Abusive supervision, leader-member exchange and moral disengagement: a moderated-mediation model of organizational deviance.

PubMed

Valle, Matthew; Kacmar, K Michele; Zivnuska, Suzanne; Harting, Troy

2018-04-20

This paper draws from social exchange theory and social cognitive theory to explore moral disengagement as a potential mediator of the relationship between abusive supervision and organizational deviance. We also explore the moderating effect of leader-member exchange (LMX) on this mediated relationship. Results indicate that employees with abusive supervisors engaged in moral disengagement strategies and subsequently in organizational deviance behaviors. Additionally, this relationship was stronger for those higher in LMX. Important implications for management research and practice are discussed.

The Importance of Relational Coordination and Reciprocal Learning for Chronic Illness Care within Primary Care Teams

PubMed Central

Noël, Polly Hitchcock; Lanham, Holly J.; Palmer, Ray F.; Leykum, Luci K.; Parchman, Michael L.

2012-01-01

Background Recent research from a complexity theory perspective suggests that implementation of complex models of care, such as the Chronic Care Model (CCM), requires strong relationships and learning capacities among primary care teams. Purposes Our primary aim was to assess the extent to which practice member perceptions of relational coordination and reciprocal learning were associated with the presence of CCM elements in community-based primary care practices. Methodology/Approach We used baseline measures from a cluster randomized controlled trial testing a practice facilitation intervention to implement the CCM and improve risk factor control for patients with type 2 diabetes in small primary care practices. Practice members (i.e., physicians, non-physician providers, and staff) completed baseline assessments, which included the Relational Coordination Scale, Reciprocal Learning Scale, and the Assessment of Chronic Illness Care (ACIC) survey, along with items assessing individual and clinic characteristics. To assess the association between Relational Coordination, Reciprocal Learning, and ACIC, we used a series of hierarchical linear regression models accounting for clustering of individual practice members within clinics and controlling for individual- and practice-level characteristics, and tested for mediation effects. Findings 283 practice members from 39 clinics completed baseline measures. Relational Coordination scores were significantly and positively associated with ACIC scores (Model 1). When Reciprocal Learning was added, Relational Coordination remained a significant yet notably attenuated predictor of ACIC (Model 2). The mediation effect was significant (z = 9.3, p<.01); 24% of the association between Relational Coordination and ACIC scores was explained by Reciprocal Learning. Of the individual and practice level covariates included in Model 3, only the presence of an electronic medical record was significant; Relational Coordination and Reciprocal Learning remained significant independent predictors of ACIC. Practice Implications Efforts to implement complex models of care should incorporate strategies to strengthen relational coordination and reciprocal learning among team members. PMID:22310483

Faculty Perspectives on Creating Community in Residence Halls

ERIC Educational Resources Information Center

Ellett, Tom; Schmidt, Anna

2011-01-01

This study sought to explore and understand the perceptions that faculty members have of community development in living-learning communities at a large, private research institution in the Northeast. Boyer's (1990) tenets of community development provided a theoretical lens for the study. The article concludes with implications for practice and…

16 CFR 254.5 - Misrepresentations of enrollment qualifications or limitations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... qualifications for enrollment in a school or program of instruction. (b) It is deceptive for an Industry Member to misrepresent, directly or indirectly, expressly or by implication, that the lack of a high school... PRACTICE RULES GUIDES FOR PRIVATE VOCATIONAL AND DISTANCE EDUCATION SCHOOLS § 254.5 Misrepresentations of...

The relative importance of relational and scientific characteristics of psychotherapy: Perceptions of community members vs. therapists.

PubMed

Farrell, Nicholas R; Deacon, Brett J

2016-03-01

Although client preferences are an integral component of evidence-based practice in psychology (American Psychological Association, 2006), relatively little research has examined what potential mental health consumers value in the psychotherapy they may receive. The present study was conducted to examine community members' preferences for the scientific and relational aspects of psychotherapy for different types of presenting problems, and how accurately therapists perceive these preferences. Community members (n = 200) were surveyed about the importance of scientific (e.g., demonstrated efficacy in clinical trials) and relational (e.g., therapist empathy) characteristics of psychotherapy both for anxiety disorders (e.g., obsessive-compulsive disorder) and disorder-nonspecific issues (e.g., relationship difficulties). Therapists (n = 199) completed the same survey and responded how they expected the average mental health consumer would. Results showed that although community members valued relational characteristics significantly more than scientific characteristics, the gap between these two was large for disorder-nonspecific issues (d = 1.24) but small for anxiety disorders (d = .27). Community members rated scientific credibility as important across problem types. Therapists significantly underestimated the importance of scientific characteristics to community members, particularly in the treatment of disorder-nonspecific issues (d = .74). Therapists who valued research less in their own practice were more likely to underestimate the importance of scientific credibility to community members. The implications of the present findings for understanding the nature of client preferences in evidence-based psychological practice are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Perceptions of distance education among nursing faculty members in North America.

PubMed

Mancuso, Josephine M

2009-06-01

A strategy to increase access to nursing education, train nurses for practice, and prepare future nurse educators is distance education. Faculty member shortages are cited as the main reason for not accepting qualified applicants. Faculty members are the core of nursing education. In order to address nursing faculty members' concerns regarding distance education and to assist in faculty member recruitment, retention, growth, and development in order to improve and enhance the quality of distance education, one must answer the question: What are nursing faculty members' perceptions of distance education in nursing? Utilizing a number of databases to locate research specific to this topic, this article provides an integrative review of the nursing literature to ascertain the faculty members' perspective of distance education. The research was analyzed, findings summarized, and limitations mentioned. Utilizing a brief supplementary review of the literature, the implications, recommendations, and need for future research are discussed.

Beyond the individual victim: multilevel consequences of abusive supervision in teams.

PubMed

Farh, Crystal I C; Chen, Zhijun

2014-11-01

We conceptualize a multilevel framework that examines the manifestation of abusive supervision in team settings and its implications for the team and individual members. Drawing on Hackman's (1992) typology of ambient and discretionary team stimuli, our model features team-level abusive supervision (the average level of abuse reported by team members) and individual-level abusive supervision as simultaneous and interacting forces. We further draw on team-relevant theories of social influence to delineate two proximal outcomes of abuse-members' organization-based self-esteem (OBSE) at the individual level and relationship conflict at the team level-that channel the independent and interactive effects of individual- and team-level abuse onto team members' voice, team-role performance, and turnover intentions. Results from a field study and a scenario study provided support for these multilevel pathways. We conclude that abusive supervision in team settings holds toxic consequences for the team and individual, and offer practical implications as well as suggestions for future research on abusive supervision as a multilevel phenomenon. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Learning, Teaching and Ambiguity in Virtual Worlds

NASA Astrophysics Data System (ADS)

Carr, Diane; Oliver, Martin; Burn, Andrew

What might online communities and informal learning practices teach us about virtual world pedagogy? In this chapter we describe a research project in which learning practices in online worlds such as World of Warcraft and Second LifeTM (SL) were investigated. Working within an action research framework, we employed a range of methods to investigate how members of online communities define the worlds they encounter, negotiate the terms of participation, and manage the incremental complexity of game worlds. The implications of such practices for online pedagogy were then explored through teaching in SL. SL eludes simple definitions. Users, or "residents", of SL partake of a range of pleasures and activities - socialising, building, creating and exhibiting art, playing games, exploring, shopping, or running a business, for instance. We argue that the variable nature of SL gives rise to degrees of ambiguity. This ambiguity impacts on inworld social practices, and has significant implications for online teaching and learning.

The Psychology of Yoga Practitioners: A Cluster Analysis.

PubMed

Genovese, Jeremy E C; Fondran, Kristine M

2017-11-01

Yoga practitioners (N = 261) completed the revised Expression of Spirituality Inventory (ESI) and the Multidimensional Body-Self Relations Questionnaire. Cluster analysis revealed three clusters: Cluster A scored high on all four spiritual constructs. They had high positive evaluations of their appearance, but a lower orientation towards their appearance. They tended to have a high evaluation of their fitness and health, and higher body satisfaction. Cluster B showed lower scores on the spiritual constructs. Like Cluster A, members of Cluster B tended to show high positive evaluations of appearance and fitness. They also had higher body satisfaction. Members of Cluster B had a higher fitness orientation and a higher appearance orientation than members of Cluster A. Members of Cluster C had low scores for all spiritual constructs. They had a low evaluation of, and unhappiness with, their appearance. They were unhappy with the size and appearance of their bodies. They tended to see themselves as overweight. There was a significant difference in years of practice between the three groups (Kruskall -Wallis, p = .0041). Members of Cluster A have the most years of yoga experience and members of Cluster B have more yoga experience than members of Cluster C. These results suggest the possible existence of a developmental trajectory for yoga practitioners. Such a developmental sequence may have important implications for yoga practice and instruction.

The Psychology of Yoga Practitioners: A Cluster Analysis.

PubMed

Genovese, Jeremy E C; Fondran, Kristine M

2017-03-30

Yoga practitioners (N = 261) completed the revised Expression of Spirituality Inventory (ESI) and the Multidimensional Body-Self Relations Questionnaire. Cluster analysis revealed three clusters: Cluster A scored high on all four spiritual constructs. They had high positive evaluations of their appearance, but a lower orientation towards their appearance. They tended to have a high evaluation of their fitness and health, and higher body satisfaction. Cluster B showed lower scores on the spiritual constructs. Like Cluster A, members of Cluster B tended to show high positive evaluations of appearance and fitness. They also had higher body satisfaction. Members of Cluster B had a higher fitness orientation and a higher appearance orientation than members of Cluster A. Members of Cluster C had low scores for all spiritual constructs. They had a low evaluation of, and unhappiness with, their appearance. They were unhappy with the size and appearance of their bodies. They tended to see themselves as overweight. There was a significant difference in years of practice between the three groups (Kruskall-Wallis, p = .0041). Members of Cluster A have the most years of yoga experience and members of Cluster B have more yoga experience than members of Cluster C. These results suggest the possible existence of a developmental trajectory for yoga practitioners. Such a developmental sequence may have important implications for yoga practice and instruction.

Evolution and the psychology of intergroup conflict: the male warrior hypothesis

PubMed Central

McDonald, Melissa M.; Navarrete, Carlos David; Van Vugt, Mark

2012-01-01

The social science literature contains numerous examples of human tribalism and parochialism—the tendency to categorize individuals on the basis of their group membership, and treat ingroup members benevolently and outgroup members malevolently. We hypothesize that this tribal inclination is an adaptive response to the threat of coalitional aggression and intergroup conflict perpetrated by ‘warrior males’ in both ancestral and modern human environments. Here, we describe how male coalitional aggression could have affected the social psychologies of men and women differently and present preliminary evidence from experimental social psychological studies testing various predictions from the ‘male warrior’ hypothesis. Finally, we discuss the theoretical implications of our research for studying intergroup relations both in humans and non-humans and discuss some practical implications. PMID:22271783

Caregiving for Dementia in Asian Communities: Implications for Practice

ERIC Educational Resources Information Center

Wang, Donna S.

2012-01-01

Dementia can be debilitating not only for the older adult suffering from memory loss and confusion, but for family members as well. Understanding caregiving for ethnic minorities is critical. In Asian communities, addressing dementia and other mental health issues can be compounded by cultural factors such as perceptions of mental health and…

Mental Health Issues in Recently Returning Women Veterans: Implications for Practice

ERIC Educational Resources Information Center

Carlson, Bonnie E.; Stromwall, Layne K.; Lietz, Cynthia A.

2013-01-01

Increasing numbers of women are found in the military, and they are now performing roles very similar to those of male service members. More returning servicewomen and veterans have been exposed to stressful and traumatic experiences, such as combat and difficult living circumstances, and military sexual trauma is common. These experiences have…

Reflections on the Elusive Promise of Religious Freedom for the Native American Church.

ERIC Educational Resources Information Center

Moore, Steven C.

1991-01-01

Analyzes the April 1990 Supreme Court decision that a member of a religion may not challenge, under the First Amendment free exercise clause, a generally applicable criminal law that infringes on a specific religious practice. Discusses political and legal implications for the Native American Church and other minority religions. (SV)

Does External Funding Push Doctoral Supervisors to Be More Directive? A Large-Scale Danish Study

ERIC Educational Resources Information Center

Wichmann-Hansen, Gitte; Herrmann, Kim Jesper

2017-01-01

Around the world, changing funding policies have pushed for university departments to find increased external project-based funding. While this trend is widely acknowledged, mixed views exist about implications for faculty members' academic practices. Regarding doctoral education, researchers have raised concern that external funding will push…

Nursing home quality of life: study of an enabling garden.

PubMed

Raske, Martha

2010-05-01

The purpose of this study was to conduct an in-depth evaluation of the impact of the construction and use of an enabling garden on resident quality of life in a rural nursing home. This qualitative study used interviews with residents, family members, staff members, and community volunteers who built the garden. Findings suggest the garden had positive effects on resident quality of life, particularly in terms of meaningful daily activities, enjoyment of daily life, resident relationships, and functional competency. Implications for research and practice are discussed.

A Difficult Journey: Reflections on Driving and Driving Cessation From a Team of Clinical Researchers.

PubMed

Liddle, Jacki; Gustafsson, Louise; Mitchell, Geoffrey; Pachana, Nancy A

2017-02-01

Recognizing the clinical importance and safety and well-being implications for the population, a multidisciplinary team has been researching older drivers and driving cessation issues for more than 15 years. Using empirical approaches, the team has explored quality of life and participation outcomes related to driving and nondriving for older people and has developed interventions to improve outcomes after driving cessation. The team members represent occupational therapists, medical practitioners, and clinical and neuropsychologists. While building the evidence base for driving- and driving cessation-related clinical practice, the researchers have also had first-hand experiences of interruptions to their own or parents' driving; involvement of older family members in road crashes; and provision of support during family members' driving assessment and cessation. This has led to reflection on their understandings and re-evaluation and refocusing of their perspectives in driving cessation research. This work will share the narratives of the authors and note their developing perspectives and foci within research as well as their clinical practice. Personal reflections have indicated the far-reaching implications for older drivers and family members of involvement in road crashes: the potential for interruptions to driving as a time for support and future planning and the conflicting and difficult roles of family members within the driving cessation process. Overall the lived, personal experience of the authors has reinforced the complex nature of driving and changes to driving status for the driver and their support team and the need for further research and support. © The Author 2016. 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.

Narrative in interprofessional education and practice: implications for professional identity, provider-patient communication and teamwork.

PubMed

Clark, Phillip G

2014-01-01

Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.

Looking Back to the Future: Current Issues Facing Nursing Education From the Reflections of a Member of the Silent Generation.

PubMed

Keating, Sarah B

2016-07-01

As a member of the Silent Generation, the author, through her lived experiences, reflects upon the successes and challenges facing nursing education in the mid-20th to 21st centuries. The author looks "back to the future" and reviews current issues that surround four key nursing education milestones. From the early entry-level baccalaureate programs in the 1950s to the current growth of the Doctor of Nursing Practice as entry into advanced practice, milestones in nursing education are linked to the cultural changes and healthcare system demands that took place at the time and their influence on nursing education and the profession. Looking to the future, the author speaks of the implications from the forecasted changes in the healthcare system that will demand interdisciplinary education and practice and the continued need for nursing research to increase the body of scientific knowledge in practice, education, and technology. Keating. © 2015 Wiley Periodicals, Inc.

Mental illness disclosure decision making.

PubMed

Pahwa, Rohini; Fulginiti, Anthony; Brekke, John S; Rice, Eric

2017-01-01

Disclosure related to mental illness has been linked to various positive outcomes, including better mental health. However, many individuals with serious mental illness (SMI) continue to practice non-disclosure. Even though disclosure inherently occurs within the context of one's social relationships, research has generally conceptualized mental illness disclosure as an individual level phenomenon and neglected to consider preferences concerning to whom an individual discloses and the factors that influence this decision. The current study uses the disclosure decision-making model (DD-MM) by Greene (2009) to better understand the processes of mental illness disclosure preference and selective disclosure for individuals with SMI (n = 60) using multivariate random intercept logistic regression with an emphasis on the constituent factors of disclosure preference at both individual and relational levels. The majority of participants were found to practice selective disclosure, with 68% of the participants identifying at least 1 network member to whom they could disclose. Family members and friends were central to the selective disclosure process, comprising the greatest proportion of network members who, both were and were not identified as preferred confidants. Women were found to show higher odds of preference for mental illness disclosure than men. Having lower perceived social support was associated with lower odds of disclosure preference. Among relational factors, greater relationship availability and lower dyadic tangible social support were associated with lower odds of disclosure preference. Practice and research implications of using social network analysis to get a deeper understanding of disclosure and disclosure preference are discussed, including implications for future interventions targeting stigma reduction. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Role of Relational Harmony in the Use of Drug-Refusal Strategies of Rural Native Hawaiian Youths

PubMed Central

Bills, Kaycee; Okamoto, Scott K.; Helm, Susana

2016-01-01

This study examined the role of maintaining relational harmony among family members in the use of drug refusal strategies for rural Hawaiian youth. Youth focus groups were conducted to validate refusal strategies used in realistic, hypothetical drug-related problem situations. The findings suggested gender-specific motivations for maintaining relational harmony among family members when faced with drug offers from them. Specifically, boys described instrumental concerns when using refusal strategies (i.e., not wanting to get into trouble), while girls described holistic relational concerns (i.e., not wanting family members to be upset with each other). Implications for prevention and social work practice are discussed. PMID:28133439

Report of Task Group on the implications of the implementation of the ICRP recommendations for a revised dose limit to the lens of the eye.

PubMed

Broughton, J; Cantone, M C; Ginjaume, M; Shah, B

2013-12-01

This report was commissioned by the IRPA President to provide an assessment of the impact on members of IRPA Associate Societies of the introduction of ICRP recommendations for a reduced dose limit for the lens of the eye. The report summarises current practice and considers possible changes that may be required. Recommendations for further collaboration, clarification and changes to working practices are suggested.

Working with culturally and linguistically diverse students and their families: perceptions and practices of school speech-language therapists in the United States.

PubMed

Maul, Christine A

2015-01-01

Speech and language therapists (SLTs) working in schools worldwide strive to deliver evidence-based services to diverse populations of students. Many suggestions have been made in the international professional literature regarding culturally competent delivery of speech and language services, but there has been limited qualitative investigation of practices school SLTs find to be most useful when modifying their approaches to meet the needs of culturally and linguistically diverse (CLD) students. To examine perceptions of nine school SLTs regarding modifications of usual practices when interacting with CLD students and their families; to compare reported practices with those suggested in professional literature; to draw clinical implications regarding the results; and to suggest future research to build a more extensive evidence base for culturally competent service delivery. For this qualitative research study, nine school SLTs in a diverse region of the USA were recruited to participate in a semi-structured interview designed to answer the question: What dominant themes, if any, can be found in SLTs' descriptions of how they modify their approaches, if at all, when interacting with CLD students and their family members? Analysis of data revealed the following themes: (1) language-a barrier and a bridge, (2) communicating through interpreters, (3) respect for cultural differences, and (4) positive experiences interacting with CLD family members. Participants reported making many modifications to their usual approaches that have been recommended as best practices in the international literature. However, some practices the SLTs reported to be effective were not emphasized or were not addressed at all in the literature. Practical implications of results are drawn and future research is suggested. © 2015 Royal College of Speech and Language Therapists.

Using Social Network Analysis to Examine the Effect of Care Management Structure on Chronic Disease Management Communication Within Primary Care.

PubMed

Holtrop, Jodi Summers; Ruland, Sandra; Diaz, Stephanie; Morrato, Elaine H; Jones, Eric

2018-05-01

Care management and care managers are becoming increasingly prevalent in primary care medical practice as a means of improving population health and reducing unnecessary care. Care managers are often involved in chronic disease management and associated transitional care. In this study, we examined the communication regarding chronic disease care within 24 primary care practices in Michigan and Colorado. We sought to answer the following questions: Do care managers play a key role in chronic disease management in the practice? Does the prominence of the care manager's connectivity within the practice's communication network vary by the type of care management structure implemented? Individual written surveys were given to all practice members in the participating practices. Survey questions assessed demographics as well as practice culture, quality improvement, care management activities, and communication regarding chronic disease care. Using social network analysis and other statistical methods, we analyzed the communication dynamics related to chronic disease care for each practice. The structure of chronic disease communication varies greatly from practice to practice. Care managers who were embedded in the practice or co-located were more likely to be in the core of the communication network than were off-site care managers. These care managers also had higher in-degree centrality, indicating that they acted as a hub for communication with team members in many other roles. Social network analysis provided a useful means of examining chronic disease communication in practice, and highlighted the central role of care managers in this communication when their role structure supported such communication. Structuring care managers as embedded team members within the practice has important implications for their role in chronic disease communication within primary care.

16 CFR 254.3 - Misrepresentation of extent or nature of accreditation or approval.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Misrepresentation of extent or nature of... extent or nature of accreditation or approval. (a) It is deceptive for an Industry Member to misrepresent, directly or indirectly, expressly or by implication, the nature, extent, or purpose of any Approval by a...

Nonlinear effects of team tenure on team psychological safety climate and climate strength: Implications for average team member performance.

PubMed

Koopmann, Jaclyn; Lanaj, Klodiana; Wang, Mo; Zhou, Le; Shi, Junqi

2016-07-01

The teams literature suggests that team tenure improves team psychological safety climate and climate strength in a linear fashion, but the empirical findings to date have been mixed. Alternatively, theories of group formation suggest that new and longer tenured teams experience greater team psychological safety climate than moderately tenured teams. Adopting this second perspective, we used a sample of 115 research and development teams and found that team tenure had a curvilinear relationship with team psychological safety climate and climate strength. Supporting group formation theories, team psychological safety climate and climate strength were higher in new and longer tenured teams compared with moderately tenured teams. Moreover, we found a curvilinear relationship between team tenure and average team member creative performance as partially mediated by team psychological safety climate. Team psychological safety climate improved average team member task performance only when team psychological safety climate was strong. Likewise, team tenure influenced average team member task performance in a curvilinear manner via team psychological safety climate only when team psychological safety climate was strong. We discuss theoretical and practical implications and offer several directions for future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Interpretation of medical information acts by UK occupational physicians.

PubMed

Batty, Lucia; Glozier, Nick; Holland-Elliott, Kevin

2009-05-01

Difficulties arise in applying the Data Protection Act 1998 and the Access to Medical Reports Act 1988 in occupational health practice. There is no guidance on detailed aspects of applying these Acts in practice and consistent advice has proved difficult to obtain. To audit the understanding and practice of UK occupational physicians to see if a consensus view existed. A postal questionnaire sent to all UK-based Society of Occupational Medicine (SOM) members between December 2005 and June 2006. Responses were analysed using the SPSS 13.0 software. Responses were received from 726 SOM members, a response rate of 48%. The study revealed wide variation and a limited consensus in practice. Significant differences existed between doctors with a Diploma in Occupational Medicine and those with higher Faculty qualifications, between part-time and full-time practitioners and between doctors who qualified pre- and post-1974. The audit revealed wide variation in responding to clinical scenarios in relation to both the Access to Medical Reports and the Data Protection Acts. The findings have implications for clinical practice, policy and research. The majority of respondents reported that national guidance is needed.

Asking the Stakeholders: Perspectives of Individuals With Aphasia, Their Family Members, and Physicians Regarding Communication in Medical Interactions.

PubMed

Burns, Michael; Baylor, Carolyn; Dudgeon, Brian J; Starks, Helene; Yorkston, Kathryn

2015-08-01

The purpose of this study was to explore the experiences of patients with aphasia, their family members, and physicians related to communication during medical interactions. Face-to-face, semistructured interviews were conducted with 18 participants—6 patients with aphasia, 6 family members involved in patient care, and 6 practicing physicians. A qualitative description approach was used to collect and summarize narratives from participants' perspectives and experiences. Participants were asked about experiences with communication during medical interactions in which the family member accompanied the patient. Interviews were audio- and/or video-recorded, transcribed, and then coded to identify main themes. Patients and family members generally described their communication experiences as positive, yet all participants discussed challenges and frustrations. Three themes emerged: (a) patients and family members work as a team, (b) patients and family members want physicians to "just try" to communicate with the patient, and (c) physicians want to interact with patients but may not know how. Participants discussed the need for successful accommodation, or changing how one communicates, to help facilitate the patients' increased understanding and ability to express themselves. Over- and underaccommodation with communication were commonly reported as problems. Speech-language pathologists have a role to play in helping to improve communication during medical interactions. Implications for current speech-language pathologist practice and future directions of research are discussed.

Safety in the c-suite: How chief executive officers influence organizational safety climate and employee injuries.

PubMed

Tucker, Sean; Ogunfowora, Babatunde; Ehr, Dayle

2016-09-01

According to social learning theory, powerful and high status individuals can significantly influence the behaviors of others. In this paper, we propose that chief executive officers (CEOs) indirectly impact frontline injuries through the collective social learning experiences and effort of different groups of organizational actors-including members of the top management team (TMT), organizational supervisors, and frontline employees. We found support for our collective social learning model using data from 2,714 frontline employees, 1,398 supervisors, and 229 members of TMTs in 54 organizations. TMT members' experiences within a CEO-driven TMT safety climate was positively related to organizational supervisors' reports of the broader organizational safety climate and their subsequent collective support for safety (reported by frontline employees). In turn, supervisory support for safety was associated with fewer employee injuries at the individual level. We discuss the theoretical and practical implications of these findings for workplace safety research and practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Major publications in the critical care pharmacotherapy literature: January-December 2014.

PubMed

Day, Sarah A; Cucci, Michaelia; Droege, Molly E; Holzhausen, Jenna M; Kram, Bridgette; Kram, Shawn; Pajoumand, Mehrnaz; Parker, Christine R; Patel, Mona K; Peitz, Gregory J; Poore, Alia; Turck, Charles J; Van Berkel, Megan A; Wong, Adrian; Zomp, Amanda; Rech, Megan A

2015-11-15

Nine recently published articles and one guideline with important implications for critical care pharmacy practice are summarized. The Critical Care Pharmacotherapy Literature Update (CCPLU) group includes more than 40 experienced critical care pharmacists across the United States. Group members monitor 29 peer-reviewed journals on an ongoing basis to identify literature relevant to pharmacy practice in the critical care setting. After evaluation by CCPLU group members, selected articles are chosen for summarization and distribution to group members nationwide based on applicability to practice, relevance, and study design and strength. Hundreds of relevant articles were evaluated by the group in 2014, of which 114 were summarized and disseminated to CCPLU group members. From among those 114 publications, 10 deemed to be of particularly high utility to the critical care practitioner were selected for inclusion in this review for their potential to change practice or reinforce current evidence-based practice. One of the selected articles presents updated recommendations on the management of patients with atrial fibrillation (AF); the other 9 address topics such as albumin replacement in patients with severe sepsis, use of enteral statins for acute respiratory distress syndrome, fibrinolysis for patients with intermediate-risk pulmonary embolism, the use of unfractionated heparin versus bivalirudin for primary percutaneous coronary intervention, and early protocol-based care for septic shock. There were many important additions to the critical care pharmacotherapy literature in 2014, including a joint guideline for the management of AF and reports of clinical trials. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Beyond these walls: Can psychosocial clubhouses promote the social integration of adults with serious mental illness in the community?

PubMed

Gumber, Shinakee; Stein, Catherine H

2018-03-01

The study examined factors associated with community integration experiences of adults with serious mental illness who were members of psychosocial rehabilitation clubhouses in New York City. Ninety-two clubhouse members completed an online survey. The study examined relative contribution of adults' reports of individual factors (self-reported psychiatric symptoms, self-esteem), community supports (self-reported employment status and perceived family support), and the clubhouse environment (self-reported time spent in the clubhouse, clubhouse supportiveness, and practical orientation) in accounting for variation in members' reports of social integration within the clubhouse and within the larger community. Hierarchical linear regression results suggest a differential pattern of variables associated with participants' experience of social integration within the clubhouse versus outside the clubhouse with the larger non-mental-health consumers. Adults' reports of more time spent in the clubhouse and perceptions of clubhouse environment as having a more practical orientation were associated with adults' reports of greater social integration within the clubhouse. In contrast, greater self-esteem and being independently employed were associated with greater social integration outside the clubhouse. Perceived family support was associated with higher levels of social integration both within and outside the clubhouse setting. Conclusion and Implication for Practice: Greater social integration of clubhouse members both in and outside the clubhouse environment is essential in understanding community integration. Recommendations for the clubhouse model to improve community integration experiences of its members are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The joint effects of personality and workplace social exchange relationships in predicting task performance and citizenship performance.

PubMed

Kamdar, Dishan; Van Dyne, Linn

2007-09-01

This field study examines the joint effects of social exchange relationships at work (leader-member exchange and team-member exchange) and employee personality (conscientiousness and agreeableness) in predicting task performance and citizenship performance. Consistent with trait activation theory, matched data on 230 employees, their coworkers, and their supervisors demonstrated interactions in which high quality social exchange relationships weakened the positive relationships between personality and performance. Results demonstrate the benefits of consonant predictions in which predictors and outcomes are matched on the basis of specific targets. We discuss theoretical and practical implications. (c) 2007 APA.

Developing a Parent-Centered Obesity Prevention Program for 4-H Families: Implications for Extension Family Programming

ERIC Educational Resources Information Center

Benke, Carrie J.; Bailey, Sandra J.; Martz, Jill; Paul, Lynn; Lynch, Wesley; Eldridge, Galen

2013-01-01

Planning youth and family programming in the 21st century is daunting given family members' busy schedules. This is even more challenging when planning programs in rural areas, where there are vast distances between communities. This article discusses a research and educational outreach project that uses best practices in program development…

Expanding Agency: Centering Gender Identity in College and University Student Records Systems

ERIC Educational Resources Information Center

Linley, Jodi L.; Kilgo, Cindy Ann

2018-01-01

This article details the process the authors--a doctoral student at the time, and a faculty member--engaged in to change the ways the University of Iowa (UI) asks for and reports student name, gender pronouns, sex, and gender identity. The UI Inclusive Student Records Initiative raises implications for practice and research. Two focus groups--one…

Social Media Use of Cooperative Extension Family Economics Educators: Online Survey Results and Implications

ERIC Educational Resources Information Center

O'Neill, Barbara; Zumwalt, Andrew; Bechman, Janet

2011-01-01

This article describes results of an online survey conducted by the eXtension Financial Security for All (FSA) Community of Practice (CoP) to determine the social media capacity and activity of its members. The survey was conducted to inform two subsequent FSA CoP programs: an archived webinar on social media programs and impact evaluation methods…

Cognitive synergy in groups and group-to-individual transfer of decision-making competencies

PubMed Central

Curşeu, Petru L.; Meslec, Nicoleta; Pluut, Helen; Lucas, Gerardus J. M.

2015-01-01

In a field study (148 participants organized in 38 groups) we tested the effect of group synergy and one's position in relation to the collaborative zone of proximal development (CZPD) on the change of individual decision-making competencies. We used two parallel sets of decision tasks reported in previous research to test rationality and we evaluated individual decision-making competencies in the pre-group and post-group conditions as well as group rationality (as an emergent group level phenomenon). We used multilevel modeling to analyze the data and the results showed that members of synergetic groups had a higher cognitive gain as compared to members of non-synergetic groups, while highly rational members (members above the CZPD) had lower cognitive gains compared to less rational group members (members situated below the CZPD). These insights extend the literature on group-to-individual transfer of learning and have important practical implications as they show that group dynamics influence the development of individual decision-making competencies. PMID:26441750

Cognitive synergy in groups and group-to-individual transfer of decision-making competencies.

PubMed

Curşeu, Petru L; Meslec, Nicoleta; Pluut, Helen; Lucas, Gerardus J M

2015-01-01

In a field study (148 participants organized in 38 groups) we tested the effect of group synergy and one's position in relation to the collaborative zone of proximal development (CZPD) on the change of individual decision-making competencies. We used two parallel sets of decision tasks reported in previous research to test rationality and we evaluated individual decision-making competencies in the pre-group and post-group conditions as well as group rationality (as an emergent group level phenomenon). We used multilevel modeling to analyze the data and the results showed that members of synergetic groups had a higher cognitive gain as compared to members of non-synergetic groups, while highly rational members (members above the CZPD) had lower cognitive gains compared to less rational group members (members situated below the CZPD). These insights extend the literature on group-to-individual transfer of learning and have important practical implications as they show that group dynamics influence the development of individual decision-making competencies.

Joint Task Force on Undergraduate Physics Programs: Implications for physics programs and why you should care

NASA Astrophysics Data System (ADS)

Hodapp, Theodore

2016-03-01

The content of undergraduate physics programs has not changed appreciably in 50 years, however, the jobs our students take have changed dramatically. Preparing students for careers they are likely to encounter requires physics programs to rethink and in some cases retool to provide an education that will not only educate an individual in the habits of mind and keen sense of how to solve complex technical problems, but also what related skills they will need to be effective in those careers. Do you teach your student how to read or create a budget? How about dealing with a low-performing member of an R&D team? This talk will explore driving forces behind this report, potential implications for physics departments, and practical steps faculty members can take to continue to consider improvements in experiences for our students. This work is supported in part by the National Science Foundation (NSF-1540570).

How family members manage risk around functional decline: the autonomy management process in households facing dementia.

PubMed

Berry, Brandon; Apesoa-Varano, Ester Carolina; Gomez, Yarin

2015-04-01

Most dementia research investigates the social context of declining ability through studies of decision-making around medical treatment and end-of-life care. This study seeks to fill an important gap in research about how family members manage the risks of functional decline at home. Drawing on three waves of in-depth interviewing in 2012-2014, it investigates how family members in US households manage decline in an affected individual's natural range of daily activities over time. The findings show that early on in the study period affected individuals were perceived to have awareness of their decline and routinely drew on family members for support. Support transformed when family members detected that the individual's deficit awareness had diminished, creating a corresponding increase in risk of self-harm around everyday activities. With a loss of confidence in the individual's ability to regulate his or her own activities to avoid these risks, family members employed unilateral practices to manage the individual's autonomy around his or her activity involvements. These practices typically involved various deceits and ruses to discourage elders from engaging in activities perceived as potentially dangerous. The study concludes by discussing the implications that the social context of interpretive work around awareness and risk plays an important role in how families perceive an elder's functional ability and manage his or her activity involvements. Copyright © 2015 Elsevier Ltd. All rights reserved.

How family members manage risk around functional decline: The autonomy management process in households facing dementia

PubMed Central

Berry, Brandon; Apesoa-Varano, Ester Carolina; Gomez, Yarin

2015-01-01

Most dementia research investigates the social context of declining ability through studies of decision-making around medical treatment and end-of-life care. This study seeks to fill an important gap in research about how family members manage the risks of functional decline at home. Drawing on three waves of retrospective interviewing in 2012–2014, it investigates how family members in US households manage decline in an affected individual’s natural range of daily activities over time. The findings show that early on in the study period affected individuals were perceived to have awareness of their decline and routinely drew on family members for support. Support transformed when family members detected that the individual’s deficit awareness had diminished, creating a corresponding increase in risk of self-harm around everyday activities. With a loss of confidence in the individual’s ability to regulate his or her own activities to avoid these risks, family members employed unilateral practices to manage the individual’s autonomy around his or her activity involvements. These practices typically involved various deceits and ruses to discourage elders from engaging in activities perceived as potentially dangerous. The study concludes by discussing the implications that the social context of interpretive work around awareness and risk plays an important role in how families perceive an elder’s functional ability and manage his or her activity involvements. PMID:25697634

Social construction and materiality: the limits of indeterminacy in therapeutic settings.

PubMed

Lannamann, J W

1998-01-01

By drawing parallels between the courtroom testimony of a Christian Science practitioner and an intersession conversation between systemic family therapists, I critique the abstract idealism of language-centered social constructionism. I argue that social constructionist inquiry that highlights the indeterminacy of meaning without a corresponding emphasis on the responsive embodied practices of family members glosses over the material conditions shaping the politics of interaction. The implications of this problem are discussed as they relate to the setting of family therapy, where social construction theory is often used to guide practical interventions.

Rehabilitation as "destination triage": a critical examination of discharge planning.

PubMed

Durocher, Evelyne; Gibson, Barbara E; Rappolt, Susan

2017-06-01

In this paper we examine how the intersection of various social and political influences shapes discharge planning and rehabilitation practices in ways that may not meet the espoused aims of rehabilitation programs or the preferences of older adults and their families. Taking a critical bioethics perspective, we used microethnographic case study methods to examine discharge-planning processes in a well-established older adult inpatient rehabilitation setting in Canada. The data included observations of discharge-planning family conferences and semi-structured interviews conducted with older adults facing discharge, their family members and rehabilitation professionals involved in discharge planning. From the time of admission, a contextual push to focus on discharge superseded program aims of providing interventions to increase older adults' functional capabilities. Professionals' primary commitment to safety limited consideration of discharge options and resulted in costly and potentially unnecessary recommendations for 24-hour care. The resulting "rehabilitation" stay was more akin to an extended process of "destination triage" biased towards the promotion of physical safety than optimizing functioning. The resulting reduction of rehabilitation into "destination triage" has significant social, financial and occupational implications for older adults and their families, and broader implications for healthcare services and overarching healthcare systems. Implications for Rehabilitation Current trends promoting consideration of discharge planning from the point of admission and prioritizing physical safety are shifting the focus of rehabilitation away from interventions to maximize recovery of function, which are the stated aims of rehabilitation. Such practices furthermore promote assessments to determine prognosis early in the rehabilitation stay when accurate prognosis is difficult, which can lead to overly conservative recommendations for discharge from rehabilitation services, thus further negating the impact of rehabilitation. Further work is required to examine the social, occupational and functional implications of superseding rehabilitation interventions to maximize capabilities with practices that prioritize safety over quality of life for older adults and their family members.

Can Leader–Member Exchange Contribute to Safety Performance in An Italian Warehouse?

PubMed Central

Mariani, Marco G.; Curcuruto, Matteo; Matic, Mirna; Sciacovelli, Paolo; Toderi, Stefano

2017-01-01

Introduction: The research considers safety climate in a warehouse and wants to analyze the Leader–Member Exchange (LMX) role in respect to safety performance. Griffin and Neal’s safety model was adopted and Leader-Member Exchange was inserted as moderator in the relationships between safety climate and proximal antecedents (motivation and knowledge) of safety performance constructs (compliance and participation). Materials and Methods: Survey data were collected from a sample of 133 full-time employees in an Italian warehouse. The statistical framework of Hayes (2013) was adopted for moderated mediation analysis. Results: Proximal antecedents partially mediated the relationship between Safety climate and safety participation, but not safety compliance. Moreover, the results from the moderation analysis showed that the Leader–Member Exchange moderated the influence of safety climate on proximal antecedents and the mediation exist only at the higher level of LMX. Conclusion: The study shows that the different aspects of leadership processes interact in explaining individual proficiency in safety practices. Practical Implications: Organizations as warehouses should improve the quality of the relationship between a leader and a subordinate based upon the dimensions of respect, trust, and obligation for high level of safety performance. PMID:28553244

Can Leader-Member Exchange Contribute to Safety Performance in An Italian Warehouse?

PubMed

Mariani, Marco G; Curcuruto, Matteo; Matic, Mirna; Sciacovelli, Paolo; Toderi, Stefano

2017-01-01

Introduction: The research considers safety climate in a warehouse and wants to analyze the Leader-Member Exchange (LMX) role in respect to safety performance. Griffin and Neal's safety model was adopted and Leader-Member Exchange was inserted as moderator in the relationships between safety climate and proximal antecedents (motivation and knowledge) of safety performance constructs (compliance and participation). Materials and Methods: Survey data were collected from a sample of 133 full-time employees in an Italian warehouse. The statistical framework of Hayes (2013) was adopted for moderated mediation analysis. Results: Proximal antecedents partially mediated the relationship between Safety climate and safety participation, but not safety compliance. Moreover, the results from the moderation analysis showed that the Leader-Member Exchange moderated the influence of safety climate on proximal antecedents and the mediation exist only at the higher level of LMX. Conclusion: The study shows that the different aspects of leadership processes interact in explaining individual proficiency in safety practices. Practical Implications: Organizations as warehouses should improve the quality of the relationship between a leader and a subordinate based upon the dimensions of respect, trust, and obligation for high level of safety performance.

Current State of Overlapping, Concurrent, and Multiple-Room Surgery in Otolaryngology: A National Survey.

PubMed

Cognetti, David M; Nussenbaum, Brian; Brenner, Michael J; Chi, David H; McCormick, Michael E; Venkatraman, Giri; Zhan, Tingting; McKinlay, Alex J

2017-12-01

Objective Multiple-room surgery has gained attention due to reports in the lay press scrutinizing the activity, with hospitals and the government collecting data on current practice. We studied practices and attitudes toward multiple-room surgery in otolaryngology. Methods A survey was developed by members of the Patient Safety and Quality Improvement Committee of the American Academy of Otolaryngology-Head and Neck Surgery. The survey was distributed to members of the Academy and included questions on demographics, current practices, and opinions regarding multiple-room surgery. The survey was designed to capture the spectrum of multidisciplinary, overlapping, and simultaneous/concurrent surgery practices. Data were collected via SurveyMonkey. Results A total of 907 of 9520 members completed the survey. Of the respondents, 40.4% reported performing some form of multiple-room surgery. Multiple-room surgery is more common amongst subspecialists than general otolaryngologists. Most believed that regulations disallowing multiple-room surgery would result in an increase in late starts (73.5%), an increase in the time to schedule surgery (84.5%), a detriment to residency training (63.1%), and no improvement in patient safety (60%.) Discussion Multiple-room surgery is common among responding otolaryngologists. Most respondents consider the practice to serve a role in facilitating access, efficiency, and training. Implications for Practice Due to recent attention placed on multiple-room surgery, institutions are reviewing policies regarding the practice. This survey suggests that policy changes that restrict multiple-room surgery must consider a potential unintended negative impact on patient care and access.

Trainee Teachers' Experiences Using Contextual Teaching and Learning: Implications for Incorporation of Indigenous Knowledge in Instructional Design

ERIC Educational Resources Information Center

Mukwambo, Muzwangowenyu

2016-01-01

Some schools do not have local formal work environments enabling learners to interact with members in community of practice. This is noticeable in schools in developing countries, including the north eastern Zambezi Region of Namibia, where the study took place. To close the gap in which trainee science and mathematics teachers who were the…

Exploring the Knowledge, Attitudes, Beliefs, and Communication Preferences of the General Public regarding HPV: Findings from CDC Focus Group Research and Implications for Practice

ERIC Educational Resources Information Center

Friedman, Allison L.; Shepeard, Hilda

2007-01-01

Genital human papillomavirus (HPV) infection is the most common sexually transmitted virus in the United States, causing genital warts, cervical cell abnormalities, and cervical cancer in women. To inform HPV education efforts, 35 focus groups were conducted with members of the general public, stratified by gender, race/ethnicity, and urban/rural…

Help a buddy take a knee: creating persuasive messages for military service members to encourage others to seek mental health help.

PubMed

Clark-Hitt, Rose; Smith, Sandi W; Broderick, Jordan S

2012-01-01

Helping service members returning from the wars in Iraq and Afghanistan who need mental health help is an important problem for the United States military. Tanielian and Jaycox (2008) estimated that approximately 14%, or 300,000, of the service members returning from the wars have posttraumatic stress disorder (PTSD), yet just over half of those needing psychological help seek it despite the availability of effective treatments. This article reports the focus group responses of military personnel about message factors associated with persuading individuals to encourage others to seek mental health help. The results have theoretical and practical implications for future message design for promoting increased usage of mental health services among members of this population. Responses are presented in terms of the communication variables of source, message, channel, and receiver factors.

Gay men with AIDS and their families of origin: an analysis of social support.

PubMed

Kadushin, G

1996-05-01

This article reviews the literature on the relationships between gay men with AIDS and their families of origin to determine why the family is not a principal source of social support. Several reasons explain the absence of the family from the support network, including the family's lack of acceptance of homosexuality and the relationship with a male partner; the stigma associated with AIDS; the inability of family members to communicate openly about homosexuality and AIDS; the lack of competence among family members in dealing with HIV issues; and overprotective, infantilizing behavior by parents. A sibling, most often a sister, is the family member to whom the gay man with AIDS feels closest and from whom he is most likely to seek support. Implications for practice and research are discussed.

Women and men who have served in Afghanistan/Iraq: coming home.

PubMed

Beder, Joan; Coe, Ray; Sommer, Darren

2011-01-01

The experience of war changes people - some will acknowledge that the changes are positive and some will feel the opposite or a combination, but that it changes a person cannot be disputed. For those who return, the experience of reintegration to civilian life or as a respite before redeployment can present numerous challenges. The research presented in this article reports the findings on interviews with over 800 service members who had returned from either Afghanistan or Iraq. The Post Deployment Reintegration Scale was used to refine the areas that respondents identified as positive or negative in their reintegration experience. Implications for practice with returning service members are noted.

Social Support: A Mixed Blessing for Women in Substance Abuse Treatment

PubMed Central

Tracy, Elizabeth M.; Munson, Michelle R.; Peterson, Lance T.; Floersch, Jerry E.

2010-01-01

Using a personal social network framework, this qualitative study sought to understand how women in substance abuse treatment describe their network members' supportive and unsupportive behaviors related to recovery. Eighty-six women were interviewed from residential and outpatient substance abuse treatment programs. Positive and negative aspects of women's social networks were assessed via open-ended questions. Analysis was guided by grounded theory techniques using three coders. The findings extend classic social support concepts such as emotional, tangible, and informational support. Practice implications are presented in light of the potential roles network members may play in substance use and recovery. PMID:20953326

Intimate partner violence among female service members and veterans: information and resources available through military and non-military websites.

PubMed

Brown, Amy; Joshi, Manisha

2014-01-01

With the expansion of women's roles in the military, the number of female service members and veterans has increased. Considerable knowledge about intimate partner violence (IPV) in civilian couples exists but little is known about IPV among female service members and veterans. Prevalence rates of IPV range from 17% to 39% for female service members, and 21.9% to 74% for veterans. Most service members and veterans indicated using the Internet at least occasionally and expressed willingness to seek information about services via the Internet. Informed by data, we conducted a systematic review of military (Army, Navy, Air Force, and Marine Corps) and non-military (Veterans Affairs and Google) websites to explore the availability and presentation of information and resources related to IPV. The websites search revealed a variety of resources and information available, and important differences between sites with regard to what and how information is presented. Implications for practice and further research are discussed.

The clubhouse as an empowering setting.

PubMed

Mowbray, Carol T; Lewandowski, Lisa; Holter, Mark; Bybee, Deborah

2006-08-01

Attention to psychosocial rehabilitation (PSR) practice has expanded in recent years. However, social work research studies on PSR are not numerous. This study focuses on operational characteristics of clubhouses, a major PSR program model, and the organizational attributes (including resource levels) that predict the extent to which the clubhouse constitutes an empowering setting. The authors present data from a statewide sample of 30 clubhouses, annually serving nearly 4,000 consumers (adults with serious mental illnesses), based on interviews of clubhouse directors, on-site observations, and government information sources. Results indicate that users were predominantly male, white, and middle age; about one-third had a major functional disability. There were wide variations in member characteristics as well as in resource levels. In terms of empowerment, this sample of clubs averaged rather low levels of member involvement in governance and operations but seemed to provide members with opportunities and assistance in making their own decisions. The empowerment variables had different predictors, including client characteristics, urban-related characteristics, staffing, and resource levels. Implications for social work practice in PSR settings are discussed.

The Impact of 'Being There': Psychiatric Staff Attitudes on the Use of Restraint.

PubMed

Dahan, Sagit; Levi, Galit; Behrbalk, Pnina; Bronstein, Israel; Hirschmann, Shmuel; Lev-Ran, Shaul

2018-03-01

The practice of mechanically restraining psychiatric patients is constantly under debate, and staff attitudes are considered a central factor influencing restraining practices. The aim of this study was to explore associations between psychiatric staff members' presence and participation in incidences of restraint and attitudes towards mechanical restraints. Staff members (psychiatrists, nurses, paramedical staff; N = 143 working in a government psychiatric hospital in Israel) completed a questionnaire including personal information, participation in incidents of restraint and attitudes towards mechanical restraints. Items were categorized into the following categories: security and care; humiliation and offending; control; order; education and punishment. Compared to those who were not present during restraint, staff members who were present agreed significantly less with statements indicating that restraints are humiliating and offending and agreed more with statements indicating that restraints are used primarily for security and care (p < .05). Among those present in incidences of restraint, staff members who physically participated in restraint agreed significantly more with statements indicating that restraints are a means for security, care and order, and less with statements indicating restraints are humiliating and offending, compared to those present but not physically participating in restraint (p < .05). These findings highlight the importance of proximity of staff members to incidences of restraints. This may have implications in understanding the professional and social discourse concerning mechanical restraints.

The Conversations About Cancer (CAC) Project – Phase II: National Findings from Viewing When Cancer Calls… and Implications for Entertainment-Education (E-E)

PubMed Central

Beach, Wayne A.; Dozier, David M.; Buller, Mary K.; Gutzmer, Kyle; Fluharty, Lyndsay; Myers, Valerie H.; Buller, David B.

2015-01-01

Objective We address cancer communication by creating and assessing the impacts of a theatrical production, When Cancer Calls…(WCC…), anchored in conversations from the first natural history of a patient and family members talking through cancer on the telephone. Methods A national study was conducted using a multi-site and randomized controlled trial. An 80-minute video was produced to assess viewing impacts across cancer patients, survivors, and family members. Comparisons were made with a control video on cancer nutrition and diet. Pretest-posttest sample size was 1006, and 669 participants completed a 30-day follow-up impacts assessment. Results All five family and communication indices increased significantly for WCC…. When compared to the placebo, average pretest-posttest change scores were higher for self-efficacy (775%), family fabric (665%), outside support (189%), and family communication (97%). One month following viewings, WCC… participants reported 30% more conversations about cancer among patients and family members about cancer. Conclusion A new genre of Entertainment-Education (E-E) was created that triggers positive reactions from audience members. Managing delicate and often complex communication about the trials, tribulations, hopes, and triumphs of cancer journeys is fundamentally important for everyday living. Practice Implications Unique opportunities exist to make WCC… available to national and global audiences, create tailored curricula, and integrate these viewings into educational programs for patients, family members, and care-provider teams. PMID:26547304

Generational differences in practice patterns of dermatologists in the United States: implications for workforce planning.

PubMed

Jacobson, Christine C; Resneck, Jack S; Kimball, Alexa Boer

2004-12-01

To examine the effect of age and other demographic factors on dermatologists' practice characteristics. Anonymous practice profile survey. Dermatologist members of the American Academy of Dermatology Association. Analyzed survey questions included information about legal practice entity, geographic area served, weekly patient care hours, patients seen per hour, and scope of patient care activities. Of 4090 surveys sent, 1425 (35%) were returned. As the age of the cohorts increased, the percentage practicing in solo practices increased (range, 21%-39%), as did the percentage serving urban areas (range, 31%-46%). Measures of physician productivity increased in the older age cohorts; however, age was not a significant factor after controlling for other variables. More patient-hours per week were associated with male sex (P < .001), solo practices (P < .001), and non-urban-based practices (P = .04), whereas a greater number of patients per hour was associated with non-rural-based practices (P = .02) and male sex (P = .03). As the cohorts progressed in age, more time was spent practicing medical dermatology. The number of hours spent practicing cosmetic dermatology peaked in the 41- to 50-year-old cohort (P = .03). Practice patterns differ significantly among dermatologists of different ages. As the current cohorts age and new dermatologists emerge from training, changes in scope of practice and generational differences in productivity are likely to cause a contraction in the effective supply of dermatologists, which has important implications for dermatology workforce planning.

Evaluating Practice-Based Learning.

PubMed

Logue, Nancy C

2017-03-01

Practice-based learning is an essential aspect of nursing education, and evaluating this form of learning is vital in determining whether students have the competence required to enter nursing practice. However, limited knowledge exists about the influences that shape how competence development is recognized in nursing programs. The purpose of this study was to explore the evaluation of practice-based learning from the students' standpoint. A qualitative design based on institutional ethnography was used to investigate evaluation of practice-based learning with students, preceptors, and faculty in a preceptorship practicum. The findings revealed how work associated with evaluation was organized by coexisting and often disparate influences within a nursing program and the workplaces where learning took place. The implications and recommendations of the inquiry are intended to encourage dialogue and action among stakeholders from education and practice to improve evaluation practices in preparing new members of the nursing profession. [J Nurs Educ. 2017;56(3):131-138.]. Copyright 2017, SLACK Incorporated.

Role of the Allergist-Immunologist and Upper Airway Allergy in Sleep-Disordered Breathing.

PubMed

Shusterman, Dennis; Baroody, Fuad M; Craig, Timothy; Friedlander, Samuel; Nsouli, Talal; Silverman, Bernard

Sleep-disordered breathing in general and obstructive sleep apnea in particular are commonly encountered conditions in allergy practice. Physiologically, nasal (or nasopharyngeal) obstruction from rhinitis, nasal polyposis, or adenotonsillar hypertrophy are credible contributors to snoring and nocturnal respiratory obstructive events. Nevertheless, existing practice parameters largely relegate the role of the allergist to adjunctive treatment in cases of continuous positive airway pressure intolerance. To survey active American Academy of Allergy, Asthma & Immunology members regarding their perceptions and practices concerning sleep-disordered breathing in adult and pediatric patients with rhinitis, and to review the medical literature concerning this connection to identify therapeutic implications and research gaps. Members of the Work Group on Rhinitis and Sleep-disordered Breathing composed and distributed a Web-based clinically oriented survey to active American Academy of Allergy, Asthma & Immunology members in mid-2015. The group, in addition, conducted an English-language literature review using PubMed and other sources. Survey results were returned by 339 of 4881 active members (7%). More than two-third of respondents routinely asked about sleep problems, believed that sleep-disordered breathing was a problem for at least a "substantial minority" (10%-30%) of their adult patients, and believed that medical therapy for upper airway inflammatory conditions could potentially help ameliorate sleep-related complaints. Literature review supported the connection between high-grade nasal congestion/adenotonsillar hypertrophy and obstructive sleep apnea, and at least in the case of pediatric patients, supported the use of anti-inflammatory medication in the initial management of obstructive sleep apnea of mild-to-moderate severity. Clinical allergy practice and the medical literature support a proactive role for allergists in the diagnosis and management of sleep-disordered breathing. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Adrift in the Gray Zone: IRB Perspectives on Research in the Learning Health System.

PubMed

Lee, Sandra Soo-Jin; Kelley, Maureen; Cho, Mildred K; Kraft, Stephanie Alessi; James, Cyan; Constantine, Melissa; Meyer, Adrienne N; Diekema, Douglas; Capron, Alexander M; Wilfond, Benjamin S; Magnus, David

2016-01-01

Human subjects protection in healthcare contexts rests on the premise that a principled boundary distinguishes clinical research and clinical practice. However, growing use of evidence-based clinical practices by health systems makes it increasingly difficult to disentangle research from a wide range of clinical activities that are sometimes called "research on medical practice" (ROMP), including quality improvement activities and comparative effectiveness research. The recent growth of ROMP activities has created an ethical and regulatory gray zone with significant implications for the oversight of human subjects research. We conducted six semi-structured, open-ended focus group discussions with IRB members to understand their experiences and perspectives on ethical oversight of ROMP, including randomization of patients to standard treatments. Our study revealed that IRB members are unclear or divided on the central questions at stake in the current policy debate over ethical oversight of ROMP: IRB members struggle to make a clear distinction between clinical research and medical practice improvement, lack consensus on when ROMP requires IRB review and oversight, and are uncertain about what constitutes incremental risk when patients are randomized to different treatments, any of which may be offered in usual care. They characterized the central challenge as a balancing act, between, on the one hand, making information fully transparent to patients and providing adequate oversight, and on the other hand, avoiding a chilling effect on the research process or harming the physician-patient relationship. Evidence-based guidance that supports IRB members in providing adequate and effective oversight of ROMP without impeding the research process or harming the physician-patient relationship is necessary to realize the full benefits of the learning health system.

Women service members, veterans, and their families: What we know now.

PubMed

Mankowski, Mariann; Everett, Joyce E

2016-12-01

The purpose of this paper is to highlight what we know now about female service members, veterans, and their families. The experiences of U.S. female service members and veterans are more complex than previous eras and significant demographic changes have taken place. U.S. female veterans are more likely to be younger, come from ethnic and racial minority groups, have children, and combat exposure. U.S. female service members report high rates of sexual violence and they are more vulnerable to homelessness and unemployment when compared to previous female military cohorts. U.S. female service members and veterans are also at higher risk for significant mental and health issues. Children and adolescents of women service members and veterans may also carry a heavy burden as a result of lengthy deployments. A majority of female service members and veterans will utilize community based healthcare and social services, therefore, it is essential that all healthcare providers understand the unique needs of this cohort of women. Practice implications at the micro, mezzo, and macro levels are discussed. Qualitative and quantitative studies that expand our understanding of women's experience in the military and as veterans are encouraged. Copyright © 2016 Elsevier Ltd. All rights reserved.

Generation Y and Blood Donation: The Impact of Altruistic Help in a Darwiportunistic Scenario

PubMed Central

Scholz, Christian

2010-01-01

Summary This article focuses on the members of Generation Y and their willingness to offer voluntary (unpaid) blood donations. Using statistics from various sources, a three-stage model is developed to explain blood donation behaviour especially of this generation. It consists of i) developing altruism, ii) raising the willingness to donate blood, and iii) activating actual blood donation behaviour. Members of Generation Y live in a Darwinistic society. They also to some degree act opportunistically, but not in contradiction to altruism. For that reason, the article positions itself in the theoretical framework of Darwi-portunism and derives practical suggestions as well as implications for research. PMID:21048826

Attitudes Toward Practice Guidelines Among ICU Personnel: A Cross-Sectional Anonymous Survey

PubMed Central

Quiros, Dave; Lin, Susan; Larson, Elaine L

2007-01-01

Objectives To assess attitudes of ICU staff members toward practice guidelines in general and toward a specific guideline, CDC's Guideline for Hand Hygiene in Healthcare Settings; to correlate these attitudes with staff and hospital characteristics; and to examine the impact of staff attitudes toward the Hand Hygiene Guideline on self reported implementation of the Guideline. Methods A cross-sectional survey of staff in 70 ICUs in 39 U.S. hospitals, members of The National Nosocomial Infection Surveillance (NNIS) System. A survey, “Attitudes Regarding Practice Guidelines”, was administered anonymously to all willing staff during a site visit at each hospital; 1,359 ICU personnel: 1,003 nurses (74%), 228 physicians (17%), and 128 others (10%) responded. Results Significantly more positive attitudes toward practice guidelines were found among staff in pediatric as compared with adult ICUs (p<0.001). Nurses and other staff when compared with physicians had more positive attitudes toward guidelines in general but not toward the specific Hand Hygiene Guideline. Those with more positive attitudes were significantly more likely to report that they had implemented recommendations of the Guideline (p<0.001) and used an alcohol product for hand hygiene (p=0.002). Conclusions The majority of staff members were familiar with the CDC Hand Hygiene Guideline. Staff attitudes toward practice guidelines varied by type of ICU and by profession, and more positive attitudes were associated with significantly better self-reported guideline implementation. Because differences in staff attitudes might hinder or facilitate their acceptance and adoption of evidence-based practice guidelines, these results may have important implications for the education and/or socialization of ICU staff. PMID:17628198

Implications for Advanced Nursing Practice in the Use of Therapeutic Touch.

DTIC Science & Technology

1993-01-01

care units, where reliance on machines and technology have isolated and depersonalized patients. Before the boon of technology in health care, so...adjunctive therapies. Meehan (1990) recommends TT be taught as part of undergraduate or graduate nursing curricula or in a continuing education program of...staff (ANA, 1986). The CNS may serve as a resource person, preceptor and role model to staff Therapeutic Touch 47 nurses and nursing students , or member

Public Relations in the Social Construction of Reality: Theoretical and Practical Implications of Berger and Luckmann's View of the Social Construction of Reality.

ERIC Educational Resources Information Center

White, Jon

As P. L. Berger and T. Luckmann argue, what the public regards as social reality is a construction to which each member contributes by selecting from all available information to develop a picture of the world. To do so, people negotiate with other people regarding the meaning of the information provided. A logical extension of this theory is that…

Physical Fitness in the United States Marine Corps: History, Current Practices and Implications for Mission Accomplishment and Human Performance

DTIC Science & Technology

2005-12-01

elements of music , dance and writing, it heavily favored sports, physical training and athletic competition.12 B. AMERICAN FIGHTING FORCES From an...the heat of competition or duress, can reveal previously unbeknownst behavior characteristics . The mundane nature of the office or workshop...Observed Status: GREEN / YELLOW : Traditionally, young enlisted Marines and junior officers are amongst the most impressionable members of a unit

Evaluations of and reasoning about normative and deviant ingroup and outgroup members: development of the black sheep effect.

PubMed

Abrams, Dominic; Palmer, Sally B; Rutland, Adam; Cameron, Lindsey; Van de Vyver, Julie

2014-01-01

Research with adults has demonstrated a "black sheep effect" (BSE) whereby, relative to evaluations of normative group members, ingroup deviants are derogated more than outgroup deviants. The developmental subjective group dynamics (DSGD) model holds that the BSE should develop during middle childhood when children apply wider social norms. Three hundred and thirty-eight children who were between 5 and 12 years old judged a normative (socially desirable) and a deviant (socially undesirable) member from an ingroup or an outgroup school. Results confirmed a developmental increase in the BSE, the first time this has been demonstrated. Children's own evaluations of group members were mediated by their expectations about ingroup peers' evaluations. In line with DSGD and social domain theories, with age, children's explanations of peer evaluations for ingroup deviance focused relatively more on loyalty. Practical and theoretical implications for peer inclusion and exclusion are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

HIV Prevention in Gay Family and House Networks: Fostering Self-Determination and Sexual Safety.

PubMed

Levitt, Heidi M; Horne, Sharon G; Freeman-Coppadge, Darren; Roberts, Tangela

2017-10-01

Many gay, bisexual, and transgender (GBT) people of color (POC) join house and/or constructed family communities, which serve as support networks composed mostly of other non-biologically related GBT/POC. These networks can decrease or increase the risk of exposure to HIV via multiple mechanisms (e.g., providing informal sexual safety education versus stigmatizing family members with HIV, encouraging sexual safety practices versus unsafe escorting, teaching self-care versus substance use) but act to support family members in the face of social and economic hardship. Researchers interviewed ten members of these social networks in the Boston metro area of the US and produced a saturated grounded theory analysis to explore the role of gay family/house networks in HIV risk management. While network members utilized HIV prevention resources, interviewees described how their efficacy was related to the intentions of leadership and strength of kinship boundaries within their community, economic opportunities, and communication skills. Clinical and research implications are discussed.

Prosocial emotions and helping: the moderating role of group membership.

PubMed

Stürmer, Stefan; Snyder, Mark; Omoto, Allen M

2005-03-01

In this article, the authors introduce and test a group-level perspective on the role of empathy and interpersonal attraction in helping. In line with our predictions, Study 1, a longitudinal field study of 166 AIDS volunteers, confirmed that empathy was a stronger predictor of helping when the recipient of assistance was an in-group member than when that person was an out-group member. Also as hypothesized, attraction was a stronger predictor of helping when the recipient was an out-group member than when that person was an in-group member. Study 2 replicated and further extended these results in a laboratory experiment on spontaneous helping of a person with hepatitis. Strengthening the validity of the findings, in both studies the effects of empathy and attraction held up even when the authors statistically controlled for potential alternative predictors of helping. The theoretical and practical implications of these findings for helping in intergroup contexts are discussed. ((c) 2005 APA, all rights reserved).

Attitudes and beliefs toward the use of a dental diagnostic terminology A survey of dental providers in a dental practice

PubMed Central

Ramoni, Rachel B.; Walji, Muhammad F.; Kim, Soyun; Tokede, Oluwabunmi; McClellan, Lyle; Simmons, Kristen; Skourtes, Eugene; Yansane, Alfa; White, Joel M.; Kalenderian, Elsbeth

2015-01-01

Background Attitudes and views are critical to the adoption of innovation. While there have been broadening calls for a standardized dental diagnostic terminology, little is known about the views of private practice dental team members towards the adoption of such a terminology. Methods A survey was developed using validated questions identified through literature review. Domain experts’ input allowed for further modifications. The final survey was administered electronically to 814 team members at a multi-office practice based in the Pacific Northwest. Results Response proportion was 92%. The survey had excellent reliability (Cronbach alpha coefficient = 0.87). Results suggested that participants showed, in general, positive attitudes and beliefs towards using a standardized diagnostic terminology in their practices. Additional written comments by participants highlighted the potential for improved communication with use of the terminology. Conclusions Dental providers and staff in one multi-office practice showed positive attitudes towards the use of a diagnostic terminology, specifically they believed it would improve communication between the dentist and patient as well as among providers, while expressing some concerns if using standardized dental diagnostic terms helps clinicians to deliver better dental care. Practical Implications As the dental profession is advancing towards the use of standardized diagnostic terminologies, successful implementation will require that dental team leaders prepare their dental teams by gauging their attitude toward the use of such a terminology. PMID:26025826

A case study on the formation and sharing process of science classroom norms

NASA Astrophysics Data System (ADS)

Chang, Jina; Song, Jinwoong

2016-03-01

The teaching and learning of science in school are influenced by various factors, including both individual factors, such as member beliefs, and social factors, such as the power structure of the class. To understand this complex context affected by various factors in schools, we investigated the formation and sharing process of science classroom norms in connection with these factors. By examining the developmental process of science classroom norms, we identified how the norms were realized, shared, and internalized among the members. We collected data through classroom observations and interviews focusing on two elementary science classrooms in Korea. From these data, factors influencing norm formation were extracted and developed as stories about norm establishment. The results indicate that every science classroom norm was established, shared, and internalized differently according to the values ingrained in the norms, the agent of norm formation, and the members' understanding about the norm itself. The desirable norms originating from values in science education, such as having an inquiring mind, were not established spontaneously by students, but were instead established through well-organized norm networks to encourage concrete practice. Educational implications were discussed in terms of the practice of school science inquiry, cultural studies, and value-oriented education.

Securing your family's future: the value of estate planning.

PubMed

Rinaldi, Ellen; Shin, Alisa M

2006-08-01

The authors provide an overview of general estate planning considerations, including minimization of federal estate taxes, estate planning techniques to be used to meet specific goals, and guidelines to ensure a well-drafted and well-organized plan. They also stress the importance of planning for incapacity. A well-thought-out and sound estate plan protects assets, minimizes estate taxes, ensures appropriate distribution to designated beneficiaries and prepares family members and business partners. In developing an estate plan, dentists should seek professional advice from a qualified attorney and a certified financial planner. Practice Implications. A sound estate plan should address business continuation or disposition with respect to the dental practice.

Motives and Power of School Board Members: Implications for School Board-Superintendent Relationships

ERIC Educational Resources Information Center

Mountford, Meredith

2004-01-01

The qualitative study presented in this article explores motivations for school board membership and conceptions of power held by school board members. The findings of the study suggest a relationship exists between the way board members define power and the type of motivation board members have for service. The implications of these findings for…

Positive affective tone and team performance: The moderating role of collective emotional skills.

PubMed

Collins, Amy L; Jordan, Peter J; Lawrence, Sandra A; Troth, Ashlea C

2016-01-01

Research on affect as a group-level phenomenon has shown that over time, individual members within a group become highly similar in their affect (i.e., members experience and display similar emotions and moods), and often become similar enough that the aggregation of individuals' affect can meaningfully represent the "affective tone" of the group. It is generally assumed that a more positive affective tone will lead to better team performance. We challenge the conclusion that positive affective tone is always good for team performance, suggesting that the relationship between positive affective tone and team performance is subject to moderating influences. Across two studies, we demonstrate that the self-reported collective emotional skills of team members play a crucial role in determining whether positive affective tone is beneficial or detrimental to team performance. Implications for theory and practice are discussed.

The influence of social preferences and reputational concerns on intergroup prosocial behaviour in gains and losses contexts

PubMed Central

Faber, Nadira S.

2015-01-01

To what extent do people help ingroup members based on a social preference to improve ingroup members’ outcomes, versus strategic concerns about preserving their reputation within their group? And do these motives manifest differently when a prosocial behaviour occurs in the context of helping another gain a positive outcome (study 1), versus helping another to avoid losing a positive outcome (study 2)? In both contexts, we find that participants are more prosocial towards ingroup (versus outgroup members) and more prosocial when decisions are public (versus private) but find no interaction between group membership and either anonymity of the decision or expected economic value of helping. Therefore, consistent with a preference-based account of ingroup favouritism, people appear to prefer to help ingroup members more than outgroup members, regardless of whether helping can improve their reputation within their group. Moreover, this preference to help ingroup members appears to take the form of an intuitive social heuristic to help ingroup members, regardless of the economic incentives or possibility of reputation management. Theoretical and practical implications for the study of intergroup prosocial behaviour are discussed. PMID:27019739

Perspectives of Mothers in Farmworker Households on Reducing the Take-Home Pathway of Pesticide Exposure

PubMed Central

Strong, Larkin L.; Sharks, Helene E.; Meischke, Hendrika; Thompson, Beti

2014-01-01

Farmworkers carry pesticide residue home on their clothing, boots, and skin, placing other household members at risk, particularly children. Specific precautions are recommended to reduce this take-home pathway, yet few studies have examined the perspectives of farmworkers and other household members regarding these behaviors and the reasons for or against adoption. The authors conducted semistructured interviews with 37 Mexican/Mexican-American women in farmworker households to explore the family and cultural context in which pesticide safety practices are performed and to identify factors that facilitate or hinder their adoption. Whereas women could describe the take-home pathway, they were less able to connect it with their family’s susceptibility to pesticide exposure. Women experienced difficulty integrating the prevention behaviors into their everyday lives because of competing responsibilities, conflicts with their husbands’ intentions and with cultural health beliefs, perceived lack of control, and community barriers that interfered with women’s motivations. Implications for practice are discussed. PMID:19136611

On teaching computer ethics within a computer science department.

PubMed

Quinn, Michael J

2006-04-01

The author has surveyed a quarter of the accredited undergraduate computer science programs in the United States. More than half of these programs offer a 'social and ethical implications of computing' course taught by a computer science faculty member, and there appears to be a trend toward teaching ethics classes within computer science departments. Although the decision to create an 'in house' computer ethics course may sometimes be a pragmatic response to pressure from the accreditation agency, this paper argues that teaching ethics within a computer science department can provide students and faculty members with numerous benefits. The paper lists topics that can be covered in a computer ethics course and offers some practical suggestions for making the course successful.

Adverse Childhood Experiences among a Community of Resilient Centenarians and Seniors: Implications for a Chronic Disease Prevention Framework.

PubMed

Spencer-Hwang, Rhonda; Torres, Xochitl; Valladares, Johanny; Pasco-Rubio, Marco; Dougherty, Molly; Kim, Wonha

2018-03-11

Research has linked adverse childhood experiences (ACEs) with chronic disease in adults and diminished life span. Adverse biological embedding of ACEs potentially occurs through inflammatory mechanisms; inflammatory marker alterations are identified as candidate biomarkers for mediating health consequences. Lifestyle practices of residents of California's Loma Linda Blue Zone, one of five worldwide longevity hotspots, may provide insight into inflammation remediation and chronic disease prevention. Little research has been done on centenarians' early-life experiences or on ACEs in a longevity community. To interview centenarians and seniors in this region regarding their childhood experiences to inform chronic disease prevention frameworks. Qualitative study of Loma Linda Blue Zone community members. Childhood exposures and practices were assessed using focus groups and semistructured key informant interviews, with open-ended questions on general hardships and ACEs and supplemented with lifestyle and resiliency factor questions. Data were audiorecorded and transcribed. Integrative grounded theory methods guided coding and theming. Exposure to ACEs and practice of resiliency factors. Participants (7 centenarians and 29 seniors) reported exposure to multiple ACEs (domains: Economic deprivation, family dysfunction, and community violence). Community members reported practicing resiliency factors, each with anti-inflammatory properties suggesting mitigation of ACE-related toxic stress. This is one of the first studies of its kind to identify a community of resilient members despite their tremendous burden of ACEs. Embedding the identified resiliency factors into chronic disease prevention frameworks has potential for mitigating systemic inflammation, alleviating chronic disease burden, and promoting a culture of health.

Adverse Childhood Experiences among a Community of Resilient Centenarians and Seniors: Implications for a Chronic Disease Prevention Framework

PubMed Central

Spencer-Hwang, Rhonda; Torres, Xochitl; Valladares, Johanny; Pasco-Rubio, Marco; Dougherty, Molly; Kim, Wonha

2018-01-01

Context Research has linked adverse childhood experiences (ACEs) with chronic disease in adults and diminished life span. Adverse biological embedding of ACEs potentially occurs through inflammatory mechanisms; inflammatory marker alterations are identified as candidate biomarkers for mediating health consequences. Lifestyle practices of residents of California’s Loma Linda Blue Zone, one of five worldwide longevity hotspots, may provide insight into inflammation remediation and chronic disease prevention. Little research has been done on centenarians’ early-life experiences or on ACEs in a longevity community. Objective To interview centenarians and seniors in this region regarding their childhood experiences to inform chronic disease prevention frameworks. Design Qualitative study of Loma Linda Blue Zone community members. Childhood exposures and practices were assessed using focus groups and semistructured key informant interviews, with open-ended questions on general hardships and ACEs and supplemented with lifestyle and resiliency factor questions. Data were audiorecorded and transcribed. Integrative grounded theory methods guided coding and theming. Main Outcome Measures Exposure to ACEs and practice of resiliency factors. Results Participants (7 centenarians and 29 seniors) reported exposure to multiple ACEs (domains: Economic deprivation, family dysfunction, and community violence). Community members reported practicing resiliency factors, each with anti-inflammatory properties suggesting mitigation of ACE-related toxic stress. Conclusion This is one of the first studies of its kind to identify a community of resilient members despite their tremendous burden of ACEs. Embedding the identified resiliency factors into chronic disease prevention frameworks has potential for mitigating systemic inflammation, alleviating chronic disease burden, and promoting a culture of health. PMID:29702049

Mental health inpatients' and staff members' suggestions for reducing physical restraint: A qualitative study.

PubMed

Wilson, C; Rouse, L; Rae, S; Kar Ray, M

2018-04-01

WHAT IS KNOWN ON THE SUBJECT?: Restraint has negative psychological, physical and relational consequences for mental health patients and staff. Restraint reduction interventions have been developed (e.g., "Safewards"). Limited qualitative research has explored suggestions on how to reduce physical restraint (and feasibility issues with implementing interventions) from those directly involved. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This paper explores mental health patients' and staff members' suggestions for reducing physical restraint, whilst addressing barriers to implementing these. Findings centred on four themes: improving communication and relationships; staffing factors; environment and space; and activities and distraction. Not all suggestions are addressed by currently available interventions. Barriers to implementation were identified, centring on a lack of time and/or resources; with the provision of more time for staff to spend with patients and implement interventions seen as essential to reducing physical restraint. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Improving communication and relationships between staff/patients, making staffing-related changes, improving ward environments and providing patient activities are central to restraint reduction in mental healthcare. Fundamental issues related to understaffing, high staff turnover, and lack of time and resources need addressing in order for suggestions to be successfully implemented. Introduction Physical restraint has negative consequences for all involved, and international calls for its reduction have emerged. Some restraint reduction interventions have been developed, but limited qualitative research explores suggestions on how to reduce physical restraint (and feasibility issues with implementation) from those directly involved. Aims To explore mental health patients' and staff members' suggestions for reducing physical restraint. Methods Interviews were conducted with 13 inpatients and 22 staff members with experience of restraint on adult mental health inpatient wards in one UK National Health Service Trust. Results Findings centred on four overarching themes: improving communication and relationships between staff/patients; making staff-related changes; improving ward environments/spaces; and having more activities. However, concerns were raised around practicalities/feasibility of their implementation. Discussion Continued research is needed into best ways to reduce physical restraint, with an emphasis on feasibility/practicality and how to make time in busy ward environments. Implications for Practice Improving communication and relationships between staff/patients, making staffing-related changes, improving ward environments and providing patient activities are central to restraint reduction in mental healthcare. However, fundamental issues related to understaffing, high staff turnover and lack of time/resources need addressing in order for these suggestions to be successfully implemented. © 2018 John Wiley & Sons Ltd.

Physician-Rating Web Sites: Ethical Implications.

PubMed

Samora, Julie Balch; Lifchez, Scott D; Blazar, Philip E

2016-01-01

To understand the ethical and professional implications of physician behavior changes secondary to online physician-rating Web sites (PRWs). The American Society for Surgery of the Hand (ASSH) Ethics and Professionalism Committee surveyed the ASSH membership regarding PRWs. We sent a 14-item questionnaire to 2,664 active ASSH members who practice in both private and academic settings in the United States. We received 312 responses, a 12% response incidence. More than 65% of the respondents had a slightly or highly unfavorable impression of these Web sites. Only 34% of respondents had ever updated or created a profile for PRWs, although 62% had observed inaccuracies in their profile. Almost 90% of respondents had not made any changes in their practice owing to comments or reviews. One-third of respondents had solicited favorable reviews from patients, and 3% of respondents have paid to improve their ratings. PRWs are going to become more prevalent, and more research is needed to fully understand the implications. There are several ethical implications that PRWs pose to practicing physicians. We contend that it is morally unsound to pay for good reviews. The recourse for physicians when an inaccurate and potentially libelous review has been written is unclear. Some physicians have required patients to sign a waiver preventing them from posting negative comments online. We propose the development of a task force to assess the professional, ethical, and legal implications of PRWs, including working with companies to improve accuracy of information, oversight, and feedback opportunities. It is expected that PRWs will play an increasing role in the future; it is unclear whether there will be a uniform reporting system, or whether these online ratings will influence referral patterns and/or quality improvement. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Implications for research and practice of the biographic approach for storytelling.

PubMed

Ewens, Beverley; Hendricks, Joyce; Sundin, Deb

2017-01-23

Background Intensive care unit survivors face many physical and psychological difficulties during their recovery following discharge from hospital. These difficulties can significantly affect their quality of life. Healthcare providers and survivors' families often do not understand what recovery means in this population, which may affect the support provided. Aim To consider the potential of the biographical method in helping to create stories that illustrate recovery in intensive care survivors and other populations. Discussion This paper identifies how the biographical approach has provided survivors with a way to uncover the hidden parts of their lives through diaries and interviews, and reveal the hidden stories of intensive care survivorship and recovery. Conclusion The application of the biographical method enabled stories to be created that identified the disruption survivors encounter as they struggle to appear recovered. Implications for practice The biographical method can illuminate experiences uncaptured by other methods. This insight into recovery journeys can help healthcare practitioners and family members to understand and recognise the need for support during recovery.

Ethical issues in research and publication.

PubMed

Iammarino, N K; O'Rourke, T W; Pigg, R M; Weinberg, A D

1989-03-01

Ethical considerations inherent in the process of research and publication represent one issue of particular concern to professionals. Members of a profession usually are guided by a code of ethics that specifies standards for practice. However, rarely do professional preparation programs sufficiently prepare students to deal with the concerns associated with research and professional publication. The authors address three specific areas of concern for health educators: the student-professor relationship, joint authorship, and ethics in publishing. Potential problems are discussed, and implications for the profession are cited.

Challenges Faced by Social Workers as Members of Interprofessional Collaborative Health Care Teams

PubMed Central

Ambrose-Miller, Wayne; Ashcroft, Rachelle

2016-01-01

Interprofessional collaboration is increasingly being seen as an important factor in the work of social workers. A focus group was conducted with Canadian social work educators, practitioners, and students to identify barriers and facilitators to collaboration from the perspective of social work. Participants identified six themes that can act as barriers and facilitators to collaboration: culture, self-identity, role clarification, decision making, communication, and power dynamics. These findings carry important implications for interprofessional collaboration with social workers in health practice. PMID:27263200

Implementing Quality Improvement in Small, Autonomous Primary Care Practices: Implications for the Patient Centered Medical Home

PubMed Central

Arar, Nedal H.; Noel, Polly H.; Leykum, Luci; Zeber, John E.; Romero, Raquel; Parchman, Michael L.

2012-01-01

Background Implementing improvement programs to enhance quality of care within primary care clinics is complex, with limited practical guidance available to help practices during the process. Understanding how improvement strategies can be implemented in primary care is timely given the recent national movement towards transforming primary care into patient-centered medical homes (PCMH). This study examined practice members’ perceptions of the opportunities and challenges associated with implementing changes in their practice. Methods Semi-structured interviews were conducted with a purposive sample of 56 individuals working in 16 small, community-based primary care practices. The interview consisted of open-ended questions focused on participants’ perceptions of: (1) practice vision, (2) perceived need for practice improvement, and (3) barriers that hinder practice improvement. The interviews were conducted at the participating clinics and were tape-recorded, transcribed, and content analyzed. Results Content analysis identified two main domains for practice improvement related to: (1) the process of care, and (2) patients’ involvement in their disease management. Examples of desired process of care changes included improvement in patient tracking/follow-up system, standardization of processes of care, and overall clinic documentations. Changes related to the patients’ involvement in their care included improving (a) health education, and (b) self care management. Among the internal barriers were: staff readiness for change, poor communication, and relationship difficulties among team members. External barriers were: insurance regulations, finances and patient health literacy. Practice Implications Transforming their practices to more patient-centered models of care will be a priority for primary care providers. Identifying opportunities and challenges associated with implementing change is critical for successful improvement programs. Successful strategy for enhancing the adoption and uptake of PCMH elements should leverage areas of concordance between practice members’ perceived needs and planned improvement efforts. PMID:22186171

Spirituality and Religion among the General Public: Implications for Social Work Discourse.

PubMed

Hodge, David R

2015-07-01

Conceptualizations play a central role in social work discourse, shaping actions in the areas of practice, research, and education. Although many formulations of spirituality and religion have been advanced by social work scholars, the views of members of the general public have been largely absent from the professional conversation. The present article adds to the profession's evolving discussion on spirituality and religion by describing common understandings of spirituality and religion among the general population and by discussing the implication of these views for social work discourse on spirituality and religion. By understanding common views among the public, the social work profession is better positioned to provide ethical and professional services that respect clients' spiritual beliefs and values.

Local IRBs vs. federal agencies: shifting dynamics, systems, and relationships.

PubMed

Klitzman, Robert L

2012-07-01

How IRBs relate to federal agencies, and the implications of these relationships, have received little, if any, systematic study. I interviewed 46 IRB chairs, directors, administrators, and members, contacting the leadership of 60 U.S. IRBs (every fourth one in the list of the top 240 institutions by NIH funding), interviewing IRB leaders from 34 (response rate=55%). IRBs describe complex direct and indirect relationships with federal agencies that affect IRBs through audits, guidance documents, and other communications, and can generate problems and challenges. Researchers often blame IRBs for frustrations, but IRBs often serve as the "local face" of federal regulations and agencies and are "stuck in the middle." These data have critical implications for policy, practice, and research.

What Influences Social Workers’ Attitudes Toward Working With Clients With Severe Mental Illness?

PubMed Central

Eack, Shaun M.; Newhill, Christina E.

2013-01-01

A national random survey of 2000 NASW members in post-master’s practice in mental health was conducted to investigate their experiences with and attitudes about working with individuals with severe and persistent mental illness (SPMI). Through a series of structural equation models, we examined the influence of different frustrations reported by the respondents on their attitudes toward working with individuals with SPMI. Results suggest that social workers’ attitudes toward working with individuals with SPMI are primarily influenced by their frustrations related to client behaviors and treatment issues, rather than frustrations with system related issues. Implications for social work practice and directions for future research are discussed. (105 words) PMID:24353397

Risky traditional practices and prevention of mother-to-child transmission of HIV: the case of Chiota community in Zimbabwe.

PubMed

Nyati-Jokomo, Zibusiso; January, James; Ruparanganda, Watch; Chitsike, Inam

2016-01-01

The objective of this study was to explore cultural practices that could expose babies to HIV infection during the postnatal period in Chiota community in Zimbabwe. Purposively selected and gender disaggregated members of the community (n = 231) were informants to 23 focus group discussions and 8 semi-structured key-informant interviews. Data were analysed thematically. Emerging themes relating to risky practices were rituals surrounding open fontanelle, toning of child's sexual libido, initiation of sex after childbirth, treatment of eye and ear infections, tongue-tie and pre-mastication. These practices exposed babies to bodily fluids such as saliva, breast milk, vaginal fluids, pre-cum and semen which in turn put the babies at low to high risk of contracting HIV. This paper discusses implications for these risky practices in prevention of mother-to-child transmission of HIV. There is, therefore, need for studies to establish the prevalence of these practices.

Perceptions of gender-based discrimination during surgical training and practice

PubMed Central

Bruce, Adrienne N.; Battista, Alexis; Plankey, Michael W.; Johnson, Lynt B.; Marshall, M. Blair

2015-01-01

Background Women represent 15% of practicing general surgeons. Gender-based discrimination has been implicated as discouraging women from surgery. We sought to determine women's perceptions of gender-based discrimination in the surgical training and working environment. Methods Following IRB approval, we fielded a pilot survey measuring perceptions and impact of gender-based discrimination in medical school, residency training, and surgical practice. It was sent electronically to 1,065 individual members of the Association of Women Surgeons. Results We received 334 responses from medical students, residents, and practicing physicians with a response rate of 31%. Eighty-seven percent experienced gender-based discrimination in medical school, 88% in residency, and 91% in practice. Perceived sources of gender-based discrimination included superiors, physician peers, clinical support staff, and patients, with 40% emanating from women and 60% from men. Conclusions The majority of responses indicated perceived gender-based discrimination during medical school, residency, and practice. Gender-based discrimination comes from both sexes and has a significant impact on women surgeons. PMID:25652117

Perceptions of gender-based discrimination during surgical training and practice.

PubMed

Bruce, Adrienne N; Battista, Alexis; Plankey, Michael W; Johnson, Lynt B; Marshall, M Blair

2015-01-01

Women represent 15% of practicing general surgeons. Gender-based discrimination has been implicated as discouraging women from surgery. We sought to determine women's perceptions of gender-based discrimination in the surgical training and working environment. Following IRB approval, we fielded a pilot survey measuring perceptions and impact of gender-based discrimination in medical school, residency training, and surgical practice. It was sent electronically to 1,065 individual members of the Association of Women Surgeons. We received 334 responses from medical students, residents, and practicing physicians with a response rate of 31%. Eighty-seven percent experienced gender-based discrimination in medical school, 88% in residency, and 91% in practice. Perceived sources of gender-based discrimination included superiors, physician peers, clinical support staff, and patients, with 40% emanating from women and 60% from men. The majority of responses indicated perceived gender-based discrimination during medical school, residency, and practice. Gender-based discrimination comes from both sexes and has a significant impact on women surgeons.

Perceptions of gender-based discrimination during surgical training and practice.

PubMed

Bruce, Adrienne N; Battista, Alexis; Plankey, Michael W; Johnson, Lynt B; Marshall, M Blair

2015-01-01

Background Women represent 15% of practicing general surgeons. Gender-based discrimination has been implicated as discouraging women from surgery. We sought to determine women's perceptions of gender-based discrimination in the surgical training and working environment. Methods Following IRB approval, we fielded a pilot survey measuring perceptions and impact of gender-based discrimination in medical school, residency training, and surgical practice. It was sent electronically to 1,065 individual members of the Association of Women Surgeons. Results We received 334 responses from medical students, residents, and practicing physicians with a response rate of 31%. Eighty-seven percent experienced gender-based discrimination in medical school, 88% in residency, and 91% in practice. Perceived sources of gender-based discrimination included superiors, physician peers, clinical support staff, and patients, with 40% emanating from women and 60% from men. Conclusions The majority of responses indicated perceived gender-based discrimination during medical school, residency, and practice. Gender-based discrimination comes from both sexes and has a significant impact on women surgeons.

A Competency Framework for the Practice of Psychology: Procedures and Implications.

PubMed

Hunsley, John; Spivak, Howard; Schaffer, Jack; Cox, Darcy; Caro, Carla; Rodolfa, Emil; Greenberg, Sandra

2016-09-01

Several competency models for training and practice in professional psychology have been proposed in the United States and Canada. Typically, the procedures used in developing and finalizing these models have involved both expert working groups and opportunities for input from interested parties. What has been missing, however, are empirical data to determine the degree to which the model reflects the views of members of the profession as a whole. Using survey data from 466 licensed or registered psychologists (approximately half of whom completed one of two versions of the survey), we examined the degree to which psychologists, both those engaged primarily in practice and those involved in doctoral training, agreed with the competency framework developed by the Association of State and Provincial Psychology Boards' Practice Analysis Task Force (Rodolfa et al., 2013). When distinct time points in training and licensure or registration were considered (i.e., entry-level supervised practice in practicum settings, advanced-level supervised practice during internship, entry level independent practice, and advanced practice), there was limited agreement by survey respondents with the competency framework's proposal about when specific competencies should be attained. In contrast, greater agreement was evident by respondents with the competency framework when the reference point was focused on entry to independent practice (i.e., the competencies necessary for licensure or registration). We discuss the implications of these findings for the development of competency models, as well as for the implementation of competency requirements in both licensure or registration and training contexts. © 2016 Wiley Periodicals, Inc.

Balancing collaborative and independent practice roles in clinical pharmacy: a qualitative research study.

PubMed

McCullough, Megan B; Solomon, Jeffrey L; Petrakis, Beth Ann; Park, Angela M; Ourth, Heather; Morreale, Anthony P; Rose, Adam J

2015-02-01

Clinical pharmacists (CPs) with a scope of practice operate as direct care providers and health care team members. Research often focuses on one role or the other; little is understood about the dynamic relationship between roles in practice settings. To identify the challenges CPs face in balancing dual roles as direct care providers and health care team members and the implications for CP effectiveness and quality of care. Pharmacists were interviewed with a primary purpose of informing an implementation effort. Besides the implementation, there were emergent themes regarding the challenges posed for CPs in negotiating dual roles. This study is, therefore, a secondary analysis of semistructured interviews and direct observation of 48 CPs, addressing this phenomenon. Interview data were entered into NVivo 10 and systematically analyzed using an emergent thematic coding strategy. Pharmacists describe role ambiguity, where they perform as direct providers or team members simultaneously or in quick succession. They note the existence of a "transaction cost," where switching causes loss of momentum or disruption of work flow. Additionally, pharmacists feel that fellow providers lack an understanding of what they do and that CP contributions are not evaluated accurately by other health professionals. It is a challenge for CPs to balance the distinct roles of serving as collaborators and primary providers. Frequent role switching is not conducive to optimal work efficiency or patient care. Our findings suggest concrete steps that medical centers can take to improve both CP worklife and quality of patient care. © The Author(s) 2014.

If you get better, will I? An actor-partner analysis of the mutual influence of group therapy outcomes.

PubMed

Paquin, Jill D; Kivlighan, D Martin; Drogosz, Lisa M

2013-04-01

The effectiveness of group psychotherapy has been empirically studied and supported over several decades; however, there remains much to understand regarding the specific factors contributing to effective group psychotherapy. The current study uses Kashy and Kenny's (2000) actor-partner interdependence model (APIM) to examine the relationship between an individual group member's outcome and the outcomes of the other group members. This is the first study to examine the effects of the outcomes of other therapy group members on those of individual members. Specifically, we examined the relationship between an individual group member's presymptom score, the aggregated presymptom scores of the other group members, and the aggregated pre- to postsymptom change of the other group members on an individual group member's pre- to postsymptom change. We analyzed the change in pre-post posttraumatic stress disorder (PTSD) symptoms of 105 women in 16 trauma-informed groups in a women's correctional facility. As hypothesized, an individual's presymptom measure (actor effect) and the aggregated presymptom measures of the other group members (partner effect) were positively related to the individual's change in PTSD symptoms. Contrary to our hypothesis, the aggregated pre-post change in PTSD symptom measures of the other group members (partner effect) was negatively associated with the pre-post change in PTSD symptom measures of an individual group member. Social comparison theory is discussed as an explanation for why a group member would report lowered amounts of change when in a group with others who are reporting a higher amount of change. Implications for research and practice are discussed.

An assessment of secondary traumatic stress in juvenile justice education workers.

PubMed

Smith Hatcher, Schnavia; Bride, Brian E; Oh, Hyejung; Moultrie King, Dione; Franklin Catrett, James

2011-07-01

Given the frequency and violent character of the traumas encountered by juvenile offenders, staff members who regularly interact with juveniles in custody are at risk of developing secondary traumatic stress. Juvenile justice teachers and staff (N = 118) were administered a cross-sectional survey, including the Secondary Traumatic Stress Scale. Respondents said the students were moderately traumatized (47%), severely traumatized (27%), and very severely traumatized (7%). Regarding STS, the most frequently reported symptom was intrusive thoughts related to work with the students, mentioned by 61% of respondents. Additionally, 81% met at least one, 55% met two, and 39% met all three core diagnostic criteria for posttraumatic stress disorder. Recommendations for juvenile justice staff members and for the organization are provided to address practice and policy implications.

Spiritual Diversity and Living with Early-Stage Dementia.

PubMed

McGee, Jocelyn Shealy; Zhao, Holly Carlson; Myers, Dennis R; Seela Eaton, Hannah

2018-01-01

Attention to spiritual diversity is necessary for the provision of culturally informed clinical care for people with early-stage dementia and their family members. In this article, an evidence-based theoretical framework for conceptualizing spiritual diversity is described in detail (Pargament, 2011). The framework is then applied to two clinical case studies of people living with early-stage dementia to elucidate the multilayered components of spiritual diversity in this population. The case studies were selected from a larger mixed-methods study on spirituality, positive psychological factors, health, and well-being in people living with early-stage dementia and their family members. To our knowledge this is the first systematic attempt to apply a theoretical framework for understanding spiritual diversity in this population. Implications for clinical practice are provided.

An Assessment of Secondary Traumatic Stress in Juvenile Justice Education Workers

PubMed Central

Hatcher, Schnavia Smith; Bride, Brian E.; Oh, Hyejung; King, Dione Moultrie; Catrett, James “Jack” Franklin

2013-01-01

Given the frequency and violent character of the traumas encountered by juvenile offenders, staff members who regularly interact with juveniles in custody are at risk of developing secondary traumatic stress. Juvenile justice teachers and staff (N = 118) were administered a cross-sectional survey, including the Secondary Traumatic Stress Scale. Respondents said the students were moderately traumatized (47%), severely traumatized (27%), and very severely traumatized (7%). Regarding STS, the most frequently reported symptom was intrusive thoughts related to work with the students, mentioned by 61% of respondents. Additionally, 81% met at least one, 55% met two, and 39% met all three core diagnostic criteria for posttraumatic stress disorder. Recommendations for juvenile justice staff members and for the organization are provided to address practice and policy implications. PMID:21571748

Social interaction in management group meetings: a case study of Finnish hospital.

PubMed

Laapotti, Tomi; Mikkola, Leena

2016-06-20

Purpose - The purpose of this paper is to understand the role of management group meetings (MGMs) in hospital organization by examining the social interaction in these meetings. Design/methodology/approach - This case study approaches social interaction from a structuration point of view. Social network analysis and qualitative content analysis are applied. Findings - The findings show that MGMs are mainly forums for information sharing. Meetings are not held for problem solving or decision making, and operational coordinating is limited. Meeting interaction is very much focused on the chair, and most of the discussion takes place between the chair and one other member, not between members. The organizational structures are maintained and reproduced in the meeting interaction, and they appear to limit discussion. Meetings appear to fulfil their goals as a part of the organization's information structure and to some extent as an instrument for management. The significance of the relational side of MGMs was recognized. Research limitations/implications - The results of this study provide a basis for future research on hospital MGMs with wider datasets and other methodologies. Especially the relational role of MGMs needs more attention. Practical implications - The goals of MGMs should be reviewed and MG members should be made aware of meeting interaction structures. Originality/value - The paper provides new knowledge about interaction networks in hospital MGMs, and describes the complexity of the importance of MGMs for hospitals.

Future directions in clinical child and adolescent psychology: a Delphi survey.

PubMed

James, Rochelle L; Roberts, Michael C

2009-10-01

This study sought to identify the future directions in three domains: clinical practice, research, and training of clinical child and adolescent psychologists in the upcoming decade. Doctoral-level active members in the field were surveyed via a two-round Delphi survey (45 in round 1; 35 in round 2). Evidence-based practice received the greatest consensus by the participants and highest rank in each of the three domains. Other highly ranked clinical practice directions included prevention and early diagnosis and treatment, and clinical services for specific psychological problems. Research directions focused on biological and social factors interactions in the etiology and treatment and specific child and adolescent disorders. In the training domain, major directions included the pursuit of specialty training in child and adolescent psychology and training emphasizing the biological basis of behavior. Implications of these future directions are discussed.

Initiating and utilizing shared leadership in teams: The role of leader humility, team proactive personality, and team performance capability.

PubMed

Chiu, Chia-Yen Chad; Owens, Bradley P; Tesluk, Paul E

2016-12-01

The present study was designed to produce novel theoretical insight regarding how leader humility and team member characteristics foster the conditions that promote shared leadership and when shared leadership relates to team effectiveness. Drawing on social information processing theory and adaptive leadership theory, we propose that leader humility facilitates shared leadership by promoting leadership-claiming and leadership-granting interactions among team members. We also apply dominance complementary theory to propose that team proactive personality strengthens the impact of leader humility on shared leadership. Finally, we predict that shared leadership will be most strongly related to team performance when team members have high levels of task-related competence. Using a sample composed of 62 Taiwanese professional work teams, we find support for our proposed hypothesized model. The theoretical and practical implications of these results for team leadership, humility, team composition, and shared leadership are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Presumed fair: ironic effects of organizational diversity structures.

PubMed

Kaiser, Cheryl R; Major, Brenda; Jurcevic, Ines; Dover, Tessa L; Brady, Laura M; Shapiro, Jenessa R

2013-03-01

This research tests the hypothesis that the presence (vs. absence) of organizational diversity structures causes high-status group members (Whites, men) to perceive organizations with diversity structures as procedurally fairer environments for underrepresented groups (racial minorities, women), even when it is clear that underrepresented groups have been unfairly disadvantaged within these organizations. Furthermore, this illusory sense of fairness derived from the mere presence of diversity structures causes high-status group members to legitimize the status quo by becoming less sensitive to discrimination targeted at underrepresented groups and reacting more harshly toward underrepresented group members who claim discrimination. Six experiments support these hypotheses in designs using 4 types of diversity structures (diversity policies, diversity training, diversity awards, idiosyncratically generated diversity structures from participants' own organizations) among 2 high-status groups in tests involving several types of discrimination (discriminatory promotion practices, adverse impact in hiring, wage discrimination). Implications of these experiments for organizational diversity and employment discrimination law are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved

Collective Care: Multiple Caregivers and Multiple Care Recipients in Mexican American Families

PubMed Central

Evans, Bronwynne C.; Coon, David W.; Belyea, Michael J.; Ume, Ebere

2016-01-01

Purpose Specific stressors associated with caregiving in Mexican-American (MA) families are not well documented, yet caregiving issues are paramount because informal care for parents is central to their culture. Although MA families who band together to provide care for one member are not unique, the literature does not describe the phenomenon of collective caregiving, which may be widespread but unrecognized. Such families are both understudied and poorly served by contemporary health systems because their characteristics are unknown. Design Descriptive, multi-site, longitudinal mixed-methods study of MA caregiving families. Findings We identified three types of collective caregivers: those providing care for multiple family members simultaneously; those providing care successively to several family members, and/or those finding themselves obliged to accept care during their caregiving of others. Discussion and Conclusions Collective caregiving of MA elders warrants further investigation. Implications for Practice Exploration of collective caregiving may provide a foundation for tailored family interventions. PMID:27389911

The use of clarification sessions in the treatment of incest victims and their families: an exploratory study.

PubMed

Demaio, Christine M; Davis, Joanne L; Smith, Daniel W

2006-01-01

The "clarification session" has been implicated as an important component of the treatment of families affected by incest. On the basis of information presented in clinical literature, however, the specific nature of this intervention varies widely. This exploratory study examined the practices and attitudes regarding clarification sessions of select members of the Association for the Treatment of Sexual Abusers. Surveys were completed by 483 members. Results indicated that approximately 77% of respondents had experience in conducting clarification sessions. The top two reported reasons for conducting clarification sessions were for the perpetrator to assume all responsibility for the abuse and to decrease the level of self-blame of the victim. The majority of respondents concurred that several activities needed to occur prior to the clarification session, whereas less consensus was indicated for activities that were deemed essential during the clarification session. Respondents' practices, attitudes, and beliefs are discussed in terms of the current state of limited, empirically based knowledge in this area. Directions for future research are suggested.

Anticipatory other-completion of augmentative and alternative communication talk: a conversation analysis study.

PubMed

Bloch, Steven

2011-01-01

The study described here investigates the practice of anticipatory completion of augmentative and alternative communication (AAC) utterances in progress. The aims were to identify and analyse features of this practice as they occur in natural conversation between a person using an AAC system and a family member. The methods and principles of Conversation Analysis (CA) were used to video record conversations between people with progressive neurological diseases and a progressive speech disorder (dysarthria) and their family members. Key features of interaction were identified and extracts transcribed. Four extracts of talk between a man with motor neurone disease/amyotrophic lateral sclerosis and his mother are presented here. Anticipatory completion of AAC utterances is intimately related to the sequential context in which such utterances occur. Difficulties can arise from topic shifts, understanding the intended action of an AAC word in progress and in recognising the possible end point an utterance. The analysis highlights the importance of understanding how AAC talk works in everyday interaction. The role of co-participants is particularly important here. These results may have implications for both AAC software design and clinical intervention.

ASCCP Colposcopy Standards: How Do We Perform Colposcopy? Implications for Establishing Standards.

PubMed

Waxman, Alan G; Conageski, Christine; Silver, Michelle I; Tedeschi, Candice; Stier, Elizabeth A; Apgar, Barbara; Huh, Warner K; Wentzensen, Nicolas; Massad, L Stewart; Khan, Michelle J; Mayeaux, Edward J; Einstein, Mark H; Schiffman, Mark H; Guido, Richard S

2017-10-01

The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. Working group 3 defined colposcopy procedure guidelines for minimum and comprehensive colposcopy practice and evaluated the use of colposcopy adjuncts. The working group performed a systematic literature review to identify best practices in colposcopy methodology and to evaluate the use of available colposcopy adjuncts. The literature provided little evidence to support specific elements of the procedure. The working group, therefore, implemented a national survey of current and recent ASCCP members to evaluate common elements of the colposcopy examination. The findings of this survey were modified by expert consensus from the ASCCP Colposcopy Standards Committee members to create guidelines for performing colposcopy. The draft recommendations were posted online for public comment and presented at an open session of the International Federation for Cervical Pathology and Colposcopy 2017 World Congress for further comment. All comments were considered in the development of final recommendations. Minimum and comprehensive colposcopy practice guidelines were developed. These guidelines represent recommended practice in all parts of the examination including the following: precolposcopy evaluation, performing the procedure, documentation of findings, biopsy practice, and postprocedure follow-up. These guidelines are intended to serve as a guide to standardize colposcopy across the United States.

A 5-Year Analysis of Peer-Reviewed Journal Article Publications of Pharmacy Practice Faculty Members

PubMed Central

Spivey, Christina; Martin, Jennifer R.; Wyles, Christina; Ehrman, Clara; Schlesselman, Lauren S.

2012-01-01

Objectives. To evaluate scholarship, as represented by peer-reviewed journal articles, among US pharmacy practice faculty members; contribute evidence that may better inform benchmarking by academic pharmacy practice departments; and examine factors that may be related to publication rates. Methods. Journal articles published by all pharmacy practice faculty members between January 1, 2006, and December 31, 2010, were identified. College and school publication rates were compared based on public vs. private status, being part of a health science campus, having a graduate program, and having doctor of pharmacy (PharmD) faculty members funded by the National Institutes of Health (NIH). Results. Pharmacy practice faculty members published 6,101 articles during the 5-year study period, and a pharmacy practice faculty member was the primary author on 2,698 of the articles. Pharmacy practice faculty members published an average of 0.51 articles per year. Pharmacy colleges and schools affiliated with health science campuses, at public institutions, with NIH-funded PharmD faculty members, and with graduate programs had significantly higher total publication rates compared with those that did not have these characteristics (p<0.006). Conclusion. Pharmacy practice faculty members contributed nearly 6,000 unique publications over the 5-year period studied. However, this reflects a rate of less than 1 publication per faculty member per year, suggesting that a limited number of faculty members produced the majority of publications. PMID:23049099

Evolution of the Birth Plan

PubMed Central

Kaufman, Tamara

2007-01-01

Many birth professionals are discarding the birth plan as an outdated and ineffectual document. This column discusses the past limitations and present uses of the birth plan in an effort to enhance current teaching on how expectant parents can write and use this important document. Encouraging expectant parents to prepare two separate, but corresponding, birth plans—the “Discussion Birth Plan” and the “Hospital Birth Plan”—is proposed. Teaching suggestions and possible implications are explored in order to give childbirth educators practical information to share with their class members. PMID:18566650

Family members' needs and experiences of driving disruption over time following an acquired brain injury: an evolving issue.

PubMed

Liang, Phyllis; Gustafsson, Louise; Liddle, Jacki; Fleming, Jennifer

2017-07-01

Family members often assume the role of driver for individuals who are not driving post-acquired brain injury (ABI). Given that return to driving can be unpredictable and uncertain, the impact of driving disruption on family members may vary at different stages post-injury. This study aims to understand the needs and experiences of family members over time during driving disruption following an ABI. A qualitative prospective longitudinal research design was used with semi-structured interviews at recruitment to study, 3 and 6 months later. Fourteen family members completed 41 interviews. The longitudinal data revealed four phases of driving disruption: (1) Wait and see, (2) Holding onto a quick fix, (3) No way out, and (4) Resolution and adjustment. The phases described a process of building tension and a need for support and resolution over time. Holding onto a quick fix is a pivotal phase whereby supports, such as engagement in realistic goal setting, are essential to facilitate family members' resolution of driving disruption issues. Family members who see no way out might not actively seek help and these points to a need for long-term and regular follow-ups. Future research can explore ways to support family members at these key times. Implications for rehabilitation Health professionals need to facilitate the process of fostering hope in family members to set realistic expectations of return to driving and the duration of driving disruption. It is necessary to follow-up with family members even years after ABI as the issue of driving disruption could escalate to be a crisis and family members might not actively seek help. Health professionals can consider both practical support for facilitating transport and emotional support when addressing the issue of driving disruption with family members.

[Institutional ethics committees in Mexico: the ambiguous boundary between health care ethics and research ethics].

PubMed

Valdez-Martínez, Edith; Lifshitz-Guinzberg, Alberto; Medesigo-Micete, José; Bedolla, Miguel

2008-08-01

To identify ethics committees in medical practice in Mexico and possible implications stemming from their composition and functions. A cross-sectional descriptive study was conducted from January-December 2005. A survey was sent by e-mail to the hospitals and family medicine centers with at 10 practices within the Mexican Institute for Social Security (Instituto Mexicano del Seguro Social) (n=437) and the Institute for Security and Social Services for State Employees (Seguridad y Servicios Sociales de los Trabajadores del Estado) (n=167) and to the Mexican Ministry of Health's most important health care centers (n=15). The following items were analyzed: name of the committee, date of formation, current status, composition, functions, and level of authority. In all, 116 committees were identified, with various names. Of these, 101 (87.1%) were active. The committees were formed from 1985-2006, with a spike occurring in 2004-2005. Of the active committees, 59 (58.4%) were charged with ethical problems/dilemmas related to clinical practice as well as those related to research projects. Of the committee members, 357 (59.0%) held managing positions in the establishment to which the committee pertained; most were medical professionals (71.5%), followed by nursing staff (11.9%). Among the members of the active committees, 77.9% had not received training in ethics. Legal conflicts can be expected, mainly within the organizations whose committees have the authority to determine a course of action. An integrated plan is needed that will set standards for the composition and proceedings of Mexico's ethics committees and the improved training of committee members.

The role of proactive personality in job satisfaction and organizational citizenship behavior: a relational perspective.

PubMed

Li, Ning; Liang, Jian; Crant, J Michael

2010-03-01

Drawing from a relational approach, the authors conceptualize the quality of leader-member exchange as a mediator and procedural justice climate as a contextual moderator for understanding the role of proactive personality in job satisfaction and organizational citizenship behavior. Data from a sample of 200 Chinese employees within 54 work groups were used to examine the hypothesized models. Results show that having a proactive personality was associated with employees establishing a high-quality exchange relationship with their supervisors; in turn, the quality of leader-member exchange was associated with greater job satisfaction and more organizational citizenship behaviors. Additionally, the relationship between proactive personality and organizational citizenship behavior was positively moderated by procedural justice climate within the group. Implications for management theory and practice are discussed. 2010 APA, all rights reserved

Sociolegal and practice implications of caring for LGBT people with dementia.

PubMed

Peel, Elizabeth; Taylor, Helen; Harding, Rosie

2016-11-30

The needs of lesbian, gay, bisexual and trans (LGBT) people with dementia are poorly recognised. This is due partly to assumptions that all older people are heterosexual or asexual. One quarter of gay or bisexual men and half of lesbian or bisexual women have children, compared with 90% of heterosexual women and men, which means LGBT older adults are more likely to reside in care homes. Older LGBT people may be unwilling to express their sexual identities in care settings and this can affect their care. Members of older people's informal care networks must be recognised to ensure their involvement in the lives of residents in care settings continues. However, healthcare professionals may not always realise that many LGBT people rely on their families of choice or wider social networks more than on their families of origin. This article explores sociolegal issues that can arise in the care of older LGBT people with dementia, including enabling autonomy, capacity and applying legal frameworks to support their identities and relationships. It also highlights implications for practice.

The Evolution of Gero-Oncology Nursing

PubMed Central

Bond, Stewart M.; Bryant, Ashley Leak; Puts, Martine

2016-01-01

Objectives This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Data Sources Peer-reviewed literature, position statements, clinical practice guidelines, web-based materials, and professional organizations’ resources. Conclusion Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gerooncology and to develop a body of evidence, nurses and healthcare systems remain under-prepared to provide high quality care for older adults with cancer. Implications for Nursing Practice Nurses need to take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. PMID:26830263

Changing spousal roles and their effect on recovery in gamblers anonymous: GamAnon, social support, wives and husbands.

PubMed

Ferentzy, Peter; Skinner, Wayne; Antze, Paul

2010-09-01

This paper examines changing spousal roles and their effects upon recovery in Gamblers Anonymous (GA). It is based upon a qualitative study designed to gage uniformity as well as variations in approaches to recovery in GA. Interviews were conducted with 39 GA members (26 men, 13 women; mean age 56.5 years). Though the study was based in the Toronto area, only 13 interviews involved participants from that region. Phone interviews were conducted with GA members from various regions of both Canada and the US. GamAnon, GA's sister fellowship, has been designed for anyone affected seriously by someone's gambling problem. In practice, GamAnon comprises mostly women--spouses of male GA members--who traditionally have taken a keen interest in the ways in which their husbands achieve and maintain abstinence from gambling. Changing spousal roles have led to fewer women joining GamAnon, as many opt instead to part with troubled spouses. As well, more women are attending GA than in the past, typically with husbands who are disinclined to join GamAnon. All of this has drastically altered how GA members pursue recovery. These changes and their implications are discussed.

Major publications in the critical care pharmacotherapy literature: January-December 2013.

PubMed

Rech, Megan A; Day, Sarah A; Kast, Jenna M; Donahey, Elisabeth E; Pajoumand, Mehrnaz; Kram, Shawn J; Erdman, Michael J; Peitz, Gregory J; Allen, John M; Palmer, Allison; Kram, Bridgette; Harris, Serena A; Turck, Charles J

2015-02-01

Ten recently published articles with important implications for critical care pharmacotherapy are summarized. The Critical Care Pharmacotherapy Literature Update (CCPLU) group is a national assembly of experienced intensive care unit (ICU) pharmacists across the United States. Group members monitor 25 peer-reviewed journals on an ongoing basis to identify literature relevant to pharmacy practice in the critical care setting. After evaluation by CCPLU group members, selected articles are chosen for summarization and distribution to group members nationwide based on (1) applicability to critical care practice, (2) relevance to pharmacy practitioners, and (3) quality of evidence or research methodology. Hundreds of relevant articles were evaluated by the group during the period January-December 2013, of which 98 were summarized and disseminated nationally to CCPLU group members. Among those 98 publications, 10 deemed to be of particularly high utility to critical care practitioners were included in this review. The 10 articles address topics such as rapid lowering of blood pressure in patients with intracranial hemorrhage, adjunctive therapy to prevent renal injury due to acute heart failure, triple-drug therapy to improve neurologic outcomes after cardiac arrest, and continuous versus intermittent infusion of β-lactam antibiotics in severe sepsis. There were many important additions to the critical care pharmacotherapy literature in 2013, including an updated guideline on the management of myocardial infarction and reports on advances in research focused on improving outcomes in patients with stroke or cardiac arrest and preventing the spread of drug-resistant pathogens in the ICU. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

An Integrative Behavioral Model of Information Security Policy Compliance

PubMed Central

Kim, Sang Hoon; Yang, Kyung Hoon; Park, Sunyoung

2014-01-01

The authors found the behavioral factors that influence the organization members' compliance with the information security policy in organizations on the basis of neutralization theory, Theory of planned behavior, and protection motivation theory. Depending on the theory of planned behavior, members' attitudes towards compliance, as well as normative belief and self-efficacy, were believed to determine the intention to comply with the information security policy. Neutralization theory, a prominent theory in criminology, could be expected to provide the explanation for information system security policy violations. Based on the protection motivation theory, it was inferred that the expected efficacy could have an impact on intentions of compliance. By the above logical reasoning, the integrative behavioral model and eight hypotheses could be derived. Data were collected by conducting a survey; 194 out of 207 questionnaires were available. The test of the causal model was conducted by PLS. The reliability, validity, and model fit were found to be statistically significant. The results of the hypotheses tests showed that seven of the eight hypotheses were acceptable. The theoretical implications of this study are as follows: (1) the study is expected to play a role of the baseline for future research about organization members' compliance with the information security policy, (2) the study attempted an interdisciplinary approach by combining psychology and information system security research, and (3) the study suggested concrete operational definitions of influencing factors for information security policy compliance through a comprehensive theoretical review. Also, the study has some practical implications. First, it can provide the guideline to support the successful execution of the strategic establishment for the implement of information system security policies in organizations. Second, it proves that the need of education and training programs suppressing members' neutralization intention to violate information security policy should be emphasized. PMID:24971373

An integrative behavioral model of information security policy compliance.

PubMed

Kim, Sang Hoon; Yang, Kyung Hoon; Park, Sunyoung

2014-01-01

The authors found the behavioral factors that influence the organization members' compliance with the information security policy in organizations on the basis of neutralization theory, Theory of planned behavior, and protection motivation theory. Depending on the theory of planned behavior, members' attitudes towards compliance, as well as normative belief and self-efficacy, were believed to determine the intention to comply with the information security policy. Neutralization theory, a prominent theory in criminology, could be expected to provide the explanation for information system security policy violations. Based on the protection motivation theory, it was inferred that the expected efficacy could have an impact on intentions of compliance. By the above logical reasoning, the integrative behavioral model and eight hypotheses could be derived. Data were collected by conducting a survey; 194 out of 207 questionnaires were available. The test of the causal model was conducted by PLS. The reliability, validity, and model fit were found to be statistically significant. The results of the hypotheses tests showed that seven of the eight hypotheses were acceptable. The theoretical implications of this study are as follows: (1) the study is expected to play a role of the baseline for future research about organization members' compliance with the information security policy, (2) the study attempted an interdisciplinary approach by combining psychology and information system security research, and (3) the study suggested concrete operational definitions of influencing factors for information security policy compliance through a comprehensive theoretical review. Also, the study has some practical implications. First, it can provide the guideline to support the successful execution of the strategic establishment for the implement of information system security policies in organizations. Second, it proves that the need of education and training programs suppressing members' neutralization intention to violate information security policy should be emphasized.

Unlicensed staff members' experiences with patients' pain on an inpatient oncology unit: implications for redesigning the care delivery system.

PubMed

Schulman-Green, Dena; Harris, Debra; Xue, Ying; Loseth, Diane B; Czaplinski, Cindy; Donovan, Constance; McCorkle, Ruth

2005-01-01

Although unlicensed staff have routine contact with patients in pain, little research relates to their role with these patients. The purpose of this study was to describe the experiences of unlicensed inpatient hospital staff caring for cancer patients in pain. We sought to understand pain identification and communication practices, describe common practice situations, and identify training needs. We conducted 4 focus groups with unit secretaries, nurses' aides, and housekeepers (N = 24) on 2 inpatient oncology units at an urban, northeastern teaching hospital. Group processes were tape-recorded, transcribed, and analyzed using Atlas/ti software and content analysis. Analysis generated 5 issues related to pain in the daily practice of unlicensed staff: perceived function with pain, building relationships with patients, interpreting patients' pain, system issues, and job challenges and coping strategies. Unlicensed staff reported performing important functions related to pain, including alerting nursing staff to patients' pain, and providing psychosocial support. Participants shared difficulties of working with patients in pain and expressed interest in education on pain identification and course of illness. Findings provide insight into the role of unlicensed staff, and have implications for the educational preparation of this group as well as the nature of their participation in the care delivery system.

Trends in dermatology practices and the implications for the workforce.

PubMed

Ehrlich, Alison; Kostecki, James; Olkaba, Helen

2017-10-01

The American Academy of Dermatology (AAD) practice profile surveys have been conducted for more than a decade to gauge trends in our workforce supply and demand. To update the trends and current workforce issues for the field of dermatology. The AAD Practice Profile Survey is sent by both e-mail and postal mail to a random sample of practicing dermatologists who are AAD members. Shifts are noted in the primary practice setting; fewer dermatologists are in solo practice and more are in group practices than in previous years. Teledermatology use trended upward from 7% to 11% between 2012 and 2014. The implementation of electronic health records increased from 51% in 2011 to 70% in 2014. There is potential for response bias and inaccurate self-reporting. Survey responses collected may not be representative of all geographic areas. The demand for dermatology services remains strong. Shifts in the practice setting may be related to increases in overhead costs that are partially associated with the implementation of technology-based medical records. Integration of electronic health records and utilization of telemedicine are increasing. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

A Phenomenological Study with Youth Gang Members: Results and Implications for School Counselors.

ERIC Educational Resources Information Center

Omizo, Michael M.; Omizo, Sharon A.; Honda, Marianne R.

1997-01-01

Using a phenomenological model, examines eight male adolescents' perceptions of their gang membership. Interviews revealed such themes as self-esteem, a sense of belonging, and protection. Outlines implications for school counselors when working with gang members individually, in groups, with families, or during school interventions. (RJM)

Parenting, family life, and well-being among sexual minorities: nursing policy and practice implications.

PubMed

Weber, Scott

2008-06-01

Parenting and family life are fundamental social constructs in human society and in law and public policy. Family structures and support systems provide important economic and psychological advantages for parents as well as for their children. Stigma toward lesbian and gay parents often marginalize individuals in these families and restrict family members' full expression of social citizenship, humanity, and personhood. Stigma directly contributes to increased risk for substance abuse, anxiety, and depressive illness among both parents and children. This article reviews the relevant policy literature to deconstruct the impacts of stigma on the psychological health and well-being of sexual minority parents so that psychiatric/mental health nurses and other health care providers can identify and counter these effects in their practices and advocate for policy improvements.

Characteristics of the home health practice setting that attract and retain physical therapists: results of a survey and implications for home health.

PubMed

Collins, Tracey L

2011-03-01

An electronic survey of the home health (HH) section members of the American Physical Therapy Association (APTA) found that physical therapists (PTs) are attracted to HH for flexible work hours, the ability to work one on one with a patient, the functional setting, and salary, in that order. They continue to practice in HH because they take pride in their work, the relationships they have with their patients/caregivers, their ability to make autonomous work decisions, their control over their schedule, the relationships they have within the home health agency (HHA), salary, the relationships they have with peers, their benefits, and their ability to handle documentation demands, in that order. Copyright © 2011 Lippincott Williams & Wilkins.

Healthcare resource allocation decisions affecting uninsured services

PubMed Central

Harrison, Krista Lyn; Taylor, Holly A.

2017-01-01

Purpose Using the example of community access programs (CAPs), the purpose of this paper is to describe resource allocation and policy decisions related to providing health services for the uninsured in the USA and the organizational values affecting these decisions. Design/methodology/approach The study used comparative case study methodology at two geographically diverse sites. Researchers collected data from program documents, meeting observations, and interviews with program stakeholders. Findings Five resource allocation or policy decisions relevant to providing healthcare services were described at each site across three categories: designing the health plan, reacting to funding changes, and revising policies. Organizational values of access to care and stewardship most frequently affected resource allocation and policy decisions, while economic and political pressures affect the relative prioritization of values. Research limitations/implications Small sample size, the potential for social desirability or recall bias, and the exclusion of provider, member or community perspectives beyond those represented among participating board members. Practical implications Program directors or researchers can use this study to assess the extent to which resource allocation and policy decisions align with organizational values and mission statements. Social implications The description of how healthcare decisions are actually made can be matched with literature that describes how healthcare resource decisions ought to be made, in order to provide a normative grounding for future decisions. Originality/value This study addresses a gap in literature regarding how CAPs actually make resource allocation decisions that affect access to healthcare services. PMID:27934550

Review of the GAS3 Family of Proteins and their Relevance to Cancer

PubMed Central

Ashki, Negin; Gordon, Lynn; Wadehra, Madhuri

2017-01-01

The GAS3 family of tetraspan proteins has recently been implicated in the progression of cancer. Currently, six members of the GAS3 family have been identified in humans and mice, and while their expressions in disease vary, data suggest that they play a role in epithelial cell structure and function. In this review, we highlight the studies implicating four of the members in disease pathogenesis as well as probe the structural similarities between the family members. Finally, the impact of targeting select members of the family such as PMP22 and EMP2 is discussed. PMID:27279240

Review of the GAS3 Family of Proteins and their Relevance to Cancer.

PubMed

Ashki, Negin; Gordon, Lynn; Wadehra, Madhuri

2015-01-01

The GAS3 family of tetraspan proteins has recently been implicated in the progression of cancer. Currently, six members of the GAS3 family have been identified in humans and mice, and while their expressions in disease vary, data suggest that they play a role in epithelial cell structure and function. In this review, we highlight the studies implicating four of the members in disease pathogenesis as well as probe the structural similarities between the family members. Finally, the impact of targeting select members of the family such as PMP22 and EMP2 is discussed.

Resisting vulnerability: the experiences of families who have kin in hospital-a feminist ethnography.

PubMed

Perry, Joann; Judith Lynam, M; Anderson, Joan M

2006-02-01

Health care restructuring, in an effort to control costs, has resulted in marked organizational change with concomitant influences on nursing practice in the hospital and community contexts. Such changes have resulted in increased levels of acuity among patients and shorter hospital stays. As a consequence, families are being asked to assume greater roles in illness care of family members. At the same time societies and therefore patient populations are becoming increasingly culturally and linguistically diverse. Yet, little is known about hospitalization and help-seeking practices of family caregivers in an ethnoculturally diverse context and the nature of support they require from the health care system. This paper addresses this gap in knowledge. Here we draw upon data gathered in two ethnographic studies of illness care and help-seeking practices in an enthoculturally diverse community. Analysis of family data identified 'resisting vulnerability' as a process central to the families' experiences. This paper examines the process of resisting vulnerability and how it was influenced by the practices of health care professionals and structures of the health system. Implications for practice are discussed.

Explaining the Behavioral Intention towards BI Implementation in Public Administrations - A Principal-Agent Theory Approach

NASA Astrophysics Data System (ADS)

Becker, Jörg; Bergener, Philipp; Lis, Łukasz; Niehaves, Björn

Business Intelligence (BI) is an established instrument to support public administrations in their management tasks by increasing their information level. BI is of special interest in the context of introducing accrual accounting in public administrations as this affects the information level of different stakeholders, leading to a possible decrease for municipal councils. The principal-agent theory can help to explain different behavioral intentions of the stakeholders concerning the introduction of BI. We employ a single qualitative case study to analyze these behavioral intentions. It shows that the introduction of accrual accounting did decrease the information level of the municipal council making the principal-agent problems possible. Furthermore, it shows that BI might be a solution for this problem. Therefore, council members show the behavioral intention to support the BI implementation while administration staff members rather resist it. Based on these finding, we discuss implications for practice and future research.

Opposites attract or attack? The moderating role of diversity climate in the team diversity-interpersonal aggression relationship.

PubMed

Drach-Zahavy, Anat; Trogan, Revital

2013-10-01

This study embraced a unit-level diversity perspective to examine interpersonal aggression, as experienced or witnessed by individual team members. Specifically, our aim was to explore the moderating role of a unit's diversity climate in the link between unit-level surface diversity in terms of ethnicity, sex, age, and tenure, and individual-level perceptions of interpersonal aggression. We tested our hypotheses with 30 nursing units using the Mixed-Linear Model procedure appropriate for nested samples. Results demonstrated that diversity climate moderated the relationships between tenure and ethnic unit diversity and interpersonal aggression, experienced or witnessed among individual team members. Moreover, regardless of the level of diversity climate, age diversity was positively linked to interpersonal aggression, whereas sex diversity was negatively linked to it. These findings imply that the unit's context affects interpersonal aggression and provides important theoretical and practical implications to proactively prevent interpersonal aggression.

Identifying the Correlates and Barriers of Future Planning Among Parents of Individuals With Intellectual and Developmental Disabilities.

PubMed

Burke, Meghan; Arnold, Catherine; Owen, Aleksa

2018-04-01

Although individuals with intellectual and developmental disabilities (IDD) are living longer lives, fewer than half of parents of individuals with IDD conduct future planning. The correlates and barriers to future planning must be identified to develop targeted interventions to facilitate future planning. In this study, 388 parents of individuals with IDD responded to a national, web-based survey. Participants who were older, more educated, attended more parent training and support activities, and had children with fewer functional abilities, were more likely to engage in future planning. Reported barriers to future planning included: (a) lack of available services, (b) financial challenges, (c) reluctance of family members, (d) lack of time, (e) the emotional nature of future planning, (f) inertia, and (g) a lack of family members to be caregivers. Implications for policy, practice, and future research are discussed.

IMMIGRATION ENFORCEMENT AND MIXED-STATUS FAMILIES: THE EFFECTS OF RISK OF DEPORTATION ON MEDICAID USE

PubMed Central

Vargas, Edward D.

2015-01-01

As Congress priorities the immigration debate on increased border security, the fate of an estimated 11 million undocumented citizens remains uncertain. Stuck in between partisan politics and practical solutions are mixed-status families in which some members of the family are U.S. citizens while other members are in the country without proper authorization. This paper, examines the relationship between risk of deportation and Medicaid use drawing from a nationally sample of mothers from the Fragile Families and Child Wellbeing Survey. These data are then merged with data from the U.S. Citizenship and Immigration Services to create a contextual risk of deportation measure. Findings suggest that an increase in risk of deportation is associated with a decrease in Medicaid use. The implications of this work have tremendous impacts for health service providers and policy makers interested in preventing and reducing health disparities in complex family structures. PMID:26435562

Children's prosocial behavioural intentions towards outgroup members.

PubMed

Abrams, Dominic; Van de Vyver, Julie; Pelletier, Joseph; Cameron, Lindsey

2015-09-01

When will children decide to help outgroup peers? We examined how intergroup competition, social perspective taking (SPT), and empathy influence children's (5-10 years, N = 287) prosocial intentions towards outgroup members. Study 1 showed that, in a minimal group situation, prosociality was lower in an intergroup competitive than in a non-competitive or interpersonal context. Study 2 revealed that, in a real groups situation involving intergroup competition, prosociality was associated with higher empathy and lower competitive motivation. In a subsequent non-competitive context, there were age differences in the impact of SPT and competitive motivation. With age, relationships strengthened between SPT and prosociality (positively) and between competitiveness and prosociality (negatively). Among older children, there was a carry-over effect whereby feelings of intergroup competitiveness aroused by the intergroup competitive context suppressed outgroup prosociality in the following non-competitive context. Theoretical and practical implications for improving children's intergroup relationships are discussed. © 2015 The British Psychological Society.

Organizational socialization in team sport environments.

PubMed

Benson, A J; Evans, M B; Eys, M A

2016-04-01

Socialization tactics are often used to manage initial group member interactions in a way that facilitates transition experiences. Although this process is heavily researched in organizational contexts, we sought to extend this line of inquiry to sport by examining the nature of socialization tactics used to integrate new members into existing teams. Interviews were conducted with 12 coaches and 12 athletes from several Canadian Interuniversity Sport teams to explore the nature of socialization and the circumstances underscoring why certain approaches are taken over others. A key process involved establishing congruency of role expectations between incoming athletes and group leaders, and socialization processes balanced expectations of conformity with encouragement of individual personalities within the group. A conceptual basis to examine socialization into team sport environments is discussed in relation to the extant organizational theories, and the practical implications of delineating sport socialization tactics are forwarded. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Co-victims of Homicide: A Systematic Review of the Literature.

PubMed

Connolly, Jennifer; Gordon, Ronit

2015-10-01

This systematic literature review examines the effects of homicide on surviving family members, the "co-victims" or "survivors" of homicide. A content analysis was conducted on 40 articles identified through a search of the literature. The research samples were predominately located in the United States, but included two U.K. samples, one Jamaican sample, and one sample from Israel. All articles were written in English. Three themes were identified. Nineteen articles explored the psychological, academic, social, occupational, and familial effects of homicide. Thirteen articles considered survivors' grieving process and how it was altered by experiences with the criminal justice system as well as coping strategies used by survivors to deal with their grief. Eight articles explored treatment interventions available to help surviving family members deal with their grief. Key findings from the articles, limitations of the current research, and implications for future research, policy, and practice are included. © The Author(s) 2014.

The Theory of Dyadic Illness Management.

PubMed

Lyons, Karen S; Lee, Christopher S

2018-02-01

Despite the importance of both members of the adult patient-care partner dyad, a majority of research on illness management is focused on the patient or the care partner. The basic principle of the Theory of Dyadic Illness Management is that illness management is a dyadic phenomenon; the theory focuses extensively on the dyad as an interdependent team. The way dyads appraise illness as a unit influences the ways in which they engage in behaviors to manage illness together in a recursive fashion that influences dyadic health. Optimizing the health of both members of the dyad is a goal of the theory. In turn, the health of the dyad can feedback to influence how they appraise and manage illness together. Finally, dyadic illness management is an inherently variable process that is influenced by several contextual factors. Supportive evidence and implications for practice and future research are presented.

From autonomy to creativity: a multilevel investigation of the mediating role of harmonious passion.

PubMed

Liu, Dong; Chen, Xiao-Ping; Yao, Xin

2011-03-01

Building on self-determination theory, we theorized about and demonstrated, through 2 multilevel field studies, the pivotal role of harmonious passion in translating organizational autonomy support and individual autonomy orientation into job creativity. Results based on 3-level data from 856 members in 111 teams within 23 work units of a porous metal company (Study 1) and from 525 employees in 98 teams of 18 branches of a large commercial bank (Study 2) revealed 2 major findings. First, organizational autonomy support from a higher organizational level (unit or branch) compensated for the effect of autonomy support from a lower organizational level (team) or individual autonomy orientation on employees' harmonious passion. Second, harmonious passion mediated the interactive effects of unit (branch) autonomy support and team member autonomy orientation, of team autonomy support and team member autonomy orientation, and of unit (branch) autonomy support and team autonomy support on individual creativity. We discuss the theoretical and practical implications of these findings in the organizational context. PsycINFO Database Record (c) 2011 APA, all rights reserved.

The Prosocial Cyberball Game: Compensating for social exclusion and its associations with empathic concern and bullying in adolescents.

PubMed

Vrijhof, Claudia I; van den Bulk, Bianca G; Overgaauw, Sandy; Lelieveld, Gert-Jan; Engels, Rutger C M E; van IJzendoorn, Marinus H

2016-10-01

In this study we examined prosocial compensating behavior towards socially excluded ingroup and outgroup members by using a 'Prosocial Cyberball Game' in 9-17 year old Dutch adolescents (N = 133). Results showed that adolescents compensated for the social exclusion of an unknown peer in a virtual ball tossing game, by tossing the ball more often to that player in compensation conditions compared to the fair play condition. The proportion of tosses towards the excluded player did not significantly differ as a function of the group status of that player. Although compensating behavior towards ingroup versus outgroup members did not differ, the underlying motivation for this behavior may vary. More empathic concern was associated with more prosocial tosses towards an ingroup member, while more self-reported bullying behavior was associated with less compensating behavior in the outgroup condition. These findings may have practical implications for programs intending to change bystander behavior in bullying situations. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Parental and God Representations Among Individuals with Psychosis: A Grounded Theory Analysis.

PubMed

Prout, Tracy A; Ottaviano, Patricia; Taveras, Alexa; Sepulveda, Carolyn; Torres, Julian

2016-12-01

Religiousness, spirituality, and social support have all been identified as having a positive impact on overall mental health outcomes. The current study describes quantitative and qualitative assessment of parental and God representations among individuals diagnosed with schizophrenia or schizoaffective disorder (N = 46). Six salient themes emerged; participants described the importance of caregiver love and nurturance, need for God, loss of family members, love of God, concrete support provided by parents, and the ability to tolerate ambivalent feelings toward parents. Participants linked their relationships with parents and God to their process of recovery. Implications for clinical practice are discussed.

Social Media and Its Implications in Pediatric Dentistry.

PubMed

Dhar, Vineet

2018-05-15

Social media is increasingly being relied upon by health care professionals, including pediatric dentists, to make decisions in their practices. While social media serves as an excellent resource, there is lack of sound guidelines on its use by health professionals in dentistry. Pediatric dentists using social media for professional purposes need to be aware of the uses as well as the challenges it presents. More importantly, members and moderators of social media groups should ensure that all patient care-related information is de-identified and discussions are compliant with federal and state privacy laws and based on evidence-based recommendations.

Sexual Relationships, Behaviors, and Experiences among Bisexual Men in Mumbai, India.

PubMed

Dodge, Brian; Banik, Swagata; Bowling, Jessamyn; Sivasubramanian, Murugesan; Mengle, Shruta; Schick, Vanessa; Herbenick, Debby; Kavi, Ashok Row; Anand, Vivek

2016-01-01

This exploratory study aimed to assess a range of sexual behaviors, relationships and related factors among a sample of bisexual men in Mumbai, India. Data collection occurred in two separate phases: 1. focus group discussions were facilitated with local community members in order to finalize an interviewer-administered questionnaire, and 2. structured interviews were conducted with a sample of 50 bisexual men using this questionnaire. Participants self-reported a wide range of sexual behaviors and relationships. Findings have implications for future research and practice focusing on bisexual men in India, as well as their partners of all genders.

Sexual Relationships, Behaviors, and Experiences among Bisexual Men in Mumbai, India

PubMed Central

Dodge, Brian; Banik, Swagata; Bowling, Jessamyn; Sivasubramanian, Murugesan; Mengle, Shruta; Schick, Vanessa; Herbenick, Debby; Kavi, Ashok Row; Anand, Vivek

2015-01-01

This exploratory study aimed to assess a range of sexual behaviors, relationships and related factors among a sample of bisexual men in Mumbai, India. Data collection occurred in two separate phases: 1. focus group discussions were facilitated with local community members in order to finalize an interviewer-administered questionnaire, and 2. structured interviews were conducted with a sample of 50 bisexual men using this questionnaire. Participants self-reported a wide range of sexual behaviors and relationships. Findings have implications for future research and practice focusing on bisexual men in India, as well as their partners of all genders. PMID:27073588

Lessons Learned from an LGBTQ Senior Center: A Bronx Tale.

PubMed

McGovern, Justine; Brown, Dwayne; Gasparro, Vita

This article describes an interdisciplinary pilot study exploring the impact of LGBTQ senior centers on the lives of center members. Many LGBTQ adults face the future having experienced stigma and bias, restricted rights, and rejection from family of origin, and are now growing older without the support of a partner and adult children. As a result, older LGBTQ adults experience higher rates of depression, loneliness and isolation, and shortened life expectancy as compared to non-LGBTQ peers. Findings from focus group and key informant interviews highlight features of LGBTQ senior center experiences that can significantly improve members' quality of life. These include providing family, acceptance and a home, which can have an impact on outlook and outcomes. Moreover, findings suggest the need for re-thinking hetero-normative definitions of "community" in the context of LGBTQ aging. Beyond sharing findings from the study, suggesting a conceptual framework for deepening understanding about LGBTQ aging, and identifying lines of future inquiry, the article articulates implications for social work research, practice and education. Ultimately, the article argues that social work is well positioned to improve quality of life for this under-served population when it adopts a cultural humility stance in research, practice and education.

Evidence-based clinical policy: case report of a reproducible process to encourage understanding and evaluation of evidence.

PubMed

Rikard-Bell, G; Waters, E; Ward, J

2006-07-01

We report within a case study a reproducible process to facilitate the explicit incorporation of evidence by a multidisciplinary group into clinical policy development. To support the decision-making of a multidisciplinary Intersectoral Advisory Group (IAG) convened by the Royal Australasian College of Physicians Health Policy Unit, a systematic review of randomized controlled trials about environmental tobacco smoke and smoking cessation interventions in paediatric settings was first undertaken. As reported in detail here, IAG members were then formally engaged in a transparent and replicable process to understand and interpret the synthesized evidence and to proffer their independent reactions regarding policy, practice and research. Our intention was to ensure that all IAG members were democratically engaged and made aware of the available evidence. As clinical policy must engage stakeholder representatives from diverse backgrounds, a process to equalize understanding of the evidence and 'democratize' judgment about its implications is needed. Future research must then examine the benefits of such explicit steps when guidelines, in turn, are implemented. We hypothesize that changes to future practice will be more likely if processes undertaken to develop guidelines are transparent to clinicians and other target groups.

Developing a practice guideline for the occupational health services by using a community of practice approach: a process evaluation of the development process.

PubMed

Kwak, Lydia; Wåhlin, Charlotte; Stigmar, Kjerstin; Jensen, Irene

2017-01-18

One way to facilitate the translation of research into the occupational health service practice is through clinical practice guidelines. To increase the implementability of guidelines it is important to include the end-users in the development, for example by a community of practice approach. This paper describes the development of an occupational health practice guideline aimed at the management of non-specific low back pain (LBP) by using a community of practice approach. The paper also includes a process evaluation of the development providing insight into the feasibility of the process. A multidisciplinary community of practice group (n = 16) consisting of occupational nurses, occupational physicians, ergonomists/physical therapists, health and safety engineers, health educators, psychologists and researchers from different types of occupational health services and geographical regions within Sweden met eleven times (June 2012-December 2013) to develop the practice guideline following recommendations of guideline development handbooks. Process-outcomes recruitment, reach, context, satisfaction, feasibility and fidelity were assessed by questionnaire, observations and administrative data. Group members attended on average 7.5 out of 11 meetings. Half experienced support from their workplace for their involvement. Feasibility was rated as good, except for time-scheduling. Most group members were satisfied with the structure of the process (e.g. presentations, multidisciplinary group). Fidelity was rated as fairly high. The described development process is a feasible process for guideline development. For future guideline development expectations of the work involved should be more clearly communicated, as well as the purpose and tasks of the CoP-group. Moreover, possibilities to improve support from managers and colleagues should be explored. This paper has important implications for future guideline development; it provides valuable information on how practitioners can be included in the development process, with the aim of increasing the implementability of the developed guidelines.

Promoting High-Quality Cancer Care and Equity Through Disciplinary Diversity in Team Composition.

PubMed

Parsons, Susan K; Fineberg, Iris C; Lin, Mingqian; Singer, Marybeth; Tang, May; Erban, John K

2016-11-01

Disciplinary diversity in team composition is a valuable vehicle for oncology care teams to provide high-quality, person-centered comprehensive care. Such diversity facilitates care that effectively addresses the complex needs (biologic, psychosocial, and spiritual) of the whole person. The concept of professional or disciplinary diversity centers on differences in function, education, and culture, reflecting variety and heterogeneity in the perspectives of team members contributing to care. Thorough understanding of the skills, knowledge, and education related to each team member's professional or lay expertise is critical for members to be able to optimize the team's potential. Furthermore, respect and appreciation for differences and similarities across disciplinary cultures allow team members to create a positive collaboration dynamic that maintains a focus on the care of the person with cancer. We present a case study of one oncology team's provision of care to the patient, a Chinese immigrant woman with breast cancer. The case illuminates the strengths and challenges of disciplinary diversity in team composition in assessing and addressing potential barriers to care. Coordinated sharing of information among the varied team members facilitated understanding and care planning focused on the patient's concerns, needs, and strengths. Importantly, collaboration across the disciplinarily diverse set of team members facilitated high-quality oncology care and promoted equity in access to the full range of care options, including enrollment on a National Cancer Institute-sponsored clinical trial. Further implications of disciplinary diversity in oncology care teams are considered for both clinical practice and research.

Migrant mothers, left-behind fathers: the negotiation of gender subjectivities in Indonesia and the Philippines.

PubMed

Lam, Theodora; Yeoh, Brenda S A

2018-01-01

The distinct feminization of labour migration in Southeast Asia - particularly in the migration of breadwinning mothers as domestic and care workers in gender-segmented global labour markets - has altered care arrangements, gender roles and practices, as well as family relationships within the household significantly. Such changes were experienced by both the migrating women and other left-behind members of the family, particularly 'substitute' carers such as left-behind husbands. During the women's absence from the home, householding strategies have to be reformulated when migrant women-as-mothers rewrite their roles (but often not their identities) through labour migration as productive workers who contribute to the well-being of their children via financial remittances and 'long-distance mothering', while left-behind fathers and/or other family members step up to assume some of the tasks vacated by the mother. Using both quantitative and qualitative interview material with returned migrants and left-behind household members in source communities in Indonesia and the Philippines experiencing considerable pressures from labour migration, this article explores how carework is redistributed in the migrant mother's absence, and the ensuing implications on the gender roles of remaining family members, specifically left-behind fathers. It further examines how affected members of the household negotiate and respond to any changing gender ideologies brought about by the mother's migration over time.

Migrant mothers, left-behind fathers: the negotiation of gender subjectivities in Indonesia and the Philippines

PubMed Central

Lam, Theodora; Yeoh, Brenda S. A.

2018-01-01

Abstract The distinct feminization of labour migration in Southeast Asia – particularly in the migration of breadwinning mothers as domestic and care workers in gender-segmented global labour markets – has altered care arrangements, gender roles and practices, as well as family relationships within the household significantly. Such changes were experienced by both the migrating women and other left-behind members of the family, particularly ‘substitute’ carers such as left-behind husbands. During the women’s absence from the home, householding strategies have to be reformulated when migrant women-as-mothers rewrite their roles (but often not their identities) through labour migration as productive workers who contribute to the well-being of their children via financial remittances and ‘long-distance mothering’, while left-behind fathers and/or other family members step up to assume some of the tasks vacated by the mother. Using both quantitative and qualitative interview material with returned migrants and left-behind household members in source communities in Indonesia and the Philippines experiencing considerable pressures from labour migration, this article explores how carework is redistributed in the migrant mother’s absence, and the ensuing implications on the gender roles of remaining family members, specifically left-behind fathers. It further examines how affected members of the household negotiate and respond to any changing gender ideologies brought about by the mother’s migration over time. PMID:29682633

Implications of privacy needs and interpersonal distancing mechanisms for space station design

NASA Technical Reports Server (NTRS)

Harrison, Albert A.; Sommer, Robert; Struthers, Nancy; Hoyt, Kathleen

1988-01-01

Isolation, confinement, and the characteristics of microgravity will accentuate the need for privacy in the proposed NASA space station, yet limit the mechanism available for achieving it. This study proposes a quantitative model for understanding privacy, interpersonal distancing, and performance, and discusses the practical implications for Space Station design. A review of the relevant literature provided the basis for a database, definitions of physical and psychological distancing, loneliness, and crowding, and a quantitative model of situational privacy. The model defines situational privacy (the match between environment and task), and focuses on interpersonal contact along visual, auditory, olfactory, and tactile dimensions. It involves summing across pairs of crew members, contact dimensions, and time, yet also permits separate analyses of subsets of crew members and contact dimensions. The study concludes that performance will benefit when the type and level of contact afforded by the environment align with that required by the task. The key to achieving this is to design a flexible, definable, and redefinable interior environment that provides occupants with a wide array of options to meet their needs for solitude, limited social interaction, and open group activity. The report presents 49 recommendations in five categories to promote a wide range of privacy options despite the space station's volumetric limitations.

Being smart or getting smarter: Implicit theory of intelligence moderates stereotype threat and stereotype lift effects.

PubMed

Froehlich, Laura; Martiny, Sarah E; Deaux, Kay; Goetz, Thomas; Mok, Sog Yee

2016-09-01

This research explores implicit theory of intelligence (TOI) as a moderator of stereotype activation effects on test performance for members of negatively stereotyped and of favourably stereotyped groups. In Germany, Turkish-origin migrants are stereotyped as low in verbal ability. We predicted that on a test diagnostic of verbal intelligence, endorsement of an entity TOI predicts stereotype threat effects for Turkish-origin students and stereotype lift effects for German students. This effect could account for some of the performance gap between immigrants and host society members after stereotype activation. Study 1 (N = 107) established structural equivalence of implicit theories across the ethnic groups. In two experimental studies (Study 2: N = 182, Study 3: N = 190), we tested the moderating effect of TOI in a 2 (stereotype activation: diagnostic vs. non-diagnostic test) × 2 (ethnicity: German vs. Turkish migration background) experimental design. The results showed that when the test was described as diagnostic of verbal intelligence, higher entity theory endorsement predicted stereotype threat effects for Turkish-origin students (Study 2 and Study 3) and stereotype lift effects for German students (Study 3). The results are discussed in terms of practical implications for educational settings and theoretical implications for processes underlying stereotype activation effects. © 2016 The British Psychological Society.

Role construction and boundaries in interprofessional primary health care teams: a qualitative study.

PubMed

MacNaughton, Kate; Chreim, Samia; Bourgeault, Ivy Lynn

2013-11-24

The move towards enhancing teamwork and interprofessional collaboration in health care raises issues regarding the management of professional boundaries and the relationship among health care providers. This qualitative study explores how roles are constructed within interprofessional health care teams. It focuses on elucidating the different types of role boundaries, the influences on role construction and the implications for professionals and patients. A comparative case study was conducted to examine the dynamics of role construction on two interprofessional primary health care teams. The data collection included interviews and non-participant observation of team meetings. Thematic content analysis was used to code and analyze the data and a conceptual model was developed to represent the emergent findings. The findings indicate that role boundaries can be organized around interprofessional interactions (giving rise to autonomous or collaborative roles) as well as the distribution of tasks (giving rise to interchangeable or differentiated roles). Different influences on role construction were identified. They are categorized as structural (characteristics of the workplace), interpersonal (dynamics between team members such as trust and leadership) and individual dynamics (personal attributes). The implications of role construction were found to include professional satisfaction and more favourable wait times for patients. A model that integrates these different elements was developed. Based on the results of this study, we argue that autonomy may be an important element of interprofessional team functioning. Counter-intuitive as this may sound, we found that empowering team members to develop autonomy can enhance collaborative interactions. We also argue that while more interchangeable roles could help to lessen the workloads of team members, they could also increase the potential for power struggles because the roles of various professions would become less differentiated. We consider the conceptual and practical implications of our findings and we address the transferability of our model to other interprofessional teams.

Role construction and boundaries in interprofessional primary health care teams: a qualitative study

PubMed Central

2013-01-01

Background The move towards enhancing teamwork and interprofessional collaboration in health care raises issues regarding the management of professional boundaries and the relationship among health care providers. This qualitative study explores how roles are constructed within interprofessional health care teams. It focuses on elucidating the different types of role boundaries, the influences on role construction and the implications for professionals and patients. Methods A comparative case study was conducted to examine the dynamics of role construction on two interprofessional primary health care teams. The data collection included interviews and non-participant observation of team meetings. Thematic content analysis was used to code and analyze the data and a conceptual model was developed to represent the emergent findings. Results The findings indicate that role boundaries can be organized around interprofessional interactions (giving rise to autonomous or collaborative roles) as well as the distribution of tasks (giving rise to interchangeable or differentiated roles). Different influences on role construction were identified. They are categorized as structural (characteristics of the workplace), interpersonal (dynamics between team members such as trust and leadership) and individual dynamics (personal attributes). The implications of role construction were found to include professional satisfaction and more favourable wait times for patients. A model that integrates these different elements was developed. Conclusions Based on the results of this study, we argue that autonomy may be an important element of interprofessional team functioning. Counter-intuitive as this may sound, we found that empowering team members to develop autonomy can enhance collaborative interactions. We also argue that while more interchangeable roles could help to lessen the workloads of team members, they could also increase the potential for power struggles because the roles of various professions would become less differentiated. We consider the conceptual and practical implications of our findings and we address the transferability of our model to other interprofessional teams. PMID:24267663

'You feel helpless, that's exactly it': parents' and young people's control beliefs about bed-wetting and the implications for practice.

PubMed

Morison, M J; Tappin, D; Staines, H

2000-05-01

'You feel helpless, that's exactly it': parents' and young people's control beliefs about bed-wetting and the implications for practice Young people wet the bed when they fail to wake up to a full bladder. The causes of bed-wetting are far from certain and this uncertainty is reflected in the diversity of treatments on offer and the lack of any guarantee that treatment will work in a particular case. Most young people are sad and ashamed about the bed-wetting and want it to stop, but they vary widely in their belief in their own capacity to influence the situation, and in their optimism about what the future holds. The problem can persist into adolescence or even adulthood, with far reaching social and emotional consequences, both for the young people and their families. In an ethnographic study involving 19 families 'perceived helplessness' emerged as a key issue permeating the whole system and often activating a downward spiral, leading to abdication of effort and responsibility by the young people themselves, by their parents and sometimes by health care professionals. Informed by the insights gained from this study and an extensive review of the literature on perceived control the Family Perspectives on Bed Wetting Questionnaire has been developed to explore family members' feelings, degree of concern and dimensions of perceived control relating to: effort, ability, luck, important others and the unknown. This questionnaire was used as a basis for structured interviews with family members in a longitudinal survey, involving 40 families attending one of nine community-based, nurse-led enuresis clinics in Greater Glasgow. It was found that only 38% of the young people were entering into treatment with the belief that they had the ability to be dry at night. This became self-fulfilling, with only 33% achieving initial success of 14 consecutive dry nights in a 16-week period (chi-squared test, P=0.029). Seventy per cent of young people felt that luck was important, while most parents felt that luck had little part to play. Implications for practice include the need to assess the families' readiness to engage in treatment, to create opportunities for effective control and to encourage realistic expectations.

An exploration of attitudes towards female genital mutilation (FGM) in men and women accessing FGM clinical services in London: a pilot study.

PubMed

Larsson, Martina; Cohen, Pollyanna; Hann, Gayle; Creighton, Sarah M; Hodes, Deborah

2018-03-21

This pilot study researched the attitudes towards and the knowledge of female genital mutilation (FGM) in adult women with FGM and their partners. The participant population consisted of English-speaking women and men over 18 years old attending specialist FGM clinics in two London hospitals. The participants completed a questionnaire on the attitudes and the knowledge of FGM, which were adapted with permission from the United Nations Children's Fund and the United States Agency for International Development household surveys. 54 participants (51 women, 3 men) took part in the surveys. 89% of participants thought that FGM should be stopped (95%CI: 0.81-0.97) and 72% said they knew FGM is illegal in the United Kingdom (UK). 15% reported that FGM caused no danger, or were unaware of any danger to women's health. This study demonstrates the opposition to FGM by participants, but some lack of knowledge regarding the legal and health implications. The exploration of attitudes in diaspora community groups is often cited as key to safeguarding girls from FGM. This is one of the first UK studies of individuals from FGM-practising communities, and we recommend use of the study questionnaires for a multicentre, cross-community study. Impact statement What is already known about this subject? Women and children are affected by female genital mutilation (FGM) globally and in the United Kingdom (UK). The majority of knowledge on practices and the attitudes towards FGM comes from UNICEF and USAID research in Africa and there is scant data on FGM practices in diaspora communities in the UK. What do the results of this study add? This study provides an appropriate questionnaire and protocol for use in community-based national research to improve healthcare for women by collecting up-to-date data on the attitudes towards FGM among the members of FGM-practising communities in the UK. What are the implications of these findings for clinical practice and further research? The implications of the results of this study are that health professionals need to understand that patients do not always know the law on FGM, even after a consultation. Health and social care professionals are placed in a unique position to work with community members to educate men and women to end FGM.

Reflecting, refueling, and reframing: a 10-year retrospective model for faculty development and its implications for nursing scholarship.

PubMed

Alteen, Anna Marie; Didham, Paula; Stratton, Cathy

2009-06-01

In this article, the authors retrace their journey during the past 10 years as faculty members engaged in the implementation of a new bachelor of nursing (collaborative) program. They outline the major personal challenges related to increasing credentials and portfolio development for teachers within a university environment. The authors extrapolate from the relevant literature on teaching and scholarship, and thereby analyze the methodologies that enhanced the faculty development process for them during this time. Specifically, they discuss the methods that facilitated meaningful reflection on their new roles and responsibilities; nurtured their professional growth and afforded opportunities for refueling and reenergizing along the way; and provided a vision for reframing their practice as nurse educators in light of previous experiences. With reference to Boyer's model of scholarship, the authors also explore possible implications for further analysis of the faculty development process within the broader context of nursing scholarship.

Familism and Health Care Provision to Hispanic Older Adults.

PubMed

Savage, Brittany; Foli, Karen J; Edwards, Nancy E; Abrahamson, Kathleen

2016-01-01

The Hispanic older adult population's rapid growth calls for an awareness of values that can affect the rendering and receipt of care. Familism, or familismo, a traditional Hispanic value, places importance of family over the self and can potentially affect health care perceptions and practices for Hispanic older adults. The current article discusses familism, which is upheld by some Hispanic older adults, and the potential for underuse of health care services. The traditional feminine role, marianismo, and masculine role, machismo, are considered, as well as implications for how decision making may be made by family members rather than the patient. Clinical implications for the provision of health care to Hispanic older adults are provided, along with the importance of considering acculturation and ethnic heterogeneity. Health care management strategies that reflect recognition and respect of familism, yet emphasize optimization of adherence and self-care, are described. Copyright 2016, SLACK Incorporated.

The global diffusion of organ transplantation: trends, drivers and policy implications

PubMed Central

Hirth, Richard; Mahíllo, Beatriz; Domínguez-Gil, Beatriz; Delmonico, Francis L; Noel, Luc; Chapman, Jeremy; Matesanz, Rafael; Carmona, Mar; Alvarez, Marina; Núñez, Jose R; Leichtman, Alan

2014-01-01

Abstract Rising incomes, the spread of personal insurance, lifestyle factors adding to the burden of illness, ageing populations, globalization and skills transfer within the medical community have increased worldwide demand for organ transplantation. The Global Observatory on Donation and Transplantation, which was built in response to World Health Assembly resolution WHA57.18, has conducted ongoing documentation of global transplantation activities since 2007. In this paper, we use the Global Observatory’s data to describe the current distribution of – and trends in – transplantation activities and to evaluate the role of health systems factors and macroeconomics in the diffusion of transplantation technology. We then consider the implications of our results for health policies relating to organ donation and transplantation. Of the World Health Organization’s Member States, most now engage in organ transplantation and more than a third performed deceased donor transplantation in 2011. In general, the Member States that engage in organ transplantation have greater access to physician services and greater total health spending per capita than the Member States where organ transplantation is not performed. The provision of deceased donor transplantation was closely associated with high levels of gross national income per capita. There are several ways in which governments can support the ethical development of organ donation and transplantation programmes. Specifically, they can ensure that appropriate legislation, regulation and oversight are in place, and monitor donation and transplantation activities, practices and outcomes. Moreover, they can allocate resources towards the training of specialist physicians, surgeons and transplant coordinators, and implement a professional donor-procurement network. PMID:25378744

The global diffusion of organ transplantation: trends, drivers and policy implications.

PubMed

White, Sarah L; Hirth, Richard; Mahíllo, Beatriz; Domínguez-Gil, Beatriz; Delmonico, Francis L; Noel, Luc; Chapman, Jeremy; Matesanz, Rafael; Carmona, Mar; Alvarez, Marina; Núñez, Jose R; Leichtman, Alan

2014-11-01

Rising incomes, the spread of personal insurance, lifestyle factors adding to the burden of illness, ageing populations, globalization and skills transfer within the medical community have increased worldwide demand for organ transplantation. The Global Observatory on Donation and Transplantation, which was built in response to World Health Assembly resolution WHA57.18, has conducted ongoing documentation of global transplantation activities since 2007. In this paper, we use the Global Observatory's data to describe the current distribution of - and trends in - transplantation activities and to evaluate the role of health systems factors and macroeconomics in the diffusion of transplantation technology. We then consider the implications of our results for health policies relating to organ donation and transplantation. Of the World Health Organization's Member States, most now engage in organ transplantation and more than a third performed deceased donor transplantation in 2011. In general, the Member States that engage in organ transplantation have greater access to physician services and greater total health spending per capita than the Member States where organ transplantation is not performed. The provision of deceased donor transplantation was closely associated with high levels of gross national income per capita. There are several ways in which governments can support the ethical development of organ donation and transplantation programmes. Specifically, they can ensure that appropriate legislation, regulation and oversight are in place, and monitor donation and transplantation activities, practices and outcomes. Moreover, they can allocate resources towards the training of specialist physicians, surgeons and transplant coordinators, and implement a professional donor-procurement network.

The Role of Natural Support Systems in the Post-deployment Adjustment of Active Duty Military Personnel.

PubMed

Welsh, Janet A; Olson, Jonathan; Perkins, Daniel F; Travis, Wendy J; Ormsby, LaJuana

2015-09-01

This study examined the relations among three different types of naturally occurring social support (from romantic partners, friends and neighbors, and unit leaders) and three indices of service member well-being (self reports of depressive symptoms, satisfaction with military life, and perceptions of unit readiness) for service members who did and did not report negative experiences associated with military deployment. Data were drawn from the 2011 Community Assessment completed anonymously by more than 63,000 USAF personnel. Regression analyses revealed that higher levels of social support was associated with better outcomes regardless of negative deployment experiences. Evidence of moderation was also noted, with all forms of social support moderating the impact of negative deployment experiences on depressive symptoms and support from unit leaders moderating the impact of negative deployment experience on satisfaction with military life. No moderation was found for perceptions of unit readiness. Subgroup analyses revealed slightly different patterns for male and female service members, with support providing fewer moderation effects for women. These findings may have value for military leaders and mental health professionals working to harness the power of naturally occurring relationships to maximize the positive adjustment of service members and their families. Implications for practices related to re-integration of post-deployment military personnel are discussed.

Frequency rates and correlates of contrapower harassment in higher education.

PubMed

DeSouza, Eros R

2011-01-01

The current study investigated incivility, sexual harassment, and racial-ethnic harassment simultaneously when the targets were faculty members and the perpetrators were students (i.e., academic contrapower harassment; ACH). The sample constituted 257 faculty members (90% were White and 53% were women) from a medium-sized state university in the Midwestern United States. They completed an anonymous survey, including an openended question about a critical ACH incident. The findings revealed that 72% of the total sample had experienced some type of mistreatment from students during the past 2 years. The author hypothesized gender differences in frequency rates for overall ACH, incivility, and sexual harassment; however, there were none. Hence, this hypothesis was not supported. The author also hypothesized that incivility would predict sexual and ethnic harassment. This hypothesis was generally supported. Furthermore, he hypothesized that demographic, work-related, and tolerance for faculty-student romance would predict ACH and its subscales. The findings generally supported this hypothesis, with somewhat different predictors by gender. He also hypothesized that harassed faculty, especially women, would experience worse job-related outcomes than never harassed faculty. Neither gender nor the interaction was significant, but the main effect for harassment was, with harassed faculty members experiencing worse job-related outcomes than nonharassed faculty members. Thus this hypothesis was partially supported. Practical implications are discussed.

Engaging military parents in a home-based reintegration program: a consideration of strategies.

PubMed

Ross, Abigail M; DeVoe, Ellen R

2014-02-01

For more than a decade, the long wars in Afghanistan and Iraq have placed tremendous and cumulative strain on U.S. military personnel and their families. The high operational tempo, length, and number of deployments-and greater in-theater exposure to threat-have resulted in well-documented psychological health concerns among service members and veterans. In addition, there is increasing and compelling evidence describing the significant deleterious impact of the deployment cycle on family members, including children, in military-connected families. However, rates of engagement and service utilization in prevention and intervention services continue to lag far below apparent need among service members and their families, because of both practical and psychological barriers. The authors describe the dynamic and ultimately successful process of engaging military families with young children in a home-based reintegration program designed to support parenting and strengthen parent-child relationships as service member parents move back into family life. In addition to the integration of existing evidence-based engagement strategies, the authors applied a strengths-based approach to working with military families and worked from a community-based participatory foundation to enhance family engagement and program completion. Implications for engagement of military personnel and their loved ones are discussed.

Protection against perceptions of powerlessness and helplessness during palliative care: the family members' perspective.

PubMed

Milberg, Anna; Strang, Peter

2011-09-01

Resilience in relation to coping with stress, loss, and bereavement has recently received increased attention. The aim of the current study was to describe aspects that are experienced as a protection against powerlessness and/or helplessness during advanced palliative home care (APHC) or as a help when coping with such perceptions. Both family members during ongoing APHC and family members 3-9 months after the patient's death responded (in total, N = 233; response rate 72%) to a postal questionnaire with mainly open-ended questions. The text responses were analyzed using Manifest Content Analysis. Protection against powerlessness and helplessness had been facilitated by a stable patient condition, the patient coping well, a trusting relationship with the patient, practical and emotional support from family and friends, access to palliative expertise, and staff support that was both individually-focused and cooperative. Other aspects that had helped or protected family members against powerlessness and helplessness were a belief that they had their own reliable knowledge to manage the difficult situation, talking to someone, doing good for the patient, distracting activities, acceptance, meaning and hope, and an inner feeling of security. The findings are discussed in relation to existential psychology, the dual process model of coping with bereavement, and repressive coping. Clinical implications are suggested.

Knowledge, attitude, and practice about malaria: Socio-demographic implications for malaria control in rural Ghana.

PubMed

Assan, Abraham; Takian, Amirhossein; Hanafi-Bojd, Ahmad Ali; Rahimiforoushani, Abbas; Nematolahi, Shahrzad

2017-11-01

Despite continuing international attention to malaria prevention, the disease remains a global public health problem. We investigated socio-demographic factors influencing knowledge, attitudes, and practices about malaria in rural Ghana. Our survey looked at 354 households. Mean knowledge score was higher among individuals with a history of volunteers having visited their households to educate them about malaria; families with 4-6 members; and males. Households with at least one under-five-aged child also had significantly higher knowledge scores. Households with at least one pregnant woman evinced a positive attitude towards malaria prevention. National malaria control strategies have achieved positive results in the fight against malaria. Nonetheless, multipronged community-based health strategies that integrate malaria programs and population growth control initiatives may be able to reach by 2030 the sustainable development goal of eliminating malaria.

'It's a cultural expectation...' The pressure on medical trainees to work independently in clinical practice.

PubMed

Kennedy, Tara J T; Regehr, Glenn; Baker, G Ross; Lingard, Lorelei A

2009-07-01

Medical trainees demonstrate a reluctance to ask for help unless they believe it is absolutely necessary, a situation which could impact on the safety of patients. This study aimed to develop a theoretical exploration of the pressure on medical trainees to be independent and to generate theory-based approaches to the implications for patient safety of this pressure towards independent working. In Phase 1, 88 teaching team members from internal and emergency medicine were observed during clinical activities (216 hours), and 65 participants completed brief interviews. In Phase 2, 36 in-depth interviews were conducted using video vignettes. Data collection and analysis employed grounded theory methodology. Participants conceived that the pressure towards independence in clinical work originated in trainees' desire to lay claim to the identity of a doctor (as a member of a group of autonomous high achievers), and in organisational issues such as heavy workloads and constant evaluations. The identity and organisational issues related to the pressure towards independence were explored through the lenses of established theories from education and psychology. Consideration of Lave and Wenger's situated learning theory suggests that giving attention to the 'independent doctor' ideal, through measures such as involving trainees when their supervisors ask for help, could impact the safety of teaching team practice. Amalberti et al.'s migration model explains how pressures to maximise productivity and individual gain may cause teaching teams to migrate beyond the boundaries of safe practice and suggests that managing triggers (such as workload and high-stakes evaluations) for violations of safe practice might improve safety. Implementation and evaluation of these theory-based approaches to the safety of teaching team practice would contribute to a better understanding of the links between trainee independence and patient safety.

Salient Multiculturalism Enhances Minority Group Members' Feelings of Power.

PubMed

Vorauer, Jacquie D; Quesnel, Matthew S

2017-02-01

The present research examined how messages advocating different intergroup ideologies affect outcomes relevant to minority group members' ability to exert power in exchanges with dominant group members. We expected that salient multiculturalism would have positive implications for minority group members' feelings of power by virtue of highlighting essential contributions they make to society, and that no such empowering effect would be evident for them in connection with alternative ideologies such as color-blindness or for dominant group members. Results across four studies involving different participant populations, operationalizations of ideology, ethnic minority groups, and experimental settings were consistent with these hypotheses and further indicated that the effects of salient multiculturalism on feelings of power had downstream implications for expectations of control in an ostensibly upcoming intergroup interaction and general goal-directed cognition.

The Stopit! programme to reduce bullying and undermining behaviour in hospitals.

PubMed

Benmore, Graham; Henderson, Steven; Mountfield, Joanna; Wink, Brian

2018-05-21

Purpose The impact of bullying and undermining behaviours on the National Health Service on costs, patient safety and retention of staff was well understood even before the Illing report, published in 2013, that reviewed the efficacy of training interventions designed to reduce bullying and harassment in the outputs. The purpose of this paper is to provide an example of a good programme well evaluated. Design/methodology/approach The methodology follows a broad realist approach, by specifying the underlying programme assumptions and intention of the designers. Three months after the event, Q-sort methodology was employed to group participants into one of three contexts - mechanism - output groups. Interviews were then undertaken with members of two of these groups, to evaluate how the programme had influenced each. Findings Q-sort identified a typology of three beneficiaries from the Stopit! workshops, characterised as professionals, colleagues and victims. Each group had acted upon different parts of the programme, depending chiefly upon their current and past experiences of bullying in hospitals. Research limitations/implications The paper demonstrates the effectiveness of using Q-sort method to identify relevant CMOs in a realist evaluation framework. Practical implications The paper considers the effectiveness of the programme to reduce bullying, rather than teach victims to cope, and how it may be strengthened based upon the research findings and Illing recommendations. Social implications Workplace bullying is invariably implicated in scandals concerning poor hospital practice, poor patient outcomes and staff illness. All too frequently, the sector responds by offering training in resilience, which though helpful, places the onus on the victim to cope rather than the employer to reduce or eliminate the practice. This paper documents and evaluates an attempt to change workplace practices to directly address bullying and undermining. Originality/value The paper describes a new programme broadly consistent with Illing report endorsements. Second, it illustrates a novel evaluation method that highlights rigorously the contexts, mechanisms and outcomes at the pilot stage of an intervention identifies contexts and mechanisms via factor analysis using Q-sort methodology.

An Exploration of Global Leadership Practices Implemented by Successful Higher Education Faculty Members

ERIC Educational Resources Information Center

Marshall, Vicki Lynn

2015-01-01

This qualitative research study explored global leadership practices implemented by higher education faculty members from eight different states in the U.S. who lead in a global environment. Four research questions guided the exploration of personal and scholarly practices that successful higher education faculty members implement. A purposeful,…

CIGARETTE SMOKING BEHAVIOR AMONG SOUTH AFRICAN INDIAN HIGH SCHOOL STUDENTS

PubMed Central

Bayat, Mahomed; Pillay, Basil J.; Cassimjee, Mohammed H.

1998-01-01

Objective: The aim of the study was to assess the knowledge, attitude and practice of cigarette smoking behavior (CSB) in a sample of Indian matriculation students. Methodology: All (N=325) Indian matriculation students, at high schools, in Northern Kwa-Zulu Natal, South Africa, were included in the study. A questionnaire was administered to assess knowledge, attitudes and practice of CSB. Results and conclusion: The study showed a prevalence of 16.9%. Most smokers (98.2%) had commenced the practice after the age of 10 years. The most common reason given for CSB was experimentation (83.6%). Main influence was family members followed by teachers and advertisements. The association between smoking and lung cancer was well-known by smokers (90.7%). There was very little awareness of anti-smoking programmes or organizations. Alarmingly, there was little formal health education on the dangers of smoking in schools. The implications of these results are discussed and recommendations on decreasing CSB are made. PMID:23008583

Genetics of Movement Disorders and the Practicing Clinician; Who and What to Test for?

PubMed

Di Fonzo, Alessio; Monfrini, Edoardo; Erro, Roberto

2018-05-23

This review aims to provide the basic knowledge on the genetics of hypokinetic and hyperkinetic movement disorders to guide clinicians in the decision of "who and what to test for?" In recent years, the identification of various genetic causes of hypokinetic and hyperkinetic movement disorders has had a great impact on a better definition of different clinical syndromes. Indeed, the advent of next-generation sequencing (NGS) techniques has provided an impressive step forward in the easy identification of genetic forms. However, this increased availability of genetic testing has challenges, including the ethical issue of genetic testing in unaffected family members, "commercially" available home testing kits and the increasing number and relevance of "variants of unknown significance." The emergent role of genetic factors has important implications on clinical practice and counseling. As a consequence, it is fundamental that practicing neurologists have a proper knowledge of the genetic background of the diseases and perform an accurate selection of who has to be tested and for which gene mutations.

Advancing nursing practice through social media: a global perspective.

PubMed

Barry, Jean; Hardiker, Nicholas R

2012-08-14

Social media has been used globally as a key vehicle for communication. As members of an innovative profession, many nurses have embraced social media and are actively utilizing its potential to enhance practice and improve health. The ubiquity of the Internet provides social media with the potential to improve both access to health information and services and equity in health care. Thus there are a number of successful nurse-led initiatives. However, the open and democratising nature of social media creates a number of potential risks, both individual and organisational. This article considers the use of social media within nursing from a global perspective, including discussion of policy and guidance documents. The impact of social media on both healthcare consumers and nurses is reviewed, followed by discussion of selected risks associated with social media. To help nurses make the most of social media tools and avoid potential pitfalls, the article conclusion suggests implications appropriate for global level practice based on available published guidance.

[Medical safety in infectious disease--chairmen's introductory remarks].

PubMed

Shimetani, Naoto; Miida, Takashi

2012-10-01

"The National Joint Action of Risk Management" was started in May 2008. The Japanese Society of Laboratory Medicine took this opportunity to set up a Medical Safety Committee as a participant in this Action. The Society holds symposia concerning medical safety to educate the Society members. Nosocomial infections are medical accidents. Whereas community-acquired infections are likely to develop depending on a balance between pathogens and hosts, nosocomial infections are implicated with medical practices, so they develop depending on the interrelationship among pathogens, hosts, and medical practices. Medical practices are mostly indispensable for providing medical services; therefore, activities against nosocomial infections are critical for establishing medical safety, freedom from anxiety, and reliability. Hence, this symposium deals with five themes: Countermeasures against and the management of needle-stick and cut accidents, collaboration between the infection control team (ICT) and the bacteriology laboratory, information transmission from the clinical laboratory department to physicians engaged in infectious disease treatment, utilization of laboratory data for infection control, and medical safety against tuberculosis infection.

Financial remuneration for clinical and behavioral research participation: ethical and practical considerations.

PubMed

Permuth-Wey, Jennifer; Borenstein, Amy R

2009-04-01

Although the practice of providing payment to clinical research participants has been ongoing for more than a century, it remains an ethically controversial topic among members of the research community. The aims of this commentary are to summarize ethical and practical considerations regarding financial remuneration of research participants and to make recommendations for researchers contemplating this practice. A PubMed search was conducted to explore the ethical implications surrounding financial remuneration and review the body of empiric data on this topic. Financial remuneration is perceived to be ethically acceptable by many researchers and research participants and can be helpful in the recruitment process. It is recommended that when investigators are contemplating whether to offer payment to research participants, they should consider the nature of the study and the potential benefits and risks to the participants, institutional or organizational guidelines, and cultural and societal norms specific to the population being studied. Financial remuneration has the ability to serve as a sign of appreciation for the contributions of research participants and a way to facilitate clinical and behavioral research.

Exploring the interaction of personal and contextual factors during the induction period of science teachers and how this interaction shapes their enactment of science reform

NASA Astrophysics Data System (ADS)

Saka, Yavuz

The first years of teaching are demanding as the novice works to gain a degree of familiarity in her/his professional work. It is during this period that many teachers decide to leave the teaching profession or move away from the reform-minded beliefs and practices acquired during their teacher preparation programs. To understand what happens during induction requires a focus on both the cognitive and contextual issues related to science teaching. The goal of this qualitative, multi-case study was to describe the induction experiences of two reform-minded first year science teachers and the strategies they used to negotiate contradictions embedded the context of schooling. Using the frame of Cultural Historical Activity Theory, in this research I focused on changes in science teachers' personal and professional identities, self-efficacy and pedagogical discontentment, the manner in which these factors shaped science teaching practices, and beliefs and practices shaped and were shaped by the context of the novices' work. Data included a year of participant observations, surveys, open-ended questionnaires, interviews, classroom observations, and mediating artifacts such as lesson plans and assignments. Identities and dispositions of these teachers played significant role their attempts to become competent members of their school communities, attempts that influenced and were influenced by their teaching self-efficacy and pedagogical discontentment. Mild contradictions in the system allowed for the refinement of reform-minded science teaching practices, while extreme contradictions in the system served to change one teacher's goals and prevented his successful enactment of science education reform. Findings indicated that the successful enactment of reform-minded practice depends not just on contextual factors related to schools, or just on individual factors associated with science teaching. Instead, personal and contextual factors interact to shape a novice's first year experience. This research also demonstrated that participation in a professional community that both acknowledges the strengths novices bring into the community and recognizes the support novices need is essential if novices are to become successful members of a community of practice. One implication of this research is the need to move beyond a singular focus on science teaching and learning in teacher education programs to include an exploration of the affective and professional aspects of teaching. Because this research points to the important role professional development communities play in the development of reform minded science teachers, a second implication of this research is that teacher preparation programs should include a close examination of the role and importance of communities in a teacher's initial success and long term development. Clearly disbanding the professional community constructed throughout a preservice experience upon graduation is artificial and counterproductive. Instead, induction programs that include some members of the preservice science teacher's community may be invaluable for providing support, recognition, and critical lens needed for novices to examine their work as they move into schools as professionals engaged in practice of reform-based science teaching.

Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society.

PubMed

Seaquist, Elizabeth R; Anderson, John; Childs, Belinda; Cryer, Philip; Dagogo-Jack, Samuel; Fish, Lisa; Heller, Simon R; Rodriguez, Henry; Rosenzweig, James; Vigersky, Robert

2013-05-01

To review the evidence about the impact of hypoglycemia on patients with diabetes that has become available since the past reviews of this subject by the American Diabetes Association and The Endocrine Society and to provide guidance about how this new information should be incorporated into clinical practice. Five members of the American Diabetes Association and five members of The Endocrine Society with expertise in different aspects of hypoglycemia were invited by the Chair, who is a member of both, to participate in a planning conference call and a 2-day meeting that was also attended by staff from both organizations. Subsequent communications took place via e-mail and phone calls. The writing group consisted of those invitees who participated in the writing of the manuscript. The workgroup meeting was supported by educational grants to the American Diabetes Association from Lilly USA, LLC and Novo Nordisk and sponsorship to the American Diabetes Association from Sanofi. The sponsors had no input into the development of or content of the report. The writing group considered data from recent clinical trials and other studies to update the prior workgroup report. Unpublished data were not used. Expert opinion was used to develop some conclusions. Consensus was achieved by group discussion during conference calls and face-to-face meetings, as well as by iterative revisions of the written document. The document was reviewed and approved by the American Diabetes Association's Professional Practice Committee in October 2012 and approved by the Executive Committee of the Board of Directors in November 2012 and was reviewed and approved by The Endocrine Society's Clinical Affairs Core Committee in October 2012 and by Council in November 2012. The workgroup reconfirmed the previous definitions of hypoglycemia in diabetes, reviewed the implications of hypoglycemia on both short- and long-term outcomes, considered the implications of hypoglycemia on treatment outcomes, presented strategies to prevent hypoglycemia, and identified knowledge gaps that should be addressed by future research. In addition, tools for patients to report hypoglycemia at each visit and for clinicians to document counseling are provided.

Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society

PubMed Central

Anderson, John; Childs, Belinda; Cryer, Philip; Dagogo-Jack, Samuel; Fish, Lisa; Heller, Simon R.; Rodriguez, Henry; Rosenzweig, James; Vigersky, Robert

2013-01-01

OBJECTIVE To review the evidence about the impact of hypoglycemia on patients with diabetes that has become available since the past reviews of this subject by the American Diabetes Association and The Endocrine Society and to provide guidance about how this new information should be incorporated into clinical practice. PARTICIPANTS Five members of the American Diabetes Association and five members of The Endocrine Society with expertise in different aspects of hypoglycemia were invited by the Chair, who is a member of both, to participate in a planning conference call and a 2-day meeting that was also attended by staff from both organizations. Subsequent communications took place via e-mail and phone calls. The writing group consisted of those invitees who participated in the writing of the manuscript. The workgroup meeting was supported by educational grants to the American Diabetes Association from Lilly USA, LLC and Novo Nordisk and sponsorship to the American Diabetes Association from Sanofi. The sponsors had no input into the development of or content of the report. EVIDENCE The writing group considered data from recent clinical trials and other studies to update the prior workgroup report. Unpublished data were not used. Expert opinion was used to develop some conclusions. CONSENSUS PROCESS Consensus was achieved by group discussion during conference calls and face-to-face meetings, as well as by iterative revisions of the written document. The document was reviewed and approved by the American Diabetes Association’s Professional Practice Committee in October 2012 and approved by the Executive Committee of the Board of Directors in November 2012 and was reviewed and approved by The Endocrine Society’s Clinical Affairs Core Committee in October 2012 and by Council in November 2012. CONCLUSIONS The workgroup reconfirmed the previous definitions of hypoglycemia in diabetes, reviewed the implications of hypoglycemia on both short- and long-term outcomes, considered the implications of hypoglycemia on treatment outcomes, presented strategies to prevent hypoglycemia, and identified knowledge gaps that should be addressed by future research. In addition, tools for patients to report hypoglycemia at each visit and for clinicians to document counseling are provided. PMID:23589542

Implications of current resident work-hour guidelines on the future practice of surgery in Canada.

PubMed

Maruscak, Adam A; VanderBeek, Laura; Ott, Michael C; Kelly, Stephen; Forbes, Thomas L

2012-01-01

Work-hour restrictions have had a profound impact on surgical training. However, little is known of how work-hour restrictions may affect the future practice patterns of current surgical residents. The purpose of this study is to compare the anticipated career practice patterns of surgical residents who are training within an environment of work-hour restrictions with the current practice of faculty surgeons. An electronic survey was sent to all surgery residents and faculty at 2 Canadian university-affiliated medical centers. The survey consisted of questions regarding expected (residents) or current (faculty) practice patterns. A total of 149 residents and 125 faculty members completed the survey (50.3% and 52.3% response rates, respectively). A greater proportion of males were in the faculty cohort than in the resident group (77.6% vs 62.4%, p = 0.0003). More faculty than residents believed that work-hour restrictions have a negative impact on both residency education (40.8% vs 20.8%, p = 0.008) and preparation for a surgical career (56.8% vs 19.5%, p < 0.0001). Compared with current faculty, residents plan to take less call (p < 0.0003), work fewer days of the week (p < 0.0001), are more likely to limit their duty hours on postcall days (p = 0.009), and take parental leave (p = 0.02) once in practice. Male and female residents differed somewhat in their responses in that more female residents plan to limit their postcall duty hours (55.4% vs 36.5%, p = 0.009) and to take a parental leave (51.8% vs 16.1%, p < 0.0001) compared with their male resident colleagues. Current surgical residents expect to adopt components of resident work-hour guidelines into their surgical practices after completing their residency. These practice patterns will have surgical workforce implications and might require larger surgical groups and reconsideration of resource allocation. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Staff Turnover in Assertive Community Treatment (Act) Teams: The Role of Team Climate.

PubMed

Zhu, Xi; Wholey, Douglas R; Cain, Cindy; Natafgi, Nabil

2017-03-01

Staff turnover in Assertive Community Treatment (ACT) teams can result in interrupted services and diminished support for clients. This paper examines the effect of team climate, defined as team members' shared perceptions of their work environment, on turnover and individual outcomes that mediate the climate-turnover relationship. We focus on two climate dimensions: safety and quality climate and constructive conflict climate. Using survey data collected from 26 ACT teams, our analyses highlight the importance of safety and quality climate in reducing turnover, and job satisfaction as the main mediator linking team climate to turnover. The findings offer practical implications for team management.

Facilitating Teamwork in Adolescent and Young Adult Oncology

PubMed Central

Macpherson, Catherine Fiona; Smith, Ashley W.; Block, Rebecca G.; Keyton, Joann

2016-01-01

A case of a young adult patient in the days immediately after a cancer diagnosis illustrates the critical importance of three interrelated core coordinating mechanisms—closed-loop communication, shared mental models, and mutual trust—of teamwork in an adolescent and young adult multidisciplinary oncology team. The case illustrates both the opportunities to increase team member coordination and the problems that can occur when coordination breaks down. A model for teamwork is presented, which highlights the relationships among these coordinating mechanisms and demonstrates how balance among them works to optimize team function and patient care. Implications for clinical practice and research suggested by the case are presented. PMID:27624944

A Set of Descriptive Case Studies of Four Dance Faculty Members' Pedagogical Practices

ERIC Educational Resources Information Center

Sims, Meredith; Erwin, Heather

2012-01-01

Dance faculty members come from a variety of backgrounds, which lead to varied knowledge bases and varied teaching practices. More information is needed about the current pedagogical practices of higher education dance faculty. This study sought to provide a description of four faculty members' pedagogical approaches to a dance technique class in…

Number and impact of published scholarly works by pharmacy practice faculty members at accredited US colleges and schools of pharmacy (2001-2003).

PubMed

Coleman, Craig I; Schlesselman, Lauren S; Lao, Eang; White, C Michael

2007-06-15

To evaluate the quantity and quality of published literature conducted by pharmacy practice faculty members in US colleges and schools of pharmacy for the years 2001-2003. The Web of Science bibliographic database was used to identify publication citations for the years 2001-2003, which were then evaluated in a number of different ways. Faculty members were identified using American Association of Colleges of Pharmacy rosters for the 2000-2001, 2001-2002, and 2002-2003 academic years. Two thousand three hundred seventy-four pharmacy practice faculty members generated 1,896 publications in Web of Science searchable journals. A small number of faculty members (2.1%) were responsible for a large proportion of publications (30.6%), and only 4.9% of faculty members published 2 or more publications in these journals per year. The average impact factor for the top 200 publications was 7.6. Pharmacy practice faculty members contributed substantially to the biomedical literature and their work has had an important impact. A substantial portion of this work has come from a small subset of faculty members.

Developing a physics expert identity in a biophysics research group

NASA Astrophysics Data System (ADS)

Rodriguez, Idaykis; Goertzen, Renee Michelle; Brewe, Eric; Kramer, Laird H.

2015-06-01

We investigate the development of expert identities through the use of the sociocultural perspective of learning as participating in a community of practice. An ethnographic case study of biophysics graduate students focuses on the experiences the students have in their research group meetings. The analysis illustrates how the communities of practice-based identity constructs of competencies characterize student expert membership. A microanalysis of speech, sound, tones, and gestures in video data characterize students' social competencies in the physics community of practice. Results provide evidence that students at different stages of their individual projects have opportunities to develop social competencies such as mutual engagement, negotiability of the repertoire, and accountability to the enterprises as they interact with group members. The biophysics research group purposefully designed a learning trajectory including conducting research and writing it for publication in the larger community of practice as a pathway to expertise. The students of the research group learn to become socially competent as specific experts of their project topic and methodology, ensuring acceptance, agency, and membership in their community of practice. This work expands research on physics expertise beyond the cognitive realm and has implications for how to design graduate learning experiences to promote expert identity development.

The contextualized self: how team-member exchange leads to coworker identification and helping OCB.

PubMed

Farmer, Steven M; Van Dyne, Linn; Kamdar, Dishan

2015-03-01

This article develops the argument that team-member exchange (TMX) relationships operate at both between- and within-group levels of analysis to influence an employee's sense of identification with coworkers in the group and their helping organizational citizenship behavior (OCB) directed at coworkers. Specifically, we propose that relatively higher quality TMX relationships of an employee as compared with other members of the group influence an employee's sense of positive uniqueness, whereas higher average level of TMX quality in the group creates a greater sense of belonging. Multilevel modeling analysis of field data from 236 bank managers and their subordinates supports the hypotheses and demonstrates 3 key findings. First, team members identify more with their coworkers when they have high relative TMX quality compared with other group members and are also embedded in groups with higher average TMX. Second, identification with coworkers is positively related to helping OCB directed toward team members. Finally, identification with coworkers mediates the interactive effect of relative TMX quality and group average TMX quality on helping. When TMX group relations allow individuals to feel a valued part of the group, but still unique, they engage in higher levels of helping. Overall moderated mediation analysis demonstrates that the mediated relationship linking relative TMX quality with helping OCB via identification with coworkers is stronger when group average TMX is high, but not present when group average TMX is low. We discuss theoretical and practical implications and recommend future research on multilevel conceptualizations of TMX. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Understanding the Factors that Support the Use of Active Learning Teaching in STEM Undergraduate Courses: Case Studies in the Field of Geoscience

NASA Astrophysics Data System (ADS)

Iverson, Ellen A. Roscoe

The purpose of this study was to understand the factors that support the adoption of active learning teaching strategies in undergraduate courses by faculty members, specifically in the STEM disciplines related to geoscience. The focus of the study centered on the context of the department which was identified as a gap in evaluation and educational research studies of STEM faculty development. The study used a mixed-method case study methodology to investigate the influences of departmental context on faculty members' adoption of active-learning teaching practices. The study compared and contrasted the influence of two faculty development strategies initiated in the field of geoscience. Six university geoscience departments were selected that had participated in two national geoscience professional development programs. Data were generated from 19 faculty interviews, 5 key informant interviews, and documents related to departmental and institutional context. The study concluded that two main factors influenced the degree to which faculty who participated in geoscience faculty development reported adoption of active learning pedagogies. These conclusions are a) the opportunity to engage in informal, regular conversations with departmental colleagues about teaching promoted adoption of new teaching approaches and ideas and b) institutional practices regarding the ways in which teaching practices were typically measured, valued, and incentivized tended to inhibit risk taking in teaching. The conclusions have implications related to institutional policy, faculty development, and the role of evaluation.

Ethics in oncology: consulting for the investment industry.

PubMed

Berlin, Jordan; Bruinooge, Suanna S; Tannock, Ian F

2007-02-01

As Ethics Committee Chair, I am pleased to introduce the first in an ongoing series of ethics vignettes. These columns, which are based on true-to-life situations that arise in oncology research and practice, are intended to identify and explore important ethical issues and provide commentary that is specific to oncology. Please look for them periodically in both the Journal of Clinical Oncology and the Journal of Oncology Practice. The idea for publishing vignettes evolved through the joint efforts of the Ethics Committee and the Board of Directors. Rather than adopt a single set of ethical principles that applies vaguely to any situation and well to none, the Committee and the Board preferred to tackle ethical dilemmas individually, specifically, and directly. Because the Ethics Committee thought the ethical and legal implications of physician interactions with the investment industry were so important and timely, it chose to address this topic in both a position article, which was previously published in the January 20, 2007, issue of the Journal of Clinical Oncology (J Clin Oncol 25:338-340, 2007) and in its first vignette column. The Ethics Committee hopes this column will be the first of several that ASCO members will find helpful as they grapple with the many ethical issues that arise in daily practice in the field of oncology. Because these columns are intended to address the concerns of ASCO members, the Committee welcomes suggestions for future topics at vignettes@asco.org. Martin D. Abeloff, MD, Chair, Ethics Committee.

Experiences of adults with high-care needs and their family members with housing and support pathways in Australia.

PubMed

McIntyre, Deborah; Fleming, Jennifer; Foster, Michele; Tweedy, Sean

2017-09-01

Many adults aged less than 65 years with high-care needs resulting from acquired disabilities are unable to access age-appropriate housing and support, and reside in residential aged care or live with family members who may struggle to navigate the disability support system. This qualitative study aimed to investigate the experiences of adults with high-care needs and their family members regarding pathways related to housing and support. Two in-depth semi-structured interviews were conducted six months apart with 21 people aged 18 to 65 with high-care needs of varying etiology and living in different housing settings. Nineteen family members involved in decision-making about housing and supports were also interviewed. Thematic data analysis yielded five themes: (1) Traveling in different directions; (2) "the fight, the battle and the war"; (3) willing but wanting; (4) uncertainty and vulnerability; and (5) redefining social roles and relationships. Current disability policy is not satisfying the housing and support requirements of adults with high-care needs and their families. The findings provide rigorous, empirical evidence which indicate the urgent need to improve access to affordable, individualized housing and support packages, including financial, practical and informational support for family members involved in caring roles. Implications for Rehabilitation Individual preferences are an important consideration in housing and support arrangements for younger people with high-care needs alongside needs-based solutions. Individualized funding approaches may provide flexibility of care and choice in housing and support for people with disability. Family members willingly provide substantial informal care, support and advocacy for younger people with high needs but perceive their role as a constant "battle". Payment of family members in recognition of caring work was perceived as a solution to relieve family hardship and ensure optimal care.

42 CFR 411.353 - Prohibition on certain referrals by physicians and limitations on billing.

Code of Federal Regulations, 2013 CFR

2013-10-01

... entity that furnishes DHS is not imputed to his or her group practice or its members or its staff. However, a referral made by a physician's group practice, its members, or its staff may be imputed to the physician if the physician directs the group practice, its members, or its staff to make the referral or if...

42 CFR 411.353 - Prohibition on certain referrals by physicians and limitations on billing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... entity that furnishes DHS is not imputed to his or her group practice or its members or its staff. However, a referral made by a physician's group practice, its members, or its staff may be imputed to the physician if the physician directs the group practice, its members, or its staff to make the referral or if...

Negotiating power: agenda ordering and the willingness to negotiate in asymmetric intergroup conflicts.

PubMed

Kteily, Nour; Saguy, Tamar; Sidanius, James; Taylor, Donald M

2013-12-01

In this research, we investigated how group power influences the way members of groups in asymmetrical conflict approach intergroup negotiations. Drawing on theories of negotiations and of intergroup power, we predicted that group power would interact with features of the proposed negotiating agenda to influence willingness to come to the table. Based on the negotiation literature, we focused on 2 types of sequential negotiation agendas: 1 beginning with the discussion of consequential issues before less consequential issues (consequential first) and 1 leaving the discussion of consequential issues until after less consequential issues are discussed (consequential later). Because they are motivated to advance changes to their disadvantaged status quo, we expected low-power group members to favor consequential first over consequential later invitations to negotiate. High-power group members, motivated to protect their advantage, were expected to show the reverse preference. Converging evidence from 5 experiments involving real-world and experimental groups supported these predictions. Across studies, participants received an invitation to negotiate from the other group involving either a consequential first or consequential later agenda. Low-power group members preferred consequential first invitations because these implied less stalling of change to the status quo, and high-power group members preferred consequential later invitations because these invitations seemed to pose less threat to their position. Theoretical and practical implications for negotiations research and conflict resolution are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Understanding health advocacy in family medicine and psychiatry curricula and practice: A qualitative study

PubMed Central

Andermann, Lisa; Fefergrad, Mark; Fung, Kenneth; Iglar, Karl; Johnson, Andrew; Whitehead, Cynthia

2018-01-01

Background We explored understanding and experiences of health advocacy among psychiatry and family medicine residents and faculty and the implications for clinical care and teaching through the lens of relationship-centred care. Methods This qualitative study was conducted in the psychiatry and family medicine departments at a large urban university. We interviewed 19 faculty members and conducted two focus groups with 18 residents. Semi-structured questions explored the relational meaning of health advocacy, how residents and faculty learned about the role and ethical considerations involved in incorporating advocacy work into clinical practice within a relationship-centred care framework. Results Four themes emerged from the interviews and focus groups: 1) health advocacy as an extension of the relationship to self; 2) health advocacy and professional boundaries in the physician–patient relationship; 3) health advocacy within a team-based approach; and 4) health advocacy and the physician–community/organization relationship. Participants described implications for practice of the challenges of health advocacy, including perceived institutional risks, professional boundaries and the appropriation of patient voice. Conclusions Our study provides insights into the relational complexities of the health advocate role in residency curriculum and clinical practice. All participants described health advocacy as a broad spectrum of actions that are guided by relationships among patients, health care professionals and communities. Our analysis revealed that some challenges that participants identified with a health advocacy role could be addressed by anchoring the role within a specific theoretical framework. This would better enable us to create a culture of advocacy in the training and development of physicians. PMID:29791466

Understanding health advocacy in family medicine and psychiatry curricula and practice: A qualitative study.

PubMed

Soklaridis, Sophie; Bernard, Carrie; Ferguson, Genevieve; Andermann, Lisa; Fefergrad, Mark; Fung, Kenneth; Iglar, Karl; Johnson, Andrew; Paton, Morag; Whitehead, Cynthia

2018-01-01

We explored understanding and experiences of health advocacy among psychiatry and family medicine residents and faculty and the implications for clinical care and teaching through the lens of relationship-centred care. This qualitative study was conducted in the psychiatry and family medicine departments at a large urban university. We interviewed 19 faculty members and conducted two focus groups with 18 residents. Semi-structured questions explored the relational meaning of health advocacy, how residents and faculty learned about the role and ethical considerations involved in incorporating advocacy work into clinical practice within a relationship-centred care framework. Four themes emerged from the interviews and focus groups: 1) health advocacy as an extension of the relationship to self; 2) health advocacy and professional boundaries in the physician-patient relationship; 3) health advocacy within a team-based approach; and 4) health advocacy and the physician-community/organization relationship. Participants described implications for practice of the challenges of health advocacy, including perceived institutional risks, professional boundaries and the appropriation of patient voice. Our study provides insights into the relational complexities of the health advocate role in residency curriculum and clinical practice. All participants described health advocacy as a broad spectrum of actions that are guided by relationships among patients, health care professionals and communities. Our analysis revealed that some challenges that participants identified with a health advocacy role could be addressed by anchoring the role within a specific theoretical framework. This would better enable us to create a culture of advocacy in the training and development of physicians.

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.

Cybersex: the impact of a contemporary problem on the practices of marriage and family therapists.

PubMed

Goldberg, Peter D; Peterson, Brennan D; Rosen, Karen H; Sara, Mary Linda

2008-10-01

The number of people accessing the Internet for sexual purposes (cybersex) has increased dramatically over the last 10 years. However, little research has been conducted to determine how frequently clients present for treatment with cybersex-related issues. One hundred sixty-four clinical members of the American Association for Marriage and Family Therapy participated in the current study, which was conducted to identify the impacts of cybersex on MFTs' practices. Most respondents report seeing clients with cybersex-related issues, with client numbers increasing over the past 2 years. Although most respondents felt prepared to diagnose and treat adults with cybersex problems, half felt unprepared to diagnose and treat children. Lastly, most respondents reported that their required college courses were not helpful in preparing them to diagnose and treat cybersex-related problems. The implications of study findings are discussed.

Helping fellow beings: anthropomorphized social causes and the role of anticipatory guilt.

PubMed

Ahn, Hee-Kyung; Kim, Hae Joo; Aggarwal, Pankaj

2014-01-01

People are often reluctant to comply with social causes because doing so may involve personal sacrifices of time, money, and effort for benefits that are shared by other members of society. In an effort to increase compliance, government agencies and public institutions sometimes employ financial tools to promote social causes. However, employing financial tools to induce prosocial behavior is expensive and often ineffective. We propose that anthropomorphizing a social cause is a practical and inexpensive tool for increasing compliance with it. Across three prosocial contexts, we found that individuals exposed to a message from an anthropomorphized social cause, compared with individuals exposed to a message relating to a nonanthropomorphized social cause, were more willing to comply with the message. This effect was mediated by feelings of anticipatory guilt experienced when they considered the likely consequences of not complying with the cause. The theoretical and practical implications of these findings are discussed.

Marketing strategy determinants in rural hospitals.

PubMed

Smith, H L; Haley, D; Piland, N F

1993-01-01

Rural hospitals confront an inauspicious environment due to changes in patient reimbursement and medical practice. Facing a situation of declining revenues, marketing presents an option for rural hospitals to adapt to the growing constraints. This paper analyzes the determinants of marketing strategy emphasis in rural hospitals. The conceptual model adopted in this study predicts that prior performance and contextual variables explain marketing strategy emphasis. The relationships are examined in a case study of rural New Mexico hospitals. Results suggest that prior performance and several contextual variables explain variations in marketing strategy emphasis. In particular, higher gross patient revenues are associated with more emphasis on television and radio advertising. Furthermore, rural New Mexico hospitals with high numbers of licensed beds and medical staff members, or that are affiliated with a chain organization, place greater emphasis on market research and market planning. The implications for marketing practice in rural hospitals are discussed.

Organizational performance focused on users' quality of life: The role of service climate and "contribution-to-others" wellbeing beliefs.

PubMed

Pătraș, Luminița; Martínez-Tur, Vicente; Estreder, Yolanda; Gracia, Esther; Moliner, Carolina; Peiró, José María

2018-06-01

The investigation of organizational factors as precursors of the quality of life (QoL) of service users in organizations for individuals with intellectual disability has been relatively neglected.With this in mind, this study tests the mediation of service climate between employee's "contribution-to-others" wellbeing beliefs (COWBs) and organizational performance focused on the QoL of individuals with intellectual disability. A total of 104 organizations participated in the study. Data were collected from 885 employees and 809 family members of individuals with intellectual disability. The results of the multilevel mediation model supported the hypotheses. When employees believe that their own wellbeing depends on helping others (COWBs) service climate reported by employees is stimulated. Service climate in turn was associated with organizational performance focused on QoL of people with intellectual disability, assessed by family members. The manuscript concludes with theoretical and practical implications of the study. Copyright © 2018 Elsevier Ltd. All rights reserved.

Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.

PubMed

Towfighi, Amytis; Ovbiagele, Bruce; El Husseini, Nada; Hackett, Maree L; Jorge, Ricardo E; Kissela, Brett M; Mitchell, Pamela H; Skolarus, Lesli E; Whooley, Mary A; Williams, Linda S

2017-02-01

Poststroke depression (PSD) is common, affecting approximately one third of stroke survivors at any one time after stroke. Individuals with PSD are at a higher risk for suboptimal recovery, recurrent vascular events, poor quality of life, and mortality. Although PSD is prevalent, uncertainty remains regarding predisposing risk factors and optimal strategies for prevention and treatment. This is the first scientific statement from the American Heart Association on the topic of PSD. Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were assigned topics relevant to their areas of expertise and reviewed appropriate literature, references to published clinical and epidemiology studies, clinical and public health guidelines, authoritative statements, and expert opinion. This multispecialty statement provides a comprehensive review of the current evidence and gaps in current knowledge of the epidemiology, pathophysiology, outcomes, management, and prevention of PSD, and provides implications for clinical practice. © 2016 American Heart Association, Inc.

Preventing Violence: A Public Health Participatory Approach to Homicide Reviews.

PubMed

O'Malley, Teagen L; Documét, Patricia I; Burke, Jessica G; Garland, Richard; Terry, Art; Slade, Roland L; Albert, Steven M

2018-05-01

Death review teams are a common method for assessing preventable deaths, yet they rarely review adult homicides and do not typically include community members. Academic-community partnerships can enhance public health research by encouraging translation of research into practice and support a data-driven approach to improve community health and well-being. We describe the Pittsburgh Homicide Review Group, a community-partnered initiative to prevent future homicides through data review and community dialogue. Group members reviewed all 42 Pittsburgh 2012 homicides informed by three primary data sources: publicly available data, local service databases, and community outreach resources. Thirty-two individuals representing relevant county agencies and community groups participated in eight reviews. Data sharing among partners resulted in a comprehensive understanding of the context of homicides. Review meetings supported a collective discussion around potential contributing factors to homicides, intervention implications, and recommendations. Academic-community homicide review partnerships are a productive approach to inform homicide prevention and interventions that are relevant to communities and should be implemented widely.

The role of perceived interactivity in virtual communities: building trust and increasing stickiness

NASA Astrophysics Data System (ADS)

Wang, Hongwei; Meng, Yuan; Wang, Wei

2013-03-01

Although previous research has explored factors affecting trust building in websites, little research has been analysed from the perceived interactivity perspective in virtual communities (VCs). A research model for verifying interactivity antecedents to trust and its impact on member stickiness behaviour is presented. Two social interactivity components and two system interactivity components are, respectively, theorised as process-based antecedents and institution-based antecedents to trust in the model. Data were collected from 310 members of VCs to test the model. The results show that connectedness and reciprocity are important antecedents to trust in members, while responsiveness and active control are important antecedents to trust in systems. The results also indicate that trust has significant influence on the members' duration and retention, which are two dimensions of member stickiness measured in this research. These findings have theoretical implications for online interaction-related literature and critical business implications for practitioners of VCs.

We'll never get past the glass ceiling! Meta-stereotyping, world-views and perceived relative group-worth.

PubMed

Owuamalam, Chuma; Zagefka, Hanna

2013-11-01

This article examines the implications of perceived negativity from members of a dominant outgroup on the world views and perceived relative group worth of members of disadvantaged groups. We hypothesized that concerns about the negative opinions a dominant outgroup is perceived to hold of the ingroup (i.e., meta-stereotypes) would undermine group members' views about societal fairness. We expected this trend to be mediated by recall of previous personal experiences of discrimination. We further hypothesized that members' views about societal fairness would predict their perception of the ingroup's worth relative to the outgroup - such that undermined views about societal fairness would be associated with lower perceived ingroup worth relative to the outgroup. Taken jointly, results from two studies using two real intergroup contexts support these hypotheses and are discussed in terms of their implications for the social mobility of members of disadvantaged groups. © 2012 The British Psychological Society.

Experience as Knowledge in a New Product Development Team: Implications for Knowledge Management

NASA Technical Reports Server (NTRS)

Cooper, Lynne P.

2009-01-01

This study was conducted to better understand how New Product Development (NPD) team members apply their experiences to meet the task needs of their project. Although "experience" is highly valued in team members, little research has looked specifically at experiences as a type of knowledge, and how this knowledge is used in work settings. This research evaluated nearly 200 instances where team members referenced past experiences during team meetings. During these experience exchanges, team members structured the sharing of their experiences to include three common elements: the source of the experience, the nature of the experience, and the degree of relevance to the current work of the team. The experiences fell into four categories: people (relationships), process, product, and politics. This paper describes how team members structured, applied, and integrated their individual experiences and presents the resulting implications for knowledge management systems that wish to exploit experience knowledge.

"Chance favors only the prepared mind": preparing minds to systematically reduce hazards in the testing process in primary care.

PubMed

Singh, Ranjit; Hickner, John; Mold, Jim; Singh, Gurdev

2014-03-01

Testing plays a vital role in primary care. Failures in the process are common and can be harmful. As the great 19th century microbiologist Louis Pasteur put it "chance favors only the prepared mind." Our objective is to prepare minds in primary care practices to improve safety in the testing process. Various principles from safety science can be applied. A prospective methodology that uses an anonymous practice survey based on concepts from failure modes and effects analysis is proposed. Responses are used to rank perceived hazards in the testing process, leading to prioritization of areas for intervention. Secondary data analysis (using data from a study of medication safety) was used to explore the value of this approach in the context of assessing the testing process. At 3 primary care practice sites, a total of 61 staff members completed 4 survey items examining the testing process. Comparison across practices shows that each has a distinct profile of hazards, which would lead each on a different path toward improvement. The proposed approach treats each practice as a unique complex adaptive system aiming to help it thrive by inculcating trust, mutual respect, and collaboration. Implications for patient safety research and practice are discussed.

Outcomes of endodontic therapy in general practice

PubMed Central

Bernstein, Susan D.; Horowitz, Allan J.; Man, Martin; Wu, Hongyu; Foran, Denise; Vena, Donald A.; Collie, Damon; Matthews, Abigail G.; Curro, Frederick A.; Thompson, Van P.; Craig, Ronald G.

2014-01-01

Background The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy. Methods Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. Results P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. Conclusions These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. Clinical Implications The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for teeth with irreversible pulpitis, necrotic pulp or periapical periodontitis. PMID:22547719

Social Threat and Motor Resonance: When a Menacing Outgroup Delays Motor Response

PubMed Central

Capellini, Roberta; Sacchi, Simona; Ricciardelli, Paola; Actis-Grosso, Rossana

2016-01-01

Motor resonance (MR) involves the activation of matching motor representations while observing others’ actions. Recent research has shown that such a phenomenon is likely to be influenced by higher order variables such as social factors (e.g., ethnic group membership). The present study investigates whether and how the perception of a social threat elicited by an outgroup member and by contextual cues can modulate motor responses while an individual observes others’ movements. In an experimental study based on an action observation paradigm, we asked participants to provide answers through computer mouse movements (MouseTracker). We manipulated the agents’ group membership (ingroup vs. outgroup) and the social valence of the objects present in a context (neutral vs. threatening) to elicit social menace through contextual cues. Response times and computer mouse trajectories were recorded. The results show a higher level of MR (i.e., participants started to respond earlier and were faster at responding) when observing an action performed by the ingroup members rather than by the outgroup members only when threatening objects are present in a given context. Participants seem to resonate better with their ingroup; conversely, the outgroup member movements tend to delay motor responses. Therefore, we extend prior research going beyond the general ingroup bias effect on MR and showing that the interaction between membership and contextual cues is likely to elicit threat-related stereotypes. Practical implications of these findings are discussed. PMID:27847491

Let Them In: Family Presence during Intensive Care Unit Procedures.

PubMed

Beesley, Sarah J; Hopkins, Ramona O; Francis, Leslie; Chapman, Diane; Johnson, Joclynn; Johnson, Nathanael; Brown, Samuel M

2016-07-01

Families have for decades advocated for full access to intensive care units (ICUs) and meaningful partnership with clinicians, resulting in gradual improvements in family access and collaboration with ICU clinicians. Despite such advances, family members in adult ICUs are still commonly asked to leave the patient's room during invasive bedside procedures, regardless of whether the patient would prefer family to be present. Physicians may be resistant to having family members at the bedside due to concerns about trainee education, medicolegal implications, possible effects on the technical quality of procedures due to distractions, and procedural sterility. Limited evidence from parallel settings does not support these concerns. Family presence during ICU procedures, when the patient and family member both desire it, fulfills the mandates of patient-centered care. We anticipate that such inclusion will increase family engagement, improve patient and family satisfaction, and may, on the basis of studies of open visitation, pediatric ICU experience, and family presence during cardiopulmonary resuscitation, decrease psychological distress in patients and family members. We believe these goals can be achieved without compromising the quality of patient care, increasing provider burden significantly, or increasing risks of litigation. In this article, we weigh current evidence, consider historical objections to family presence at ICU procedures, and report our clinical experience with the practice. An outline for implementing family procedural presence in the ICU is also presented.

Number and Impact of Published Scholarly Works by Pharmacy Practice Faculty Members at Accredited US Colleges and Schools of Pharmacy (2001-2003)

PubMed Central

Coleman, Craig I.; Schlesselman, Lauren S.; Lao, Eang

2007-01-01

Objective To evaluate the quantity and quality of published literature conducted by pharmacy practice faculty members in US colleges and schools of pharmacy for the years 2001-2003. Methods The Web of Science bibliographic database was used to identify publication citations for the years 2001-2003, which were then evaluated in a number of different ways. Faculty members were identified using American Association of Colleges of Pharmacy rosters for the 2000-2001, 2001-2002, and 2002-2003 academic years. Results Two thousand three hundred seventy-four pharmacy practice faculty members generated 1,896 publications in Web of Science searchable journals. A small number of faculty members (2.1%) were responsible for a large proportion of publications (30.6%), and only 4.9% of faculty members published 2 or more publications in these journals per year. The average impact factor for the top 200 publications was 7.6. Conclusion Pharmacy practice faculty members contributed substantially to the biomedical literature and their work has had an important impact. A substantial portion of this work has come from a small subset of faculty members. PMID:17619644

Establishing a Community of Practice between an Elementary Educator and a Scientist as a Means of Professional Development

NASA Astrophysics Data System (ADS)

Dashoush, Nermeen

This dissertation reports on an ethnographic study to examine and detail emerging practices in a community of practice comprised of an elementary teacher and a scientist (microbiologist). The study was conducted in order to design a model for professional development. It also aimed to contribute to the limited research involving elementary educators and their work with scientists. Furthermore, extra attention was given to understanding how both the elementary teacher and the scientist benefitted from their participation in the community of practice created from working together in teaching and learning science as a form of professional development. This was in accordance with a community of practice framework, which details that a healthy community is one without a perception of hierarchy among members (Wenger, 1998). The elementary teacher and scientist as participants collaborated in the creation of a science unit for an afterschool program. A wide variety of data was collected, including: interviews, transcribed meetings, and online journals from both participants. The data was coded for reoccurring themes surrounding practices and shifts in perception about science teaching and learning that emerged from this community of practice as professional development. The findings have implications for practices that could be used as a foundational structure in future collaborations involving elementary teachers and scientists for elementary science professional development.

Mindfulness Practices in Mentoring and Teaching

ERIC Educational Resources Information Center

Trube, Barbara

2017-01-01

Mentoring, including peer mentoring, is a key element of teacher education programs and subsequent teaching practice. In order to share the benefits of mindfulness practices, a faculty member in a state university in the Midwestern United States promoted the practice of mindfulness by teacher candidates enrolled in her courses. As members of a…

Views of physicians, disciplinary board members and practicing lawyers on the new statutory disciplinary system for health care in The Netherlands.

PubMed

Cuperus-Bosma, Jacqueline M; Hout, Fredericus A G; Hubben, Joep H; van der Wal, Gerrit

2006-07-01

The introduction of the Individual Health Care Professions Act (IHCP Act) at the end of 1997 brought a change in various aspects of the disciplinary proceedings. The opinions of those directly involved give an overview of the way in which the disciplinary proceedings functions under the IHCP Act in daily practice, and thus an indication of the contribution made by the disciplinary system to fostering and monitoring high standards of professional practice. Questionnaires were sent to 1300 physicians: 400 general practitioners, 350 internists, 250 gynaecologists and 300 psychiatrists (response 69%, 65%, 60% and 60%, respectively), all 388 disciplinary board members (response 89%) and 43 practicing lawyers (response 65%). Almost all of the disciplinary board members and the practicing lawyers, compared to less than one-third of the physicians, were of the opinion that in their judgement of the complaints the disciplinary boards complied adequately with the concept of good professional practice. A large majority of the disciplinary board members and the practicing lawyers regretted that a complaint could not be declared justified without a sanction being imposed. Most of them were of the opinion that there would be an increase in the number of justified complaints if this possibility were incorporated in the Act. According to the majority of the disciplinary board members and practicing lawyers, the change in the composition of the disciplinary boards had not strengthened the position of the complainant. Most of the respondents were of the opinion that the inclusion of a health professional instead of a legally qualified member was necessary in order to promote consistency in the verdicts concerning professional practice, and thought that a member from the same specialism should always be involved in the judgement of a complaint. A further contribution to the fostering and monitoring of high standards of professional practice could be made by increasing the number of health professional members, adapting the composition of the disciplinary boards to suit the specialism of the accused professional, and introducing the possibility to justify a complaint without imposing a sanction.

Use of cuffed tracheal tubes in neonates, infants and children: A practice survey of members of the Society of Pediatric Anesthesia.

PubMed

Sathyamoorthy, Madhankumar; Lerman, Jerrold; Okhomina, Victoria I; Penman, Alan D

2016-09-01

This study aimed to characterize the current practice patterns with cuffed tracheal tubes (CTT) in neonates, infants, and children among members of the Society of Pediatric Anesthesia (SPA). An electronic mail survey was distributed using Survey Monkey to members of SPA between December 2013 and February 2014. Each member was permitted one response. Not applicable as this is a practice survey study. A total of 805 (28%) of the 2901 members of the SPA responded. Of the respondents, 88% were from the US, 83% were fellowship trained, 82% practiced pediatric anesthesia >50% of the time, and 65% practiced in academic centers. Eighty-five percent used CTT >50% of the time in children >2 years and 60% used CTT in full-term neonates >50% of the time. Twenty-nine percent reported always using CTT whereas 5% reported never using CTT. Those in practice <5 years, who were fellowship trained or in academic practice used CTT more often in neonates compared with those in practice >20 years, not fellowship trained or in private practice (P< .0001, P= .0003 and P= .0005, respectively). The most common reason for avoiding CTT was concern about post-extubation stridor (39%). Almost 70% of respondents accept the TT if it passes the subglottis without resistance and has a leak at 15 to 20 cmH2O. More than 60% of respondents do not monitor cuff pressures in CTT. A majority of SPA members routinely use CTT in neonates, infants and children. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessing the Impact of a Program Designed to Develop Sustainability Leadership amongst Staff Members in Higher Education Institutes: A Case Study from a Community of Practice Perspective

ERIC Educational Resources Information Center

Alkaher, Iris; Avissar, Ilana

2018-01-01

This study focuses on the impact of a sustainability leadership development program (SLDP) designed to develop staff members as leaders who encourage sustainability practices within institutions of higher education (IHE). Using the framework of community of practice (CoP), we explored the program's contribution by interviewing 16 staff members who…

The New Age of Bullying and Violence in Health Care: Part 3: Managing the Bullying Boss and Leadership.

PubMed

Fink-Samnick, Ellen

PRIMARY PRACTICE SETTING(S):: Applicable to all health care sections where case management is practiced. This article is the third of a 4-part series on the topic of bullying in the health care workplace. Part 3 addresses the dimensions of the bullying boss and leadership, posing major implications for patient safety plus the mental health of staff members. The complex constructs and dynamics broached by the bullying boss and department leadership are explored. These include the underlying forces at play such as power, gender, leadership styles, plus weaves in assessment models. Strategic and proactive management of bullying by leadership is vital to workforce retention and well-being. The increasing incidence and impact of bullying across all sectors have made it a major workforce performance management challenge. Health care settings are especially tense environments, often making it difficult for individuals to distinguish between bullying behavior and high expectations for staff. Bullying impacts both direct targets and bystanders who witness the assaultive behaviors, with ethical implications as well.Case management is poised to promote a safe health care workplace for patients and practitioners alike amid these intricate circumstances. Understanding types of bullying bosses and leadership styles is integral to a case manager's success in the workplace.

Attachment and group psychotherapy: introduction to a special section.

PubMed

Tasca, Giorgio A

2014-03-01

The application of attachment theory to adult psychotherapy represents a growing area of research and practice. Despite the conceptual overlap between group therapeutic factors, attachment theory, and therapeutic tasks as outlined by Bowlby (1988), there is little research on attachment functioning in group therapy. Hence, there remain substantial questions about the role of attachment theory in understanding group therapy processes and outcomes. The three studies in this special section advance the research in some of these important areas, including showing that positive changes in self-reported attachment insecurity among clients persist long after group therapy ends; attachment anxiety affects the level and rate of interpersonal learning in groups; and change in attachment to the therapy group has an impact on longer term change in individual group members' attachment. Each article also examines the impact of these attachment concepts on treatment outcomes. Numerous areas remain to be explored when it comes to the implications of attachment theory for understanding and conducting group therapy, including the conceptual and practical overlap between attachment concepts such as security and exploration with group therapeutic factors such as cohesion and interpersonal learning. The articles in this special section begin to address some of these issues related to attachment theory and its implications for group therapists. (c) 2014 APA, all rights reserved.

Practical implications of pre-employment nurse assessments.

PubMed

Kuthy, James E; Ramon, Cheree; Gonzalez, Ronald; Biddle, Dan A

2013-01-01

Hiring nurses is a difficult task that can have serious repercussions for medical facilities. If nurses without proper skills are hired, patients can suffer from insufficient quality of care and potentially life-threatening conditions. Nurse applicants' technical knowledge is extremely important to avoid negative outcomes; however, there are soft skills that factor into their success, such as bedside manner, personality, communication, and decision making. In order for medical facilities to select and maintain high-performing nurse staff, hiring managers must incorporate evaluations for these types of skills in their hiring process. The current study focused on using content/criterion-related validation design to create assessments by which nurse applicants can be evaluated for both technical knowledge/skills and soft skills. The study included participation of more than 876 nursing staff members. To rank applicants on divergent skills, 3 assessment types were investigated, resulting in the creation of an assessment with 3 components. The clinical, situational, and behavioral components that were created measure applicants' job knowledge, interpersonal competency in medical facility-related situations, and aspects of personality and behavior, respectively. Results indicate that using the assessment can predict 45% of a nurse applicant's future job performance. Practical implications include hiring and maintaining a higher quality of nurses and decreased hiring costs.

Assessing health in an urban neighborhood: community process, data results and implications for practice.

PubMed

Idali Torres, M

1998-06-01

This article examines the community process and data results of a health assessment conducted in an urban neighborhood of a middle-size city in Western Massachusetts. It describes the four-stage development process of the Health Assessment Project (HAP), a collaboration of the UMASS School of Public Health faculty and students, community based organizations and youth residents: (1) planning with a contemporary participatory approach, (2) implementing the data collection with traditional survey methodology, (3) tailoring the data analysis for a presentation at a community forum and report, and (4) incorporating the community's reaction to data results. In addition, it presents selected data results on health conditions of individual household members and perceived community health concerns and resources. Salient data results include high rates of chronic health conditions such as asthma and other respiratory problems among residents 0-18, back pain and other musculoskeletal among younger adults 19-54, and high blood pressure and other cardi-circulatory problems among older adults age 55 and older. The three most prevalent perceived community concerns are substance abuse, gangs and drug dealing. Identified community resources include sources of (1) providers of primary care, (2) health information as family/friends and Spanish media, (3) social activity such as churches and schools. Finally, this paper concludes by discussing implications for community health practice.

Reserve Component Alignment with Law, Policy, and Strategy

DTIC Science & Technology

2011-02-07

10 addressed the Armed Forces; Title 32, the National Guard; and Title 34, the Navy. However, these laws were enacted as “ prima facie ” evidence only... Duty members available to accomplish a mission. The implication is that all of these conditions are temporary and that the reserves are to be...when national security requires it, or (4) when there are insufficient Active Duty members available to accomplish a mission. The implication is

Environmental justice: implications for occupational health nurses.

PubMed

Postma, Julie

2006-11-01

Through the use of innovative tools, such as clinical mnemonics, exercises in risk and asset mapping, and strategic program development, occupational health nurses can incorporate dimensions of environmental justice (EJ) into the workplace. Occupational health nurses who also take on educational roles can use case studies and network with labor and EJ groups to provide clinical experiences for occupational and environmental health nursing students, thereby integrating EJ into occupational and environmental health nursing practice. Occupational health nurses are well positioned to serve as technical experts within community-based participatory research projects. Occupational health nurses must share their knowledge and experience as members of coalitions that represent workers in their fight for worker health and safety.

Fragile X--a challenge to models of the mind and to best clinical practice.

PubMed

Hay, David A

2008-06-01

Cornish et al. (2008, this issue) provide an excellent review of Fragile X a common but very complex cause of intellectual disability. They report on a cohort of such males of normal intelligence quotient (IQ) and socioeconomic status (SES), but who have deficits in selective attention and growing impairment in response inhibition. This paper has theoretical views for our models of the mind and clinical implications for families where Fragile X may never have been considered as a possible cause of some of the problems in male and female family members and possibly as well for other disorders such as attention deficit hyperactivity disorder (ADHD) and autism.

Policing Matters: Addressing the Controversial Issue of Policing Through Education for Reconciliation

NASA Astrophysics Data System (ADS)

Cusack, Mella

2009-05-01

Policing is widely held to constitute a contentious issue in classrooms on both sides of the border on the island of Ireland, despite the fact that the ongoing peace process has led to a normalising of cross-border policing relationships. The Education for Reconciliation Project works with teachers and members of the two police services to produce teaching/learning modules on law and policing for use in Citizenship Education classrooms. This paper examines the commonly-held teacher perception of policing as a controversial issue and the reasons why these perceptions exist. It takes into consideration the opinion that it is time for schools to begin work on policing, and investigates the implications for practice.

Predictors of burden among lower socioeconomic status caregivers of persons with chronic mental illness.

PubMed

Biegel, D E; Milligan, S E; Putnam, P L; Song, L Y

1994-10-01

This study uses a stress-coping-support framework to examine the predictors of caregiver burden with a sample of 103 lower social class family caregivers of persons with chronic mental illness. Results of multiple regression analyses show that the greater the frequency of client behavioral symptoms and the lower the amount of perceived support from family members, the higher the level of overall caregiver burden. Examination of the predictors of specific types of burden-family disruption, stigma, strain, and dependency-reveal that different constellations of variables predict different types of burden. The need for mental health agencies to address caregiver and client concerns is addressed. Implications are presented for practice and future research.

Transforming nursing education in a 140-character world: The efficacy of becoming social.

PubMed

Stevens, Karen Patterson; Nies, Mary A

A generational gap exists across educational settings today. The potential and actual mismatch of learning styles and curriculum delivery suggests that the current educational models are in need of change. The advent of social media has transformed students from passive recipients of information to co-creators and engaged members of a global and information rich community. Responding proactively with social media integration through a responsive curriculum delivery system would serve to enhance student engagement and improve collaborative learning opportunities. Future implications for social media use in research and education will allow for rapid and efficient research to practice dissemination. Copyright © 2017 Elsevier Inc. All rights reserved.

Direct-to-consumer (DTC) antidepressant advertising and consumer misperceptions about the chemical imbalance theory of depression: the moderating role of skepticism.

PubMed

Park, Jin Seong; Ahn, Ho-Young Anthony

2013-01-01

Based on a survey with members of an online consumer panel (N= 699), this study revealed that: (a) a substantial percentage of consumers held misperceptions about the chemical imbalance theory of depression; (b) personal and interpersonal experiences with depression positively related to such misperceptions; (c) overall, exposure to direct-to-consumer (DTC) antidepressant advertising did not significantly relate to misperceptions; and (d) DTC exposure magnified misperceptions when consumers were highly trustful of DTC advertising, whereas exposure diluted misperceptions when consumers were highly skeptical. Theoretical and practical implications of the research are discussed, especially in light of the social responsibility of DTC advertising.

Implications of privacy needs and interpersonal distancing mechanisms for space station design

NASA Technical Reports Server (NTRS)

Harrison, A. A.; Sommer, R.; Struthers, N.; Hoyt, K.

1985-01-01

Privacy needs, or the need of people to regulate their degree of contact with one another, and interpersonal distancing mechanisms, which serve to satisfy these needs, are common in all cultures. Isolation, confinement, and other conditions accociated with space flight may at once accentuate privacy needs and limit the availability of certain common interpersonal contact. Loneliness occurs when people have less contact with one another than they desire. Crowding occurs when people have more contact with one another than they desire. Crowding, which is considered the greater threat to members of isolated and confined groups, can contribute to stress, a low quality of life, and poor performance. Drawing on the general literature on privacy, personal space, and interpersonal distancing, and on specialized literature on life aboard spacecraft and in spacecraft-analogous environments, a quantitative model for understanding privacy, interpersonal distancing, loneliness, and crowding was developed and the practical implications of this model for space station design were traced.

Understanding the Use of Violence Among Men Who Sustain Intimate Terrorism

PubMed Central

Hines, Denise A.; Douglas, Emily M.

2011-01-01

Researchers in the field of intimate partner violence (IPV) are paying increasing levels of attention to the notion that members of aggressive and violent relationships cannot always be dichotomized as innocent victims versus blameworthy perpetrators; nonetheless, no research has documented characteristics of IPV victims that may predict their use of abusive and aggressive behaviors in response to their partners’ IPV. This study fills this gap and is unique because it uses a sample of 302 men who sustained intimate terrorism from their female partners and sought help. Results showed that victims who used physical IPV, in comparison with victims who did not, were younger and were more likely to abuse alcohol. In addition, in comparison with victims who used minor physical IPV, victims who used severe physical IPV were more likely to use—and use more frequently—other forms of IPV, and they were more likely to be substance abusers. Results are discussed in terms of possible theoretical implications, directions for future research, and practice implications. PMID:21841962

Software Engineering Laboratory Ada performance study: Results and implications

NASA Technical Reports Server (NTRS)

Booth, Eric W.; Stark, Michael E.

1992-01-01

The SEL is an organization sponsored by NASA/GSFC to investigate the effectiveness of software engineering technologies applied to the development of applications software. The SEL was created in 1977 and has three organizational members: NASA/GSFC, Systems Development Branch; The University of Maryland, Computer Sciences Department; and Computer Sciences Corporation, Systems Development Operation. The goals of the SEL are as follows: (1) to understand the software development process in the GSFC environments; (2) to measure the effect of various methodologies, tools, and models on this process; and (3) to identify and then to apply successful development practices. The activities, findings, and recommendations of the SEL are recorded in the Software Engineering Laboratory Series, a continuing series of reports that include the Ada Performance Study Report. This paper describes the background of Ada in the Flight Dynamics Division (FDD), the objectives and scope of the Ada Performance Study, the measurement approach used, the performance tests performed, the major test results, and the implications for future FDD Ada development efforts.

Assessing Implementation of Learner-Centered Teaching While Providing Faculty Development

ERIC Educational Resources Information Center

Blumberg, Phyllis

2016-01-01

This article describes a study of 58 faculty members using a practical method for assessing the prevalence of learner-centered practices through individual interviews and rating their described practices with published rubrics. Analysis of the interviews found that the same faculty member might use more learner-centered practices in one course and…

Preparing practicing dentists to engage in practice-based research

PubMed Central

DeRouen, Timothy A.; Hujoel, Philippe; Leroux, Brian; Mancl, Lloyd; Sherman, Jeffrey; Hilton, Thomas; Berg, Joel; Ferracane, Jack

2013-01-01

Background The authors describe an educational program designed to prepare practicing dentists to engage in practice-based research in their practices—a trend receiving more emphasis and funding from the National Institute of Dental and Craniofacial Research (NIDCR). Methods The Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT), an NIDCR-funded network of which the authors are members, developed a one-day educational program to educate practitioners in principles of good clinical research. The program has four components built around the following questions: “What is the question?”; “What are the options?”; “How do you evaluate the evidence?”; and “How do you conduct a study?” Results The intensive one-day program initially offered in early 2006, which concluded with applications of research principles to research topics of interest to practitioners, was well-received. Despite their admission that the research methodology by itself was not of great interest, the dentists recognized the importance of the background material in equipping them to conduct quality studies in their practices. Conclusions Dentists interested in participating in practice-based research view training in research methodology as helpful to becoming better practitioner-investigators. The PRECEDENT training program seemed to reinforce their interest. Practice Implications As dentistry evolves to become more evidence-based, more and more of the evidence will come from practice-based research. This training program prepares practicing dentists to become engaged in this trend. PMID:18310739

Becoming a Physicist: How Identities and Practices Shape Physics Trajectories

NASA Astrophysics Data System (ADS)

Quan, Gina M.

This dissertation studies the relationships and processes which shape students' participation within the discipline of physics. Studying this early disciplinary participation gives insight to how students are supported in or pushed out of physics, which is an important step in cultivating a diverse set of physics students. This research occurs within two learning environments that we co-developed: a physics camp for high school girls and a seminar for undergraduate physics majors to get started in physics research. Using situated learning theory, we conceptualized physics learning to be intertwined with participation in physics practices and identity development. This theoretical perspective draws our attention to relationships between students and the physics community. Specifically, we study how students come to engage in the practices of the community and who they are within the physics community. We find that students' interactions with faculty and peers impact the extent to which students engage in authentic physics practices. These interactions also impact the extent to which students develop identities as physicists. We present implications of these findings for the design of physics learning spaces. Understanding this process of how students become members of the physics community will provide valuable insights into fostering a diverse set of successful trajectories in physics.

Implications for the Self Determine Benevolence and Self-Protection in Intergroup Relations.

PubMed

Malloy, Thomas E; Kinney, Lorin

2017-01-01

People often favor groups they belong to over those beyond the in-group boundary. Yet, in-group favoritism does not always occur, and people will sometimes favor an out-group over the in-group. We delineate theoretically when in-group favoritism (i.e., self-protection) and out-group favoritism (i.e., benevolence) should occur. In two experiments, groups' relative status and competence stereotypes were manipulated; groups' outcomes were non-contingent in Experiment 1 and contingent in Experiment 2. When allocating reward, members of a low status group were self-protective, favoring the in-group over the out-group under both non-contingent and contingent outcomes. Those with high status benevolently favored the out-group when outcomes were non-contingent, but were self-protective with contingent outcomes. People were willing to engage in social activities with an out-group member regardless of competence. However, when task collaboration had implications for the self, those with low status preferred competent over less competent out-group members. Traits of high status targets were differentiated by those with low status in both experiments, whereas those with high status differentiated low status members' traits only when outcomes were contingent. A general principle fits the data: the implications of intergroup responses for the self determine benevolence and self-protection. Implications for the Self Determine Benevolence and Self Protection in Intergroup Relations.

Different concepts and models of information for family-relevant genetic findings: comparison and ethical analysis.

PubMed

Lenk, Christian; Frommeld, Debora

2015-08-01

Genetic predispositions often concern not only individual persons, but also other family members. Advances in the development of genetic tests lead to a growing number of genetic diagnoses in medical practice and to an increasing importance of genetic counseling. In the present article, a number of ethical foundations and preconditions for this issue are discussed. Four different models for the handling of genetic information are presented and analyzed including a discussion of practical implications. The different models' ranges of content reach from a strictly autonomous position over self-governed arrangements in the practice of genetic counseling up to the involvement of official bodies and committees. The different models show a number of elements which seem to be very useful for the handling of genetic data in families from an ethical perspective. In contrast, the limitations of the standard medical attempt regarding confidentiality and personal autonomy in the context of genetic information in the family are described. Finally, recommendations for further ethical research and the development of genetic counseling in families are given.

Charting the 7 c's of cultural change affecting foreign nurses: competency, communication, consistency, cooperation, customs, conformity and courage.

PubMed

Parrone, Joyce; Sedrl, Darlene; Donaubauer, Carolyn; Phillips, Marge; Miller, Marilyn

2008-01-01

Eighty-two percent of practicing RNs are located in metropolitan areas in which the predominant employment setting is the hospital according to the National Sample Survey of Registered Nurses (Services, 2000). However, despite current trends toward moderate increased enrollment in nursing schools, a 2001American Hospital Survey (AHA) among 715 member hospitals revealed that 126,000 registered nurse positions across America remain unfilled. As a result, hospitals have adopted creative solutions to ease the nursing shortage. One creative solution is to import foreign nurses. According to the Commission on Graduates of Foreign Nursing Schools (CGFNS) many come from the Philippines, are single, female and between 23-27 years of age. The foreign nurse will encounter many barriers and practice problems no matter his/her level of skill. This article explores seven areas of clinical competency that nurses from the Philippines will encounter and must surmount as well as some of the implications for nursing practice that veteran and newly graduated nurses might want to be aware of when working with foreign nurses.

The collective approach to psychiatric practice in the People's Republic of China.

PubMed

Lu, Y C

1978-10-01

This paper describes and analyzes the effects of the dramatic changes of social values in China on the approach to treatment of the mentally ill since the 1949 revolution. It is mainly based on observations, interviews, and experiences in mental hospitals during three recent trips to the People's Republic of China. Attention here is focused on the effects of four new social values on psychiatric practice: first, the value of collective responsibility as reflected in the new program to integrate mental hospitals with the community; second, the application of the value of sharing and "serving the people" to methods of psychiatric therapy; third, the value of "minimization of elitism" as practiced in the role relationships among members of different categories in mental hospitals; and fourth, the reaffirmation of faith in human ability to conquer difficulties, as shown in changes of patients' outlook on life and behavior. Finally, the implications of this alternative approach on our established assumptions and methods of psychiatric therapy in the West are discussed, and the future direction of theoretical formulation is suggested.

The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals.

PubMed

Wexler, Anna

2016-04-01

Scientists and neuroethicists have recently drawn attention to the ethical and regulatory issues surrounding the do-it-yourself (DIY) brain stimulation community, which comprises individuals stimulating their own brains with transcranial direct current stimulation (tDCS) for self-improvement. However, to date, existing regulatory proposals and ethical discussions have been put forth without engaging those involved in the DIY tDCS community or attempting to understand the nature of their practices. I argue that to better contend with the growing ethical and safety concerns surrounding DIY tDCS, we need to understand the practices of the community. This study presents the results of a preliminary inquiry into the DIY tDCS community, with a focus on knowledge that is formed, shared and appropriated within it. I show that when making or acquiring a device, DIYers (as some members call themselves) produce a body of knowledge that is completely separate from that of the scientific community, and share it via online forums, blogs, videos and personal communications. However, when applying tDCS, DIYers draw heavily on existing scientific knowledge, posting links to academic journal articles and scientific resources and adopting the standardised electrode placement system used by scientists. Some DIYers co-opt scientific knowledge and modify it by creating their own manuals and guides based on published papers. Finally, I explore how DIYers cope with the methodological limitations inherent in self-experimentation. I conclude by discussing how a deeper understanding of the practices of DIY tDCS has important regulatory and ethical implications. 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/

Towards Contextual Experimentation: Creating a Faculty Learning Community to Cultivate Writing-to-Learn Practices

ERIC Educational Resources Information Center

Chang, Mary K.; Rao, Kavita; Stewart, Maria L.; Farley, Cynthia A.; Li, Katherine

2016-01-01

In order to explore ways to integrate new pedagogical practices, five faculty members created an informal faculty learning community focused on writing-to-learn practices, an inquiry and process-based writing pedagogy. The faculty members learned the writing-to-learn practices together, periodically met to discuss how they implemented the…

Research engagement of health sciences librarians: a survey of research-related activities and attitudes.

PubMed

Lessick, Susan; Perryman, Carol; Billman, Brooke L; Alpi, Kristine M; De Groote, Sandra L; Babin, Ted D

2016-04-01

The extent to which health sciences librarians are engaged in research is a little-studied question. This study assesses the research activities and attitudes of Medical Library Association (MLA) members, including the influence of work affiliation. An online survey was designed using a combination of multiple-choice and open-ended questions and distributed to MLA members. Responses were analyzed using descriptive statistics, content analysis, and significance testing. The authors used statistical tools and categorized open-ended question topics by the constant comparative method, also applying the broad subject categories used in a prior study. Pearson's chi-square analysis was performed on responses to determine significant differences among respondents employed in three different institutional environments. Analysis showed that 79% of respondents read research articles at least once a month; 58% applied published research studies to practice; 44% had conducted research; 62% reported acting on research had enhanced their libraries; 38% had presented findings; and 34% had authored research articles. Hospital librarians were significantly less likely than academic librarians to have participated in research activities. Highly ranked research benefits, barriers, and competencies of health sciences librarians are described. Findings indicate that health sciences librarians are actively engaged in research activities. Practice implications for practitioners, publishers, and stakeholders are discussed. Results suggest that practitioners can use published research results and results from their own research to affect practice decisions and improve services. Future studies are needed to confirm and extend these findings, including the need for intervention studies to increase research and writing productivity.

Research engagement of health sciences librarians: a survey of research-related activities and attitudes

PubMed Central

Lessick, Susan; Perryman, Carol; Billman, Brooke L.; Alpi, Kristine M.; De Groote, Sandra L.; Babin, Ted D.

2016-01-01

Introduction The extent to which health sciences librarians are engaged in research is a little-studied question. This study assesses the research activities and attitudes of Medical Library Association (MLA) members, including the influence of work affiliation. Methods An online survey was designed using a combination of multiple-choice and open-ended questions and distributed to MLA members. Responses were analyzed using descriptive statistics, content analysis, and significance testing. The authors used statistical tools and categorized open-ended question topics by the constant comparative method, also applying the broad subject categories used in a prior study. Pearson's chi-square analysis was performed on responses to determine significant differences among respondents employed in three different institutional environments. Results Analysis showed that 79% of respondents read research articles at least once a month; 58% applied published research studies to practice; 44% had conducted research; 62% reported acting on research had enhanced their libraries; 38% had presented findings; and 34% had authored research articles. Hospital librarians were significantly less likely than academic librarians to have participated in research activities. Highly ranked research benefits, barriers, and competencies of health sciences librarians are described. Conclusions Findings indicate that health sciences librarians are actively engaged in research activities. Practice implications for practitioners, publishers, and stakeholders are discussed. Results suggest that practitioners can use published research results and results from their own research to affect practice decisions and improve services. Future studies are needed to confirm and extend these findings, including the need for intervention studies to increase research and writing productivity. PMID:27076808

Knowledge, Attitudes, and Practices of Pediatric Dentists Regarding Speech Evaluation of Patients: Implications for Dental Education.

PubMed

Van Eyndhoven, Lisa; Chussid, Steven; Yoon, Richard K

2015-11-01

The aim of this cross-sectional study was to determine pediatric dentists' attitudes about speech evaluation in the dental setting and assess their knowledge of speech development and pathology. In October 2013, members of the American Academy of Pediatric Dentistry were invited to participate in an electronic questionnaire. Categories of questions were demographics, attitudes and confidence in speech pathology, and theoretical and practical knowledge of speech development and speech pathology. Theoretical knowledge was assessed using questions about phonetics and speech milestones. Practical knowledge was determined with three 30-second interview-style video clips. A total of 539 responses were received for a response rate of 10.4%. The majority of respondents reported feeling that speech evaluation should be part of the pediatric dental visit (72.8%) and felt confident in their ability to detect speech issues (73.2%). However, they did poorly on the theoretical knowledge questions (41.9%) as well as the practical knowledge questions (8.5%). There was a statistically significant difference in theoretical score between gender and type of occupation (p<0.05). This difference was not observed when examining practical knowledge. This study suggests that although pediatric dentists are in an ideal position to aid in the detection of speech issues, they currently have insufficient training and knowledge to do so.

The Development and Implications of Peer Emotional Support for Student Service Members/Veterans and Civilian College Students

ERIC Educational Resources Information Center

Whiteman, Shawn D.; Barry, Adam E.; Mroczek, Daniel K.; MacDermid Wadsworth, Shelley

2013-01-01

Student service members/veterans represent a growing population on college campuses. Despite this growth, scholarly investigations into their health- and adjustment-related issues are almost nonexistent. The limited research that is available suggests that student service members/veterans may have trouble connecting with their civilian…

Implications of Leader-Member Exchange Theory and Research for Human Resource Development Research.

ERIC Educational Resources Information Center

Burns, Janet Z.; Otte, Fred L.

1999-01-01

Leader/member exchange theory is proposed as an alternate approach to the study of organizational leadership. Recent research supports the theory but additional development work is needed. The theory seeks to explain how leader/member relationships develop and the behavioral components of leadership relations. Contains 74 references. (Author/JOW)

Nursing care of the adoption triad.

PubMed

Foli, Karen J

2012-10-01

This study describes the practice settings and interventions of nurses who care for members of the adoption triad (AT; birth parents, adoptive parents, child). A 28-item, descriptive, cross-sectional survey was used. Ninety-seven (97) nurses provided complete (65) or partial (32) responses. Most frequently reported practice settings were labor, delivery or postpartum unit, and pediatrics. Assessed needs varied by AT members. However, interventions for all members of the triad included emotional support and therapeutic communication. The unique placement of advanced practice nurses in various clinical settings allows for contact with members of the AT in vulnerable and crisis periods. © 2012 Wiley Periodicals, Inc.

Court applications for withdrawal of artificial nutrition and hydration from patients in a permanent vegetative state: family experiences

PubMed Central

Kitzinger, Celia; Kitzinger, Jenny

2016-01-01

Withdrawal of artificially delivered nutrition and hydration (ANH) from patients in a permanent vegetative state (PVS) requires judicial approval in England and Wales, even when families and healthcare professionals agree that withdrawal is in the patient's best interests. Part of the rationale underpinning the original recommendation for such court approval was the reassurance of patients’ families, but there has been no research as to whether or not family members are reassured by the requirement for court proceedings or how they experience the process. The research reported here draws on in-depth narrative interviews with 10 family members (from five different families) of PVS patients who have been the subject of court proceedings for ANH-withdrawal. We analyse the empirical evidence to understand how family members perceive and experience the process of applying to the courts for ANH-withdrawal and consider the ethical and practice implications of our findings. Our analysis of family experience supports arguments grounded in economic and legal analysis that court approval should no longer be required. We conclude with some suggestions for how we might develop other more efficient, just and humane mechanisms for reviewing best interests decisions about ANH-withdrawal from these patients. PMID:26486571

How do leader-member exchange quality and differentiation affect performance in teams? An integrated multilevel dual process model.

PubMed

Li, Alex Ning; Liao, Hui

2014-09-01

Integrating leader-member exchange (LMX) research with role engagement theory (Kahn, 1990) and role system theory (Katz & Kahn, 1978), we propose a multilevel, dual process model to understand the mechanisms through which LMX quality at the individual level and LMX differentiation at the team level simultaneously affect individual and team performance. With regard to LMX differentiation, we introduce a new configural approach focusing on the pattern of LMX differentiation to complement the traditional approach focusing on the degree of LMX differentiation. Results based on multiphase, multisource data from 375 employees of 82 teams revealed that, at the individual level, LMX quality positively contributed to customer-rated employee performance through enhancing employee role engagement. At the team level, LMX differentiation exerted negative influence on teams' financial performance through disrupting team coordination. In particular, teams with the bimodal form of LMX configuration (i.e., teams that split into 2 LMX-based subgroups with comparable size) suffered most in team performance because they experienced greatest difficulty in coordinating members' activities. Furthermore, LMX differentiation strengthened the relationship between LMX quality and role engagement, and team coordination strengthened the relationship between role engagement and employee performance. Theoretical and practical implications of the findings are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Where dentistry stands in light of health care reform.

PubMed

Collignon, B H

1994-01-01

The hot topic from Capitol Hill in Washington to Capitol Hill in Jefferson City is health care reform. President Clinton started the ball rolling during the campaign in 1992 by including health care reform in his platform. He continued the effort after his election by appointing his wife, Hillary, to chair a task force to present an outline for federal legislation. Since the package was presented to Congress, there has been much discussion, lobbying, and rumoring about the implications of health care reform and what it could mean to all of us as dentists. On the home front, Governor Carnahan has introduced legislation in Missouri to reform the health care system. This effort is known as the Missouri Health Assurance Plan (H.B. 1622). Missouri Dental Association members are vitally concerned about the impact of health care reform on their practice, their taxes, their relationship with their patients and employees, and on their ability to seek out health care services since each member is also a consumer of health care. This article represents answers to some of the questions being asked by MDA members in order that they might be more aware of the activities by the MDA, the ADA, and other levels of organized dentistry relating to health care reform.

Attitudes of emergency department staff toward family presence during resuscitation.

PubMed

Wacht, Oren; Dopelt, Keren; Snir, Yoram; Davidovitch, Nadav

2010-06-01

While family presence during resuscitation has been researched extensively in the international and especially American medical literature, in Israel this subject has rarely been researched. Because such policies have become common practice in many countries, it is important to investigate the attitudes of health care staff in Israeli emergency departments to better understand the potential implication of adopting such policies. To examine the attitudes of the physicians and nurses in the ED of Soroka Medical Center to FPDR. The methods we used were both qualitative (partly structured open interviews of 10 ED staff members from various medical professions) and quantitative (an anonymous questionnaire that collected sociodemographic, professional, and attitude data). The qualitative and quantitative results showed that most staff members opposed FPDR. The main reasons for objecting to FPDR were concern about family criticism, the added pressure that would be put on the staff members, fear of lawsuits, fear of hurting the feelings of the families, and the danger of losing one's "objectivity" while treating patients. Physicians objected more strongly to FPDR than did nurses. More research is needed on FPDR in Israel, including an examination of its medical, ethical, legal and logistic aspects. In addition to the views of the medical staff, the attitudes of patients and their families should also be examined.

A catalyst for system change: a case study of child health network formation, evolution and sustainability in Canada.

PubMed

McPherson, Charmaine; Ploeg, Jenny; Edwards, Nancy; Ciliska, Donna; Sword, Wendy

2017-02-01

The purpose of this study was to examine key processes and supportive and inhibiting factors involved in the development, evolution, and sustainability of a child health network in rural Canada. This study contributes to a relatively new research agenda aimed at understanding inter-organizational and cross-sectoral health networks. These networks encourage collaboration focusing on complex issues impacting health - issues that individual agencies cannot effectively address alone. This paper presents an overview of the study findings. An explanatory qualitative case study approach examined the Network's 13-year lifespan. Data sources were documents and Network members, including regional and 71 provincial senior managers from 11 child and youth service sectors. Data were collected through 34 individual interviews and a review of 127 documents. Interview data were analyzed using framework analysis methods; Prior's approach guided document analysis. Three themes related to network development, evolution and sustainability were identified: (a) Network relationships as system triggers, (b) Network-mediated system responsiveness, and (c) Network practice as political. Study findings have important implications for network organizational development, collaborative practice, interprofessional education, public policy, and public system responsiveness research. Findings suggest it is important to explicitly focus on relationships and multi-level socio-political contexts, such as supportive policy environments, in understanding health networks. The dynamic interplay among the Network members; central supportive and inhibiting factors; and micro-, meso-, and macro-organizational contexts was identified.

Bacterial community variations in an alfalfa-rice rotation system revealed by 16S rRNA gene 454-pyrosequencing.

PubMed

Lopes, Ana R; Manaia, Célia M; Nunes, Olga C

2014-03-01

Crop rotation is a practice harmonized with the sustainable rice production. Nevertheless, the implications of this empirical practice are not well characterized, mainly in relation to the bacterial community composition and structure. In this study, the bacterial communities of two adjacent paddy fields in the 3rd and 4th year of the crop rotation cycle and of a nonseeded subplot were characterized before rice seeding and after harvesting, using 454-pyrosequencing of the 16S rRNA gene. Although the phyla Acidobacteria, Proteobacteria, Chloroflexi, Actinobacteria and Bacteroidetes predominated in all the samples, there were variations in relative abundance of these groups. Samples from the 3rd and 4th years of the crop rotation differed on the higher abundance of groups of presumable aerobic bacteria and of presumable anaerobic and acidobacterial groups, respectively. Members of the phylum Nitrospira were more abundant after rice harvest than in the previously sampled period. Rice cropping was positively correlated with the abundance of members of the orders Acidobacteriales and 'Solibacterales' and negatively with lineages such as Chloroflexi 'Ellin6529'. Studies like this contribute to understand variations occurring in the microbial communities in soils under sustainable rice production, based on real-world data. © 2013 Federation of European Microbiological Societies. Published by John Wiley & Sons Ltd. All rights reserved.

Neuroscientists' everyday experiences of ethics: the interplay of regulatory, professional, personal and tangible ethical spheres.

PubMed

Brosnan, Caragh; Cribb, Alan; Wainwright, Steven P; Williams, Clare

2013-11-01

The ethical issues neuroscience raises are subject to increasing attention, exemplified in the emergence of the discipline neuroethics. While the moral implications of neurotechnological developments are often discussed, less is known about how ethics intersects with everyday work in neuroscience and how scientists themselves perceive the ethics of their research. Drawing on observation and interviews with members of one UK group conducting neuroscience research at both the laboratory bench and in the clinic, this article examines what ethics meant to these researchers and delineates four specific types of ethics that shaped their day-to-day work: regulatory, professional, personal and tangible. While the first three categories are similar to those identified elsewhere in sociological work on scientific and clinical ethics, the notion of 'tangible ethics' emerged by attending to everyday practice, in which these scientists' discursive distinctions between right and wrong were sometimes challenged. The findings shed light on how ethical positions produce and are, in turn, produced by scientific practice. Informing sociological understandings of neuroscience, they also throw the category of neuroscience and its ethical specificity into question, given that members of this group did not experience their work as raising issues that were distinctly neuro-ethical. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Social media in nurse education: Utilization and E-professionalism.

PubMed

Duke, Valda J A; Anstey, Allan; Carter, Sandra; Gosse, Natalie; Hutchens, Karen M; Marsh, Janice A

2017-10-01

To explore faculty and student utilization of social media and its professional implications in nurse education. A descriptive study. Five hundred six Bachelor of Nursing students, 112 Practical Nursing students and 74 faculty members were invited to complete a questionnaire of 28 questions relating to social media. Three hundred thirty-seven students and 29 faculty responded. Students spent significantly more time using social media compared to faculty and both groups used it mainly for personal use. However, almost twice as many students used social media for educational purposes than did faculty (58.5% vs 27.6%, p<0.001). While almost 96% of students used social media to talk about academic related problems, only 28% of faculty did so (p<0.000). Almost 60% of faculty expressly disagreed with using social media to discuss academic related problems. YouTube and text messaging were popular platforms for educational purposes. While Facebook was also a popular educational site for students (95% used it for informal learning; 67% for formal learning), it was much less commonly used by faculty (45% used it for informal learning; 17% for formal learning). More students than faculty felt that they were aware of privacy features, and of the professional behavior expected when using social media. In addition, more students (90.7%) than faculty (71.43%) used these privacy features (p<0.000). However, 100% of students compared to only 13.79% of faculty reported that they had posted information that they would not want a prospective employer/member of academic staff to view (p=0.003). There is a high reported usage of social media among students and faculty. Utilization of public platforms, while potentially beneficial, can have professional implications if not used appropriately with both personal and academic use. Developing best practice approaches for using social media in nurse education is essential to ensure that faculty and students are informed of e-professionalism. Copyright © 2017 Elsevier Ltd. All rights reserved.

Understanding the mental health consequences of family separation for refugees: Implications for policy and practice.

PubMed

Miller, Alexander; Hess, Julia Meredith; Bybee, Deborah; Goodkind, Jessica R

2018-01-01

Consistent evidence documents the negative impacts of family separation on refugee mental health and concerns for the welfare of distant family members and desire to reunite with family members as priorities for refugees postmigration. Less is known about refugees' emic perspectives on their experiences of family separation. Using mixed methods data from a community-based mental health intervention study, we found that family separation was a major source of distress for refugees and that it was experienced in a range of ways: as fear for family still in harm's way, as a feeling of helplessness, as cultural disruption, as the greatest source of distress since resettlement, and contributing to mixed emotions around resettlement. In addition to these qualitative findings, we used quantitative data to test the relative contribution of family separation to refugees' depression/anxiety symptoms, posttraumatic stress disorder (PTSD) symptoms, and psychological quality of life. Separation from a family member was significantly related to all 3 measures of mental health, and it explained significant additional variance in all 3 measures even after accounting for participants' overall level of trauma exposure. Relative to 26 other types of trauma exposure, family separation was 1 of only 2 traumatic experiences that explained additional variance in all 3 measures of mental health. Given the current global refugee crisis and the need for policies to address this large and growing issue, this research highlights the importance of considering the ways in which family separation impacts refugee mental health and policies and practices that could help ameliorate this ongoing stressor. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

A global view of direct access and patient self-referral to physical therapy: implications for the profession.

PubMed

Bury, Tracy J; Stokes, Emma K

2013-04-01

International policy advocates for direct access, but the extent to which it exists worldwide was unknown. The purpose of this study was to map the presence of direct access to physical therapy services in the member organizations of the World Confederation for Physical Therapy (WCPT) in the context of physical therapist practice and health systems. A 2-stage, mixed-method, descriptive study was conducted. A purposive sample of member organizations of WCPT in Europe was used to refine the survey instrument, followed by an online survey sent to all WCPT member organizations. Data were analyzed using descriptive statistics, and content analysis was used to analyze open-ended responses to identify themes. A response rate of 68% (72/106) was achieved. Direct access to physical therapy was reported by 58% of the respondents, with greater prevalence in private settings. Organizations reported that professional (entry-level) education equipped physical therapists for direct access in 69% of the countries. National physical therapy associations (89%) and the public (84%) were thought to be in support of direct access, with less support perceived from policy makers (35%) and physicians (16%). Physical therapists' ability to assess, diagnose, and refer patients on to specialists was more prevalent in the presence of direct access. The findings may not be representative of the Asia Western Pacific (AWP) region, where there was a lower response rate. Professional legislation, the medical profession, politicians, and policy makers are perceived to act as both barriers to and facilitators of direct access. Evidence for clinical effectiveness and cost-effectiveness and examples of good practice are seen as vital resources that could be shared internationally, and professional leadership has an important role to play in facilitating change and advocacy.

Perceptions and use of iPad technology by pharmacy practice faculty members.

PubMed

DiVall, Margarita V; Zgarrick, David P

2014-04-17

To explore the potential of tablet technology to address the specific workload challenges of pharmacy practice faculty members and to evaluate tablet usage after a department-wide iPad initiative. After conducting a needs assessment to determine pharmacy faculty attitudes towards tablet technology and to identify potential usage scenarios, all faculty members in a department of pharmacy practice received an iPad. After iPad distribution, training sessions and virtual tutorials were provided. An anonymous survey was administered to evaluate the pilot. The needs assessment survey revealed positive attitudes towards iPad technology, identified use scenarios, and led to a department-wide iPad pilot program. Most faculty members used iPads for connectivity with students (86%), paper/project annotation (68%), assessment (57%), and demonstration of tools used in practice (36%). For teaching, 61% of faculty members used iPads in seminars/laboratories, 57% used iPads in the experiential setting, and 43% used iPads in the classroom. Use of iPads for patient-care activities varied and depended on site support for mobile technology. The 23 faculty members with external practice sites used iPads to a greater extent and had more positive attitudes towards this technology compared with campus-based faculty members. Integration of tablet technology into the pharmacy education setting resulted in faculty-reported increased productivity and decreased paper waste. It also allowed faculty members to experiment with new teaching strategies in the classroom and experiential setting. Administrators at institutions exploring the use of tablet technology should allocate resources based on faculty needs and usage patterns.

Exploring the APA Fifth Edition "Publication Manual"'s Impact on the Analytic Preferences of Journal Editorial Board Members.

ERIC Educational Resources Information Center

Capraro, Mary Margaret; Capraro, Robert M.

2003-01-01

Studied the reporting preferences of editorial board members of four scholarly journals in education and psychology with regard to analytic practices in the fifth edition of the American Psychological Association "Publication Manual." Responses of 106 board members show the movement toward reform in research reporting practices. (SLD)

Academic Freedom in Al Al-Bayt University and the Level of Practicing It from the View Point of the Faculty Members Based on Some Variables

ERIC Educational Resources Information Center

Al-Madi, Bayan

2013-01-01

The purpose of this study is to identify the level of practicing academic freedom by the faculty members of Al al-Bayt University. The study population included all the faculty members (297) of Al al-Bayt University, during the academic year, 2010/2011. The study sample was randomly selected and included 250 faculty members. To achieve the aims of…

The roles of family members, health care workers, and others in decision-making processes about genetic testing among individuals at risk for Huntington disease.

PubMed

Klitzman, Robert; Thorne, Deborah; Williamson, Jennifer; Marder, Karen

2007-06-01

To understand how individuals at risk for Huntington disease view the roles of others, e.g., family members and health care workers, in decision making about genetic testing. Twenty-one individuals (eight mutation-positive, four mutation-negative, and nine not tested) were interviewed for approximately 2 hours each. Interviewees illuminated several key aspects of the roles of family members and health care workers (in genetics and other fields) in decision making about testing that have been underexplored. Family members often felt strongly about whether an individual should get tested. Health care workers provided information and assistance with decision making and mental health referrals that were often helpful. Yet health care workers varied in knowledge and sensitivity regarding testing issues, and the quality of counseling and testing experiences can range widely. At times, health care workers without specialized knowledge of Huntington disease offered opinions of whether to test. Input from families and health care workers could also conflict with each other and with an individual's own preferences. Larger institutional and geographic contexts shaped decisions as well. Decision-making theories applied to Huntington disease testing have frequently drawn on psychological models, yet the current data highlight the importance of social contexts and relationships in testing decisions. This report, the first to our knowledge to explore individuals' perceptions of social factors (particularly family and health care worker involvement) in Huntington disease testing decisions, has critical implications for practice, education, research, and policy.

Reflexive intergroup bias in third-party punishment.

PubMed

Yudkin, Daniel A; Rothmund, Tobias; Twardawski, Mathias; Thalla, Natasha; Van Bavel, Jay J

2016-11-01

Humans show a rare tendency to punish norm-violators who have not harmed them directly-a behavior known as third-party punishment. Research has found that third-party punishment is subject to intergroup bias, whereby people punish members of the out-group more severely than the in-group. Although the prevalence of this behavior is well-documented, the psychological processes underlying it remain largely unexplored. Some work suggests that it stems from people's inherent predisposition to form alliances with in-group members and aggress against out-group members. This implies that people will show reflexive intergroup bias in third-party punishment, favoring in-group over out-group members especially when their capacity for deliberation is impaired. Here we test this hypothesis directly, examining whether intergroup bias in third-party punishment emerges from reflexive, as opposed to deliberative, components of moral cognition. In 3 experiments, utilizing a simulated economic game, we varied participants' group relationship to a transgressor, measured or manipulated the extent to which they relied on reflexive or deliberative judgment, and observed people's punishment decisions. Across group-membership manipulations (American football teams, nationalities, and baseball teams) and 2 assessments of reflexive judgment (response time and cognitive load), reflexive judgment heightened intergroup bias, suggesting that such bias in punishment is inherent to human moral cognition. We discuss the implications of these studies for theories of punishment, cooperation, social behavior, and legal practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Medicine as a Community of Practice: Implications for Medical Education.

PubMed

Cruess, Richard L; Cruess, Sylvia R; Steinert, Yvonne

2018-02-01

The presence of a variety of independent learning theories makes it difficult for medical educators to construct a comprehensive theoretical framework for medical education, resulting in numerous and often unrelated curricular, instructional, and assessment practices. Linked with an understanding of identity formation, the concept of communities of practice could provide such a framework, emphasizing the social nature of learning. Individuals wish to join the community, moving from legitimate peripheral to full participation, acquiring the identity of community members and accepting the community's norms.Having communities of practice as the theoretical basis of medical education does not diminish the value of other learning theories. Communities of practice can serve as the foundational theory, and other theories can provide a theoretical basis for the multiple educational activities that take place within the community, thus helping create an integrated theoretical approach.Communities of practice can guide the development of interventions to make medical education more effective and can help both learners and educators better cope with medical education's complexity. An initial step is to acknowledge the potential of communities of practice as the foundational theory. Educational initiatives that could result from this approach include adding communities of practice to the cognitive base; actively engaging students in joining the community; creating a welcoming community; expanding the emphasis on explicitly addressing role modeling, mentoring, experiential learning, and reflection; providing faculty development to support the program; and recognizing the necessity to chart progress toward membership in the community.

Single European currency and Monetary Union. Macroeconomic implications for pharmaceutical spending.

PubMed

Kanavos, P

1998-01-01

This article examines the potential implications of introducing a single currency among the Member States of the European Union for national pharmaceutical prices and spending. In doing so, it provides a brief account of the direct effects of introducing a single currency on pharmaceutical business. These are static in nature and include the elimination of exchange rate volatility and transaction costs, increased price transparency and limited potential for parallel trade. It subsequently analyses the potential medium and long term macroeconomic policy choices facing the Member States and their impact on pharmaceutical spending following the introduction of a single currency. These include policy directions in order to meet the Maastricht convergence criteria in the run-up to forming an Economic and Monetary Union (EMU) and the implications of EMU on national macroeconomic policy thereafter. This article argues that the necessity for tight fiscal policies across the EU and, in particular, in those Member States facing high budget deficits and overall debt levels, will continue to exert considerable downward pressure on pharmaceutical spending.

On the Consideration of Adoption and Implementation of The Next Generation Science Standards in a Local-Control Context: Supporting the Epistemology of Science through Education Policy

NASA Astrophysics Data System (ADS)

Lazzaro, Christopher C.

On the Consideration of Adoption and Implementation of The Next Generation Science Standards in a Local-Control Context: Supporting the Epistemology of Science through Education Policy. Christopher C Lazzaro. The primary purpose of this research is to understand how and why members at each of the three levels of the education system within a local-control state made the decisions they did in supporting or hindering the adoption and implementation of the Next Generation Science Standards. This research concentrates on three levels of the education system in a local-control state; 1) the state level, 2) the district level, and 3) the school/teacher level, while investigating the following questions: 1. To what extent, and in what ways, do members in each of the three levels of the state education system advocate for adoption and implementation of the Next Generation Science Standards? 2. Are the members in each of the three levels motivated or compelled to consider adoption and implementation of the Next Generation Science Standards, why or why not? 3. To what extent, and in what ways, do the members in each of the three levels take into account science epistemology in their overall consideration of adoption/implementation of the NGSS? The data drew from a series of interviews from a prior study, "Challenges of Implementing the Next Generation Science Standards in Local-Control States in the U.S." (Sevian, Foster, & Scheff, 2012). After these data were coded and analyzed around the three research questions, this phenomenographic research study identified four key findings: Key Finding 1 - As the District Coordinators are uniquely situated within the state education system to be able to see both the on-the-ground practical implications and the high-level policy pressures of adopting and implementing the NGSS, they reflect the deepest level of awareness of how to best advocate for adoption and implementation of the NGSS. Key Finding 2 - Motivation to adopt and implement the NGSS is highly nuanced. The most significant factor influencing motivation to adopt or implement the NGSS at each level is related to assessment. The reasons assessment affects motivation is different at each level. Key Finding 3 - Each interviewee at each level demonstrated awareness that the NGSS are significantly different from prior standards in some way. While teachers and SSCs sometimes cited the science practices as the critical difference, they were not able to meaningfully elaborate on what "science practices" are. Conversely, the District Coordinators demonstrated a deeper level of awareness and were able to comment more specifically on the practices and how they would affect science education in their state. Key Finding 4 - Regardless of level, the better a participant reflected an awareness of epistemology, the more likely they were to advocate for adoption and implementation of the NGSS. Similarly, the better a participant reflected an awareness of epistemology, the more likely they were motivated to consider adoption and implementation of the NGSS. The implications of the findings in this current study can; inform the supplemental materials and dissemination of information by standards writers, help policy makers engage stakeholders appropriately at each level by illustrating how national reform efforts play out in local-control states, and aid school based employees by identifying how and where they can participate in state level policy discussion and where their input could be valuable.

Teaching to Transform? Addressing Race and Racism in the Teaching of Clinical Social Work Practice

ERIC Educational Resources Information Center

Varghese, Rani

2016-01-01

Faculty members are key stakeholders to support social work students' learning about race and racism in practice and to promote the professional standards established by the field. This qualitative study examines how 15 clinical social work faculty members teaching advanced practice in the Northeast conceptualize and incorporate their…

A network of networks.

PubMed

Iedema, Rick; Verma, Raj; Wutzke, Sonia; Lyons, Nigel; McCaughan, Brian

2017-04-10

Purpose To further our insight into the role of networks in health system reform, the purpose of this paper is to investigate how one agency, the NSW Agency for Clinical Innovation (ACI), and the multiple networks and enabling resources that it encompasses, govern, manage and extend the potential of networks for healthcare practice improvement. Design/methodology/approach This is a case study investigation which took place over ten months through the first author's participation in network activities and discussions with the agency's staff about their main objectives, challenges and achievements, and with selected services around the state of New South Wales to understand the agency's implementation and large system transformation activities. Findings The paper demonstrates that ACI accommodates multiple networks whose oversight structures, self-organisation and systems change approaches combined in dynamic ways, effectively yield a diversity of network governances. Further, ACI bears out a paradox of "centralised decentralisation", co-locating agents of innovation with networks of implementation and evaluation expertise. This arrangement strengthens and legitimates the role of the strategic hybrid - the healthcare professional in pursuit of change and improvement, and enhances their influence and impact on the wider system. Research limitations/implications While focussing the case study on one agency only, this study is unique as it highlights inter-network connections. Contributing to the literature on network governance, this paper identifies ACI as a "network of networks" through which resources, expectations and stakeholder dynamics are dynamically and flexibly mediated and enhanced. Practical implications The co-location of and dynamic interaction among clinical networks may create synergies among networks, nurture "strategic hybrids", and enhance the impact of network activities on health system reform. Social implications Network governance requires more from network members than participation in a single network, as it involves health service professionals and consumers in a multi-network dynamic. This dynamic requires deliberations and collaborations to be flexible, and it increasingly positions members as "strategic hybrids" - people who have moved on from singular taken-as-given stances and identities, towards hybrid positionings and flexible perspectives. Originality/value This paper is novel in that it identifies a critical feature of health service reform and large system transformation: network governance is empowered through the dynamic co-location of and collaboration among healthcare networks, particularly when complemented with "enabler" teams of people specialising in programme implementation and evaluation.

Transformational leadership practices of nurse leaders in professional nursing associations.

PubMed

Ross, Erin J; Fitzpatrick, Joyce J; Click, Elizabeth R; Krouse, Helene J; Clavelle, Joanne T

2014-04-01

This study describes the transformational leadership (TL) practices of nurse leaders in professional nursing associations (PNAs). Professional nursing associations are vehicles to provide educational opportunities for nurses as well as leadership opportunities for members. Little has been published about the leadership practices of PNA members. E-mail surveys of 448 nurse leaders in PNAs were conducted in 2013 using the Leadership Practices Inventory (LPI). The top 2 TL practices of these nurse leaders were enabling others to act and encouraging the heart. Respondents with more leadership training reported higher TL practices. This is the 1st study to describe TL practices of nurse leaders in PNAs. Results of this study show that nurse leaders of PNAs emulate practices of TL. Transformational leaders can mobilize and direct association members in reaching shared values, objectives, and outcomes. Understanding TL practices of nurse leaders in PNAs are important to the future of nursing in order to enable nurses to lead change and advance health through these organizations.

A Community of Practice Model for Introducing Mobile Tablets to University Faculty

ERIC Educational Resources Information Center

Drouin, Michelle; Vartanian, Lesa Rae; Birk, Samantha

2014-01-01

We examined the effectiveness of a community of practice (CoP) model for introducing tablets to 139 faculty members at a higher education institution. Using a CoP within a systems model, we used large- and small-group mentorship to foster collaboration among faculty members. Most faculty members agreed that the project was well organized and…

1983 Home Study Survey. A Report on Current Course Structure and Educational Practices in NHSC Member Institutions.

ERIC Educational Resources Information Center

National Home Study Council, Washington, DC.

A study examined the course structure and educational practices used by National Home Study Council (NHSC) member institutions. To gather data for the study, researchers mailed questionnaires to 60 members of the NHSC. Based on data from the 51 usable responses, the researchers determined that the average age of students enrolled in programs…

Conveying empathy to hospice family caregivers: Team responses to caregiver empathic communication

PubMed Central

Wittenberg-Lyles, Elaine; Oliver, Debra Parker; Demiris, George; Rankin, Anna; Shaunfield, Sara; Kruse, Robin L.

2012-01-01

Objective The goal of this study was to explore empathic communication opportunities presented by family caregivers and responses from interdisciplinary hospice team members. Methods Empathic opportunities and hospice team responses were analyzed from biweekly web-based videoconferences between family caregivers and hospice teams. The authors coded the data using the Empathic Communication Coding System (ECCS) and identified themes within and among the coded data. Results Data analysis identified 270 empathic opportunity-team response sequences. Caregivers expressed statements of emotion and decline most frequently. Two-thirds of the hospice team responses were implicit acknowledgments of caregiver statements and only one-third of the team responses were explicit recognitions of caregiver empathic opportunities. Conclusion Although hospice team members frequently express emotional concerns with family caregivers during one-on-one visits, there is a need for more empathic communication during team meetings that involve caregivers. Practice implications Hospice clinicians should devote more time to discussing emotional issues with patients and their families to enhance patient-centered hospice care. Further consideration should be given to training clinicians to empathize with patients and family caregivers. PMID:22554387

Adolescent Alcoholism and Drug Addiction: The Experience of Parents.

PubMed

Choate, Peter W

2015-10-29

Alcoholism and drug addiction have marked impacts on the ability of families to function. Much of the literature has been focused on adult members of a family who present with substance dependency. There is limited research into the effects of adolescent substance dependence on parenting and family functioning; little attention has been paid to the parents' experience. This qualitative study looks at the parental perspective as they attempted to adapt and cope with substance dependency in their teenage children. The research looks into family life and adds to family functioning knowledge when the identified client is a youth as opposed to an adult family member. Thirty-one adult caregivers of 21 teenagers were interviewed, resulting in eight significant themes: (1) finding out about the substance dependence problem; (2) experiences as the problems escalated; (3) looking for explanations other than substance dependence; (4) connecting to the parent's own history; (5) trying to cope; (6) challenges of getting help; (7) impact on siblings; and (8) choosing long-term rehabilitation. Implications of this research for clinical practice are discussed.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gerald Hill; Kenneth Nemeth; Gary Garrett

The Southern States Energy Board's (SSEB) 'Regional Effort to Deploy Clean Coal Technologies' program began on June 1, 2003, and was completed on January 31, 2009. The project proved beneficial in providing state decision-makers with information that assisted them in removing barriers or implementing incentives to deploy clean coal technologies. This was accomplished through two specific tasks: (1) domestic energy security and diversity; and (2) the energy-water interface. Milestones accomplished during the project period are: (1) Presentations to Annual Meetings of SSEB Members, Associate Member Meetings, and the Gasification Technologies Council. (2) Energy: Water reports - (A) Regional Efforts tomore » Deploy Clean Coal Technologies: Impacts and Implications for Water Supply and Quality. June 2004. (B) Energy-Water Interface Challenges: Coal Bed Methane and Mine Pool Water Characterization in the Southern States Region. 2004. (C) Freshwater Availability and Constraints on Thermoelectric Power Generation in the Southeast U.S. June 2008. (3) Blackwater Interactive Tabletop Exercise - Decatur, Georgia April 2007. (4) Blackwater Report: Blackwater: Energy and Water Interdependency Issues: Best Practices and Lessons Learned. August 2007. (5) Blackwater Report: BLACKWATER: Energy Water Interdependency Issues REPORT SUMMARY. April 2008.« less

Occupational UVR skin protection by make-up.

PubMed

Bonner, R; Khazova, M; O'Hagan, J B; Squire, H

2012-03-01

New legislation has been introduced in the Member States of the European Union, covering worker exposure to artificial optical radiation. Use of make-up could reduce the ultraviolet hazard level and provide additional protection for skin against UV radiation (UVR). This is particularly important in entertainment and filming where intentional exposure of the actors and presenters to the very intense light sources may be required for extended periods of time. This document presents the assessment of UVR protection of make-up used in entertainment and demonstrates that the protection level varies considerably for different luminaires and application techniques. An important practical implication of this finding is that make-up alone cannot be considered as a reliable protection measure against skin exposure to actinic UV.

Crowdfunding: an innovative way to fund your project.

PubMed

Walker, Dawn-Marie

2017-06-22

Background Getting research funded is extremely difficult, with research councils rejecting more than 70% of grant applications ( Else 2014 ). It is even more difficult if you are a junior researcher who doesn't have a track record of being awarded grant money or leading a research project. Crowdfunding may offer a solution. It is a method of raising funds from members of the public online and can offer an alternative to the more formal methods of research funding. Aim To outline how this model works and provide tips on designing a campaign. Discussion The authors provide an overview of the literature regarding this model, as well as a set of resources for future reference when designing a campaign. Conclusion Crowdfunding can provide small amounts of money for your first project. Implications for practice It is expected that clinicians practice evidence based medicine, and research in health environments is commonplace. Crowdfunding can offer you support in becoming more engaged in research.

The Role of Parents' Critical Thinking About Media in Shaping Expectancies, Efficacy and Nutrition Behaviors for Families.

PubMed

Austin, Erica Weintraub; Pinkleton, Bruce E; Radanielina-Hita, Marie Louise; Ran, Weina

2015-01-01

A convenience survey completed online by 137 4-H parents in Washington state explored their orientation toward critical thinking regarding media sources and content and its implications for family dietary behaviors. Parents' critical thinking toward media sources predicted their information efficacy about content. Critical thinking toward media content predicted information efficacy about sources, expectancies for parental mediation, and expectancies for family receptiveness to lower-fat dietary changes. Expectancies for receptiveness to dietary changes and expectancies for parental mediation predicted efficacy for implementing healthy dietary practices; this strongly predicted healthy dietary practices. Media-related critical thinking, therefore, indirectly but consistently affected self-reported family dietary behaviors through its effects on efficacy for managing media and expectancies for the family's receptiveness to healthy dietary changes. The results suggest parents' media literacy skills affect their family's dietary behavior. Health campaigns that help parents interpret and manage the media environment may benefit all family members.

Communication-based behaviour support for adults with intellectual disabilities receiving dental care: A focus group study exploring dentists' decision-making and communication.

PubMed

Phadraig, Caoimhin Mac Giolla; Griffiths, Colin; McCallion, Philip; McCarron, Mary; Nunn, June

2017-01-01

A better understanding of how communication-based behaviour supports are applied with adults with intellectual disabilities may reduce reliance on restrictive practices such as holding, sedation and anaesthesia in dentistry. In this study, we explore how communication is used by dentists who provide treatment for adults with intellectual disabilities. A descriptive qualitative study, adopting synchronous online focus groups, was undertaken with six expert dentists in Ireland. Members were contacted again in pairs or individually for further data collection, analysed using thematic content analysis. Two relevant categories emerged from the data, relating to the selection and application of communication-based behaviour support for adults with intellectual disabilities. Decision-making processes were explored. Building on these categories, a co-regulating process of communication emerged as the means by which dentists iteratively apply and adapt communicative strategies. This exploration revealed rationalist and intuitive decision-making. Implications for education, practice and research are identified.

Defining the boundaries: how sexual assault nurse examiners (SANEs) balance patient care and law enforcement collaboration.

PubMed

Campbell, Rebecca; Greeson, Megan; Patterson, Debra

2011-03-01

Forensic nursing is multidisciplinary in nature, which can create tensions for practitioners between their responsibilities to patient care and collaborations with law enforcement and prosecutors. Because there are compelling reasons grounded in both nursing theory and legal precedent to maintain separation, there is a pressing need to understand how sexual assault nurse examiner (SANE) programs successfully negotiate these potentially conflicting roles. The purpose of this study was to examine how SANEs define their work with their patients, how they collaborate with law enforcement, and how they negotiate roles differentiation. As part of a mixed methods evaluation of a community-based SANE program, qualitative interviews were conducted with forensic nurses regarding their interactions with patients and members of the legal community. Results indicated that a strong patient care practice had positive indirect effects on victims' participation in the criminal justice system. Implications for forensic nursing practice are discussed. © 2011 International Association of Forensic Nurses.

The View Behind and Ahead: Implications of Certification *

PubMed Central

Darling, Louise

1973-01-01

The Medical Library Association's certification plan, never of real significance in employment and promotion practices in health sciences librarianship, does not reflect the many changes which have occurred in swift progression since adoption of the code in 1949. Solutions to the problems which have accumulated since then are sought in a brief examination of trends in credentialing and certification in the health professions and in the library field, both general and special. Emphasis is given to the historical development of provisions in the MLA Code for the Training and Certification of Medical Librarians, the limited opportunity for practical implementation of most of the provisions, the importance of the code in stimulating the Association's educational programs, the impact of the Medical Library Assistance Act, Regional Medical Programs, and increases in demand for health information on manpower requirements for health science libraries, the specific dissatisfactions MLA members have expressed over certification, and the role of the Ad Hoc Committee to Develop a New Certification Code. PMID:4744343

Qigong in Injured Military Service Members.

PubMed

Reb, Anne Marie; Saum, Nancy Seaby; Murphy, Deborah Ann; Breckenridge-Sproat, Sara Todd; Su, Xiaogang; Bormann, Jill Ellen

2017-03-01

Wounded, ill, and injured (WII) Military Service members experience significant stress and are at risk for developing chronic conditions including posttraumatic stress disorder and depression. Qigong, a meditative movement practice, may positively affect their ability to engage in successful rehabilitation. We assessed the feasibility of Qigong practice in WII Service members returning from combat; effects on stress, sleep, and somatic symptoms; satisfaction; and participants' experience with the practice. Single-group, pre- and posttest, mixed methods approach. Twenty-six WII were enrolled. The program was designed to include 20 classes over 10 weeks. Participants completed self-report questionnaires, practice logs, and an exit interview. Average attendance was 8.14 classes ( SD = 4.9); mean engagement was 5.7 ( SD = 3.5) weeks. Participants endorsed a high level of satisfaction with the practice. Qualitative themes included coping with stress; feeling more resilient and empowered; improvement in symptoms including sleep and physical function; and factors affecting practice. Participant-reported facilitators included accessibility and portability of the practice; barriers included scheduling conflicts and personal challenges. Participants recommended offering shorter programs with flexible scheduling options, increasing program awareness, and including significant others in future classes. Qigong was safe, portable, and easily adapted for WII Service members.

Caffeine's implications for women's health and survey of obstetrician-gynecologists' caffeine knowledge and assessment practices.

PubMed

Anderson, Britta L; Juliano, Laura M; Schulkin, Jay

2009-09-01

Caffeine has relevance for women's health and pregnancy, including significant associations with spontaneous abortion and low birth weight. According to scientific data, pregnant women and women of reproductive age should be advised to limit their caffeine consumption. This article reviews the implications of caffeine for women's psychological and physical health, and presents data on obstetrician-gynecologists' (ob-gyns) knowledge and practices pertaining to caffeine. Ob-gyns (N = 386) who are members of the American College of Obstetricians and Gynecologists' Collaborative Ambulatory Research Network responded to a 21-item survey about caffeine. Although most knew that caffeine is passed through breast milk, only 24.8% were aware that caffeine metabolism significantly slows as pregnancy progresses. Many respondents were not aware of the caffeine content of commonly used products, such as espresso and Diet Coke, with 14.3% and 57.8% indicating amounts within an accurate range, respectively. Furthermore, ob-gyns did not take into account large differences in caffeine content across different caffeinated beverages with most recommending one to two servings of coffee or tea or soft drinks per day. There was substantial inconsistency in what was considered to be "high levels" of maternal caffeine consumption, with only 31.6% providing a response. When asked to indicate the risk that high levels of caffeine have on various pregnancy outcomes, responses were not consistent with scientific data. For example, respondents overestimated the relative risk of stillbirths and underestimated the relative risk of spontaneous abortion. There was great variability in assessment and advice practices pertaining to caffeine. More than half advise their pregnant patients to consume caffeine under certain circumstances, most commonly to alleviate headache and caffeine withdrawal. The data suggest that ob-gyns could benefit from information about caffeine and its relevance to their clinical practice. The development of clinical practice guidelines for caffeine may prove to be useful.

Investigation into health science students' awareness of occupational therapy: implications for interprofessional education.

PubMed

Alotaibi, Naser; Shayea, Abdulaziz; Nadar, Mohammed; Abu Tariah, Hashem

2015-01-01

To investigate the level of awareness of the occupational therapy profession among final-year health sciences students at Kuwait University. This study utilized a survey targeting final-year students in the Health Sciences Center at Kuwait University schools of medicine, pharmacy, dentistry, and allied health sciences. The survey addressed awareness of occupational therapy, its scope of practice, work environments, and preference for learning more about the profession. Of the 244 surveys distributed, 132 were returned, for a 54% response rate. The proportion of those who knew about occupational therapy ranged from 94% (radiologic science) to a low of 17% (medicine). Most respondents learned about occupational therapy from colleagues (77.1%), rather than from their academic programs (28.1%). RESULTS indicated that about one fifth of students (21.4%) were unsure about the role of occupational therapists as members of the health care team. Preferences for learning more about the profession were consistent with interprofessional opportunities, such as observing an occupational therapy session (64.5%) and attending a workshop (63.6%) or presentation (59.8%). Although most respondents had some awareness of occupational therapy, specifics about its scope of practice and relevance to the health care team were lacking. Preferences for learning more about occupational therapy were consistent with the current trend for interprofessional education in health care. Implications for interprofessional education are presented.

Left to their own devices: Post-ELSI, ethical equipment and the International Genetically Engineered Machine (iGEM) Competition

PubMed Central

Balmer, Andrew S; Bulpin, Kate J

2013-01-01

In this article, we evaluate a novel method for post-ELSI (ethical, legal and social implications) collaboration, drawing on ‘human practices' (HP) to develop a form of reflexive ethical equipment that we termed ‘sociotechnical circuits'. We draw on a case study of working collaboratively in the International Genetically Engineered Machine Competition (iGEM) and relate this to the parts-based agenda of synthetic biology. We use qualitative methods to explore the experience of undergraduate students in the Competition, focussing on the 2010 University of Sheffield team. We examine how teams work collaboratively across disciplines to produce novel microorganisms. The Competition involves a HP component and we examine the way in which this has been narrowly defined within the ELSI framework. We argue that this is a much impoverished style of HP when compared with its original articulation as the development of ‘ethical equipment'. Inspired by this more theoretically rich HP framework, we explore the relations established between team members and how these were shaped by the norms, materials and practices of the Competition. We highlight the importance of care in the context of post-ELSI collaborations and report on the implications of our case study for such efforts and for the relation of the social sciences to the life sciences more generally. PMID:24159360

Huddle up!: The adoption and use of structured team communication for VA medical home implementation.

PubMed

Rodriguez, Hector P; Meredith, Lisa S; Hamilton, Alison B; Yano, Elizabeth M; Rubenstein, Lisa V

2015-01-01

Daily clinical team meetings (i.e., "huddles") may be helpful in implementing new roles and responsibilities for patient care because they provide a regular opportunity for member learning and feedback. We examined how huddles were implemented in the context of the VA patient-centered medical home (PCMH) transformation, including assessing barriers and facilitators to regular huddling among small teams ("teamlets"). We assessed the extent to which teamlet members that huddled had higher self-efficacy for PCMH changes, reported better teamwork experiences, and perceived more supportive practice environments. We used a convergent mixed-methods approach to analyze 79 teamlet member interviews from six VA primary care practices and 418 clinician and staff PCMH survey responses from the six interviewed practices and 13 additional practices in the same region. Most members reported participating in teamlet huddles when asked in surveys (85%). A minority of interview participants, however, described routine huddling focused on previsit planning that included all members. When members reported routine teamlet huddling, activities included (a) previsit planning, (b) strategizing treatment plans for patients with special or complex needs, (c) addressing daily workflow and communication issues through collective problem solving, and (d) ensuring awareness of what team members do and what actions are happening on the teamlet and in the practice. Primary care providers (PCPs) were least likely to report routine huddling. PCP huddlers reported greater self-efficacy for implementing PCMH changes. All huddlers, irrespective of role, reported better teamwork and more supportive practice climates. The most common barriers to teamlet huddling were limited time and operational constraints. In order to improve the impact of huddles on patient care, practice leaders should clearly communicate the goals, requirements, and benefits of huddling and provide adequate time and resources to ensure that frontline teams use huddle time to improve patient care.

In Asian Americans, is Having a Family Member Diagnosed with Cancer Associated with Fatalistic Beliefs?

PubMed

Polek, Carolee; Hardie, Thomas

2016-01-01

Cancer can evoke long-held cultural beliefs which either facilitate or impede efforts to expand the health literacy of families. Among these beliefs is fatalism which holds that controlling ones' outcome is not possible, and that ones' outcome is predestined. Some fatalistic beliefs are broadly held within the Asian American (AA) community and may be challenged or reinforced by the experience of having a family member diagnosed with cancer. This study evaluated the relationship between having a family member diagnosed with cancer and selected demographics in AAs on fatalistic beliefs. Data from 519 AA subjects from the Centers for Disease Control and Prevention Health Information Trends Survey were used to complete a secondary analysis. Descriptive statistics characterize fatalistic beliefs. Four models using four questions assessed fatalistic beliefs as dependent variables and independent variables of having or not having a family member diagnosed with cancer, completing college or not, sex, and age were assessed using ordinal regression. All of the fatalistic beliefs examined were endorsed by large portions of the subjects. When considering the role of being exposed to having a family member with cancer, it was associated with an increase in the likelihood in a belief that one is likely to get cancer, and everything can cause cancer. Being exposed to a family member diagnosed with cancer was not significantly associated with believing, there was little one could do to control their cancer risk. This belief was broadly rejected. While the belief that there are so many different recommendations about preventing cancer, it is hard to know what to do, was broadly endorsed and not associated with having a family member diagnosed with cancer. The major practice implications within oncology nursing suggest the importance in assessing cancer health literacy and providing corrective knowledge in families with a member diagnosed with cancer. While recognizing the need for more knowledge, cancer diagnoses may represent a significant teachable moment for family members enhancing their health knowledge and supporting behavioral change. Two beliefs were contradictory and broadly held with the AA community, thus support will be needed for further public health research.

Does the Reputation of a Faculty Member's Graduate Programme and Institution Matter for Labour Market Outcomes?

ERIC Educational Resources Information Center

Warshaw, Jarrett B.; Toutkoushian, Robert K.; Choi, Hyejin

2017-01-01

For a future faculty member the choice of which graduate programme and institution to attend is considered to have important implications for securing academic employment, developing skills to succeed in academia, and yielding positive returns on investment of time and money in education. Yet does it matter where a faculty member attends graduate…

How often do neuroradiologists perform sonography of the carotid arteries? A survey of academic and nonacademic radiology practices, with implications for fellowship training.

PubMed

Friedman, David P; Maitino, Andrea J

2003-08-01

Debate in the neuroradiology community surrounds the amount of formal training in sonography of the carotid arteries that should be provided to fellows. This study was designed to assess current practice patterns at both academic and nonacademic practices regarding the performance of carotid sonography. A neurovascular radiology survey was sent to all 102 program directors of neuroradiology fellowships in the United States and Canada (academic practices). The survey was also sent to 146 randomly selected senior members of the ASNR (three per state, except one each for Alaska and Vermont) who were not affiliated with fellowship programs (nonacademic practices). Fifty-seven surveys from academic practices and 70 surveys from nonacademic practices were returned. Radiologists at academic practices performed approximately 42% of studies (general radiologists or sonography specialists, 36%; neuroradiologists, 5%; cardiovascular radiologists, 1%). Nonradiologists performed approximately 58% of studies (vascular surgeons, 47%; neurologists, 10%; cardiologists, 1%; neurosurgeons, <1%). Neuroradiologists performed carotid sonography at 11% (6/57) of academic practices. On average, radiologists at nonacademic practices performed approximately 62% of studies (general radiologists or sonography specialists, 38%; neuroradiologists, 15%; cardiovascular radiologists, 9%). Nonradiologists performed approximately 38% of studies (vascular surgeons, 25%; neurologists, 6%; cardiologists or internists, 6%). Neuroradiologists performed carotid sonography at 53% (37/70) of nonacademic practices. At most academic practices, neuroradiologists do not perform sonography of the carotid arteries. This may explain the reluctance of some fellowships to provide formal training in this technique. In contrast, although neuroradiologists perform carotid sonography at a majority of the nonacademic practices, the percentage of studies that they perform is small; moreover, neuroradiologists perform far fewer studies than do general radiologists or sonography specialists.

Essential Elements for a Pharmacy Practice Mentoring Program

PubMed Central

Hardy, Yolanda M.; Jarvis, Courtney; Stoner, Steven C.; Pitlick, Matthew; Hilaire, Michelle L.; Hanes, Scott; Carey, Katherine; Burke, Jack; Lodise, Nicole M.

2013-01-01

Formal guidelines for mentoring faculty members in pharmacy practice divisions of colleges and schools of pharmacy do not exist in the literature. This paper addresses the background literature on mentoring programs, explores the current state of mentoring programs used in pharmacy practice departments, and provides guidelines for colleges and schools instituting formal mentoring programs. As the number of pharmacy colleges and schools has grown, the demand for quality pharmacy faculty members has dramatically increased. While some faculty members gain teaching experience during postgraduate residency training, new pharmacy practice faculty members often need professional development to meet the demands of their academic responsibilities. A mentoring program can be 1 means of improving faculty success and retention. Many US colleges and schools of pharmacy have developed formal mentoring programs, whereas several others have informal processes in place. This paper discusses those programs and the literature available, and makes recommendations on the structure of mentoring programs. PMID:23519448

Observed Handwashing with Soap Practices Among Cholera Patients and Accompanying Household Members in a Hospital Setting (CHoBI7 Trial).

PubMed

Zohura, Fatema; Bhuyian, Sazzadul Islam; Monira, Shirajum; Begum, Farzana; Biswas, Shwapon K; Parvin, Tahmina; Sack, David; Sack, R Bradley; Leontsini, Elli; Saif-Ur-Rahman, K M; Rashid, Mahamud-Ur; Sharmin, Rumana; Zhang, Xiaotong; Alam, Munirul; George, Christine Marie

2016-12-07

Household members of cholera patients are at a 100 times higher risk of cholera than the general population. Despite this risk, there are only a handful of studies that have investigated the handwashing practices among hospitalized diarrhea patients and their accompanying household members. To investigate handwashing practices in a hospital setting among this high-risk population, 444 hours of structured observation was conducted in a hospital in Dhaka, Bangladesh, among 148 cholera patients and their household members. Handwashing with soap practices were observed at the following key events: after toileting, after cleaning the anus of a child, after removing child feces, during food preparation, before eating, and before feeding. Spot-checks were also conducted to observe the presence of soap at bathroom areas. Overall, 4% (4/103) of key events involved handwashing with soap among cholera patients and household members during the structured observation period. This was 3% (1/37) among cholera patients and 5% (3/66) for household members. For toileting events, observed handwashing with soap was 7% (3/46) overall, 7% (1/14) for cholera patients, and 6% (2/32) for household members. For food-related events, overall observed handwashing with soap was 2% (2/93 overall), and 0% (0/34) and 3% (2/59) for cholera patients and household members, respectively. Soap was observed at only 7% (4/55) of handwashing stations used by patients and household members during spot-checks. Observed handwashing with soap at key times among patients and accompanying household members was very low. These findings highlight the urgent need for interventions to target this high-risk population. © The American Society of Tropical Medicine and Hygiene.

Embattled and embittered or empowered and evolving: nurse practitioner attitudes toward managed care.

PubMed

Hayes, Eileen F

2007-03-01

To explore the attitudes of nurse practitioners (NPs) toward managed care and to identify the sources of negative attitudes and the factors that may ameliorate them. NPs, members of the Massachusetts Coalition of NPs, participated in in-depth interviews about the impact of managed care on their practice. The sources of NP negativity about managed care for many study participants lay in their not appreciating the importance of the business aspects of practice and the provider's role in controlling healthcare costs, reluctance to work with what they perceived as a rigid "system," and lack of support for them to navigate it. They felt pressured by productivity issues, time constraints, practice restrictions, and documentation demands associated with reimbursement. Those who sustained a more positive attitude were realistic about healthcare economics, were willing and able to negotiate the system, were creative and flexible, and felt empowered by knowledge of the business of practice. Some NPs, however, chose to work in practices where they did not feel as pressured as their counterparts in large, busy primary care practices. IMPLICATIONS FOR NP PRACTICE AND EDUCATION: Understanding experiences that have influenced NP attitudes regarding managed care may assist NP faculty to better prepare NP students for their future roles. NPs must be able to challenge, yet be part of, an evolving system that promotes cost-effective health care for everyone, which was what managed care originally was intended to do.

Developing an Ethical Framework for All Geoscientists: AGI Guidelines for Ethical Professional Conduct

NASA Astrophysics Data System (ADS)

Boland, Maeve A.; Leahy, P. Patrick; Keane, Christopher M.

2016-04-01

In 1997, a group of geoscientists and others recognized the need for a broad-based set of ethical standards for the geosciences that would be an expression of the highest common denominator of values for the profession. The American Geosciences Institute (AGI) coordinated the development of the 1999 AGI Guidelines for Ethical Professional Conduct and their subsequent revision in 2015. AGI is a nonprofit federation of 51 geoscientific and professional organizations that span the geosciences and have approximately 250,000 members. AGI serves as a voice for shared interests in the geoscience community and one of its roles is to facilitate collaboration and discussion among its member societies on matters of common or overarching concern. In this capacity, AGI convened a working group to create the 1999 Guidelines for Ethical Professional Conduct and a further working group to revise the Guidelines in 2015 through a consensus process involving all member societies. The Guidelines are an aspirational document, setting out ideals and high levels of achievement for the profession. They have no provision for disciplinary of enforcement action and they do not supersede the ethics statements or codes of any member society. The 1999 Guidelines pay considerable attention to the professional behavior of geoscientists. The 2015 Guidelines place greater emphasis on the societal context of the geosciences and the responsibilities of geoscientists in areas such as communication, education, and the challenges of understanding complex natural systems. The 2015 Guidelines have been endorsed by 29 member societies to date. To translate the aspirations in the Guidelines into specific actions, AGI has facilitated discussions on the practical implications of aspects of the Guidelines. One outcome of these discussions has been a Consensus Statement Regarding Access and Inclusion of Individuals Living with Disabilities in the Geosciences.

Developing a Taxonomy of Helpful and Harmful Practices for Clinical Work with Boys and Men

ERIC Educational Resources Information Center

Mahalik, James R.; Good, Glenn E.; Tager, David; Levant, Ronald F.; Mackowiak, Christopher

2012-01-01

This study drew upon the knowledge base of member practitioners of the American Psychological Association (APA) to develop a taxonomy of helpful and harmful practices for treatment with boys and men. Four hundred seventy-five APA-member practitioners solicited from practice-related divisions provided responses to 4 open-ended questions about…

QuickStats: Distribution of Long-Term Care Staffing* Hours,(†) by Staff Member Type and Sector - United States, 2014.

PubMed

2016-04-29

In 2014, aides provided more hours of care in the major sectors of long-term care than the other staffing types shown. Aides accounted for 60% of all staffing hours in nursing homes, compared with licensed practical or vocational nurses (21%), registered nurses (13%), activities staff members (5%), and social workers (2%). Aides accounted for 75% of all staffing hours in residential care communities, in contrast to activities staff members (11%), registered nurses (7%), licensed practical or vocational nurses (6%), and social workers (1%). In adult day services centers, aides provided 41% of all staffing hours, followed by activities staff members (32%), registered nurses (12%), licensed practical or vocational nurses (9%), and social workers (6%).

Pharmacy practice department chairs' perspectives on part-time faculty members.

PubMed

Fjortoft, Nancy; Winkler, Susan R; Mai, Thy

2012-05-10

To identify the benefits and consequences of having part-time faculty members in departments of pharmacy practice from the department chair's perspective. A stratified purposive sample of 12 pharmacy practice department chairs was selected. Eleven telephone interviews were conducted. Two investigators independently read interview notes and categorized and enumerated responses to determine major themes using content analysis. The investigators jointly reviewed the data and came to consensus on major themes. Benefits of allowing full-time faculty members to reduce their position to part-time included faculty retention and improved individual faculty work/life balance. Consequences of allowing part-time faculty positions included the challenges of managing individual and departmental workloads, the risk of marginalizing part-time faculty members, and the challenges of promotion and tenure issues. All requests to switch to part-time status were faculty-driven and most were approved. There are a variety of benefits and consequences of having part-time faculty in pharmacy practice departments from the chair's perspective. Clear faculty and departmental expectations of part-time faculty members need to be established to ensure optimal success of this working arrangement.

Adapting total quality management for general practice: evaluation of a programme.

PubMed Central

Lawrence, M; Packwood, T

1996-01-01

OBJECTIVE: Assessment of the benefits and limitations of a quality improvement programme based on total quality management principles in general practice over a period of one year (October 1993-4). DESIGN: Questionnaires to practice team members before any intervention and after one year. Three progress reports completed by facilitators at four month intervals. Semistructured interviews with a sample of staff from each practice towards the end of the year. SETTING: 18 self selected practices from across the former Oxford Region. Three members of each practice received an initial residential course and three one day seminars during the year. Each practice was supported by a facilitator from their Medical Audit Advisory Group. MEASURES: Extent of understanding and implementation of quality improvement methodology. Number, completeness, and evaluation of quality improvement projects. Practice team members' attitudes to and involvement in team working and quality improvement. RESULTS: 16 of the 18 practices succeeded in implementing the quality improvement methods. 48 initiatives were considered and staff involvement was broad. Practice members showed increased involvement in, and appreciation of, strategic planning and team working, and satisfaction from improved patients services. 11 of the practices intend to continue with the methodology. The commonest barrier expressed was time. CONCLUSION: Quality improvement programmes based on total quality management principles produce beneficial changes in service delivery and team working in most general practices. It is incompatible with traditional doctor centred practice. The methodology needs to be adapted for primary care to avoid quality improvement being seen as separate from routine activity, and to save time. PMID:10161529

Family members facilitating community re-integration and return to productivity following traumatic brain injury - motivations, roles and challenges.

PubMed

Gagnon, Alicia; Lin, Jenny; Stergiou-Kita, Mary

2016-01-01

This study explores the experiences of family members in supporting community re-integration and return to productive occupations of the traumatic brain injury (TBI) survivor in order to: (i) describe family members' supportive roles, (ii) determine challenges family members experience in supporting the TBI survivor; and (iii) identify supports that family members require to maintain and enhance their roles. This qualitative descriptive study involved 14 interviews with immediate family members of TBI survivors. Data was analyzed using thematic analysis. Family members expressed strong motivation and engaged in six key roles to support TBI survivors: researcher, case manager, advocate, coach, activities of daily living (ADL)/instrumental ADLs and emotional supporter. Personal and family stressors and challenges navigating the health care system were perceived as challenges in meeting demands of their supportive roles. Stigma also presented a barrier to successful community and vocational re-integration. Subsequently, family members desired more education related to the functional implications of TBI, to be connected to health care and community resources, and sought a greater family-centred care approach. Family members require on-going counseling and community supports to prevent burnout and allow for their continued engagement in their supportive roles. Further education on how to navigate the health care system, access community programs and rights to workplace accommodation is also warranted. Family members are strongly motivated to support survivors' return to productive occupation following a traumatic brain injury, but require counseling and community support to enable their on-going engagement and prevent burnout. Family members can be further empowered through the implementation of family-centred care. Family members requested further education on the long-term functional implications of TBI, how to navigate the health care system, how to access community programs and workers' rights to workplace accommodations.

Education System Reform in China after 1978: Some Practical Implications

ERIC Educational Resources Information Center

Sun, Miantao

2010-01-01

Purpose: This paper aims to provide an overview of education system reform in China since 1978, and its practical implications. Design/methodology/approach: Data were collected from literature review and interview. An overview of education system reform and its practical implications was found through data analysis. Findings: There has been two…

Use of communication techniques by Maryland dentists.

PubMed

Maybury, Catherine; Horowitz, Alice M; Wang, Min Qi; Kleinman, Dushanka V

2013-12-01

Health care providers' use of recommended communication techniques can increase patients' adherence to prevention and treatment regimens and improve patient health outcomes. The authors conducted a survey of Maryland dentists to determine the number and type of communication techniques they use on a routine basis. The authors mailed a 30-item questionnaire to a random sample of 1,393 general practice dentists and all 169 members of the Maryland chapter of the American Academy of Pediatric Dentistry. The overall response rate was 38.4 percent. Analysis included descriptive statistics, analysis of variance and ordinary least squares regression analysis to examine the association of dentists' characteristics with the number of communication techniques used. They set the significance level at P < .05. General dentists reported routinely using a mean of 7.9 of the 18 communication techniques and 3.6 of the seven basic techniques, whereas pediatric dentists reported using a mean of 8.4 and 3.8 of those techniques, respectively. General dentists who had taken a communication course outside of dental school were more likely than those who had not to use the 18 techniques (P < .01) but not the seven basic techniques (P < .05). Pediatric dentists who had taken a communication course outside of dental school were more likely than those who had not to use the 18 techniques (P < .05) and the seven basic techniques (P < .01). The number of communication techniques that dentists used routinely varied across the 18 techniques and was low for most techniques. Practical Implications. Professional education is needed both in dental school curricula and continuing education courses to increase use of recommended communication techniques. Specifically, dentists and their team members should consider taking communication skills courses and conducting an overall evaluation of their practices for user friendliness.

Electronic cigarettes: a survey of perceived patient use and attitudes among members of the British thoracic oncology group.

PubMed

Sherratt, Frances C; Newson, Lisa; Field, John K

2016-05-17

Smoking cessation following lung cancer diagnosis has been found to improve several patient outcomes. Electronic cigarette (e-cigarette) use is now prevalent within Great Britain, however, use and practice among patients with lung cancer has not as yet been explored. The current study aims to explore e-cigarette use among patients and examine current practice among clinicians. The results have important implications for future policy and practice. Members of The British Thoracic Oncology Group (BTOG) were contacted via several e-circulations (N = 2,009), requesting them to complete an online survey. Of these, 7.7 % (N = 154) completed the survey, which explored participant demographics and smoking history, perceptions of patient e-cigarette use, practitioner knowledge regarding sources of guidance pertaining to e-cigarettes, and practitioner advice. Practitioners frequently observed e-cigarette use among patients with lung cancer. The majority of practitioners (81.4 %) reported responding to patient queries pertaining to e-cigarettes within the past year; however, far fewer (21.0 %) felt confident providing patients with e-cigarette advice. Practitioner confidence was found to differentiate by gender (p = 0.012) and employment speciality (p = 0.030), with nurses reporting particularly low levels of confidence in advising. The results also demonstrate extensive variability regarding the practitioner advice content. The results demonstrate that patients refer to practitioners as a source of e-cigarette guidance, yet few practitioners feel confident advising. The absence of evidence-based guidance may have contributed towards the exhibited inconsistencies in practitioner advice. The findings highlight that training should be delivered to equip practitioners with the knowledge and confidence to advise patients effectively; this could subsequently improve smoking cessation rates and patient outcomes.

Religious and Secular Coping and Family Relationships in the Neonatal Intensive Care Unit

PubMed Central

Brelsford, Gina M.; Ramirez, Joshua; Veneman, Kristin; Doheny, Kim K.

2017-01-01

Background Preterm birth is an unanticipated and stressful event for parents. In addition, the unfamiliar setting of the intensive care nursery necessitates strategies for coping. Purpose The primary study objective of this descriptive study was to determine whether secular and religious coping strategies were related to family functioning in the neonatal intensive care unit. Methods Fifty-two parents of preterm (25–35 weeks’ gestation) infants completed the Brief COPE (secular coping), the Brief RCOPE (religious coping), and the Family Environment Scale within 1 week of their infant’s hospital admission. Findings This descriptive study found that parents’ religious and secular coping was significant in relation to family relationship functioning. Specifically, negative religious coping (ie, feeling abandoned or angry at God) was related to poorer family cohesion and use of denial. Implications for Practice These findings have relevance for interventions focused toward enhancing effective coping for families. Implications for Research Further study of religious and secular coping strategies for neonatal intensive care unit families is warranted in a larger more diverse sample of family members. PMID:27391569

Count Your Calories and Share Them: Health Benefits of Sharing mHealth Information on Social Networking Sites.

PubMed

Oeldorf-Hirsch, Anne; High, Andrew C; Christensen, John L

2018-04-23

This study investigates the relationship between sharing tracked mobile health (mHealth) information online, supportive communication, feedback, and health behavior. Based on the Integrated Theory of mHealth, our model asserts that sharing tracked health information on social networking sites benefits users' perceptions of their health because of the supportive communication they gain from members of their online social networks and that the amount of feedback people receive moderates these associations. Users of mHealth apps (N = 511) completed an online survey, and results revealed that both sharing tracked health information and receiving feedback from an online social network were positively associated with supportive communication. Network support both corresponded with improved health behavior and mediated the association between sharing health information and users' health behavior. As users received greater amounts of feedback from their online social networks, however, the association between sharing tracked health information and health behavior decreased. Theoretical implications for sharing tracked health information and practical implications for using mHealth apps are discussed.

Financial and employment problems in families of children with special health care needs: implications for research and practice.

PubMed

Looman, Wendy S; O'Conner-Von, Susan K; Ferski, Gabriela J; Hildenbrand, Debra A

2009-01-01

The purpose of this study was to identify factors related to financial burden among families of children with special needs and to identify specific provider-level activities associated with decreased risk for such burden. Data for secondary analysis are from the National Survey of Children with Special Health Care Needs (CSHCN). Logistic regression analysis of state-level data was conducted to identify significant predictors of financial and employment problems among families of children with SHCN in Minnesota. Children with more severe conditions and whose family members provided health care at home were more likely to have parents report financial and employment problems due to the child's condition. On the other hand, families whose health care providers communicated well with other service providers and who helped them feel like partners in their child's care were significantly less likely to report financial and employment problems. Pediatric nurses and nurse practitioners can use these findings as they work with families for optimal family outcomes. Advocacy and policy implications at state and federal levels also are discussed.

Insights into the Shifting Perspectives of Members of the Gypsy and Traveller Community on Schooling, and Implications for School Leaders

ERIC Educational Resources Information Center

Smith, Anna R. T.

2017-01-01

This article focuses on the perceptions and experiences of education of two female adult members of the Gypsy and Traveller community and one female adult member of the settled community who works closely with Travellers. Narrative interviews were conducted in England in 2016, to gain some understanding of the factors contributing to the…

Exploring sources of knowledge utilized in practice among Jordanian registered nurses.

PubMed

Al-Ghabeesh, Suhair Husni; Abu-Moghli, Fathieh; Salsali, Mahvash; Saleh, Mohammad

2013-10-01

Understanding sources of knowledge used in everyday practice is very helpful in improving the quality of health care services. There is a consensus in the literature that nurses mostly relied in their practice on experiential knowledge gained through their interactions with other members of health care professionals and patients. The general aim of this study is to explore the sources of knowledge Jordanian registered nurses use during their practice. A descriptive correlational design was used to collect data from 539 Jordanian registered nurses from 10 hospitals using a self-administered questionnaire. The mean year of experience of the sample was 7.08 years. Of the 615 questionnaires distributed, 555 were returned. This yields a response rate of 87.6%. Results revealed that the top five ranked sources used by Jordanian registered nurses include: the information that nurses learned during nursing education, personal experience in nursing over time, what was learned through providing care to patients, information gained through discussion between physicians and nurses about patients, and information from policy and procedure manuals. Jordanian registered nurses recognize the value of research and that research utilization (RU) is an important issue and must not be ignored. The study has many implications for practice, education and research. Health care managers and decision makers need to play a more visible and instrumental role in encouraging RU to improve patients' quality of life. © 2012 John Wiley & Sons Ltd.

Clinical PhD graduate student views of their scientist-practitioner training.

PubMed

VanderVeen, Joseph W; Reddy, L Felice; Veilleux, Jennifer C; January, Alicia M; DiLillo, David

2012-09-01

The goal of the scientist-practitioner (S-P) training model is to produce clinical psychologists equipped to integrate and utilize both science and practice in the clinical and research domains. However, much has been written regarding the possible shortcomings of S-P training and whether clinical psychology graduate students are actually gaining the knowledge and skills to integrate science and practice during graduate training and beyond (Chang, Lee, & Hargreaves, 2008; Gelso, 2006; Merlo, Collins, & Bernstein, 2008; Phillips, 1993). As such, the present study assessed ratings of satisfaction, perception of ability, and use of the S-P training model within 653 clinical psychology graduate students enrolled in programs that are members of the Council of University Directors of Clinical Psychology. Findings suggest that students are consistently trained in the integration of science and practice and have confidence in their abilities to apply the S-P integration to research and clinical work. However, despite understanding the ways in which science can influence practice, over one third of students reported that they rarely use science-based decisions when informing clients of the clinical services they will be providing. The implications of these results support the need for a more detailed evaluation of clinical psychology graduate students as well as the use of research-informed practice and the process of providing clients with information they need to make informed choices about treatment. © 2012 Wiley Periodicals, Inc.

Who Sleeps by Whom Revisited: A Method for Extracting the Moral Goods Implicit in Practice.

ERIC Educational Resources Information Center

Schweder, Richard A; And Others

1995-01-01

Explores the specific family practice of determining which family members share a bed or sleeping space. Discusses ways of extracting the moral principles implicit in the practice of arranging where family members sleep at night. Examines similarities and differences in the preferred moral goods of two culture regions--rural Hindu India and urban…

Self-care practices and experiences of people living with HIV not receiving antiretroviral therapy in an urban community of Lusaka, Zambia: implications for HIV treatment programmes

PubMed Central

2013-01-01

Background Despite the increasingly wider availability of antiretroviral therapy (ART), some people living with HIV (PLHIV) and eligible for treatment have opted to adopt self-care practices thereby risking early AIDS-related mortality. Methods A qualitative study was conducted in urban Zambia to gain insights into PLHIV self-care practices and experiences and explore the implications for successful delivery of ART care. Between March 2010 and September 2011, in-depth interviews were conducted with PLHIV who had dropped out of treatment (n=25) and those that had opted not to initiate medication (n=37). Data was entered into and managed using Atlas ti, and analysed inductively using latent content analysis. Results PHIV used therapeutic and physical health maintenance, psychological well-being and healthy lifestyle self-care practices to maintain physical health and mitigate HIV-related symptoms. Herbal remedies, faith healing and self-prescription of antibiotics and other conventional medicines to treat HIV-related ailments were used for therapeutic and physical health maintenance purposes. Psychological well-being self-care practices used were religiosity/spirituality and positive attitudes towards HIV infection. These practices were modulated by close social network relationships with other PLHIV, family members and peers, who acted as sources of emotional, material and financial support. Cessations of sexual relationships, adoption of safe sex to avoid re-infections and uptake of nutritional supplements were the commonly used risk reduction and healthy lifestyle practices respectively. Conclusions While these self-care practices may promote physical and psychosocial well-being and mitigate AIDS-related symptoms, at least in the short term, they however undermine PLHIV access to ART care thereby putting PLHIV at risk of early AIDS-related mortality. The use of scientifically unproven herbal remedies raises health and safety concerns; faith healing may create fatalism and resignation with death while the reported self-prescription of antibiotics to treat HIV-related infections raises concerns about future development of microbial drug resistance amongst PLHIV. Collectively, these self-care practices undermine efforts to effectively abate the spread and burden of HIV and reduce AIDS-related mortality. Therefore, there is need for sensitization campaigns on the benefits of ART and the risks associated with widespread self-prescription of antibiotics and use of scientifically unproven herbal remedies. PMID:23675734

The meaning of technology in an intensive care unit--an interview study.

PubMed

Wikström, Ann-Charlott; Cederborg, Ann-Christin; Johanson, Marita

2007-08-01

Previous research has suggested technology may dehumanise patient care and also that technology may restrict nurses' freedom of action. This raises questions about the relationship between technology, care and medicine in units where the patient's need for treatment is often an emergency. The aim of the study was to explore how staff members in an intensive care unit (ICU) make sense of technology in their everyday practice. Twelve staff members from one ICU were interviewed about their understanding of technology in their everyday practice. Three main findings emerged from the analysis: Technology seems to be considered decisive as it directs and controls medical treatment and results in the patients' well being; technology is seen as facilitating everyday practice because it makes treatment more secure and decreases workload; however technology can complicate the staff members' everyday practice as it is not completely trustworthy, is not easy to handle and can cause ethical dilemmas. Contrary to previous findings this study shows that technology seems to be embedded in care and medical treatment. Furthermore, the meaning of technology appears to be dependent on the different staff members' accounting practices.

Consent process for US-based family reference DNA samples.

PubMed

Katsanis, Sara H; Snyder, Lindsey; Arnholt, Kelly; Mundorff, Amy Z

2018-01-01

DNA collection from family members of the missing is a tenet for missing persons' and mass fatality investigations. Procedures for consenting family members are disparate, depending on the context supporting the reason for sample collection. While guidelines and best practices have been developed for handling mass fatalities and for identification of the missing, these guidelines do not address standard consent practices for living family members of potential victims. We examined the relevant U.S. laws, international guidelines and best practices, sampled consent forms currently used for DNA collection of family members, and drafted model language for a consent form to communicate the required and recommended information. We modeled the consent form on biobank consenting practices and tested the consent language among students and the general population for constructive feedback and readability. We also asked respondents to consider the options for DNA collection and either hypothetically agree or disagree. The model language presented here highlights information important to relay in consent processes and can serve as a foundation for future consent practices in mass fatalities and missing persons' investigations. Copyright © 2017 Elsevier B.V. All rights reserved.

A pilot study of the experience of participating in a Therapeutic Touch practice group.

PubMed

Moore, Theresa; Ting, Brigid; Rossiter-Thornton, Maria

2008-09-01

This pilot study explored the experience of participating in a Therapeutic Touch practice group. A qualitative descriptive-exploratory method was used, involving 12 members of practice groups in Ontario and British Columbia, Canada. Analysis of the data using an extraction-synthesis process yielded four themes: (a) learning with others through sharing and hands-on experience is valued; (b) connecting with a network of supportive relationships that sustain self and Therapeutic Touch practice; (c) comfort-discomfort arising with self, others, or ideas; and (d) meaningful changes emerge while experiencing group energy and Therapeutic Touch. The findings expand current knowledge about the positive aspects of participating in practice groups and provide a beginning understanding of member discomfort, which had not been previously reported. This knowledge will be useful to Therapeutic Touch organizations, practice group leaders, and group members. It will also guide health care agencies and practitioners of other healing modalities who may be considering establishing practice groups.

District health manager and mid-level provider perceptions of practice environments in acute obstetric settings in Tanzania: a mixed-method study.

PubMed

Ng'ang'a, Njoki; Byrne, Mary Woods; Kruk, Margaret E; Shemdoe, Aloisia; de Pinho, Helen

2016-08-08

In sub-Saharan Africa, the capacity of human resources for health (HRH) managers to create positive practice environments that enable motivated, productive, and high-performing HRH is weak. We implemented a unique approach to examining HRH management practices by comparing perspectives offered by mid-level providers (MLPs) of emergency obstetric care (EmOC) in Tanzania to those presented by local health authorities, known as council health management teams (CHMTs). This study was guided by the basic strategic human resources management (SHRM) component model. A convergent mixed-method design was utilized to assess qualitative and quantitative data from the Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers project. Survey data was obtained from 837 mid-level providers, 83 of whom participated in a critical incident interview whose aim was to elicit negative events in the practice environment that induced intention to leave their job. HRH management practices were assessed quantitatively in 48 districts with 37 members of CHMTs participating in semi-structured interviews. The eight human resources management practices enumerated in the basic SHRM component model were implemented unevenly. On the one hand, members of CHMTs and mid-level providers agreed that there were severe shortages of health workers, deficient salaries, and an overwhelming workload. On the other hand, members of CHMTs and mid-level providers differed in their perspectives on rewards and allocation of opportunities for in-service training. Although written standards of performance and supervision requirements were available in most districts, they did not reflect actual duties. Members of CHMTs reported high levels of autonomy in key HRH management practices, but mid-level providers disputed the degree to which the real situation on the ground was factored into job-related decision-making by CHMTs. The incongruence in perspectives offered by members of CHMTs and mid-level providers points to deficient HRH management practices, which contribute to poor practice environments in acute obstetric settings in Tanzania. Our findings indicate that members of CHMTs require additional support to adequately fulfill their HRH management role. Further research conducted in low-income countries is necessary to determine the appropriate package of interventions required to strengthen the capacity of members of CHMTs.

Important challenges for coordination and inter-municipal cooperation in health care services: a Delphi study

PubMed Central

2013-01-01

Background Demographical changes have stimulated a coordination reform in the Norwegian health care sector, creating new working practices and extending coordination within and between primary and hospital care, increasing the need for inter-municipal cooperation (IMC). This study aimed to identify challenges to coordination and IMC in the Norwegian health care sector as a basis for further theorizing and managerial advice in this growing area of research and practice. Methods A Delphi study of consensus development was used. Experts in coordination and IMC in health care services were selected by the healthcare manager or the councillor in their respective municipalities. In the first round, an expert panel received open-ended questions addressing possible challenges, and their answers were categorized and consolidated as the basis for further validation in the second round. The expert panel members were then asked to point out important statements in the third round, before the most important statements ranked by a majority of the members were rated again in the fourth round, including the option to explain the ratings. The same procedure was used in round five, with the exception that the expert panel members could view the consolidated results of their previous rankings as the basis for a new and final rating. The statements reaching consensus in round five were abstracted and themed. Results Nineteen experts consented to participate. Nine experts (47%) completed all of the five rounds. Eight statements concerning coordination reached consensus, resulting in four themes covering these challenges: different culture, uneven balance of power, lack of the possibility to communicate electronically, and demanding tasks in relation to resources. Three statements regarding challenges to IMC reached consensus, resulting in following themes: coopetition, complex leadership, and resistance to change. Conclusions This study identified several important challenges for coordination and it supports previous research. IMC in health care services deals with challenges other than coordination, and these must be addressed specifically. Our study contributes to extended knowledge of theoretical and practical implications in the field of coordination and IMC in health care sector. PMID:24171839

Palliative and end-of-life care in stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

PubMed

Holloway, Robert G; Arnold, Robert M; Creutzfeldt, Claire J; Lewis, Eldrin F; Lutz, Barbara J; McCann, Robert M; Rabinstein, Alejandro A; Saposnik, Gustavo; Sheth, Kevin N; Zahuranec, Darin B; Zipfel, Gregory J; Zorowitz, Richard D

2014-06-01

The purpose of this statement is to delineate basic expectations regarding primary palliative care competencies and skills to be considered, learned, and practiced by providers and healthcare services across hospitals and community settings when caring for patients and families with stroke. Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were chosen to reflect the diversity and expertise of professional roles in delivering optimal palliative care. Writing group members were assigned topics relevant to their areas of expertise, reviewed the appropriate literature, and drafted manuscript content and recommendations in accordance with the American Heart Association's framework for defining classes and level of evidence and recommendations. The palliative care needs of patients with serious or life-threatening stroke and their families are enormous: complex decision making, aligning treatment with goals, and symptom control. Primary palliative care should be available to all patients with serious or life-threatening stroke and their families throughout the entire course of illness. To optimally deliver primary palliative care, stroke systems of care and provider teams should (1) promote and practice patient- and family-centered care; (2) effectively estimate prognosis; (3) develop appropriate goals of care; (4) be familiar with the evidence for common stroke decisions with end-of-life implications; (5) assess and effectively manage emerging stroke symptoms; (6) possess experience with palliative treatments at the end of life; (7) assist with care coordination, including referral to a palliative care specialist or hospice if necessary; (8) provide the patient and family the opportunity for personal growth and make bereavement resources available if death is anticipated; and (9) actively participate in continuous quality improvement and research. Addressing the palliative care needs of patients and families throughout the course of illness can complement existing practices and improve the quality of life of stroke patients, their families, and their care providers. There is an urgent need for further research in this area. © 2014 American Heart Association, Inc.

Netball team members, but not hobby group members, distinguish team characteristics from group characteristics.

PubMed

Stillman, Jennifer A; Fletcher, Richard B; Carr, Stuart C

2007-04-01

Research on groups is often applied to sport teams, and research on teams is often applied to groups. This study investigates the extent to which individuals have distinct schemas for groups and teams. A list of team and group characteristics was generated from 250 individuals, for use in this and related research. Questions about teams versus groups carry an a priori implication that differences exist; therefore, list items were presented to new participants and were analyzed using signal detection theory, which can accommodate a finding of no detectable difference between a nominated category and similar items. Participants were 30 members from each of the following: netball teams, the general public, and hobby groups. Analysis revealed few features that set groups apart from teams; however, teams were perceived as more structured and demanding, requiring commitment and effort toward shared goals. Team and group characteristics were more clearly defined to team members than they were to other participant groups. The research has implications for coaches and practitioners.

Ensuring Resident Competence: A Narrative Review of the Literature on Group Decision Making to Inform the Work of Clinical Competency Committees.

PubMed

Hauer, Karen E; Cate, Olle Ten; Boscardin, Christy K; Iobst, William; Holmboe, Eric S; Chesluk, Benjamin; Baron, Robert B; O'Sullivan, Patricia S

2016-05-01

Background The expectation for graduate medical education programs to ensure that trainees are progressing toward competence for unsupervised practice prompted requirements for a committee to make decisions regarding residents' progress, termed a clinical competency committee (CCC). The literature on the composition of these committees and how they share information and render decisions can inform the work of CCCs by highlighting vulnerabilities and best practices. Objective We conducted a narrative review of the literature on group decision making that can help characterize the work of CCCs, including how they are populated and how they use information. Methods English language studies of group decision making in medical education, psychology, and organizational behavior were used. Results The results highlighted 2 major themes. Group member composition showcased the value placed on the complementarity of members' experience and lessons they had learned about performance review through their teaching and committee work. Group processes revealed strengths and limitations in groups' understanding of their work, leader role, and information-sharing procedures. Time pressure was a threat to the quality of group work. Conclusions Implications of the findings include the risks for committees that arise with homogeneous membership, limitations to available resident performance information, and processes that arise through experience rather than deriving from a well-articulated purpose of their work. Recommendations are presented to maximize the effectiveness of CCC processes, including their membership and access to, and interpretation of, information to yield evidence-based, well-reasoned judgments.

Panel 4: Report of the Microbiology Panel

PubMed Central

Barenkamp, Stephen J.; Chonmaitree, Tasnee; Hakansson, Anders P.; Heikkinen, Terho; King, Samantha; Nokso-Koivisto, Johanna; Novotny, Laura A.; Patel, Janak A.; Pettigrew, Melinda; Swords, W. Edward

2017-01-01

Objective To perform a comprehensive review of the literature from July 2011 until June 2015 on the virology and bacteriology of otitis media in children. Data Sources PubMed database of the National Library of Medicine. Review Methods Two subpanels comprising experts in the virology and bacteriology of otitis media were created. Each panel reviewed the relevant literature in the fields of virology and bacteriology and generated draft reviews. These initial reviews were distributed to all panel members prior to meeting together at the Post-symposium Research Conference of the 18th International Symposium on Recent Advances in Otitis Media, National Harbor, Maryland, in June 2015. A final draft was created, circulated, and approved by all panel members. Conclusions Excellent progress has been made in the past 4 years in advancing our understanding of the microbiology of otitis media. Numerous advances were made in basic laboratory studies, in animal models of otitis media, in better understanding the epidemiology of disease, and in clinical practice. Implications for Practice (1) Many viruses cause acute otitis media without bacterial coinfection, and such cases do not require antibiotic treatment. (2) When respiratory syncytial virus, metapneumovirus, and influenza virus peak in the community, practitioners can expect to see an increase in clinical otitis media cases. (3) Biomarkers that predict which children with upper respiratory tract infections will develop otitis media may be available in the future. (4) Compounds that target newly identified bacterial virulence determinants may be available as future treatment options for children with otitis media. PMID:28372529

Panel 4: Report of the Microbiology Panel.

PubMed

Barenkamp, Stephen J; Chonmaitree, Tasnee; Hakansson, Anders P; Heikkinen, Terho; King, Samantha; Nokso-Koivisto, Johanna; Novotny, Laura A; Patel, Janak A; Pettigrew, Melinda; Swords, W Edward

2017-04-01

Objective To perform a comprehensive review of the literature from July 2011 until June 2015 on the virology and bacteriology of otitis media in children. Data Sources PubMed database of the National Library of Medicine. Review Methods Two subpanels comprising experts in the virology and bacteriology of otitis media were created. Each panel reviewed the relevant literature in the fields of virology and bacteriology and generated draft reviews. These initial reviews were distributed to all panel members prior to meeting together at the Post-symposium Research Conference of the 18th International Symposium on Recent Advances in Otitis Media, National Harbor, Maryland, in June 2015. A final draft was created, circulated, and approved by all panel members. Conclusions Excellent progress has been made in the past 4 years in advancing our understanding of the microbiology of otitis media. Numerous advances were made in basic laboratory studies, in animal models of otitis media, in better understanding the epidemiology of disease, and in clinical practice. Implications for Practice (1) Many viruses cause acute otitis media without bacterial coinfection, and such cases do not require antibiotic treatment. (2) When respiratory syncytial virus, metapneumovirus, and influenza virus peak in the community, practitioners can expect to see an increase in clinical otitis media cases. (3) Biomarkers that predict which children with upper respiratory tract infections will develop otitis media may be available in the future. (4) Compounds that target newly identified bacterial virulence determinants may be available as future treatment options for children with otitis media.

Ensuring Resident Competence: A Narrative Review of the Literature on Group Decision Making to Inform the Work of Clinical Competency Committees

PubMed Central

Hauer, Karen E.; Cate, Olle ten; Boscardin, Christy K.; Iobst, William; Holmboe, Eric S.; Chesluk, Benjamin; Baron, Robert B.; O'Sullivan, Patricia S.

2016-01-01

Background The expectation for graduate medical education programs to ensure that trainees are progressing toward competence for unsupervised practice prompted requirements for a committee to make decisions regarding residents' progress, termed a clinical competency committee (CCC). The literature on the composition of these committees and how they share information and render decisions can inform the work of CCCs by highlighting vulnerabilities and best practices. Objective We conducted a narrative review of the literature on group decision making that can help characterize the work of CCCs, including how they are populated and how they use information. Methods English language studies of group decision making in medical education, psychology, and organizational behavior were used. Results The results highlighted 2 major themes. Group member composition showcased the value placed on the complementarity of members' experience and lessons they had learned about performance review through their teaching and committee work. Group processes revealed strengths and limitations in groups' understanding of their work, leader role, and information-sharing procedures. Time pressure was a threat to the quality of group work. Conclusions Implications of the findings include the risks for committees that arise with homogeneous membership, limitations to available resident performance information, and processes that arise through experience rather than deriving from a well-articulated purpose of their work. Recommendations are presented to maximize the effectiveness of CCC processes, including their membership and access to, and interpretation of, information to yield evidence-based, well-reasoned judgments. PMID:27168881

Intergroup Contact and Outgroup Humanization: Is the Causal Relationship Uni- or Bidirectional?

PubMed

Capozza, Dora; Di Bernardo, Gian Antonio; Falvo, Rossella

2017-01-01

The attribution of uniquely human characteristics to the outgroup may favor the search for contact with outgroup members and, vice versa, contact experiences may improve humanity attributions to the outgroup. To explore this bidirectional relationship, two studies were performed. In Study 1, humanity perceptions were manipulated using subliminal conditioning. Two experimental conditions were created. In the humanization condition, the unconditioned stimuli (US) were uniquely human words; in the dehumanization condition, the US were non-uniquely human and animal words. In both conditions, conditioned stimuli were typical outgroup faces. An approach/avoidance technique (the manikin task) was used to measure the willingness to have contact with outgroup members. Findings showed that in the humanization condition participants were faster in approaching than in avoiding outgroup members: closeness to the outgroup was preferred to distance. Latencies of approach and avoidance movements were not different in the dehumanization condition. In Study 2, contact was manipulated using the manikin task. One approach (contact) condition and two control conditions were created. The attribution of uniquely human traits to the outgroup was stronger in the contact than in the no-contact conditions. Furthermore, the effect of contact on humanity attributions was mediated by increased trust toward the outgroup. Thus, findings demonstrate the bidirectionality of the relationship between contact and humanity attributions. Practical implications of findings are discussed.

CE: Original Research: The Experience of Transitioning to a Caregiving Role for a Family Member with Alzheimer's Disease or Related Dementia.

PubMed

Czekanski, Kathleen

2017-09-01

: Background: Alzheimer's disease is a chronic, debilitating disease that currently affects an estimated 5.5 million Americans. The majority are being cared for at home by family caregivers, who are known to have higher levels of burden than any other group of caregivers. The purpose of this phenomenological study was to explore the lived experiences of people who transition to the role of caregiver for a family member with Alzheimer's disease or a related dementia. The study used purposeful sampling. Eight women and two men (mean age, 66.3 years) participated. Data were collected through in-depth semistructured interviews, along with observational field notes. Data were analyzed using a hermeneutic phenomenological approach. The average duration of caregiving reported by participants was five years. Seven themes were uncovered: something is wrong; journey to diagnosis: ambiguity and negative emotions; shifting roles and relationships: losses and challenges; seeking knowledge and support: solutions and frustrations; adapting to the topsy-turvy world of caregiving: finding purpose; preserving self without guilt; and finding a way out. The study findings have implications for nursing education, research, and practice, with participants expressing needs for better communication and access to resources. The findings also suggest the importance of health care planning early in the disease process, and of raising awareness about nurses as a resource for family members.

Variation of Kozinets' framework and application to nursing research.

PubMed

Witney, Cynthia; Hendricks, Joyce; Cope, Vicki

2016-05-01

Online communities are new sites for undertaking research, with their textual interactions providing a rich source of data in real time. 'Ethnonetnography' is a research methodology based on ethnography that can be used in these online communities. In this study, the researcher and a specialist breast care nurse (SBCN) were immersed in the online community, adding to patients' breast cancer care and providing a nursing research component to the community. To examine Kozinets' ( 2010 ) framework for ethnonetnography and how it may be varied for use in a purpose-built, disease-specific, online support community. The online community provided an area where members could communicate with each other. Kozinets' ( 2010 ) framework was varied in that the research was carried out in a purpose-built community opf which an SBCN was a member who could provide support and advice. The application of the ethnonetnographic methodology has wide implications for clinical nursing practice and research. Ethnonetnography can be used to study disease-specific communities in a focused manner and can provide immediate benefits through the inclusion of an expert nurse and contemporaneous application of research findings to patient care. With ethical permission and the permission of online community members, nurse researchers can enter already established online communities. Ethnonetnography is ideally suited to nursing research as it provides the immediacy of evidence-based interaction with an expert nurse. These real-time responses improve support for those experiencing a critical life event.

Patient and family communication during consultation visits: The effects of a decision aid for treatment decision-making for localized prostate cancer

PubMed Central

Song, Lixin; Tyler, Christina; Clayton, Margaret F.; Rodgiriguez-Rassi, Eleanor; Hill, Latorya; Bai, Jinbing; Pruthi, Raj; Bailey, Donald E.

2016-01-01

Objective To analyze the effects of a decision aid on improving patients’ and family members’ information giving and question asking during consultations for prostate cancer treatment decision-making. Methods This study is a secondary analysis of archived audio-recorded real-time consultation visits with participants from a randomized clinical trial. Participants were randomly assigned into three groups: TD—intervention targeted patient-only; TS—intervention targeted patients and family members; and control—a handout on staying healthy during treatment. We conducted content analysis using a researcher-developed communication coding system. Using SAS 9.3, we conducted Chi-square/Fisher’s exact test to examine whether information giving and question asking among patients and family members varied by groups when discussing different content/topics. Results Compared with those in the TS and control groups, significantly higher percentages of participants in the TD group demonstrated information giving in discussing topics about diagnosis, treatment options, risks and benefits, and preferences; and engaged in question asking when discussing diagnosis, watchful waiting/active surveillance, risks and benefits, and preferences for treatment impacts. Conclusion Information support and communication skills training for patients were effective in improving communication during treatment decision-making consultations. Practice implications Providing information about prostate cancer and communication skills training empower patients and their family members. PMID:27692491

Do Antidepressant Advertisements Educate Consumers and Promote Communication Between Patients with Depression and Their Physicians?

PubMed Central

Bell, Robert A.; Taylor, Laramie D.; Kravitz, Richard L.

2010-01-01

Objective To examine how online depression support group members respond to direct-to-consumer (DTC) antidepressant advertising. Methods Survey of 148 depression forum members, administered via an online questionnaire. Results Chronicity was high, as 79.1% had received a diagnosis of depression 3 or more years earlier. Respondents reported seeing advertisements for an average of 4.3 of 7 brands investigated. A majority rated the information quality of these advertisements as “poor” or “fair.” Attitudes toward antidepressant advertisements were neutral (mean: 2.96 on a 5-point scale). More than half (52.4%) visited official websites provided in these advertisements, 39.9% had talked with a doctor after seeing an advertisement, 20.3% made an advertisement-induced prescription request, and 25.7% said these advertisements reminded them to take their antidepressants. Amount of attention given to these advertisements correlated positively with belief in the brain chemical imbalance causal model, but belief in this model did not predict prescription requests. Conclusion Awareness of DTC antidepressant advertisements is high among individuals with depression, but so is skepticism. Practice Implications Among members of an on-line support group, these advertisements encourage patient-doctor dialogue, prescription requests, and adherence, but might also reduce the acceptability of psychotherapy and encourage doctor switching in a small number of patients. PMID:20176456

Exploring community faculty members’ engagement in educational scholarship

PubMed Central

Law, Marcus; Wright, Sarah; Mylopoulos, Maria

2016-01-01

Abstract Objective To obtain a deeper understanding of community faculty members’ perceptions about engagement in educational scholarship. Design One-on-one semistructured interviews that were audiorecorded, transcribed verbatim, and subsequently analyzed. Setting Toronto, Ont. Participants Purposive, theoretical sample of 8 physician faculty members at the University of Toronto. Methods Interview transcripts were analyzed using a grounded theory approach. Emergent themes were identified by the research team through a process of constant comparative analysis. Main findings Community faculty members identified themselves professionally as clinicians and teachers, and they did not see themselves as scholars in medical education. While they believed that educational scholarship was important for the field more broadly, they did not see the personal or professional value of being involved. This attitude stemmed from the perception that there was not a direct link between scholarly activity and improvement in teaching or patient care. Instead, participants viewed scholarly activity as a mode of career advancement rather than practice improvement. Furthermore, they equated educational scholarship with clinical research, thereby excluding themselves from participation in scholarly activities. Conclusion When developing strategies to engage community faculty members in educational scholarship, it is important to consider the implications of members’ professional identity, as well as implicit models of scholarship. To expand the concept of educational scholarship beyond research activities, additional scholarly contributions need to be supported, recognized, and valued. PMID:27629687

Effects of New Funding Models for Patient-Centered Medical Homes on Primary Care Practice Finances and Services: Results of a Microsimulation Model.

PubMed

Basu, Sanjay; Phillips, Russell S; Song, Zirui; Landon, Bruce E; Bitton, Asaf

2016-09-01

We assess the financial implications for primary care practices of participating in patient-centered medical home (PCMH) funding initiatives. We estimated practices' changes in net revenue under 3 PCMH funding initiatives: increased fee-for-service (FFS) payments, traditional FFS with additional per-member-per-month (PMPM) payments, or traditional FFS with PMPM and pay-for-performance (P4P) payments. Net revenue estimates were based on a validated microsimulation model utilizing national practice surveys. Simulated practices reflecting the national range of practice size, location, and patient population were examined under several potential changes in clinical services: investments in patient tracking, communications, and quality improvement; increased support staff; altered visit templates to accommodate longer visits, telephone visits or electronic visits; and extended service delivery hours. Under the status quo of traditional FFS payments, clinics operate near their maximum estimated possible net revenue levels, suggesting they respond strongly to existing financial incentives. Practices gained substantial additional net annual revenue per full-time physician under PMPM or PMPM plus P4P payments ($113,300 per year, 95% CI, $28,500 to $198,200) but not under increased FFS payments (-$53,500, 95% CI, -$69,700 to -$37,200), after accounting for costs of meeting PCMH funding requirements. Expanding services beyond minimum required levels decreased net revenue, because traditional FFS revenues decreased. PCMH funding through PMPM payments could substantially improve practice finances but will not offer sufficient financial incentives to expand services beyond minimum requirements for PCMH funding. © 2016 Annals of Family Medicine, Inc.

Cognitive behavioral therapy in practice: therapist perceptions of techniques, outcome measures, practitioner qualifications, and relation to research.

PubMed

Bohman, Benjamin; Santi, Alberto; Andersson, Gerhard

2017-09-01

Cognitive behavioral therapy (CBT) has a strong evidence base for several psychiatric disorders, however, it may be argued that currently there is no overall agreement on what counts as 'CBT'. One reason is that CBT is commonly perceived as encompassing a broad range of treatments, from purely cognitive to purely behavioral, making it difficult to arrive at a clear definition. The purpose of the present study was to explore practicing therapists' perceptions of CBT. Three hundred fifty members of two multi-disciplinary interest groups for CBT in Sweden participated. Mean age was 46 years, 68% were females, 63% psychologists and mean number of years of professional experience was 12 years. Participants completed a web-based survey including items covering various aspects of CBT practice. Overall, therapist perceptions of the extent to which different treatment techniques and procedures were consistent with CBT were in line with current evidence-based CBT protocols and practice guidelines, as were therapists' application of the techniques and procedures in their own practice. A majority of participants (78%) agreed that quality of life or level of functioning were the most important outcome measures for evaluating treatment success. Eighty percent of therapists believed that training in CBT at a basic level was a requirement for practicing CBT. There was a medium size Spearman correlation of r s= .46 between the perceived importance of research to practice and the extent to which participants kept themselves updated on research. Implications for training, quality assurance, and the effectiveness of CBT in clinical practice are discussed.

Understanding Mental Illness Stigma Toward Persons With Multiple Stigmatized Conditions: Implications of Intersectionality Theory.

PubMed

Oexle, Nathalie; Corrigan, Patrick W

2018-05-01

People with mental illness are often members of multiple stigmatized social groups. Therefore, experienced disadvantage might not be determined solely by mental illness stigma. Nevertheless, most available research does not consider the effects and implications of membership in multiple stigmatized social groups among people with mental illness. Reflecting on intersectionality theory, the authors discuss two intersectional effects determining disadvantage among people with mental illness who are members of multiple stigmatized social groups, namely double disadvantage and prominence. To be effective, interventions to reduce disadvantage experienced by people with mental illness need to be flexible and targeted rather than universal in order to address the implications of intersectionality. Whereas education-based approaches usually assume homogeneity and use universal strategies, contact-based interventions consider diversity among people with mental illness.

Alcohol management practices in community football clubs: Association with risky drinking at the club and overall hazardous alcohol consumption.

PubMed

Rowland, Bosco; Tindall, Jenny; Wolfenden, Luke; Gillham, Karen; Ramsden, Robyn; Wiggers, John

2015-07-01

Across the world, it has been estimated that approximately 270 million people participate in community football clubs. However, the community sports club setting is associated with high levels of risky alcohol consumption. The study examined if sporting club alcohol management practices are associated with risky consumption of alcohol by club members while at the club, and also whether such consumption is directly and indirectly associated with club member overall hazardous alcohol consumption. Telephone surveys were conducted with a representative from 72 community football clubs in New South Wales, Australia, and 1428 club members. A path and mediation analysis was undertaken to determine the association between 11 club alcohol management practices and member alcohol consumption, at the club and overall hazardous consumption. Three alcohol management practices were associated with an increased probability of risky drinking while at the club: having alcohol promotions; serving intoxicated patrons; and having bar open longer than 4 h. A mediation analyses identified that risky drinking at the club as a result of these three practices was also linked to increase risk in being an overall hazardous drinker. Modifying alcohol management practices in community football clubs has the potential to reduce both risky alcohol consumption by members in this setting and the prevalence of overall hazardous alcohol consumption. Coordinated, multi-strategic interventions are required to support community football clubs to modify their alcohol management practices and hence contribute to reducing the burden of alcohol-related harm in the community. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Virtual race transformation reverses racial in-group bias.

PubMed

Hasler, Béatrice S; Spanlang, Bernhard; Slater, Mel

2017-01-01

People generally show greater preference for members of their own racial group compared to racial out-group members. This type of 'in-group bias' is evident in mimicry behaviors. We tend to automatically mimic the behaviors of in-group members, and this behavior is associated with interpersonal sensitivity and empathy. However, mimicry is reduced when interacting with out-group members. Although race is considered an unchangeable trait, it is possible using embodiment in immersive virtual reality to engender the illusion in people of having a body of a different race. Previous research has used this technique to show that after a short period of embodiment of White people in a Black virtual body their implicit racial bias against Black people diminishes. Here we show that this technique powerfully enhances mimicry. We carried out an experiment with 32 White (Caucasian) female participants. Half were embodied in a White virtual body and the remainder in a Black virtual body. Each interacted in two different sessions with a White and a Black virtual character, in counterbalanced order. The results show that dyads with the same virtual body skin color expressed greater mimicry than those of different color. Importantly, this effect occurred depending on the virtual body's race, not participants' actual racial group. When embodied in a Black virtual body, White participants treat Black as their novel in-group and Whites become their novel out-group. This reversed in-group bias effect was obtained regardless of participants' level of implicit racial bias. We discuss the theoretical and practical implications of this surprising psychological phenomenon.

What is a 'secure base' when death is approaching? A study applying attachment theory to adult patients' and family members' experiences of palliative home care.

PubMed

Milberg, A; Wåhlberg, R; Jakobsson, M; Olsson, E-C; Olsson, M; Friedrichsen, M

2012-08-01

Attachment theory has received much interest lately in relation to how adults cope with stress and severe illness. The aim of this study was using the experiences of patients and family members to explore palliative home care as a 'secure base' (a central concept within the theory). Twelve patients and 14 family members were interviewed during ongoing palliative home care. The interviews were analysed with deductive qualitative content analysis. Informants expressed the relevance of sensing security during palliative home care because death and dying were threats that contributed to vulnerability. Palliative home care could foster a feeling of security and provide a secure base. This was facilitated when informants had trust in staff (e.g. due to availability and competence in providing symptom relief), felt recognised as individuals and welcomed to contact the team in times of needs. Being comfortable, informed and having an everyday life also contributed to a perception of palliative home care as a secure base. Family members stressed the importance of being relieved from responsibilities that were too heavy. The underlying meanings of experiencing palliative home care as a secure base involved gaining a sense of control and of inner peace, perceiving that despite a demanding and changed life situation, one could continue partially being oneself and having something to hope for, even if this no longer concerned cure for the ill person. Important aspects of palliative home care as providing a secure base were identified and these have implications for clinical practice. Copyright © 2011 John Wiley & Sons, Ltd.

Virtual race transformation reverses racial in-group bias

PubMed Central

Hasler, Béatrice S.; Spanlang, Bernhard

2017-01-01

People generally show greater preference for members of their own racial group compared to racial out-group members. This type of ‘in-group bias’ is evident in mimicry behaviors. We tend to automatically mimic the behaviors of in-group members, and this behavior is associated with interpersonal sensitivity and empathy. However, mimicry is reduced when interacting with out-group members. Although race is considered an unchangeable trait, it is possible using embodiment in immersive virtual reality to engender the illusion in people of having a body of a different race. Previous research has used this technique to show that after a short period of embodiment of White people in a Black virtual body their implicit racial bias against Black people diminishes. Here we show that this technique powerfully enhances mimicry. We carried out an experiment with 32 White (Caucasian) female participants. Half were embodied in a White virtual body and the remainder in a Black virtual body. Each interacted in two different sessions with a White and a Black virtual character, in counterbalanced order. The results show that dyads with the same virtual body skin color expressed greater mimicry than those of different color. Importantly, this effect occurred depending on the virtual body’s race, not participants’ actual racial group. When embodied in a Black virtual body, White participants treat Black as their novel in-group and Whites become their novel out-group. This reversed in-group bias effect was obtained regardless of participants’ level of implicit racial bias. We discuss the theoretical and practical implications of this surprising psychological phenomenon. PMID:28437469

Getting with the times: a narrative review of the literature on group decision making in virtual environments and implications for promotions committees.

PubMed

Acai, Anita; Sonnadara, Ranil R; O'Neill, Thomas A

2018-06-01

Concerns around the time and administrative burden of trainee promotion processes have been reported, making virtual meetings an attractive option for promotions committees in undergraduate and postgraduate medicine. However, whether such meetings can uphold the integrity of decision-making processes has yet to be explored. This narrative review aimed to summarize the literature on decision making in virtual teams, discuss ways to improve the effectiveness of virtual teams, and explore their implications for practice. In August 2017, the Web of Science platform was searched with the terms 'decision making' AND 'virtual teams' for articles published within the last 20 years. The search yielded 336 articles, which was narrowed down to a final set of 188 articles. A subset of these, subjectively deemed to be of high-quality and relevant to the work of promotions committees, was included in this review. Virtual team functioning was explored with respect to team composition and development, idea generation and selection, group memory, and communication. While virtual teams were found to potentially offer a number of key benefits over face-to-face meetings including convenience and scheduling flexibility, inclusion of members at remote sites, and enhanced idea generation and external storage, these benefits must be carefully weighed against potential challenges involving planning and coordination, integration of perspectives, and relational conflict among members, all of which can potentially reduce decision-making quality. Avenues to address these issues and maximize the outcomes of virtual promotions meetings are offered in light of the evidence.

School Board Member Practices in Governance, Teamwork and Board Development, and Their Sense of Effectiveness in High and Low Math Academic Achievement Districts of New York State

ERIC Educational Resources Information Center

Siegel, Kyrie

2009-01-01

The purpose of this study was to examine the relationships among New York State school board member attitudes toward components of school board governance and their sense of effectiveness in high and low math academic achievement districts in New York State. The study examined board members' perceptions of their actual practices in policy…

Exploring leadership and team communication within the organizational environment of a dental practice.

PubMed

Chilcutt, Alexa Stough

2009-10-01

A lack of training in leadership and communication skills can place dentists at a disadvantage, leading to high degrees of staff-related stress and turnover. A dentist's leadership style directly affects an office's communication practices, and specific leadership behaviors affect the degree of team identity, interdependence and social distance (a measure of the influential power of team members). The author recruited 10 dental offices to take part in a study. Qualitative methods included in-depth interviews of one dentist, one senior staff member and one newer staff member from each office. The interview findings show that clear and definable relationships exist between leadership behaviors--hierarchical or team-oriented organizational perspectives, proactive or laissez-faire leadership styles, and autocratic or participative decision-making processes--and the team's communication practices. Decision-making processes directly affect the degree of team identification experienced by staff members, and conflict-management tactics affect team members' sense of interdependence and social distance. The findings of this study indicate that dentists should engage in participative decision-making processes that include staff members, thereby communicating their value to the practice and empowering employees. They also must become proactive in facilitating an environment that encourages collaboration and confrontation as healthy forms of conflict management. These leadership and communication behaviors are the most significant in creating a real rather than nominal team culture, which, in turn, leads to increased overall productivity, an enhanced level of services provided to patients and improved team member satisfaction.

Across sectional study: the knowledge, attitude, perception, misconception and views (KAPMV) of adult family members of people living with human immune virus-HIV acquired immune deficiency syndrome-AIDS (PLWHA).

PubMed

Bhagavathula, Akshaya Srikanth; Bandari, Deepak Kumar; Elnour, Asim Ahmad; Ahmad, Akram; Khan, Muhammad Umair; Baraka, Mohamed; Hamad, Farah; Shehab, Abdulla

2015-01-01

We intended to assess knowledge, attitude, perception, misconception and views (KAP-MV) of family members of PLWHA. A cross-sectional retrospective study conducted in Anti-retroviral centre of Mahatma Gandhi Memorial-MGM hospital, Warangal, Telangana, South-India from July to September 2014. A questionnaire containing 41 items was distributed among adult family members accompanying patients living with HIV/AIDS-PLWHA. Level of KAP-MV was categorized into poor (0-28), average (29-55) and good (56-82). Analysis was performed by Pearson's Chi square, analysis of variance and Spearman's correlation test on 41 variables using SPSS version 21 and p < 0.01. 538 questionnaires were distributed, response rate was (96 %). On knowledge scale, respondents had a mean score of 8.0 ± 1.7, attitude 5.8 ± 3.4, perception 23.4 ± 4.1, misconceptions 8.0 ± 2.1 and views 8.0 ± 3.9. The respondents mean score was 53.2 ± 9.1 (64.9 %). Overall, level of education, marital status, religious beliefs, and employment status has significant (p < 0.001) associations with KAP-MV. Knowledge was significantly correlated with respondents' attitude (r = -0.15, p < 0.001), perception (0.39; p < 0.001), and views (0.381; p < 0.001). Family members of PLWHA with less knowledge score had more negative attitude, perception and views. Level of education, marital status, religious beliefs and employment status were identified as key barriers. Interventions targeting family members of PLWHA are warranted. Practice implications are as follows: Encourage role of family members.Deploy interventions.Minimize barriers.Change misconceptions.

"Members of the same club": challenges and decisions faced by US IRBs in identifying and managing conflicts of interest.

PubMed

Klitzman, Robert

2011-01-01

Conflicts of interest (COIs) in research have received increasing attention, but many questions arise about how Institutional Review Boards (IRBs) view and approach these. I conducted in-depth interviews of 2 hours each with 46 US IRB chairs, administrators, and members, exploring COI and other issues related to research integrity. I contacted leaders of 60 IRBs (every fourth one among the top 240 institutions by NIH funding), and interviewed IRB leaders from 34 of these institutions (response rate = 55%). Data were analyzed using standard qualitative methods, informed by Grounded Theory. IRBs confront financial and non-financial COIs of PIs, institutions, and IRBs themselves. IRB members may seek to help, or compete with, principal investigators (PIs). Non-financial COI also often appear to be "indirect financial" conflicts based on gain (or loss) not to oneself, but to one's colleagues or larger institution. IRBs faced challenges identifying and managing these COI, and often felt that they could be more effective. IRBs' management of their own potential COI vary, and conflicted members may observe, participate, and/or vote in discussions. Individual IRB members frequently judge for themselves whether to recuse themselves. Challenges arise in addressing these issues, since institutions and PIs need funding, financial information is considered confidential, and COI can be unconscious. This study, the first to explore qualitatively how IRBs confront COIs and probe how IRBs confront non-financial COIs, suggests that IRBs face several types of financial and non-financial COIs, involving themselves, PIs, and institutions, and respond varyingly. These data have critical implications for practice and policy. Disclosure of indirect and non-financial COIs to subjects may not be feasible, partly since IRBs, not PIs, are conflicted. Needs exist to consider guidelines and clarifications concerning when and how, in protocol reviews, IRB members should recuse themselves from participating, observing, and/or voting.

“Members of the Same Club”: Challenges and Decisions Faced by US IRBs in Identifying and Managing Conflicts of Interest

PubMed Central

Klitzman, Robert

2011-01-01

Conflicts of interest (COIs) in research have received increasing attention, but many questions arise about how Institutional Review Boards (IRBs) view and approach these. Methods I conducted in-depth interviews of 2 hours each with 46 US IRB chairs, administrators, and members, exploring COI and other issues related to research integrity. I contacted leaders of 60 IRBs (every fourth one among the top 240 institutions by NIH funding), and interviewed IRB leaders from 34 of these institutions (response rate = 55%). Data were analyzed using standard qualitative methods, informed by Grounded Theory. Results IRBs confront financial and non-financial COIs of PIs, institutions, and IRBs themselves. IRB members may seek to help, or compete with, principal investigators (PIs). Non-financial COI also often appear to be “indirect financial” conflicts based on gain (or loss) not to oneself, but to one's colleagues or larger institution. IRBs faced challenges identifying and managing these COI, and often felt that they could be more effective. IRBs' management of their own potential COI vary, and conflicted members may observe, participate, and/or vote in discussions. Individual IRB members frequently judge for themselves whether to recuse themselves. Challenges arise in addressing these issues, since institutions and PIs need funding, financial information is considered confidential, and COI can be unconscious. Conclusions This study, the first to explore qualitatively how IRBs confront COIs and probe how IRBs confront non-financial COIs, suggests that IRBs face several types of financial and non-financial COIs, involving themselves, PIs, and institutions, and respond varyingly. These data have critical implications for practice and policy. Disclosure of indirect and non-financial COIs to subjects may not be feasible, partly since IRBs, not PIs, are conflicted. Needs exist to consider guidelines and clarifications concerning when and how, in protocol reviews, IRB members should recuse themselves from participating, observing, and/or voting. PMID:21829516

Building capacity for information and communication technology use in global health research and training in China: a qualitative study among Chinese health sciences faculty members.

PubMed

Wang, Jie; Abdullah, Abu S; Ma, Zhenyu; Fu, Hua; Huang, Kaiyong; Yu, Hongping; Wang, Jiaji; Cai, Le; He, Huimin; Xiao, Jian; Quintiliani, Lisa; Friedman, Robert H; Yang, Li

2017-06-28

The demand to use information and communications technology (ICT) in education and research has grown fast among researchers and educators working in global health. However, access to ICT resources and the capacity to use them in global health research remains limited among developing country faculty members. In order to address the global health needs and to design an ICT-related training course, we herein explored the Chinese health science faculty members' perceptions and learning needs for ICT use. Nine focus groups discussions (FGDs) were conducted during December 2015 to March 2016, involving 63 faculty members working in areas of health sciences from six universities in China. All FGDs were audio recorded and analysed thematically. The findings suggest that the understandings of ICT were not clear among many researchers; some thought that the concept of ICT was too wide and ambiguous. Most participants were able to cite examples of ICT application in their research and teaching activities. Positive attitudes and high needs of ICT use and training were common among most participants. Recommendations for ICT training included customised training programmes focusing on a specific specialty, maintaining a balance between theories and practical applications, more emphasis on the application of ICT, and skills in finding the required information from the bulk information available in the internet. Suggestions regarding the format and offering of training included short training programmes, flexible timing, lectures with practicum opportunities, and free of charge or with very minimal cost to the participants. Two participants suggested the linking of ICT-related training courses with faculty members' year-end assessment and promotion. This study among health sciences faculty members in China demonstrated a high level of need and interest in learning about ICT use in research and training. The results have important implications for the design and implementation of ICT-related educational programmes in China and other developing countries.

Advancing Professional Development Through a Community of Practice: the New England Network for Faculty Affairs.

PubMed

Power, Christine M; Thorndyke, Luanne E; Milner, Robert J; Lowney, Kathleen; Irvin, Charles G; Fonseca-Kelly, Zoe; Benjamin, Emelia J; Bhasin, Robina M; Connelly, Maureen T

2018-01-01

In an era of competing priorities, funding is increasingly restricted for offices of faculty affairs and development. Opportunities for professional staff to grow and network through attendance at national meetings and to share best practices are limited. We sought to describe a community of practice established to enhance the professional development of faculty affairs professionals and to document its impact. We outlined the process of formation of the New England Network for Faculty Affairs (NENFA), reviewed the pedagogical approaches to professional development, and surveyed members to evaluate the impact of NENFA on their activities, professional network and their institutions. After a successful 2011 initial meeting, NENFA created an organizing committee and conducted a needs assessment among potential members. NENFA's charter, mission, goals, and structure were based on survey results. NENFA's regional community of practice grew to 31 institutions and held 10 meetings over 5 years. Meetings have examined a faculty development topic in depth using multiple learning formats to engage participants from academic medical centers and allied professions. Results from a 2015 member survey confirmed the value of NENFA. Multiple members documented changes in practice as a result of participating. NENFA has been sustained by volunteer leadership, collaboration, and the value that the group has brought to its members. We propose that a "community of practice" offers an effective model for collaborative learning among individuals at different institutions within a competitive health care environment. We recommend that the approach be replicated in other regions.

Perceptions of Relationships and Evaluations of Satisfaction: An Exploration of Interaction.

ERIC Educational Resources Information Center

Bruning, Stephen D.; Ledingham, John A.

2000-01-01

Examines key public members' perceptions of the personal, professional, and community relationships they have with a bank and relates those perceptions to evaluations of satisfaction. Finds members' perceptions of their personal and professional relationships significantly influence evaluations of overall satisfaction. Discusses implications for…

Type 1 and type 2 diabetes mellitus in childhood in the United States: practice patterns by pediatric endocrinologists.

PubMed

Rapaport, Robert; Silverstein, Janet H; Garzarella, Linda; Rosenbloom, Arlan L

2004-06-01

To determine the relative frequency of type 2 diabetes mellitus (DM) in the US, and to assess diabetes practice patterns in the US. A questionnaire regarding pediatric diabetes practice patterns was distributed to the members of the Lawson Wilkins Pediatric Endocrine Society in 1999. Only one member of each practice group was requested to respond. Responses received through early 2000 were analyzed. One hundred and twenty-six practices representing 45% of the members of the Society responded. 11.9% of pediatric patients with DM were considered to have type 2 DM. On average 53 new patients with DM were seen each year. The average practice consisted of 2.5 physicians, 1.5 nurse educators, 1.3 dieticians, 1.0 social workers and 0.5 nurse practitioners. Management practices comply by and large with the recommendations of the American Diabetes Association and reflect a trend toward more intensive treatment and monitoring. Type 2 DM was seen in 11.9% of patients. Most diabetes practices in the US utilize a team approach to the management of youth with DM.

Knowledge, attitudes, and practices concerning malaria in pregnancy: results from a qualitative study in Madang, Papua New Guinea.

PubMed

Andrew, Erin V W; Pell, Christopher; Angwin, Angeline; Auwun, Alma; Daniels, Job; Mueller, Ivo; Phuanukoonnon, Suparat; Pool, Robert

2015-01-01

Malaria is the leading cause of illness and death in Papua New Guinea (PNG). Infection during pregnancy with falciparum or vivax malaria, as occurs in PNG, has health implications for mother and child, causing complications such as maternal anemia, low birth weight and miscarriage. This article explores knowledge, attitudes and practices concerning malaria during pregnancy and it's prevention in Madang, PNG, a high prevalence area. As part of a qualitative study in Madang, exploring MiP, participatory techniques (free-listing and sorting) were conducted along with focus group discussions, in-depth interviews (with pregnant women, health staff and other community members) and observations in the local community and health facilities. The main themes explored were attitudes towards and knowledge of MiP, its risks, and prevention. Although there was a general awareness of the term "malaria", it was often conflated with general sickness or with pregnancy-related symptoms. Moreover, many preventive methods for MiP were related to practices of general healthy living. Indeed, varied messages from health staff about the risks of MiP were observed. In addition to ideas about the seriousness and risk of MiP, other factors influenced the uptake of interventions: availability and perceived comfort of sleeping under insecticide-treated mosquito nets were important determinants of usage, and women's heavy workload influenced Chloroquine adherence. The non-specific symptoms of MiP and its resultant conflation with symptoms of pregnancy that are perceived as normal have implications for MiP prevention and control. However, in Madang, PNG, this was compounded by the inadequacy of health staff's message about MiP.

Pharmacy Practice Department Chairs’ Perspectives on Part-Time Faculty Members

PubMed Central

Winkler, Susan R.; Mai, Thy

2012-01-01

Objective. To identify the benefits and consequences of having part-time faculty members in departments of pharmacy practice from the department chair’s perspective. Methods. A stratified purposive sample of 12 pharmacy practice department chairs was selected. Eleven telephone interviews were conducted. Two investigators independently read interview notes and categorized and enumerated responses to determine major themes using content analysis. The investigators jointly reviewed the data and came to consensus on major themes. Results. Benefits of allowing full-time faculty members to reduce their position to part-time included faculty retention and improved individual faculty work/life balance. Consequences of allowing part-time faculty positions included the challenges of managing individual and departmental workloads, the risk of marginalizing part-time faculty members, and the challenges of promotion and tenure issues. All requests to switch to part-time status were faculty-driven and most were approved. Conclusions. There are a variety of benefits and consequences of having part-time faculty in pharmacy practice departments from the chair’s perspective. Clear faculty and departmental expectations of part-time faculty members need to be established to ensure optimal success of this working arrangement. PMID:22611268

Mergers and acquisitions: some implications of cultural change.

PubMed

Cavanaugh, S J

1996-01-01

A result of recent National Health Service reforms is the need to investigate, and possibly change, the culture of the professional working relationship between members of staff and their employer. This is particularly the case in situations of mergers and acquisitions where staff working from different cultural environments must work together. Mergers are becoming a feature of health service provision, perhaps this becomes most obvious with the recent moves by colleges of nursing and midwifery into the higher education sector and amalgamations of some purchasing authorities. Mergers highlight the practical issues of bringing together different organizational and work cultures to deliver a high quality service. This article discusses some aspects of the nature of organizational culture, the human impact of mergers and acquisitions and offers strategies for managing these events.

Contempt and defensiveness in couple relationships related to childhood sexual abuse histories for self and partner.

PubMed

Walker, Eric C; Sheffield, Rachel; Larson, Jeffry H; Holman, Thomas B

2011-01-01

This study examined the relationship between a history of childhood sexual abuse (CSA) for one or both members of a romantic couple and perceptions of contempt and defensiveness for self and partner. Data from the Relationship Evaluation (RELATE) were analyzed for 10,061 couples. The findings suggest that when either or both partner(s) has a history of CSA, contempt and defensiveness in the couple relationship are greater than when neither reports a history of CSA. Furthermore, the males' experience of CSA had a greater impact on their perceptions of self and partner's contempt and defensiveness than females' experience of CSA. Explanations of gender differences are offered and implications for future research and practice are suggested. © 2011 American Association for Marriage and Family Therapy.

Narratives About Mental Illnesses in China: The Voices of Generation Y.

PubMed

Tang, Lu; Bie, Bijie

2016-01-01

This study explores the cultured understanding of mental health and mental illnesses among members of Generation Y in China through a narrative approach. Five prominent narratives are identified through the analysis of stories about mental illnesses collected through semistructured interviews with college students. These five narratives feature the tragic genius, the psychotic criminal, the fragile victim, the antisocial recluse, and the homosexual. These narratives are gendered, in that women are the primary protagonists in the narrative about the fragile victim, while men are featured prominently in the narratives about the tragic genius, the psychotic criminal, and the antisocial recluse. Our study demonstrates that these narratives are based on, and will further reinforce, highly cultural-specific stereotypes and biases about mental illnesses in China. Theoretical and practical implications of this study are discussed.

Gender differences and dynamics shaping the adoption life cycle: review of the literature and recommendations.

PubMed

Freeark, Kristine; Rosenberg, Elinor B; Bornstein, Jane; Jozefowicz-Simbeni, Debra; Linkevich, Michael; Lohnes, Kelly

2005-01-01

The role of gender in the experiences of adoptive family members has received little systematic attention. Gender differences in response to different tasks and phases of the adoption life cycle are described. Gendered dynamics within the adoptive family, for birth parents, and in the field of adoption are highlighted. Birth fathers and adoptive fathers are typically marginalized, which leaves women to address emotion, connection, and communication, and family dialogues about adoption may engage daughters more successfully than sons. The article reviews reasons why differential rates of problem behavior for adopted boys and girls may result from gender differences in emotional expressiveness, social support seeking, and identity formation. Implications of the feminization of adoption are explored, and recommendations for practice and research are proposed.

Communication nonaccommodation in family conversations about end-of-life health decisions.

PubMed

Scott, Allison M; Caughlin, John P

2015-01-01

Furthering our understanding of how communication can improve end-of-life decision making requires a shift in focus from whether people talk to how people talk about end-of-life health decisions. This study used communication accommodation theory to examine the extent to which communication nonaccommodation distinguished more from less successful end-of-life conversations among family members. We analyzed elicited conversations about end-of-life health decisions from 121 older parent/adult child dyads using outside ratings of communication over- and underaccommodation and self-reported conversational outcomes. Results of multilevel linear modeling revealed that outside ratings of underaccommodation predicted self-reported and partner-reported uncertainty, and ratings of overaccommodation predicted self-reported decision-making efficacy and change in concordance accuracy. We discuss the methodological, theoretical, and practical implications of these findings.

How IRBs View and Make Decisions About Consent Forms

PubMed Central

Klitzman, Robert L.

2013-01-01

IRBs have been criticized for long and complicated consent forms, but how IRBs make decisions about these issues hasn’t been examined. I contacted leaders of 60 IRBs, and interviewed IRB leaders from 34 (response rate = 55%), and 13 members and administrators. IRBs confront challenges and dilemmas regarding these documents: what and how much these forms should include (e.g., how “perfect” forms should be). While IRBs generally seek to decrease the length and complexity, institutions and industry funders often want these forms to be legal documents. IRBs may also “nitpick” these documents without realizing the costs. This study, the first to explore how IRBs view and make decisions about consent forms, suggests underlying tensions, ambiguities, and subjectivities that have important implications for future policy, practice, education, and research. PMID:23485667

Alcohol consumption and sport: a cross-sectional study of alcohol management practices associated with at-risk alcohol consumption at community football clubs

PubMed Central

2013-01-01

Background Excessive alcohol consumption is responsible for considerable harm from chronic disease and injury. Within most developed countries, members of sporting clubs participate in at-risk alcohol consumption at levels above that of communities generally. There has been limited research investigating the predictors of at-risk alcohol consumption in sporting settings, particularly at the non-elite level. The purpose of this study was to examine the association between the alcohol management practices and characteristics of community football clubs and at-risk alcohol consumption by club members. Methods A cross sectional survey of community football club management representatives and members was conducted. Logistic regression analysis (adjusting for clustering by club) was used to determine the association between the alcohol management practices (including alcohol management policy, alcohol-related sponsorship, availability of low- and non-alcoholic drinks, and alcohol-related promotions, awards and prizes) and characteristics (football code, size and location) of sporting clubs and at-risk alcohol consumption by club members. Results Members of clubs that served alcohol to intoxicated people [OR: 2.23 (95% CI: 1.26-3.93)], conducted ‘happy hour’ promotions [OR: 2.84 (95% CI: 1.84-4.38)] or provided alcohol-only awards and prizes [OR: 1.80 (95% CI: 1.16-2.80)] were at significantly greater odds of consuming alcohol at risky levels than members of clubs that did not have such alcohol management practices. At-risk alcohol consumption was also more likely among members of clubs with less than 150 players compared with larger clubs [OR:1.45 (95% CI: 1.02-2.05)] and amongst members of particular football codes. Conclusions The findings of this study suggest a need and opportunity for the implementation of alcohol harm reduction strategies targeting specific alcohol management practices at community football clubs. PMID:23947601

Exploring the financial impact of caring for family members receiving palliative and end-of-life care: a systematic review of the literature.

PubMed

Gardiner, Clare; Brereton, Louise; Frey, Rosemary; Wilkinson-Meyers, Laura; Gott, Merryn

2014-05-01

Research regarding the economic dimensions of palliative care is relatively limited. The economic implications of providing informal care are well recognised; however, within the context of palliative care, little is known about the costs and implications of providing care for a loved one at the end of life. To explore the financial costs and the financial impact of caring for family members receiving palliative/end-of-life care. A systematic literature review of empirical research following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seven electronic databases were searched from inception to April 2012. Inclusion criteria were as follows: articles relating to the financial costs or implications of family caregiving at the end-of-life care, English language articles, empirical research or systematic reviews and articles relating to adults. The review identified 21 relevant articles; however, evidence relating to the costs and implications of caregiving was relatively limited. The results indicate that the financial costs of caring for someone at the end of life are substantial. Financial costs can result in significant and multidimensional caregiver burden. Various factors were found to mediate the extent of financial burden. This review identified a significant gap in the evidence base regarding the economic implications of providing care to a family member within a palliative care context. Economic costs and implications are likely to be significant, and research to address this gap is urgently needed, particularly given policy initiatives in a number of developed countries to move the provision of palliative and end-of-life care from hospital to community settings.

A 2011 survey of clinical practice patterns in the management of Graves' disease.

PubMed

Burch, Henry B; Burman, Kenneth D; Cooper, David S

2012-12-01

More than two decades have passed since members from the American Thyroid Association (ATA), European Thyroid Association, and Japan Thyroid Association were surveyed on management practices for patients with hyperthyroidism due to Graves' disease (GD). We sought to document current practices in the management of GD and compare these results both to those documented in earlier surveys and to practice recommendations made in the 2011 ATA/American Association of Clinical Endocrinologists (AACE) hyperthyroidism practice guidelines. Lastly, we sought to examine differences in GD management among international members of U.S.-based endocrine societies. Members of The Endocrine Society (TES), ATA, and AACE were invited to participate in a web-based survey dealing with testing, treatment preference, and modulating factors in patients with GD. A total of 730 respondents participated in the survey, 696 of whom completed all sections. Respondents included 641 TES members, 330 AACE members, and 157 ATA members. The preferred mode of therapy in uncomplicated GD was antithyroid drugs (ATDs) by 53.9% of respondents, radioactive iodine (RAI) therapy by 45.0%, and thyroid surgery in 0.7%. Compared with 1991, fewer U.S. (59.7 vs. 69%) and European (13.3% vs. 25%) respondents would use RAI therapy. Methimazole and carbimazole were the preferred ATDs, with only 2.7% of respondents selecting propylthiouracil. Patients with Graves' ophthalmopathy were treated with ATDs (62.9%) or surgery (18.5%) and less frequently with RAI plus corticosteroids (16.9%) or RAI alone (1.9%). Striking changes have occurred in the management of GD over the past two decades, with a shift away from RAI and toward ATDs in patients with uncomplicated GD. Apparent international differences persist but should be interpreted with caution. Current practices diverge in some areas from recently published guidelines; these differences should be assessed serially to determine the impact of the guidelines on future clinical practice.

Practices of Productive Adult Book Clubs

ERIC Educational Resources Information Center

Beach, Richard; Yussen, Steven

2011-01-01

Abstract: This article examines two adult book club members' responses to literary texts over a 23-month period to identify practices that contribute to productive book club participation. Members were interviewed regarding their book selection procedures, preparation for and perceptions of the discussions, and what they valued about the…

Knowledge and practice regarding dengue and chikungunya: a cross-sectional study among Healthcare workers and community in Northern Tanzania.

PubMed

Kajeguka, Debora C; Desrochers, Rachelle E; Mwangi, Rose; Mgabo, Maseke R; Alifrangis, Michael; Kavishe, Reginald A; Mosha, Franklin W; Kulkarni, Manisha A

2017-05-01

To investigate knowledge and prevention practices regarding dengue and chikungunya amongst community members, as well as knowledge, treatment and diagnostic practices among healthcare workers. We conducted a cross-sectional survey with 125 community members and 125 healthcare workers from 13 health facilities in six villages in the Hai district of Tanzania. A knowledge score was generated based on participant responses to a structured questionnaire, with a score of 40 or higher (of 80 and 50 total scores for community members and healthcare workers, respectively) indicating good knowledge. We conducted qualitative survey (n = 40) to further assess knowledge and practice regarding dengue and chikungunya fever. 15.2% (n = 19) of community members had good knowledge regarding dengue, whereas 53.6%, (n = 67) of healthcare workers did. 20.3% (n = 16) of participants from lowland areas and 6.5% (n = 3) from highland areas had good knowledge of dengue (χ 2 = 4.25, P = 0.03). Only 2.4% (n = 3) of all participants had a good knowledge score for chikungunya. In the qualitative study, community members expressed uncertainty about dengue and chikungunya. Some healthcare workers thought that they were new diseases. There is insufficient knowledge regarding dengue and chikungunya fever among community members and healthcare workers. Health promotion activities on these diseases based on Ecological Health Mode components to increase knowledge and improve preventive practices should be developed. © 2017 John Wiley & Sons Ltd.

Human Services Students' Attitudes toward Working with an Inner-City Gang Member: The Case of Alphonse.

ERIC Educational Resources Information Center

Ancis, Julie R.; Burke, Mary C.

1997-01-01

Investigates the attitudes of 91 human service counseling students toward working with an inner-city gang member. Results reveal qualitative differences in students' self-perceived ability to work with this client. Presents implications for human service education and training. (MKA)

Mexican American Fathers' Occupational Conditions: Links to Family Members' Psychological Adjustment

ERIC Educational Resources Information Center

Crouter, Ann C.; Davis, Kelly D.; Updegraff, Kimberly; Delgado, Melissa; Fortner, Melissa

2006-01-01

To examine the implications of fathers' occupational conditions (i.e., income, work hours, shift work, pressure, workplace racism, and underemployment) for family members' psychological adjustment, home interviews were conducted with fathers, mothers, and two adolescent offspring in each of 218 Mexican American families. Results underscored the…

Global Team Development. Symposium 7. [AHRD Conference, 2001].

ERIC Educational Resources Information Center

2001

This document contains three papers on global team development. "Virtual Executives: A Paradox with Implications for Development" (Andrea Hornett), which is based on a case study exploring power relationships among members of a virtual team, demonstrates that members of a virtual team describe power differently for situations inside…

Implementing AORN Recommended Practices for Laser Safety.

PubMed

Castelluccio, Donna

2012-05-01

Lasers used in the OR pose many risks to both patients and personnel. AORN's "Recommended practices for laser safety in perioperative practice settings" identifies the potential hazards associated with laser use, such as eye damage and fire- and smoke-related injuries. The practice recommendations are intended to be used as a guide for establishing best practices in the workplace and to give perioperative nurses strategies for implementing the recommended safety measures. A laser safety program should include measures to control access to laser use areas; protect staff members and patients from exposure to the laser beam; provide staff members and patients with the appropriate safety eyewear for use in the laser use area; and protect staff members and patients from surgical smoke, electrical, and fire hazards. Measures such as using a safety checklist or creating a laser cart can help perioperative nurses successfully incorporate the practice recommendations. Patient scenarios are included as examples of how to use the document in real-life situations. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Locus of control, sources of motivation, and mental boundaries as antecedents of leader-member exchange quality.

PubMed

Barbuto, John E; Finch, Weltmer Dayna; Pennisi, Lisa A

2010-02-01

In this study were examined leaders' and members' scores on locus of control, sources of motivation, and mental boundaries to predict the quality of leader-member exchanges. 80 elected officials and their 388 direct reports were sampled in a field study. Analysis indicated followers' scores on locus of control, leaders' scores of self-concept internal motivation, leaders' scores on locus of control, and followers' rated goal-internalization motivation were positively related to leader-member exchanges. Implications and directions for research are discussed.

Support for traumatic brain injury patients' family members in neurosurgical nursing: a systematic review.

PubMed

Coco, Kirsi; Tossavainen, Kerttu; Jääskeläinen, Juha Erik; Turunen, Hannele

2011-12-01

This systematic literature review describes how adult traumatic brain injury (TBI) patients' family members received support. The research question was "What in healthcare constitutes support for a TBI patient's family members?" The data for this review were based on 22 empirical studies published in scientific journals in 2004-2010, which were found in the Cinahl, PsychINFO, and ISI Web of Knowledge databases. The review includes the study design, sample, method, and main results. The data were analyzed using content analysis. Social support for brain injury patients' family members was divided into 3 main categories: informational, emotional, and practical support. The subcategories of informational support were information about the patient's symptoms, information about care, quality of information, and information about the prognosis. The subcategories of emotional support were taking emotions into account, caring, listening, and respecting. The subcategories of practical support were support in decision making, promoting the welfare of the family, encouraging family members to participate in care, cooperation with the family members, and counseling services. The results are available for nurses in practical work. The review offers nurses a structure for supporting TBI patients' families, and according to this review, supporting TBI patients' families appears to have many dimensions. The results suggest that nurses should be informed that it is important for family members to know the facts about TBI to understand the condition and to receive practical advice on how to help their significant other with TBI with daily activities. In addition, the results provide a basis for further research and development of interventions that support brain injury patients and their family members.

Effects of New Funding Models for Patient-Centered Medical Homes on Primary Care Practice Finances and Services: Results of a Microsimulation Model

PubMed Central

Basu, Sanjay; Phillips, Russell S.; Song, Zirui; Landon, Bruce E.; Bitton, Asaf

2016-01-01

PURPOSE We assess the financial implications for primary care practices of participating in patient-centered medical home (PCMH) funding initiatives. METHODS We estimated practices’ changes in net revenue under 3 PCMH funding initiatives: increased fee-for-service (FFS) payments, traditional FFS with additional per-member-per-month (PMPM) payments, or traditional FFS with PMPM and pay-for-performance (P4P) payments. Net revenue estimates were based on a validated microsimulation model utilizing national practice surveys. Simulated practices reflecting the national range of practice size, location, and patient population were examined under several potential changes in clinical services: investments in patient tracking, communications, and quality improvement; increased support staff; altered visit templates to accommodate longer visits, telephone visits or electronic visits; and extended service delivery hours. RESULTS Under the status quo of traditional FFS payments, clinics operate near their maximum estimated possible net revenue levels, suggesting they respond strongly to existing financial incentives. Practices gained substantial additional net annual revenue per full-time physician under PMPM or PMPM plus P4P payments ($113,300 per year, 95% CI, $28,500 to $198,200) but not under increased FFS payments (−$53,500, 95% CI, −$69,700 to −$37,200), after accounting for costs of meeting PCMH funding requirements. Expanding services beyond minimum required levels decreased net revenue, because traditional FFS revenues decreased. CONCLUSIONS PCMH funding through PMPM payments could substantially improve practice finances but will not offer sufficient financial incentives to expand services beyond minimum requirements for PCMH funding. PMID:27621156

Trends in a changing vascular practice environment for members of the Society for Vascular Surgery

PubMed Central

Matthews, Mika A. B.; Satiani, Bhagwan; Lohr, Joann M.

2013-01-01

Objective To survey the Society for Vascular Surgery (SVS) membership with regard to practice trends related to work effort, employment status, practice ownership, endovascular cases, and anticipated changes in practice in the near future. Methods A survey questionnaire was developed to gather information about member demographics and practice, hours worked, full-time (FT) or part-time status, employment status, practice ownership, competition for referrals, proportion of endovascular vs open procedures, and anticipated changes in practice in the next 3 years. We used SurveyMonkey and distributed the survey to all active vascular surgeon (VS) members of the SVS. Results The response rate was 207 of 2230 (10.7%). Two thirds were in private practice, and 21% were in solo practice. Twenty-four percent were employed by hospitals/health systems. Those VS under the age of 50 years were more likely to exclusively practice vascular surgery compared with VS over the age of 50 years (P = .0003). Sixty-eight of the physicians (32.7%) were between 50 and 59 years old, 186 (90.3%) were men, 192 (92.8%) worked FT (>36 hours of patient care per week), and almost two thirds worked >60 hours per week. Those in physician-owned practices worked >40 hours of patient care per week more often than did FT employed VS (P = .012). Younger VS (age <50 years) more frequently reported >50% of their workload being endovascular compared with older VS (age ≥50 years; P < .001). Eighty percent of FT VS planned to continue their current practice over the next 3 years. Of the 43.6% indicating loss of referrals, 82% pointed to cardiologists as the competition. Conclusions The current workforce is predominately male and works FT; one-third is between the ages of 50 and 59 years. Younger VS (age <50 years) are more likely to exclusively practice VS and have a higher caseload of endovascular procedures. Those in physician-owned practices are more likely to put in >40 hours of patient care per week than are FT employed VS. Longitudinal surveys of SVS members are imperative to help tailor educational, training, and practice management offerings, guide governmental activities, advocate for issues important to members, improve branding initiatives, and sponsor workforce analyses. PMID:23254185

Provider Experiences with Chronic Care Management (CCM) Services and Fees: A Qualitative Research Study.

PubMed

O'Malley, Ann S; Sarwar, Rumin; Keith, Rosalind; Balke, Patrick; Ma, Sai; McCall, Nancy

2017-12-01

Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward. Semi-structured telephone interviews from January to April 2016 with 71 respondents. Sixty billing and non-billing providers and practice staff knowledgeable about their practices' CCM services, and 11 professional society representatives. Practice respondents noted that most patients expressed positive views of CCM services. Practice respondents also perceived several patient benefits, including improved adherence to treatment, access to care team members, satisfaction, care continuity, and care coordination. Facilitators of CCM provision included having an in-practice care manager, patient-centered medical home recognition, experience developing care plans, patient trust in their provider, and supplemental insurance to cover CCM copayments. Most billing practices reported few problems obtaining patients' consent for CCM, though providers felt that CMS could better facilitate consent by marketing CCM's goals to beneficiaries. Barriers reported by professional society representatives and by billing and non-billing providers included inadequacy of CCM payments to cover upfront investments for staffing, workflow modification, and time needed to manage complex patients. Other barriers included inadequate infrastructure for health information exchange with other providers and limited electronic health record capabilities for documenting and updating care plans. Practices owned by hospital systems and large medical groups faced greater bureaucracy in implementing CCM than did smaller, independent practices. Improving providers' experiences with and uptake of CCM will require addressing several challenges, including the upfront investment for CCM set-up and the time required to provide CCM to more complex patients.

The importance of relational coordination and reciprocal learning for chronic illness care within primary care teams.

PubMed

Noël, Polly Hitchcock; Lanham, Holly J; Palmer, Ray F; Leykum, Luci K; Parchman, Michael L

2013-01-01

Recent research from a complexity theory perspective suggests that implementation of complex models of care, such as the Chronic Care Model (CCM), requires strong relationships and learning capacities among primary care teams. Our primary aim was to assess the extent to which practice member perceptions of relational coordination and reciprocal learning were associated with the presence of CCM elements in community-based primary care practices. We used baseline measures from a cluster randomized controlled trial testing a practice facilitation intervention to implement the CCM and improve risk factor control for patients with Type 2 diabetes in small primary care practices. Practice members (i.e., physicians, nonphysician providers, and staff) completed baseline assessments, which included the Relational Coordination Scale, Reciprocal Learning Scale, and the Assessment of Chronic Illness Care (ACIC) survey, along with items assessing individual and clinic characteristics. To assess the association between Relational Coordination, Reciprocal Learning, and ACIC, we used a series of hierarchical linear regression models accounting for clustering of individual practice members within clinics and controlling for individual- and practice-level characteristics and tested for mediation effects. A total of 283 practice members from 39 clinics completed baseline measures. Relational Coordination scores were significantly and positively associated with ACIC scores (Model 1). When Reciprocal Learning was added, Relational Coordination remained a significant yet notably attenuated predictor of ACIC (Model 2). The mediation effect was significant (z = 9.3, p < .01); 24% of the association between Relational Coordination and ACIC scores was explained by Reciprocal Learning. Of the individual- and practice-level covariates included in Model 3, only the presence of an electronic medical record was significant; Relational Coordination and Reciprocal Learning remained significant independent predictors of ACIC. Efforts to implement complex models of care should incorporate strategies to strengthen relational coordination and reciprocal learning among team members.

Human Subjects Protection: A Source for Ethical Service-Learning Practice

ERIC Educational Resources Information Center

Wendler, Rachael

2012-01-01

Human subjects research ethics were developed to ensure responsible conduct when university researchers learn by interacting with community members. As service-learning students also learn by interacting with community members, a similar set of principles may strengthen the ethical practice of service-learning. This article identifies ethical…

Work-based learning: a leadership development example from an action research study of shared governance implementation.

PubMed

Williamson, Tracey

2005-11-01

An empowering action research study was undertaken to evaluate and strengthen the implementation of shared governance. One aim was to identify factors that acted as aids or barriers to effective decision-making by clinical leaders. As a work-based learning approach, action research was expected to lead to integration of learning into practice by researcher and participants alike. Shared governance replaces traditional hierarchies and requires and develops clinical leaders. Strategies are needed to maximize learning from introduction of such initiatives at the individual, group and organizational level. Participant-observations and interviews were undertaken with shared governance council members from one model in north-west England. Leadership skills and knowledge and shared governance practices were significantly enhanced. Preparation for council roles was considered inadequate. Increased structured time for reflection and action planning was indicated. Implementation of shared governance has succeeded in developing leadership capacity. Evaluation findings have led to improvements in the overall shared governance model. Action research has been found to have great utility at optimizing work-based learning. Nurse Managers need to develop their coaching and facilitating skills and recognize there is no "quick fix" for developing clinical leaders. Implications include the need to support learners in identifying and implementing changes arising from work-based learning activities, the significant resource implications and the need to optimize the organizational climate if work-based learning approaches to leadership and management development are to succeed.

Panel 7: Otitis Media: Treatment and Complications.

PubMed

Schilder, Anne G M; Marom, Tal; Bhutta, Mahmood F; Casselbrant, Margaretha L; Coates, Harvey; Gisselsson-Solén, Marie; Hall, Amanda J; Marchisio, Paola; Ruohola, Aino; Venekamp, Roderick P; Mandel, Ellen M

2017-04-01

Objective We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice. Data Sources PubMed, Ovid Medline, the Cochrane Library, and Clinical Evidence (BMJ Publishing). Review Methods All types of articles related to otitis media treatment and complications between June 2011 and March 2015 were identified. A total of 1122 potential related articles were reviewed by the panel members; 118 relevant articles were ultimately included in this summary. Conclusions Recent literature and guidelines emphasize accurate diagnosis of acute otitis media and optimal management of ear pain. Watchful waiting is optional in mild to moderate acute otitis media; antibiotics do shorten symptoms and duration of middle ear effusion. The additive benefit of adenoidectomy to tympanostomy tubes in recurrent acute otitis media and otitis media with effusion is controversial and age dependent. Topical antibiotic is the treatment of choice in acute tube otorrhea. Symptomatic hearing loss due to persistent otitis media with effusion is best treated with tympanostomy tubes. Novel molecular and biomaterial treatments as adjuvants to surgical closure of eardrum perforations seem promising. There is insufficient evidence to support the use of complementary and alternative treatments. Implications for Practice Emphasis on accurate diagnosis of otitis media, in its various forms, is important to reduce overdiagnosis, overtreatment, and antibiotic resistance. Children at risk for otitis media and its complications deserve special attention.

Free Trade Agreements: Impact on U.S. Trade and Implications for U.S. Trade Policy

DTIC Science & Technology

2010-02-23

markets in which member countries go beyond a customs union by eliminating barriers to labor and capital flows across national borders within the... market ; and • economic unions where members merge their economies even further by establishing a common currency, and therefore a unified monetary... market over the lowest tariff wall. Most FTAs also include procedures on the settlement of disputes arising among members and rules on the

International definition of a point-of-care test in family practice: a modified e-Delphi procedure.

PubMed

Schols, Angel M R; Dinant, Geert-Jan; Hopstaken, Rogier; Price, Christopher P; Kusters, Ron; Cals, Jochen W L

2018-01-29

The use of point-of-care tests (POCTs) in family practice is increasing, and the term POCT is often used in medical literature and clinical practice. Yet, no widely supported definition by several professional fields exists. To reach consensus on an international definition of a POCT in family practice. We performed a modified international e-Delphi procedure of four rounds among expert panel members from different professional backgrounds-family practitioners, laboratory specialists, policymakers, researchers and manufacturers. Of 27 panel members from seven different countries, 26 participated in all rounds. Most panel members were active in POCT research or policymaking and 70% worked in family medicine. After choosing important components, structuring of answers and feedback, the following definition was chosen as the best or second best definition by 81% of panel members: a point-of-care test in family practice is a test to support clinical decision making, which is performed by a qualified member of the practice staff nearby the patient and on any part of the patient's body or its derivatives, during or very close to the time of consultation, to help the patient and physician to decide upon the best suited approach, and of which the results should be known at the time of the clinical decision making. The definition emerging from this study can inform family practitioners, laboratory specialists, policymakers and manufacturers on the most widely supported and recognized definition and could act as a clear starting point for the organization and execution of professional point-of-care testing in family practice worldwide. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Implications for the Self Determine Benevolence and Self-Protection in Intergroup Relations

PubMed Central

Malloy, Thomas E.; Kinney, Lorin

2017-01-01

People often favor groups they belong to over those beyond the in-group boundary. Yet, in-group favoritism does not always occur, and people will sometimes favor an out-group over the in-group. We delineate theoretically when in-group favoritism (i.e., self-protection) and out-group favoritism (i.e., benevolence) should occur. In two experiments, groups’ relative status and competence stereotypes were manipulated; groups’ outcomes were non-contingent in Experiment 1 and contingent in Experiment 2. When allocating reward, members of a low status group were self-protective, favoring the in-group over the out-group under both non-contingent and contingent outcomes. Those with high status benevolently favored the out-group when outcomes were non-contingent, but were self-protective with contingent outcomes. People were willing to engage in social activities with an out-group member regardless of competence. However, when task collaboration had implications for the self, those with low status preferred competent over less competent out-group members. Traits of high status targets were differentiated by those with low status in both experiments, whereas those with high status differentiated low status members’ traits only when outcomes were contingent. A general principle fits the data: the implications of intergroup responses for the self determine benevolence and self-protection. Implications for the Self Determine Benevolence and Self Protection in Intergroup Relations PMID:29225518

Science Faculty Belief Systems in a Professional Development Program: Inquiry in College Laboratories

NASA Astrophysics Data System (ADS)

Hutchins, Kristen L.; Friedrichsen, Patricia J.

2012-12-01

The purpose of this study was to investigate how science faculty members' belief systems about inquiry-based teaching changed through their experience in a professional development program. The program was designed to support early career science faculty in learning about inquiry and incorporating an inquiry-based approach to teaching laboratories. Data sources for this qualitative study included three semi-structured interviews, observations during the program and during faculty members' implementation in their courses, and a researcher's journal. In the first phase of data analysis, we created profiles for each of the four participants. Next, we developed assertions, and tested for confirming and disconfirming evidence across the profiles. The assertions indicated that, through the professional development program, participants' knowledge and beliefs about inquiry-based teaching shifted, placing more value on student-directed learning and classroom inquiry. Participants who were internally motivated to participate and held incoming positive attitudes toward the mini-journal inquiry-based approach were more likely to incorporate the approach in their future practice. Students' responses played a critical role in participants' belief systems and their decision to continue using the inquiry-based format. The findings from this study have implications for professional development design.

Panel 3: Genetics and Precision Medicine of Otitis Media.

PubMed

Lin, Jizhen; Hafrén, Hena; Kerschner, Joseph; Li, Jian-Dong; Brown, Steve; Zheng, Qing Y; Preciado, Diego; Nakamura, Yoshihisa; Huang, Qiuhong; Zhang, Yan

2017-04-01

Objective The objective is to perform a comprehensive review of the literature up to 2015 on the genetics and precision medicine relevant to otitis media. Data Sources PubMed database of the National Library of Medicine. Review Methods Two subpanels were formed comprising experts in the genetics and precision medicine of otitis media. Each of the panels reviewed the literature in their respective fields and wrote draft reviews. The reviews were shared with all panel members, and a merged draft was created. The entire panel met at the 18th International Symposium on Recent Advances in Otitis Media in June 2015 and discussed the review and refined the content. A final draft was made, circulated, and approved by the panel members. Conclusion Many genes relevant to otitis media have been identified in the last 4 years in advancing our knowledge regarding the predisposition of the middle ear mucosa to commensals and pathogens. Advances include mutant animal models and clinical studies. Many signaling pathways are involved in the predisposition of otitis media. Implications for Practice New knowledge on the genetic background relevant to otitis media forms a basis of novel potential interventions, including potential new ways to treat otitis media.

Investigating and profiling the leadership behaviours of Jordanian nursing leaders.

PubMed

Mrayyan, Majd; Khasawneh, Israa

Leadership' is a social process in which a member or members of a group influence the interpretation of events, choice of goals/outcomes, organization of work activities, motivation, abilities, power relations, and shared orientations. This study identifies leadership behaviours of Jordanian nursing leaders. A descriptive comparative design was used to collect data from four governmental and three private hospitals. Data were collected during April 2005. The total number of recruited nursing leaders was 140 with a 70% response rate. T-tests and chi-squares were performed to compare the phenomenon of interest. The mean reported leadership behaviours were slightly higher in private hospitals than those in governmental hospitals. However, more than half of the time, leaders in both types of hospitals used supportive leadership behaviours. There were significant differences between governmental and private hospitals in most demographics of the sample. Based on types of hospitals and gender, differences in leadership behaviours were advantageous for nursing leaders in private hospitals, while differences based on units and wards were advantageous for nursing leaders in governmental hospitals. In general, Jordanian nursing leaders used supportive leadership behaviours. Differences in leadership behaviours have implications for nursing practice, research, and education.

Organization aesthetics in nursing homes.

PubMed

Hujala, Anneli; Rissanen, Sari

2011-05-01

The aim of this study was to make visible the material dimensions of nursing management.   Management theories have mainly ignored the material dimensions, namely the physical spaces in which management actually takes place as well as the physical bodies of organization members. The perspective of organization aesthetics enhances our understanding of the role of materiality in nursing management. The data were collected in 2009 using observation and interviews in eight nursing homes. Qualitative content analysis with critical interpretations was used. Three main issues of organizational aesthetics related to nursing management were identified: (1) the functionality of working spaces and equipment; (2) the relevance of 'organizational' space; and (3) the emotional-aesthetic dimension of daily work. Materiality is closely related to management topics, such as decision-making, values and identity formation of organizational members. Aesthetic dimensions of care are constructed by management practices which, in their turn, influence the nature of management. Implications for nursing management  Nurse managers need to be aware of the unintended and unnoticed consequences of materiality and aesthetics. Space and body issues may have considerable effects, for example, on the identity of care workers and on the attractiveness of the care branch. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Therapists' experiences and perceptions of teamwork in neurological rehabilitation: critical happenings in effective and ineffective teamwork.

PubMed

Suddick, Kitty M; De Souza, Lorraine H

2007-12-01

This paper reports the second part of an exploratory study into occupational therapists' and physiotherapists' perceptions and experiences of teamwork in neurological rehabilitation: the factors that were thought to influence effective and ineffective teamwork, and the meaning behind effective and ineffective teamwork in neurological rehabilitation. The study was undertaken through semi-structured interviews of 10 therapists from three different neurological rehabilitation teams based in the United Kingdom, and used the critical incident technique. Through analysis of the data, several main themes emerged regarding the perceived critical happenings in effective and ineffective teamwork. These were: team events and characteristics, team members' characteristics, shared and collaborative working practices, communication, specific organizational structures, environmental, external, and patient and family-related factors. Effective and ineffective team-work was perceived to impact on a number of levels: having implications for the team, the patient, individual team members, and the neurological rehabilitation service. The study supported the perceived value of team work within neurological rehabilitation. It also indicated the extensive and variable factors that may influence the team-working process as well as the complex and diverse nature of the process.

Eating together and eating alone: meal arrangements in British households.

PubMed

Yates, Luke; Warde, Alan

2017-03-01

Sociology traditionally accounts for eating in terms of the social organization of meals, their provision and consumption. A recurrent public concern is that the meal is being subverted. This paper examines meal arrangements in British households in 2012, drawing on an online survey in the format of a food diary administered to 2784 members of a supermarket consumer panel. It charts the organization of contemporary eating occasions, paying attention to socio-demographic variation in practice. Especially, it explores companionless meals, putting them in contexts of food provisioning and temporal rhythms. Findings show that eating alone is associated with simpler, quicker meals, and that it takes place most commonly in the morning and midday. Those living alone eat alone more often, but at similar meal times, and they take longer over their lone meals. Comparison with a similar study in 1955-6 suggests some fragmentation or relaxation in collective schedules. The implications are not straightforward, and the causes probably lie more in institutional shifts than personal preferences. Declining levels of commensality are, however, associated with a reduction in household size and, especially in households with children, difficulties of coordinating family members' schedules. © London School of Economics and Political Science 2016.

"Well, I'm tired of tryin'!" Organizational citizenship behavior and citizenship fatigue.

PubMed

Bolino, Mark C; Hsiung, Hsin-Hua; Harvey, Jaron; LePine, Jeffery A

2015-01-01

This study seeks to identify workplace conditions that influence the degree to which employees feel worn out, tired, or on edge attributed to engaging in organizational citizenship behavior (OCB) and also how this phenomenon, which we refer to as citizenship fatigue, is associated with future occurrences of OCB. Using data collected from 273 employees and their peers at multiple points in time, we found that the relationship between OCB and citizenship fatigue depends on levels of perceived organizational support, quality of team-member exchange relationships, and pressure to engage in OCB. Specifically, the relationship between OCB and citizenship fatigue is significantly stronger and positive when perceived organizational support is low, and it is significantly stronger and negative when the quality of team-member exchange is high and pressure to engage in OCB is low. Our results also indicate that citizenship fatigue is negatively related to subsequent acts of OCB. Finally, supplemental analyses reveal that the relationship between OCB and citizenship fatigue may vary as a function of the specific facet of OCB. We conclude with a discussion of the key theoretical and practical implications of our findings. (c) 2015 APA, all rights reserved.

On the front lines: Stakeholder threat cues determine how identified employees cope with scandal.

PubMed

Grandey, Alicia A; Krannitz, Morgan A; Slezak, Tyler

2015-07-01

When organizational identity is threatened as a result of scandal, highly identified members who represent the threatened organization to stakeholders have a particularly challenging and overlooked experience. Addressing a theoretical paradox, we propose that organizational identification interacts with the threat cues from stakeholders to determine employee responses. We conducted a multimethod, in vivo test of these ideas with university fundraising employees after events threatened the university's moral identity. Interview and archival data demonstrated that stakeholders expressed identity threat to fundraisers, who experienced their own identity-related distress and engaged in both group-dissociative and group-affirming responses. Surveys of professional and student university fundraisers demonstrated that more identified employees were more distressed (e,g., felt anxious, grief, betrayed) regardless of stakeholder threat cues. Yet, when employees perceived weak threat cues from stakeholders, more identified members were less likely to dissociate from the group and more likely to affirm the group's positive identity with stakeholders. These benefits of identification were not present when the stakeholder threat cues were strong. We discuss future research and practical implications of front-line employee identification and stakeholder cues during scandal. (c) 2015 APA, all rights reserved).

Negotiating the equivocality of palliative care: a grounded theory of team communicative processes in inpatient medicine.

PubMed

Ledford, Christy J W; Canzona, Mollie Rose; Cafferty, Lauren A; Kalish, Virginia B

2016-01-01

In the majority of U.S. hospitals, inpatient medicine teams make palliative care decisions in the absence of a formalized palliative system. Using a grounded theory approach, interviews with inpatient team members were systematically analyzed to uncover how participants conceptualize palliative care and how they regard the communicative structures that underlie its delivery. During analysis, Weick's model of organizing emerged as a framework that fit the data. The 39 participant inpatient team members discussed palliative care as primarily a communicative process. Themes describing the meaning of palliative care emerged around the concepts of receiver of care, timeline of care, and location of care. The emerging model included four stages in the communicative processes of inpatient palliative care: (a) interpret the need, (b) initiate the conversation, (c) integrate the processes, and (d) identify what works. In contrast to stable, focused palliative care teams or hospice care teams, which have prescribed patient populations and processes, the inpatient medicine team faces the equivocality of providing palliative care within a broader practice. This research offers a four-phase model to show how these inpatient teams communicate within this context. Implications for the provision of palliative care are discussed.

How can hospitals better protect the privacy of electronic medical records? Perspectives from staff members of health information management departments.

PubMed

Sher, Ming-Ling; Talley, Paul C; Cheng, Tain-Junn; Kuo, Kuang-Ming

2017-05-01

The adoption of electronic medical records (EMR) is expected to better improve overall healthcare quality and to offset the financial pressure of excessive administrative burden. However, safeguarding EMR against potentially hostile security breaches from both inside and outside healthcare facilities has created increased patients' privacy concerns from all sides. The aim of our study was to examine the influencing factors of privacy protection for EMR by healthcare professionals. We used survey methodology to collect questionnaire responses from staff members in health information management departments among nine Taiwanese hospitals active in EMR utilisation. A total of 209 valid responses were collected in 2014. We used partial least squares for analysing the collected data. Perceived benefits, perceived barriers, self-efficacy and cues to action were found to have a significant association with intention to protect EMR privacy, while perceived susceptibility and perceived severity were not. Based on the findings obtained, we suggest that hospitals should provide continuous ethics awareness training to relevant staff and design more effective strategies for improving the protection of EMR privacy in their charge. Further practical and research implications are also discussed.

Prevalence of financial conflicts of interest among panel members producing clinical practice guidelines in Canada and United States: cross sectional study.

PubMed

Neuman, Jennifer; Korenstein, Deborah; Ross, Joseph S; Keyhani, Salomeh

2011-10-11

To determine the prevalence of financial conflicts of interest among members of panels producing clinical practice guidelines on screening, treatment, or both for hyperlipidaemia or diabetes. Cross sectional study. Relevant guidelines published by national organisations in the United States and Canada between 2000 and 2010. Members of guideline panels. Prevalence of financial conflicts of interest among members of guideline panels and chairs of panels. Fourteen guidelines met our search criteria, of which five had no accompanying declaration of conflicts of interest by panel members. 288 panel members had participated in the guideline development process. Among the 288 panel members, 138 (48%) reported conflicts of interest at the time of the publication of the guideline and 150 (52%) either stated that they had no such conflicts or did not have an opportunity to declare any. Among 73 panellists who formally declared no conflicts, 8 (11%) were found to have one or more. Twelve of the 14 guideline panels evaluated identified chairs, among whom six had financial conflicts of interest. Overall, 150 (52%) panel members had conflicts, of which 138 were declared and 12 were undeclared. Panel members from government sponsored guidelines were less likely to have conflicts of interest compared with guidelines sponsored by non-government sources (15/92 (16%) v 135/196 (69%); P<0.001). The prevalence of financial conflicts of interest and their under-reporting by members of panels producing clinical practice guidelines on hyperlipidaemia or diabetes was high, and a relatively high proportion of guidelines did not have public disclosure of conflicts of interest. Organisations that produce guidelines should minimise conflicts of interest among panel members to ensure the credibility and evidence based nature of the guidelines' content.

Minority ethnic community participation in needs assessment and service development in primary care: perceptions of Pakistani and Bangladeshi people about psychological distress.

PubMed

Kai, Joe; Hedges, Clive

1999-03-01

OBJECTIVES: To promote community participation in exploring perceptions of psychological distress amongst Pakistani and Bangladeshi people, in order to develop appropriate services. DESIGN: Training and facilitation of resident community members (as community project workers), to define and conduct qualitative research involving semistructured interviews in their own communities, informing primary care led commissioning and service decision making. Setting A socio-economically disadvantaged inner-city locality in the UK. Participants One-hundred and four South Asian people (49 of Pakistani and 55 of Bangladeshi origin), interviewed by 13 resident community members. RESULTS: All community project workers completed training leading to a National Vocational Qualification, and successfully executed the research. Most study respondents located their main sources of stress within pervasive experience of racism and socio-economic disadvantage. They were positive about 'talking' and neutral listening as helpful, but sought strategies beyond non-directive counselling services that embraced practical welfare advice and social support. The roles of primary health care professionals were believed to be restricted to physical ill health rather than personal distress. The importance of professionals' sex, age, ethnicity and social status were emphasized as affecting open communication. Practical recommendations for the re-orientation and provision of services were generated and implemented in response to the findings, through dialogue with a primary care commissioning group, Health and Local Authority, and voluntary agencies. CONCLUSIONS: The work illustrates the feasibility and value of a community participation approach to research and service development in addressing a challenging and neglected area of minority ethnic health need. It offers one model for generating responsive service change in the context of current health policy in the UK, whilst also imparting skills and empowering community members. The study findings emphasize the need to recognize the social contexts in which distress is experienced and have implications for effective responses.

The "millennials": first year in practice.

PubMed

Olson, Marianne E

2009-01-01

Each year, thousands of novice nurses join the workforce. The overwhelming majority begin their careers in an acute care facility. Most of what we know about novice nurses comes from studies conducted over the last several decades. These studies have focused heavily on issues such as novice/expert differences on the performance of tasks. While they illuminate differences in judgment and decision-making skills, they provide little information on the reality of the novices' clinical practice. What is missing in the literature is an insider's look from the perspective of the millennial-born (1980-1999) novice nurse. Millennial novice nurses have both educators and experienced nurses searching for communication and learning strategies to engage the newest members of the nursing profession, yet the perceptions of millennial novice nurses have not yet been identified. This is a qualitative interpretive longitudinal study that utilized phenomenology as the philosophical and context method to illuminate the perceptions of millennial novice nurses. Audio-taped interviews were conducted at 3 months, 6 months, and 1 year. Findings have implications for both nurse educators and nurses in acute care facilities, especially those orienting the newest generation of novice nurses.

High school students presenting science: An interactional sociolinguistic analysis

NASA Astrophysics Data System (ADS)

Bleicher, Robert

Presenting science is an authentic activity of practicing scientists. Thus, effective communication of science is an important skill to nurture in high school students who are learning science. This study examines strategies employed by high school students as they make science presentations; it assesses students' conceptual understandings of particular science topics through their presentations and investigates gender differences. Data are derived from science presentation given by eight high school students, three females and five males who attended a summer science program. Data sources included videotaped presentations, ethnographic fieldnotes, interviews with presenters and members of the audience, and presenter notes and overheads. Presentations were transcribed and submitted to discourse analysis from an interactional sociolinguistic perspective. This article focuses on the methodology employed and how it helps inform the above research questions. The author argues that use of this methodology leads to findings that inform important social-communicative issues in the learning of science. Practical advice for teaching students to present science, implications for use of presentations to assess conceptual learning, and indications of some possible gender differences are discussed.Received: 14 April 1993; Revised: 15 February 1994;

Psychological implications of living with familial adenomatous polyposis.

PubMed

Claes, E; Renson, M; Delespesse, A; De Hoe, V; Haelterman, G; Kartheuser, A; Van Cutsem, E

2011-09-01

Psychosocial implications of living with FAP remain largely unexplored. This article reviews available literature on three topics: 1) Implications of living with FAP 2) genetic testing and reproductive decision-making and 3) family communication. Papers published until 2009 about psychosocial and behavioral issues in FAP were identified. Psychometric data indicate that FAP patients and at-risk relatives as a group do not exhibit clinical symptoms of mental health problems after clinical or genetic diagnosis. However, some subgroups revealed to be more vulnerable to distress. Also, concerns related to the disease and its consequences were reported. While interest in prenatal diagnosis or preimplantation genetic diagnosis seems to be high it is important to study actual uptake because this may reveal to be much lower. Family members are an important source of information and the few available data suggest that family communication is problematic. The findings described have several shortcomings. They were obtained from only a few studies often conducted using specific or mixed study groups, originating from the 90ties and mostly cross-sectional in nature. For clinical practice, it is important to have more research data on how FAP patients at different ages cope with the disease, on the impact of genetic testing on reproductive decision-making and on family communication. Results reported here need to be confirmed by additional research and new themes need to be explored.

School physics teacher class management, laboratory practice, student engagement, critical thinking, cooperative learning and use of simulations effects on student performance

NASA Astrophysics Data System (ADS)

Riaz, Muhammad

The purpose of this study was to examine how simulations in physics class, class management, laboratory practice, student engagement, critical thinking, cooperative learning, and use of simulations predicted the percentage of students achieving a grade point average of B or higher and their academic performance as reported by teachers in secondary school physics classes. The target population consisted of secondary school physics teachers who were members of Science Technology, Engineeering and,Mathematics Teachers of New York City (STEMteachersNYC) and American Modeling Teachers Association (AMTA). They used simulations in their physics classes in the 2013 and 2014 school years. Subjects for this study were volunteers. A survey was constructed based on a literature review. Eighty-two physics teachers completed the survey about instructional practice in physics. All respondents were anonymous. Classroom management was the only predictor of the percent of students achieving a grade point average of B or higher in high school physics class. Cooperative learning, use of simulations, and student engagement were predictors of teacher's views of student academic performance in high school physics class. All other variables -- class management, laboratory practice, critical thinking, and teacher self-efficacy -- were not predictors of teacher's views of student academic performance in high school physics class. The implications of these findings were discussed and recommendations for physics teachers to improve student learning were presented.

Family Obligations in Micronesian Cultures: Implications for Educators

ERIC Educational Resources Information Center

Ratliffe, Katherine T.

2010-01-01

Micronesian people, a new group of immigrants to the USA, have a strong system of responsibilities to family members that guides their priorities and actions. When family obligations clash with school priorities, conflicts can occur. I interviewed 26 adults to learn about the relationships and responsibilities of family members to each other in…

Inuit Voices on Quality Education in Nunavut: Policy Implications

ERIC Educational Resources Information Center

Fredua-Kwarteng, Eric

2016-01-01

This paper is based on a research that explored how Inuit community members in Nunavut Territory, Canada, conceptualized quality education in the socio-cultural context of the territory. Data were collected through telephone interviews of 13 Inuit community members in Nunavut and document reviews both of which were conducted in 2010. The data…

An Examination of University Conducting Faculty Members' Score Study Attitudes and Practices

ERIC Educational Resources Information Center

Silvey, Brian A.; Springer, D. Gregory; Eubanks, Stephen C.

2016-01-01

The purpose of this study was to examine university conducting teachers' attitudes about score study, the source materials they used to teach score study, their personal score study practices, and the score study approaches they taught their undergraduate conducting students. Respondents (N = 236) were members of the College Band Directors…

Risk Management: An Accountability Guide for University and College Boards

ERIC Educational Resources Information Center

Abraham, Janice M.

2013-01-01

With proven advice and practical best practices for sound risk management, this robust publication written by the CEO of United Educators identifies how engaged board members should collaborate closely with institutional leaders on a variety of operational and strategic risks. All board members, whatever their role or committee assignment, will…

27 CFR 10.52 - Practice which puts trade buyer independence at risk.

Code of Federal Regulations, 2010 CFR

2010-04-01

... place trade buyer independence at risk within the description of exclusion in § 10.51: Industry member...-employer in return for the employee agreeing to order distilled spirits, wine, or malt beverages from the industry member. The practice enumerated here is an example and does not constitute a complete list of...

Effective Superintendent-School Board Practices: Strategies for Developing and Maintaining Good Relationships with Your Board

ERIC Educational Resources Information Center

Townsend, Rene S.; Johnston, Gloria L.; Gross, Gwen E.; Lynch, Peggy; Garcy, Lorraine M.; Roberts, Benita B.; Novotney, Patricia B.

2006-01-01

Foster a strong superintendent-school board relationship centered on quality teaching and learning! This book helps current and future superintendents and school board members develop an effective governance team that prioritizes quality teaching and learning. Designed for practicing and aspiring superintendents and school board members, this…

Assessment Practices of Multi-Disciplinary School Team Members in Determining Special Education Services for English Language Learners

ERIC Educational Resources Information Center

Sadowski, Garrett; O'Neill, Rob; Bermingham, Doug

2014-01-01

Multidisciplinary team members were surveyed to identify the frequency with which they use recommended assessment practices, how they interpret assessment information, and their confidence working with English Language Learners (ELLs) for the purpose of determining possible eligibility to receive special education services. Results of this study…

Organizational Members as Storywriters: On Organizing Practices of Reflexivity

ERIC Educational Resources Information Center

Gherardi, Silvia; Cozza, Michela; Poggio, Barbara

2018-01-01

Purpose: The purpose of this paper is to describe how organizational members became storywriters of an important process of organizational change. Writing became a practice designed to create a space, a time and a methodology with which to author the process of change and create a learning context. The written stories produced both the…

Grief Counseling Groups for Adolescents Based on Re-Membering Practices

ERIC Educational Resources Information Center

Granados, Stephanie; Winslade, John; De Witt, Megan; Hedtke, Lorraine

2009-01-01

Focusing on "re-membering" practices is new to grief counseling. Traditional approaches to grief counseling are guided by the concepts of stages or tasks, usually to move the person toward accepting the reality of loss and to "say goodbye" to their deceased loved one. This alternative approach to grief counseling, driven by…

Student-Faculty Partnership in Explorations of Pedagogical Practice: A Threshold Concept in Academic Development

ERIC Educational Resources Information Center

Cook-Sather, Alison

2014-01-01

Student-faculty partnerships position students as informants, participants, and change agents in collaboration with faculty members. Enacting one form of such collaboration, Bryn Mawr College's SaLT program pairs faculty members and undergraduate students in explorations of pedagogical practice. The program provides both context and case study for…

Centres for Leadership: a strategy for academic integration.

PubMed

King, Gillian; Parker, Kathryn; Peacocke, Sean; Curran, C J; McPherson, Amy C; Chau, Tom; Widgett, Elaine; Fehlings, Darcy; Milo-Manson, Golda

2017-05-15

Purpose The purpose of this paper is to describe how an Academic Health Science Centre, providing pediatric rehabilitation services, research, and education, developed a Centres for Leadership (CfL) initiative to integrate its academic functions and embrace the goal of being a learning organization. Design/methodology/approach Historical documents, tracked output information, and staff members' insights were used to describe the ten-year evolution of the initiative, its benefits, and transformational learnings for the organization. Findings The evolutions concerned development of a series of CfLs, and changes over time in leadership and management structure, as well as in operations and targeted activities. Benefits included enhanced clinician engagement in research, practice-based research, and impacts on clinical practice. Transformational learnings concerned the importance of supporting stakeholder engagement, fostering a spirit of inquiry, and fostering leaderful practice. These learnings contributed to three related emergent outcomes reflecting "way stations" on the journey to enhanced evidence-informed decision making and clinical excellence: enhancements in authentic partnerships, greater innovation capacity, and greater understanding and actualization of leadership values. Practical implications Practical information is provided for other organizations interested in understanding how this initiative evolved, its tangible value, and its wider benefits for organizational collaboration, innovation, and leadership values. Challenges encountered and main messages for other organizations are also considered. Originality/value A strategy map is used to present the structures, processes, and outcomes arising from the initiative, with the goal of informing the operations of other organizations desiring to be learning organizations.

Family support in cancer survivorship.

PubMed

Muhamad, Mazanah; Afshari, Mojgan; Kazilan, Fitrisehara

2011-01-01

This paper raises issues about the role of family members in providing support for breast cancer survivors. Data were collected from 400 breast cancer survivors in Peninsular Malaysia through a custom-designed questionnaire fielded at hospitals and support group meetings. The data were analyzed using descriptive statistics. The analyses show that all family members could be supportive, especially in decision making and help with emotional issues. The spouse was the main support provider among the family members (others were children, parents, siblings and more distant relatives). The results also indicated that a significant percentage practiced collaborative decision-making. Breast cancer survivors needed their family members' support for information on survivorship strategies such as managing emotions, health, life style and dietary practice. The family members' supportive role may be linked to the Malaysian strong family relationship culture. For family members to contribute more adequately to cancer survivorship, it is suggested that appropriate educational intervention also be provided to them.

Workplace Democracy: A Review of Literature and Implications for Human Resource Development

ERIC Educational Resources Information Center

Hatcher, Tim

2007-01-01

A review of workplace democracy revealed that both practice and research need updating. The results are discussed in terms of history, theory, research and practice. Implications for human resource development research and practice are also included. (Contains 2 tables.)

Professional Demands and Job Satisfaction in Orthopaedic Trauma: An OTA Member Survey.

PubMed

Cunningham, Brian P; Swanson, David C; Basmajian, Hrayr; McLemore, Ryan; Ortega, Gilbert

2015-12-01

The goal of this study was to examine the factors that affect career satisfaction in orthopaedic traumatologists. We hypothesize that the level of stress and career satisfaction in orthopaedic traumatology would be affected by increased number of call nights and work hours. A 30-question survey was emailed to members of the OTA. The survey evaluated 5 critical areas: training/experience, practice characteristics, demands, stress management strategies, and satisfaction. After approval by the OTA research committee, all active and associate US members of the OTA were contacted. The survey was open to the OTA members from July through November of 2012. Of 1031 members of the OTA, 263 members responded for an overall response rate of 25.5%. Most respondents were fellowship-trained (218, 82.9%) and predominantly young (<5 years in practice, 34.4%) or established surgeons (>15 years in practice, 28.5%). Most surgeons were married (229, 87.1%) and have not been divorced (226, 85.9%). Career satisfaction was statistically improved by belonging to larger practice (P = 0.016), decreased by work for more hours per week (P = 0.001), and improved by taking more call (P = 0.014). Career satisfaction among orthopaedic trauma surgeons was extremely high. Our results indicate that young surgeons may improve their job satisfaction and potentially prolong their career by limiting the numbers of hours worked, taking a consistent number of calls and joining a larger group. Prognostic Level V. See Instructions for Authors for a complete description of levels of evidence.

The Global Health Service Partnership: An Academic-Clinical Partnership to Build Nursing and Medical Capacity in Africa.

PubMed

Stuart-Shor, Eileen M; Cunningham, Elizabeth; Foradori, Laura; Hutchinson, Elizabeth; Makwero, Martha; Smith, Jill; Kasozi, Jane; Johnston, Esther M; Khaki, Aliasgar; Vandervort, Elisa; Moshi, Fabiola; Kerry, Vanessa B

2017-01-01

The World Health Organization estimates a global deficit of about 12.9 million skilled health professionals (midwives, nurses, and physicians) by 2035. These shortages limit the ability of countries, particularly resource-constrained countries, to deliver basic health care, to respond to emerging and more complex needs, and to teach, graduate, and retain their future health professionals-a vicious cycle that is perpetuated and has profound implications for health security. The Global Health Service Partnership (GHSP) is a unique collaboration between the Peace Corps, President's Emergency Plan for AIDS Relief, Seed and host-country institutions, which aims to strengthen the breadth and quality of medical and nursing education and care delivery in places with dire shortages of health professionals. Nurse and physician educators are seconded to host institutions to serve as visiting faculty alongside their local colleagues. They serve for 1 year with many staying longer. Educational and clinical best practices are shared, emphasis is placed on integration of theory and practice across the academic-clinical domains and the teaching and learning environment is expanded to include implementation science and dissemination of locally tailored and sustainable practice innovations. In the first 3 years (2013-2016) GHSP placed 97 nurse and physician educators in three countries (Malawi, Tanzania, and Uganda). These educators have taught 454 courses and workshops to 8,321 trainees, faculty members, and practicing health professionals across the curriculum and in myriad specialties. Mixed-methods evaluation included key stakeholder interviews with host institution faculty and students who indicate that the addition of GHSP enhanced clinical teaching (quality and breadth) resulting in improved clinical skills, confidence, and ability to connect theory to practice and critical thinking. The outputs and outcomes from four exemplars which focus on the translation of evidence to practice through implementation science are included. Findings from the first 3 years of GHSP suggest that an innovative, locally tailored and culturally appropriate multi-country academic-clinical partnership program that addresses national health priorities is feasible and generated new knowledge and best practices relevant to capacity building for nursing and medical education. This in turn has implications for improving the health of populations who suffer a disproportionate burden of global disease.

The Global Health Service Partnership: An Academic–Clinical Partnership to Build Nursing and Medical Capacity in Africa

PubMed Central

Stuart-Shor, Eileen M.; Cunningham, Elizabeth; Foradori, Laura; Hutchinson, Elizabeth; Makwero, Martha; Smith, Jill; Kasozi, Jane; Johnston, Esther M.; Khaki, Aliasgar; Vandervort, Elisa; Moshi, Fabiola; Kerry, Vanessa B.

2017-01-01

The World Health Organization estimates a global deficit of about 12.9 million skilled health professionals (midwives, nurses, and physicians) by 2035. These shortages limit the ability of countries, particularly resource-constrained countries, to deliver basic health care, to respond to emerging and more complex needs, and to teach, graduate, and retain their future health professionals—a vicious cycle that is perpetuated and has profound implications for health security. The Global Health Service Partnership (GHSP) is a unique collaboration between the Peace Corps, President’s Emergency Plan for AIDS Relief, Seed and host-country institutions, which aims to strengthen the breadth and quality of medical and nursing education and care delivery in places with dire shortages of health professionals. Nurse and physician educators are seconded to host institutions to serve as visiting faculty alongside their local colleagues. They serve for 1 year with many staying longer. Educational and clinical best practices are shared, emphasis is placed on integration of theory and practice across the academic–clinical domains and the teaching and learning environment is expanded to include implementation science and dissemination of locally tailored and sustainable practice innovations. In the first 3 years (2013–2016) GHSP placed 97 nurse and physician educators in three countries (Malawi, Tanzania, and Uganda). These educators have taught 454 courses and workshops to 8,321 trainees, faculty members, and practicing health professionals across the curriculum and in myriad specialties. Mixed-methods evaluation included key stakeholder interviews with host institution faculty and students who indicate that the addition of GHSP enhanced clinical teaching (quality and breadth) resulting in improved clinical skills, confidence, and ability to connect theory to practice and critical thinking. The outputs and outcomes from four exemplars which focus on the translation of evidence to practice through implementation science are included. Findings from the first 3 years of GHSP suggest that an innovative, locally tailored and culturally appropriate multi-country academic–clinical partnership program that addresses national health priorities is feasible and generated new knowledge and best practices relevant to capacity building for nursing and medical education. This in turn has implications for improving the health of populations who suffer a disproportionate burden of global disease. PMID:28791282

Nursing Care at the Time of Death: A Bathing and Honoring Practice.

PubMed

Rodgers, Debra; Calmes, Beth; Grotts, Jonathan

2016-05-01

To explore family members' experience of a bathing and honoring practice after a loved one's death in the acute care setting.
. A descriptive, qualitative design using a semistructured telephone interview script.
. The Inpatient Adult Oncology Unit at Santa Barbara Cottage Hospital in California. 
. 13 family members who participated in the bathing and honoring practice after their loved one's death on the oncology unit.
. Participants were selected by purposive sampling and interviewed by telephone three to six months after their loved one's death. Interviews using a semistructured script with open-ended questions were recorded, transcribed, verified, and analyzed using phenomenologic research techniques to identify common themes of experience.
. 24 first-level themes and 11 superordinate themes emerged from the data. All participants indicated that the bathing and honoring practice was a positive experience and supported the grieving process. The majority found the practice to be meaningful and stated that it honored their loved one. Many expressed that the bathing and honoring was spiritually significant in a nondenominational way and that they hope it will be made available to all families of patients who die in the hospital. 
. After patient death, a bathing and honoring practice with family member participation is positive and meaningful, and it supports family members' initial grieving.
. This study is a first step toward establishing specific nursing interventions as evidence-based practice that can be incorporated in routine nursing care for patients and families at the end of life.

How minority members' perceptions of majority members' acculturation preferences shape minority members' own acculturation preferences: evidence from Chile.

PubMed

Zagefka, Hanna; González, Roberto; Brown, Rupert

2011-06-01

Two survey studies were conducted in Chile with members of the indigenous minority group Mapuche (Ns = 566; 394). The aim was to find predictors of minority members' acculturation preferences, especially integration. It was hypothesized that minority members' preferences would depend on their perceptions of what majority members want. Specifically, it was predicted that a perception that majority members want minority members to maintain their original culture would be associated with a greater desire for culture maintenance among minority participants. Further, it was predicted that a perception that majority members want intergroup contact would be associated with a greater desire for contact among minority participants. Finally, it was predicted that a perception that majority members are in favour of both culture maintenance and contact (i.e., integration) would be associated with more support for integration among minority participants. Results bore out these predictions. Theoretical and policy implications are discussed. ©2010 The British Psychological Society.

The Human Genome Project and Mental Retardation: An Educational Program. Final Progress Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Davis, Sharon

The Arc, a national organization on mental retardation, conducted an educational program for members, many of whom have a family member with a genetic condition causing mental retardation. The project informed members about the Human Genome scientific efforts, conducted training regarding ethical, legal and social implications and involved members in issue discussions. Short reports and fact sheets on genetic and ELSI topics were disseminated to 2,200 of the Arc's leaders across the country and to other interested individuals. Materials produced by the project can e found on the Arc's web site, TheArc.org.

Customer Service: Implications for Reference Practice.

ERIC Educational Resources Information Center

Whitlatch, Jo Bell

1995-01-01

The past decade has seen an increasing emphasis on customer service in business research and management. Two concepts in understanding business customer service practices are discussed: the service encounter and total quality management. Highlights include customer service research and practices in business; implications for library reference…

Scaffolding student learning in clinical practice.

PubMed

Spouse, J

1998-05-01

For many years the profession has acknowledged a schism between theories taught in the classroom and the practice of clinicians. This tends to arise from beliefs that knowledge which has been generalized (formalized) can be readily transferred to informal settings (practice). Whilst apprehension of formalized knowledge is crucial to professional development, a mediator is necessary to demonstrate its relevance to practice. A variety of solutions have been offered which all have value but without effective social support fail to resolve the problem. Findings from a longitudinal study investigating the professional development of pre-registration nursing students indicate the importance of sponsorship by a member of clinical staff and participation in legitimate peripheral activities. In the absence of effective sponsorship, students found it difficult to participate in clinical activities or to learn. As a result, their professional development during placements became stunted with subsequent implications for their professional future. Questions concerned with this phenomena were explored using documentary evidence supplied by research participants, observations of their practice and focused interviews throughout their programme. Sociocultural or activity theories of human learning offer some attractive explanations. One strategy is scaffolding which takes place within sponsored nursing activities and builds on the important concept of the Zone of Proximal Development (ZPD), where speech becomes a tool to mediate learning and development. As a diagnostic tool, scaffolding enables both supervisor and learner to recognize knowledge-in-waiting and knowledge-in-use and hence learning need, thus stimulating opportunities for further learning and professional development beneficial to both learner and supervisor. It provides a means for theory and practice to become integrated.

Psychodynamic Leadership Approach and Leader-Member Exchange (LMX): A Psychiatric Perspective on Two Leadership Theories and Implications for Training Future Psychiatrist Leaders.

PubMed

Plakiotis, Christos

2017-01-01

An increased emphasis in recent years on psychiatrists as healthcare leaders has not only drawn attention to the skills they can bring to this role but has also raised questions about how to best train and prepare them to assume leadership responsibilities. Such training should not be conducted in isolation from, and oblivious to, the wide-ranging expertise in human behaviour and relationships that psychiatrists can bring to the leadership arena. The aim of this theoretical paper is to draw attention to how psychiatrists can use their existing knowledge and skill set to inform their understanding of leadership theory and practice. In particular, the Psychodynamic Leadership Approach and Leader-Member Exchange theory are compared and contrasted to illustrate this point. The former represents a less well-known approach to leadership theory and practice whereas the latter is a widely familiar, conventional theory that is regularly taught in leadership courses. Both are underpinned by their emphasis on leader-follower relationships-and human relationships more broadly-and are intuitively appealing to psychiatrists endeavouring to understand aspects of organisational behaviour in the healthcare settings in which they work and lead. The application of these theories to assist reflection on and understanding of professional and personal leadership behaviours through leadership-oriented Balint-style groups and 360-degree appraisal is proposed. It is hoped that this paper will serve to stimulate thought and discussion about how leadership training for future psychiatrists can be tailored to better harness their existing competencies, thereby developing richer formative learning experiences and, ultimately, achieving superior leadership outcomes.

Evaluation of a telenovela designed to improve knowledge and behavioral intentions among Hispanic patients with end-stage renal disease in Southern California.

PubMed

Forster, Myriam; Allem, Jon-Patrick; Mendez, Nicole; Qazi, Yasir; Unger, Jennifer B

2016-01-01

Culturally relevant education is needed to improve rates of successful kidney transplantation among Hispanic patients with end-stage renal disease (ESRD). This study examined whether patients' knowledge about kidney disease, postoperative care, and proactive health practices improved after watching a telenovela series about ESRD. 334 ESRD patients and 94 family members/caregivers were assigned to watch a telenovela ('Fixing Paco,' a bilingual health education film) or receive standard of care at a transplant center or at a dialysis clinic. Outcomes for pre-transplant patients assigned to standard of care at dialysis centers or at a transplant center were compared to pre-transplant patients in the treatment condition (standard of care + telenovela). Knowledge and behavioral intention scores at baseline across conditions and locations were similar, suggesting that assignment resulted in comparable groups at baseline. Using linear regression, this study found statistically significant improvements in knowledge scores among the telenovela group as compared to the standard of care groups. The telenovela group also had greater improvements in behavioral intention scores compared to the standard of care groups. Family members assigned to the telenovela group had significant improvements in knowledge scores as compared to the standard of care groups. Being well informed about ESRD and adopting proactive health behaviors are important mechanisms in improving transplantation outcomes. These findings suggest that knowledge about kidney disease, postoperative care, and proactive health practices could be improved by viewing a telenovela. Implications, limitations, and directions for future research are discussed.

Challenges in providing culturally-competent care to patients with metastatic brain tumours and their families.

PubMed

Longo, Lianne; Slater, Serena

2014-01-01

Being diagnosed with a metastatic brain tumour can be devastating as it is characterized by very low cure rates, as well as significant morbidity and mortality. Given the poor life expectancy and progressive disability that ensues, patients and family members experience much turmoil, which includes losses that bring about changes to family roles, routines and relationships. Crisis and conflict are common during such major disruptions to a family system, as individual members attempt to make sense of the illness experience based on cultural and spiritual beliefs, past experiences and personal philosophies. It is imperative health care providers strive towards increased awareness and knowledge of how culture affects the overall experience of illness and death in order to help create a mutually satisfactory care plan. Providing culturally-competent care entails the use of proper communication skills to facilitate the exploration of patient and family perspectives and allows for mutual decision making. A case study will illustrate the challenges encountered in providing culturally-competent care to a woman with brain cancer and her family. As the patient's health declined, the family entered into a state of crisis where communication between family members and health care professionals was strained; leading to conflict and sub-optimal outcomes. This paper will address the ethical dilemma of providing culturally-competent care when a patient's safety is at risk, and the nursing implications of upholding best practices in the context of differing beliefs and priorities.

Family involvement is helpful and harmful to patients’ self-care and glycemic control

PubMed Central

Mayberry, Lindsay Satterwhite; Osborn, Chandra Y.

2014-01-01

Objective We assessed the relationships between supportive and obstructive family behaviors and patients’ diabetes self-care activities and HbA1C, and potential interaction effects and differences by demographic characteristics. Methods In a cross-sectional study, 192 adults with type 2 diabetes completed the Diabetes Family Behavior Checklist-II, the Summary of Diabetes Self-Care Activities, and a glycemic control (HbA1C) test. Results Participants reported similar rates of supportive and obstructive behaviors that were positively correlated (rho=0.61, p<.001). In adjusted analyses, supportive family behaviors were associated with adherence to different self-care behaviors (β=0.20–0.50, p<.05), whereas obstructive family behaviors were associated with less adherence to self-care behaviors (β=−0.28–−0.39, p<.01) and worse HbA1C (β=0.18, p<.05). Supportive behaviors protected against the detrimental effect of obstructive behaviors on HbA1C (interaction β=−0.22, p<.001). Non-Whites reported more supportive and obstructive behaviors than Whites, but race did not affect the relationships between family behaviors and self-care or HbA1C. Conclusion Involving family members in patients’ diabetes management may compromise patients’ self-care and glycemic control unless family members are taught to avoid obstructive behaviors. Practice Implications Our findings endorse interventions that help family members develop actionable plans to support patients’ self-care and train them to communicate productively about diabetes management. PMID:25282327

27 CFR 8.54 - Criteria for determining retailer independence.

Code of Federal Regulations, 2010 CFR

2010-04-01

... purchase or the quantity in which to purchase them for sale to consumers. (b) The industry member obligates... has a continuing obligation to purchase or otherwise promote the industry member's product. (d) The... purchase of the industry member's products. (e) The practice involves the industry member in the day-to-day...

Scientists@Home: What Drives the Quantity and Quality of Online Citizen Science Participation?

PubMed Central

Nov, Oded; Arazy, Ofer; Anderson, David

2014-01-01

Online citizen science offers a low-cost way to strengthen the infrastructure for scientific research and engage members of the public in science. As the sustainability of online citizen science projects depends on volunteers who contribute their skills, time, and energy, the objective of this study is to investigate effects of motivational factors on the quantity and quality of citizen scientists' contribution. Building on the social movement participation model, findings from a longitudinal empirical study in three different citizen science projects reveal that quantity of contribution is determined by collective motives, norm-oriented motives, reputation, and intrinsic motives. Contribution quality, on the other hand, is positively affected only by collective motives and reputation. We discuss implications for research on the motivation for participation in technology-mediated social participation and for the practice of citizen science. PMID:24690612

Creating the final conversations scale: a measure of end-of-life relational communication with terminally ill individuals.

PubMed

Generous, Mark Alan; Keeley, Maureen P

2014-01-01

Final conversations (FCs) are defined as the communicative interactions, both verbal and nonverbal, that occur between terminally ill patients and relational partners. In this study, the "Final Conversations Scale" was developed and tested. A total of 152 participants that had engaged in final conversations with individuals that were terminally ill completed the newly developed instrument. Factor analysis produced a five-factor structure, including: messages of spirituality/religion; expressions of love; proactive difficult relationship talk; everyday communication; and talk about illness/death. Participants' perceptions of the relational closeness and difficulty with the deceased significantly influenced the individuals' recalled frequency of FCs messages. Practical and scholarly implications focus on the needs of the family members regarding their communication with terminally ill individuals, as well as directions for future research with the FCs Scale.

Lagged effects of family-supportive organization perceptions and supervision in relation to generalized work-related resources.

PubMed

Matthews, Russell A; Toumbeva, Tatiana H

2015-07-01

In the present study, grounded in organizational support and social exchange theory, the dynamic lagged interplay between family supportive supervision (FSS), family supportive organization perceptions (FSOP), perceived organizational support (POS), and leader-member exchange (LMX) was examined. Data were collected from 435 respondents over 3 time points with 6-week lags between assessments. Consistent with theory, FSS had a significant lagged effect on FSOP, whereas the reverse relationship was not supported. Interestingly, contrary to conservation of resources theory, we did not find significant lagged effects between POS and FSOP. Results further indicated that LMX and FSS were reciprocally related over time, suggesting the potential for a dynamic, mutually beneficial exchange relationship between subordinates and supervisors. Theoretical implications and considerations for research and practice are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Nursing faculty--an endangered species?

PubMed

De Young, S; Bliss, J B

1995-01-01

A present faculty shortage has been documented, and the potential for an even worse shortage in the future is very real. Implications of a continued shortage for both nursing education and practice are serious. They include limitations on enrollments leading to future nursing shortages, burnout of present faculty, or possible decline in the quality of programs. Contributing factors such as aging of educators, fewer graduate students going into teaching, non-competitive salaries, and increased job opportunities for nurses with graduate degrees are explored. Possible solutions include adding more education courses or tracks in graduate programs, obtaining increased federal funds for graduate education, emphasizing the many rewards and benefits of the faculty role, recruiting faculty from new areas, mentoring people into teaching, giving flexible teaching assignments to older faculty members, and making changes in the ways that clinical instruction is performed.

Scientists@Home: what drives the quantity and quality of online citizen science participation?

PubMed

Nov, Oded; Arazy, Ofer; Anderson, David

2014-01-01

Online citizen science offers a low-cost way to strengthen the infrastructure for scientific research and engage members of the public in science. As the sustainability of online citizen science projects depends on volunteers who contribute their skills, time, and energy, the objective of this study is to investigate effects of motivational factors on the quantity and quality of citizen scientists' contribution. Building on the social movement participation model, findings from a longitudinal empirical study in three different citizen science projects reveal that quantity of contribution is determined by collective motives, norm-oriented motives, reputation, and intrinsic motives. Contribution quality, on the other hand, is positively affected only by collective motives and reputation. We discuss implications for research on the motivation for participation in technology-mediated social participation and for the practice of citizen science.

Culture- and Immigration-Related Stress Faced by Chinese American Families with a Patient Having Schizophrenia.

PubMed

Kung, Winnie W

2016-07-01

The impact of culture and immigration on the experience of Chinese American families with a member having schizophrenia is explored within the frameworks of family systems and stress and coping. This qualitative study was conducted within an intervention study of family psychoeducation using therapists' session notes from 103 family sessions and 13 relatives' group sessions from nine patients and 19 relatives. The high stigma attached to mental illness leading to social isolation, and families' devotion to caregiving exacerbated caregiver burden. Taboo against discussing dating and sexuality and the consideration of arranged marriages caused unique stress. The insecurity as immigrants and shortage of bilingual services were related to greater enmeshment within these families. Implications on research methodology and practice are discussed. © 2015 American Association for Marriage and Family Therapy.

Social support and well-being at mid-life among mothers of adolescents and adults with autism spectrum disorders.

PubMed

Smith, Leann E; Greenberg, Jan S; Seltzer, Marsha Mailick

2012-09-01

The present study investigated the impact of social support on the psychological well-being of mothers of adolescents and adults with ASD (n = 269). Quantity of support (number of social network members) as well as valence of support (positive support and negative support) were assessed using a modified version of the "convoy model" developed by Antonucci and Akiyama (1987). Having a larger social network was associated with improvements in maternal well-being over an 18-month period. Higher levels of negative support as well as increases in negative support over the study period were associated with increases in depressive symptoms and negative affect and decreases in positive affect. Social support predicted changes in well-being above and beyond the impact of child behavior problems. Implications for clinical practice are discussed.

Social workers' experiences as the family support person during cardiopulmonary resuscitation attempts.

PubMed

Firn, Janice; DeVries, Keli; Morano, Dawnielle; Spano-English, Toni

2017-07-01

During inhospital cardiopulmonary resuscitation attempts, a designated family support person (FSP) may provide guidance and support to family members. Research on nurses and chaplains in this role has been published. Social workers also regularly fulfill this service, however, little is known about how they perceive and enact this role. To explore their experiences, qualitative interviews (n = 10) were conducted with FSP social workers. Critical realist thematic analysis identified five themes: walking in cold, promoting family presence, responding to the whole spectrum of grief, going beyond the family support role, and repercussions of bearing witness. Social workers perform a variety of tasks to promote family presence during resuscitation attempts and provide psychosocial support over the continuum of care. The FSP role impacts social workers emotionally and professionally. Implications for hospital policy, staffing, and clinical practice are discussed.

EMQN/CMGS best practice guidelines for the molecular genetic testing of Huntington disease.

PubMed

Losekoot, Monique; van Belzen, Martine J; Seneca, Sara; Bauer, Peter; Stenhouse, Susan A R; Barton, David E

2013-05-01

Huntington disease (HD) is caused by the expansion of an unstable polymorphic trinucleotide (CAG)n repeat in exon 1 of the HTT gene, which translates into an extended polyglutamine tract in the protein. Laboratory diagnosis of HD involves estimation of the number of CAG repeats. Molecular genetic testing for HD is offered in a wide range of laboratories both within and outside the European community. In order to measure the quality and raise the standard of molecular genetic testing in these laboratories, the European Molecular Genetics Quality Network has organized a yearly external quality assessment (EQA) scheme for molecular genetic testing of HD for over 10 years. EQA compares a laboratory's output with a fixed standard both for genotyping and reporting of the results to the referring physicians. In general, the standard of genotyping is very high but the clarity of interpretation and reporting of the test result varies more widely. This emphasizes the need for best practice guidelines for this disorder. We have therefore developed these best practice guidelines for genetic testing for HD to assist in testing and reporting of results. The analytical methods and the potential pitfalls of molecular genetic testing are highlighted and the implications of the different test outcomes for the consultand and his or her family members are discussed.

From the nurses' station to the health team hub: how can design promote interprofessional collaboration?

PubMed

Gum, Lyn Frances; Prideaux, David; Sweet, Linda; Greenhill, Jennene

2012-01-01

Interprofessional practice implies that health professionals are able to contribute patient care in a collaborative environment. In this paper, it is argued that in a hospital the nurses' station is a form of symbolic power. The term could be reframed as a "health team hub," which fosters a place for communication and interprofessional working. Studies have found that design of the Nurses' Station can impact on the walking distance of hospital staff, privacy for patients and staff, jeopardize patient confidentiality and access to resources. However, no studies have explored the implications of nurses' station design on interprofessional practice. A multi-site collective case study of three rural hospitals in South Australia explored the collaborative working culture of each hospital. Of the cultural concepts being studied, the physical design of nurses' stations and the general physical environment were found to have a major influence on an effective collaborative practice. Communication barriers were related to poor design, lack of space, frequent interruptions and a lack of privacy; the name "nurses' station" denotes the space as the primary domain of nurses rather than a workspace for the healthcare team. Immersive work spaces could encourage all members of the healthcare team to communicate more readily with one another to promote interprofessional collaboration.

Kal Dristi , Stolen Babies and 'Blocked Uteruses': Poverty and Infertility Anxieties among Married Adolescent Women Living in a Slum in Dhaka, Bangladesh.

PubMed

Rashid, Sabina Faiz

2007-08-01

The paper is about the neglect of infertility and women's interests in the health policy of developing countries, and how this shapes married adolescent women's understandings and practices surrounding infertility. Ethnographic fieldwork among married adolescent girls, aged 15-19, was carried out in a slum in Dhaka, Bangladesh from December 2001 to January 2003, including 50 in-depth interviews and eight case studies from 153 married adolescent girls, and observations and discussions with family and community members. There are newer understandings with the re-labelling of infertility from spirit world afflictions to something that is also attributed to family planning and 'build up of fat' in the uterus and stomach. Corrective practices range from not using or discontinuing a contraceptive method, dilatation and curettage (D&C) and visiting traditional healers. The absence of state services to address infertility concerns has implications for contraceptive use, with unintended pregnancies and unsafe abortions. Local beliefs continue to largely attribute the primary cause of infertility to the spirit world, but the emergence of newer infertility understandings reveal the influence of Western cultural beliefs (family planning campaigns, health practices influenced by biomedicine) and highlight the gender politics in the harsh environment of urban slums.

Public health approaches to safer cycling for children based on developmental and physiological readiness: implications for practice

PubMed Central

Lenton, Simon; Finlay, Fiona Olwen

2018-01-01

Introduction Cyclists have a high mortality and morbidity per mile travelled compared with car occupants, a figure that is likely to increase if campaigns to increase active travel are successful. Concerns about safety is the leading factor limiting cycling for children. Objective This review brings together a paediatric perspective based on the developmental readiness of children and young people and a public health approach to reducing injuries, to produce a practical agenda for improving the safety of cycling for children. Method Selective literature review. Results While most sports realise the importance of practice and training to create mastery of the game, similar thinking has not been consistently applied to cycling proficiency, so many children do not have an opportunity to master cycling before riding on the roads. Conclusions The aim should be to minimise road traffic injuries involving children and young people in ways that create cobenefits for other members of society, increasing opportunities for active travel, reducing air pollution, creating more green space to play and reducing dependence on motor vehicles. Changes in legislation are required now to enable younger children to cycle on pavements while learning to ride and improvements in road design to separate cyclists from motor vehicles especially routes to school for older children. PMID:29637180

Practical Issues in Developing a Culturally Tailored Physical Activity Promotion Program for Chinese and Korean American Midlife Women: A Pilot Study

PubMed Central

Chee, Wonshik; Kim, Sangmi; Chu, Tsung-Lan; Ji, Xiaopeng; Zhang, Jingwen; Chee, Eunice; Im, Eun-Ok

2016-01-01

Background With advances in computer technologies, Web-based interventions are widely accepted and welcomed by health care providers and researchers. Although the benefits of Web-based interventions on physical activity promotion have been documented, the programs have rarely targeted Asian Americans, including Asian American midlife women. Subsequently, culturally competent Web-based physical activity programs for Asian Americans may be necessary. Objective The purpose of our study was to explore practical issues in developing and implementing a culturally competent Web-based physical activity promotion program for 2 groups of Asian American women—Chinese American and Korean American midlife women—and to provide implications for future research. Methods While conducting the study, the research team members wrote individual memos on issues and their inferences on plausible reasons for the issues. The team had group discussions each week and kept the minutes of the discussions. Then, the memos and minutes were analyzed using a content analysis method. Results We identified practical issues in 4 major idea categories: (1) bilingual translators’ language orientations, (2) cultural sensitivity requirement, (3) low response rate, interest, and retention, and (4) issues in implementation logistics. Conclusions Based on the issues, we make several suggestions for the use of bilingual translators, motivational strategies, and implementation logistics. PMID:27872035

Constructing professional and organisational fields.

PubMed

Gurney, Robert

2016-01-01

Purpose - The purpose of this paper is to fill an apparent gap in the literature addressing issues of leadership and change - the development and activities of constructing and leading sports sciences and medicine professions, and similarly, the construction and leadership of multidisciplinary/inter-disciplinary organisations that practice sports sciences and medicine. Design/methodology/approach - This study incorporated explorations through conducting both interviews and survey questionnaires with members of Sports Medicine Australia (SMA). The interviews (qualitative) were semi-structured and asked questions addressing what changed, why change and how change was implemented. Findings - The health sciences and medicine professions moving to specialised sports sciences and medicine disciplines and SMA, evolved through forces driving the need for change (legitimacy, resource dependency, positioning and core competencies). Practical implications - The knowledge developed from understanding activities of change that traditional professions conducted to become specialised Disciplines and parallel changes in a single Discipline organisation evolving to an umbrella organisation (SMA), comprised a membership of specialised Disciplines, can act as a catalyst for inquiry by other professional and organisational groups. Originality/value - The findings of this study contributes to the literature investigating change in professional and organisations fields. More specifically, this study promotes inquiry into leadership practices of sports sciences and medicine, as contributors to the field of health services.

The development and implications of peer emotional support for student service members/veterans and civilian college students.

PubMed

Whiteman, Shawn D; Barry, Adam E; Mroczek, Daniel K; Macdermid Wadsworth, Shelley

2013-04-01

Student service members/veterans represent a growing population on college campuses. Despite this growth, scholarly investigations into their health- and adjustment-related issues are almost nonexistent. The limited research that is available suggests that student service members/veterans may have trouble connecting with their civilian counterparts and be at risk for social isolation. The present study compared the development and implications of emotional support from peers among 199 student service members/veterans and 181 civilian students through 3 distinct occasions over the course of 1 calendar year. Data were collected via electronic survey. Measured constructs included perceived emotional support from university friends, mental health, alcohol use, and academic functioning. A series of multilevel models revealed that student service members/veterans reported less emotional support from their peers compared with their civilian counterparts; yet, emotional support from peers increased similarly for both groups over time. Although, increasing peer emotional support was generally related to better academic and mental health outcomes for both groups, the links between emotional support and mental health were stronger for civilian students. Results suggest that mental health practitioners, particularly those on college campuses, should be prepared to deal with veteran-specific experiences that occur before and during college.

The Development and Implications of Peer Emotional Support for Student Service Members/Veterans and Civilian College Students

PubMed Central

Whiteman, Shawn D.; Barry, Adam E.; Mroczek, Daniel K.; Wadsworth, Shelley MacDermid

2013-01-01

Student service members/veterans represent a growing population on college campuses. Despite this growth, scholarly investigations into their health- and adjustment-related issues are almost nonexistent. The limited research that is available suggests that student service members/veterans may have trouble connecting with their civilian counterparts and be at risk for social isolation. The present study compared the development and implications of emotional support from peers among 199 student service members/veterans and 181 civilian students through 3 distinct occasions over the course of 1 calendar year. Data were collected via electronic survey. Measured constructs included perceived emotional support from university friends, mental health, alcohol use, and academic functioning. A series of multilevel models revealed that student service members/veterans reported less emotional support from their peers compared with their civilian counterparts; yet, emotional support from peers increased similarly for both groups over time. Although, increasing peer emotional support was generally related to better academic and mental health outcomes for both groups, the links between emotional support and mental health were stronger for civilian students. Results suggest that mental health practitioners, particularly those on college campuses, should be prepared to deal with veteran-specific experiences that occur before and during college. PMID:23421774

Cognitive dissonance experienced by nurse practitioner faculty.

PubMed

Fontenot, Holly B; Hawkins, Joellen W; Weiss, Josie A

2012-08-01

The purpose of this study was to explicate the concept of cognitive dissonance as experienced and reported by nurse practitioner (NP) faculty members. Responses from NP faculty members to an online survey about their experiences with cognitive dissonance. The respondents detailed their experiences with cognitive dissonance, citing differences between expectations for which they are rewarded and those for which they are paid. Expecting all faculty members to excel in practice, research, teaching, and service may create unrealistic workloads for NP faculty members. Examining expectations and considering creation of a clinical track for faculty who practice may be options administrators of NP programs might explore. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.

Delivering high quality hip fracture rehabilitation: the perspective of occupational and physical therapy practitioners.

PubMed

Leland, Natalie E; Lepore, Michael; Wong, Carin; Chang, Sun Hwa; Freeman, Lynn; Crum, Karen; Gillies, Heather; Nash, Paul

2018-03-01

The majority of post-acute hip fracture rehabilitation in the US is delivered in skilled nursing facilities (SNFs). Currently, there are limited guidelines that equip occupational and physical therapy practitioners with a summary of what constitutes evidence-based high quality rehabilitation. Thus, this study aimed to identify rehabilitation practitioners' perspectives on the practices that constitute high quality hip fracture rehabilitation. Focus groups were conducted with 99 occupational and physical therapy practitioners working in SNFs in southern California. Purposive sampling of facilities was conducted to capture variation in key characteristics known to impact care delivery for this patient population (e.g., financial resources, staffing, and patient case-mix). Questions aimed to elicit practitioners' perspectives on high quality hip fracture rehabilitation practices. Each session was audio-recorded and transcribed. Data were systematically analyzed using a modified grounded theory approach. Seven themes emerged: objectives of care; first 72 h; positioning, pain, and precautions; use of standardized assessments; episode of care practices; facilitating insight into progress; and interdisciplinary collaboration. Clinical guidelines are critical tools to facilitate clinical decision-making and achieve desired patient outcomes. The findings of this study highlight the practitioners' perspective on what constitutes high quality hip fracture rehabilitation. This work provides critical information to advance the development of stakeholder-driven rehabilitation clinical guidelines. Future research is needed to verify the findings from other stakeholders (e.g., patients), ensure the alignment of our findings with current evidence, and develop measures for evaluating their delivery and relationship to desired outcomes. Implications for Rehabilitation This study highlights occupational and physiotherapy therapy practitioners' perspectives on the cumulative best practices that reflect high quality care, which should be delivered during hip fracture rehabilitation. While this study was limited to two professions within the broader interdisciplinary team, consistently occupational and physiotherapy therapy practitioners situated their role and practices within the team, emphasizing that high quality care was driven by collaboration among all members of the team as well as the patient and caregivers. Future research needs to evaluate the (a) frequency at which these practices are delivered and the relationship to patient-centered outcomes, and (b) perspectives of rehabilitation practitioners working in other PAC settings, patients, caregivers, as well as the other members of the interdisciplinary PAC team.

Alignment of governance and senior executive perceptions of culture.

PubMed

Looi, Evelyn Suk Yi; Greatbanks, Richard; Everett, André M

2016-09-19

Purpose The purpose of this paper is to examine the alignment of perceived organizational culture between Health Board chairs and Board members with that of their respective senior executive teams. It compares the degree of alignment between these two groups, and analyses them against District Health Board (DHB) performance using the New Zealand Ministry of Health's national measure "shorter stays in Emergency Departments." Design/methodology/approach Primary survey data were collected across eight DHBs using a modified version of the Organizational Culture Assessment Instrument and utilizes a sample of both higher and lower performing DHBs as defined by the "shorter stays" measure. Findings Many health organizations cite Ovseiko and Buchan's (2012) preferred culture as an ideal model. However, this study's findings indicate that most DHBs scored higher than the preferred score for "Hierarchical" and "Rational" cultures, and lower for "Clan" and "Developmental" cultures, and therefore calls into question the validity of this organizational profile as the "preferred" cultural state. Research limitations/implications This research considers perceived organizational culture from the perspective of the Board members and their respective senior executive teams. It uses a relatively small sample size and excludes potential interactions of national culture. Practical implications The findings indicate that healthcare organizations should de-emphasize the dominant "Hierarchical" and "Rational" cultures, and promote "Clan" and "Developmental" cultures within their organizations as a means of potentially improving healthcare performance. Originality/value Organizational culture has been highlighted as a major component of performance within healthcare organizations, yet very few studies examine how organizational culture is perceived by governance and executive groups. This study empirically counters prevailing knowledge regarding the most appropriate organizational cultures for healthcare organizations.

Evolution of Knowledge, Awareness, and Practices regarding Zika Virus from 2016 to 2017

PubMed Central

Godiwala, Prachi; Macri, Charles; Pineles, Beth; Simon, Gary; Chang, Aileen; Ahmadzia, Homa

2017-01-01

Objective Our team created a knowledge, attitudes, and practice (KAP) survey in order to assess changes over time in healthcare provider and community member awareness of Zika virus symptoms, transmission, treatment, and current and future concerns. Study Design The cross-sectional survey was issued at an academic medical center in Washington, DC, and via an online link to healthcare providers and community members between June and August 2016. Survey distribution was then repeated the following year, from March to April 2017. Outcomes were compared by survey year and healthcare provider versus community member status using SAS Program Version 9.4. Results Significant differences in knowledge, attitudes, and practices existed between 2016 and 2017 survey time points. By 2017, more respondents had knowledge of various Zika virus infection characteristics; however healthcare provider knowledge also waned in certain areas. Attitudes towards Zika virus infection displayed an overall decreased concern by 2017. Practice trends by 2017 demonstrated fewer travel restrictions to Zika-endemic areas and increased mosquito protective measures within the US. Conclusions Our results provide novel insight into the transformation of knowledge, attitudes, and practice of community members and healthcare providers regarding Zika virus since its declaration as a public health emergency of international concern in 2016. PMID:29348707

The evolving practice of nuclear cardiology: results from the 2011 ASNC member survey.

PubMed

Tilkemeier, Peter; Green, Jacqueline; Einstein, Andrew J; Fazel, Reza; Reames, Patricia; Shaw, Leslee J

2012-12-01

Today's imaging laboratories face challenges including reimbursement, prior authorization, and accreditation standards. The impact on the practice of nuclear cardiology in the United States is unknown. We conducted a survey of ASNC members to provide a snapshot of nuclear cardiology imaging laboratories in 2011. The survey identified practice patterns including personnel, volumes, protocols used, and laboratory characteristics. We employed random sampling methodology stratified geographically. The response rate was 19.5% (73/374 laboratories). A non-random survey conducted in 2001 of 25 laboratories served as a comparator. A total of 73 laboratories, representing 202 physicians and 177 technologists responded. The reported median procedural volume was 1,225 studies annually; 88.9% of laboratories were accredited. Compared with 2001, dual isotope imaging protocol use dropped from 72% to 15.6%. Five markers of quality were surveyed. Half of laboratories use the American College of Cardiology's Appropriate Use Criteria, 61% used segmental scoring, and 32% provided guidance on post-test therapeutic management. 89% perform catheterization correlations while only 33% implemented radiation dose tracking. This survey of ASNC members provides critical information on nuclear cardiology practice to better target and service our members' needs. These data can prove invaluable to target educational needs and inform healthcare policy of contemporary nuclear cardiology practice.

An Exploration of Leadership in Virtual Communities of Practice

ERIC Educational Resources Information Center

Chrisentary, John

2013-01-01

Virtual community of practice (VCoP) teams are becoming a typical function in many knowledge-based organizations. VCoP teams can consist of team members located in various cities, states, and countries. The main characteristic of the VCoP is team members' sense of community that allows individuals to share knowledge. Knowledge sharing in a VCoP…

Lessons in Higher Education: Five Pedagogical Practices that Promote Active Learning for Faculty and Students

ERIC Educational Resources Information Center

Cook-Sather, Alison

2011-01-01

Active learning by faculty members complements and promotes active learning for students. Through The Andrew W. Mellon Teaching and Learning Institute at Bryn Mawr College, faculty members actively engage with one another and with undergraduate students positioned as pedagogical consultants to explore and to practice a wide range of pedagogies. In…

Education for Sustainable Development: Liberation or Indoctrination? An Assessment of Faculty Members' Attitudes and Classroom Practices

ERIC Educational Resources Information Center

Qablan, Ahmad Mohammad; Al-Ruz, Jamal Abu; Khasawneh, Samer; Al-Omari, Aieman

2009-01-01

The purpose of this study was to investigate the attitudes and classroom practices of environmental science faculty members in Jordanian universities. Mix data collection methodology was employed to collect data in this study. In addition to the developed survey, several participants' interviews and classroom observations were conducted with…

Sanctification and spiritual disclosure in parent-child relationships: implications for family relationship quality.

PubMed

Brelsford, Gina M

2013-08-01

Social scientific research on family life, religion, and spirituality tends to focus on global religiousness and spirituality with few studies seeking to understand interpersonal religious and spiritual contributors, namely sanctification and spiritual disclosure, from multiple family members' perspectives. This study explored 91 mother-college student and 64 father-college student dyads who rated their use of spiritual disclosure and theistic and nontheistic sanctification of the parent-child dyad in relation to parent-child relationship quality (e.g., parent-child relationship satisfaction and open communication). Results indicate significant positive links between higher levels of spiritual disclosure and greater theistic and nontheistic sanctification, for mothers, fathers, and their children. However, only greater nontheistic sanctification and higher levels spiritual disclosure were significantly related to increased parent-child relationship quality. Through use of Actor-Partner Interdependence Models (APIMs) results indicated unique contributions of spiritual disclosure to parent-child relationship quality above nontheistic sanctification for open communication in the family. However, full models, which included nontheistic sanctification and spiritual disclosure, predict college students' relationship satisfaction with their mothers and fathers. Implications for interpersonal religiousness and spirituality as contributors to familial relationship quality in research and practice are discussed. © 2013 American Psychological Association

Overcoming the Fear of Lethal Injury: Evaluating Suicidal Behavior in the Military through the Lens of the Interpersonal-Psychological Theory of Suicide

PubMed Central

Selby, Edward A.; Anestis, Michael D.; Bender, Theodore W.; Ribeiro, Jessica D.; Nock, Matthew K.; Rudd, M. David; Bryan, Craig J.; Lim, Ingrid C.; Baker, Monty T.; Gutierrez, Peter M.; Joiner, Thomas E.

2009-01-01

Suicide rates have been increasing in military personnel since the start of Operation Enduring Freedom and Operation Iraqi Freedom, and it is vital that efforts be made to advance suicide risk assessment techniques and treatment for members of the military who may be experiencing suicidal symptoms. One potential way to advance the understanding of suicide in the military is through the use of the Interpersonal-Psychological Theory of Suicide. This theory proposes that three necessary factors are needed to complete suicide: feelings that one does not belong with other people, feelings that one is a burden on others or society, and an acquired capability to overcome the fear and pain associated with suicide. This review analyzes the various ways that military service may influence suicidal behavior and integrates these findings into an overall framework with relevant practical implications. Findings suggest that although there are many important factors in military suicide, the acquired capability may be the most impacted by military experience because combat exposure and training may cause habituation to fear of painful experiences, including suicide. Future research directions, ways to enhance risk assessment, and treatment implications are also discussed. PMID:20051309

Conducting a Surgical Site Infection Prevention Tracer.

PubMed

Padgette, Polly; Wood, Brittain

2018-05-01

Surgical site infections (SSIs) are the most common health care-associated infections in patients. Approximately half of SSIs are preventable when using evidence-based strategies; however, deviations from evidence-based practice can occur over time. Infection preventionists and perioperative staff members can help prevent these deviations by observing staff member practices using tracer methodology. Tracer methodology uses clinical information to follow patient care, treatment, or services provided throughout the care delivery system. The goal of tracer methodology for SSI prevention is to validate that organizational processes are promoting safer patient care. Using tracers, perioperative and infection prevention staff members can develop strategies to eliminate deviations from evidence-based practice, thereby helping to prevent SSIs and improve patient outcomes. © AORN, Inc, 2018.

Facilitating Changes in College Teaching Practices: Instructional Reform, Identity Conflict and Professional Community in a K-20 Partnership

NASA Astrophysics Data System (ADS)

Olitsky, Stacy

2015-08-01

In this paper, I explain variation in the adoption of student-centred teaching practices among college faculty members in a program designed to promote K-20 instructional reform. I analyze data from a qualitative study of a Math and Science Partnership in order to understand why some faculty members had undergone extensive changes to their practices whereas others had not, even though both groups had demonstrated changes in their beliefs. Findings show that when collective identities focused on reform become more salient than the role identities associated with their teaching positions, faculty members are able to persist through the loss of self-efficacy that results from struggles with new student-centred practices. This study demonstrates how professional communities can enhance "collective efficacy", thereby affecting whether the cognitive dissonance that accompanies professional development leads to instructional change rather than disengagement from reform initiatives.

42 CFR 411.352 - Group practice.

Code of Federal Regulations, 2012 CFR

2012-10-01

... practices under common ownership or control through a physician practice management company, hospital... of whether the member's time in the HPSA is spent in a group practice, clinic, or office setting. (5...

A survey of current practice of vascular surgeons in venous disease management.

PubMed

Bush, Ruth L; Gloviczki, Peter

2013-01-01

Acute venous thromboembolism and chronic venous diseases are common conditions that affect a large proportion of the United States population. The diagnosis of venous disease has improved, and the treatment options have rapidly evolved over the past decade. To date, it is unclear to what extent vascular surgeons have become involved in the modern management of venous disorders. This survey was undertaken to explore the current interest and practice of vascular surgeons in the contemporary care of venous disease. A survey was administered via a web-based platform to active and candidate members of the Society for Vascular Surgery (SVS). The survey included 30 questions investigating the characteristics of venous surgeons and scope of venous practice. Open-ended questions were also included for commentary. A total of 1879 surveys were sent to SVS members nationwide, and 385 members participated (response rate of 20.5%). The participants were mostly men (89.6%) with 37.7% practicing in an academic setting and 59.2% in private practice. The respondents treated superficial veins (92.9%) and deep veins (85.8%) in clinical practice, with 89.9% having their own vascular laboratory. A wide spectrum of interventions for superficial (91.9%), deep (85.8%), and perforator veins (52.7% endovenous, 19.4% subfascial endoscopic perforator surgery) are being performed by respondents. Only 26.2% had learned endovenous thermal ablation in their training program; however, over 96% of those performing venous interventions utilized this technique. Overall, the majority (85.5%) devoted 50% or less of practice to venous disorders. Respondents indicated that limitations to expansion of vein practices mainly involved challenges with third party payers, local competition, and existing large volumes of arterial interventions needing to be performed. Despite the widespread incorporation of venous disease into current vascular practices, 66.1% are not members of the American Venous Forum (AVF) or other venous society. Many believe there is still a lack of standardization of care and guidelines for venous disease. The care of patients with venous disease has become more widespread among SVS members, with most offering both deep and superficial venous interventions as well as incorporation of minimally invasive techniques into their treatment armamentarium. Dissemination and incorporation of protocols and guidelines into clinical practice as well as postgraduate courses in venous disease may be areas in which the SVS could facilitate members' involvement in the care of patients with venous disease. Published by Elsevier Inc.

Will the EU Clinical Trials Regulation Support the Innovative Industry in Bringing New Medicines Faster to Patients?

PubMed

Atzor, Sabine; Gokhale, Surendra; Doherty, Michael

2013-04-01

A perspective from the innovative industry is provided in this article about the long awaited legal proposal for a Clinical Trial Regulation ("Proposal"), adopted in July 2012. With this Proposal, the European Commission reacted to a call by all stakeholders for more harmonization and streamlining of the provisions for conducting clinical trials in the EU. Discrepant approaches between Member States, a failure to respect legal timelines, and a lack of formal coordination mechanisms within and between Member States have resulted in an increased workload for the industry and contributed to a decline in Europe's attractiveness as a place to carry out research and development. The Proposal introduces a concept whereby the sponsor makes a single submission of the clinical trial application dossier to an EU portal, which is followed by a single assessment based on cooperation between Member States. A possibility for the sponsor to choose a 'reporting Member State' to take the lead on key aspects of the assessment is expected to support excellence building and work sharing of Competent Authorities in the EU. The Proposal respects the fact that certain aspects need to be reviewed nationally. The new process aims to lead to a single decision per clinical trial per concerned Member State. The rules are built on the principle of strict adherence to timelines for authorization. The timelines are ambitious but at the same time competitive, as the process builds in mechanisms that strengthen compliance. The rules have been designed to encourage sponsors to file complete submission packages, since any substantial modification to a trial would lead to delays in its commencement. Sponsors need to streamline their internal processes accordingly. In the end, streamlining is an effort that needs to be accepted by all parties involved. The Proposal does not detail how Member States organize the involvement of different bodies, such as Competent Authorities and Ethics Committees, because according to the EU Treaty, the EU cannot legislate on aspects falling into pure Member State competence. The Proposal, however, establishes the assessment objectives on the basis of Good Clinical Practices set by the International Conference on Harmonisation (ICH) and the Declaration of Helsinki by the World Medical Association. As such, the new legislation is likely to have implications on Member States' internal organization. In addition, Ethics Committees in Europe would benefit from an EU platform for best practice exchange-a concept that would need to be requested by the Council and the European Parliament through the legislative process. A single decision system for the entire EU per clinical trial has been discussed as an option, but such an approach was difficult to achieve while respecting national competencies. In this situation, the Proposal represents an acceptable compromise, provided its proposed mechanisms, processes, and timelines are retained upon implementation. As the Proposal is now on the table for discussion by the 27 Member States' governments and by the European Parliament, co-legislators and stakeholders should be aware that any dilution of these provisions would be detrimental to the objective to ensure patient access and make the conditions for clinical research in Europe attractive and fit for the future.

A Study of Attitudes toward College Student-Athletes: Implications for Faculty-Athletics Engagement

ERIC Educational Resources Information Center

Comeaux, Eddie

2011-01-01

To gauge the differential attitudes of faculty members toward student-athletes at a large Division I-A university, a revised version of the Situational Attitude Scale (SAS) Student-Athlete was administered to 464 faculty members. Findings revealed differences in the attitudes of faculty toward student-athletes by race, gender, and college…

Patterns of Social Support in the Middle Childhood to Early Adolescent Transition: Implications for Adjustment

ERIC Educational Resources Information Center

Levitt, Mary J.; Levitt, Jerome; Bustos, Gaston L.; Crooks, Noel A.; Santos, Jennifer D.; Telan, Paige; Hodgetts, Jennifer; Milevsky, Avidan

2005-01-01

Children's social networks often include close family members, extended family members, and friends, but little is known about interindividual differences in the patterning of support from these sources. In this study, we used person-oriented analyses to differentiate patterns of support for children undergoing the transition to adolescence.…

Lessons from the Great Recession: A Digital Recovery Rewards Digital Skills in Emerging Fields

ERIC Educational Resources Information Center

Fitzgerald, Brian K.; Barkanic, Steve; Cardenas-Navia, Isabel; Chen, Janet; Gross, Ursula; Hughes, Debbie

2018-01-01

This essay reviews the work of the US Business--Higher Education Forum (BHEF) in data science and analytics and offers a brief review of how BHEF catalysed responses from its academic members to meet the talent needs of its business members, highlighting implications for business and higher education in the future.

Pedagogical Implications on Medical Students' Linguistic Needs

ERIC Educational Resources Information Center

Hwang, Yanling

2011-01-01

In this paper, an extended teaching implication is performed based on the study of medical students' linguistic needs in Tawian (Hwang, Lin, 2010). The aims of previous study were to provide a description of the linguistic needs and perceptions of medical students and faculty members in Taiwan. However, this paper put more thoughts on the…

Mentoring Postsecondary Tenure-Track Faculty: A Theory-Building Case Study and Implications for Institutional Policy

ERIC Educational Resources Information Center

Davis, Dannielle Joy; Boyer, Patricia; Russell, Isela

2011-01-01

The featured research uses theory-building case study to understand the experiences of junior faculty in a mentoring program. Findings suggest the importance of professional interaction for faculty members' integration into their campus communities. An explanatory model illustrates the findings and supplements discussion of the implications for…

Teacher Strategies for Effective Intervention with Students Presenting Social, Emotional and Behavioural Difficulties: Implications for Policy and Practice

ERIC Educational Resources Information Center

Cooper, Paul

2011-01-01

In this paper some key practice and policy implications emerging from a review of literature on effective teacher strategies for social, emotional and behavioural difficulties are set out. Particular attention is given to implications in relation to the development of teachers' skills.

[Record of the role given to members of the psychological professions in the French Multidisciplinary Prenatal Diagnosis Centers (CPDPN)].

PubMed

Abdel-Hamid, N; Frin, G; Flandrin, A; Boulot, P

2015-01-01

Create a record of the role given to members of the psychological professions in CPDPN Centers (multidisciplinary prenatal diagnosis). After more than 10 years in operation, describe the work methods of the different centers and their members, evaluate the possible diversity of practices and clarify the scope of interventions used by psychologists with patients and members of the CPDPN. A descriptive survey consisting of 71 questions sent to psychologists, paediatricians and psychiatrists involved with the 48 CPDPN Centers in France. The main parameters studied are the means used by the CPDPN and their organization in the field of psychology, pre-medical counseling for the termination of pregnancy (IMG), conditions of hospitalization and post-IMG counseling. The survey revealed a high-level of homogeneous practices in the French CPDPN Centers between members of the medical and psychological professions, through joint consultations, ethical committees or specific case meetings for complex fetal pathologies. This study has established a working relationship between members of the psychological professions working in the French CPDPN Centers and has led to the creation of a listing/directory, which facilitates the exchange of information. Video-conferencing is currently being considered in order to share respective practices. Copyright © 2014. Published by Elsevier Masson SAS.

Analytical Implications of Using Practice Theory in Workplace Information Literacy Research

ERIC Educational Resources Information Center

Moring, Camilla; Lloyd, Annemaree

2013-01-01

Introduction: This paper considers practice theory and the analytical implications of using this theoretical approach in information literacy research. More precisely the aim of the paper is to discuss the translation of practice theoretical assumptions into strategies that frame the analytical focus and interest when researching workplace…

Direct Observation of Treatment Provided by a Family Member as Compared to Non-Family Member among Children with New Tuberculosis: A Pragmatic, Non-Inferiority, Cluster-Randomized Trial in Gujarat, India.

PubMed

Dave, Paresh Vamanrao; Shah, Amar Niranjan; Nimavat, Pankaj B; Modi, Bhavesh B; Pujara, Kirit R; Patel, Pradip; Mehariya, Keshabhai; Rade, Kiran Vaman; Shekar, Soma; Sachdeva, Kuldeep S; Oeltmann, John E; Kumar, Ajay M V

2016-01-01

The World Health Organization recommends direct observation of treatment (DOT) to support patients with tuberculosis (TB) and to ensure treatment completion. As per national programme guidelines in India, a DOT provider can be anyone who is acceptable and accessible to the patient and accountable to the health system, except a family member. This poses challenges among children with TB who may be more comfortable receiving medicines from their parents or family members than from unfamiliar DOT providers. We conducted a non-inferiority trial to assess the effect of family DOT on treatment success rates among children with newly diagnosed TB registered for treatment during June-September 2012. We randomly assigned all districts (n = 30) in Gujarat to the intervention (n = 15) or usual-practice group (n = 15). Adult family members in the intervention districts were given the choice to become their child's DOT provider. DOT was provided by a non-family member in the usual-practice districts. Using routinely collected clinic-based TB treatment cards, we compared treatment success rates (cured and treatment completed) between the two groups and the non-inferiority limit was kept at 5%. Of 624 children with newly diagnosed TB, 359 (58%) were from intervention districts and 265 (42%) were from usual-practice districts. The two groups were similar with respect to baseline characteristics including age, sex, type of TB, and initial body weight. The treatment success rates were 344 (95.8%) and 247 (93.2%) (p = 0.11) among the intervention and usual-practice groups respectively. DOT provided by a family member is not inferior to DOT provided by a non-family member among new TB cases in children and can attain international targets for treatment success. Clinical Trials Registry-India, National Institute of Medical Statistics (Indian Council of Medical Research) CTRI/2015/09/006229.

Current clinical practices of the Rhinoplasty Society members.

PubMed

Lee, Michael; Unger, Jacob G; Gryskiewicz, Joe; Rohrich, Rod J

2013-11-01

As rhinoplasty remains among the most challenging and controversial operations in plastic surgery, we sought to elucidate present-day practice characteristics. Members of The Rhinoplasty Society were polled in preparation for the national meeting held in Boston, Mass, on May 2011. The goal was to provide information regarding surgical approaches used as well as technique and practice patterns used. Two electronic surveys were distributed to members of The Rhinoplasty Society in preparation for the annual meeting. All 76 members received the surveys as well as instructions for completion. The initial survey included 10 questions discussing the preferred approach for rhinoplasty and practice details. The second survey dealt with specific techniques used during rhinoplasty. Data were collected and reviewed. The primary survey yielded a 61.8% response rate, whereas the secondary survey 48.7%. Of all surgeons, 72% reported doing the open approach for primary rhinoplasty more than 50% of the time, whereas the remaining 28% use the closed approach. For secondary rhinoplasty, 76% reported using the open approach in more than half of cases for which they were not the primary surgeons. In contrast, 53% used the closed approach in more than half the cases of secondary surgery if they were the initial surgeons. Revision rates for primary and secondary rhinoplasties were 9.1% and 7.8%, respectively. The difference was not statistically significant. On average, members performed 101 nasal surgeries per year. Previous patient recommendation was the most common reason for referral. Of the members, 54% reported using spreader grafts in more than half of the cases of aesthetic rhinoplasty and 75.7% when pertaining to functional rhinoplasty. Finally, 37.8% of responding members reported using tip grafts more than half the time when performing aesthetic rhinoplasty. Of the responding members of The Rhinoplasty Society, the open approach is the preferred choice for both primary and other surgeons' revision rhinoplasties. Spreader grafts are commonplace in both functional and aesthetic rhinoplasties.

Direct Observation of Treatment Provided by a Family Member as Compared to Non-Family Member among Children with New Tuberculosis: A Pragmatic, Non-Inferiority, Cluster-Randomized Trial in Gujarat, India

PubMed Central

Modi, Bhavesh B.; Pujara, Kirit R.; Patel, Pradip; Mehariya, Keshabhai; Rade, Kiran Vaman; Shekar, Soma; Sachdeva, Kuldeep S.; Oeltmann, John E.; Kumar, Ajay M. V.

2016-01-01

Background The World Health Organization recommends direct observation of treatment (DOT) to support patients with tuberculosis (TB) and to ensure treatment completion. As per national programme guidelines in India, a DOT provider can be anyone who is acceptable and accessible to the patient and accountable to the health system, except a family member. This poses challenges among children with TB who may be more comfortable receiving medicines from their parents or family members than from unfamiliar DOT providers. We conducted a non-inferiority trial to assess the effect of family DOT on treatment success rates among children with newly diagnosed TB registered for treatment during June–September 2012. Methods We randomly assigned all districts (n = 30) in Gujarat to the intervention (n = 15) or usual-practice group (n = 15). Adult family members in the intervention districts were given the choice to become their child’s DOT provider. DOT was provided by a non-family member in the usual-practice districts. Using routinely collected clinic-based TB treatment cards, we compared treatment success rates (cured and treatment completed) between the two groups and the non-inferiority limit was kept at 5%. Results Of 624 children with newly diagnosed TB, 359 (58%) were from intervention districts and 265 (42%) were from usual-practice districts. The two groups were similar with respect to baseline characteristics including age, sex, type of TB, and initial body weight. The treatment success rates were 344 (95.8%) and 247 (93.2%) (p = 0.11) among the intervention and usual-practice groups respectively. Conclusion DOT provided by a family member is not inferior to DOT provided by a non-family member among new TB cases in children and can attain international targets for treatment success. Trial Registration Clinical Trials Registry–India, National Institute of Medical Statistics (Indian Council of Medical Research) CTRI/2015/09/006229 PMID:26849442

Value gaps in dental practice: understanding how differences in core values can adversely affect the practice.

PubMed

Newsome, Philip; Wolfe, Ira S

2003-11-01

The authors explore the importance of human values in dental practice, an area often overlooked as we struggle to deal with the everyday demands of treating patients and managing staff members. Such values are, however, fundamental to the success of any practice; therefore, it is important to understand their significance. Problems arise in dental practices when gaps develop between the values held by the various players involved (that is, between the entire dental team and patients, the dentist/owner's personal values and business goals, the dentist/owner and staff members, and the dental practice and any third-party funding organizations). By understanding the potentially damaging consequences of value gaps for practice viability, dental practice owners and managers can take steps to create a more harmonious workplace in which all parties strive to reach common goals.

There is no "i" in teamwork in the patient-centered medical home: defining teamwork competencies for academic practice.

PubMed

Leasure, Emily L; Jones, Ronald R; Meade, Lauren B; Sanger, Marla I; Thomas, Kris G; Tilden, Virginia P; Bowen, Judith L; Warm, Eric J

2013-05-01

Evidence suggests that teamwork is essential for safe, reliable practice. Creating health care teams able to function effectively in patient-centered medical homes (PCMHs), practices that organize care around the patient and demonstrate achievement of defined quality care standards, remains challenging. Preparing trainees for practice in interprofessional teams is particularly challenging in academic health centers where health professions curricula are largely siloed. Here, the authors review a well-delineated set of teamwork competencies that are important for high-functioning teams and suggest how these competencies might be useful for interprofessional team training and achievement of PCMH standards. The five competencies are (1) team leadership, the ability to coordinate team members' activities, ensure appropriate task distribution, evaluate effectiveness, and inspire high-level performance, (2) mutual performance monitoring, the ability to develop a shared understanding among team members regarding intentions, roles, and responsibilities so as to accurately monitor one another's performance for collective success, (3) backup behavior, the ability to anticipate the needs of other team members and shift responsibilities during times of variable workload, (4) adaptability, the capability of team members to adjust their strategy for completing tasks on the basis of feedback from the work environment, and (5) team orientation, the tendency to prioritize team goals over individual goals, encourage alternative perspectives, and show respect and regard for each team member. Relating each competency to a vignette from an academic primary care clinic, the authors describe potential strategies for improving teamwork learning and applying the teamwork competences to academic PCMH practices.

The effect of families on the process of outpatient visits in family practice.

PubMed

Main, D S; Holcomb, S; Dickinson, P; Crabtree, B F

2001-10-01

Our goal was to describe how physician knowledge of patients' families affects the processes of patient care in family practices. Using a multimethod comparative case study design, detailed dictated field notes were recorded after direct observation of patient encounters and the office environment as part of the Prevention and Competing Demands in Primary Care Study. We identified domains of outpatient visits in which patients were accompanied by a family member or in which family-oriented content was discussed. Outpatient encounters with 1637 patients presenting in 18 family practices in the Midwest were analyzed using an editing style. We developed a typology for ways in which family context affects outpatient visits. Patients were accompanied during 35% of all outpatient visits, the vast majority of these visits involving children. Family history or a family member's problems were discussed during 35% of visits during which no family member was present. An analysis of these "family-oriented" visits resulted in a typology of 6 ways that family context informs and affects the outpatient visit: (1) using family social context to illuminate patient disease, illness, and health; (2) using family to discover the source of an illness; (3) discussing and managing the health and illness of family members; (4) family concern for patient's health; (5) using the family as a care resource and care collaborator; and, (6) giving family members unscheduled care. Family context is an important feature of family practice that influences the processes of patient care. Since family-oriented care is an essential feature of family practice, outcomes of this largely hidden part of care deserve further study.

A Survey of Rank, Salary, Promotion, and Tenure Policies in Fifteen Colleges and Universities. A Survey of Current Practices.

ERIC Educational Resources Information Center

Southeast Missouri State Univ., Cape Girardeau.

Questionnaires designed to find out how institutional policies for evaluating special degrees affected institutional practices in determining initial rank, salary level, tenure status, and eligibility for promotion of faculty members were sent to 27 institutions. The special degrees fell in 4 categories: (1) faculty members with a degree in law…

A Campus-Wide Study of STEM Courses: New Perspectives on Teaching Practices and Perceptions

PubMed Central

Vinson, Erin L.; Smith, Jeremy A.; Lewin, Justin D.; Stetzer, MacKenzie R.

2014-01-01

At the University of Maine, middle and high school science, technology, engineering, and mathematics (STEM) teachers observed 51 STEM courses across 13 different departments and collected information on the active-engagement nature of instruction. The results of these observations show that faculty members teaching STEM courses cannot simply be classified into two groups, traditional lecturers or instructors who teach in a highly interactive manner, but instead exhibit a continuum of instructional behaviors between these two classifications. In addition, the observation data reveal that student behavior differs greatly in classes with varied levels of lecture. Although faculty members who teach large-enrollment courses are more likely to lecture, we also identified instructors of several large courses using interactive teaching methods. Observed faculty members were also asked to complete a survey about how often they use specific teaching practices, and we find that faculty members are generally self-aware of their own practices. Taken together, these findings provide comprehensive information about the range of STEM teaching practices at a campus-wide level and how such information can be used to design targeted professional development for faculty. PMID:25452485

Cropping practices manipulate abundance patterns of root and soil microbiome members paving the way to smart farming.

PubMed

Hartman, Kyle; van der Heijden, Marcel G A; Wittwer, Raphaël A; Banerjee, Samiran; Walser, Jean-Claude; Schlaeppi, Klaus

2018-01-16

Harnessing beneficial microbes presents a promising strategy to optimize plant growth and agricultural sustainability. Little is known to which extent and how specifically soil and plant microbiomes can be manipulated through different cropping practices. Here, we investigated soil and wheat root microbial communities in a cropping system experiment consisting of conventional and organic managements, both with different tillage intensities. While microbial richness was marginally affected, we found pronounced cropping effects on community composition, which were specific for the respective microbiomes. Soil bacterial communities were primarily structured by tillage, whereas soil fungal communities responded mainly to management type with additional effects by tillage. In roots, management type was also the driving factor for bacteria but not for fungi, which were generally determined by changes in tillage intensity. To quantify an "effect size" for microbiota manipulation, we found that about 10% of variation in microbial communities was explained by the tested cropping practices. Cropping sensitive microbes were taxonomically diverse, and they responded in guilds of taxa to the specific practices. These microbes also included frequent community members or members co-occurring with many other microbes in the community, suggesting that cropping practices may allow manipulation of influential community members. Understanding the abundance patterns of cropping sensitive microbes presents the basis towards developing microbiota management strategies for smart farming. For future targeted microbiota management-e.g., to foster certain microbes with specific agricultural practices-a next step will be to identify the functional traits of the cropping sensitive microbes.

Conditions that influence the impact of malpractice litigation risk on physicians’ behavior regarding patient safety

PubMed Central

2014-01-01

Background Practicing safe behavior regarding patients is an intrinsic part of a physician’s ethical and professional standards. Despite this, physicians practice behaviors that run counter to patient safety, including practicing defensive medicine, failing to report incidents, and hesitating to disclose incidents to patients. Physicians’ risk of malpractice litigation seems to be a relevant factor affecting these behaviors. The objective of this study was to identify conditions that influence the relationship between malpractice litigation risk and physicians’ behaviors. Methods We carried out an exploratory field study, consisting of 22 in-depth interviews with stakeholders in the malpractice litigation process: five physicians, two hospital board members, five patient safety staff members from hospitals, three representatives from governmental healthcare bodies, three healthcare law specialists, two managing directors from insurance companies, one representative from a patient organization, and one representative from a physician organization. We analyzed the comments of the participants to find conditions that influence the relationship by developing codes and themes using a grounded approach. Results We identified four factors that could affect the relationship between malpractice litigation risk and physicians’ behaviors that run counter to patient safety: complexity of care, discussing incidents with colleagues, personalized responsibility, and hospitals’ response to physicians following incidents. Conclusion In complex care settings procedures should be put in place for how incidents will be discussed, reported and disclosed. The lack of such procedures can lead to the shift and off-loading of responsibilities, and the failure to report and disclose incidents. Hospital managers and healthcare professionals should take these implications of complexity into account, to create a supportive and blame-free environment. Physicians need to know that they can rely on the hospital management after reporting an incident. To create realistic care expectations, patients and the general public also need to be better informed about the complexity and risks of providing health care. PMID:24460754

The ethical implications of genetic testing in the classroom.

PubMed

Taylor, Ann T S; Rogers, Jill Cellars

2011-07-01

The development of classroom experiments where students examine their own DNA is frequently described as an innovative teaching practice. Often these experiences involve students analyzing their genes for various polymorphisms associated with disease states, like an increased risk for developing cancer. Such experiments can muddy the distinction between classroom investigation and medical testing. Although the goals and issues surrounding classroom genotyping do not directly align with those of clinical testing, instructors can use the guidelines and standards established by the medical genetics community when evaluating the ethics of human genotyping. We developed a laboratory investigation and discussion which allowed undergraduate science students to explore current DNA manipulation techniques to isolate their p53 gene, followed by a dialogue probing the ethical implications of examining their sample for various polymorphisms. Students never conducted genotyping on their samples because of the ethical concerns presented in this paper, so the discussion replaced the actual genetic testing in the class. A science faculty member led the laboratory portion, while a genetic counselor facilitated the discussion of the ethical concepts underlying genetic counseling: autonomy, beneficence, confidentiality, and justice. In their final papers, students demonstrated an understanding of the practice guidelines established by the genetics community and acknowledged the ethical considerations inherent in p53 genotyping. Given the burgeoning market for personalized medicine, teaching undergraduates about the psychosocial and ethical dimensions of human genetic testing is important and timely. Moreover, incorporating a genetic counselor in the classroom discussion provided a rich and dynamic discussion of human genetic testing. Copyright © 2011 Wiley Periodicals, Inc.

Meeting the complex needs of the health care team: identification of nurse-team communication practices perceived to enhance patient outcomes.

PubMed

Propp, Kathleen M; Apker, Julie; Zabava Ford, Wendy S; Wallace, Nancy; Serbenski, Michele; Hofmeister, Nancee

2010-01-01

Nurses occupy a central position in today's increasingly collaborative health care teams that place a premium on quality patient care. In this study we examined critical team processes and identified specific nurse-team communication practices that were perceived by team members to enhance patient outcomes. Fifty patient-care team members were interviewed to uncover forms of nurse communication perceived to improve team performance. Using a grounded theory approach and constant comparative analysis, study findings reveal two critical processes nurses contribute to as the most central and consistent members of the health care team: ensuring quality decisions and promoting a synergistic team. Moreover, the findings reveal 15 specific nurse-team communication practices that comprise these processes, and thereby are theorized to improve patient outcomes.

Process evaluation of a multifaceted intervention to improve cardiovascular disease prevention in general practice.

PubMed

Lobo, Claudia M; Euser, Lya; Kamp, Jeanine; Frijling, Bernard D; Severens, Johan L; Hulscher, Marlies E J L; Grol, Richard P T M; Prins, Ad; van der Wouden, Johannes C

2003-09-01

To perform a process evaluation of a multifaceted intervention to improve cardiovascular and diabetes care in general practice. The feasibility of the intervention, carried out by outreach visitors in 62 practices, was addressed by evaluating whether the intervention programme was performed as planned and the extent to which it was accepted by the practice team. In addition, the costs of the programme were determined. The intervention was largely carried out as planned, although the intervention period had to be extended by three months. Of the 18 topics that could be addressed during the intervention period, 12 (mean) were addressed. The number of outreach visits per practice was 15.2 (mean), each visit lasted about one hour. Most practice members endorsed both the key recommendations for clinical decision-making and cardiovascular risk profiling. The majority of GPs (range 63-98%) agreed with the guidelines for clinical decision-making, and 29-97% had a positive opinion about the guidelines for practice organisation. According to practice staff members, the outreach visitor had sufficient knowledge and skills to support them in changing the practice organisation. GPs were less positive about the outreach visitor's knowledge and skills in optimising clinical decision-making; however 78% believed that the outreach visitor contributed to effecting change in their clinical decision-making. The total costs of the intervention per practice were Euro 4317. This process evaluation demonstrated that the intervention was usually carried out as planned and achieved a high satisfaction rating from the participating practice members.

"It puts a human face on the researched"--A qualitative evaluation of an Indigenous health research governance model.

PubMed

Bond, Chelsea; Foley, Wendy; Askew, Deborah

2016-04-01

To describe the Inala Aboriginal and Torres Strait Islander Community Jury for Health Research, and evaluate its usefulness as a model of Indigenous research governance within an urban Indigenous primary health care service from the perspectives of jury members and researchers. Informed by a phenomenological approach and using narrative inquiry, a focus group was conducted with jury members and key informant interviews were undertaken with researchers who had presented to the Community Jury in its first year of operation. The jury was a site of identity work for researchers and jury members, providing an opportunity to observe and affirm community cultural protocols. Although researchers and jury members had differing levels of research literacy, the jury processes enabled respectful communication and relationships to form, which positively influenced research practice, community aspirations and clinical care. The jury processes facilitated transformative research practice among researchers and resulted in transference of power from researchers to the jury members, to the mutual benefit of both. Ethical Indigenous health research practice requires an engagement with Indigenous peoples and knowledge at the research governance level, not simply as subjects or objects of research. © 2015 The Authors.

Inclusion in political and public life: the experiences of people with intellectual disability on government disability advisory bodies in Australia.

PubMed

Frawley, Patsie; Bigby, Christine

2011-03-01

Civil and political participation lies at the core of citizenship. Increasingly, people with intellectual disability are members of disability advisory bodies. This study investigated the political orientations of advisory body members with intellectual disability, their participatory experiences, and the types of support they received. The 9 people with intellectual disability who in 2005 were members of disability advisory bodies at a state, national, and Victorian local government level were interviewed, together with 12 other members or secretariat staff of these bodies. Observations were also conducted of advisory body meetings. The political perspective of members with intellectual disability varied, but all had a background in self-advocacy. They found the work hard but rewarding and encountered both practical and intangible obstacles to participation. Members received varying types of practical support, but a supportive collegial milieu was characteristic among members who felt most confident about their participation. The milieu, structures, and processes of advisory bodies must all be adjusted to accommodate people with intellectual disability if they are to participate meaningfully.

Social Justice Advocacy in Rural Communities: Practical Issues and Implications

ERIC Educational Resources Information Center

Bradley, Joshua M.; Werth, James L., Jr.; Hastings, Sarah L.

2012-01-01

The professional literature related to social justice has increased, but there has been little discussion of the practical issues and implications associated with social advocacy. However, adding new roles will result in new considerations for counseling psychologists. The need to be attuned to how the practical aspects of advocacy intersect with…

Democratic Schooling in Norway: Implications for Leadership in Practice

ERIC Educational Resources Information Center

Moller, Jorunn

2006-01-01

This article explores the meaning of an education based on democratic values and the implications for school leadership in practice. Based on findings from a case study in a Norwegian upper secondary school, the study describes democratic school leadership in practice, with particular attention to the distribution of power and leadership in the…

Direct access and patient/client self-referral to physiotherapy: a review of contemporary practice within the European Union.

PubMed

Bury, T J; Stokes, E K

2013-12-01

Direct access refers to service users being able to refer themselves to physiotherapy without a third-party referral. It represents a model of practice supported globally by the profession, growing research evidence and health policy in some health systems. To the authors' knowledge, no research has been reported to ascertain the extent to which direct access is available within the physiotherapy profession within the European Union (EU). To survey member organisations of the World Confederation for Physical Therapy (WCPT); establish the number of member states within the EU where it is possible for individuals seeking physiotherapy services to self-refer; describe the legislative/regulatory and reimbursement contexts in which physiotherapy services are delivered; examine if physiotherapy practice is different in member states where direct access is permitted compared with member states where direct access is not permitted; and to describe the barriers and facilitators to direct access perceived by member organisations of the WCPT. Cross-sectional, online survey using a purposive sample. Member organisations of the WCPT in the EU. Direct access is not available in all member states of the EU, despite the majority having legislation to regulate the profession, and entry-level education programmes that produce graduates with the requisite competencies. Key barriers perceived are those that can influence policy development, including the views of the medical profession and politicians. Support of service users and politicians, as well as professional autonomy, are seen as key facilitators. These results represent the first report of a comprehensive mapping of direct access to physiotherapy and contexts within the EU. In over half of member states, service users can self-refer to physiotherapists. These results provide insights to further individuals' understanding about the similarities and differences in working practices and service delivery factors, such as reimbursement across and within EU member states. The synergies between barriers and facilitators indicate the importance of targeted advocacy strategies in the introduction of direct access/self-referral to physiotherapy. Copyright © 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Status and Developments of eLearning in the EU10 Member States: The Cases of Estonia, Hungary and Slovenia

ERIC Educational Resources Information Center

Ala-Mutka, Kirsti; Gaspar, Pal; Kismihok, Gabor; Suurna, Margit; Vehovar, Vasja

2010-01-01

This article summarises research carried out between 2006 and 2008 by IPTS (Institution for Prospective Technological Studies) in collaboration with a consortium of experts from 10 member states, led by ICEGEC. The project gathered information on eLearning developments to assess drivers and barriers and to suggest implications for policy and…

Identifying a Mechanism for Crosstalk Between the Estrogen and Glucocorticoid Receptors | Center for Cancer Research

Cancer.gov

Estrogen has long been known to play important roles in the development and progression of breast cancer. Its receptor (ER), a member of the steroid receptor family, binds to estrogen response elements (EREs) in DNA and regulates gene transcription. More recently, another steroid receptor family member, the glucocorticoid receptor (GR), has been implicated in breast cancer

How Families Experience the Phenomenon of Adolescent Pregnancy and Parenting: Implications for Family Therapists and Educators

ERIC Educational Resources Information Center

Boyer, Glenda J.

2012-01-01

The purpose of this qualitative study was to describe how family members experience the phenomenon of adolescent pregnancy and parenting in the family unit, over time, and to examine the meanings family members attach to the experience. The participants were six nuclear families (20 individuals) of six adolescent mothers who had previously…

Communities of Practice Transition Online - Lessons learned from NASA's EPO Online Workspace

NASA Astrophysics Data System (ADS)

Davey, B.

2012-12-01

The Earth Forum Education and Public Outreach (EP/O) community has long interacted to better their practice as a community as well as individually. Working together to share knowledge and grow, they function as a community of practice. In 2009, NASA designed and implemented an online workspace in hopes of promoting the communities continued interactions. This study examines the role of an online workspace component of a community in the work of a community of practice. Much has been studied revealing the importance of communities of practice to organizations, project success, and knowledge management and some of these same successes hold true for virtual communities of practice. Study participants were 75 Education and Public Outreach community members of NASA's Science Mission Directorate Earth Forum. In this mixed methods study, online workspace metrics were used to track participation and a survey completed by 21 members was used to quantify participation. For a more detailed analysis, 15 community members (five highly active users, five average users, and five infrequent users) selected based on survey responses, were interviewed. Finally, survey data was gathered from seven online facilitators to understand their role in the community. Data collected from these 21 community members and five facilitating members suggest that highly active users (logging into the workspace daily), were more likely to have transformative experiences, co-create knowledge, feel ownership of community knowledge, have extended opportunities for community exchange, and find new forms of evaluation. Average users shared some similar characteristics with both the highly active members and infrequent users, representing a group in transition as they become more engaged and active in the online workspace. Inactive users viewed the workspace as having little value, being difficult to navigate, being mainly for gaining basic information about events and community news, and as another demand on their time. Results show the online workspace component of the Earth Science Education and Outreach Forum is playing an important and emerging role for this community by supporting knowledge building and knowledge sharing, and growing in value for those that utilizing it more frequently. The evidence suggests that with increased participation or "usage" comes increased value to the participant and the organization. This research illustrates the possible change in mindset held by participating community members when it comes to the nature of co-location. Additionally, it may be of particular importance in exploring changes in the community members' feelings of connection and belonging.

Deviance as adherence to injunctive group norms: the overlooked role of social identification in deviance.

PubMed

Crane, Monique F; Platow, Michael J

2010-12-01

We currently report three studies investigating group members' expressions of dissatisfaction and discontent with the behaviour and attitudes of their in-group members. Our analysis examines the context in which group members will deviate from actual group member behaviour. We argue that highly identifying group members will challenge fellow group member behaviour when that group member behaviour is perceived to violate injunctive group norms. Further, we predicted that high identifiers would still challenge such group member behaviour even if that behaviour were conducted by a majority of group members. Thus, high identifiers were predicted to express descriptively deviant opinions when the behaviour of other members contravenes injunctive group norms. In Studies 1 and 2, group-level self-definition served as a moderator in the relationship between the expression of discontent and perceived injunctive norm violation; in Study 3, group-level self-investment served as this moderator. The findings supported our predictions. This support was particularly strong when a majority of group members violated group norms. Implications for the analysis of the relationship between social identification and deviance are discussed.

How much do residential aged care staff members know about the nutritional needs of residents?

PubMed

Beattie, Elizabeth; O'Reilly, Maria; Strange, Elise; Franklin, Sara; Isenring, Elisabeth

2014-03-01

Undernutrition, weight loss and dehydration are major clinical issues for people with dementia in residential care, with excessive weight loss contributing to increased risk of frailty, immobility, illness and premature morbidity. This paper discusses a nutritional knowledge and attitudes survey conducted as part of a larger project focused on improving nutritional intake of people with dementia within a residential care facility in Brisbane, Australia. The specific aims of the survey were to identify (i) knowledge of the nutritional needs of aged care facility residents; (ii) mealtime practices; and (iii) attitudes towards mealtime practices and organisation. A survey based on those used in other healthcare settings was completed by 76 staff members. The survey included questions about nutritional knowledge, opinions of the food service, frequency of feeding assistance provided and feeding assessment practices. Nutritional knowledge scores ranged from 1 to 9 of a possible 10, with a mean score of 4.67. While 76% of respondents correctly identified risk factors associated with malnutrition in nursing home residents, only 38% of participants correctly identified the need for increased protein and energy in residents with pressure ulcers, and just 15% exhibited correct knowledge of fluid requirements. Further, while nutritional assessment was considered an important part of practice by 83% of respondents, just 53% indicated that they actually carried out such assessments. Identified barriers to promoting optimal nutrition included insufficient time to observe residents (56%); being unaware of residents' feeding issues (46%); poor knowledge of nutritional assessments (44%); and unappetising appearance of food served (57%). An important step towards improving health and quality of life for residents of aged care facilities would be to enhance staff nutritional awareness and assessment skills. This should be carried out through increased attention to both preservice curricula and on-the-job training. The residential facility staff surveyed demonstrated low levels of nutrition knowledge, which reflects findings from the international literature. This has implications for the provision of responsive care to residents of these facilities and should be explored further. © 2013 Blackwell Publishing Ltd.

How to communicate climate change 'impact and solutions' to vulnerable population of Indian Sundarbans? From theory to practice.

PubMed

Chowdhury, Abhiroop; Maiti, Subodh Kumar; Bhattacharyya, Santanu

2016-01-01

Global consciousness on climate change problems and adaptation revolves around the disparity of information sharing and communication gap between theoretical scientific knowledge at academic end and practical implications of these at the vulnerable populations' end. Coastal communities facing socio-economic stress, like densely populated Sundarbans, are the most affected part of the world, exposed to climate change problems and uncertainties. This article explores the successes of a socio-environmental project implemented at Indian Sundarbans targeted towards economic improvement and aims at communicating environmental conservation through organized community participation. Participatory rural appraisal (PRA) and the wealth rank tool (WRT) were used to form a "group based organization" with 2100 vulnerable families to give them knowledge about capacity building, disaster management, resource conservation and sustainable agriculture practices. Training was conducted with the selected group members on resource conservation, institution building, alternative income generation activities (AIGA) like, Poultry, Small business, Tricycle van, Organic farming and disaster management in a participatory mode. The climate change 'problems-solutions' were communicated to this socio-economically marginalized and ostracized community through participatory educational theater (PET). WRT revealed that 45 % of the population was under economic stress. Out of 2100 beneficiaries', 1015 beneficiaries' started organic farming, 133 beneficiaries' adopted poultry instead of resource exploitive livelihood and 71 beneficiaries' engaged themselves with small business, which was the success stories of this project. To mitigate disaster, 10-committees were formed and the endemic knowledge about climate change was recorded by participatory method validated through survey by structured questionnaire. As a part of this project 87 ha of naked deforested mudflat was reclaimed with endangered mangroves involving target community members aimed to sequester CO2, control soil erosion and act as a barrier during natural disasters. This case study concluded that participatory method of communication, aiming not only to communicate theoretical knowledge, but also to devise adaptation strategies through conservation of endemic knowledge, popularizing sustainability through Micro Finance Institutions and promoting AIGA along with motivating vulnerable community to restore degraded forest lands, could be a effective solution to practically combat climate change problems.

Identifying and ranking implicit leadership strategies to promote evidence-based practice implementation in addiction health services.

PubMed

Guerrero, Erick G; Padwa, Howard; Fenwick, Karissa; Harris, Lesley M; Aarons, Gregory A

2016-05-14

Despite a solid research base supporting evidence-based practices (EBPs) for addiction treatment such as contingency management and medication-assisted treatment, these services are rarely implemented and delivered in community-based addiction treatment programs in the USA. As a result, many clients do not benefit from the most current and efficacious treatments, resulting in reduced quality of care and compromised treatment outcomes. Previous research indicates that addiction program leaders play a key role in supporting EBP adoption and use. The present study expanded on this previous work to identify strategies that addiction treatment program leaders report using to implement new practices. We relied on a staged and iterative mixed-methods approach to achieve the following four goals: (a) collect data using focus groups and semistructured interviews and conduct analyses to identify implicit managerial strategies for implementation, (b) use surveys to quantitatively rank strategy effectiveness, (c) determine how strategies fit with existing theories of organizational management and change, and (d) use a consensus group to corroborate and expand on the results of the previous three stages. Each goal corresponded to a methodological phase, which included data collection and analytic approaches to identify and evaluate leadership interventions that facilitate EBP implementation in community-based addiction treatment programs. Findings show that the top-ranked strategies involved the recruitment and selection of staff members receptive to change, offering support and requesting feedback during the implementation process, and offering in vivo and hands-on training. Most strategies corresponded to emergent implementation leadership approaches that also utilize principles of transformational and transactional leadership styles. Leadership behaviors represented orientations such as being proactive to respond to implementation needs, supportive to assist staff members during the uptake of new practices, knowledgeable to properly guide the implementation process, and perseverant to address ongoing barriers that are likely to stall implementation efforts. These findings emphasize how leadership approaches are leveraged to facilitate the implementation and delivery of EBPs in publicly funded addiction treatment programs. Findings have implications for the content and structure of leadership interventions needed in community-based addiction treatment programs and the development of leadership interventions in these and other service settings.

Where Do the Poorest Go to Seek Outpatient Care in Bangladesh: Hospitals Run by Government or Microfinance Institutions?

PubMed Central

Tseng, Yu-hwei; Khan, Mujibul Alam

2015-01-01

Introduction Health programs implemented by microfinance institutions (MFIs) aim to benefit the poor, but whether these services reach the poorest remains uncertain. This study intended to investigate the socioeconomic distribution of patients in hospitals operated by microfinance institutions (i.e. MFI hospitals) in Bangladesh and compare the differences with public hospitals to determine if the programs were consistent with their pro-poor mandate. Methods In this cross-sectional study, we used the convenience sampling method to conduct an interviewer-assisted questionnaire survey among 347 female outpatients, with 170 in public hospitals and 177 in MFI hospitals. Independent variables were patient characteristics categorized into predisposing factors (age, education, marital status, family size), enabling factors (microcredit membership, household income) and need factors (self-rated health, perceived needs for care). We employed Generalized Estimating Equations (GEE) to evaluate how these factors contributed to MFI hospital use. Results Use of MFI hospitals was associated with microcredit membership over 5 years (OR=2.9, p<.01), moderately poor household (OR=4.09, p<.001), non-poor household (OR=7.34, p<.01) and need for preventive care (OR=3.4, p<.01), compared with public hospitals. Combining membership and income, we found microcredit members had a higher tendency towards utilization but membership effect pertained to the non- and moderately-poor. Compared with the group who were non-members and the poorest, microcredit members who were non-poor had the highest likelihood (OR=7.46, p<.001) to visit MFI hospitals, followed by members with moderate income (OR=6.91, p<.001) and then non-members in non-poor households (OR=4.48, p<.01). Those who were members but the poorest had a negative association (OR=0.42), though not significant. Despite a higher utilization of preventive services in MFI hospitals, expenditure there was significantly higher. Conclusion Inequity was more pronounced in MFI hospitals than public ones. MFI hospitals appeared to miss their target population. We suggest that MFIs reorganize health programs toward primary health care to make care equitable and universally accessible. This study holds practical implications for governments, development agencies and microfinance practitioners working at the grassroots level. PMID:25807500

Where do the poorest go to seek outpatient care in Bangladesh: hospitals run by government or microfinance institutions?

PubMed

Tseng, Yu-hwei; Khan, Mujibul Alam

2015-01-01

Health programs implemented by microfinance institutions (MFIs) aim to benefit the poor, but whether these services reach the poorest remains uncertain. This study intended to investigate the socioeconomic distribution of patients in hospitals operated by microfinance institutions (i.e. MFI hospitals) in Bangladesh and compare the differences with public hospitals to determine if the programs were consistent with their pro-poor mandate. In this cross-sectional study, we used the convenience sampling method to conduct an interviewer-assisted questionnaire survey among 347 female outpatients, with 170 in public hospitals and 177 in MFI hospitals. Independent variables were patient characteristics categorized into predisposing factors (age, education, marital status, family size), enabling factors (microcredit membership, household income) and need factors (self-rated health, perceived needs for care). We employed Generalized Estimating Equations (GEE) to evaluate how these factors contributed to MFI hospital use. Use of MFI hospitals was associated with microcredit membership over 5 years (OR=2.9, p<.01), moderately poor household (OR=4.09, p<.001), non-poor household (OR=7.34, p<.01) and need for preventive care (OR=3.4, p<.01), compared with public hospitals. Combining membership and income, we found microcredit members had a higher tendency towards utilization but membership effect pertained to the non- and moderately-poor. Compared with the group who were non-members and the poorest, microcredit members who were non-poor had the highest likelihood (OR=7.46, p<.001) to visit MFI hospitals, followed by members with moderate income (OR=6.91, p<.001) and then non-members in non-poor households (OR=4.48, p<.01). Those who were members but the poorest had a negative association (OR=0.42), though not significant. Despite a higher utilization of preventive services in MFI hospitals, expenditure there was significantly higher. Inequity was more pronounced in MFI hospitals than public ones. MFI hospitals appeared to miss their target population. We suggest that MFIs reorganize health programs toward primary health care to make care equitable and universally accessible. This study holds practical implications for governments, development agencies and microfinance practitioners working at the grassroots level.

Family Risk and Resilience in the Context of War and Terrorism

ERIC Educational Resources Information Center

MacDermid Wadsworth, Shelley M.

2010-01-01

War and terrorism are exerting increasing force on world affairs, with growing implications for families and the scholars who study them. In this review, I consider the implications of mass violence for families, with particular emphasis on families with members serving in the U.S. military and families around the world who live where mass…

Evidence-based practice instruction by faculty members and librarians in North American optometry and ophthalmology programs.

PubMed

MacDonald, Katherine A; Hrynchak, Patricia K; Spafford, Marlee M

2014-07-01

North American optometry and ophthalmology faculty members and vision science librarians were surveyed online (14% response rate) about teaching evidence-based practice (EBP). Similar to studies of other health care programs, all five EBP steps (Ask, Acquire, Appraise, Apply, Assess) were taught to varying degrees. Optometry and ophthalmology EBP educators may want to place further emphasis on (1) the Apply and Assess steps, (2) faculty- and student-generated questions and self-assessment in clinical settings, (3) online teaching strategies, (4) programmatic integration of EBP learning objectives, and (5) collaboration between faculty members and librarians.

Improving Collaboration Among Social Work and Nursing Students Through Interprofessional Simulation.

PubMed

Kuehn, Mary Beth; Huehn, Susan; Smalling, Susan

2017-08-01

This project implemented first-time simulation with nursing and social work students. Students participated in a contextual learning experience through a patient simulation of interprofessional practice as a health care team member and reflection through debriefing and open response comments. Simulation offers a means to practice interprofessional collaboration prior to entering practice. Participants reported an increased understanding of the scope of practice of other team members through their reflections following simulation. In addition, participants reported increased comprehension of team dynamics and their relationship to improved patient care. Overall, the simulation encouraged development of the skills necessary to function as part of a collaborative, interprofessional team.

The cyanobacterial bicarbonate transporter BicA: its physiological role and the implications of structural similarities with human SLC26 transporters.

PubMed

Price, G Dean; Howitt, Susan M

2011-04-01

The cyanobacterial Na+-dependent HCO3- transporter BicA is a member of the ubiquitous and important SulP/SLC26 family of anion transporters found in eukaryotes and prokaryotes. BicA is an important component of the cyanobacterial CO2 concentrating mechanism, an adaptation that contributes to cyanobacteria being able to achieve an estimated 25% of global primary productivity, largely in the oceans. The human SLC26 members are involved in a range of key cellular functions involving a diverse range of anion transport activities including Cl-/HCO3-, I-/HCO3-, and SO42-/HCO3- exchange; mutations in SLC26 members are known to be associated with debilitating diseases such as Pendred syndrome, chondrodysplasias, and congenital chloride diarrhoea. We have recently experimentally determined the membrane topology of BicA using the phoA-lacZ reporter system and here consider some of the extrapolated implications for topology of the human SLC26 family and the Sultr plant sulphate transporters.

Suffering in Silence: Impact of Tobacco Use on Communication Dynamics Within Vietnamese and Chinese Immigrant Families.

PubMed

Petersen, Anne Berit; Tsoh, Janice Y; Nguyen, Tung T; McPhee, Stephen J; Burke, Nancy J

2015-12-29

The goal of this project was to explore family communication dynamics and their implications for smoking cessation. We conducted 39 in-depth dyadic and individual qualitative interviews with 13 immigrant smoker-family member pairs of Vietnamese (n = 9 dyads, 18 individuals) and Chinese (n = 4 dyads, 8 individuals) descent, including seven current and six former smokers and 13 family members. All 13 dyadic and 26 individual interviews were analyzed using a collaborative crystallization process as well as grounded theory methods. We identified three interrelated pathways by which tobacco use in immigrant Vietnamese and Chinese families impacts family processes and communication dynamics. Using a two-dimensional model, we illustrate how the shared consequences of these pathways can contribute to a dynamic of avoidance and noncommunication, resulting in individual family members "suffering in silence" and ultimately smoking being reinforced. We discuss the implications of these findings for development of smoking cessation interventions. © The Author(s) 2015.

Goal Development Practices of Physical Therapists Working in Educational Environments.

PubMed

Wynarczuk, Kimberly D; Chiarello, Lisa A; Gohrband, Catherine L

2017-11-01

The aims of this study were to (1) describe the practices that school-based physical therapists use in developing student goals, and (2) identify facilitators and barriers to development of goals that are specific to participation in the context of the school setting. 46 school-based physical therapists who participated in a previous study on school-based physical therapy practice (PT COUNTS) completed a questionnaire on goal development. Frequencies and cross tabulations were generated for quantitative data. Open-ended questions were analyzed using an iterative qualitative analysis process. A majority of therapists reported that they frequently develop goals collaboratively with other educational team members. Input from teachers, related services personnel, and parents has the most influence on goal development. Qualitative analysis identified five themes that influence development of participation-based goals: (1) school-based philosophy and practice; (2) the educational environment, settings, and routines; (3) student strengths, needs, and personal characteristics; (4) support from and collaboration with members of the educational team; and (5) therapist practice and motivation. Goal development is a complex process that involves multiple members of the educational team and is influenced by many different aspects of practice, the school environment, and student characteristics.

27 CFR 8.4 - Jurisdictional limits.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... The regulations in this part apply where: (1) The industry member requires, by agreement or otherwise, a retailer to purchase distilled spirits, wine, or malt beverages from such industry member to the...) The industry member engages in the practice of using a requirement to such an extent as substantially...

45 CFR 1607.3 - Composition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... percent (60%) of a governing body shall be attorney members. (1) A majority of the members of the governing body shall be attorney members appointed by the governing body(ies) of one or more State, county or municipal bar associations, the membership of which represents a majority of attorneys practicing...

Medicare Chronic Care Management Payments and Financial Returns to Primary Care Practices: A Modeling Study.

PubMed

Basu, Sanjay; Phillips, Russell S; Bitton, Asaf; Song, Zirui; Landon, Bruce E

2015-10-20

Physicians have traditionally been reimbursed for face-to-face visits. A new non-visit-based payment for chronic care management (CCM) of Medicare patients took effect in January 2015. To estimate financial implications of CCM payment for primary care practices. Microsimulation model incorporating national data on primary care use, staffing, expenditures, and reimbursements. National Ambulatory Medical Care Survey and other published sources. Medicare patients. 10 years. Practice-level. Comparison of CCM delivery approaches by staff and physicians. Net revenue per full-time equivalent (FTE) physician; time spent delivering CCM services. If nonphysician staff were to deliver CCM services, net revenue to practices would increase despite opportunity and staffing costs. Practices could expect approximately $332 per enrolled patient per year (95% CI, $234 to $429) if CCM services were delivered by registered nurses (RNs), approximately $372 (CI, $276 to $468) if services were delivered by licensed practical nurses, and approximately $385 (CI, $286 to $485) if services were delivered by medical assistants. For a typical practice, this equates to more than $75 ,00 of net annual revenue per FTE physician and 12 hours of nursing service time per week if 50% of eligible patients enroll. At a minimum, 131 Medicare patients (CI, 115 to 140 patients) must enroll for practices to recoup the salary and overhead costs of hiring a full-time RN to provide CCM services. If physicians were to deliver all CCM services, approximately 25% of practices nationwide could expect net revenue losses due to opportunity costs of face-to-face visit time. The CCM program may alter long-term primary care use, which is difficult to predict. Practices that rely on nonphysician team members to deliver CCM services will probably experience substantial net revenue gains but must enroll a sufficient number of eligible patients to recoup costs. None.

Physicians in private practice: reasons for being a social franchise member.

PubMed

Huntington, Dale; Mundy, Gary; Hom, Nang Mo; Li, Qingfeng; Aung, Tin

2012-08-01

Evidence is emerging on the cost-effectiveness, quality and health coverage of social franchises. But little is known about the motivations of providers to join or remain within a social franchise network, or the impact that franchise membership has on client volumes or revenue earnings. (i) Uncontrolled facility based of a random sample of 230 franchise members to assess self-reported motivations; (ii) A 24 month prospective cohort study of 3 cohorts of physicians who had been in the franchise for 4 years, 2 years and new members to track monthly case load and revenue generated. The most common reasons for joining the franchise were access to high quality and cheap drugs (96.1%) and feelings of social responsibility, (95.2%). The effects of joining the franchise on the volume of family planning services is shown in the 2009 cohort where the average monthly service volume increased from 18.5 per physician to 70.6 per physician during their first 2 years in the franchise, (p<0.01). These gains are sustained during the 3rd and 4th year of franchise membership, as the 2007 cohort reported increases of monthly average family planning service volume from 71.2 per physician to 102.8 per physician (p<0.01). The net income of cohort 2009 increased significantly (p=0.024) during their first two years in the franchise. The results for cohorts 2007 and 2005 also show a generalized trend in increasing income. The findings show how franchise membership impacts the volume of franchise and non-franchised services. The increases in client volumes translated directly into increases in earnings among the franchise members, an unanticipated effect for providers who joined in order to better serve the poor. This finding has implications for the social franchise business model that relies upon subsidized medical products to reduce financial barriers for the poor. The increases in out of pocket payments for health care services that were not price controlled by the franchise is a concern. As the field of social franchises continues to mature its business models towards more sustainable and cost recovery management practices, attention should be given towards avoiding commercialization of services.

Physicians in private practice: reasons for being a social franchise member

PubMed Central

2012-01-01

Background Evidence is emerging on the cost-effectiveness, quality and health coverage of social franchises. But little is known about the motivations of providers to join or remain within a social franchise network, or the impact that franchise membership has on client volumes or revenue earnings. Methods (i) Uncontrolled facility based of a random sample of 230 franchise members to assess self-reported motivations; (ii) A 24 month prospective cohort study of 3 cohorts of physicians who had been in the franchise for 4 years, 2 years and new members to track monthly case load and revenue generated. Results The most common reasons for joining the franchise were access to high quality and cheap drugs (96.1%) and feelings of social responsibility, (95.2%). The effects of joining the franchise on the volume of family planning services is shown in the 2009 cohort where the average monthly service volume increased from 18.5 per physician to 70.6 per physician during their first 2 years in the franchise, (p<0.01). These gains are sustained during the 3rd and 4th year of franchise membership, as the 2007 cohort reported increases of monthly average family planning service volume from 71.2 per physician to 102.8 per physician (p<0.01). The net income of cohort 2009 increased significantly (p=0.024) during their first two years in the franchise. The results for cohorts 2007 and 2005 also show a generalized trend in increasing income. Conclusions The findings show how franchise membership impacts the volume of franchise and non-franchised services. The increases in client volumes translated directly into increases in earnings among the franchise members, an unanticipated effect for providers who joined in order to better serve the poor. This finding has implications for the social franchise business model that relies upon subsidized medical products to reduce financial barriers for the poor. The increases in out of pocket payments for health care services that were not price controlled by the franchise is a concern. As the field of social franchises continues to mature its business models towards more sustainable and cost recovery management practices, attention should be given towards avoiding commercialization of services. PMID:22849434

Facilitating Changes in College Teaching Practices: Instructional Reform, Identity Conflict and Professional Community in a K-20 Partnership

ERIC Educational Resources Information Center

Olitsky, Stacy

2015-01-01

In this paper, I explain variation in the adoption of student-centred teaching practices among college faculty members in a program designed to promote K-20 instructional reform. I analyze data from a qualitative study of a Math and Science Partnership in order to understand why some faculty members had undergone extensive changes to their…