routines to varying degrees. In the nursing literature, routine is described as having both negative and positive aspects, but use of the term is inconsistent, and empirical evidence is sparse. In the research on organisational routines, a distinction is made between routine as a rule and routine as action. A qualitative design using a phenomenological-hermeneutic approach. Data collection from three focus groups focused on nurses' experience of routines. Seventeen individual interviews from a previous study focusing on caring culture were also analysed in a secondary qualitative analysis. All participants were employed as 'qualified nursing pool' nurses. Routines are experienced as pragmatic, obstructive and meaningful. The aim of the pragmatic routine was to ensure that daily working life works; this routine is practised more on the basis of rational arguments and obvious intentions. The obstructive routine had negative consequences for nursing practice and was described as nursing losing its humanity and violating the patient's integrity. The meaningful routine involved becoming one with the routine and for the nurses, it felt right and meaningful to adapt to it. Routines become meaningful when the individual action is in harmony with the cultural pattern on which the nursing work is based. Instead of letting contemporary practice passively become routine, routines can be assessed and developed using research and theoretical underpinnings as a starting point for nursing practice. Leaders have a special responsibility to develop and support meaningful routines. One approach could be to let wards examine their routines from a patient perspective on the basis of the themes of pragmatic, meaningful and obstructive routine. © 2010 Blackwell Publishing Ltd.

Community nursing needs more silver surfers: a questionnaire survey of primary care nurses' use of information technology

PubMed Central

Chan, Tom; Brew, Sarah; de Lusignan, Simon

2004-01-01

Background In the UK the health service is investing more than ever before in information technology (IT) and primary care nurses will have to work with computers. Information about patients will be almost exclusively held in electronic patient records; and much of the information about best practice is most readily accessible via computer terminals. Objective To examine the influence of age and nursing profession on the level of computer use. Methods A questionnaire was developed to examine: access, training received, confidence and use of IT. The survey was carried out in a Sussex Primary Care Trust, in the UK. Results The questionnaire was sent to 109 nurses with a 64% response rate. Most primary care nurses (89%) use their computer regularly at work: 100% of practice nurses daily, compared with 60% of district nurses and 59% of health visitors (p < 0.01). Access to IT was not significantly different between different age groups; but 91% of practice nurses had their own computer while many district nurses and health visitors had to share (p < 0.01). Nurses over 50 had received more training that their younger colleagues (p < 0.01); yet despite this, they lacked confidence and used computers less (p < 0.001). 96% of practice nurses were confident at in using computerised medical records, compared with 53% of district nurses and 44% of health visitors (p < 0.01.) One-to-one training and workshops were the preferred formats for training, with Internet based learning and printed manuals the least popular (p < 0.001). Conclusions Using computers in the surgery has become the norm for primary care nurses. However, nurses over 50, working out in the community, lack the confidence and skill of their younger and practice based colleagues. PMID:15469616

Impact of a behavioural sleep intervention on symptoms and sleep in children with attention deficit hyperactivity disorder, and parental mental health: randomised controlled trial

PubMed Central

Sciberras, Emma; Mensah, Fiona; Gerner, Bibi; Efron, Daryl; Khano, Sonia; Oberklaid, Frank

2015-01-01

Objective To examine whether behavioural strategies designed to improve children’s sleep problems could also improve the symptoms, behaviour, daily functioning, and working memory of children with attention deficit hyperactivity disorder (ADHD) and the mental health of their parents. Design Randomised controlled trial. Setting 21 general paediatric practices in Victoria, Australia. Participants 244 children aged 5-12 years with ADHD attending the practices between 2010 and 2012. Intervention Sleep hygiene practices and standardised behavioural strategies delivered by trained psychologists or trainee paediatricians during two fortnightly consultations and a follow-up telephone call. Children in the control group received usual clinical care. Main outcome measures At three and six months after randomisation: severity of ADHD symptoms (parent and teacher ADHD rating scale IV—primary outcome), sleep problems (parent reported severity, children’s sleep habits questionnaire, actigraphy), behaviour (strengths and difficulties questionnaire), quality of life (pediatric quality of life inventory 4.0), daily functioning (daily parent rating of evening and morning behavior), working memory (working memory test battery for children, six months only), and parent mental health (depression anxiety stress scales). Results Intervention compared with control families reported a greater decrease in ADHD symptoms at three and six months (adjusted mean difference for change in symptom severity −2.9, 95% confidence interval −5.5 to −0.3, P=0.03, effect size −0.3, and −3.7, −6.1 to −1.2, P=0.004, effect size −0.4, respectively). Compared with control children, intervention children had fewer moderate-severe sleep problems at three months (56% v 30%; adjusted odds ratio 0.30, 95% confidence interval 0.16 to 0.59; P<0.001) and six months (46% v 34%; 0.58, 0.32 to 1.0; P=0.07). At three months this equated to a reduction in absolute risk of 25.7% (95% confidence interval 14.1% to 37.3%) and an estimated number needed to treat of 3.9. At six months the number needed to treat was 7.8. Approximately a half to one third of the beneficial effect of the intervention on ADHD symptoms was mediated through improved sleep, at three and six months, respectively. Intervention families reported greater improvements in all other child and family outcomes except parental mental health. Teachers reported improved behaviour of the children at three and six months. Working memory (backwards digit recall) was higher in the intervention children compared with control children at six months. Daily sleep duration measured by actigraphy tended to be higher in the intervention children at three months (mean difference 10.9 minutes, 95% confidence interval −19.0 to 40.8 minutes, effect size 0.2) and six months (9.9 minutes, −16.3 to 36.1 minutes, effect size 0.3); however, this measure was only completed by a subset of children (n=54 at three months and n=37 at six months). Conclusions A brief behavioural sleep intervention modestly improves the severity of ADHD symptoms in a community sample of children with ADHD, most of whom were taking stimulant medications. The intervention also improved the children’s sleep, behaviour, quality of life, and functioning, with most benefits sustained to six months post-intervention. The intervention may be suitable for use in primary and secondary care. Trial registration Current Controlled Trials ISRCTN68819261. PMID:25646809

Impact of a behavioural sleep intervention on symptoms and sleep in children with attention deficit hyperactivity disorder, and parental mental health: randomised controlled trial.

PubMed

Hiscock, Harriet; Sciberras, Emma; Mensah, Fiona; Gerner, Bibi; Efron, Daryl; Khano, Sonia; Oberklaid, Frank

2015-01-20

To examine whether behavioural strategies designed to improve children's sleep problems could also improve the symptoms, behaviour, daily functioning, and working memory of children with attention deficit hyperactivity disorder (ADHD) and the mental health of their parents. Randomised controlled trial. 21 general paediatric practices in Victoria, Australia. 244 children aged 5-12 years with ADHD attending the practices between 2010 and 2012. Sleep hygiene practices and standardised behavioural strategies delivered by trained psychologists or trainee paediatricians during two fortnightly consultations and a follow-up telephone call. Children in the control group received usual clinical care. At three and six months after randomisation: severity of ADHD symptoms (parent and teacher ADHD rating scale IV-primary outcome), sleep problems (parent reported severity, children's sleep habits questionnaire, actigraphy), behaviour (strengths and difficulties questionnaire), quality of life (pediatric quality of life inventory 4.0), daily functioning (daily parent rating of evening and morning behavior), working memory (working memory test battery for children, six months only), and parent mental health (depression anxiety stress scales). Intervention compared with control families reported a greater decrease in ADHD symptoms at three and six months (adjusted mean difference for change in symptom severity -2.9, 95% confidence interval -5.5 to -0.3, P=0.03, effect size -0.3, and -3.7, -6.1 to -1.2, P=0.004, effect size -0.4, respectively). Compared with control children, intervention children had fewer moderate-severe sleep problems at three months (56% v 30%; adjusted odds ratio 0.30, 95% confidence interval 0.16 to 0.59; P<0.001) and six months (46% v 34%; 0.58, 0.32 to 1.0; P=0.07). At three months this equated to a reduction in absolute risk of 25.7% (95% confidence interval 14.1% to 37.3%) and an estimated number needed to treat of 3.9. At six months the number needed to treat was 7.8. Approximately a half to one third of the beneficial effect of the intervention on ADHD symptoms was mediated through improved sleep, at three and six months, respectively. Intervention families reported greater improvements in all other child and family outcomes except parental mental health. Teachers reported improved behaviour of the children at three and six months. Working memory (backwards digit recall) was higher in the intervention children compared with control children at six months. Daily sleep duration measured by actigraphy tended to be higher in the intervention children at three months (mean difference 10.9 minutes, 95% confidence interval -19.0 to 40.8 minutes, effect size 0.2) and six months (9.9 minutes, -16.3 to 36.1 minutes, effect size 0.3); however, this measure was only completed by a subset of children (n=54 at three months and n=37 at six months). A brief behavioural sleep intervention modestly improves the severity of ADHD symptoms in a community sample of children with ADHD, most of whom were taking stimulant medications. The intervention also improved the children's sleep, behaviour, quality of life, and functioning, with most benefits sustained to six months post-intervention. The intervention may be suitable for use in primary and secondary care.Trial registration Current Controlled Trials ISRCTN68819261. © Hiscock et al 2015.

Mothers raising children with sickle cell disease at the intersection of race, gender, and illness stigma.

PubMed

Burnes, David P R; Antle, Beverley J; Williams, Charmaine C; Cook, Lisa

2008-08-01

This qualitative study used the long interview method with Canadian mothers of African and Caribbean descent to understand the underresearched experience of raising a child with sickle cell disease (SCD). Mothers' realities were explored through three levels of social organization: daily caregiver coping (micro level); community views of SCD, such as stigma (meso level); and systemic SCD health care provision (macro level). Through the use of population health and structural social work perspectives, mothers' experiences were examined in the context of perceived gender and racial oppression. Saturation was achieved after initial interviews with 10 participants and a four-month postinterview with half of the participants. Mothers commonly reported several daily coping challenges: fear of their children's death, separation anxiety, loss of control over life, helplessness, and loneliness/isolation. SCD stigma interacted with racism, contributed to social isolation, and prevented families from organizing as a group. All mothers perceived racism as a salient factor behind inadequate mainstream SCD health care. Recommendations to improve SCD health care and implications for social work practice and research are discussed. This is the first known Canadian psychosocial study of SCD and investigation into SCD stigma outside of rural Nigeria.

Validity of using a work habits scale for the daily evaluation of nurse anesthetists' clinical performance while controlling for the leniencies of the rating anesthesiologists.

PubMed

Dexter, Franklin; Ledolter, Johannes; Hindman, Bradley J

2017-11-01

Anesthesiologists can provide psychometrically reliable daily evaluations of certified registered nurse anesthetist (CRNA) work habits for purposes of the mandatory ongoing professional practice evaluation (OPPE). Our goal was to evaluate the validity of assessing CRNA work habits. Observational study. Large teaching hospital. N=77 anesthesiologists evaluated work habits of N=67 CRNAs. The non-technical attribute of work habits was measured on a 6-item scale (e.g., 1="Only assumed responsibility when forced to, and failed to follow through consistently" versus 5="Consistently identified tasks and completed them efficiently and thoroughly"). One year of scores were used to assess validity. Each daily evaluation could also be accompanied by a written comment. Content analysis of comments was performed using two years of data. Statistical analyses were performed using mixed effects logistic regression, treating each anesthesiologist as a fixed effect to compensate for the leniency of their ratings. The N=77 anesthesiologists' response rate was 97.3%, obtained at a mean 2.93days after the request. The internal consistency of the scale was large: Cronbach's alpha 0.952. Controlling the false discovery rate at 5.0%, among the 67 CRNAs, 8 were significantly below average (each P≤0.0048) and 6 were above average (each P≤0.0018). During the 6months after CRNAs knew that their work habits scores would be used for OPPE, there were significant increases in the scores compared with the preceding 6months (odds ratio 1.93, P<0.0001). Greater CRNA's qualitative annual evaluation scores made by the chief CRNA, without knowledge of the work habit scores or comments, were associated with greater odds of the CRNA's leniency-adjusted work habit scores equaling 5.00 (odds ratio 1.53, P=0.0004). Comments of negative sentiment made by the anesthesiologists were associated with greater odds of the leniency-adjusted work habit scores being <5.00 (odds ratio 54.5, P<0.0001). Even though the anesthesiologists were already providing information about work habits using the work habits scale, approximately half the comments of negative sentiment included the theme of work habits (92/153, 60.1%). Reporting OPPE metrics are mandatory for the maintenance of clinical privileges of anesthesia practitioners in the USA. Basing such peer review on work habits can be quantitative, psychometrically reliable, and valid. Copyright © 2017 Elsevier Inc. All rights reserved.

Timing matters: length of leave and working mothers' daily reentry regrets.

PubMed

Wiese, Bettina S; Ritter, Johannes O

2012-11-01

Dealing with developmental tasks in work and family domains is an important challenge for young and middle-aged adults. We investigated a transition that has evolved into a normative task for women, namely, the retransition back to paid work following maternity leave. In a diary study with 149 mothers who had just returned to work, we examined the daily experienced regrets concerning this return. In addition to personal resources (i.e., emotional stability, feeling prepared for the transition) and financial requirements needed to return to work, daily experienced family stress predicted decisional regrets. Moreover, our results suggest that leave length is related to psychological resilience in the face of day-to-day stress experiences: Late returners reported fewer regrets in general and were unaffected by daily family stress. Return-to-work regrets, in turn, were predictive of withdrawal intentions. This underlines the relevancy of the timing of the transition back to work in terms of successful development during this life phase.

Surveying the Impact of Work Hours and Schedules on Commercial Motor Vehicle Driver Sleep.

PubMed

Hege, Adam; Perko, Michael; Johnson, Amber; Yu, Chong Ho; Sönmez, Sevil; Apostolopoulos, Yorghos

2015-06-01

Given the long hours on the road involving multiple and interacting work stressors (i.e., delivery pressures, irregular shifts, ergonomic hazards), commercial drivers face a plethora of health and safety risks. Researchers goal was to determine whether and to what extent long-haul trucker work schedules influence sleep duration and quality. Survey and biometric data collected from male long-haul truck drivers at a major truckstop in central North Carolina over a six month period. Daily hours worked (mean = 11 hours, 55 minutes) and frequency of working over government-mandated daily HOS regulations (23.8% "frequently or always") were statistically significant predictors of sleep duration. Miles driven per week (mean = 2,812.61), irregular daily hours worked (63.8%), and frequency of working over the daily hour limit (23.8% "frequently or always") were statistically significant predictors of sleep quality. Implications of findings suggest a comprehensive review of the regulations and operational conditions for commercial motor vehicle drivers be undertaken.

[Competence development in undergraduate medical schools: a model with entrusted professional activities].

PubMed

Torruco-García, Uri; Ortiz-Montalvo, Armando; Varela-Ruiz, Margarita Elena; Hamui-Sutton, Alicia

2016-01-01

Today´s relevant educational models emphasize that a great part of learning be situated and reflexive; one of those is the Entrusted Professional Activities model. The study objective was to develop a model that integrates Entrusted Professional Activities with a medical school curriculum. From October 2012 a multidisciplinary group met to develop a model with the specialty of obstetrics and gynecology. From two published models of Entrusted Professional Activities and the curriculum of a school of medicine, blocks, units, and daily clinical practice charts were developed. The thematic content of the curriculum was integrated with the appropriate milestones for undergraduate students and the clinical practice needed to achieve it. We wrote a manual with 37 daily clinical practice charts for students (18 of gynecology and 19 of obstetrics) and 37 for teachers. Each chart content was the daily clinical practice, reflection activities, assessment instruments, and bibliography. It is feasible to combine a model of Entrusted Professional Activities with an undergraduate curriculum, which establishes a continuum with postgraduate education.

Practice activities of privately-practicing nurse practitioners: Results from an Australian survey.

PubMed

Currie, Jane; Chiarella, Mary; Buckley, Thomas

2018-03-01

To facilitate expansion of privately-practicing nurse practitioners in community and primary care settings, a legislative amendment in 2010 made privately-practicing nurse practitioners eligible to provide services subsidised through the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme. To evaluate their practice activities, a national survey of privately-practicing nurse practitioners in Australia was conducted, and data analysed using descriptive statistics and thematic analysis (n = 73). As part of their role, 96% (n = 70) participants reported undertaking direct patient care, 95% (n = 69) patient education and health promotion, 95% (n = 69) prescribed medications, 92% (n = 67) referred patients for diagnostic investigations, and 88% (n = 64) reported making a diagnosis. Over 50% of participants saw up to 15 patients daily, and 80% (n = 58) treated the same patients on a regular basis. Of the participants, 59% (n = 43) perceived that they worked to their full scope of practice. The mainstay of privately-practicing nurse practitioner services is provision of direct patient care in community and primary healthcare settings, suggesting they have emerging potential in addressing the ever-increasing demand for healthcare in Australia. © 2017 John Wiley & Sons Australia, Ltd.

How do Supervising Clinicians of a University Hospital and Associated Teaching Hospitals Rate the Relevance of the Key Competencies within the CanMEDS Roles Framework in Respect to Teaching in Clinical Clerkships?

PubMed

Jilg, Stefanie; Möltner, Andreas; Berberat, Pascal; Fischer, Martin R; Breckwoldt, Jan

2015-01-01

In German-speaking countries, the physicians' roles framework of the "Canadian Medical Education Directives for Specialists" (CanMEDS) is increasingly used to conceptualize postgraduate medical education. It is however unclear, whether it may also be applied to the final year of undergraduate education within clinical clerkships, called "Practical Year" (PY). Therefore, the aim of this study was to explore how clinically active physicians at a university hospital and at associated teaching hospitals judge the relevance of the seven CanMEDS roles (and their (role-defining) key competencies) in respect to their clinical work and as learning content for PY training. Furthermore, these physicians were asked whether the key competencies were actually taught during PY training. 124 physicians from internal medicine and surgery rated the relevance of the 28 key competencies of the CanMEDS framework using a questionnaire. For each competency, following three aspects were rated: "relevance for your personal daily work", "importance for teaching during PY", and "implementation into actual PY teaching". In respect to the main study objective, all questionnaires could be included into analysis. All seven CanMEDS roles were rated as relevant for personal daily work, and also as important for teaching during PY. Furthermore, all roles were stated to be taught during actual PY training. The roles "Communicator", "Medical Expert", and "Collaborator" were rated as significantly more important than the other roles, for all three sub-questions. No differences were found between the two disciplines internal medicine and surgery, nor between the university hospital and associated teaching hospitals. Participating physicians rated all key competencies of the CanMEDS model to be relevant for their personal daily work, and for teaching during PY. These findings support the suitability of the CanMEDS framework as a conceptual element of PY training.

Why Don’t You Go to Bed on Time? A Daily Diary Study on the Relationships between Chronotype, Self-Control Resources and the Phenomenon of Bedtime Procrastination

PubMed Central

Kühnel, Jana; Syrek, Christine J.; Dreher, Anne

2018-01-01

Background: This daily diary study investigates the phenomenon of bedtime procrastination. Bedtime procrastination is defined as going to bed later than intended, without having external reasons for doing so. We highlight the role chronotype (interindividual differences in biological preferences for sleep-wake-times) plays for bedtime procrastination. Moreover, we challenge the view that bedtime procrastination is the result of a lack of self-regulatory resources by investigating momentary self-regulatory resources as a predictor of day-specific bedtime procrastination. Methods: One-hundred and eight employees working in various industries completed a general electronic questionnaire (to assess chronotype and trait self-control) and two daily electronic questionnaires (to assess momentary self-regulatory resources before going to bed and day-specific bedtime procrastination) over the course of five work days, resulting in 399 pairs of matched day-next-day measurements. Results: Results of multilevel regression analyses showed that later chronotypes (also referred to as evening types or ‘owls’) tended to report more bedtime procrastination on work days. Moreover, for late chronotypes, day-specific bedtime procrastination declined over the course of the work week. This pattern is in line with expectations derived from chronobiology and could not be explained by trait self-control. In addition, on evenings on which employees had less self-regulatory resources available before going to bed—compared to evenings on which they had more self-regulatory resources available before going to bed—employees showed lower bedtime procrastination. This finding contradicts the prevailing idea that bedtime procrastination is the result of a lack of self-regulatory resources. Conclusion: The findings of this study provide important implications for how bedtime procrastination should be positioned in the field of procrastination as self-regulatory failure and for how bedtime procrastination should be dealt with in practice. PMID:29456519

Why Don't You Go to Bed on Time? A Daily Diary Study on the Relationships between Chronotype, Self-Control Resources and the Phenomenon of Bedtime Procrastination.

PubMed

Kühnel, Jana; Syrek, Christine J; Dreher, Anne

2018-01-01

Background: This daily diary study investigates the phenomenon of bedtime procrastination. Bedtime procrastination is defined as going to bed later than intended, without having external reasons for doing so. We highlight the role chronotype (interindividual differences in biological preferences for sleep-wake-times) plays for bedtime procrastination. Moreover, we challenge the view that bedtime procrastination is the result of a lack of self-regulatory resources by investigating momentary self-regulatory resources as a predictor of day-specific bedtime procrastination. Methods: One-hundred and eight employees working in various industries completed a general electronic questionnaire (to assess chronotype and trait self-control) and two daily electronic questionnaires (to assess momentary self-regulatory resources before going to bed and day-specific bedtime procrastination) over the course of five work days, resulting in 399 pairs of matched day-next-day measurements. Results: Results of multilevel regression analyses showed that later chronotypes (also referred to as evening types or 'owls') tended to report more bedtime procrastination on work days. Moreover, for late chronotypes, day-specific bedtime procrastination declined over the course of the work week. This pattern is in line with expectations derived from chronobiology and could not be explained by trait self-control. In addition, on evenings on which employees had less self-regulatory resources available before going to bed-compared to evenings on which they had more self-regulatory resources available before going to bed-employees showed lower bedtime procrastination. This finding contradicts the prevailing idea that bedtime procrastination is the result of a lack of self-regulatory resources. Conclusion: The findings of this study provide important implications for how bedtime procrastination should be positioned in the field of procrastination as self-regulatory failure and for how bedtime procrastination should be dealt with in practice.

Practical strategies for increasing efficiency and effectiveness in critical care education.

PubMed

Joyce, Maurice F; Berg, Sheri; Bittner, Edward A

2017-02-04

Technological advances and evolving demands in medical care have led to challenges in ensuring adequate training for providers of critical care. Reliance on the traditional experience-based training model alone is insufficient for ensuring quality and safety in patient care. This article provides a brief overview of the existing educational practice within the critical care environment. Challenges to education within common daily activities of critical care practice are reviewed. Some practical evidence-based educational approaches are then described which can be incorporated into the daily practice of critical care without disrupting workflow or compromising the quality of patient care. It is hoped that such approaches for improving the efficiency and efficacy of critical care education will be integrated into training programs.

Intergenerational Support in a Daily Context

PubMed Central

Fingerman, Karen L.; Kim, Kyungmin; Tennant, Patrick S.; Birditt, Kira S.; Zarit, Steven H.

2016-01-01

Purpose of the Study: Using retrospective global reports, studies have found that middle-aged adults in the United States provide intermittent support to their aging parents and more frequent support to grown children. To date, studies have not examined support middle-aged adults provide to different generations on a daily basis. Daily support may include mundane everyday exchanges that may (or may not) affect well-being. Design and Methods: Middle-aged adults (N = 191, mean age 55.93) completed a general interview regarding family ties, followed by interviews each day for 7 days (N = 1,261 days). Daily interviews assessed support (e.g., advice, emotional, practical help) participants provided each grown child (n = 454) and aging parent (n = 253). Participants also reported daily mood. Results: Most participants provided emotional support (80%), advice (87%), and practical help (69%) to a grown child and also provided emotional support (61%) and advice (61%) or practical help (43%) to a parent that week. Multilevel models confirmed generational differences; grown children were more likely to receive everyday support than parents. Providing support to grown children was associated with positive mood, whereas providing support to parents was associated with more negative mood. Implications: Daily intergenerational support was more common than studies using global reports of support have found. Some daily support may be fleeting and not stand out in memory. The findings were consistent with the intergenerational stake hypothesis, which suggests middle-aged adults are more invested in their grown children than in their parents. Nonetheless, middle-aged adults were highly involved with aging parents. PMID:26035892

Artificial Intelligence for Pathologists Is Not Near--It Is Here: Description of a Prototype That Can Transform How We Practice Pathology Tomorrow.

PubMed

Ye, Jay J

2015-07-01

Pathologists' daily tasks consist of both the professional interpretation of slides and the secretarial tasks of translating these interpretations into final pathology reports, the latter of which is a time-consuming endeavor for most pathologists. To describe an artificial intelligence that performs secretarial tasks, designated as Secretary-Mimicking Artificial Intelligence (SMILE). The underling implementation of SMILE is a collection of computer programs that work in concert to "listen to" the voice commands and to "watch for" the changes of windows caused by slide bar code scanning; SMILE responds to these inputs by acting upon PowerPath Client windows (Sunquest Information Systems, Tucson, Arizona) and its Microsoft Word (Microsoft, Redmond, Washington) Add-In window, eventuating in the reports being typed and finalized. Secretary-Mimicking Artificial Intelligence also communicates relevant information to the pathologist via the computer speakers and message box on the screen. Secretary-Mimicking Artificial Intelligence performs many secretarial tasks intelligently and semiautonomously, with rapidity and consistency, thus enabling pathologists to focus on slide interpretation, which results in a marked increase in productivity, decrease in errors, and reduction of stress in daily practice. Secretary-Mimicking Artificial Intelligence undergoes encounter-based learning continually, resulting in a continuous improvement in its knowledge-based intelligence. Artificial intelligence for pathologists is both feasible and powerful. The future widespread use of artificial intelligence in our profession is certainly going to transform how we practice pathology.

Daily impaired detachment and short-term effects of impaired sleep quality on next-day commuting near-accidents - an ambulatory diary study.

PubMed

Pereira, Diana; Bucher, Sarah; Elfering, Achim

2016-08-01

This study investigated the short-term effects of daily recovery, that is, impaired psychological detachment from work and various actigraphical indicators of sleep quality, on near-accidents when commuting to work the next morning. Furthermore, the mediating effect of actigraphically assessed sleep quality on the relationship between impaired psychological detachment from work and near-accidents when commuting to work was analysed. Fifty-six full-time employees of a Swiss assurance company participated in the one-week study. Multilevel analyses revealed that impaired detachment was highly related to a decrease in sleep duration. Furthermore, impaired daily recovery processes, such as impaired psychological detachment from work and disturbed sleep quality, were related to commuting near-accidents. Impaired sleep quality mediated the effect of impaired psychological detachment from work on these near-accidents. Our results show that occupational safety interventions should address both impaired psychological detachment from work and sleep quality in order to prevent near accidents when commuting to work. Practitioner Summary: Commuting accidents occur frequently and have detrimental effects on employees, organisations and society. This study shows that daily lack of recovery, that is, impaired psychological detachment and impaired sleep quality, is related to near-accidents when commuting to work the next morning. Primary prevention of commuting accidents should therefore address daily lack of recovery.

Return to work outcomes of the Redesigning Daily Occupations (ReDO) program for women with stress-related disorders--a comparative study.

PubMed

Eklund, Mona; Erlandsson, Lena-Karin

2011-11-01

Stress-related disorders are a frequent cause for sick leave, with consequences such as great distress and adverse economic effects for the affected person and substantial costs for society. Identifying effective interventions that facilitate return to work is thus important. The aim of this study was to evaluate the effectiveness of the 16-week Redesigning Daily Occupations program as a work rehabilitation method for Swedish women with stress-related disorders. The authors of this study hypothesized that, compared to women who got Care as Usual, 12 months after completed rehabilitation a larger proportion of the Redesigning Daily Occupations women would have returned to work, and they would have less sick leave, perceive less stress, and have greater self-esteem. Forty-two women entered the Redesigning Daily Occupations intervention and a matched comparison group received Care as Usual. The data, collected between 2007 and 2010, consisted of registry information and questionnaires targeting socio-demographics, perceived stress, and self-esteem. The findings partly verified the hypotheses. A larger proportion of the Redesigning Daily Occupations women returned to work and they decreased their sick leave and increased their self-esteem more than the Care as Usual group, but the groups did not differ in stress reduction. Thus, the Redesigning Daily Occupations seems to be a promising work rehabilitation method for women with stress-related disorders.

Women's experiences and health care-seeking practices in relation to uterine prolapse in a hill district of Nepal.

PubMed

Shrestha, Binjwala; Onta, Sharad; Choulagai, Bishnu; Poudyal, Amod; Pahari, Durga Prasad; Uprety, Aruna; Petzold, Max; Krettek, Alexandra

2014-02-03

Although uterine prolapse (UP) occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP. This study aimed to explore women's experiences of UP and its effect on daily life, its perceived causes, and health care-seeking practices. Using a convenience sampling method, we conducted 115 semi-structured and 16 in-depth interviews with UP-affected women during September-December 2012. All interviews occurred in outreach clinics in villages of the Dhading district. Study participants were 23-82 years of age. Twenty-four percent were literate, 47.2% had experienced a teenage pregnancy, and 29% had autonomy to make healthcare decisions. Most participants (>85%) described the major physical discomforts of UP as difficulty with walking, standing, working, sitting, and lifting. They also reported urinary incontinence (68%) bowel symptoms (42%), and difficulty with sexual activity (73.9%). Due to inability to perform household chores or fulfill their husband's sexual desires, participants endured humiliation, harassment, and torture by their husbands and other family members, causing severe emotional stress. Following disclosure of UP, 24% of spouses remarried and 6% separated from the marital relationship. Women perceived the causes of UP as unsafe childbirth, heavy work during the postpartum period, and gender discrimination. Prior to visiting these camps some women (42%) hid UP for more than 10 years. Almost half (48%) of participants sought no health care; 42% ingested a herb and ate nutritious food. Perceived barriers to accessing health care included shame (48%) and feeling that care was unnecessary (12.5%). Multiple responses (29%) included shame, inability to share, male service provider, fear of stigma and discrimination, and perceiving UP as normal for childbearing women. UP adversely affects women's daily life and negatively influences their physical, mental, and social well-being. The results of our study are useful to generate information on UP symptoms and female health care seeking practices. Our findings can be helpful for effective development of UP awareness programs to increase service utilization at early stages of UP and thereby might contribute to both primary and secondary prevention of UP.

Guideline recommendations for post-acute postoperative physiotherapy in total hip and knee arthroplasty: are they used in daily clinical practice?

PubMed

Peter, W F; Nelissen, R G H H; Vlieland, T P M Vliet

2014-09-01

In a Dutch guideline on physiotherapy (PT) in hip and knee osteoarthritis, a number of recommendations on post-acute (i.e. after discharge from hospital) PT following total hip (THA) and total knee (TKA) arthroplasty were included. Little is known about the uptake of these recommendations in daily clinical practice. The aim of the present study was to determine the extent to which the guideline recommendations regarding post-acute PT after THA and TKA are followed in daily clinical practice. An online pilot survey on the delivery of post-acute, postoperative PT was sent to a random sample of 957 Dutch physiotherapists. The survey included questions on the application of recommended, neither recommended nor advised against, and advised against treatment modalities and various treatment modalities for which there were no formulated recommendations. A total of 219 physiotherapists completed the questionnaire, with a mean age of 40 years (standard deviation 12.6), 55% female and 95% working in primary care. The vast majority reported the use of the recommended exercise modalities (muscle strengthening exercises (96%), and functional exercises (99%). Continuous passive motion, which was neither recommended nor advised against, and electrical muscle stimulation, which was not recommended, were provided by 1%. Reported treatment modalities for which there were no formulated recommendations included patient education (99%), gait training (95%), active range of motion (ROM) exercises (93%), balance exercises (86%), passive ROM exercises (58%), aerobic exercises (50%), massage (18%) and cold therapy (11%). The vast majority of physiotherapists reported adhering to recommendations on post-acute postoperative PT in THA and TKA patients after discharge from hospital. Although yet to be confirmed in a larger nationwide survey, the relatively high frequency of use of many other treatment modalities, for which there were no formulated recommendations, suggests the need to extend the current set of recommendations to include evidence-based statements on additional treatment modalities. Copyright © 2014 John Wiley & Sons, Ltd.

The Second Physical Therapy Summit on Global Health: developing an action plan to promote health in daily practice and reduce the burden of non-communicable diseases.

PubMed

Dean, Elizabeth; de Andrade, Armele Dornelas; O'Donoghue, Grainne; Skinner, Margot; Umereh, Gloria; Beenen, Paul; Cleaver, Shaun; Afzalzada, DelAfroze; Delaune, Mary Fran; Footer, Cheryl; Gannotti, Mary; Gappmaier, Ed; Figl-Hertlein, Astrid; Henderson, Bobbie; Hudson, Megan K; Spiteri, Karl; King, Judy; Klug, Jerry L; Laakso, E-Liisa; LaPier, Tanya; Lomi, Constantina; Maart, Soraya; Matereke, Noel; Meyer, Erna Rosenlund; M'kumbuzi, Vyvienne R P; Mostert-Wentzel, Karien; Myezwa, Hellen; Olsén, Monika Fagevik; Peterson, Cathy; Pétursdóttir, Unnur; Robinson, Jan; Sangroula, Kanchan; Stensdotter, Ann-Katrin; Tan, Bee Yee; Tschoepe, Barbara A; Bruno, Selma; Mathur, Sunita; Wong, Wai Pong

2014-05-01

Based on indicators that emerged from The First Physical Therapy Summit on Global Health (2007), the Second Summit (2011) identified themes to inform a global physical therapy action plan to integrate health promotion into practice across the World Confederation for Physical Therapy (WCPT) regions. Working questions were: (1) how well is health promotion implemented within physical therapy practice; and (2) how might this be improved across five target audiences (i.e. physical therapist practitioners, educators, researchers, professional body representatives, and government liaisons/consultants). In structured facilitated sessions, Summit representatives (n = 32) discussed: (1) within WCPT regions, what is working and the challenges; and (2) across WCPT regions, what are potential directions using World Café(TM) methodology. Commonalities outweighed differences with respect to strategies to advance health-focused physical therapy as a clinical competency across regions and within target audiences. Participants agreed that health-focused practice is a professional priority, and a strategic action plan was needed to develop it as a clinical competency. The action plan and recommendations largely paralleled the principles and objectives of the World Health Organization's non-communicable diseases action plan. A third Summit planned for 2015 will provide a mechanism for follow-up to evaluate progress in integrating health-focused physical therapy within the profession.

Occupational heat exposure among municipal workers.

PubMed

Uejio, Christopher K; Morano, Laurel Harduar; Jung, Jihoon; Kintziger, Kristina; Jagger, Meredith; Chalmers, Juanita; Holmes, Tisha

2018-06-05

Outdoor workers face elevated and prolonged heat exposures and have limited access to air-conditioned spaces. This study's overarching research aim is to increase knowledge of municipal worker heat exposure and adaptation practices. The study's sub-objectives are: (1) quantifying exposure misclassification from estimating personal heat exposure from the official weather station; (2) surveying worker's knowledge and practices to adapt to extreme heat; and (3) relating heat exposure and adaptation practices to self-reported thermal comfort. Participants wore a personal heat exposure sensor over 7 days from June 1st to July 3rd, 2015 in Tallahassee, Florida US. Next, participants confirmed the days that they wore the sensor and reported their daily thermal comfort and heat adaptations. Finally, participants completed an extreme heat knowledge, attitudes, and practices survey. Some participants (37%) experienced hotter and more humid conditions (heat index > 2) than the weather station. The most common heat adaptations were staying hydrated (85%), wearing a hat (46%), and seeking shade (40%). During work hours, higher temperatures increased the odds (odds ratio: 1.21, 95% confidence interval: 1.03-1.41, p = 0.016) of a participant feeling too hot. Shifting work duty indoors made workers to feel more comfortable (odds ratio: 0.28, 95% confidence interval: 0.11-0.70, p = 0.005). In hot and humid climates, everyday, heat exposures continuously challenge the health of outdoor workers.

Work-Family Balance and Energy: A Day-Level Study on Recovery Conditions

ERIC Educational Resources Information Center

Sanz-Vergel, Ana Isabel; Demerouti, Evangelia; Moreno-Jimenez, Bernardo; Mayo, Margarita

2010-01-01

The present study examines whether daily recovery inhibiting and enhancing conditions predict day-levels of work-family conflict (WFC), work-family facilitation (WFF), exhaustion and vigor. Forty-nine individuals from various professional backgrounds in Spain provided questionnaire and daily survey measures over a period of five working days.…

Homeless children: Experiences and meanings of the environments they construct.

PubMed

Forero Pulido, Constanza; Giraldo Pineda, Álvaro; Martínez Hernández, Johana Victoria

2016-04-01

This work sought to learn of the experiences of homeless children and understand the meanings they give to environments they construct within these spaces. The study took place in Medellín, Colombia in 2015. Ours was a qualitative research with ethnographic approach. Non-structured interviews and observations were conducted; a field diary was kept. The street, although a space of public use, is converted by children into their private space; they carry in it almost all their activities and construct two big environments: that of the street that attracts and educates and that of the work that is transitory because it is performed to survive. These children dream with an ideal environment that allows them to live quietly. Children convert the street into a private place where they carry out their daily practices: socializing, working, sleeping, having fun, and relaxing, that is, a place of social construction.

Collaborating with cardiac sonographers to develop work-related musculoskeletal disorder interventions

PubMed Central

Sommerich, Carolyn M.; Lavender, Steven A.; Evans, Kevin; Sanders, Elizabeth; Joines, Sharon; Lamar, Sabrina; Umar, Radin Zaid Radin; Yen, Wei-Ting; Li, Jing; Nagavarapu, Shasank; Dickerson, Jennifer A.

2016-01-01

For more than two decades, surveys of imaging technologists, including cardiac sonographers, diagnostic medical sonographers, and vascular technologists, have consistently reported high prevalence of work-related musculoskeletal discomfort (WRMSD). Yet, intervention research involving sonographers is limited. In this study, we used a participatory approach to identifying needs and opportunities for developing interventions to reduce sonographers’ exposures to WMSD risk factors. In this paper, we present some of those needs. We include descriptions of two interventions, targeted for cardiac sonographers, that were developed, through an iterative process, into functional prototypes that were evaluated in pilot tests by practicing sonographers. One of these interventions is now in daily use. We would like other engineers and ergonomists to recognize this area of opportunity to apply their knowledge of biomechanics and design in order to begin to address the high prevalence of WRMSDs in sonographers, by working with sonographers to develop useful and usable interventions. PMID:26642863

Intersecting vulnerabilities in professionals and patients in intensive care

PubMed Central

Dargent, Auguste; Ecarnot, Fiona; Rigaud, Jean-Philippe; Andreu, Pascal; Large, Audrey; Quenot, Jean-Pierre

2017-01-01

In the context of healthcare delivery, the vulnerabilities of patients in the intensive care unit (ICU) are intricately linked with those experienced on a daily basis by caregivers in the ICU in a symbiotic relation, whereby patients who are suffering can in turn engender suffering in the caregivers. In the same way, caregivers who are suffering themselves may be a source of suffering for their patients. The vulnerabilities of both patients and caregivers in the ICU are simultaneously constituted through a process that is influenced on the one hand by the healthcare objectives of the ICU, and on the other hand, by the conformity of the patients who are managed in that ICU. The specific challenges of management in high-technology units such as an ICU may have consequences on the practices and work conditions of healthcare professionals. Constructing the patient, collectively redefining the patient’s identity, and ascribing the patient to a specific healthcare trajectory enables professionals to circumscribe, contain and fight against the spectrum of extreme vulnerabilities of their patients. Imposing this normative framework is the sole means of guiding these professionals through their daily practices. In spite of this, situations of suffering remain a constitutive feature of the caregiving relation in the ICU. PMID:29302595

Management of Paediatric Ulcerative Colitis, Part 2: Acute Severe Colitis; An Evidence-based Consensus Guideline from ECCO and ESPGHAN.

PubMed

Turner, Dan; Ruemmele, Frank M; Orlanski-Meyer, Esther; Griffiths, Anne M; Carpi, Javier Martin de; Bronsky, Jiri; Veres, Gabor; Aloi, Marina; Strisciuglio, Caterina; Braegger, Christian P; Assa, Amit; Romano, Claudio; Hussey, Séamus; Stanton, Michael; Pakarinen, Mikko; de Ridder, Lissy; Katsanos, Konstantinos H; Croft, Nick; Navas-López, Víctor Manuel; Wilson, David C; Lawrence, Sally; Russell, Richard K

2018-05-30

Acute severe colitis (ASC) is one of the few emergencies in paediatric gastroenterology. Tight monitoring and timely medical and surgical interventions may improve outcomes and minimize morbidity and mortality. We aimed to standardize daily treatment of ASC in children through detailed recommendations and practice points which are based on a systematic review of the literature and consensus of experts. These guidelines are a joint effort of the European Crohn's and Colitis Organization (ECCO) and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). Fifteen predefined questions were addressed by working subgroups. An iterative consensus process, including two face-to-face meetings, was followed by voting by the national representatives of ECCO and all members of the Paediatric Inflammatory Bowel Disease (IBD) Porto group of ESPGHAN (43 voting experts). A total of 24 recommendations and 43 practice points were endorsed with a consensus rate of at least 91% regarding diagnosis, monitoring and management of ASC in children. A summary flowchart is presented based on daily scoring of the Paediatric Ulcerative Colitis Activity Index (PUCAI). Several topics have been altered since the previous 2011 guidelines and from those published in adults. These guidelines standardize the management of ASC in children in an attempt to optimize outcomes of this intensive clinical scenario.

Quantile uncertainty and value-at-risk model risk.

PubMed

Alexander, Carol; Sarabia, José María

2012-08-01

This article develops a methodology for quantifying model risk in quantile risk estimates. The application of quantile estimates to risk assessment has become common practice in many disciplines, including hydrology, climate change, statistical process control, insurance and actuarial science, and the uncertainty surrounding these estimates has long been recognized. Our work is particularly important in finance, where quantile estimates (called Value-at-Risk) have been the cornerstone of banking risk management since the mid 1980s. A recent amendment to the Basel II Accord recommends additional market risk capital to cover all sources of "model risk" in the estimation of these quantiles. We provide a novel and elegant framework whereby quantile estimates are adjusted for model risk, relative to a benchmark which represents the state of knowledge of the authority that is responsible for model risk. A simulation experiment in which the degree of model risk is controlled illustrates how to quantify Value-at-Risk model risk and compute the required regulatory capital add-on for banks. An empirical example based on real data shows how the methodology can be put into practice, using only two time series (daily Value-at-Risk and daily profit and loss) from a large bank. We conclude with a discussion of potential applications to nonfinancial risks. © 2012 Society for Risk Analysis.

A rehabilitation program based on music practice for patients with unilateral spatial neglect: a single-case study.

PubMed

Guilbert, Alma; Clément, Sylvain; Moroni, Christine

2017-02-01

Two major limitations of unilateral spatial neglect (USN) rehabilitation methods are actually reported: a lack of long-term efficiency and a lack of generalization to daily life. The aim of our case study was to underline how a multisensory method-music practice-could avoid these limitations. Mrs BV suffered from a chronic severe USN. She had rehabilitation sessions of music practice over 8 weeks. An improvement of her USN was found on paper-pencil tests but also in daily activities. Benefits subsisted 4 months after rehabilitation. Music practice seemed to avoid the major limitations of USN rehabilitations and could represent a promising tool.

Recommendations to Improve Employee Thermal Comfort When Working in 40°F Refrigerated Cold Rooms.

PubMed

Ceballos, Diana; Mead, Kenneth; Ramsey, Jessica

2015-01-01

Cold rooms are commonly used for food storage and preparation, and are usually kept around 40°F following food safety guidelines. Some food preparation employees may spend 8 or more hours inside cold rooms. These employees may not be aware of the risks associated with mildly cold temperatures, dampness, and limited ventilation. We performed an evaluation of cold rooms at an airline catering facility because of concerns with exposure to cold temperatures. We spoke with and observed employees in two cold rooms, reviewed daily temperature logs, evaluated employee's physical activity, work/rest schedule, and protective clothing. We measured temperature, percent relative humidity, and air velocities at different work stations inside the cold rooms. We concluded that thermal comfort concerns perceived by cold room employees may have been the result of air drafts at their workstations, insufficient use of personal protective equipment due to dexterity concerns, work practices, and lack of knowledge about good health and safety practices in cold rooms. These moderately cold work conditions with low air velocities are not well covered in current occupational health and safety guidelines, and wind chill calculations do not apply. We provide practical recommendations to improve thermal comfort of cold room employees. Engineering control recommendations include the redesigning of air deflectors and installing of suspended baffles. Administrative controls include the changing out of wet clothing, providing hand warmers outside of cold rooms, and educating employees on cold stress. We also recommended providing more options on personal protective equipment. However, there is a need for guidelines and educational materials tailored to employees in moderately cold environments to improve thermal comfort and minimize health and safety problems.

Recommendations to Improve Employee Thermal Comfort When Working in 40°F Refrigerated Cold Rooms

PubMed Central

Ceballos, Diana; Mead, Kenneth; Ramsey, Jessica

2015-01-01

Cold rooms are commonly used for food storage and preparation, and are usually kept around 40°F following food safety guidelines. Some food preparation employees may spend 8 or more hours inside cold rooms. These employees may not be aware of the risks associated with mildly cold temperatures, dampness, and limited ventilation. We performed an evaluation of cold rooms at an airline catering facility because of concerns with exposure to cold temperatures. We spoke with and observed employees in two cold rooms, reviewed daily temperature logs, evaluated employee’s physical activity, work/rest schedule, and protective clothing. We measured temperature, percent relative humidity, and air velocities at different work stations inside the cold rooms. We concluded that thermal comfort concerns perceived by cold room employees may have been the result of air drafts at their workstations, insufficient use of personal protective equipment due to dexterity concerns, work practices, and lack of knowledge about good health and safety practices in cold rooms. These moderately cold work conditions with low air velocities are not well covered in current occupational health and safety guidelines, and wind chill calculations do not apply. We provide practical recommendations to improve thermal comfort of cold room employees. Engineering control recommendations include the redesigning of air deflectors and installing of suspended baffles. Administrative controls include the changing out of wet clothing, providing hand warmers outside of cold rooms, and educating employees on cold stress. We also recommended providing more options on personal protective equipment. However, there is a need for guidelines and educational materials tailored to employees in moderately cold environments to improve thermal comfort and minimize health and safety problems. PMID:25961447

Continuous Improvement and Employee Engagement, Part 2: Design, Implementation, and Outcomes of a Daily Management System.

PubMed

Maurer, Marsha; Browall, Pamela; Phelan, Cynthia; Sanchez, Sandra; Sulmonte, Kimberlyann; Wandel, Jane; Wang, Allison

2018-04-01

A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact quality or work flow and to address them on a daily basis. Through a DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 2 describes the implementation and outcomes of the program.

Husbandry, working practices and field performance when using draught oxen in land preparation in Shambat, Nile Valley, Sudan.

PubMed

Makki, Elsamawal Khalil

2014-01-01

Little quantitative information is available on animal power in the Nile Valley in Sudan, despite that it is being used in the area for centuries and playing an important role in agriculture in the present day. A survey was conducted to assess draught oxen management and its association with field capacity and efficiency at the farm level and to identify potential areas for intervention. A sample of 50 farmers was selected for this purpose using the systematic random sampling technique. The main management parameters discussed were animal health, feeding, housing, work strategy and care for yoke and plough. The results showed that most of the farmers poorly manage their animals, and this was reflected in low working speeds and field efficiencies. The main dimensions of poor management were in veterinary care (78 % did not take their animals to the veterinary centre), feeding (66 % feed their animals shortly before work) and care for yoke (80 % did not follow daily care measures for their yokes) and plough (74 % did not follow plough care measure before and after work). Low working speeds (0.90–2.0 km/h) were recorded by the majority of the farmers (64 %). The majority of the farmers (70 %) recorded field capacities between 0.06 and 0.10 ha/h, while all of them worked at high field efficiencies of >86 %. The only parameter that significantly affected field capacity was the yoke-related wounds (p = 0.019). Extension advice and capacity building in husbandry and working practices were identified as principal entry points for intervention.

Behavioral change in rural practice: improving patient motivation in primary care.

PubMed

Clark, Karen; Weir, Christine

2013-01-01

As the disparities in rural healthcare have become better understood, the need to adjust and compensate for these unique challenges becomes a priority. This manuscript suggests three constructs that can be readily integrated into rural care providers' daily work to improve treatment outcomes. Autonomy support, relational support, and competence support are among the motivational constructs discussed with a special consideration for the unique cultural and environmental influences of rural West Virginia residents. The overall objective of this review is to renew the basic tenants of shared decision making as they related to successful behavioral change in primary care.

[How can we give quick yet relevant nutritional advice in our daily medical practice?].

PubMed

Girardin, S; Andrey, M; Ruiz, J

2007-06-06

Within our diabetology Unit CHUV-PMU, the dietetic consultation is an integral part of the patients' management, for the majority of diabetic patients. The general practitioner offers very different perspectives. What are the possible modalities of ambulatory dietetic counselling? Are the numerous existing standardized documents really relevant? We bring a critical analysis on such documents, the use of which often engenders a feeling of failure for the patients and the health professionals. We suggest an intervention guide so that the nutritional education work undertaken in an ambulatory consultation may then lead to dietetic management.

Ki aikido: a solution to stress.

PubMed

Wiles, L

1990-03-10

It is common knowledge that the life of the general dental practitioner is extremely stressful. Different dentists resort to various ways of unwinding--perhaps a game of golf, a sailing trip, or mending the odd clock as occupational therapy. These are all ways of getting away from the stress of day-to-day work--but perhaps the time has come to look for a more fundamental solution. How many dentists have considered taking up a martial art to alleviate the problem of stress? Here, we outline the background of ki aikido and its practical applications in daily life.

A day in the life of a junior doctor: everyday ethical encounters.

PubMed

Quarini, Catherine J

2010-11-01

This paper presents a hypothetical 'day in the life' of junior doctors working on a busy hospital ward. It illustrates the fact that, although the everyday ethical encounters faced by doctors are generally not as dramatic as some of the ethical issues discussed at medical school, the underlying principles, such as consent, confidentiality and resource allocation, are highly relevant to daily practice. After presenting some of the ethical challenges faced by junior doctors, from patients confused by poor explanations to inadequate consent procedures, the paper ends with suggestions on how to improve the situation.

Adoption of innovations by specialised nurses: personal, work and organisational characteristics.

PubMed

van der Weide, Marian; Smits, Jeroen

2004-04-01

To gain insight in the factors that influence the adoption of professional information by specialised nurses, we studied the effects of individual, work and organisational characteristics on the extent to which continence nurses gained knowledge and made use of a book on nursing diagnosis and interventions for patients with urinary incontinence, which they received as a present. Subjects were all members of the Dutch Association of Continence Nurses. Data collection took place via a postal questionnaire with closed questions. In total, 109 valid questionnaires (78%) were received back. Stepwise selected ordered logit models were estimated with reading the book and knowledge and use of five selected parts of it as dependent variables and individual, work and organisational characteristics as independent variables. The most important factors found to promote reading of the book and taking knowledge of the parts of it were a personal characteristic of the nurses called "information directedness" (or eagerness to acquire professional information from other sources), the presence of an "innovative atmosphere" at the department, and "relevance" of the information for daily nursing practice. The most important factors found to promote the use of the book are (again) information directedness, working at a (relatively) small department and having experience with nursing diagnosis. Results suggest that nurses differ in the degree to which they are open to innovations and that information directedness might be a useful indicator of this characteristic. In addition, the degree of innovativeness of the atmosphere at the department and the relevance of the innovation for nursing practice are important factors influencing the success or failure of innovations in nursing practice.

Novel Tools in Determining the Physiological Demands and Nutritional Practices of Ontario FireRangers during Fire Deployments

PubMed Central

Robertson, A. H.; Larivière, C.; Leduc, C. R.; McGillis, Z.; Eger, T.; Godwin, A.; Larivière, M.; Dorman, S. C.

2017-01-01

Introduction The seasonal profession of wildland fire fighting in Canada requires individuals to work in harsh environmental conditions that are physically demanding. The purpose of this study was to use novel technologies to evaluate the physiological demands and nutritional practices of Canadian FireRangers during fire deployments. Methods Participants (n = 21) from a northern Ontario Fire Base volunteered for this study and data collection occurred during the 2014 fire season and included Initial Attack (IA), Project Fire (P), and Fire Base (B) deployments. Deployment-specific energy demands and physiological responses were measured using heart-rate variability (HRV) monitoring devices (Zephyr BioHarness3 units). Food consumption behaviour and nutrient quantity and quality were captured using audio-video food logs on iPod Touches and analyzed by NutriBase Pro 11 software. Results Insufficient kilocalories were consumed relative to expenditure for all deployment types. Average daily kilocalories consumed: IA: 3758 (80% consumption rate); P: 2945±888.8; B: 2433±570.8. Average daily kilocalorie expenditure: IA: 4538±106.3; P: 4012±1164.8; B: 2842±649.9. The Average Macronutrient Distribution Range (AMDR) for protein was acceptable: 22–25% (across deployment types). Whereas the AMDR for fat and carbohydrates were high: 40–50%; and low: 27–37% respectively, across deployment types. Conclusions This study is the first to use the described methodology to simultaneously evaluate energy expenditures and nutritional practices in an occupational setting. The results support the use of HRV monitoring and video-food capture, in occupational field settings, to assess job demands. FireRangers expended the most energy during IA, and the least during B deployments. These results indicate the need to develop strategies centered on maintaining physical fitness and improving food practices. PMID:28107380

Novel Tools in Determining the Physiological Demands and Nutritional Practices of Ontario FireRangers during Fire Deployments.

PubMed

Robertson, A H; Larivière, C; Leduc, C R; McGillis, Z; Eger, T; Godwin, A; Larivière, M; Dorman, S C

2017-01-01

The seasonal profession of wildland fire fighting in Canada requires individuals to work in harsh environmental conditions that are physically demanding. The purpose of this study was to use novel technologies to evaluate the physiological demands and nutritional practices of Canadian FireRangers during fire deployments. Participants (n = 21) from a northern Ontario Fire Base volunteered for this study and data collection occurred during the 2014 fire season and included Initial Attack (IA), Project Fire (P), and Fire Base (B) deployments. Deployment-specific energy demands and physiological responses were measured using heart-rate variability (HRV) monitoring devices (Zephyr BioHarness3 units). Food consumption behaviour and nutrient quantity and quality were captured using audio-video food logs on iPod Touches and analyzed by NutriBase Pro 11 software. Insufficient kilocalories were consumed relative to expenditure for all deployment types. Average daily kilocalories consumed: IA: 3758 (80% consumption rate); P: 2945±888.8; B: 2433±570.8. Average daily kilocalorie expenditure: IA: 4538±106.3; P: 4012±1164.8; B: 2842±649.9. The Average Macronutrient Distribution Range (AMDR) for protein was acceptable: 22-25% (across deployment types). Whereas the AMDR for fat and carbohydrates were high: 40-50%; and low: 27-37% respectively, across deployment types. This study is the first to use the described methodology to simultaneously evaluate energy expenditures and nutritional practices in an occupational setting. The results support the use of HRV monitoring and video-food capture, in occupational field settings, to assess job demands. FireRangers expended the most energy during IA, and the least during B deployments. These results indicate the need to develop strategies centered on maintaining physical fitness and improving food practices.

Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative

PubMed Central

Visser, K; Katchamart, W; Loza, E; Martinez-Lopez, J A; Salliot, C; Trudeau, J; Bombardier, C; Carmona, L; van der Heijde, D; Bijlsma, J W J; Boumpas, D T; Canhao, H; Edwards, C J; Hamuryudan, V; Kvien, T K; Leeb, B F; Martín-Mola, E M; Mielants, H; Müller-Ladner, U; Murphy, G; Østergaard, M; Pereira, I A; Ramos-Remus, C; Valentini, G; Zochling, J; Dougados, M

2009-01-01

Objectives: To develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders. Methods: 751 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2007–8 consisting of three separate rounds of discussions and Delphi votes. Ten clinical questions concerning the use of methotrexate in rheumatic disorders were formulated. A systematic literature search in Medline, Embase, Cochrane Library and 2005–7 American College of Rheumatology/European League Against Rheumatism meeting abstracts was conducted. Selected articles were systematically reviewed and the evidence was appraised according to the Oxford levels of evidence. Each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed. Results: A total of 16 979 references was identified, of which 304 articles were included in the systematic reviews. Ten multinational key recommendations on the use of methotrexate were formulated. Nine recommendations were specific for rheumatoid arthritis (RA), including the work-up before initiating methotrexate, optimal dosage and route, use of folic acid, monitoring, management of hepatotoxicity, long-term safety, mono versus combination therapy and management in the perioperative period and before/during pregnancy. One recommendation concerned methotrexate as a steroid-sparing agent in other rheumatic diseases. Conclusions: Ten recommendations for the use of methotrexate in daily clinical practice focussed on RA were developed, which are evidence based and supported by a large panel of rheumatologists, enhancing their validity and practical use. PMID:19033291

Work and Non-Work Physical Activity Predict Real-Time Smoking Level and Urges in Young Adults.

PubMed

Nadell, Melanie J; Mermelstein, Robin J; Hedeker, Donald; Marquez, David X

2015-07-01

Physical activity (PA) and smoking are inversely related. However, evidence suggests that some types of PA, namely work-related PA, may show an opposite effect. Despite growing knowledge, there remains a paucity of studies examining the context of these behaviors in naturalistic settings or in young adults, a high-risk group for escalation. Participants were 188 young adults (mean age = 21.32; 53.2% female; 91% current smokers) who participated in an electronic diary week to assess daily smoking and urges and a PA recall to examine daily PA. PA was coded into non-work-related and work-related activity to examine differential effects. We considered both participants' weekly average PA and their daily deviations from their average. Mixed-effects regression models revealed that higher weekly average non-work PA was associated with lower smoking level and urges. Daily deviations in non-work PA did not predict urges; however, increased daily non-work PA relative to participants' weekly average was associated with lower smoking for females but higher levels for males. Regarding work PA, only higher weekly average work PA was associated with higher smoking level for both genders; work PA did not predict urges. Results extend previous literature by documenting differential associations between non-work and work PA and young adult smoking and suggest that young adults engaged in work PA should be considered a high-risk group for escalation. Findings provide theoretical and clinical implications for the use of PA in intervention and highlight the necessity of considering PA as a multidimensional construct when examining its links to health behavior. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Consensus best practice pathway of the UK Scleroderma Study Group: digital vasculopathy in systemic sclerosis.

PubMed

Hughes, Michael; Ong, Voon H; Anderson, Marina E; Hall, Frances; Moinzadeh, Pia; Griffiths, Bridget; Baildam, Eileen; Denton, Christopher P; Herrick, Ariane L

2015-11-01

Digital vasculopathy (comprising RP, digital ulceration and critical digital ischaemia) is responsible for much of the pain and disability experienced by patients with SSc. However, there is a limited evidence base to guide clinicians in the management of SSc-related digital vasculopathy. Our aim was to produce recommendations that would be helpful for clinicians, especially for those managing patients outside specialist centres. The UK Scleroderma Study Group set up several working groups to develop a number of consensus best practice pathways for the management of SSc-specific complications, including digital vasculopathy. This overview presents the background and best practice consensus pathways for SSc-related RP, digital ulceration and critical ischaemia. Examples of drug therapies, including doses, are suggested in order to inform prescribing practice. A number of treatment algorithms are provided that are intended to provide the clinician with accessible reference tools for use in daily management. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A masterclass to teach public health professionals to conduct practice-based research to promote evidence-based practice: a case study from The Netherlands.

PubMed

Jansen, Maria W J; Hoeijmakers, Marjan

2013-01-01

Public health professionals have a pivotal position in efforts to obtain more practice-based evidence about what people need and what works in real circumstances. Close collaboration with researchers should enable public health professionals to design and conduct research in practical settings to address today's complex public health problems and increase the external validity of results. This requires expanding the research competencies of public health professionals. We developed and implemented a masterclass for public health professionals, modeled on an existing scientific training course for general practitioners and rehabilitation physicians. The masterclass was evaluated using a multiple method design, involving quantitative and qualitative methods. Evaluation took place during, at the end of, and 9 months after the masterclass. Twenty-one candidates (mean age, 41 y) started the program, 66% of whom completed it. Teaching materials, lectures, organization, and facilities were favorably evaluated. At the end of the masterclass, participants were able to design and implement a research proposal in their daily work setting, write a draft article, and critically appraise scientific research for practice and policy purposes. Participants had become more confident about their research competence. Management support from their employer proved crucial. Results obtained with the different methods were consistent. The masterclass appeared to be an effective instrument to increase the practice-based research skills of public health professionals, provided the research is implemented in a supportive organization with management backing and supervision by senior university researchers. We recommend using masterclasses to contribute to the improvement of practice-based evidence for projects addressing current and future public health problems.

Protecting personal information: Implications of the Protection of Personal Information (POPI) Act for healthcare professionals.

PubMed

Buys, M

2017-10-31

Careless handling of patient information in daily medical practice can result in Health Professions Council of South Africa sanction, breach of privacy lawsuits and, in extreme cases, serious monetary penalty or even imprisonment. This review will focus on the Protection of Personal Information (POPI) Act (No. 4 of 2013) and the implications thereof for healthcare professionals in daily practice. Recommendations regarding the safeguarding of information are made.

Impact of estradiol-valerate/dienogest on work productivity and activities of daily living in European and Australian women with heavy menstrual bleeding

PubMed Central

Wasiak, Radoslaw; Filonenko, Anna; Vanness, David J; Wittrup-Jensen, Kim U; Stull, Donald E; Siak, Steven; Fraser, Ian

2012-01-01

Background The purpose of this study was to quantify the impact of estradiol-valerate/dienogest (E2V/DNG; Qlaira®/Natazia®) on work productivity and activities of daily living in European and Australian women with heavy menstrual bleeding. Methods Women aged 18–54 years with a confirmed diagnosis of heavy menstrual bleeding and no recognizable pathology were recruited across nine European countries (the Czech Republic, Finland, Germany, Hungary, The Netherlands, Poland, Sweden, UK, and Ukraine) and Australia. The women were randomized to receive either E2V/DNG (n = 149) or placebo (n = 82) for seven treatment cycles (196 days). The outcomes assessed included work productivity (ie, productivity while at work) and activities of daily living, measured on a Likert scale from 0 to 10 (with higher values denoting higher impairment levels) at baseline and at the end of the third and seventh cycles (days 84 and 196). The equivalent monetary value associated with the changes in work productivity and activities of daily living was also calculated. Results Across all the countries, greater improvements from baseline to the end of treatment were observed with E2V/DNG treatment than placebo in work productivity (46.0% versus 15.1%) and activities of daily living (55.6% versus 30.8%). In 2008, savings associated with improvements in work productivity and activities of daily living due to E2V/DNG treatment (net of placebo improvement) were estimated to be between US$22–62 and US$18–56 per month (in purchasing power parity of US$), respectively. Conclusion E2V/DNG has a consistent positive impact on work productivity and activities of daily living in European and Australian women with heavy menstrual bleeding. These improvements were associated with a reduction in monetary burden of heavy menstrual bleeding compared with the placebo group, consistent with the response to treatment observed. PMID:22927764

Impact of estradiol-valerate/dienogest on work productivity and activities of daily living in European and Australian women with heavy menstrual bleeding.

PubMed

Wasiak, Radoslaw; Filonenko, Anna; Vanness, David J; Wittrup-Jensen, Kim U; Stull, Donald E; Siak, Steven; Fraser, Ian

2012-01-01

The purpose of this study was to quantify the impact of estradiol-valerate/dienogest (E(2)V/DNG; Qlaira(®)/Natazia(®)) on work productivity and activities of daily living in European and Australian women with heavy menstrual bleeding. Women aged 18-54 years with a confirmed diagnosis of heavy menstrual bleeding and no recognizable pathology were recruited across nine European countries (the Czech Republic, Finland, Germany, Hungary, The Netherlands, Poland, Sweden, UK, and Ukraine) and Australia. The women were randomized to receive either E(2)V/DNG (n = 149) or placebo (n = 82) for seven treatment cycles (196 days). The outcomes assessed included work productivity (ie, productivity while at work) and activities of daily living, measured on a Likert scale from 0 to 10 (with higher values denoting higher impairment levels) at baseline and at the end of the third and seventh cycles (days 84 and 196). The equivalent monetary value associated with the changes in work productivity and activities of daily living was also calculated. Across all the countries, greater improvements from baseline to the end of treatment were observed with E(2)V/DNG treatment than placebo in work productivity (46.0% versus 15.1%) and activities of daily living (55.6% versus 30.8%). In 2008, savings associated with improvements in work productivity and activities of daily living due to E(2)V/DNG treatment (net of placebo improvement) were estimated to be between US$22-62 and US$18-56 per month (in purchasing power parity of US$), respectively. E(2)V/DNG has a consistent positive impact on work productivity and activities of daily living in European and Australian women with heavy menstrual bleeding. These improvements were associated with a reduction in monetary burden of heavy menstrual bleeding compared with the placebo group, consistent with the response to treatment observed.

Enhancing systematic implementation of skills training modules for persons with schizophrenia: three steps forward and two steps back?

PubMed

van Erp, Nicole H J; van Vugt, Maaike; Verhoeven, Dorien; Kroon, Hans

2009-01-01

This brief report addresses the systematic implementation of skills training modules for persons with schizophrenia or related disorders in three Dutch mental health agencies. Information on barriers, strategies and integration into routine daily practice was gathered at 0, 12 and 24 months through interviews with managers, program leaders, trainers, practitioners and clients. Overall implementation of the skills training modules for 74% of the persons with schizophrenia or related disorders was not feasible. Implementation was impeded by an incapable program leader, organizational changes, disappointing referrals and loss of trainers. The agencies made important steps forward to integrate the modules into routine daily practice. A reach percentage of 74% in two years time is too ambitious and needs to be adjusted. Systematic integration of the modules into routine daily practice is feasible, but requires solid program management and continuous effort to involve clients and practitioners.

Factors related to coping strategies during Japanese physical therapy students' clinical practice.

PubMed

Higuchi, Daisuke; Echigo, Ayumi

2017-08-01

[Purpose] This study aimed to identify social skills and support that are related to the coping strategies Janpanese physical therapy students use during their clinical practice. [Subjects and Methods] Third-year students who were finished with their clinical practice participated. Self-administered questionnaires were used, including the daily life skill scale, social support scale, and tri-axial coping scale. Spearman's partial correlation coefficients were calculated between social skills, support of daily living, and coping strategies used during the clinical practice, while controlling for gender. [Results] A total of 56 completed questionnaires (median of age: 21 years; 27 males). Social skills during personal situations-knowledge summarization, self-esteem, and positive thinking-were significantly, positively correlated with planning and affirmative interpreting strategies to approach stressors regarding clinical practice, and negatively related to giving up strategies to avoid stressors. Intimacy, leadership, and empathy (social skills during interpersonal situations) were significantly, positively correlated with the following responses to approach stressors: catharsis, information gathering, and affirmative interpreting. Moreover, emotional/companionship social support was significantly, positively correlated with all avoidant coping strategies. [Conclusion] Japanese physical therapy students who had low personal and interpersonal social skills and excess emotional/companionship support in daily life tend to select avoidance, not approach, coping strategies during clinical practice.

Using Practice-Based Evidence to Improve Supportive Care Practices to Reduce Central Line-Associated Bloodstream Infections in a Pediatric Oncology Unit [Formula: see text].

PubMed

Linder, Lauri A; Gerdy, Cheryl; Abouzelof, Rouett; Wilson, Andrew

Children with cancer are a subset of patients with central lines with distinct risk factors for infection including periods of prolonged neutropenia and compromised mucous membrane integrity. This article relates the implementation of principles of practice-based evidence to identify interventions in addition to best practice maintenance care bundles to reduce central line-associated bloodstream infections involving viridans group streptococci and coagulase-negative staphylococci on an inpatient pediatric oncology unit. Review of individual events combined with review of current clinical practice guided the development of structured protocols emphasizing routine oral care and general supportive cares. Key principles of the protocols emphasized a 1-2-3 mnemonic and included daily bathing, twice daily oral care, and out-of-bed activity 3 times daily. Poisson regression identified a significant main effect for time period for central line-associated bloodstream infection rates involving both viridans group streptococci and coagulase-negative staphylococci. Significant differences were present between the preintervention baseline and implementation of the supportive care protocols. Project outcomes demonstrate the added value of using principles of practice-based evidence to guide the development of interventions to improve clinical care when evidence-based sources are limited.

Surveying the Impact of Work Hours and Schedules on Commercial Motor Vehicle Driver Sleep

PubMed Central

Hege, Adam; Perko, Michael; Johnson, Amber; Yu, Chong Ho; Sönmez, Sevil; Apostolopoulos, Yorghos

2015-01-01

Background Given the long hours on the road involving multiple and interacting work stressors (i.e., delivery pressures, irregular shifts, ergonomic hazards), commercial drivers face a plethora of health and safety risks. Researchers goal was to determine whether and to what extent long-haul trucker work schedules influence sleep duration and quality. Methods Survey and biometric data collected from male long-haul truck drivers at a major truckstop in central North Carolina over a six month period. Results Daily hours worked (mean = 11 hours, 55 minutes) and frequency of working over government-mandated daily HOS regulations (23.8% “frequently or always”) were statistically significant predictors of sleep duration. Miles driven per week (mean = 2,812.61), irregular daily hours worked (63.8%), and frequency of working over the daily hour limit (23.8% “frequently or always”) were statistically significant predictors of sleep quality. Conclusion Implications of findings suggest a comprehensive review of the regulations and operational conditions for commercial motor vehicle drivers be undertaken. PMID:26106509

[Understanding nurses' awareness as to the use of therapeutic play in child care].

PubMed

Maia, Edmara Bazoni Soares; Ribeiro, Circéa Amália; de Borba, Regina Issuzu Hirooka

2011-08-01

The objective of this study was to understand how nurses become aware of the use of therapeutic play as a nursing intervention instrument. Symbolic Interactionism was the theoretical framework and Interpretive Interactionism was used as the methodological framework. Participants were seven nurses working at hospitals and outpatient pediatric units who used the therapeutic play in their practice. Four representative themes emerged: Expanding the way he/she sees the child; Becoming fascinated with a new possibility to provide care; Noticing his/her revalidated action; and Committing himself/herself to the theme development. Such themes revealed that when nurses become acquainted with therapeutic play and use it in his/her practice, they begin on a journey that allows him/her to recognize the benefits of this intervention. By doing so, nurses revalidate their actions more and more, thus valuing play as a nursing intervention tool. The authors believe that teaching about therapeutic play and integrating it to nurses' daily practice are challenges yet to be overcome.

[The satisfied patient in aesthetic dermatology. Consensus work on patient satisfaction in botulinum toxin A treatment].

PubMed

Kreyden, O P; Rzany, B; Becker-Wegerich, P; Boudny-Frey, C; Carrozza-Merlani, P; Hess-Schmid, M; Schlagenhauff, B

2015-02-01

Patient satisfaction is an important factor for successful therapy. Many consensus reports have been published regarding correct treatment with botulinum toxin A (BTX-A). However, the focus of most of these publications has been on technical aspects and the important topic of patient satisfaction was often only one aspect among others. The Swiss Group of Esthetic Dermatology and Skincare (SGEDS) pursued these questions in a two-day consensus meeting. Patients of aesthetic dermatology are healthy and therefore place higher demands in contrast to ill patients of medical dermatology. This demands a great deal of the physician, the practice staff and the conditions in the practice to accommodate the special requirements of aesthetic clients. Informative consultation and patient education are of major importance; this also holds true for clinical performance and care before, during and after treatment with BTX-A. This publication aims at finding ways to gain greater patient satisfaction in daily practice.

Bronfenbrenner's Bioecological Theory Revision: Moving Culture From the Macro Into the Micro.

PubMed

Vélez-Agosto, Nicole M; Soto-Crespo, José G; Vizcarrondo-Oppenheimer, Mónica; Vega-Molina, Stephanie; García Coll, Cynthia

2017-09-01

Bronfenbrenner's bioecological theory of human development is one of the most widely known theoretical frameworks in human development. In spite of its popularity, the notion of culture within the macrosystem, as a separate entity of everyday practices and therefore microsystems, is problematic. Using the theoretical and empirical work of Rogoff and Weisner, and influenced as they are by Vygotsky's sociocultural perspective, we reconceptualize Bronfenbrenner's model by placing culture as an intricate part of proximal development processes. In our model, culture has the role of defining and organizing microsystems and therefore becomes part of the central processes of human development. Culture is an ever changing system composed of the daily practices of social communities (families, schools, neighborhoods, etc.) and the interpretation of those practices through language and communication. It also comprises tools and signs that are part of the historical legacy of those communities, and thus diversity is an integral part of the child's microsystems, leading to culturally defined acceptable developmental processes and outcomes.

On-demand rather than daily-routine chest radiography prescription may change neither the number nor the impact of chest computed tomography and ultrasound studies in a multidisciplinary intensive care unit.

PubMed

Kröner, Anke; Binnekade, Jan M; Graat, Marleen E; Vroom, Margreeth B; Stoker, Jaap; Spronk, Peter E; Schultz, Marcus J

2008-01-01

Elimination of daily-routine chest radiographs (CXRs) may influence chest computed tomography (CT) and ultrasound practice in critically ill patients. This was a retrospective cohort study including all patients admitted to a university-affiliated intensive care unit during two consecutive periods of 5 months, one before and one after elimination of daily-routine CXR. Chest CT and ultrasound studies were identified retrospectively by using the radiology department information system. Indications for and the diagnostic/therapeutic yield of chest CT and ultrasound studies were collected. Elimination of daily-routine CXR resulted in a decrease of CXRs per patient day from 1.1 +/- 0.3 to 0.6 +/- 0.4 (P < 0.05). Elimination did not affect duration of stay or mortality rates. Neither the number of chest CT studies nor the ratio of chest CT studies per patient day changed with the intervention: Before elimination of daily-routine CXR, 52 chest CT studies were obtained from 747 patients; after elimination, 54 CT studies were obtained from 743 patients. Similarly, chest ultrasound practice was not affected by the change of CXR strategy: Before and after elimination, 21 and 27 chest ultrasound studies were performed, respectively. Also, timing of chest CT and ultrasound studies was not different between the two study periods. During the two periods, 40 of 106 chest CT studies (38%) and 18 of 48 chest ultrasound studies (38%) resulted in a change in therapy. The combined therapeutic yield of chest CT and ultrasound studies did not change with elimination of daily-routine CXR. Elimination of daily-routine CXRs may not affect chest CT and ultrasound practice in a multidisciplinary intensive care unit.

Intergenerational Support in a Daily Context.

PubMed

Fingerman, Karen L; Kim, Kyungmin; Tennant, Patrick S; Birditt, Kira S; Zarit, Steven H

2016-10-01

Using retrospective global reports, studies have found that middle-aged adults in the United States provide intermittent support to their aging parents and more frequent support to grown children. To date, studies have not examined support middle-aged adults provide to different generations on a daily basis. Daily support may include mundane everyday exchanges that may (or may not) affect well-being. Middle-aged adults (N = 191, mean age 55.93) completed a general interview regarding family ties, followed by interviews each day for 7 days (N = 1,261 days). Daily interviews assessed support (e.g., advice, emotional, practical help) participants provided each grown child (n = 454) and aging parent (n = 253). Participants also reported daily mood. Most participants provided emotional support (80%), advice (87%), and practical help (69%) to a grown child and also provided emotional support (61%) and advice (61%) or practical help (43%) to a parent that week. Multilevel models confirmed generational differences; grown children were more likely to receive everyday support than parents. Providing support to grown children was associated with positive mood, whereas providing support to parents was associated with more negative mood. Daily intergenerational support was more common than studies using global reports of support have found. Some daily support may be fleeting and not stand out in memory. The findings were consistent with the intergenerational stake hypothesis, which suggests middle-aged adults are more invested in their grown children than in their parents. Nonetheless, middle-aged adults were highly involved with aging parents. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Hydrochemical processes in lowland rivers: insights from in situ, high-resolution monitoring

NASA Astrophysics Data System (ADS)

Wade, A. J.; Palmer-Felgate, E. J.; Halliday, S. J.; Skeffington, R. A.; Loewenthal, M.; Jarvie, H. P.; Bowes, M. J.; Greenway, G. M.; Haswell, S. J.; Bell, I. M.; Joly, E.; Fallatah, A.; Neal, C.; Williams, R. J.; Gozzard, E.; Newman, J. R.

2012-11-01

This paper introduces new insights into the hydrochemical functioning of lowland river systems using field-based spectrophotometric and electrode technologies. The streamwater concentrations of nitrogen species and phosphorus fractions were measured at hourly intervals on a continuous basis at two contrasting sites on tributaries of the River Thames - one draining a rural catchment, the River Enborne, and one draining a more urban system, The Cut. The measurements complement those from an existing network of multi-parameter water quality sondes maintained across the Thames catchment and weekly monitoring based on grab samples. The results of the sub-daily monitoring show that streamwater phosphorus concentrations display highly complex dynamics under storm conditions dependent on the antecedent catchment wetness, and that diurnal phosphorus and nitrogen cycles occur under low flow conditions. The diurnal patterns highlight the dominance of sewage inputs in controlling the streamwater phosphorus and nitrogen concentrations at low flows, even at a distance of 7 km from the nearest sewage treatment works in the rural River Enborne. The time of sample collection is important when judging water quality against ecological thresholds or standards. An exhaustion of the supply of phosphorus from diffuse and multiple septic tank sources during storm events was evident and load estimation was not improved by sub-daily monitoring beyond that achieved by daily sampling because of the eventual reduction in the phosphorus mass entering the stream during events. The results highlight the utility of sub-daily water quality measurements and the discussion considers the practicalities and challenges of in situ, sub-daily monitoring.

Exercise and sleep predict personal resources in employees' daily lives.

PubMed

Nägel, Inga J; Sonnentag, Sabine

2013-11-01

The present study investigates the interaction of exercise and sleep on state-like personal resources in employees' daily lives. Further, the study examines the association between state-like personal resources and emotional exhaustion. We conducted a diary study over five consecutive working days (total of 443 days) with 144 employees who answered daily online surveys after work and before bedtime. Multilevel modeling showed that exercise after work was positively related to the next day's personal resources when sleep duration during the night time was longer compared to other nights. Furthermore, personal resources positively related to lower emotional exhaustion after work on the next day. This study demonstrates that exercise and sleep may help to renew personal resources. Results stress the importance of balancing exercise and sleep in daily life. © 2013 The International Association of Applied Psychology.

Total and domain-specific sitting time among employees in desk-based work settings in Australia.

PubMed

Bennie, Jason A; Pedisic, Zeljko; Timperio, Anna; Crawford, David; Dunstan, David; Bauman, Adrian; van Uffelen, Jannique; Salmon, Jo

2015-06-01

To describe the total and domain-specific daily sitting time among a sample of Australian office-based employees. In April 2010, paper-based surveys were provided to desk-based employees (n=801) in Victoria, Australia. Total daily and domain-specific (work, leisure-time and transport-related) sitting time (minutes/day) were assessed by validated questionnaires. Differences in sitting time were examined across socio-demographic (age, sex, occupational status) and lifestyle characteristics (physical activity levels, body mass index [BMI]) using multiple linear regression analyses. The median (95% confidence interval [CI]) of total daily sitting time was 540 (531-557) minutes/day. Insufficiently active adults (median=578 minutes/day, [95%CI: 564-602]), younger adults aged 18-29 years (median=561 minutes/day, [95%CI: 540-577]) reported the highest total daily sitting times. Occupational sitting time accounted for almost 60% of total daily sitting time. In multivariate analyses, total daily sitting time was negatively associated with age (unstandardised regression coefficient [B]=-1.58, p<0.001) and overall physical activity (minutes/week) (B=-0.03, p<0.001) and positively associated with BMI (B=1.53, p=0.038). Desk-based employees reported that more than half of their total daily sitting time was accrued in the work setting. Given the high contribution of occupational sitting to total daily sitting time among desk-based employees, interventions should focus on the work setting. © 2014 Public Health Association of Australia.

Determinants of Knowledge and Safety Practices of Occupational Hazards of Textile Dye Workers in Sokoto, Nigeria: A Descriptive Analytic Study.

PubMed

Okafoagu, Nneka Christina; Oche, Mansur; Awosan, Kehinde Joseph; Abdulmulmuni, Hashim Bala; Gana, Godwin Jiya; Ango, Jessica Timane; Raji, Ismail

2017-06-23

Textile dye workers are subject to occupational hazards on a daily basis due to exposure to precarious conditions in the workplace. This study aimed to assess the knowledge, attitude and safety practices and its determinants among textile dye workers in Sokoto metropolis, Nigeria. This is a descriptive cross-sectional study conducted among 200 textile dye workers and the respondents were selected by multi stage sampling technique. Data was collected using an interviewer administered questionnaire. Data was processed using SPSS IBM version 20 and analyzed using descriptive and inferential statistics. Majority of the respondents (74.0%) had good knowledge of workplace hazards; (81.0%) had positive attitude and only 20% observed all the safety practices. Formal education (P=0.047); working less than 5 days a week (P=0.001) and permanent employment (P=0.013) were found to be determinants of respondents' knowledge and attitude towards workplace hazards. Although the respondents had good knowledge and positive attitude, their lack of observance of safety practices brings to fore the need for direct safety instruction and training and retraining of textile dye workers on workplace hazards and safety practices.

Physician perceptions of the role and value of basic science knowledge in daily clinical practice.

PubMed

Fischer, Jennifer A; Muller-Weeks, Susan

2012-01-01

The role of basic science education in a clinical setting remains unclear. Research to understand how academic clinicians perceive and use this part of their education can aid curricular development. To assess physician's attitudes toward the value of science knowledge in their clinical practice. Academic physicians from three medical schools completed a questionnaire about the utility of basic science education in core clinical tasks and in practice-based learning and improvement. A total of 109 clinical faculty returned the survey. Overall, 89% of the respondents indicated that basic science education is valuable to their clinical practice. When asked about the utility of basic science information in relation to direct patient care, greater than 50% of the doctors felt they use this when diagnosing and communicating with patients. This rose to greater than 60% when asked about choosing treatment options for their patients. Individuals also responded that basic science knowledge is valuable when developing evidence-based best practices. Specifically, 89% felt that they draw upon this information when training students/residents and 84% use this information when reading journal articles. This study shows that basic science education is perceived by responding academic physicians to be important to their clinical work.

Knowledge, Attitude, and Practices Regarding Occupational HIV Exposure and Protection among Health Care Workers in China: Census Survey in a Rural Area.

PubMed

Wu, Qian; Xue, Xiao Fei; Shah, Dimpy; Zhao, Jian; Hwang, Lu-Yu; Zhuang, GuiHua

2016-09-01

Health care workers (HCWs) seek, treat, and care for patients living with HIV/AIDS on a daily basis and thus face a significant risk to work-related infections. To assess the knowledge, attitude, and practices regarding occupational HIV exposure and protection among HCWs in low HIV prevalence areas of rural China. A cross-sectional questionnaire survey was carried out among all medical units in Pucheng County, Shaanxi, China. Response rate of this study was 94%. The average overall knowledge score of HCWs was 10.9 of 21.0. Deficiencies in general, transmission, exposure, and protection knowledge were identified among HCWs at all levels. A high rate of occupational exposure (85%) and lack of universal precautions practice behavior were recorded. Significant predictors of universal precautions practice behavior were female sex, prior training, and greater knowledge about HIV/AIDS. Health care workers at various levels have inadequate knowledge on HIV/AIDS and do not practice universal precautions. Nurses and medical technicians at the county level faced more occupation risk than other HCWs. The key of AIDS training for different levels of HCWs should be distinguished. © The Author(s) 2014.

Going the extra mile and feeling energized: An enrichment perspective of organizational citizenship behaviors.

PubMed

Lam, Chak Fu; Wan, Wylie H; Roussin, Christopher J

2016-03-01

Scholars have voiced concerns about the potential dark side of Organizational Citizenship Behavior (OCB), arguing that OCB consumes energy, which contributes to a depletion of personal resources and results in poorer well-being. Drawing from research on the meaningfulness of work, we propose a pattern opposite to depletion: that OCB enhances energy, which contributes to an enrichment of personal resources and results in better well-being. This idea was tested over the course of a workweek with 224 day-level ratings from 67 employees and 30 managers working in a service management firm. Three-level hierarchical linear modeling indicated that supervisor-rated daily OCB was positively associated with employees' vigor at the end of the workday, and multilevel structural equation modeling analyses showed that this relationship was mediated by meaningfulness of work. Moreover, we found that the association between OCB and work meaningfulness was stronger for employees with greater role ambiguity. Exploratory analyses revealed that daily in-role performance and daily OCB interacted to predict meaningfulness of work, such that the association between daily OCB and meaningfulness of work was more prominent among those who exhibited high levels of daily in-role performance. We discuss implications of these findings, limitations, and directions for future research. (c) 2016 APA, all rights reserved).

[Diabetes mellitus in cardiology practice in Spain. Survey by the Working Group on Heart and Diabetes regarding the importance of diabetes mellitus in relation with other cardiovascular diseases].

PubMed

Palma Gámiz, José L; Hernández Madrid, Antonio; Bertomeu Martínez, Vicente; González-Juanatey, José R; López García-Aranda, Víctor; Calderón Montero, Alberto; Alegría Ezquerra, Eduardo; Cadierno Carpintero, Moisés

2004-07-01

Diabetes mellitus has been defined as a cardiovascular disease of metabolic origin. This article reports the results of a survey of cardiologists regarding their knowledge about this disease and their management of patients with diabetes in daily practice. A survey was mailed to all 1840 cardiologists who were members of the Spanish Society of Cardiology, and responses were returned by 348 (18.9%). The survey consisted of 16 questions dealing with organizational and practical aspects of cardiological management for patients with diabetes. The creation of a Working Group on the Heart and Diabetes was judged necessary by 90.2% of the responders. Almost two thirds of the members felt their knowledge of diabetes and its treatment was inadequate, and 82.5% declared that cardiologists should be better able to treat patients with diabetes, since between 15% and 30% of the patients they see have this disease. With respect to secondary prevention, 65.8% of the cardiologists felt that medical care is much better for coronary patients than for patients with diabetes. Among the latter, angiotensin-inhibiting drugs, statins and aspirin are used for secondary prevention. Because of gaps in the cardiologist's knowledge of how to manage diabetes, the high prevalence of diabetes and its unquestionable impact on the cardiovascular system additional clinical training and educational efforts are needed. One potentially useful measure is the creation of a specific Working Group on the Heart and Diabetes.

The knowledge of intensive care professionals about diarrhea

PubMed Central

Lordani, Cláudia Regina Felicetti; Eckert, Raquel Goreti; Tozetto, Altevir Garcia; Lordani, Tarcísio Vitor Augusto; Duarte, Péricles Almeida Delfino

2014-01-01

Objective To assess the opinions and practices of intensive care professionals with regard to diarrhea in critically ill patients. Methods A multicenter cross-sectional study was conducted among health care professionals working at three adult intensive care units. Participants responded individually to a self-administered questionnaire about their length of work experience in intensive care; the definition, characterization, and causes of diarrhea; types of records in the patient's medical record; and training received. Results A total of 78 professionals participated in this study, of whom 59.0% were nurse technicians, 25.7% were nurses, and 15.3% were physicians; 77.0% of them had worked in intensive care for over 1 year. Only 37.2% had received training on this topic. Half of the interviewees defined diarrhea as "liquid and/or pasty stools" regardless of frequency, while the other 50.0% defined diarrhea based on the increased number of daily bowel movements. The majority of them mentioned diet as the main cause of diarrhea, followed by "use of medications" (p<0.001). Distinct nutritional practices were observed among the analyzed professionals regarding episodes of diarrhea, such as discontinuing, maintaining, or reducing the volume of enteral nutrition; physicians reported that they do not routinely communicate the problem to other professionals (for example, to a nutritionist) and do not routinely record and quantify diarrhea events in patients' medical records. Conclusion Different opinions and practices were observed in intensive care professionals with regard to diarrhea. PMID:25295825

Pollen and mold exposure impairs the work performance of employees with allergic rhinitis.

PubMed

Kessler, R C; Almeida, D M; Berglund, P; Stang, P

2001-10-01

Although quality of life studies suggest that allergic rhinitis has a substantial impact on work impairment, national survey estimates of the magnitude of this impairment have varied widely. Retrospective recall bias is likely to be a major cause of this variability. This study used a nationally representative daily diary sample to obtain prospective data that improve on previous estimates of the work impairment because of allergic rhinitis. The MacArthur Foundation National Survey of Daily Experience is a daily diary survey that included a nationally representative subsample of 739 employed people, each of whom provided daily reports on work performance for 1 randomly assigned week of the calendar year. National Allergy Bureau monitoring station data were merged with the survey data to study the association of time-space variation in pollen/mold exposure with impaired daily work quality and quantity. National Allergy Bureau pollen/mold counts are significantly related to work impairments only among respondents with self-reported allergic rhinitis. The average estimated monthly salary-equivalent work impairment costs associated with pollen/mold exposure for each allergy sufferer is between $109 and $156, with an annualized national projection of between $5.4 billion and $7.7 billion. The extent to which these costs can be recovered by increasing the proportion of allergy sufferers who are successfully treated remains unknown and can only be evaluated definitively in effectiveness trials.

Mindfulness meditation in older adults with postherpetic neuralgia: a randomized controlled pilot study.

PubMed

Meize-Grochowski, Robin; Shuster, George; Boursaw, Blake; DuVal, Michelle; Murray-Krezan, Cristina; Schrader, Ron; Smith, Bruce W; Herman, Carla J; Prasad, Arti

2015-01-01

This parallel-group, randomized controlled pilot study examined daily meditation in a diverse sample of older adults with postherpetic neuralgia. Block randomization was used to allocate participants to a treatment group (n = 13) or control group (n = 14). In addition to usual care, the treatment group practiced daily meditation for six weeks. All participants completed questionnaires at enrollment in the study, two weeks later, and six weeks after that, at the study's end. Participants recorded daily pain and fatigue levels in a diary, and treatment participants also noted meditation practice. Results at the 0.10 level indicated improvement in neuropathic, affective, and total pain scores for the treatment group, whereas affective pain worsened for the control group. Participants were able to adhere to the daily diary and meditation requirements in this feasibility pilot study. Copyright © 2015 Elsevier Inc. All rights reserved.

Service workers' chain reactions to daily customer mistreatment: Behavioral linkages, mechanisms, and boundary conditions.

PubMed

Chi, Nai-Wen; Yang, Jixia; Lin, Chia-Ying

2018-01-01

Drawing on the stressor-emotion model, we examine how customer mistreatment can evoke service workers' passive forms of deviant behaviors (i.e., work withdrawal behavior [WWB]) and negative impacts on their home life (i.e., work-family conflict [WFC]), and whether individuals' core self-evaluations and customer service training can buffer the negative effects of customer mistreatment. Using the experience sampling method, we collect daily data from 77 customer service employees for 10 consecutive working days, yielding 546 valid daily responses. The results show that daily customer mistreatment increases service workers' daily WWB and WFC through negative emotions. Furthermore, employees with high core self-evaluations and employees who received customer service training are less likely to experience negative emotions when faced with customer mistreatment, and thus are less likely to engage in WWB or provoke WFC. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Acceptability Among Community Healthcare Nurses of Intelligent Wireless Sensor-system Technology for the Rapid Detection of Health Issues in Home-dwelling Older Adults.

PubMed

Cohen, Christine; Kampel, Thomas; Verloo, Henk

2017-01-01

The effective care and support of community healthcare nurses (CHNs) contribute greatly to the healthy aging of older adults living at home. Integrating innovative technologies into CHNs' daily practice offers new opportunities and perspectives for early detection of health issues and interventions among home-dwelling older adults. To explore the perception of acceptability among CHNs of an intelligent wireless sensor system (IWSS) for use in daily practice for the detection of health issues in home-dwelling older adults receiving home healthcare. Descriptive and qualitative data were sourced from a pilot randomized controlled trial involving 17 CHNs using an IWSS in their daily practice to rapidly detect falls and other health issues in patients' homes. IWSS alerts indicating behavior changes were sent to CHNs. Their perceived usefulness (PU) and perceived ease of use (PEOU) were assessed. The acceptability of IWSS technology was explored using a questionnaire and focus group discussions. The PU and PEOU of the IWSS technology were low to moderate. A majority of the CHNs were dissatisfied with its performance and intrusiveness; they reported multiple obstacles in the usefulness and ease of use of the IWSS technology in daily practice. To improve the IWSS technology's low to moderate acceptability among CHNs, we recommend a more user-centered implementation strategy and an embedded model of nursing care.

40 CFR 439.12 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2011 CFR

2011-07-01

... percent reduction in the long-term average daily BOD5 load of the raw (untreated) process wastewater, multiplied by a variability factor of 3.0. (1) The long-term average daily BOD5 load of the raw process... concentration value reflecting a reduction in the long-term average daily COD load in the raw (untreated...

40 CFR 439.12 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2010 CFR

2010-07-01

... percent reduction in the long-term average daily BOD5 load of the raw (untreated) process wastewater, multiplied by a variability factor of 3.0. (1) The long-term average daily BOD5 load of the raw process... concentration value reflecting a reduction in the long-term average daily COD load in the raw (untreated...

Blogs-Learning a New Arts Learning Medium: So Far Neither Rare nor Exactly Well Done

ERIC Educational Resources Information Center

Chaney, Keidra

2005-01-01

Blogging as a practice can be defined as different things to different people. There are those that keep personal online diaries to keep friends, family, and total strangers abreast of what's going on in their daily lives; news blogs that keep a daily or weekly digest of current events; politically oriented blogs that report daily events…

Aging Parents' Daily Support Exchanges With Adult Children Suffering Problems.

PubMed

Huo, Meng; Graham, Jamie L; Kim, Kyungmin; Birditt, Kira S; Fingerman, Karen L

2017-06-17

When adult children incur life problems (e.g., divorce, job loss, health problems), aging parents generally report providing more frequent support and experiencing poorer well-being. Yet, it is unclear how adult children's problems may influence aging parents' daily support exchanges with these children or the parents' daily mood. Aging parents from the Family Exchanges Study Wave 2 (N = 207, Mage = 79.86) reported providing and receiving emotional support, practical support, and advice from each adult child each day for 7 days. Parents also rated daily positive and negative mood. Multilevel models showed that aging parents were more likely to provide emotional and practical support to adult children incurring life problems than children not suffering problems. Parents were also more likely to receive emotional support and advice from these children with problems. Further, parents reported less negative mood on days when providing practical support to children with problems. Examining daily support exchanges adds to our understanding of how children's problems influence parent-child ties in late life. Prior research suggests that children's problems upset parents. In this study, however, it appears that supporting adult children who suffer problems may alleviate aging parents' distress regarding such children. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Self-reporting of internal medicine house staff work hours.

PubMed

Saunders, David L; Kehoe, Kimberly C; Rinehart, Vivian H; Berg, Benjamin W

2005-01-01

The 80-hour workweek became a reality for residency programs nationwide on July 1, 2003. In this review of administrative data, we examine the self-reporting of work hours by a cohort of Internal Medicine residents. Data was collected from 27 residents in training at Tripler Army Medical Center over a 4 month period from September 1 to December 31 2002. House staff reported their hours on a daily basis by responding to an email message, as well as on a monthly basis utilizing the Army's UCAPERs (Uniform Chart of Account Personnel System) mandatory monthly workload tracking system. Data from the two separate reporting systems was compared for accuracy, completeness and internal consistency. Compliance with daily reporting was variable (67-97% with overall compliance rate of 86%) but lower when compared with the mandatory military monthly reporting system (95-100%). There were large differences in reporting of average weekly work hours among individual residents when monthly reporting was compared to daily reporting of data with higher averages with monthly data reporting. Weekly totals averaged nearly 12 hours higher when reported monthly compared to reporting on a daily basis (p < 0.0001). A total of 18 residents reported that they worked more than 80 hours per week during one month using monthly data, while only 7 reported that they averaged more than 80 hours with the daily reporting data. When average weekly hours reported on a daily basis were compared with the total number of inpatient days worked over the four month period using a simple regression model, there was a significant relationship with average hours increasing with increasing number of inpatient days worked (adjusted R square = 0. 19, p = 0.01). Little internal consistency was found in the comparison of daily versus monthly work hour reporting, indicating that self-reporting may not provide accurate data. Complying with the 80-hour workweek is crucial for residency programs to maintain accreditation, and thus programs will need a way to accurately capture consistent resident work hour data. Further studies are indicated to determine the most accurate way of assessing house staff work hours.

Ethics reflection groups in community health services: an evaluation study.

PubMed

Lillemoen, Lillian; Pedersen, Reidar

2015-04-17

Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health (including nursing homes and residency), - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project. A mixed-methods design with qualitative focus group interviews, observations and written reports were used to evaluate. The study was conducted at two nursing homes, two home care districts and a residence for people with learning disabilities. Participants were employees, facilitators and service managers. The study was guided by ethical standard principles and was approved by the Norwegian Social Science Data Services. We found support for ethics reflection as a valuable measure to strengthen clinical practice. New and improved solutions, more cooperation between employees, and improved collaboration with patients and their families are some of the results. No negative experiences were found. Instead, the ethics reflection based on experiences and challenges in the workplace, was described as a win-win situation. The evaluation also revealed what is needed to succeed and useful tips for further development of ethics support in community health services. Ethics reflection groups focusing on ethical challenges from the participants' daily work were found to be significant for improved practice, collegial support and cooperation, personal and professional development among staff, facilitators and managers. Resources needed to succeed were managerial support, and anchoring ethics sessions in the routine of daily work.

Intervention to reduce heat stress and improve efficiency among sugarcane workers in El Salvador: Phase 1.

PubMed

Bodin, T; García-Trabanino, R; Weiss, I; Jarquín, E; Glaser, J; Jakobsson, K; Lucas, R A I; Wesseling, C; Hogstedt, C; Wegman, D H

2016-06-01

Chronic heat stress and dehydration from strenuous work in hot environments is considered an essential component of the epidemic of chronic kidney disease in Central America. (1) To assess feasibility of providing an intervention modelled on OSHA's Water.Rest.Shade programme (WRS) during sugarcane cutting and (2) to prevent heat stress and dehydration without decreasing productivity. Midway through the 6-month harvest, the intervention introduced WRS practices. A 60-person cutting group was provided water supplied in individual backpacks, mobile shaded rest areas and scheduled rest periods. Ergonomically improved machetes and efficiency strategies were also implemented. Health data (anthropometric, blood, urine, questionnaires) were collected preharvest, preintervention, mid-intervention and at the end of harvest. A subsample participated in focus group discussions. Daily wet bulb globe temperatures (WBGT) were recorded. The employer provided individual production records. Over the harvest WBGT was >26°C from 9:00 onwards reaching average maximum of 29.3±1.7°C, around 13:00. Postintervention self-reported water consumption increased 25%. Symptoms associated with heat stress and with dehydration decreased. Individual daily production increased from 5.1 to a high of 7.3 tons/person/day postintervention. This increase was greater than in other cutting groups at the company. Focus groups reported a positive perception of components of the WRS, and the new machete and cutting programmes. A WRS intervention is feasible in sugarcane fields, and appears to markedly reduce the impact of the heat stress conditions for the workforce. With proper attention to work practices, production can be maintained with less impact on worker health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Intervention to reduce heat stress and improve efficiency among sugarcane workers in El Salvador: Phase 1

PubMed Central

Bodin, T; García-Trabanino, R; Weiss, I; Jarquín, E; Glaser, J; Jakobsson, K; Lucas, R A I; Wesseling, C; Hogstedt, C; Wegman, D H

2016-01-01

Background Chronic heat stress and dehydration from strenuous work in hot environments is considered an essential component of the epidemic of chronic kidney disease in Central America. Objective (1) To assess feasibility of providing an intervention modelled on OSHA's Water.Rest.Shade programme (WRS) during sugarcane cutting and (2) to prevent heat stress and dehydration without decreasing productivity. Methods Midway through the 6-month harvest, the intervention introduced WRS practices. A 60-person cutting group was provided water supplied in individual backpacks, mobile shaded rest areas and scheduled rest periods. Ergonomically improved machetes and efficiency strategies were also implemented. Health data (anthropometric, blood, urine, questionnaires) were collected preharvest, preintervention, mid-intervention and at the end of harvest. A subsample participated in focus group discussions. Daily wet bulb globe temperatures (WBGT) were recorded. The employer provided individual production records. Results Over the harvest WBGT was >26°C from 9:00 onwards reaching average maximum of 29.3±1.7°C, around 13:00. Postintervention self-reported water consumption increased 25%. Symptoms associated with heat stress and with dehydration decreased. Individual daily production increased from 5.1 to a high of 7.3 tons/person/day postintervention. This increase was greater than in other cutting groups at the company. Focus groups reported a positive perception of components of the WRS, and the new machete and cutting programmes. Conclusions A WRS intervention is feasible in sugarcane fields, and appears to markedly reduce the impact of the heat stress conditions for the workforce. With proper attention to work practices, production can be maintained with less impact on worker health. PMID:27073211

Interprofessional team management in pediatric critical care: some challenges and possible solutions

PubMed Central

Stocker, Martin; Pilgrim, Sina B; Burmester, Margarita; Allen, Meredith L; Gijselaers, Wim H

2016-01-01

Background Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU) has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous. Methods We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts. Findings The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal factors to learning in daily practice. Finally, changes in small steps at the level of the microlevel unit are the bases to improve interprofessional team management and patient safety. Once small things with potential impact can be changed in one’s own unit, engagement of health care professionals occurs and projects become accepted. Conclusion Bottom–up patient safety initiatives encouraging participation of every single care provider by learning effective interprofessional team management within daily practice may be an effective way of fostering patient safety. PMID:26955279

Interprofessional team management in pediatric critical care: some challenges and possible solutions.

PubMed

Stocker, Martin; Pilgrim, Sina B; Burmester, Margarita; Allen, Meredith L; Gijselaers, Wim H

2016-01-01

Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU) has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous. We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts. The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal factors to learning in daily practice. Finally, changes in small steps at the level of the microlevel unit are the bases to improve interprofessional team management and patient safety. Once small things with potential impact can be changed in one's own unit, engagement of health care professionals occurs and projects become accepted. Bottom-up patient safety initiatives encouraging participation of every single care provider by learning effective interprofessional team management within daily practice may be an effective way of fostering patient safety.

Perceived Barriers and Facilitators of Using a Web-Based Interactive Decision Aid for Colorectal Cancer Screening in Community Practice Settings: Findings From Focus Groups With Primary Care Clinicians and Medical Office Staff

PubMed Central

2013-01-01

Background Information is lacking about the capacity of those working in community practice settings to utilize health information technology for colorectal cancer screening. Objective To address this gap we asked those working in community practice settings to share their perspectives about how the implementation of a Web-based patient-led decision aid might affect patient-clinician conversations about colorectal cancer screening and the day-to-day clinical workflow. Methods Five focus groups in five community practice settings were conducted with 8 physicians, 1 physician assistant, and 18 clinic staff. Focus groups were organized using a semistructured discussion guide designed to identify factors that mediate and impede the use of a Web-based decision aid intended to clarify patient preferences for colorectal cancer screening and to trigger shared decision making during the clinical encounter. Results All physicians, the physician assistant, and 8 of the 18 clinic staff were active participants in the focus groups. Clinician and staff participants from each setting reported a belief that the Web-based patient-led decision aid could be an informative and educational tool; in all but one setting participants reported a readiness to recommend the tool to patients. The exception related to clinicians from one clinic who described a preference for patients having fewer screening choices, noting that a colonoscopy was the preferred screening modality for patients in their clinic. Perceived barriers to utilizing the Web-based decision aid included patients’ lack of Internet access or low computer literacy, and potential impediments to the clinics’ daily workflow. Expanding patients’ use of an online decision aid that is both easy to access and understand and that is utilized by patients outside of the office visit was described as a potentially efficient means for soliciting patients’ screening preferences. Participants described that a system to link the online decision aid to a computerized reminder system could promote a better understanding of patients’ screening preferences, though some expressed concern that such a system could be difficult to keep up and running. Conclusions Community practice clinicians and staff perceived the Web-based decision aid technology as promising but raised questions as to how the technology and resultant information would be integrated into their daily practice workflow. Additional research investigating how to best implement online decision aids should be conducted prior to the widespread adoption of such technology so as to maximize the benefits of the technology while minimizing workflow disruptions. PMID:24351420

The Baby Care Questionnaire: A measure of parenting principles and practices during infancy☆

PubMed Central

Winstanley, Alice; Gattis, Merideth

2013-01-01

The current report provides a new framework to explore the role of parenting practices and principles during infancy. We identify structure and attunement as key parenting principles during infancy. Structure represents reliance on regularity and routines in daily life. Attunement represents reliance on infant cues and close physical contact. We suggest parents’ relative endorsement of these parenting principles is related to their choices about practices such as feeding, holding and night-time sleeping. We designed the Baby Care Questionnaire to measure parents’ endorsement of structure and attunement, as well as their daily parenting practices. We report data demonstrating the factor structure, reliability and validity of the BCQ. The BCQ, to our knowledge, is the first comprehensive measure of parenting practices and principles during infancy. We conclude with a discussion of future directions for the measure. PMID:24050932

Barriers and Facilitators to eHealth Use in Daily Practice: Perspectives of Patients and Professionals in Dermatology

PubMed Central

Schussler-Raymakers, Florine ML; Frima, Cynthia; Flinterman, Annebeth; Hamminga, Eefje; Arents, Bernd WM; Bruijnzeel-Koomen, Carla AFM; de Bruin-Weller, Marjolein S; van Os-Medendorp, Harmieke

2017-01-01

Background The number of eHealth interventions in the management of chronic diseases such as atopic dermatitis (AD) is growing. Despite promising results, the implementation and use of these interventions is limited. Objectives This study aimed to assess opinions of the most important stakeholders influencing the implementation and use of eHealth services in daily dermatology practice. Methods The perspectives of health care professionals and patients towards the implementation and use of eHealth services in daily practice were assessed by using a mixed method design. A cross-sectional survey based on the eHealth implementation toolkit (eHit) was conducted to explore factors influencing the adoption of eHealth interventions offering the possibility of e-consultations, Web-based monitoring, and Web-based self-management training among dermatologists and dermatology nurses. The perspectives of patients with atopic dermatitis (AD) regarding the use of eHealth services were discussed in an online focus group. Results Health care professionals (n=99) and patients (n=9) acknowledged the value of eHealth services and were willing to use these digital tools in daily dermatology practice. Key identified barriers (statements with <50% of the participants scoring totally agree or agree) in the implementation and adoption of eHealth interventions included concerns about the availability (12/99, 12%) and allocation (14/99, 14%) of resources, financial aspects (26/99, 26%), reliability, security, and confidentially of the intervention itself (29/99, 29%), and the lack of education and training (6/99, 6%). Conclusions Health care professionals and patients acknowledge the benefits arising from the implementation and use of eHealth services in daily dermatology practice. However, some important barriers were identified that might be useful in addressing the implementation strategy in order to enhance the implementation success of eHealth interventions in dermatology. PMID:28874336

Meanings of immediate: the practical use of the Patient's Charter in the accident and emergency department.

PubMed

Sbaih, Lynn C

2002-05-01

The publication of the Patient's Charter in Britain enabled patients to have access to a series of documented standards relating to health care provision in a variety of situations. However since its introduction much discussion has taken place as to its application in clinical practice. An initial interest in the accomplishment of routine accident and emergency (A& E) nursing work led to the identification of issues associated with the use of the Patient's Charter standards; particularly those associated with immediate assessment in the A & E department. Data were collected from 60 nurses in five A& E departments and analysed using a multidisciplinary multistage approach. Findings suggest that nurses are expected to juggle the daily tensions produced by the Charter standards, associated with initial assessment, alongside the accomplishment of other aspects of the work dedicated to the safe movement of patients through the system. Tensions are rooted in two particular issues. Firstly, the meanings of immediate assessment continue to remain open to interpretation and therefore difficult to capture and manage. Secondly, the Patient's Charter standards, associated with immediate assessment, deal with one aspect of the work only and yet the accomplishment of A & E work is dependent upon maintaining a perception of order and shape throughout the whole department. Ultimately both issues have an impact on nurses' recognition and management of what they know to be the normal appearances and shape of routine work.

The effects of employment status and daily stressors on time spent on daily household chores in middle-aged and older adults.

PubMed

Wong, Jen D; Almeida, David M

2013-02-01

This study examines how employment status (worker vs. retiree) and life course influences (age, gender, and marital status) are associated with time spent on daily household chores. Second, this study assesses whether the associations between daily stressors and time spent on daily household chores differ as a function of employment status and life course influences. Men and women aged 55-74 from the National Study of Daily Experiences (N = 268; 133 workers and 135 retirees), a part of the National Survey of Midlife in the United States (MIDUS), completed telephone interviews regarding their daily experiences across 8 consecutive evenings. Working women spent more than double the amount of time on daily household chores than working men. Unmarried retirees spent the most time on daily household chores in comparison to their counterparts. There was a trend toward significance for the association between home stressors from the previous day and time spent on daily household chores as a function of employment and marital status. These findings highlight the importance of gender and marital status in the associations between employment status and time spent on daily household chores and the role that daily stressors, in particular home stressful events, have on daily household chore participation.

29 CFR 794.142 - Special compensation when overtime in excess of 12 daily or 56 weekly hours is worked in the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... employee in a workweek when his hours worked do not exceed 56 in the week; and for all weekly overtime hours in excess of 56 which he works in a workweek when he does not work more than 12 hours in any day. When an employee works in excess of both the daily and weekly maximum hours standards in any workweek...

Reflective practice and daily ward reality: a covert power game.

PubMed

Mantzoukas, Stefanos; Jasper, Melanie A

2004-11-01

The concept of reflection is propounded in the literature as an epistemology for practice that enables practitioners to solve their daily problematic situations through conscious thought processes which eventually leads to practice-based knowledge. Hence, reflection became a central tenet of both theory development and educational provision in nursing. Furthermore, this centrality of reflection was reinforced by statutory nursing bodies and service providers by adopting it as the means for carrying out adequate professional practice. Although this may be the case, issues of implementation of reflection within the daily reality of practitioners are frequently overlooked within the literature. Moreover, little consideration appears to be given on the impact that the organizational culture and the politics of power may exert on the implementation of reflective practices within daily ward reality. This paper explores how reflection is viewed by nurses within their daily reality in the medical wards, examines the relationships between the organizational culture of these wards and the practitioners and investigates whether reflective methods of practice were being implemented when the study was conducted. An interpretative ethnographical methodology was implemented and the data collecting methods used were observation, interviews and qualitative content analysis with a group of 16 practising nurses from four medical wards of one NHS Trust in England. Two interviews were conducted with each nurse within 3-week intervals. The content of these interviews evolved from the analysis of episodes of practice observed when the nurses were giving nursing care. These data were supplemented by narratives from the nurses' in the form of written reflective accounts that were analysed via qualitative content analysis techniques. Four themes were generated: (i) relationships between nurses and doctors; (ii) relationships between nurses and managers; (iii) nursing practice; and (iv) nurses' input in the outcome of a clinical situation. The concept of reflection appears to be invalidated by the organizational hierarchy of the wards on the basis of a power struggle game. The ward structure portrays reflection as an abnormal method of practice and knowledge development. This belittlement of reflection does not mirror the practitioners' reality. Instead, it is an intelligent and intentional act on behalf of the dominant professional groups in the wards to create an illusionary picture of ward reality to allow them to survey and define nursing practice and thus maintain and remain in power. This is explicated by using Foucault's analysis and critical social theory framework. Hence, reflective processes are constrained by this covert power game; reflection, where used, is confined to nurses' personal time and space. The realization of this covert power game by individual clinical nurses can become the incipient point for formally using reflective methods in the practice setting.

Expectations of younger patients concerning activities after knee arthroplasty: are we asking the right questions?

PubMed

Witjes, Suzanne; van Geenen, Rutger C I; Koenraadt, Koen L M; van der Hart, Cor P; Blankevoort, Leendert; Kerkhoffs, Gino M M J; Kuijer, P Paul F M

2017-02-01

Indications for total and unicondylar knee arthroplasty (KA) have expanded to younger patients, in which Patient-Reported Outcome Measures (PROMs) often show ceiling effects. This might be due to higher expectations. Our aims were to explore expectations of younger patients concerning activities in daily life, work and leisure time after KA and to assess to what extent PROMs meet and evaluate these activities of importance. Focus groups were performed among osteoarthritis (OA) patients <65 years awaiting KA, in which they indicated what activities they expected to perform better in daily life, work and leisure time after KA. Additionally, 28 activities of daily life, 17 of work and 27 of leisure time were depicted from seven PROMS, which were rated on importance, frequency and bother. A total score, representing motivation for surgery, was also calculated. Data saturation was reached after six focus groups including 37 patients. Younger OA patients expect to perform better on 16 activities after KA, including high-impact leisure time activities. From the PROMs, daily life and work activities were rated high in both importance and motivation for surgery, but for leisure time activities importance varied highly between patients. All seven PROMs score activities of importance, but no single PROM incorporates all activities rated important. Younger patients expect to perform better on many activities of daily life, work and leisure time after KA, and often at demanding levels. To measure outcomes of younger patients, we suggest using PROMs that include work and leisure time activities besides daily life activities, in which preferably scored activities can be individualized.

Total food duplicate study on nutrient intake of working women in Manila, the Philippines.

PubMed

Nakatsuka, H; Zhang, Z W; Agetano, M G; Subida, R D; Inouguchi, N; Watanabe, T; Shimbo, S; Higashikawa, K; Ikeda, M

1998-03-01

Intakes of various nutrients by working women in Manila, the Philippines, was surveyed by the total food duplicate method, with foci to elucidate relative weight of three meals and snack in addition to quantitative evaluation of nutrient intakes. In practice, 45 women (average age; 37.2 years) volunteered, who were all nonsmokers and nonhabitual drinkers, and mostly married. In parallel, hematology, serum biochemistry, anthropometry and clinical examinations were conducted. On average, the women took 1787 kcal energy, 57 g protein, and 54 g lipid daily. Comparison with the Recommended Dietary Allowances (RDA) for Filipinos showed that intakes of energy and major nutrients were adequate, whereas that of minerals (e.g., 15 mg Fe/day vs. 26 mg Fe/day as RDA) and vitamins (e.g., 0.65 mg vitamin B1/day vs. 1 mg/day as RDA) were generally insufficient. Prevalence of anemia was however rather low with an average hemoglobin concentration of 12.9 g/100 ml blood. Rice was the staple source of energy for daily life, and beef rather than fish and shellfish was the leading source of protein. Lunch was the richest meal of a day (with the largest intake of energy, protein and lipid), and snacks rather than dinner appeared to be next substantial.

Outsourcing issues for nurse practitioner practices.

PubMed

Mackey, Thomas A; McNiel, Nancy O; Klingensmith, Kenneth

2004-01-01

Nurse practitioner managed practices face multiple business and clinical processes. While most practice managers are prepared as clinicians, they are not well prepared to deal with the daily multiple business infrastructure issues they face. To provide for increased efficiency and effectiveness, nurse practitioner practices should consider outsourcing context business functions.

The application of participatory ergonomics in a healthcare setting in Hong Kong.

PubMed

Lee, Edwin W C; Fok, Joan P C; Lam, Augustine T; Law, Rainbow K Y; Szeto, Grace P Y; Li, Philip P K

2014-01-01

Work-related musculoskeletal disorders (WRMDs) are recognized as a major source of significant pain and disability in the healthcare sector. However, they are preventable if appropriate surveillance and intervention programs are implemented. The purpose of this paper is to describe the holistic ergonomic approach that was used to address the multifactorial problems encountered by healthcare workers in their daily work. Using participatory ergonomics, healthcare workers in this study teamed up with management and staff with expertise in ergonomic analysis, design, and implementation of remedies. Selected participatory ergonomic intervention programs targeted at an organizational level are elaborated. Interventions included pre-work stretching, workplace surveillance at a psychiatric department, on-site ergonomic teaching for community nurses, and display screen equipment consultancy. Changes in workplace design, equipment re-arrangement, awareness of proper posture, and adoption of good work practices all play important roles in reducing musculoskeletal disorders among healthcare workers. Prompt occupational medicine and rehabilitation services were also provided to complement the work disability prevention process. The impact of the various intervention programs on staff health, costs and productivity of the organization are simultaneously discussed.

Evaluating Food Safety Knowledge and Practices of Food Processors and Sellers Working in Food Facilities in Hanoi, Vietnam.

PubMed

Tran, Bach Xuan; DO, Hoa Thi; Nguyen, Luong Thanh; Boggiano, Victoria; LE, Huong Thi; LE, Xuan Thanh Thi; Trinh, Ngoc Bao; DO, Khanh Nam; Nguyen, Cuong Tat; Nguyen, Thanh Trung; Dang, Anh Kim; Mai, Hue Thi; Nguyen, Long Hoang; Than, Selena; Latkin, Carl A

2018-04-01

Consumption of fast food and street food is increasingly common among Vietnamese, particularly in large cities. The high daily demand for these convenient food services, together with a poor management system, has raised concerns about food hygiene and safety (FHS). This study aimed to examine the FHS knowledge and practices of food processors and sellers in food facilities in Hanoi, Vietnam, and to identify their associated factors. A cross-sectional study was conducted with 1,760 food processors and sellers in restaurants, fast food stores, food stalls, and street vendors in Hanoi in 2015. We assessed each participant's FHS knowledge using a self-report questionnaire and their FHS practices using a checklist. Tobit regression was used to determine potential factors associated with FHS knowledge and practices, including demographics, training experience, and frequency of health examination. Overall, we observed a lack of FHS knowledge among respondents across three domains, including standard requirements for food facilities (18%), food processing procedures (29%), and food poisoning prevention (11%). Only 25.9 and 38.1% of participants used caps and masks, respectively, and 12.8% of food processors reported direct hand contact with food. After adjusting for socioeconomic characteristics, these factors significantly predicted increased FHS knowledge and practice scores: (i) working at restaurants and food stalls, (ii) having FHS training, (iii) having had a physical examination, and (iv) having taken a stool test within the last year. These findings highlight the need of continuous training to improve FHS knowledge and practices among food processors and food sellers. Moreover, regular monitoring of food facilities, combined with medical examination of their staff, should be performed to ensure food safety.

Positive Emotion Correlates of Meditation Practice: A Comparison of Mindfulness Meditation and Loving-kindness Meditation.

PubMed

Fredrickson, Barbara L; Boulton, Aaron J; Firestine, Ann M; Van Cappellen, Patty; Algoe, Sara B; Brantley, Mary M; Kim, Sumi Loundon; Brantley, Jeffrey; Salzberg, Sharon

2017-12-01

The purpose of this study was to uncover the day-to-day emotional profiles and dose-response relations, both within-persons and between-persons, associated with initiating one of two meditation practices, either mindfulness meditation or loving-kindness meditation. Data were pooled across two studies of midlife adults ( N = 339) who were randomized to learn either mindfulness meditation or loving-kindness meditation in a six-week workshop. The duration and frequency of meditation practice was measured daily for nine weeks, commencing with the first workshop session. Likewise, positive and negative emotions were also measured daily, using the modified Differential Emotions Scale (Fredrickson, 2013). Analysis of daily emotion reports over the targeted nine-week period showed significant gains in positive emotions and no change in negative emotions, regardless of meditation type. Multilevel models also revealed significant dose-response relations between duration of meditation practice and positive emotions, both within-persons and between-persons. Moreover, the within-person dose-response relation was stronger for loving-kindness meditation than for mindfulness meditation. Similar dose-response relations were observed for the frequency of meditation practice. In the context of prior research on the mental and physical health benefits produced by subtle increases in day-to-day experiences of positive emotions, the present research points to evidence-based practices - both mindfulness meditation and loving-kindness meditation - that can improve emotional wellbeing.

40 CFR 439.22 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2011 CFR

2011-07-01

... limitation for BOD5 that is less than the equivalent of 45 mg/L. (1) The long-term average daily BOD5 load of... to this subpart, calculation of the long-term average daily BOD5 load in the influent to the... this section is higher than a concentration value reflecting a reduction in the long-term average daily...

40 CFR 439.52 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2012 CFR

2012-07-01

..., kg) per day, must reflect not less than 74 percent reduction in the long-term average daily COD load... long-term average daily BOD5 or COD mass loading of the raw process wastewater (i.e., the base number..., calculation of the long-term average daily BOD5 or COD load in the influent to the wastewater treatment system...

40 CFR 439.22 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2013 CFR

2013-07-01

... average limitation for BOD5 that is less than the equivalent of 45 mg/L. (1) The long-term average daily... subject to this subpart, calculation of the long-term average daily BOD5 load in the influent to the... this section is higher than a concentration value reflecting a reduction in the long-term average daily...

40 CFR 439.22 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2010 CFR

2010-07-01

... limitation for BOD5 that is less than the equivalent of 45 mg/L. (1) The long-term average daily BOD5 load of... to this subpart, calculation of the long-term average daily BOD5 load in the influent to the... this section is higher than a concentration value reflecting a reduction in the long-term average daily...

40 CFR 439.52 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2014 CFR

2014-07-01

..., kg) per day, must reflect not less than 74 percent reduction in the long-term average daily COD load... long-term average daily BOD5 or COD mass loading of the raw process wastewater (i.e., the base number..., calculation of the long-term average daily BOD5 or COD load in the influent to the wastewater treatment system...

40 CFR 439.52 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2013 CFR

2013-07-01

..., kg) per day, must reflect not less than 74 percent reduction in the long-term average daily COD load... long-term average daily BOD5 or COD mass loading of the raw process wastewater (i.e., the base number..., calculation of the long-term average daily BOD5 or COD load in the influent to the wastewater treatment system...

40 CFR 439.12 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2013 CFR

2013-07-01

... than 90 percent reduction in the long-term average daily BOD5 load of the raw (untreated) process wastewater, multiplied by a variability factor of 3.0. (1) The long-term average daily BOD5 load of the raw..., calculation of the long-term average daily BOD5 load in the influent to the wastewater treatment system must...

40 CFR 439.12 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2012 CFR

2012-07-01

... than 90 percent reduction in the long-term average daily BOD5 load of the raw (untreated) process wastewater, multiplied by a variability factor of 3.0. (1) The long-term average daily BOD5 load of the raw..., calculation of the long-term average daily BOD5 load in the influent to the wastewater treatment system must...

40 CFR 439.12 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2014 CFR

2014-07-01

... than 90 percent reduction in the long-term average daily BOD5 load of the raw (untreated) process wastewater, multiplied by a variability factor of 3.0. (1) The long-term average daily BOD5 load of the raw..., calculation of the long-term average daily BOD5 load in the influent to the wastewater treatment system must...

40 CFR 439.22 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2014 CFR

2014-07-01

... average limitation for BOD5 that is less than the equivalent of 45 mg/L. (1) The long-term average daily... subject to this subpart, calculation of the long-term average daily BOD5 load in the influent to the... this section is higher than a concentration value reflecting a reduction in the long-term average daily...

40 CFR 439.22 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2012 CFR

2012-07-01

... average limitation for BOD5 that is less than the equivalent of 45 mg/L. (1) The long-term average daily... subject to this subpart, calculation of the long-term average daily BOD5 load in the influent to the... this section is higher than a concentration value reflecting a reduction in the long-term average daily...

An Evaluation of the Quality of Research on Evidence-Based Practices for Daily Living Skills for Individuals with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Hong, Ee Rea; Ganz, Jennifer B.; Ninci, Jennifer; Neely, Leslie; Gilliland, Whitney; Boles, Margot

2015-01-01

This study presents a literature review of interventions for improving daily living skills of individuals with ASD. This review investigated the quality of the design and evidence of the literature base and determined the state of the evidence base related to interventions for improving daily living skills of individuals with ASD. Included studies…

Indicators of Preclinical Disability: Women’s Experiences of an Aging Body

PubMed Central

LORENZ, REBECCA ANN

2010-01-01

This paper is derived from a larger multimethod longitudinal study of women’s bodily experiences and coping practices before the onset of disability. Twelve women participated in repeated performance measures, in-depth interviews of daily life and physically challenging events, and observations of daily activities conducted over 18 months. Interpretive phenomenological analysis of textual data showed that women’s bodies provided multiple indicators or symptoms of preclinical disability. These indicators informed the women that their body was out of synch with their environment; conspicuous during social activities; and vulnerable to becoming dependent on others, technology, or assistive devices to accomplish daily activities. Greater attention to bodily indicators or symptoms may offer a practical method for clinicians to identify preclinical disability. PMID:19418344

Bottom lines: the influence of government funding on 20th century district nursing practice in Australia.

PubMed

Madsen, Wendy

2009-10-01

To investigate the impact of past government policy and legislation on the practice of district nursing in Australia. Nurses have historically been politically passive and have not engaged in the political processes of policy development. However, legislation can have profound impacts on the daily work of nurses as demonstrated in this paper. Historical analysis. The archival records of six district nursing services in Australia were analysed within the political, social and economic context of the 20th century, with particular focus on the 1950s and 1970s. Two pieces of Federal legislation passed in 1956 and 1973, respectively, had critical effects on the work of district nurses. Both resulted in significant expansion of district nursing in Australia; neither was formulated with input from district nursing services. However, together these acts shifted district nursing from being a voluntary, charity based activity to one that was greatly controlled by government. Greater government funding allowed district nursing to expand beyond the capacity possible when funding was locally based, but with government funding came other restrictions related to accountability processes and expectations regarding services provided, and these had profound effects on nursing practice, including excess workloads to the point of unsafe practice. Nurses need to engage with the political processes associated with government policy formulation and implementation if they are to avoid placing themselves and their clients in vulnerable situations as a result of government decisions.

When can employees have a family life? The effects of daily workload and affect on work-family conflict and social behaviors at home.

PubMed

Ilies, Remus; Schwind, Kelly M; Wagner, David T; Johnson, Michael D; DeRue, D Scott; Ilgen, Daniel R

2007-09-01

This article presents a longitudinal examination of antecedents and outcomes of work-to-family conflict. A total of 106 employees participating in an experience-sampling study were asked to respond to daily surveys both at work and at home, and their spouses were interviewed daily via telephone for a period of 2 weeks. Intraindividual analyses revealed that employees' perceptions of workload predicted work-to-family conflict over time, even when controlling for the number of hours spent at work. Workload also influenced affect at work, which in turn influenced affect at home. Finally, perhaps the most interesting finding in this study was that employees' behaviors in the family domain (reported by spouses) were predicted by the employees' perceptions of work-to-family conflict and their positive affect at home. (c) 2007 APA.

[Changing to a career in general practice - a qualitative study reveals motives of specialists].

PubMed

Schwill, Simon; Magez, Julia; Jäger, Cornelia; von Meißner, Wolfgang Cg; Szecsenyi, Joachim; Flum, Elisabeth

2016-12-01

In 2011, the national German Medical Association (Bundesärztekammer) published guidelines for a slim-lined training program in general practice (Quereinstieg) for qualified medical specialists in other fields (e. g., surgeons, internists or anesthesiologists). This step is part of a strategy to prevent further shortages of general practitioners in Germany. In the state of Baden-Wuerttemberg, qualified medical specialists are allowed to complete their general practice training in approximately two years instead of five. The aim of this study was to understand the reasons of specialists for changing to a career in general practice. The postgraduate training program Verbundweiterbildung plus Baden-Württemberg had 597 trainees at the time of the study in December 2015. Previously qualified specialists in another medical discipline were identified and invited to participate in this study. Qualitative data was gathered using semi-structured interviews with content analysis of the interviews performed by three independent members of the research team. In total, 36 out of 597 trainees were identified as previously qualified specialists in another medical discipline. All 36 were invited to take part and 15 agreed to participate in this study. Overall, 15 interviews were performed, with a mean time of 24.19minutes. Participants with a median age of 40 years (33-59 years) - mainly anesthesiologists (n=7), surgeons (n=3) and internists (n=3) - presented with an average of 6.5 years of professional experience in their specialty. First, the participants' motivation to switch career arose from the wish to intensify the quality of patient contacts with a holistic approach including family and social background and from the infinite variety of general practice. Another reason given for a career change was self-employment opportunities. Finally, feelings of frustration over poor working conditions in hospitals resulted in a job search elsewhere in medicine, taking account of the challenges of ageing and family life. A major finding was that without the slim-lined program, the majority of participants would not have changed their career. The slim-lined training program in general practice attracts experienced medical doctors. Specialists decide to change career because of the particular ways of working in general practice and with the intention to improve their daily work as a physician, either to improve individual working conditions and/or to improve their individual curative work profile. In addition, specialists are attracted by the concept of self-employment in general practice. Therefore, appreciation of the specific ways of working in general practice as well as management skills are most important during the reduced 2-year training. Further studies should investigate if facilitating a career switch to general practice is a good way to improve the shortage of general practitioners. Copyright © 2016. Published by Elsevier GmbH.

Impact of spinal pain on daily living activities in postmenopausal women working in agriculture.

PubMed

Raczkiewicz, Dorota; Owoc, Alfred; Sarecka-Hujar, Beata; Saran, Tomasz; Bojar, Iwona

2017-03-22

Postmenopausal women working in agriculture suffer from spinal pain for two overlapping reasons, the first is related to the menopause and the second to the specificity of rural work, which includes lifting heavy objects and changing weather conditions. Spinal pain affects the daily life of women as well as their ability to work. The objective of the study was to analyse the impact of spinal pain on activities of daily life in Polish postmenopausal women performing agricultural work. The study was conducted in 2016 in Poland and included 1,119 post-menopausal women living in rural areas and working in agriculture. The women assessed the severity of spinal pain in 3 sections: neck, thorax and lumbar. Neck Disability Index (NDI) and Oswestry Low Back Disability Index (ODI) questionnaires were used to assess the impact of spinal pain on daily life activities. Generalized linear models were estimated in statistical analyses. Postmenopausal women working in agriculture suffered most often from pain in the lumbar spine, less frequently in the neck, and the least in the thoracic. The most common was an isolated pain in only one section of the spine. Spinal pain disturbed the most the women's rest, standing, lifting objects, while sleep, concentration, and walking the least. The impact of spinal pain on the activities of daily life, on average, was moderate, and increased with greater pain severity, the earlier the age the pain started, the higher the body weight, the lower education level and if there was a co-existing pain in any of the other spine sections. The impact of spinal pain on daily life activities did not depend on age between 45-65, WHR, age at last menstruation, parity, and number and types of births. The impact of spinal pain on daily life activities in postmenopausal women working in agriculture was assessed as moderate, on average, and depended mainly on spinal pain-related characteristics, such as severity, age at onset and co-existence of pain in any other spinal sections.

Patient Expectations and Perceptions of Goal-setting Strategies for Disease Management in Rheumatoid Arthritis.

PubMed

Strand, Vibeke; Wright, Grace C; Bergman, Martin J; Tambiah, Jeyanesh; Taylor, Peter C

2015-11-01

To identify how patients perceive the broad effect of active rheumatoid arthritis (RA) on their daily lives and indicate how RA disease management could benefit from the inclusion of individual goal-setting strategies. Two multinational surveys were completed by patients with RA. The "Good Days Fast" survey was conducted to explore the effect of disease on the daily lives and relationships of women with RA. The "Getting to Your Destination Faster" survey examined RA patients' treatment expectations and goal-setting practices. Respondents from all countries agreed that RA had a substantial negative effect on many aspects of their lives (work productivity, daily routines, participation in social and leisure activities) and emotional well-being (loss of self-confidence, feelings of detachment, isolation). Daily pain was a paramount issue, and being pain- and fatigue-free was considered the main indicator of a "good day." Setting personal, social, and treatment goals, as well as monitoring disease progress to achieve these, was considered very beneficial by patients with RA, but discussion of treatment goals seldom appeared to be a part of medical appointments. Many patients with RA feel unable to communicate their disease burden and treatment goals, which are critically important to them, to their healthcare provider (HCP). Insights gained from these 2 surveys should help to guide patients and HCP to better focus upon mutually defined goals for continued improvement of management and achievement of optimal care in RA.

Study protocol: the effectiveness and cost effectiveness of an employer-led intervention to increase walking during the daily commute: the Travel to Work randomised controlled trial.

PubMed

Audrey, Suzanne; Cooper, Ashley R; Hollingworth, William; Metcalfe, Chris; Procter, Sunita; Davis, Adrian; Campbell, Rona; Gillison, Fiona; Rodgers, Sarah E

2015-02-18

Physical inactivity increases the risk of many chronic diseases including coronary heart disease, type 2 diabetes and some cancers. It is recommended that adults should undertake at least 150 minutes of moderate intensity physical activity throughout the week but many adults do not achieve this. An opportunity for working adults to accumulate the recommended activity levels is through the daily commute. Employees will be recruited from workplaces in south-west England and south Wales. In the intervention arm, workplace Walk-to-Work promoters will be recruited and trained. Participating employees will receive Walk-to-Work materials and support will be provided through four contacts from the promoters over 10 weeks. Workplaces in the control arm will continue with their usual practice. The intervention will be evaluated by a cluster randomized controlled trial including economic and process evaluations. The primary outcome is daily minutes of moderate to vigorous physical activity (MVPA). Secondary outcomes are: overall physical activity; sedentary time; modal shift away from private car use during the commute; and physical activity/MVPA during the commute. Accelerometers, GPS receivers and travel diaries will be used at baseline and one year follow-up. Questionnaires will be used at baseline, immediately post intervention, and one year follow-up. The process evaluation will examine the context, delivery and response to the intervention from the perspectives of employers, Walk-to-Work promoters and employees using questionnaires, descriptive statistics, fieldnotes and interviews. A cost-consequence study will include employer, employee and health service costs and outcomes. Time and consumables used in implementing the intervention will be measured. Journey time, household commuting costs and expenses will be recorded using travel diaries to estimate costs to employees. Presenteeism, absenteeism, employee wellbeing and health service use will be recorded. Compared with other forms of physical activity, walking is a popular, familiar and convenient, and the main option for increasing physical activity in sedentary populations. To our knowledge, this is the first full-scale randomised controlled trial to objectively measure (using accelerometers and GPS receivers) the effectiveness of a workplace intervention to promote walking during the commute to and from work. ISRCTN15009100 (10 December 2014).

Associations of Low-Income Working Mothers' Daily Interactions with Supervisors and Mother-Child Interactions

ERIC Educational Resources Information Center

Gassman-Pines, Anna

2011-01-01

This study investigated associations of low-income working mothers' daily interactions with supervisors and their interactions with children. Sixty-one mothers of preschool-aged children were asked to report on their interactions with their supervisors at work and their interactions with children for 2 weeks (N = 520 workdays). Results show…

Nonstandard Work Schedules, Perceived Family Well-Being, and Daily Stressors

ERIC Educational Resources Information Center

Davis, Kelly D.; Goodman, W. Benjamin; Pirretti, Amy E.; Almeida, David M.

2008-01-01

Data from two studies assessed the effects of nonstandard work schedules on perceived family well-being and daily stressors. Study 1, using a sample of employed, married adults aged 25-74 (n = 1,166) from the National Survey of Midlife in the United States, showed that night work was associated with perceptions of greater marital instability,…

Workplace Flexibility and Daily Stress Processes in Hotel Employees and their Children

PubMed Central

Almeida, David M.; Davis, Kelly D.

2013-01-01

Our research aims to understand the consequences of inadequate workplace flexibility through the lens of daily stress processes. Using a sample of hourly hotel employees with children aged 10 to 18 who participated in a daily diary study, we compared workers with low and high flexibility on stressor exposure, reactivity, and transmission. Our findings showed a consistent pattern of hourly workers with low flexibility having greater exposure to work stressors in general and to work place arguments in particular. Workers with low flexibility were also more emotional and physically reactive to work stressors. There was some evidence of stressor transmission to children when parents had low flexibility. Increasing workplace flexibility could serve as a protective factor in exposure and reactivity to stressors that are experienced in daily life. PMID:23833321

Seizing opportunities for change at the operational level.

PubMed

Restrepo, Diana; Charron-Latour, Julie; Pourmonet, Hugo; Bassetto, Samuel

2016-04-18

Purpose - This paper presents a method for handling everyday opportunities for improvement, led by floor staff in healthcare institutions. More than 400,000 incidents and accidents were recorded in Quebec healthcare institutions in 2013. The burden of treatment falls on hospital floor staff. The purpose of this paper is to raise the visibility of this problem and support staff better in their efforts to handle opportunities for improvement. Design/methodology/approach - Based on issues identified in the literature, which have been found to exist in various organizations, the method involved reviewing practices in the field, proposing a solution, and testing it to assess its relevance and limitations. The method was tested in partnership with the Centre Hospitalier de l'Université de Montréal, in the internal medicine unit at Hôtel-Dieu campus. The test lasted three months. Indicators from this test have been compared to results in the literature. Findings - The proposed method presents a 68 per cent increase in ideas generated per person and per week compared to the reference study. The mean time for closing actions was about 41 per cent better (lower) than in the reference case. Research limitations/implications - The test lasted 15 weeks; a longer test is needed to collect more data. Practical implications - The first practical implication of this study was the creation of a method allowing employees to seize opportunities for improvement in their daily work. The application of this method revealed: first, the operational nature of the proposal (empowerment of the work team); second, the operationalization of continuous improvement (71 per cent of ideas were finalized while the initiative was monitored); third, the smooth operation of the mechanism for facilitating continuous improvement (organization of weekly meetings and team participation in these meetings in 90 per cent of cases); and fourth, a shared feeling that intra- and inter-team communication had been strengthened. Originality/value - The main value of this paper is that it proposes a simple problem-solving process that gives employees an opportunity to improve their daily work. The originality of this paper resides in comparing results to a standard case and observing an improvement. This paper proposes a new problem-solving structure and tests it scientifically.

Understandings of participation in daily activity services among people with intellectual disabilities: A pedagogical sociocultural perspective.

PubMed

Svanelöv, Eric; Enarsson, Per; Flygare Wallén, Eva; Stier, Jonas

2017-01-01

This study sought to explore different understandings of participation in daily activity services among people with intellectual disabilities. Using a pedagogical sociocultural perspective, the research focused on individuals' perspectives and understandings as well as their account of social interaction, working and learning. In all, 17 people working in daily activity services were interviewed once, and, of these, 14 were interviewed a second time. Using qualitative content analysis, two themes and three categories were singled out. The results show that participation can be understood in two major ways: social interaction and performing work tasks.

Daily sleep, weekly working hours, and risk of work-related injury: US National Health Interview Survey (2004-2008).

PubMed

Lombardi, David A; Folkard, Simon; Willetts, Joanna L; Smith, Gordon S

2010-07-01

The impact on health and safety of the combination of chronic sleep deficits and extended working hours has received worldwide attention. Using the National Health Interview Survey (NHIS), an in-person household survey using a multistage, stratified, clustered sample design representing the US civilian, non-institutionalized population, the authors estimated the effect of total daily self-reported sleep time and weekly working hours on the risk of a work-related injury. During the survey period 2004-2008, 177,576 persons (ages 18-74) sampled within households reported that they worked at a paid job the previous week and reported their total weekly work hours. A randomly selected adult in each household (n = 75,718) was asked to report his/her usual (average) total daily sleep hours the prior week; complete responses were obtained for 74,415 (98.3%) workers. Weighted annualized work-related injury rates were then estimated across a priori defined categories of both average total daily sleep hours and weekly working hours. To account for the complex sampling design, weighted multiple logistic regression was used to independently estimate the risk of a work-related injury for categories of usual daily sleep duration and weekly working hours, controlling for important covariates and potential confounders of age, sex, race/ethnicity, education, type of pay, industry, occupation (proxy for job risk), body mass index, and the interaction between sleep duration and work hours. Based on the inclusion criteria, there were an estimated 129,950,376 workers annually at risk and 3,634,446 work-related medically treated injury episodes (overall injury rate 2.80/100 workers). Unadjusted annualized injury rates/100 workers across weekly work hours were 2.03 (< or =20 h), 3.01 (20-30 h), 2.45 (31-40 h), 3.45 (40-50 h), 3.71 (50-60 h), and 4.34 (>60 h). With regards to self-reported daily sleep time, the estimated annualized injury rates/100 workers were 7.89 (<5 h sleep), 5.21 (5-5.9 h), 3.62 (6-6.9 h), 2.27 (7-7.9 h), 2.50 (8-8.9 h), 2.22 (9-9.9 h), and 4.72 (>10 h). After controlling for weekly work hours, and aforementioned covariates, significant increases in risk/1 h decrease were observed for several sleep categories. Using 7-7.9 h sleep as reference, the adjusted injury risk (odds ratio [OR] for a worker sleeping a total of <5 h/day was 2.65 (95% confidence interval [CI]: 1.57-4.47), for 5-5.9 h 1.79 (95% CI: 1.22-2.62), and for 6-6.9 h 1.40 (95% CI: 1.10-1.79). No other usual sleep duration categories were significantly different than the reference; however, for >10 h of usual daily sleep, the OR was marginally significantly elevated, 1.82 (95% CI: 0.96-3.47). These results suggest significant increases in work-related injury risk with decreasing usual daily self-reported sleep hours and increasing weekly work hours, independent of industry, occupation, type of pay, sex, age, education, and body mass.

On the Edge of Life, II: House Officer Struggles Recorded in an Intensive Care Unit Journal

PubMed Central

Sekeres, Mikkael A.; Stern, Theodore A.

2002-01-01

Background: In a general hospital, few clinical settings match the intensity of the intensive care unit (ICU) experience. Clinical rotations in ICUs elicit and emphasize the struggles house officers face on a daily basis throughout their training. Method: These struggles were recorded by hundreds of residents in a journal maintained in one Medical ICU for the past 20 years. We systematically reviewed these unsolicited entries to develop categories that define and illustrate common stressors. Results: Stressors for house officers include isolation, insecurity, care for the terminally ill, sleep deprivation, and long work weeks. Conclusion: By placing the struggles of house staff in context, trainees and their residency training programs can be prepared for the intensity of the experience and for work in clinical practice settings that follows completion of training. PMID:15014706

Perhaps I am one of the lucky ones.

PubMed

Heenan, Michael

2010-01-01

I recently participated in the Ontario Hospital Association (OHA) webinar on quality and safety, in which I was asked to address the topic of engaging physicians in performance measurement, quality and safety. I am not a physician, but much of my work in healthcare has involved working with clinical leaders in these areas. At St. Joseph's Healthcare Hamilton, we started our quality and safety journey by creating a medical quality scorecard specifically designed for physicians. The card, written in physician-friendly versus business language, enabled physicians to drop the traditional business quadrants of finance and human resources and select four quadrants focused on clinical process and outcome indicators that matched their daily practice. Quality improvement initiatives resulting from the scorecard included the launch of a sepsis-management campaign in the emergency room and a new approach to neonatal safety.

Adolescents and the internet: what mental health clinicians need to know.

PubMed

Rafla, Malak; Carson, Nicholas J; DeJong, Sandra M

2014-09-01

The Internet's permeation into daily life has profoundly changed the practice of psychiatry with adolescents, who mobilize online social media and related technologies in their efforts to develop identity and "hang out" with peers. Technology offers both challenges and opportunities to mental health professionals working with teens. Practitioners will need a new skill-set, including keeping abreast of technological developments; professionally incorporating technology into clinical assessment and practice; identifying the negative impacts of technology on teens' physical and mental health and the particular vulnerabilities of at-risk patients in a digital world; and guiding patients and parents about interventions. Particular patient factors related to race/ethnicity, gender and sexual orientation, mental health and trauma history, family culture, parenting style, and personality traits will need to be considered. This article provides an overview of the literature on adolescents and the Internet focusing on recent research on Internet and digital technologies used for social communication among youth.

Creating Conditions for Patients’ Values to Emerge in Clinical Conversations: Perspectives of Health Care Team Members

PubMed Central

Berry, Andrew B.L.; Lim, Catherine; Hartzler, Andrea L.; Hirsch, Tad; Ludman, Evette; Wagner, Edward H.; Ralston, James D.

2017-01-01

Eliciting, understanding, and honoring patients’ values— the things most important to them in daily life—is a cornerstone of patient-centered care. However, this rarely occurs explicitly as a routine part of clinical practice. This is particularly problematic for individuals with multiple chronic conditions (MCC) because they face difficult choices about how to balance competing demands for self-care in accordance with their values. In this study, we sought to inform the design of interventions to support conversations about patient values between patients with MCC and their health care providers. We conducted a field study that included observations of 21 clinic visits for patients who have MCC, and interviews with 16 care team members involved in those visits. This paper contributes a practice-based account of ways in which providers engage with patient values, and discusses how future work in interactive systems design might extend and enrich these engagements. PMID:28890950

A commitment to values. A system integrates core values with leadership development.

PubMed

Maxfield, M M

1991-01-01

The Values in Leadership program, a new leadership development program created by the Sisters of Charity Health Care Systems (SCHCS), is designed to empower effective leaders to live out personal values compatible with those of the organization. The program, designed for middle and senior managers, comprises seven educational modules- Living Our Values; Valuing Individual Differences; Leader as Servant; Leader as Visionary; Leader as Catalyst; Leader as Mentor; Formative Leadership; and Leader as Mentor; Motivational Coaching. Throughout the sessions, participants discuss the four roles of an effective leader-servant, visionary, catalyst, and mentor-which are grounded in SCHCS core values. Participants are also challenged to identify specific actions that can be integrated into their leadership styles. These actions, drawn from SCHCS leadership practices and core values, are reinforced when participants return to their jobs and write plans to incorporate these practices into their daily work.

Essential and Nonessential Micronutrients and Sport

NASA Astrophysics Data System (ADS)

Beavers, Kristen M.; Serra, Monica C.

The purpose of this chapter is to review the role of micronutrients in sport. Attention is given to the function of micronutrients in the body, examples of quality dietary sources of each micronutrient, and an assessment of the literature examining how the recommended daily intake of a micronutrient may or may not change with exercise. The discussion includes plausible biological mechanisms of proposed performance enhancement and current research to support or negate these claims. Water-soluble vitamins, fat-soluble vitamins, macrominerals, and select microminerals are discussed in detail, and a comprehensive table reviewing all micronutrients recommendations for the athlete is provided. Practical applications for professionals working with athletes conclude the chapter.

Art and Plastic Surgery.

PubMed

Fernandes, Julio Wilson; Metka, Susanne

2016-04-01

The roots of science and art of plastic surgery are very antique. Anatomy, drawing, painting, and sculpting have been very important to the surgery and medicine development over the centuries. Artistic skills besides shape, volume, and lines perception can be a practical aid to the plastic surgeons' daily work. An overview about the interactions between art and plastic surgery is presented, with a few applications to rhinoplasty, cleft lip, and other reconstructive plastic surgeries. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

"De-humanised females and Amazonians": British wartime fashion and its representation in Home chat, 1914-1918.

PubMed

Buckley, Cheryl

2002-01-01

Popular representations of the fashionably dressed female body between 1914 and 1918 were highly contradictory and, as this essay will show, were sharply delineated in Home Chat, one of a growing number of relatively new women's magazines which addressed the needs of an expanding skilled working-class and lower-middle-class female readership. Aiming to provide women with practical advice about all aspects of their daily lives, from the traditional concerns of fashion and beauty, marriage and children, to the more contentious issue of women's aspirations beyond the home, Home Chat was uniquely placed to reflect shifting gender and class relations.

Successful practices in the use of secure e-mail.

PubMed

Johnson, Laura W; Garrido, Terhilda; Christensen, Kate; Handley, Matt

2014-01-01

Physician use of secure e-mail with patients is anticipated to increase under Stage 2 Meaningful Use requirements, but little is known about how physicians can successfully incorporate it into daily work. We interviewed 27 "super user" physicians at Kaiser Permanente and Group Health who were identified by leaders as being technologically, operationally, and clinically adept and as having high levels of secure e-mail use with patients. They highly valued the use of secure e-mail with patients, despite concerns about a lack of adequate time to respond, and provided tips for using it successfully. They identified benefits that included better care and improved relationships with their patients.

Using dew points to estimate savings during a planned cooling shutdown

NASA Astrophysics Data System (ADS)

Friedlein, Matthew T.; Changnon, David; Musselman, Eric; Zielinski, Jeff

2005-12-01

In an effort to save money during the summer of 2003, Northern Illinois University (NIU) administrators instituted a four-day working week and stopped air conditioning buildings for the three-day weekends (Friday through Sunday). Shutting down the air conditioning systems caused a noticeable drop in electricity usage for that part of the campus that features in our study, with estimated total electricity savings of 1,268,492 kilowatt-hours or 17% of the average usage during that eight-week period. NIU's air conditioning systems, which relied on evaporative cooling to function, were sensitive to dew point levels. Greatest savings during the shutdown period occurred on days with higher dew points. An examination of the regional dew point climatology (1959 2003) indicated that the average summer daily dew point for 2003 was 14.9°C (58.8°F), which fell in the lowest 20% of the distribution. Based on the relationship between daily average dew points and electrical usage, a predictive model that could estimate electrical daily savings was created. This model suggests that electrical savings related to any future three-day shutdowns over summer could be much greater in more humid summers. Studies like this demonstrate the potential value of applying climatological information and of integrating this information into practical decision-making.

Factors Related to Parenting Practices in Taiwan.

ERIC Educational Resources Information Center

Chen, Fu-Mei; Luster Tom

2002-01-01

This study examined factors related to authoritarian and authoritative parenting practices among 463 Chinese mothers with preschoolers in Taiwan. Questionnaire findings suggested that maternal depression, child temperament, and degree of parenting daily hassles might have cross-culturally universal influence on parenting practices. Chinese…

How do Supervising Clinicians of a University Hospital and Associated Teaching Hospitals Rate the Relevance of the Key Competencies within the CanMEDS Roles Framework in Respect to Teaching in Clinical Clerkships?

PubMed Central

Jilg, Stefanie; Möltner, Andreas; Berberat, Pascal; Fischer, Martin R.; Breckwoldt, Jan

2015-01-01

Background and aim: In German-speaking countries, the physicians’ roles framework of the “Canadian Medical Education Directives for Specialists” (CanMEDS) is increasingly used to conceptualize postgraduate medical education. It is however unclear, whether it may also be applied to the final year of undergraduate education within clinical clerkships, called “Practical Year” (PY). Therefore, the aim of this study was to explore how clinically active physicians at a university hospital and at associated teaching hospitals judge the relevance of the seven CanMEDS roles (and their (role-defining) key competencies) in respect to their clinical work and as learning content for PY training. Furthermore, these physicians were asked whether the key competencies were actually taught during PY training. Methods: 124 physicians from internal medicine and surgery rated the relevance of the 28 key competencies of the CanMEDS framework using a questionnaire. For each competency, following three aspects were rated: “relevance for your personal daily work”, “importance for teaching during PY”, and “implementation into actual PY teaching”. Results: In respect to the main study objective, all questionnaires could be included into analysis. All seven CanMEDS roles were rated as relevant for personal daily work, and also as important for teaching during PY. Furthermore, all roles were stated to be taught during actual PY training. The roles “Communicator”, “Medical Expert”, and “Collaborator” were rated as significantly more important than the other roles, for all three sub-questions. No differences were found between the two disciplines internal medicine and surgery, nor between the university hospital and associated teaching hospitals. Conclusion: Participating physicians rated all key competencies of the CanMEDS model to be relevant for their personal daily work, and for teaching during PY. These findings support the suitability of the CanMEDS framework as a conceptual element of PY training. PMID:26413171

Long hours in paid and domestic work and subsequent sickness absence: does control over daily working hours matter?

PubMed

Ala-Mursula, L; Vahtera, J; Kouvonen, A; Väänänen, A; Linna, A; Pentti, J; Kivimäki, M

2006-09-01

To explore the associations of working hours (paid, domestic, commuting, and total) with sickness absence, and to examine whether these associations vary according to the level of employee control over daily working hours. Prospective cohort study among 25 703 full-time public sector employees in 10 towns in Finland. A survey of working hours and control over working hours was carried out in 2000-01. The survey responses were linked with register data on the number of self-certified (< or =3 days) and medically certified (>3 days) sickness absences until the end of 2003. Poisson regression analyses with generalised estimating equations were used to take into account the fact that the employees were nested within work units. Adjustments were made for work and family characteristics and health behaviour. The mean follow-up period was 28.1 (SD 8.1) months. Long domestic and total working hours were associated with higher rates of medically certified sickness absences among both genders. In contrast, long paid working hours were associated with lower rates of subsequent self-certified sickness absences. Long commuting hours were related to increased rates of sickness absence of both types. Low control over daily working hours predicted medically certified sickness absences for both the women and men and self-certified absences for the men. In combinations, high control over working hours reduced the adverse associations of long domestic and total working hours with medically certified absences. Employee control over daily working hours may protect health and help workers successfully combine a full-time job with the demands of domestic work.

Sarcopenia in daily practice: assessment and management.

PubMed

Beaudart, Charlotte; McCloskey, Eugène; Bruyère, Olivier; Cesari, Matteo; Rolland, Yves; Rizzoli, René; Araujo de Carvalho, Islène; Amuthavalli Thiyagarajan, Jotheeswaran; Bautmans, Ivan; Bertière, Marie-Claude; Brandi, Maria Luisa; Al-Daghri, Nasser M; Burlet, Nansa; Cavalier, Etienne; Cerreta, Francesca; Cherubini, Antonio; Fielding, Roger; Gielen, Evelien; Landi, Francesco; Petermans, Jean; Reginster, Jean-Yves; Visser, Marjolein; Kanis, John; Cooper, Cyrus

2016-10-05

Sarcopenia is increasingly recognized as a correlate of ageing and is associated with increased likelihood of adverse outcomes including falls, fractures, frailty and mortality. Several tools have been recommended to assess muscle mass, muscle strength and physical performance in clinical trials. Whilst these tools have proven to be accurate and reliable in investigational settings, many are not easily applied to daily practice. This paper is based on literature reviews performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group on frailty and sarcopenia. Face-to-face meetings were afterwards organized for the whole group to make amendments and discuss further recommendations. This paper proposes some user-friendly and inexpensive methods that can be used to assess sarcopenia in real-life settings. Healthcare providers, particularly in primary care, should consider an assessment of sarcopenia in individuals at increased risk; suggested tools for assessing risk include the Red Flag Method, the SARC-F questionnaire, the SMI method or different prediction equations. Management of sarcopenia should primarily be patient centered and involve the combination of both resistance and endurance based activity programmes with or without dietary interventions. Development of a number of pharmacological interventions is also in progress. Assessment of sarcopenia in individuals with risk factors, symptoms and/or conditions exposing them to the risk of disability will become particularly important in the near future.

Unsatisfactory knowledge and use of terminology regarding malnutrition, starvation, cachexia and sarcopenia among dietitians.

PubMed

Ter Beek, Lies; Vanhauwaert, Erika; Slinde, Frode; Orrevall, Ylva; Henriksen, Christine; Johansson, Madelene; Vereecken, Carine; Rothenberg, Elisabet; Jager-Wittenaar, Harriët

2016-12-01

Clinical signs of malnutrition, starvation, cachexia and sarcopenia overlap, as they all imply muscle wasting to a various extent. However, the underlying mechanisms differ fundamentally and therefore distinction between these phenomena has therapeutic and prognostic implications. We aimed to determine whether dietitians in selected European countries have 'sufficient knowledge' regarding malnutrition, starvation, cachexia and sarcopenia, and use these terms in their daily clinical work. An anonymous online survey was performed among dietitians in Belgium, the Netherlands, Norway and Sweden. 'Sufficient knowledge' was defined as having mentioned at least two of the three common domains of malnutrition according to ESPEN definition of malnutrition (2011): 'nutritional balance', 'body composition' and 'functionality and clinical outcome', and a correct answer to three cases on starvation, cachexia and sarcopenia. Chi-square test was used to analyse differences in experience, work place and number of malnourished patients treated between dietitians with 'sufficient knowledge' vs. 'less sufficient knowledge'. 712/7186 responded to the questionnaire, of which data of 369 dietitians were included in the analysis (5%). The term 'malnutrition' is being used in clinical practice by 88% of the respondents. Starvation, cachexia and sarcopenia is being used by 3%, 30% and 12% respectively. The cases on starvation, cachexia and sarcopenia were correctly identified by 58%, 43% and 74% respectively. 13% of the respondents had 'sufficient knowledge'. 31% of the respondents identified all cases correctly. The proportion of respondents with 'sufficient knowledge' was significantly higher in those working in a hospital or in municipality (16%, P < 0.041), as compared to those working in other settings (7%). The results of our survey among dietitians in four European countries show that the percentage of dietitians with 'sufficient knowledge' regarding malnutrition, starvation, cachexia and sarcopenia is unsatisfactory (13%). The terms starvation, cachexia and sarcopenia are not often used by dietitians in daily clinical work. As only one-third (31%) of dietitians identified all cases correctly, the results of this study seem to indicate that nutrition-related disorders are suboptimally recognized in clinical practice, which might have a negative impact on nutritional treatment. The results of our study require confirmation in a larger sample of dietitians. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Registered nurses' experiences of daily work, a balance between strain and stimulation: a qualitative study.

PubMed

Hallin, Karin; Danielson, Ella

2007-09-01

The challenges in the health care have given rise to a highly stressful work situation and a more complicated role for registered nurses (RNs). Qualitative studies about daily work as a whole is limited. It is therefore vital for future development of nursing knowledge and nursing education to recurrently investigate RNs' experiences of their ability to grasp and manage their daily work situation and to promote a high quality of care. The aim of this study was to describe RNs' experiences of their daily work. This follow up study was carried out involving 15 Swedish RNs 6 years after their graduation. Interviews, conducted with conversational strategy, were chosen for the data collection and content analysis was used to handle the interview texts. The analysis resulted in a main theme 'to balance strain and stimulation', two themes and seven sub-themes. The first theme 'a stressful work situation' consisted of the sub-themes: 'to meet all demands', 'to be insufficient', 'to be unsure of oneself', and 'too little contact with patient'. The second theme 'a stimulating work situation' consisted of the sub-themes: 'to encounter patients and health care staff is enriching', 'to have the situation under control', and 'to have the skills necessary to be independent'. A pattern emerged throughout the themes, which showed that due to the increasing number of patients RNs' capacity for management, prioritising and planning out of team work, and performing exacting documentation diminished. The RNs' daily work has been illustrated as a scale of balance that oscillated between strain and stimulation; an oscillation towards strain could lead to a vicious circle. The RNs need support from the start through nursing education and continuously in profession. This is a crucial issue for nursing education and health care sector.

Correlates of daily leisure-time physical activity in a community sample: Narrow personality traits and practical barriers.

PubMed

Gallagher, Patrick; Yancy, William S; Denissen, Jaap J A; Kühnel, Anja; Voils, Corrine I

2013-12-01

Previous studies examining correlates of leisure time physical activity (LTPA) have identified personality factors that are correlated with LTPA and practical factors that impede LTPA. The purpose of the present study was to test how several narrow traits predict daily reports of LTPA and to test whether traits that predict LTPA moderate the effects of practical barriers. 1192 participants completed baseline measures of personality, then reported their LTPA and several situational and environmental factors daily for 25 days. We used generalized estimating equations to measure how personality traits, practical barriers, and interactions between these factors affected (1) the odds of engaging in LTPA and (2) the duration of daily LTPA. Higher standing on Activity and Discipline and lower standing on Assertiveness predicted greater odds of engaging in LTPA and longer duration of LTPA, and higher standing on Aesthetics predicted shorter duration of LTPA. Poor weather conditions and less leisure time were associated with less LTPA, and effects of these barriers were generally greater among participants 30 and older. In participants older than 30, poor weather was associated with less LTPA among those with lower standing on Activity but was not associated with LTPA among those high in Activity. Despite Discipline's overall positive association with LTPA, less leisure time and less routineness were greater barriers for those high in Discipline. Assessing narrow personality traits could help target LTPA interventions to individual patients' needs and could help identify important new personality dynamics that affect LTPA.

Acceptability Among Community Healthcare Nurses of Intelligent Wireless Sensor-system Technology for the Rapid Detection of Health Issues in Home-dwelling Older Adults

PubMed Central

Cohen, Christine; Kampel, Thomas; Verloo, Henk

2017-01-01

Background: The effective care and support of community healthcare nurses (CHNs) contribute greatly to the healthy aging of older adults living at home. Integrating innovative technologies into CHNs’ daily practice offers new opportunities and perspectives for early detection of health issues and interventions among home-dwelling older adults. Aim: To explore the perception of acceptability among CHNs of an intelligent wireless sensor system (IWSS) for use in daily practice for the detection of health issues in home-dwelling older adults receiving home healthcare. Method: Descriptive and qualitative data were sourced from a pilot randomized controlled trial involving 17 CHNs using an IWSS in their daily practice to rapidly detect falls and other health issues in patients’ homes. IWSS alerts indicating behavior changes were sent to CHNs. Their perceived usefulness (PU) and perceived ease of use (PEOU) were assessed. The acceptability of IWSS technology was explored using a questionnaire and focus group discussions. Results: The PU and PEOU of the IWSS technology were low to moderate. A majority of the CHNs were dissatisfied with its performance and intrusiveness; they reported multiple obstacles in the usefulness and ease of use of the IWSS technology in daily practice. Conclusion: To improve the IWSS technology’s low to moderate acceptability among CHNs, we recommend a more user-centered implementation strategy and an embedded model of nursing care. PMID:28567170

Adapting Practices of Science Journalism to Foster Science Literacy

ERIC Educational Resources Information Center

Polman, Joseph L.; Newman, Alan; Saul, Ellen Wendy; Farrar, Cathy

2014-01-01

In this paper, the authors describe how the practices of expert science journalists enable them to act as "competent outsiders" to science. We assert that selected science journalism practices can be used to design reform-based science instruction; these practices not only foster science literacy that is useful in daily life, but also…

Effect of workplace incivility on end-of-work negative affect: examining individual and organizational moderators in a daily diary study.

PubMed

Zhou, Zhiqing E; Yan, Yu; Che, Xin Xuan; Meier, Laurenz L

2015-01-01

Although previous studies have linked workplace incivility with various negative outcomes, they mainly focused on the long-term effects of chronic exposure to workplace incivility, whereas targets' short-term reactions to incivility episodes have been largely neglected. Using a daily diary design, the current study examined effects of daily workplace incivility on end-of-work negative affect and explored potential individual and organizational moderators. Data collected from 76 full-time employees across 10 consecutive working days revealed that daily workplace incivility positively predicted end-of-work negative affect while controlling for before-work negative affect. Further, the relationship was stronger for people with low emotional stability, high hostile attribution bias, external locus of control, and people experiencing low chronic workload and more chronic organizational constraints, as compared with people with high emotional stability, low hostile attribution bias, internal locus of control, and people experiencing high chronic workload and fewer chronic organizational constraints, respectively. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PsycINFO Database Record (c) 2014 APA, all rights reserved.

Engagement in patterns of daily occupations and perceived health among women of working age.

PubMed

Håkansson, Carita; Lissner, Lauren; Björkelund, Cecilia; Sonn, Ulla

2009-05-01

The aim of the present cross-sectional study was to examine how subjective experiences of engagement in patterns of daily occupations (gainful employment, domestic work, enjoyable and recreational occupations) were associated with perceived health among women of working age. The sample (n=488) was drawn from a longitudinal cohort study of women of working age in Gothenburg, Sweden. Participants were women 38 (n=202) and 50 (n=286) years of age. They completed a questionnaire including questions about occupational experiences in relation to their patterns of daily occupations, perceived health, and socioeconomic factors. The results of the present study showed that a combination of different experience dimensions of patterns of daily occupations was associated with perceived health among women of working age, even when adjusted for socioeconomic factors and age. The results provided occupational pattern-related health indicators, i.e. manageability, personally meaningful occupations, and occupational balance. To combine these health indicators can be a way for occupational therapists to enable women to develop strategies to promote health and to prevent stress and sick leave.

The use of evidenced-based information by nurses and midwives to inform practice.

PubMed

Veeramah, Ven

2016-02-01

To examine the implementation of evidence-based information by nurses and midwives to inform their practice. It is widely recognised that the main benefits of using evidence-based information are to improve and update clinical practice and to enhance the quality of care and outcomes for patients. However, despite a large body of research showing that nurses and midwives have positive attitudes towards evidence-based practice , its implementation remains a considerable and significant challenge. This was a cross-sectional on-line survey. A self-completed questionnaire was used to collect data from a convenience sample of 386 nursing and midwifery diplomates and graduates from June-December 2013. One hundred and seventy-two participants completed the questionnaire, giving a response rate of 44·6%. The majority of respondents expressed very positive attitude towards evidence-based practice and nearly everyone felt that this should become an important part of daily practice. A significant number stated that they have regular access to research through a number of relevant databases and the Internet at their place of work and evidence-based guidelines relevant to their speciality were also available. The two top barriers perceived by respondents were lack of time to search for relevant evidence-based information and being able to make time during working hours to look for new information. The most popular strategy suggested was to ensure evidence-based information is readily available in a form which nurses and midwives can easily understand the implications for their practice. Health services and government agencies should make a concerted effort to make time for nurses and midwives to access, appraise and use evidence-based information to inform practice. More resources including protected time should be made available to support nurses and midwives to use evidence-based information to improve the quality of care provided. © 2016 John Wiley & Sons Ltd.

School Obesity Prevention Policies and Practices in Minnesota and Student Outcomes: A Longitudinal Cohort Study.

PubMed

Nanney, Marilyn S; MacLehose, Richard F; Kubik, Martha Y; Davey, Cynthia S; O'Connell, Michael J; Grannon, Katherine Y; Nelson, Toben F

2016-11-01

The School Obesity-related Policy Evaluation (ScOPE) Study uses existing public surveillance data and applies a rigorous study design to evaluate effectiveness of school policies and practices impacting student behavioral and weight outcomes. The ScOPE Study used a cohort of 50 combined junior-senior and high schools in Minnesota to evaluate the change in weight-related policy environments in 2006 and 2012 and test the effect of policy change on students attending those schools in 2007 and 2013. Exposure variables included school practices about foods and beverages available in school vending machines and school stores, physical education requirements, and intramural opportunities. Primary study outcomes were average school-level ninth grade student BMI percentile, obesity prevalence, daily servings of fruits/vegetables, and daily glasses of soda. Availability of fruits/vegetables in schools was associated with a significant increase in total daily intake among ninth grade students by 0.4 servings. Availability of soda in schools was associated with a significant increase in total daily intake among ninth grade boys by 0.5 servings. Less-healthy snack and drink availability in schools was associated with a small, significant increase (1%) in student BMI percentile at the school level. Use of a school-level longitudinal cohort study design over a 6-year period uniquely adds to the methodologic rigor of school policy and practice evaluation studies. The ScOPE Study provides marginal evidence that school policies and practices, especially those that restrict vending and school store offerings, may have small effects on weight status among ninth grade students. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Evidence-Based Practice and School Nurse Practice: A Review of Literature

ERIC Educational Resources Information Center

Yonkaitis, Catherine F.

2018-01-01

School nurses report that evidence-based practice (EBP) is not a part of their daily practice, and most have had no formal education regarding EBP or its implementation. The purpose of this review is to identify what strategies might be effective to educate school nurses about EBP as a first step toward establishing EBP in school nurse practice.…

Qualification and assessment of work organisation in livestock farms.

PubMed

Madelrieux, S; Dedieu, B

2008-03-01

Farmers have to cope with both society and market pressures in their working practices, as well as with the enlargement of farms, off-farm opportunities and profound changes in the workforce. Expectations in terms of working duration and rhythms are increasingly expressed by farmers, meaning that working conditions and the efficiency of work organisation are critical issues nowadays. The bibliography shows that work organisation is mainly discussed by social scientists, but that livestock scientists make a significant contribution to the debate. Indeed, technical changes modify working calendars, priorities between tasks and interchangeability among workers; technical adaptations are levers to solving problems of work with equipment, buildings and the workforce. We present here French approaches to work organisation that take into account livestock management and its implications in work organisation. The 'Work Assessment' method represents the work organisation and evaluates work durations and time flexibility for farmers. The ATELAGE model describes and qualifies work organisation with its various regulations and time scales, integrating the other activities - economic or private - that farmers can carry on. Three principles underpin them: not all workers are interchangeable; tasks have different temporal characteristics (rhythms, postponement, etc.); and the year is a succession of work periods that differ in their daily form of organisation. We illustrate with concrete examples how these approaches contribute to helping and guiding farmers in their thoughts about change.

7 CFR 59.101 - Mandatory daily reporting for steers and heifers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) LIVESTOCK MANDATORY REPORTING Cattle Reporting § 59.101 Mandatory daily reporting for steers and...

Family Interview to Enable Donation of Organs for Transplantation: Evidence-based Practice.

PubMed

de Moraes, E L; Dos Santos, M J; de Barros E Silva, L B; de Lima Pilan, L A S; de Lima, E A A; de Santana, A C; Martins, M S

2018-04-01

In this study we propose a theoretical and practical basis for the best practices for interviewing relatives of brain-dead eligible organ donors. This investigation was a reflective study of the methodologic factors of the family interview that affect their decision regarding the donation of a deceased patient's organs for transplantation. The articles that formed the empirical basis of the trial were obtained from PubMed, which is a free-access tool of the MEDLINE database of the United States National Library of Medicine. Published articles that allowed us to reflect on evidence-based family interview practice were selected. Thirty-six scientific articles were used to guide our assessment the family interview, providing evidence for its adequate execution in view of the following prerequisites: When should the family interview be performed? Where should it be done? How many and which people should participate in the interview? Who should perform it? How should it be done? Scientific studies offer evidence to donation and transplantation specialists that can help them in their daily work regarding their interactions with relatives in the process of decisionmaking and family consent. Copyright © 2018 Elsevier Inc. All rights reserved.

Discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia: Recommendations for clinical practice from the French Chronic Myeloid Leukemia Study Group.

PubMed

Rea, Delphine; Ame, Shanti; Berger, Marc; Cayuela, Jean-Michel; Charbonnier, Aude; Coiteux, Valérie; Cony-Makhoul, Pascale; Dubruille, Viviane; Dulucq, Stéphanie; Etienne, Gabriel; Legros, Laurence; Nicolini, Franck; Roche-Lestienne, Catherine; Escoffre-Barbe, Martine; Gardembas, Martine; Guerci-Bresler, Agnès; Johnson-Ansah, Hyacinthe; Rigal-Huguet, Françoise; Rousselot, Philippe; Mahon, François-Xavier

2018-05-03

The ultimate goal of chronic myeloid leukemia management in the tyrosine kinase inhibitor (TKI) era for patients who obtain deep molecular responses is maintaining a durable off-treatment response after treatment discontinuation; this situation is called treatment-free remission (TFR). Knowledge accumulated during the last 10 years justifies moving TFR strategies from research to clinical practice. Twenty experts from the French Chronic Myeloid Leukemia Study Group (France Intergroupe des Leucémies Myéloïdes Chroniques), including 17 hematologists, 2 molecular biologists, and 1 cytogeneticist, critically reviewed published data with the goal of developing evidence-based recommendations for TKI discontinuation in clinical practice. Clinically relevant questions were addressed, including the selection of candidate patients (with known prognostic factors for outcomes taken into account), detailed monitoring procedures during the treatment-free phase, a definition of relapse requiring therapy resumption, and monitoring after treatment reintroduction. This work presents consensus statements with the aim of guiding physicians and biologists by means of pragmatic recommendations for safe TKI discontinuation in daily practice. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Changes in daily occupations and the meaning of work for three women caring for relatives post-stroke.

PubMed

Van Dongen, Isabella; Josephsson, Staffan; Ekstam, Lisa

2014-09-01

This qualitative study explored how some working Austrians experienced and coped with changes in their daily occupations after becoming informal carers of persons who had had a stroke. The study provides insights into the working carers' occupational experiences and strategies during a period of pronounced life changes. Three participants, who were employed in full- or part-time work, as well as being informal carers of persons who had had a stroke, were interviewed on two occasions. The data from these interviews were analysed using Interpretative Phenomenological Analyses. Carers found themselves in an ongoing process, ranging from the disruption of daily occupations to their eventual restructure. First, the stroke led to involuntary changes in the carers' daily life, which resulted in challenges in their own, and in shared, occupations. Second, carers actively changed their values and performance of occupations, which appeared to be a strategy to shape their well-being. Paid work was found to be a stabilizing and balancing occupation, which contributed to coping and the well-being of carers. The authors' findings demonstrate the benefits of paid work and engagement in meaningful occupation for the carers' well-being. These results should encourage occupational therapists to be sensitive to the complexity of the lives of working informal carers.

Dietitians' opinions regarding refeeding syndrome, clinical guidelines and extended scope of practice.

PubMed

Matthews, Kylie L; Palmer, Michelle A; Capra, Sandra M

2018-04-30

Refeeding syndrome (RFS) prevalence rates vary across studies depending on the criteria used for assessment and identification. For registered dietitians, the assessment and management of RFS is highly reliant on daily serum electrolyte values; however, registered dietitians working within Australia do not currently possess laboratory test ordering privileges. We aimed to examine the opinions of registered dietitians regarding RFS identification, management and guidelines and the option of using extended scope of practice to order electrolyte monitoring autonomously. A multi-method action research approach was used, incorporating two projects. The first was a survey examining Australian registered dietitians' (n = 187) opinions regarding RFS identification, management and guidelines, and autonomous electrolyte monitoring. To establish if results were similar internationally, an interview was conducted with 22 registered dietitians working within 10 different countries. Data were analysed using chi-square tests and thematic analysis. Australian registered dietitians (75%) identify patients at risk of RFS at a high rate of more than once per fortnight, with 74% reporting that they have previously worked with a patient diagnosed with RFS. Results varied internationally, with respondents from eight countries reporting that RFS is a problem within acute care versus respondents from five countries having never treated a patient with RFS. The majority (≥89%) of registered dietitians desire new guidelines and the option to order patient electrolyte monitoring autonomously. Our findings suggest that more stringent tools for the identification of RFS are necessary. There was limited uniformity across countries, and updated practice guidelines are needed. © 2018 Dietitians Association of Australia.

Women’s experiences and health care-seeking practices in relation to uterine prolapse in a hill district of Nepal

PubMed Central

2014-01-01

Background Although uterine prolapse (UP) occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP. This study aimed to explore women’s experiences of UP and its effect on daily life, its perceived causes, and health care-seeking practices. Methods Using a convenience sampling method, we conducted 115 semi-structured and 16 in-depth interviews with UP-affected women during September–December 2012. All interviews occurred in outreach clinics in villages of the Dhading district. Results Study participants were 23–82 years of age. Twenty-four percent were literate, 47.2% had experienced a teenage pregnancy, and 29% had autonomy to make healthcare decisions. Most participants (>85%) described the major physical discomforts of UP as difficulty with walking, standing, working, sitting, and lifting. They also reported urinary incontinence (68%) bowel symptoms (42%), and difficulty with sexual activity (73.9%). Due to inability to perform household chores or fulfill their husband’s sexual desires, participants endured humiliation, harassment, and torture by their husbands and other family members, causing severe emotional stress. Following disclosure of UP, 24% of spouses remarried and 6% separated from the marital relationship. Women perceived the causes of UP as unsafe childbirth, heavy work during the postpartum period, and gender discrimination. Prior to visiting these camps some women (42%) hid UP for more than 10 years. Almost half (48%) of participants sought no health care; 42% ingested a herb and ate nutritious food. Perceived barriers to accessing health care included shame (48%) and feeling that care was unnecessary (12.5%). Multiple responses (29%) included shame, inability to share, male service provider, fear of stigma and discrimination, and perceiving UP as normal for childbearing women. Conclusions UP adversely affects women’s daily life and negatively influences their physical, mental, and social well-being. The results of our study are useful to generate information on UP symptoms and female health care seeking practices. Our findings can be helpful for effective development of UP awareness programs to increase service utilization at early stages of UP and thereby might contribute to both primary and secondary prevention of UP. PMID:24490616

A matter of priorities? Exploring the persistent gender pay gap in hospital medicine.

PubMed

Weaver, A Charlotta; Wetterneck, Tosha B; Whelan, Chad T; Hinami, Keiki

2015-08-01

Gender earnings disparities among physicians exist even after considering differences in specialty, part-time status, and practice type. Little is known about the role of job satisfaction priorities on earnings differences. To examine gender differences in work characteristics and job satisfaction priorities, and their relationship with gender earnings disparities among hospitalists. Observational cross-sectional survey study. US hospitalists in 2010. Self-reported income, work characteristics, and priorities among job satisfaction domains. On average, women compared to men hospitalists were younger, less likely to be leaders, worked fewer full-time equivalents, worked more nights, reported fewer daily billable encounters, more were pediatricians, worked in university settings, worked in the Western United States, and were divorced. More hospitalists of both genders prioritized optimal workload among the satisfaction domains. However, substantial pay ranked second in prevalence by men and fourth by women. Women hospitalists earned $14,581 less than their male peers in an analysis adjusting for these differences. The gender earnings gap persists among hospitalists. A portion of the disparity is explained by the fewer women hospitalists compared to men who prioritize pay. © 2015 Society of Hospital Medicine.

Developing a Strong Direct Care Workforce.

PubMed

Stear, Lynda A

The aging population of the United States has led to a need for more direct care workers to provide personal care to older adults and disabled people in their homes. The U.S. Bureau of Labor Statistics predicts employment of paraprofessionals in home care will grow 49% between 2012 and 2022 as the baby boomer generation ages and requires more assistance in activities of daily living. The typical direct care worker is a female aged 25 to 54 years old, a demographic that is projected to remain flat in the coming years. Direct care workers typically are poorly paid for work that is labor-intensive and often work in less than optimal working conditions. It is important that agencies hiring direct care workers understand the challenges these workers face and institute sound hiring practices and provide proper training and ongoing supervision. It is possible to have a quality direct care team. Proper training, role modeling, and supervision will improve employee satisfaction, decrease turnover, and improve care outcomes for patients.

The formation of social reintegration strategies of the psychic suffering carrier: new directions for psychiatric nursing in Brazil.

PubMed

Souza, Emilia Jales Simões de; Moreira, Lilian Hortale de Oliveira; Cardoso, Maria Manuela Vila Nova; Ferreira, Rosa Gomes dos Santos; Silva, Thuany Cristine Santos da

2014-09-01

This is an exploratory and descriptive study of a qualitative nature. Its objective is to analyse the formation of strategies for social reintegration of the psychic suffering carrier in the practice of nurses working in hospital psychiatric institutions. For this study, we use, as a basis, the concepts and processes of the formation of strategies presented by Isabel Nicholau, 2001. Twelve nurses with health care experience in hospital psychiatric institutions participated in this study, and data collection occurred through semi-structured interviews in the year 2013. The data revealed that, in addition to human, material, and financial resources, institutional support is needed as is articulation and interaction among professionals and services. The importance of the social dimension and of the negotiation process depicts the development of conception of collective and integrated work. We conclude that strategies are emerging from the daily life of work and are not limited to a rational logic of cost and fundraising, but instead are developed through a negotiated process.

Planning Under Continuous Time and Resource Uncertainty: A Challenge for AI

NASA Technical Reports Server (NTRS)

Bresina, John; Dearden, Richard; Meuleau, Nicolas; Smith, David; Washington, Rich; Clancy, Daniel (Technical Monitor)

2002-01-01

There has been considerable work in Al on decision-theoretic planning and planning under uncertainty. Unfortunately, all of this work suffers from one or more of the following limitations: 1) it relies on very simple models of actions and time, 2) it assumes that uncertainty is manifested in discrete action outcomes, and 3) it is only practical for very small problems. For many real world problems, these assumptions fail to hold. A case in point is planning the activities for a Mars rover. For this domain none of the above assumptions are valid: 1) actions can be concurrent and have differing durations, 2) there is uncertainty concerning action durations and consumption of continuous resources like power, and 3) typical daily plans involve on the order of a hundred actions. We describe the rover problem, discuss previous work on planning under uncertainty, and present a detailed. but very small, example illustrating some of the difficulties of finding good plans.

In vivo diagnosis of allergic diseases--allergen provocation tests.

PubMed

Agache, I; Bilò, M; Braunstahl, G-J; Delgado, L; Demoly, P; Eigenmann, P; Gevaert, P; Gomes, E; Hellings, P; Horak, F; Muraro, A; Werfel, T; Jutel, M

2015-04-01

The allergen challenge test has been the mainstay of diagnosis of allergic diseases for a long time since it offers a direct proof of the clinical relevance of a particular allergen for the allergic disease symptoms and severity. Standardisation and availability for daily practice (including safety issues) are still to be refined but most of the challenge tests have safely crossed the border from research tools to diagnostic tests available for daily practice for a well trained clinical staff. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Developing education tailored to clinical roles: genetics education for haemophilia nurses.

PubMed

Burke, Sarah; Barker, Colin; Marshall, Dianne

2012-01-01

Genetics is an important component of the clinical work of haemophilia nurses, but little was known about the genetic education needs of haemophilia nurses. To develop, deliver and evaluate genetic education for haemophilia nurses, based on clinical roles. Perceived relevance of genetics to haemophilia nursing practice was explored using electronic voting (response rate 75%, 58/77). A follow-on questionnaire to a volunteer sample of participants explored educational preferences (response rate 41%, 17/41). Results informed development of a two-hour genetics workshop session, evaluated by questionnaire (response rate 67%, 47/70). Genetic competences were considered relevant to the clinical practice of haemophilia nurses, and learning needs were identified. Preference was expressed for education focused on practical skills. During the subsequent workshop, participant confidence ratings significantly increased in the four areas addressed. Planned changes to clinical care and training were reported. Within new areas of advanced nursing practice, learning needs can be addressed by: identifying relevant clinical activities and associated learning needs; creating a strategy and resources using preferred forms of delivery; implementing the strategy; and evaluating its effect. This will enable development of education that addresses the real needs of practising nurses, grounded in their daily clinical practice. Copyright © 2011 Elsevier Ltd. All rights reserved.

Avenue for integrating geoethics into the working world.

NASA Astrophysics Data System (ADS)

Boon, Jan

2017-04-01

GeoEthics is a young field and is taking shape through events such as the International Declaration on GeoEthics (2011) and conference sessions held since 2013 (http://www.geoethics.org/events). Many of these focused on the geoscience community and had an academic or educational focus. While interest in the subject is growing, the number of participants is still low as compared to that of other geoscience disciplines. The author has found it difficult to generate interest in the formal inclusion of geoethics and the related fields of social and environmental responsibility into university geoscience curricula. This paper proposes to link geoethics to the huge effort that has been under way over the past decade and a half in the extractive industries to develop industry-wide codes that facilitate and structure the introduction of social and environmental responsibility into company operations. All of these codes contain specific references to ethics. The paper builds on two well-developed codes: "e3 Plus - A Framework or Responsible Exploration" (Prospectors and Developers Association of Canada) and "Towards Sustainable Mining" (Mining Association of Canada) to propose an overall practical reference frame for geoethics that may facilitate the transfer of geoethicists' work into daily practice in the extractive industries.

Effectiveness of daily versus non-daily granulocyte colony-stimulating factors in patients with solid tumours undergoing chemotherapy: a multivariate analysis of data from current practice

PubMed Central

Almenar Cubells, D; Bosch Roig, C; Jiménez Orozco, E; Álvarez, R; Cuervo, JM; Díaz Fernández, N; Sánchez Heras, AB; Galán Brotons, A; Giner Marco, V; Codes M De Villena, M

2013-01-01

We conducted a multicentre, retrospective, observational study including patients with solid tumours (excluding breast cancer) that received granulocyte colony-stimulating factors (G-CSF) and chemotherapy. We investigated the effectiveness of daily vs. non-daily G-CSFs (pegfilgrastim) adjusting by potential confounders. The study included 391 patients (211 daily G-CSF; 180 pegfilgrastim), from whom 47.3% received primary prophylaxis (PP) (57.8% pegfilgrastim), 26.3% secondary prophylaxis (SP: initiation after cycle 1 and no reactive treatment in any cycle) (51.5% pegfilgrastim) and 26.3% reactive treatment (19.4% pegfilgrastim). Only 42.2% of patients with daily G-CSF and 46.2% with pegfilgrastim initiated prophylaxis within 72 h after chemotherapy, and only 10.5% of patients with daily G-CSF received it for ≥7 days. In the multivariate models, daily G-CSF was associated with higher risk of grade 3-4 neutropenia (G3-4N) vs. pegfilgrastim [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.004–2.97]. Relative to SP, PP protected against G3-4N (OR for SP vs. PP: 6.0, 95%CI: 3.2–11.4) and febrile neutropenia (OR: 3.1, 95%CI: 1.1–8.8), and was associated to less chemotherapy dose delays and reductions (OR for relative dose intensity <85% for SP vs. PP: 3.1, 95%CI: 1.7–5.4) and higher response rate (OR: 2.1, 95%CI: 1.2–3.7). Data suggest that pegfilgrastim, compared with a daily G-CSF, and PP, compared with SP, could be more effective in preventing neutropenia and its related events in the clinical practice. PMID:23331323

African American Homeschooling Practices: Empirical Evidence

ERIC Educational Resources Information Center

Mazama, Ama

2016-01-01

Despite a significant increase in scholarly interest for homeschooling, some of its most critical aspects, such as instructional daily practices, remain grossly understudied. This essay thus seeks to fill that void by presenting empirical evidence regarding the homeschooling practices of a specific group, African Americans. Most specifically, the…

Effect of task-oriented training and high-variability practice on gross motor performance and activities of daily living in children with spastic diplegia.

PubMed

Kwon, Hae-Yeon; Ahn, So-Yoon

2016-10-01

[Purpose] This study investigates how a task-oriented training and high-variability practice program can affect the gross motor performance and activities of daily living for children with spastic diplegia and provides an effective and reliable clinical database for future improvement of motor performances skills. [Subjects and Methods] This study randomly assigned seven children with spastic diplegia to each intervention group including that of a control group, task-oriented training group, and a high-variability practice group. The control group only received neurodevelopmental treatment for 40 minutes, while the other two intervention groups additionally implemented a task-oriented training and high-variability practice program for 8 weeks (twice a week, 60 min per session). To compare intra and inter-relationships of the three intervention groups, this study measured gross motor performance measure (GMPM) and functional independence measure for children (WeeFIM) before and after 8 weeks of training. [Results] There were statistically significant differences in the amount of change before and after the training among the three intervention groups for the gross motor performance measure and functional independence measure. [Conclusion] Applying high-variability practice in a task-oriented training course may be considered an efficient intervention method to improve motor performance skills that can tune to movement necessary for daily livelihood through motor experience and learning of new skills as well as change of tasks learned in a complex environment or similar situations to high-variability practice.

Factors influencing the impact of oral health on the daily activities of adolescents, adults and older adults

PubMed Central

Bulgareli, Jaqueline Vilela; de Faria, Eduardo Tanajura; Cortellazzi, Karine Laura; Guerra, Luciane Miranda; Meneghim, Marcelo de Castro; Ambrosano, Glaucia Maria Bovi; Frias, Antonio Carlos; Pereira, Antonio Carlos

2018-01-01

ABSTRACT OBJECTIVE: Analyze if clinical, sociodemographic and access to dental services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults. METHODS: A cross-sectional study with secondary data from the State Oral Health Survey (SB São Paulo 2015) conducted in 163 cities of São Paulo. A total of 17,560 individuals from three age groups: 15–19-year-old (n = 5,558), 35–44-year-old (n = 6,051), and older people of 65 years or more (n = 5,951) participated in the survey. The selection was made by probabilistic sample by conglomerates in two stages. The endpoint variable was the impact of oral health on daily activities, evaluated by the Oral Impacts on Daily Performances questionnaire, containing questions about eating, talking, oral hygiene, relaxation, sports practice, smile, study or work, social contact, and sleep. Oral Impacts on Daily Performances was dichotomized with and without impact. The independent variables were sociodemographic, clinical and access variables, divided into three blocks. A hierarchical multiple logistic regression analysis was performed considering the complex sampling plan of clusters. Each observation received a specific weight, depending on the location that resulted in weighted frequencies and adjusted for the design effect. RESULTS: The presence of oral health impact was observed in 27.9% of the individuals. In block 1, female gender and black/brown ethnic group had a greater chance of impact of oral health on quality of life, as well as the adults and the older adults in relation to adolescents. In block 2, family income up to R$1,500 was associated with the presence of impact. In block 3, individuals who reported toothache, used the public service and sought dental treatment had a greater chance of impact. CONCLUSIONS: Sociodemographic, clinical and access to health services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults. PMID:29668813

Applying Contemporary Developmental and Movement Science Theories and Evidence to Early Intervention Practice

ERIC Educational Resources Information Center

Hickman, Robbin; McCoy, Sarah Westcott; Long, Toby M.; Rauh, Mitchell J.

2011-01-01

Changes in early childhood science, theory, and best practices for improving outcomes of children with motor delay or dysfunction and their families have evolved rapidly since EI began. Changes in daily early intervention (EI) practice have been more elusive. Closing the gap between knowledge and practice requires EI providers to piece together…

An Affordable Microsurgical Training System for a Beginning Neurosurgeon: How to Realize the Self-Training Laboratory.

PubMed

Chung, Sang-Bong; Ryu, Jiwook; Chung, Yeongu; Lee, Sung Ho; Choi, Seok Keun

2017-09-01

To provide detailed information about how to realize a self-training laboratory with cost-effective microsurgical instruments, especially pertinent for the novice trainee. Our training model is designed to allow the practice of the microsurgery skills in an efficient and cost-effective manner. A used stereoscopic microscope is prepared for microsurgical training. A sufficient working distance for microsurgical practice is obtained by attaching an auxiliary objective lens. The minimum instrument list includes 2 jeweler's forceps, iris scissors, and alligator clips. The iris scissors and alligator clip provide good alternatives to micro-scissors and microvascular clamp. The short time needed to set up the microscope and suture the gauze with micro-forceps makes the training model suitable for daily practice. It takes about 15 minutes to suture 10 neighboring fibers of the gauze with 10-0 nylon; thus, training can be completed more quickly. We have developed an inexpensive and efficient micro-anastomosis training system using a stereoscopic microscope and minimal micro-instruments. Especially useful for novice trainees, this system provides high accessibility for microsurgical training. Copyright © 2017 Elsevier Inc. All rights reserved.

Implementing Montessori Methods for Dementia™ in Ontario long-term care homes: Recreation staff and multidisciplinary consultants' perceptions of policy and practice issues.

PubMed

Ducak, Kate; Denton, Margaret; Elliot, Gail

2018-01-01

Montessori-based activities use a person-centred approach to benefit persons living with dementia by increasing their participation in, and enjoyment of, daily life. This study investigated recreation staff and multidisciplinary consultants' perceptions of factors that affected implementing Montessori Methods for Dementia™ in long-term care homes in Ontario, Canada. Qualitative data were obtained during semi-structured telephone interviews with 17 participants who worked in these homes. A political economy of aging perspective guided thematic data analysis. Barriers such as insufficient funding and negative attitudes towards activities reinforced a task-oriented biomedical model of care. Various forms of support and understanding helped put Montessori Methods for Dementia™ into practice as a person-centred care program, thus reportedly improving the quality of life of residents living with dementia, staff and family members. These results demonstrate that when Montessori Methods for Dementia™ approaches are learned and understood by staff they can be used as practical interventions for long-term care residents living with dementia.

Astronomy in Cuba: practice and trends. An effort to develop a non-formal education programme

NASA Astrophysics Data System (ADS)

Pomares, Oscar A.

In the recent past years, a daily stronger movement of non-professional astronomers has become the center of development for astronomy, a subject of study practically absent now from the national education system in Cuba. A key roll in this movement has been played by the professional staff of the Department of Astronomy of the Institute of Geophysics and Astronomy. As direct outcome of this joint effort between astronomers and amateurs is the research on meteors and comets, presented in two national and one international scientific meeetings. The opening last year of the "Palacio de las Ciencias" in the main building of the country, "El Capitolio Nacional", the participation in conferences and workshops of professional astronomers facing the general public, and their participation in prime-time TV and radio programs open a way for the growth of astronomical knowledge among the Cuban people. Two national meeetings gathering together professional and non- professional astronomers have been held already. Future works in the NEOs international campaign are foreseen. Practice and trends of astronomy in Cuba clarify views of our future in the oldest natural science.

Descriptive survey of Summer Genetics Institute nurse graduates in the USA.

PubMed

Hickey, Kathleen T; Sciacca, Robert R; McCarthy, Mary S

2013-03-01

The purpose of this study was to describe the clinical, research, educational, and professional activities that nurses are engaged in following participation in a 2 month intramural genetics training program. An online survey was administered in 2010 to graduates of the program sponsored by the US National Institute of Nursing Research from 2000 to 2009, in Bethesda, Maryland, USA. The electronic, voluntary survey was sent to 189 graduates via email. The survey included demographic characteristics, educational preparation, professional roles and responsibilities, and attitudes about genetic testing and privacy issues. Of the 95 graduates responding to the survey, 74% had doctorates and 70% were advanced practice nurses. All respondents reported incorporating genetics knowledge into daily clinical, academic, or research practices since completing the program, with 72% reporting being involved in genetically-focused research (52% with research funding), 32% incorporating genetics into patient care, and 79% providing genetics education. Respondents working in a hospital setting or academic institution were more likely to desire additional training in genetics. National Institute of Nursing Research graduates have successfully integrated genomics into a variety of nursing practices. © 2012 Wiley Publishing Asia Pty Ltd.

Long hours in paid and domestic work and subsequent sickness absence: does control over daily working hours matter?

PubMed Central

Ala‐Mursula, L; Vahtera, J; Kouvonen, A; Väänänen, A; Linna, A; Pentti, J; Kivimäki, M

2006-01-01

Objectives To explore the associations of working hours (paid, domestic, commuting, and total) with sickness absence, and to examine whether these associations vary according to the level of employee control over daily working hours. Methods Prospective cohort study among 25 703 full‐time public sector employees in 10 towns in Finland. A survey of working hours and control over working hours was carried out in 2000–01. The survey responses were linked with register data on the number of self‐certified (⩽3 days) and medically certified (>3 days) sickness absences until the end of 2003. Poisson regression analyses with generalised estimating equations were used to take into account the fact that the employees were nested within work units. Adjustments were made for work and family characteristics and health behaviour. The mean follow‐up period was 28.1 (SD 8.1) months. Results Long domestic and total working hours were associated with higher rates of medically certified sickness absences among both genders. In contrast, long paid working hours were associated with lower rates of subsequent self‐certified sickness absences. Long commuting hours were related to increased rates of sickness absence of both types. Low control over daily working hours predicted medically certified sickness absences for both the women and men and self‐certified absences for the men. In combinations, high control over working hours reduced the adverse associations of long domestic and total working hours with medically certified absences. Conclusions Employee control over daily working hours may protect health and help workers successfully combine a full‐time job with the demands of domestic work. PMID:16728502

Building a Culture of Continuous Improvement and Employee Engagement Using a Daily Management System Part 1: Overview.

PubMed

Maurer, Marsha; Canacari, Elena; Eng, Kimberly; Foley, Jane; Phelan, Cynthia; Sulmonte, Kimberlyann; Wandel, Jane

2018-03-01

A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact quality or workflow and to address them on a daily basis. Through DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 1 describes the background and organizing framework of the program.

Interpersonal conflict and sarcasm in the workplace.

PubMed

Calabrese, K R

2000-11-01

Violence and aggression in the workplace are problems that most Americans confront on a daily basis. The present study is an exploration of the predisposition to conflict in a work environment in which personality traits responsible for increased sarcasm and increased anger in response to sarcasm are identified. Participants represented two subdepartments within a city general hospital. The Keirsey Temperament Sorter (D. Keirsey, 1998) test for departmental temperament and a sarcasm survey designed by the author were used to test for frequency of sarcasm and anger in relation to differing categories of sarcasm. Angry reactions were gauged in relation to sarcasm directed at job performance, personal life, behavior, and appearance. Conclusions from this study point to many variables as causes for workplace anger; these include influences from organizational culture, work environment, psychological defense mechanisms, leadership decisions, stress, task orientation, and personality differences. Sarcasm trigger points leading to anger may be predicted based on a work group's personality composition. A homogeneous personality composition within a work group may involve factors such as personality characteristics common to a particular profession, organizational demands, and hiring practices.

What Do District Health Managers in Ghana Use Their Working Time for? A Case Study of Three Districts.

PubMed

Bonenberger, Marc; Aikins, Moses; Akweongo, Patricia; Bosch-Capblanch, Xavier; Wyss, Kaspar

2015-01-01

Ineffective district health management potentially impacts on health system performance and service delivery. However, little is known about district health managing practices and time allocation in resource-constrained health systems. Therefore, a time use study was conducted in order to understand current time use practices of district health managers in Ghana. All 21 district health managers working in three districts of the Eastern Region were included in the study and followed for a period of three months. Daily retrospective interviews about their time use were conducted, covering 1182 person-days of observation. Total time use of the sample population was assessed as well as time use stratified by managerial position. Differences of time use over time were also evaluated. District health managers used most of their working time for data management (16.6%), attending workshops (12.3%), financial management (8.7%), training of staff (7.1%), drug and supply management (5.0%), and travelling (9.6%). The study found significant variations of time use across the managerial cadres as well as high weekly variations of time use impulsed mainly by a national vertical program. District health managers in Ghana use substantial amounts of their working time in only few activities and vertical programs greatly influence their time use. Our findings suggest that efficiency gains are possible for district health managers. However, these are unlikely to be achieved without improvements within the general health system, as inefficiencies seem to be largely caused by external factors.

Information-seeking trends of medical professionals and students from middle-income countries: a focus on the Philippines.

PubMed

Gavino, Alex I; Ho, Beverly Lorraine C; Wee, Pura Angela A; Marcelo, Alvin B; Fontelo, Paul

2013-12-01

Increased emphasis has been given to the practice of evidence-based medicine (EBM) worldwide. Access to quality health information is essential to the practice of EBM in developing countries. To understand the information needs and sources of information of physicians from low- and middle-income countries (LMICs). Medical doctors and students participated in an 18-question online or paper study. Of the 156 respondents from six LMICs, 146 (94%) came from the Philippines. Eighty-eight per cent encountered at least one clinical question daily, while 58% were very likely to search for answers. A basic mobile phone was the most used device at home (94%) and at work (82%). More than half had Internet connectivity at home (62%) and just under half at work (46%). In decreasing order, short messaging services (SMS), email, instant messaging and multimedia messaging services (MMS) were the most commonly used messaging tools at home and at work. The primary source for medication questions was a formulary, but for diagnostic dilemmas, colleagues were consulted first. PubMed use was high for therapy and management questions. The use of health information from the Internet through mobile devices may be increasing. Access to health information was higher at home than at work. These results may be useful when planning resources for healthcare givers in resource-poor settings. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group.

The value of participatory development to support antimicrobial stewardship with a clinical decision support system.

PubMed

Beerlage-de Jong, Nienke; Wentzel, Jobke; Hendrix, Ron; van Gemert-Pijnen, Lisette

2017-04-01

Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily practice. Our aim was to demonstrate why and how participatory development (involving end-users and other stakeholders) can contribute to the success of CDSSs in ASPs. A mixed-methods approach was applied, combining scenario-based prototype evaluations (to support verbalization of work processes and out-of-the-box thinking) among 6 medical resident physicians with an online questionnaire (to cross-reference findings of the prototype evaluations) among 54 Dutch physicians. The prototype evaluations resulted in insight into the end-users and their way of working, as well as their needs and expectations. The online questionnaire that was distributed among a larger group of medical specialists, including lung and infection experts, complemented the findings of the prototype evaluations. It revealed a say/do problem concerning the unrecognized need of support for selecting diagnostic tests. Low-fidelity prototypes of a technology allow researchers to get to know the end-users, their way of working, and their work context. Involving experts allows technology developers to continuously check the fit between technology and clinical practice. The combination enables the participatory development of technology to successfully support ASPs. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Performance and sleepiness in nurses working 12-h day shifts or night shifts in a community hospital.

PubMed

Wilson, Marian; Permito, Regan; English, Ashley; Albritton, Sandra; Coogle, Carlana; Van Dongen, Hans P A

2017-10-05

Hospitals are around-the-clock operations and nurses are required to care for patients night and day. The nursing shortage and desire for a more balanced work-to-home life has popularized 12-h shifts for nurses. The present study investigated sleep/wake cycles and fatigue levels in 22 nurses working 12-h shifts, comparing day versus night shifts. Nurses (11day shift and 11 night shift) were recruited from a suburban acute-care medical center. Participants wore a wrist activity monitor and kept a diary to track their sleep/wake cycles for 2 weeks. They also completed a fatigue test battery, which included the Psychomotor Vigilance Test (PVT) and the Karolinska Sleepiness Scale (KSS), at the beginning, middle and end of 4 duty shifts. Daily sleep duration was 7.1h on average. No overall difference in mean daily sleep duration was found between nurses working day shifts versus night shifts. Objective performance on the PVT remained relatively good and stable at the start, middle, and end of duty shifts in day shift workers, but gradually degraded across duty time in night shift workers. Compared to day shift workers, night shift workers also exhibited more performance variability among measurement days and between participants at each testing time point. The same pattern was observed for subjective sleepiness on the KSS. However, congruence between objective and subjective measures of fatigue was poor. Our findings suggest a need for organizations to evaluate practices and policies to mitigate the inevitable fatigue that occurs during long night shifts, in order to improve patient and healthcare worker safety. Examination of alternative shift lengths or sanctioned workplace napping may be strategies to consider. Copyright © 2017 Elsevier Ltd. All rights reserved.

A 30-Year Follow-Up Study of Actual Applied Music Practice Versus Estimated Practice

ERIC Educational Resources Information Center

Madsen, Clifford K.

2004-01-01

This study was designed to determine if adults are able to remember how much time they actually spent practicing during a past time period of their lives where detailed daily records were kept of actual number of minutes practiced. It also addressed how past practice time relates to their highest level of musical performance across the 30 years on…

The development of accurate and high quality radiotherapy treatment delivery

NASA Astrophysics Data System (ADS)

Griffiths, Susan E.

Accurate radiotherapy delivery is required for curing cancer. Historical radiotherapy accuracy studies at Leeds (1983-1991) are discussed in context of when radiographers were not involved in practice design. The seminal research was unique in being led by a radiographer practitioner, and in prospectively studying the accuracy of different techniques within one department. The viability of alignment of treatment beams with marks painted on a patient's skin varied daily, and, using film I showed that the alignment of treatment on anatomy varied. I then led 6 sequential studies with collaborating oncologists. Unique outcomes were in identifying the origins of treatment inaccuracies, implementing and evidencing changes in multi-disciplinary practice, thus improving accuracy and reproducibility generally and achieving accuracy for the pelvis to within current norms. Innovations included: discontinuation of painted skin marks and developing whole-body patient positioning using lasers, tattoos, and standardised supports; unification of set-up conditions through planning and treatment; planning normal tissue margins round target tissue to allow for inaccuracies (1985); improved manual shielding methods, changed equipment usage, its quality assurance and design; influenced the development of portal imaging and image analysis. Consequences and current implications. The research, still cited internationally, contributed to clinical management of lymphoma, and critically underpins contemporary practice. It led to my becoming the first radiographer invited into multi-disciplinary collaborative work, to advise in the first multi-centre clinical trials to consider treatment delivery accuracy, contribute to books written from within other disciplines and inform guidelines for good practice so helping to improve practices, with recent publications. I thus led my profession into research activity. Later work included development of a national staffing formula for radiotherapy Centres, and contributing to the evidence-base for improved National radiotherapy resourcing. I recently researched and developed a textbook (second edition) on quality in treatment delivery.

Compliance with infection control practices in an university hospital dental clinic

PubMed Central

Mutters, Nico T.; Hägele, Ulrike; Hagenfeld, Daniel; Hellwig, Elmar; Frank, Uwe

2014-01-01

Aim: Compliance with infection control practices is the key to quality care and excellence in dentistry. Infection control remains one of the most cost-beneficial interventions available. However, implementing control procedures requires full compliance of the whole dental team. The aim of our study was to measure the compliance in daily clinical practice. Methods: The compliance with infection control practices in dentistry by dental health care personnel (DHCP) in a German university dental clinic was observed during clinical work. In addition, a survey was conducted to assess the individual knowledge about infection control procedures. Contamination of the workplace during invasive dental procedures was tested, as well. Results: A total of 58 invasive dental treatments implying close contacts between HCWs and patients were scrutinized. All HCWs (100%) wore gloves during dental work, but in some cases (female dentists: 14.3%; dental assistants: 28.6%) gloves were neither changed nor hands were disinfected between different activities or patient contacts (female dentists: 68.6%; male dentists: 60.9%; dental assistants: 93%). Only 31.4% of female and 39.1% of male dentists carried out adequate hygienic hand disinfection after removing gloves. Male dentists wore significantly more often (100%) protective eyewear compared to 77.1% of female dentists (p<0.05). In addition, most of female dentists (62.9%) and dental assistants (80.7%) wore jewelry during dental procedures. Conclusion: Despite the knowledge of distinct hygiene procedures only a small percentage of dental staff performs hygiene practices according to recommended guidelines. Strict audit is clearly needed in the dental setting to ensure compliance with infection control guidelines to prevent transmission of pathogens. Our results provide insights for the development of a targeted education and training strategy to enhance compliance of dental staff especially of dental assistants with infection control procedures. PMID:25285262

Compliance with infection control practices in an university hospital dental clinic.

PubMed

Mutters, Nico T; Hägele, Ulrike; Hagenfeld, Daniel; Hellwig, Elmar; Frank, Uwe

2014-01-01

Compliance with infection control practices is the key to quality care and excellence in dentistry. Infection control remains one of the most cost-beneficial interventions available. However, implementing control procedures requires full compliance of the whole dental team. The aim of our study was to measure the compliance in daily clinical practice. The compliance with infection control practices in dentistry by dental health care personnel (DHCP) in a German university dental clinic was observed during clinical work. In addition, a survey was conducted to assess the individual knowledge about infection control procedures. Contamination of the workplace during invasive dental procedures was tested, as well. A total of 58 invasive dental treatments implying close contacts between HCWs and patients were scrutinized. All HCWs (100%) wore gloves during dental work, but in some cases (female dentists: 14.3%; dental assistants: 28.6%) gloves were neither changed nor hands were disinfected between different activities or patient contacts (female dentists: 68.6%; male dentists: 60.9%; dental assistants: 93%). Only 31.4% of female and 39.1% of male dentists carried out adequate hygienic hand disinfection after removing gloves. Male dentists wore significantly more often (100%) protective eyewear compared to 77.1% of female dentists (p<0.05). In addition, most of female dentists (62.9%) and dental assistants (80.7%) wore jewelry during dental procedures. Despite the knowledge of distinct hygiene procedures only a small percentage of dental staff performs hygiene practices according to recommended guidelines. Strict audit is clearly needed in the dental setting to ensure compliance with infection control guidelines to prevent transmission of pathogens. Our results provide insights for the development of a targeted education and training strategy to enhance compliance of dental staff especially of dental assistants with infection control procedures.

A diary study on work-related smartphone use, psychological detachment and exhaustion: examining the role of the perceived segmentation norm.

PubMed

Derks, Daantje; van Mierlo, Heleen; Schmitz, Elisabeth B

2014-01-01

In this diary study, we examined the associations between daily work-related smartphone use and daily psychological detachment and daily work-related exhaustion within a group of smartphone owners. In addition, we studied the role of the perceived segmentation norm at the workplace as a moderator of the link between work-related smartphone use and detachment. A total of 70 employees using smartphones on initiative of their employer completed a diary questionnaire on 4 successive workdays (N = 268 data points). We hypothesized that work-related smartphone use is negatively related to psychological detachment and that psychological detachment, in turn, is negatively related to work-related exhaustion. Finally, we expected that especially employees who perceive a high segmentation norm at their workplace have difficulties to psychologically detach from work on days that they use their smartphone more intensively. Overall, the results of multilevel analyses supported these hypotheses. The findings emphasize the importance of a clear organizational policy regarding work-related smartphone use outside of work hours. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Working Memory Maturation: Can We Get at the Essence of Cognitive Growth?

PubMed

Cowan, Nelson

2016-03-01

The theoretical and practical understanding of cognitive development depends on working memory, the limited information temporarily accessible for such daily activities as language processing and problem solving. In this article, I assess many possible reasons that working memory performance improves with development. A first glance at the literature leads to the weird impression that working memory capacity reaches adult levels during infancy but then regresses during childhood. In place of that unlikely explanation, I consider how infant studies may lead to overestimates of capacity if one neglects supports that the tasks provide, compared with adult-level tasks. Further development of working memory during the school years is also considered. Many investigators have come to suspect that working memory capacity may be constant after infancy because of various factors such as developmental increases in knowledge, filtering out of irrelevant distractions, encoding and rehearsal strategies, and pattern formation. With each of these factors controlled, though, working memory still improves during the school years. Suggestions are made for research to bridge the gap between infant and child developmental research, to understand the focus and control of attention in working memory and how these skills develop, and to pinpoint the nature of capacity and its development from infancy forward. © The Author(s) 2016.

Working Memory Maturation: Can We Get At the Essence of Cognitive Growth?

PubMed Central

Cowan, Nelson

2015-01-01

Our theoretical and practical understanding of cognitive development depends on working memory, the limited information temporarily accessible for such daily activities as language processing and problem-solving. Here I assess many possible reasons why working memory performance improves with development. A first glance at the literature leads to the weird impression that working memory capacity reaches adult-like levels during infancy but then regresses during childhood. In place of that unlikely surmise, I consider how infant studies may lead to overestimates of capacity if one neglects supports that the tasks provide, compared to adult-like tasks. Further development of working memory during the school years is also considered. Various confounding factors have led many investigators to suspect that working memory capacity may be constant after infancy; the factors include developmental increases in knowledge, filtering out of irrelevant distractions, encoding and rehearsal strategies, and pattern formation. With each of these factors controlled, though, working memory still improves during the school years. Suggestions are made for research to bridge the gap between infant and child developmental research, to understand the focus and control of attention in working memory and how they develop, and to pinpoint the nature of capacity and its development from infancy on. PMID:26993277

Practical Considerations Informing Teachers' Technology Integration Decisions: The Case of Tablet PCs

ERIC Educational Resources Information Center

Pareja Roblin, Natalie; Tondeur, Jo; Voogt, Joke; Bruggeman, Bram; Mathieu, Griet; van Braak, Johan

2018-01-01

The unique characteristics of tablet PCs promise important benefits for education. Yet, little is known about the rationale underlying teachers' decisions concerning their educational uses within the constraints of daily classroom practice. The current multiple case study investigated the practical considerations informing nine secondary school…

Developing with Residual Practice in EFL Classrooms

ERIC Educational Resources Information Center

Kivanç Çaganaga, Çagda; Kaymakamoglu, Sibel

2015-01-01

This article explores the concept of residual practice as a means of understanding the importance of daily experience on classroom management. The suggested theory can adequately illuminate the nature and process of learning while teaching in classrooms. This article aims to provide residual practice as a comprehensive framework for evaluating the…

Exercises of Practical Life: Introduction and List

ERIC Educational Resources Information Center

Joosten, A. M.

2013-01-01

Albert Joosten wrote this article in 1968, and it is still the most comprehensive article on practical life to date. He develops his thesis beginning with "daily activities" leading to "developmental and creative activities." At the same time, Mr. Joosten establishes the psychological backdrop for the practical life exercises…

Diabetes-Related Goals, Practices, and Beliefs of Practicing Pediatricians.

ERIC Educational Resources Information Center

Lorenz, Rodney A.; Pichert, James W.

1982-01-01

Practicing pediatricians were surveyed to assess their need for diabetes education programs. Pediatricians generally have fewer than five diabetic patients, see them less than every four months, prescribe single daily insulin injections, and do not include diatetic services in the treatment program. No adequate rationale for continuing education…

Barriers and Facilitators to eHealth Use in Daily Practice: Perspectives of Patients and Professionals in Dermatology.

PubMed

Ariens, Lieneke Fm; Schussler-Raymakers, Florine Ml; Frima, Cynthia; Flinterman, Annebeth; Hamminga, Eefje; Arents, Bernd Wm; Bruijnzeel-Koomen, Carla Afm; de Bruin-Weller, Marjolein S; van Os-Medendorp, Harmieke

2017-09-05

The number of eHealth interventions in the management of chronic diseases such as atopic dermatitis (AD) is growing. Despite promising results, the implementation and use of these interventions is limited. This study aimed to assess opinions of the most important stakeholders influencing the implementation and use of eHealth services in daily dermatology practice. The perspectives of health care professionals and patients towards the implementation and use of eHealth services in daily practice were assessed by using a mixed method design. A cross-sectional survey based on the eHealth implementation toolkit (eHit) was conducted to explore factors influencing the adoption of eHealth interventions offering the possibility of e-consultations, Web-based monitoring, and Web-based self-management training among dermatologists and dermatology nurses. The perspectives of patients with atopic dermatitis (AD) regarding the use of eHealth services were discussed in an online focus group. Health care professionals (n=99) and patients (n=9) acknowledged the value of eHealth services and were willing to use these digital tools in daily dermatology practice. Key identified barriers (statements with <50% of the participants scoring totally agree or agree) in the implementation and adoption of eHealth interventions included concerns about the availability (12/99, 12%) and allocation (14/99, 14%) of resources, financial aspects (26/99, 26%), reliability, security, and confidentially of the intervention itself (29/99, 29%), and the lack of education and training (6/99, 6%). Health care professionals and patients acknowledge the benefits arising from the implementation and use of eHealth services in daily dermatology practice. However, some important barriers were identified that might be useful in addressing the implementation strategy in order to enhance the implementation success of eHealth interventions in dermatology. ©Lieneke FM Ariens, Florine ML Schussler-Raymakers, Cynthia Frima, Annebeth Flinterman, Eefje Hamminga, Bernd WM Arents, Carla AFM Bruijnzeel-Koomen, Marjolein S de Bruin-Weller, Harmieke van Os-Medendorp. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.09.2017.