Sample records for organizations practical implications

  1. Capitalism's New Handmaiden: The Biotechnical World Negotiated through Children's Fiction

    ERIC Educational Resources Information Center

    Sawers, Naarah

    2009-01-01

    In an era when the merger between capitalism and science becomes an accepted norm, new questions need to be asked about the ethical implications of scientific practices. One such practice is organ transplantation. However, potent debates surround the just distribution and ethical implications of organ transplantation. This paper examines the ways…

  2. Benchmarking Professional Development Practices across Youth-Serving Organizations: Implications for Extension

    ERIC Educational Resources Information Center

    Garst, Barry A.; Baughman, Sarah; Franz, Nancy

    2014-01-01

    Examining traditional and contemporary professional development practices of youth-serving organizations can inform practices across Extension, particularly in light of the barriers that have been noted for effectively developing the professional competencies of Extension educators. With professional development systems changing quickly,…

  3. Impact of tax sanctions on physician practice acquisitions and employment.

    PubMed

    Hardy, C T; Lyden, S M; Kasmarcak, S J

    1997-07-01

    The intermediate tax sanctions create significant concerns for tax-exempt healthcare organizations that seek to integrate practicing physicians through practice acquisition or employment. The sanctions will force not-for-profit healthcare organizations to examine both the strategic and business implications of the dollars they have committed to practice acquisition and physician employment. The sanctions also should motivate organizations to reexamine their existing physician compensation arrangements, which may be creating negative incentives for practice productivity.

  4. The implications of Istanbul Declaration on organ trafficking and transplant tourism.

    PubMed

    Delmonico, Francis L

    2009-04-01

    Organ trafficking, transplant tourism and transplant commercialism are now defined by the Declaration of Istanbul; the Declaration provides principles of practice based on those definitions. Organ trafficking and transplant tourism should be prohibited because they violate the principles of equity, justice and respect for human dignity. This report provides a country-by-country description of current events that may effect the practice of transplantation internationally for the foreseeable future. The implications of the Istanbul Declaration are profound. It calls for a legal and professional framework in each country to govern organ donation and transplantation activities. It calls for a transparent regulatory oversight system that ensures donor and recipient safety and enforces the prohibitions of unethical practices. Governments should ensure the provision of care and follow-up of living donors be no less than the care and attention provided for transplants recipients.

  5. Logistics, electronic commerce, and the environment

    NASA Astrophysics Data System (ADS)

    Sarkis, Joseph; Meade, Laura; Talluri, Srinivas

    2002-02-01

    Organizations realize that a strong supporting logistics or electronic logistics (e-logistics) function is important from both commercial and consumer perspectives. The implications of e-logistics models and practices cover the forward and reverse logistics functions of organizations. They also have direct and profound impact on the natural environment. This paper will focus on a discussion of forward and reverse e-logistics and their relationship to the natural environment. After discussion of the many pertinent issues in these areas, directions of practice and implications for study and research are then described.

  6. Organizational and Clinical Implications of Integrating an Alcohol Screening and Brief Intervention Within Non-Substance Abuse Serving Agencies

    PubMed Central

    PATTERSON, DAVID A.; WOLF (ADELV UNEGV WAYA), SILVER; McKIERNAN, PATRICK M.

    2012-01-01

    Although there have been efforts to advance evidenced-based practices into community-based organizations the limited successes of dissemination and poor implementation of efficacious treatments within these organizations are beginning to be documented. This article builds on the knowledge gained from organizational research and those internal structures (e.g., culture and climate), which possibly impede or enhance evidenced-based practice implementation within community-based organizations. While there are many evidenced-based practices available to human services organizations, there seems to be a gap between research and the implementation of these clinical practices. Recommendations are provided to better enable community-based organizations to integrate evidenced-based practice into its existing service structures. PMID:20799131

  7. Organizational and clinical implications of integrating an alcohol screening and brief intervention within non-substance abuse serving agencies.

    PubMed

    Patterson, David A; Wolf Adelv Unegv Waya, Silver; McKiernan, Patrick M

    2010-07-01

    Although there have been efforts to advance evidenced-based practices into community-based organizations the limited successes of dissemination and poor implementation of efficacious treatments within these organizations are beginning to be documented. This article builds on the knowledge gained from organizational research and those internal structures (e.g., culture and climate), which possibly impede or enhance evidenced-based practice implementation within community-based organizations. While there are many evidenced-based practices available to human services organizations, there seems to be a gap between research and the implementation of these clinical practices. Recommendations are provided to better enable community-based organizations to integrate evidenced-based practice into its existing service structures.

  8. Practical implications of incentive systems are utilized by dental franchises.

    PubMed

    Yavner, S B

    1989-01-01

    The success of any dental practice depends, among other factors, on the critical role of staff employees. In order to encourage desired staff behaviors, incentive systems can be designed for employee dentists, assistants/hygienists and managers. A survey of dental franchises was conducted in 1987 for the purpose of examining their incentive control systems. The specific incentives employed by these dental franchises for their employees are analyzed. The implications of these incentive systems used by dental franchise organizations for all dental practices are then discussed.

  9. Implications of organizational ethics to healthcare.

    PubMed

    Ells, Carolyn; MacDonald, Chris

    2002-01-01

    Organizational ethics is an emerging field concerned with the study and practice of the ethical behaviour of organizations. For effective application to healthcare settings, we argue that organizational ethics requires attention to organizations' special characteristics combined with tools borrowed from the fields of business ethics and bioethics. We identify and discuss several implications of this burgeoning field to healthcare organizations, showing how organizational ethics can facilitate policy making, accountability, self-evaluation, and patient and business perspectives. In our conclusion, we suggest an action plan for healthcare organizations to help them respond appropriately to their ethical responsibilities.

  10. Policy Implications of Education Informatics

    ERIC Educational Resources Information Center

    Carr, Jo Ann; O'Brien, Nancy P.

    2010-01-01

    Background/Context: This concluding article identifies the policy implications of education informatics and explores impacts of current copyright laws, legislative structures, publishing practices, and education organizations. Synthesizing the discussions in the preceding articles, this article highlights the importance of designing information…

  11. Performance management in healthcare: a critical analysis.

    PubMed

    Hewko, Sarah J; Cummings, Greta G

    2016-01-01

    Purpose - The purpose of this paper is to explore the underlying theoretical assumptions and implications of current micro-level performance management and evaluation (PME) practices, specifically within health-care organizations. PME encompasses all activities that are designed and conducted to align employee outputs with organizational goals. Design/methodology/approach - PME, in the context of healthcare, is analyzed through the lens of critical theory. Specifically, Habermas' theory of communicative action is used to highlight some of the questions that arise in looking critically at PME. To provide a richer definition of key theoretical concepts, the authors conducted a preliminary, exploratory hermeneutic semantic analysis of the key words "performance" and "management" and of the term "performance management". Findings - Analysis reveals that existing micro-level PME systems in health-care organizations have the potential to create a workforce that is compliant, dependent, technically oriented and passive, and to support health-care systems in which inequalities and power imbalances are perpetually reinforced. Practical implications - At a time when the health-care system is under increasing pressure to provide high-quality, affordable services with fewer resources, it may be wise to investigate new sector-specific ways of evaluating and managing performance. Originality/value - In this paper, written for health-care leaders and health human resource specialists, the theoretical assumptions and implications of current PME practices within health-care organizations are explored. It is hoped that readers will be inspired to support innovative PME practices within their organizations that encourage peak performance among health-care professionals.

  12. Identifying best practices for audit committees.

    PubMed

    Burke, J V; Luecke, R W; Meeting, D

    1996-06-01

    Most healthcare organizations have an audit committee of the governing board, or a finance committee, that fulfills the audit oversight function. Financial managers play a key role in shaping the content, agency, and operation of the audit committee. The findings of a recent research study conducted by Arthur Anderson & Co., SC, into the best practices of audit committees have implications for healthcare organizations.

  13. Comparison of Transformational Leadership Practices: Implications for School Districts and Principal Preparation

    ERIC Educational Resources Information Center

    Quin, Jeff; Deris, Aaron; Bischoff, Greg; Johnson, James T.

    2015-01-01

    The purpose of this study was to determine the leadership practices needed to improve academic achievement and generate positive change in school organizations. The study was also conducted to provide insight to principal preparation programs and school districts about effective transformational leadership practices. A quantitative research method…

  14. Science Camps in Europe--Collaboration with Companies and School, Implications and Results on Scientific Literacy

    ERIC Educational Resources Information Center

    Lindner, M.; Kubat, C.

    2014-01-01

    The paper informs on the characteristics of a Comenius Network of seven organizations, who are collaborating in exchanging best practice on science camps. This exchange includes evaluation results on more science camps of European organizations, which will deliver information on organization, collaboration with companies, pedagogical aspects, as…

  15. Dulse on the Distaff Side.

    ERIC Educational Resources Information Center

    MacKenzie, Marion

    1983-01-01

    Scientific research leading to the discovery of female plants of the red alga Palmaria plamata (dulse) is described. This discovery has not only advanced knowledge of marine organisms and taxonomic relationships but also has practical implications. The complete life cycle of this organism is included. (JN)

  16. High reliability and implications for nursing leaders.

    PubMed

    Riley, William

    2009-03-01

    To review high reliability theory and discuss its implications for the nursing leader. A high reliability organization (HRO) is considered that which has measurable near perfect performance for quality and safety. The author has reviewed the literature, discussed research findings that contribute to improving reliability in health care organizations, and makes five recommendations for how nursing leaders can create high reliability organizations. Health care is not a safe industry and unintended patient harm occurs at epidemic levels. Health care can learn from high reliability theory and practice developed in other high-risk industries. Viewed by HRO standards, unintended patient injury in health care is excessively high and quality is distressingly low. HRO theory and practice can be successfully applied in health care using advanced interdisciplinary teamwork training and deliberate process design techniques. Nursing has a primary leadership function for ensuring patient safety and achieving high quality in health care organizations. Learning HRO theory and methods for achieving high reliability is a foremost opportunity for nursing leaders.

  17. National cultures, performance appraisal practices, and organizational absenteeism and turnover: a study across 21 countries.

    PubMed

    Peretz, Hilla; Fried, Yitzhak

    2012-03-01

    Performance appraisal (PA) is a key human resource activity in organizations. However, in this global economy, we know little about how societal cultures affect PA practices. In this study, we address this gap by focusing on 2 complementary issues: (a) the influence of societal (national) cultural practices on PA practices adopted by organizations and (b) the contribution of the level of congruence between societal cultural practices and the characteristics of organizational PA practices to absenteeism and turnover. The results, based on a large data set across multiple countries and over 2 time periods, support the hypothesized effects of societal (national) cultural practices on particular PA practices and the interactive effects of societal cultural practices and PA practices on absenteeism and turnover. We discuss theoretical and practical implications of our findings.

  18. The Competitive Advantage of Organizational Learning.

    ERIC Educational Resources Information Center

    Appelbaum, Steven H.; Gallagher, John

    2000-01-01

    Explores theories of organizational learning and identifies the implications of the following for learning organizations: the new economy, strategic planning, management practices, and communication. (Contains 32 references.) (SK)

  19. Bridging the Research-to-Practice Gap: The Role of the Nurse Scientist.

    PubMed

    Brant, Jeannine M

    2015-11-01

    To describe the emerging role of the nurse scientist in health care organizations. Historical perspectives of the role are explored along with the roles of the nurse scientist, facilitators, barriers, and future implications. Relevant literature on evidence-based practice and research in health care organizations; nurse scientist role; interview with University of Colorado nurse scientist. The nurse scientist role is integral for expanding evidence-based decisions and nursing research. A research mentor is considered the most important facilitator for a successful nursing research program. Organizations should consider including the nurse scientist role to facilitate evidence-based practice and expand opportunities for nursing research. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Donor and procurement related issues in vascularized composite allograft transplantation.

    PubMed

    McDiarmid, Sue V

    2013-12-01

    To understand the unique requirements of vascularized composite allograft (VCA) donation and procurement practices and the integral role of the established nationwide organ procurement organizations in organ procurement. The recent issuance of a Final Rule (July 2013) by the United States Secretary of Health that redefines VCAs as organs rather than tissues, opens up the potential to formalize policies and procedures, under the auspices of the Organ Procurement and Transplantation Network, that can improve VCA donation, procurement practices, develop allocation algorithms and provide transparent oversight. Improved VCA donation rates, procurement procedures and broader sharing nationwide of VCA donors will have important implications in advancing the emerging field of VCA transplantation.

  1. Building organizational supports for knowledge sharing in county human service organizations: a cross-case analysis of works-in-progress.

    PubMed

    Lee, Chris; Austin, Michael J

    2012-01-01

    Building on the literature related to evidence-based practice, knowledge management, and learning organizations, this cross-case analysis presents twelve works-in-progress in ten local public human service organizations seeking to develop their own knowledge sharing systems. The data for this cross-case analysis can be found in the various contributions to this Special Issue. The findings feature the developmental aspects of building a learning organization that include knowledge sharing systems featuring transparency, self-assessment, and dissemination and utilization. Implications for practice focus on the structure and processes involved in building knowledge sharing teams inside public human service organizations. Copyright © Taylor & Francis Group, LLC

  2. Employee Involvement and Organizational Citizenship: Implications for Labor Law Reform and "Lean Production."

    ERIC Educational Resources Information Center

    Cappelli, Peter; Rogovsky, Nikolai

    1998-01-01

    Organizational citizenship--behavior that promotes organizations without explicit reward--was measured in a survey of 512 employees and 91 supervisors. Involvement in work organization increased citizenship behavior indirectly by changing job characteristics. Involvement in decisions about employment practices had little or no effect. (SK)

  3. Performance Improvement: Applying a Human Performance Model to Organizational Processes in a Military Training Environment

    ERIC Educational Resources Information Center

    Aaberg, Wayne; Thompson, Carla J.; West, Haywood V.; Swiergosz, Matthew J.

    2009-01-01

    This article provides a description and the results of a study that utilized the human performance (HP) model and methods to explore and analyze a training organization. The systemic and systematic practices of the HP model are applicable to military training organizations as well as civilian organizations. Implications of the study for future…

  4. Translating Theory into Practice: Implications of Japanese Management Theory for Student Personnel Administrators. NASPA Monograph Series Volume 3. First Edition.

    ERIC Educational Resources Information Center

    Deegan, William L.; And Others

    Japanese management theory was studied to identify specific models for consideration by student personnel administrators. The report is organized into three sections: major components of Japanese management theory, potential implications for student personnel administration, and three models, based on components of Japanese management theory, for…

  5. Accountable care organizations and prostate cancer care.

    PubMed

    Hollenbeck, Brent K; Kaufman, Samuel R; Borza, Tudor; Yan, Phyllis; Herrel, Lindsey A; Miller, David C; Luckenbaugh, Amy N; Skolarus, Ted A; Shahinian, Vahakn B

    2017-11-01

    Accountable care organizations have the potential to increase the value of healthcare by improving population health and enhanced financial stewardship. How practice context modifies effects on a specialty-focused disease, such as prostate cancer care, has implications for their success. We performed a retrospective cohort study of newly diagnosed men with prostate cancer between 2012 and 2013 using national Medicare data. Practice affiliation (small single-specialty, large single-specialty, multispecialty groups) and accountable care organization alignment were measured at the patient level. Generalized linear multivariable models were fitted to derive adjusted rates of treatment and spending for the 12-month period after diagnosis according to accountable care organization alignment and practice affiliation. Of 15,640 patients with newly diagnosed prostate cancer, 1,100 (7.0%) were aligned with accountable care organizations. Patients in these organizations had similar use of curative treatment to those not in accountable care organizations (71.4% vs. 70.0%, respectively; p=0.33), which did not vary with practice affiliation (p=0.39). Adjusted spending was higher among patients in accountable care organizations ($20,916 vs. $19,773, p=0.03); however, this relationship was independent of the practice affiliation (p=0.90). Higher accountable care organization penetration within a practice was associated with increased spending (p<0.05) but not with treatment (p=0.87). Prostate cancer patients aligned with accountable care organizations had similar rates of treatment, but increased spending, in the year following diagnosis. These findings were similar across practice affiliations. Better specialist engagement by accountable care organizations may be necessary for them to alter practice patterns for specialty care.

  6. Bella's Beetle: Approaching Bioscience Practice from Its Silent Kinaesthetic and Affective Side

    ERIC Educational Resources Information Center

    Hay, David

    2017-01-01

    This article critically explores the epistemic "practices" of bioscience, using creative writing and analyses of science studies to implicate the non-linguistic side of science where a "feeling for the organism" matters more, perhaps, than theoretical precision. It offers new critique of curricula in science which are so…

  7. Tomorrow's Workers: A Peek at What Demographers See for Workforce 2000.

    ERIC Educational Resources Information Center

    Fischer, Rick

    Meant to be a practical guide for public relations educators and practitioners responsible for anticipating change and helping their organizations adapt, this guide presents 10 predictions and projected demographic data for the year 2000. Also included for each prediction in the guide are implications for public relations practice. The guide…

  8. A practical implementation science heuristic for organizational readiness: R = MC2

    PubMed Central

    Cook, Brittany S.; Lamont, Andrea; Wandersman, Abraham; Castellow, Jennifer; Katz, Jason; Beidas, Rinad S.

    2015-01-01

    There are many challenges when an innovation (i.e., a program, process, or policy that is new to an organization) is actively introduced into an organization. One critical component for successful implementation is the organization’s readiness for the innovation. In this article, we propose a practical implementation science heuristic, abbreviated as R= MC2. We propose that organizational readiness involves: 1) the motivation to implement an innovation, 2) the general capacities of an organization, and 3) the innovation-specific capacities needed for a particular innovation. Each of these components can be assessed independently and be used formatively. The heuristic can be used by organizations to assess readiness to implement and by training and technical assistance providers to help build organizational readiness. We present an illustration of the heuristic by showing how behavioral health organizations differ in readiness to implement a peer specialist initiative. Implications for research and practice of organizational readiness are discussed. PMID:26668443

  9. Special Education Teacher Preparation in Classroom Management: Implications for Students with Emotional and Behavioral Disorders

    ERIC Educational Resources Information Center

    Oliver, Regina M.; Reschly, Daniel J.

    2010-01-01

    Special education teachers' skills with classroom organization and behavior management affect the emergence and persistence of behavior problems as well as the success of inclusive practice for students with emotional and behavioral disorders (EBD). Adequate special education teacher preparation and strong classroom organization and behavior…

  10. Implementing Innovative Workplaces: Organizational Implications of Different Strategies. Workscape 21: The Ecology of New Ways of Working.

    ERIC Educational Resources Information Center

    Becker, Franklin; Quinn, Kristen L.; Rappaport, Andrew J.; Sims, William R.

    This document reports a study that examined implementation processes for new workplace practices--nonterritorial offices--in five international organizations in four countries. The organizations are IBM and Ernst & Young in the United Kingdom; Digital Equipment's Natural Office in Sweden; SOL Cleaning Company headquarters in Finland; and…

  11. Research on High Reliability Organizations: Implications for School Effects Research, Policy, and Educational Practice.

    ERIC Educational Resources Information Center

    Stringfield, Sam

    Current theorizing in education, as in industry, is largely devoted to explaining trial-and-error, failure-tolerant, low-reliability organizations. This article examines changing societal demands on education and argues that effective responses to those demands require new and different organizational structures. Schools must abandon industrial…

  12. Problem Types in Synthetic Organic Chemistry Research: Implications for the Development of Curricular Problems for Second-Year Level Organic Chemistry Instruction

    ERIC Educational Resources Information Center

    Raker, Jeffrey R.; Towns, Marcy H.

    2012-01-01

    Understanding of the nature of science is key to the development of new curricular materials that mirror the practice of science. Three problem types (project level, synthetic planning, and day-to-day) in synthetic organic chemistry emerged during a thematic content analysis of the research experiences of eight practising synthetic organic…

  13. Commercial pressures and professional ethics: troubling revisions to the recent ACOG Practice Bulletins on surgery for pelvic organ prolapse.

    PubMed

    Wall, L Lewis; Brown, Douglas

    2009-07-01

    Commercial interests are reshaping the practice of gynecological surgery by promoting the use of trochar-and-mesh surgical "kits" for the treatment of stress incontinence and pelvic organ prolapse. In this article, we discuss the ethical implications of changes in surgical practice that are driven by commercial interests. We point out the dangers inherent in the adoption of new procedures without adequate and documented evidence to support their safety and efficacy. We discuss the most recent American College of Obstetricians and Gynecologists (ACOG) Practice Bulletins on pelvic organ prolapse (numbers 79 and 85) which were altered without explanation to downplay the experimental nature of these commercial products. We suggest that in so doing, ACOG is not meeting its fiduciary responsibilities to patients and is undermining important professional values.

  14. New Evidence on the Green House Model of Nursing Home Care: Synthesis of Findings and Implications for Policy, Practice, and Research.

    PubMed

    Zimmerman, Sheryl; Bowers, Barbara J; Cohen, Lauren W; Grabowski, David C; Horn, Susan D; Kemper, Peter

    2016-02-01

    To synthesize new findings from the THRIVE Research Collaborative (The Research Initiative Valuing Eldercare) related to the Green House (GH) model of nursing home care and broadly consider their implications. Interviews and observations conducted in GH and comparison homes, Minimum Data Set (MDS) assessments, Medicare data, and Online Survey, Certification and Reporting data. Critical integration and interpretation of findings based on primary data collected 2011-2014 in 28 GH homes (from 16 organizations), and 15 comparison nursing home units (from 8 organizations); and secondary data derived from 2005 to 2010 for 72 GH homes (from 15 organizations) and 223 comparison homes. Implementation of the GH model is inconsistent, sometimes differing from design. Among residents of GH homes, adoption lowers hospital readmissions, three MDS measures of poor quality, and Part A/hospice Medicare expenditures. Some evidence suggests the model is associated with lower direct care staff turnover. Recommendations relate to assessing fidelity, monitoring quality, capitalizing opportunities to improve care, incorporating evidence-based practices, including primary care providers, supporting high-performance workforce practices, aligning Medicare financial incentives, promoting equity, informing broad culture change, and conducting future research. © Health Research and Educational Trust.

  15. Women's self-perception and self-care practice: implications for health care delivery.

    PubMed

    Mendias, E P; Clark, M C; Guevara, E B

    2001-01-01

    Mexican American women experience unique health care needs related to integration of Mexican and American cultures. To learn how to better promote self-care practices and service utilization in women of Mexican origin living in Texas, researchers used a qualitative approach to interview a convenience sample of 11 low-income women attending a health clinic. Researchers collected narrative data about the women's perceptions of health, wellness, and self-care. Using the matrix approach described by Miles and Huberman, we organized findings around women's roles, including participants' descriptions of themselves, their health and wellness awareness, self-care practices for health/illness and wellness/nonwellness, barriers to self-care, origin of self-care practices, and perceptions of life control. Implications for health planning and service delivery are presented.

  16. Who Supports the Successful Implementation and Sustainability of Evidence-Based Practices? Defining and Understanding the Roles of Intermediary and Purveyor Organizations.

    PubMed

    Franks, Robert P; Bory, Christopher T

    2015-01-01

    Research on implementation science has increased significantly over the past decade. In particular, psychologists have looked closely at the value and importance of bridging the gap between science and practice. As evidence-based practices (EBPs) become more prevalent, concrete mechanisms are needed to bring these scientifically supported treatments and interventions to community-based settings. Intermediary and purveyor organizations (IPOs) have emerged in recent years that specialize in bringing research to practice. Using a framework developed by Franks (), this descriptive study surveyed respondents that self-identified as IPOs and focused on identifying shared definitions, functions, and activities. Results indicated that seven descriptive roles previously identified were supported by this survey and many common shared activities, goals, and functions across these organizations were observed. Further, these organizations appear to be influenced by the growing field of implementation science. Limitations and implications of this study are discussed. © 2015 Wiley Periodicals, Inc.

  17. Implications of Community Activism among Urban Minority Young People for Education for Engaged and Critical Citizenship

    ERIC Educational Resources Information Center

    Nam, Chaebong

    2012-01-01

    Citizenship is fundamentally defined by praxis--i.e., engagement in local and diverse forms of civic practices--rather than by a legal status tied to the nation-state (Tully, 2008). This study examined the participatory democracy practices of a community activist group that was organizing to resist gentrification in a Puerto Rican community in…

  18. Dowry in 21st-century India: the sociocultural face of exploitation.

    PubMed

    Banerjee, Priya R

    2014-01-01

    The World Health Organization (2009) implicates deep-rooted cultural and social norms as influential contributing factors toward physical and intimate partner violence against women. The dowry system is a social practice that perpetuates the oppression, torture, and murder of women in India. The practice of dowry is an expected part of marriage in cultures where arranged marriages are the norm. Violence can occur when the dowry or bride-price is deemed unsatisfactory by the recipient. In India, in spite of laws prohibiting the practice, not much has changed over the last 30 years. The National Crime Records Bureau of India, recorded a total of 8,618 female deaths related to dowry disputes in 2011, and the Asian Women's Human Rights Council (2009) estimates that the practice of dowry is implicated in 25,000 deaths and maiming of women between the ages of 15-34 in India every year. The current review of literature reveals that despite efforts on the part of the Indian government, social activists and feminists organizations in India, not much has changed over the past decade, in fact, the problem has increased, resulting in an unprecedented amount of mortality and morbidity among women in India.

  19. Role of organic amendments on enhanced bioremediation of heavy metal(loid) contaminated soils.

    PubMed

    Park, Jin Hee; Lamb, Dane; Paneerselvam, Periyasamy; Choppala, Girish; Bolan, Nanthi; Chung, Jae-Woo

    2011-01-30

    As land application becomes one of the important waste utilization and disposal practices, soil is increasingly being seen as a major source of metal(loid)s reaching food chain, mainly through plant uptake and animal transfer. With greater public awareness of the implications of contaminated soils on human and animal health there has been increasing interest in developing technologies to remediate contaminated sites. Bioremediation is a natural process which relies on soil microorganisms and higher plants to alter metal(loid) bioavailability and can be enhanced by addition of organic amendments to soils. Large quantities of organic amendments, such as manure compost, biosolid and municipal solid wastes are used as a source of nutrients and also as a conditioner to improve the physical properties and fertility of soils. These organic amendments that are low in metal(loid)s can be used as a sink for reducing the bioavailability of metal(loid)s in contaminated soils and sediments through their effect on the adsorption, complexation, reduction and volatilization of metal(loid)s. This review examines the mechanisms for the enhanced bioremediation of metal(loid)s by organic amendments and discusses the practical implications in relation to sequestration and bioavailability of metal(loid)s in soils. Copyright © 2010 Elsevier B.V. All rights reserved.

  20. Personalizing knowledge delivery services: a conceptual framework

    NASA Technical Reports Server (NTRS)

    Majchrzak, Ann; Chelleppa, Ramnath K.; Cooper, Lynne P.; Hars, Alexander

    2003-01-01

    Consistent with the call of the Minnesota Symposium for new theory in knowledge management, we offer a new conceptualization of Knowledge Management Systems (KMS) as a portfolio of personalized knowledge delivery services. Borrowing from research on online consumer behavior, we describe the challenges imposed by personalized knowledge delivery services, and suggest design parameters that can help to overcome these challenges. We develop our design constructs through a set of hypotheses and discuss the research implications of our new conceptualization. Finally, we describe practical implications suggested by our conceptualization - practical suggestions that we hope to gain some experience with as part of an ongoing action research project at our partner organization.

  1. Implications of Accounting Practice for Financial Analysis.

    ERIC Educational Resources Information Center

    Wilkinson, William M.

    1979-01-01

    Different kinds of financial data are needed by different levels of management and in different areas of support. Accounting principles for nonprofit organizations need to be determined. Accrual accounting principles, fund accounting, restricted and unrestricted funds, etc., are described. (MLW)

  2. Organizations as machines, organizations as conversations: two core metaphors and their consequences.

    PubMed

    Suchman, Anthony L

    2011-12-01

    One factor contributing to the limited success of organizational change initiatives is the use of an outmoded conceptual model: the organization as machine. This metaphor leads to the creation of detailed blueprints for desired changes; invites unrealistic expectations of control; and creates anxiety, blame and defensiveness when events inevitably do not proceed according to plan, thus hindering the work. An alternative conceptualization--the organization as conversation--portrays an organization not as a reified object upon which we can act but as self-organizing patterns of thinking (organizational identity and knowledge) and relating (organizational culture) that exist in the medium of human interaction in which we participate. Principles of complexity dynamics (self-organization) have important implications for organizational change practices. (1) Organizational change requires mindful participation--reflecting on and talking about what we are doing together here and now, what patterns of thinking and interacting we are enacting, and what new behaviors might interrupt old patterns or give rise to new ones. (2) Diversity and responsiveness favor the emergence of novel patterns. Skilled facilitation can enhance these characteristics when novelty is desirable; checklists and protocols can diminish these characteristics when consistency and reliability are needed. (3) We cannot know in advance the outcomes of our actions so we need to hold plans lightly, value "not knowing" and practice emergent design. The organization-as-conversation perspective also has important implications for T3 translational research, redefining its purpose, suggesting new methodologies, and requiring new approaches for evaluating proposed and completed projects.

  3. An institutional analysis of HIV prevention efforts by the nation's outpatient drug abuse treatment units.

    PubMed

    D'Aunno, T; Vaughn, T E; McElroy, P

    1999-06-01

    Drawing from an institutional-theory perspective on innovations in organizations, this paper examines the use of human immunodeficiency virus (HIV) prevention practices by the nation's outpatient substance abuse treatment units during a critical period from 1988 to 1995. An institutional perspective argues that organizations adopt new practices not only for technical reasons, but also because external actors actively promote or model the use of particular practices. We examine the extent to which treatment units use several practices to prevent HIV infection among their clients and among drug-users not in treatment. Results from random-effects regression analyses of national survey data show that treatment units significantly increased their use of HIV prevention practices from 1988 to 1995. Further, the results show that treatment units' use of prevention practices was related to clients' risk for HIV infection, unit resources available to support these practices, and organizational support for the practices. Implications are discussed for an institutional view of organizational innovation as well as for research on HIV prevention.

  4. Educational Organization for the Future

    ERIC Educational Resources Information Center

    Cote, Ron Roy

    1977-01-01

    Five basic components of the emerging educational system--forecasts and assessment, program planning, alternative environments, electronics and socialization, and differentiated faculty--summarize both current trends in educational practice and the implications for schools provided by analysts of the radically different society America is…

  5. Implications of complex adaptive systems theory for the design of research on health care organizations

    PubMed Central

    McDaniel, Reuben R.; Lanham, Holly Jordan; Anderson, Ruth A.

    2013-01-01

    Background Because health care organizations (HCOs) are complex adaptive systems (CASs), phenomena of interest often are dynamic and unfold in unpredictable ways, and unfolding events are often unique. Researchers of HCOs may recognize that the subject of their research is dynamic; however, their research designs may not take this into account. Researchers may also know that unfolding events are often unique, but their design may not have the capacity to obtain information from meager evidence. Purpose These two concerns led us to examine two ideas from organizational theory: (a) the ideas of K. E. Weick (1993) on organizational design as a verb and (b) the ideas of J. G. March, L. S. Sproull, and M. Tamuz (1991) on learning from samples of one or fewer. In this article, we applied these ideas to develop an enriched perspective of research design for studying CASs. Methodology/Approach We conducted a theoretical analysis of organizations as CASs, identifying relevant characteristics for research designs. We then explored two ideas from organizational theory and discussed the implications for research designs. Findings Weick's idea of “design as a verb” helps in understanding dynamic and process-oriented research design. The idea of “learning from samples of one or fewer” of March, Sproull, and Tamuz provides strategies for research design that enables learning from meager evidence. When studying HCOs, research designs are likely to be more effective when they (a) anticipate change, (b) include tension, (c) capitalize on serendipity, and (d) use an “act-then-look” mind set. Implications for practice are discussed. Practice Implications Practitioners who understand HCOs as CASs will be cautious in accepting findings from studies that treat HCOs mechanistically. They will consider the characteristics of CAS when evaluating the evidence base for practice. Practitioners can use the strategies proposed in this article to stimulate discussion with researchers seeking to conduct research in their HCO. PMID:19322050

  6. [Sexual partners and practices of young homosexuals in Rio de Janeiro].

    PubMed

    Rios, Luís Felipe

    2003-01-01

    This article focuses on the organization of the erotic lives of young men who engage in homosexual practices. The reflections presented here are based on ethnographic research including observation in places of homosociability and interviews with young men in Rio de Janeiro reporting homosexual practices. By presenting erotic scenes pertaining to a homoerotic circuit and recording the sexual trajectories of young men engaging in homosexual practices, the article seeks to identify the implications of the observed erotic scripts and sex-partner patterns for the sexual health of these individuals. The text calls special attention to reports concerning the emergence of different forms of erotic interaction in childhood, as well as cross-age and crossgenerational partnerships that extend into adulthood, with a growing trend toward seeking younger partners as the young men themselves grow older. The article suggests that such phenomena require a more in-depth understanding, since they have serious implications for planning sexual health measures for young men (and boys) who engage in homosexual practices.

  7. Understanding Digital Note-Taking Practice for Visualization.

    PubMed

    Willett, Wesley; Goffin, Pascal; Isenberg, Petra

    2015-05-13

    We present results and design implications from a study of digital note-taking practice to examine how visualization can support revisitation, reflection, and collaboration around notes. As digital notebooks become common forms of external memory, keeping track of volumes of content is increasingly difficult. Information visualization tools can help give note-takers an overview of their content and allow them to explore diverse sets of notes, find and organize related content, and compare their notes with their collaborators. To ground the design of such tools, we conducted a detailed mixed-methods study of digital note-taking practice. We identify a variety of different editing, organization, and sharing methods used by digital note-takers, many of which result in notes becoming "lost in the pile''. These findings form the basis for our design considerations that examine how visualization can support the revisitation, organization, and sharing of digital notes.

  8. Communities of Practice: Towards Leveraging Knowledge in the Military

    DTIC Science & Technology

    2007-09-01

    Sveiby (2001b) explains how the private sector went through a similar cycle in the 1980s that gave birth to the emergence of the modern “KM movement... 1980s (Svieby, 2001b) organizations were already quite proficient at “managing” knowledge. Consider the apprenticeship and mentorship programs...linking KM with HRM has 40 important implications for organizational performance. Hislop (2005) argues that Human Resource Management (HRM) practice

  9. Medical talent management: a model for physician deployment.

    PubMed

    Brightman, Baird

    2007-01-01

    This article aims to provide a focused cost-effective method for triaging physicians into appropriate non-clinical roles to benefit both doctors and healthcare organizations. Reviews a validated career-planning process and customize it for medical talent management. A structured career assessment can differentiate between different physician work styles and direct medical talent into best-fit positions. This allows healthcare organizations to create a more finely tuned career ladder than the familiar "in or out" binary choice. PRACTICAL IMPLICATIONS--Healthcare organizations can invest in cost-effective processes for the optimal utilization of their medical talent. Provides a new use for a well-validated career assessment and planning system. The actual value of this approach should be studied using best-practices in ROI research.

  10. Future trends in health and health care: implications for social work practice in an aging society.

    PubMed

    Spitzer, William J; Davidson, Kay W

    2013-01-01

    Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.

  11. Environmental Scanning Practices for Rural Colleges.

    ERIC Educational Resources Information Center

    Friedel, Janice Nahra; Lapin, Joel D.

    1995-01-01

    Discusses the importance of environmental scanning in the planning efforts of rural community colleges. Reviews basic techniques and terminology and suggests sources of data. Argues that environmental scanning allows rural colleges to inexpensively forecast change, identify implications for the organization, and plan preferred responses to shape…

  12. General patterns of managerial approaches to work motivation: Implications for rehabilitation professionals involved in occupational rehabilitation.

    PubMed

    Murphy, G C; Foreman, P

    1993-03-01

    Calls for rehabilitation counselors to learn more about the world of work have been recently repeated. The validity of these calls is suggested by a group of studies which indicate that the rehabilitation counseling literature has an established emphasis on matters of counseling and adjustment rather than on matters related to behavior in organizations. A survey of rehabilitation counsellors' beliefs about key topics in organizational behavior indicates that their beliefs are often discrepant with those of practicing managers and supervisors. A summary of dominant models of work motivation adopted by managerial workers is presented and some implications for occupational rehabilitation practice identified. Finally, some contemporary literature relevant to managerial approaches to employee motivation are identified and it is suggested that familiarity with this literature could assist rehabilitation practitioners move from a more narrow occupational rehabilitation role to a broader involvement in organizational life via the expansion of the disability management approach in work organizations.

  13. Impact of Perceived Security on Organizational Adoption of Smartphones.

    PubMed

    Arpaci, Ibrahim; Yardimci Cetin, Yasemin; Turetken, Ozgur

    2015-10-01

    Organizational adoption of new technologies is a practically important research area. The present study aims to investigate the impact of perceived security on organizational adoption of mobile communication technologies, specifically smartphones. For this purpose, a research model is developed extending the Technology Acceptance Model (TAM). The research model is tested using a structural equation modeling based on data that were collected from senior managers of 201 private sector organizations in Turkey. The results show that, along with the traditional constructs of perceived ease of use and perceived usefulness, perceived security significantly affects organizations' adoption of smartphones. Both the theoretical and practical implications of these results are discussed.

  14. Dimensions of Publicness and Performance in Substance Abuse Treatment Organizations

    ERIC Educational Resources Information Center

    Heinrich, Carolyn J.; Fournier, Elizabeth

    2004-01-01

    Changes in funding, clientele, and treatment practices of public and privately owned substance abuse treatment programs, compelled in part by increased cost containment pressures, have prompted researchers' investigations of the implications of organizational form for treatment programs. These studies primarily probe associations between ownership…

  15. Water and Plant Cells: Notes on a Teaching Scheme for O-Level.

    ERIC Educational Resources Information Center

    Grenville, H. W.

    1983-01-01

    Offers suggestions for teaching some aspects of water economy in plants. These include diffusion/osmosis, water transport, the part played by turgor in structural support, and its implications for plant organs or whole plants. Several practical demonstrations/experiments are also described. (JN)

  16. When politics meets science: What impact might Brexit have on organ donation and transplantation in the United Kingdom?

    PubMed

    Shapey, Iestyn M; Summers, Angela M; Simkin, Iain J; Augustine, Titus; van Dellen, David

    2018-06-21

    Brexit may lead to major political, societal, and financial changes-this has significant implications for a tax revenue funded healthcare system such as the United Kingdom's (UK) National Health Service. The complex relationship between European Union (EU) legislation and clinical practice of organ donation and transplantation is poorly understood. However, it is unclear what impact Brexit may have on organ donation and transplantation in the UK and EU. This work aims to describe the current legislative interactions affecting organ donation and transplantation regulation and governance within the UK and EU. We consider the potential impact of Brexit on the practical aspects of transplantation such organ-sharing networks, logistics, and the provision of health care for transplant patients when traveling to the EU from the UK and vice versa, as well as personnel, and research. Successful organ donation and transplantation practices rely on close collaboration and co-operation across Europe and throughout the United Kingdom. The continuation of such relationships, despite the proposed legislative change, will remain a vital and necessary component for the ongoing success of transplantation programs. © 2018 The Authors. Clinical Transplantation Published by John Wiley & Sons Ltd.

  17. A Prospective Examination of Clinician and Supervisor Turnover Within the Context of Implementation of Evidence-Based Practices in a Publicly-Funded Mental Health System.

    PubMed

    Beidas, Rinad S; Marcus, Steven; Wolk, Courtney Benjamin; Powell, Byron; Aarons, Gregory A; Evans, Arthur C; Hurford, Matthew O; Hadley, Trevor; Adams, Danielle R; Walsh, Lucia M; Babbar, Shaili; Barg, Frances; Mandell, David S

    2016-09-01

    Staff turnover rates in publicly-funded mental health settings are high. We investigated staff and organizational predictors of turnover in a sample of individuals working in an urban public mental health system that has engaged in a system-level effort to implement evidence-based practices. Additionally, we interviewed staff to understand reasons for turnover. Greater staff burnout predicted increased turnover, more openness toward new practices predicted retention, and more professional recognition predicted increased turnover. Staff reported leaving their organizations because of personal, organizational, and financial reasons; just over half of staff that left their organization stayed in the public mental health sector. Implications include an imperative to focus on turnover, with a particular emphasis on ameliorating staff burnout.

  18. Family medicine practice performance and knowledge management.

    PubMed

    Orzano, A John; McInerney, Claire R; Tallia, Alfred F; Scharf, Davida; Crabtree, Benjamin F

    2008-01-01

    Knowledge management (KM) is the process by which people in organizations find, share, and develop knowledge for action. KM affects performance by influencing work relationships to enhance learning and decision making. To identify how family medicine practices exhibit KM. A model and a template of KM concepts were derived from a comprehensive organizational literature review. Two higher and two lower performing family medicine practices were purposefully selected from existing comparative case studies based on prevention delivery rates and innovation. Interviews, fieldnotes of operations, and clinical encounters were coded independently using the template. Face-to-face discussions resolved coding differences. All practices had processes and tools for finding, sharing, and developing knowledge; however, KM overall was limited despite implementation of expensive technologies like an electronic medical record. Where present, KM processes and tools were used by individuals but not integrated throughout the organization. Loss of information was prominent, and finding knowledge was underdeveloped. The use of technical tools and developing knowledge by reconfiguration and measurement were particularly limited. Socially related tools, such as face-to-face-communication for sharing and developing knowledge, were more developed. As in other organizations, tool use was tailored for specific outcomes and leveraged by other organizational capacities. Differences in KM occur within family practices and between family practices and other organizations and may have implications for improving practice performance. Understanding interaction patterns of work relationships and KM may explain why costly technical or externally imposed "one size fits all" practice organizational interventions have had mixed results and limited sustainability.

  19. Time management strategies in nursing practice.

    PubMed

    Waterworth, Susan

    2003-09-01

    With the increasing emphasis on efficiency and effectiveness in health care, how a nurse manages her time is an important consideration. Whilst time management is recognized as an important component of work performance and professional nursing practice, the reality of this process in nursing practice has been subject to scant empirical investigation. To explore how nurses organize and manage their time. A qualitative study was carried out, incorporating narratives (22 nurses), focus groups (24 nurses) and semi-structured interviews (22 nurses). In my role as practitioner researcher I undertook observation and had informal conversations, which provided further data. Study sites were five health care organizations in the United Kingdom during 1995-1999. Time management is complex, with nurses using a range of time management strategies and a repertoire of actions. Two of these strategies, namely routinization and prioritizing, are discussed, including their implications for understanding time management by nurses in clinical practice. Ignoring the influence of 'others', the team and the organization perpetuates a rather individualistic and self-critical perspective of time management. This may lead to a failure to address problems in the organizing of work, and the co-ordinating of care involving other health care workers.

  20. 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.

  1. People adopt optimal policies in simple decision-making, after practice and guidance.

    PubMed

    Evans, Nathan J; Brown, Scott D

    2017-04-01

    Organisms making repeated simple decisions are faced with a tradeoff between urgent and cautious strategies. While animals can adopt a statistically optimal policy for this tradeoff, findings about human decision-makers have been mixed. Some studies have shown that people can optimize this "speed-accuracy tradeoff", while others have identified a systematic bias towards excessive caution. These issues have driven theoretical development and spurred debate about the nature of human decision-making. We investigated a potential resolution to the debate, based on two factors that routinely differ between human and animal studies of decision-making: the effects of practice, and of longer-term feedback. Our study replicated the finding that most people, by default, are overly cautious. When given both practice and detailed feedback, people moved rapidly towards the optimal policy, with many participants reaching optimality with less than 1 h of practice. Our findings have theoretical implications for cognitive and neural models of simple decision-making, as well as methodological implications.

  2. Soil health paradigms and implications for disease management.

    PubMed

    Larkin, Robert P

    2015-01-01

    Soil health has been defined as the capacity of soil to function as a vital living system to sustain biological productivity, maintain environmental quality, and promote plant, animal, and human health. Building and maintaining soil health are essential to agricultural sustainability and ecosystem function. Management practices that promote soil health, including the use of crop rotations, cover crops and green manures, organic amendments, and conservation tillage, also have generally positive effects on the management of soilborne diseases through a number of potential mechanisms, including increasing soil microbial biomass, activity, and diversity, resulting in greater biological suppression of pathogens and diseases. However, there also may be particular disease issues associated with some soil health management practices. In this review, research and progress made over the past twenty years regarding soil health, sustainability, and soil health management practices, with an emphasis on their implications for and effects on plant disease and disease management strategies, are summarized.

  3. Implications of Preparing School Administrators for Knowledge Work Organizations: A Case Study.

    ERIC Educational Resources Information Center

    Mulkeen, Thomas A.; Cooper, Bruce S.

    1992-01-01

    The Executive Leadership Program at Fordham University presents a model for practicing school administrators' continuing education that reflects a changing society and schools' changing needs. The program is based on four innovations: an intellectual/change agent approach; a clinical, field-based research experience; an instructional agenda…

  4. "I Took This Picture Because?…?": Accessing Teachers' Depictions of Change

    ERIC Educational Resources Information Center

    Parker, Melissa; Patton, Kevin; Sinclair, Christina

    2016-01-01

    Background: Achieving teacher change and the lofty goals of educational reform initiatives necessitates professional development (PD) designed to help teachers rethink their practice. A key implication for physical education, therefore, is that PD must be organized in ways that utilize teachers' voice, providing opportunities for teachers to build…

  5. The effect of total carbon on microscopic soil properties and implications for crop production

    USDA-ARS?s Scientific Manuscript database

    Soil structure is a dynamic property affected by physical, chemical, and microbiological processes. Addition of organic matter to soils and the use of different management practices have been reported to impact soil structure and crop production. Moderation in soil temperature and increases in mic...

  6. Can Man Control His Biological Evolution? A Symposium on Genetic Engineering. Artificial Synthesis of New Life Forms

    ERIC Educational Resources Information Center

    Danielli, James F.

    1972-01-01

    Research in manipulation of genetic inheritance opens new vistas. Biologically-styled industrial synthesis is better in many respects than chemical engineering practices now in use. An approach for improving hereditary characters in living organisms without considering social implications is unwise. (PS)

  7. Using Solution-Focused Applications for Transitional Coping of Workplace Survivors

    ERIC Educational Resources Information Center

    Germain, Marie-Line; Palamara, Sherry A.

    2007-01-01

    Solution-focused applications are proposed to assist survivor employees to return to workplace homeostasis after co-workers voluntarily or involuntarily leave the organization. A model for transitional coping is presented as well as a potential case study illustrating the application of the model. Implications for the theory, practice, and…

  8. From blood donation to kidney sales: the gift relationship and transplant commercialism.

    PubMed

    Koplin, Julian J

    2015-01-01

    In The Gift Relationship, Richard Titmuss argued that the practice of altruistic blood donation fosters social solidarity while markets in blood erode it. This paper considers the implications of this line of argument for the organ market debate. I defend Titmuss' arguments against a number of criticisms and respond to claims that Titmuss' work is not relevant to the context of live donor organ transplantation. I conclude that Titmuss' arguments are more resilient than many advocates of organ markets suggest, and more relevant to the debate than is commonly appreciated.

  9. The Internet and hospital marketing strategy: a survey.

    PubMed

    Lin, B; James, K; Vassar, J; Martin, C

    2001-01-01

    This project, which was conducted in the U.S. using a large number of healthcare organizations, is an attempt to discover if we can find any evidence of the impact of marketing theories on the real world of healthcare organizations. This paper addresses three major themes: Do healthcare organizations have an Internet strategy? Are they using the Internet in a strategic fashion? Can we identify any difference among the sectors concerning the strategic use of the Internet? Finally, implications for further research and health care practices are highlighted as well.

  10. Earth Science Informatics Community Requirements for Improving Sustainable Science Software Practices: User Perspectives and Implications for Organizational Action

    NASA Astrophysics Data System (ADS)

    Downs, R. R.; Lenhardt, W. C.; Robinson, E.

    2014-12-01

    Science software is integral to the scientific process and must be developed and managed in a sustainable manner to ensure future access to scientific data and related resources. Organizations that are part of the scientific enterprise, as well as members of the scientific community who work within these entities, can contribute to the sustainability of science software and to practices that improve scientific community capabilities for science software sustainability. As science becomes increasingly digital and therefore, dependent on software, improving community practices for sustainable science software will contribute to the sustainability of science. Members of the Earth science informatics community, including scientific data producers and distributers, end-user scientists, system and application developers, and data center managers, use science software regularly and face the challenges and the opportunities that science software presents for the sustainability of science. To gain insight on practices needed for the sustainability of science software from the science software experiences of the Earth science informatics community, an interdisciplinary group of 300 community members were asked to engage in simultaneous roundtable discussions and report on their answers to questions about the requirements for improving scientific software sustainability. This paper will present an analysis of the issues reported and the conclusions offered by the participants. These results provide perspectives for science software sustainability practices and have implications for actions that organizations and their leadership can initiate to improve the sustainability of science software.

  11. An examination of three theoretical models to explain the organ donation attitude--registration discrepancy among mature adults.

    PubMed

    Quick, Brian L; Anker, Ashley E; Feeley, Thomas Hugh; Morgan, Susan E

    2016-01-01

    An inconsistency in the research indicates positive attitudes toward organ donation do not map reliably onto organ donor registrations. Various models have sought to explain this inconsistency and the current analysis formally compared three models: the Bystander Intervention Model (BIM), the Organ Donor Model (ODM), and Vested Interest Theory (VIT). Mature (N = 688) adults between the ages of 50 to 64 years completed surveys related to organ donation. Results revealed that VIT accounted for the most variance in organ donation registrations followed by the BIM and ODM. The discussion emphasizes the importance of employing theories to explain a phenomenon as well as the practical implications of the findings.

  12. Improving nutritional care: innovation and good practice.

    PubMed

    Chapman, Carol; Barker, Mary; Lawrence, Wendy

    2015-04-01

    This paper presents examples of good practice in nutritional screening and care and identifies methods used to overcome contextual constraints and discusses the implications for nursing practice in hospitals. Nutritional screening is an important step in identifying those at risk of malnutrition, but does not produce improved nutritional care unless it results in a care plan that is acted on. The importance of nutrition and implications for clinical care make it imperative to improve practice. Qualitative investigation. Between January 2011-February 2012, focus groups were held using a semi-structured discussion guide with nine groups of health professionals (n = 80) from one hospital: four with nurses, three with doctors and two with dietitians. Discussions were audio-recorded, transcribed and coded into themes and sub-themes, which were then depicted in a thematic map and illustrated with verbatim quotes. Three strategies for sustaining effective nutritional practice emerged: establishing routines to ensure screening was undertaken; re-organizing aspects of care to promote good practice; developing innovative approaches. Issues to be addressed were the perceived disconnection between mandatory screening and the delivery of effective care, a requirement for nutrition education, organizational constraints of a large university hospital and the complexities of multidisciplinary working. Professionals seeking to improve nutritional care in hospitals need to understand the interaction of system and person to facilitate change. Nursing staff need to be able to exercise autonomy and the hospital system must offer enough flexibility to allow wards to organize nutritional screening and care in a way that meets the needs of individual patients. © 2014 John Wiley & Sons Ltd.

  13. A Paradigm Shift in the Implementation of Ethics Codes in Construction Organizations in Hong Kong: Towards an Ethical Behaviour.

    PubMed

    Ho, Christabel Man-Fong; Oladinrin, Olugbenga Timo

    2018-01-30

    Due to the economic globalization which is characterized with business scandals, scholars and practitioners are increasingly engaged with the implementation of codes of ethics as a regulatory mechanism for stimulating ethical behaviours within an organization. The aim of this study is to examine various organizational practices regarding the effective implementation of codes of ethics within construction contracting companies. Views on ethics management in construction organizations together with the recommendations for improvement were gleaned through 19 semi-structured interviews, involving construction practitioners from various construction companies in Hong Kong. The findings suggested some practices for effective implementation of codes of ethics in order to diffuse ethical behaviours in an organizational setting which include; introduction of effective reward schemes, arrangement of ethics training for employees, and leadership responsiveness to reported wrongdoings. Since most of the construction companies in Hong Kong have codes of ethics, emphasis is made on the practical implementation of codes within the organizations. Hence, implications were drawn from the recommended measures to guide construction companies and policy makers.

  14. Economic empowerment of impoverished IPV survivors: a review of best practice literature and implications for policy.

    PubMed

    Hahn, Sur Ah; Postmus, Judy L

    2014-04-01

    Best practices in advocating for economic empowerment of impoverished intimate partner violence (IPV) survivors require the comprehensive and holistic organization of program and service delivery systems. This article outlines the best practices literature that addresses IPV in the lives of impoverished women, as well as the literature that specifically examines the interventions to economically empower IPV survivors--whether impoverished or not. This article concludes with suggestions for policy makers on how to incorporate these best practices into the Violence Against Women Act and for practitioners to ensure a comprehensive approach to interventions for impoverished IPV survivors.

  15. The Information and Communication Technology User Role: Implications for the Work Role and Inter-Role Spillover.

    PubMed

    Piszczek, Matthew M; Pichler, Shaun; Turel, Ofir; Greenhaus, Jeffrey

    2016-01-01

    Management and organization research has traditionally focused on employees' work role and the interface between their work and family roles. We suggest that persons assume a third role in modern society that is relevant to work and organizations, namely the Information and Communication Technology User (ICTU) role. Based on role theory and boundary theory, we develop propositions about the characteristics of this role, as well as how ICTU role characteristics are related to boundary spanning activity, inter-role spillover with the work role, and work role performance. To this end, we first conceptualize the ICTU role and its associations with work and family roles. We then apply identity theory and boundary management theory to advance our understanding of how the ICTU role is related to criteria that are important to individuals and to organizations, namely self-selection into certain types of work roles and positive and negative inter-role spillover. The implications of this role for theory, research, and practice in management and organizations are discussed.

  16. Financial aspects of organ procurement from deceased donors in the USA-Relevance to xenotransplantation.

    PubMed

    Saari, Ryan J; Cooper, David K C

    2017-07-01

    When clinical xenotransplantation is introduced, the costs associated with acquisition of a genetically engineered pig organ are as yet unknown. How will these costs compare with those currently associated with the acquisition of deceased human organs? An understanding of the financial aspects of deceased organ and tissue procurement in the USA is therefore worthwhile. We have therefore attempted to review certain economic aspects of non-profit and for-profit organizations that provide cadaveric organs and/or tissues for purposes of transplantation into patients with end-stage organ failure, cellular deficiencies, or in need of reconstructive procedures. We briefly consider the laws, organizations, and business practices that govern the acquisition, processing, and/or distribution of cadaveric organs and tissues, and the economic implications of industry practices. In particular, we explore and highlight what we perceive as a lack of transparency and oversight with regard to financial practices, and we question whether donor families would be entirely happy with the business environment that has developed from their altruistic donations. Until xenotransplantation becomes established clinically, which will negate the need for any system of organ procurement and allocation, we suggest that those involved in organ and cell transplantation, as well as those who participate in reconstructive surgery, should take responsibility to ensure that the financial practices associated with procurement are transparent, and overseen/regulated by a responsible authority. We suggest the major transplant societies should take a lead in this respect. The ability to acquire a genetically engineered pig organ whenever required through a simple commercial transaction (as in the acquisition of a life-saving drug) will be greatly to the patient's benefit. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. When health care workers experience mental ill health: institutional practices of silence.

    PubMed

    Moll, Sandra; Eakin, Joan M; Franche, Renée-Louise; Strike, Carol

    2013-02-01

    Based on findings from an institutional ethnography in a large mental health organization, we explore how institutional forces shape the experiences of health care workers with mental health issues. We interviewed 20 employees about their personal experiences with mental health issues and work and 12 workplace stakeholders about their interactions with workers who had mental health issues. We also reviewed organizational texts related to health, illness, and productivity. In analyzing transcripts and texts, silence emerged as a core underlying process characterizing individual and organizational responses to employees with mental health issues. Silence was an active practice that took many forms; it was pervasive, complex, and at times, paradoxical. It served many functions for workers and the organization. We discuss the theoretical and practical implications of the findings for workers with mental health issues.

  18. A prospective examination of clinician and supervisor turnover within the context of implementation of evidence-based practices in a publicly-funded mental health system

    PubMed Central

    Marcus, Steven; Wolk, Courtney Benjamin; Powell, Byron; Aarons, Gregory A.; Evans, Arthur C.; Hurford, Matthew O.; Hadley, Trevor; Adams, Danielle R.; Walsh, Lucia M.; Babbar, Shaili; Barg, Frances; Mandell, David S.

    2015-01-01

    Staff turnover rates in publicly-funded mental health settings are high. We investigated staff and organizational predictors of turnover in a sample of individuals working in an urban public mental health system that has engaged in a system-level effort to implement evidence-based practices. Additionally, we interviewed staff to understand reasons for turnover. Greater staff burnout predicted increased turnover, more openness toward new practices predicted retention, and more professional recognition predicted increased turnover. Staff reported leaving their organizations because of personal, organizational, and financial reasons; just over half of staff that left their organization stayed in the public mental health sector. Implications include an imperative to focus on turnover, with a particular emphasis on ameliorating staff burnout. PMID:26179469

  19. Lessons Learned in Scaling up Effective Practices: Implications for Promoting Self-Determination within Developmental Disabilities

    ERIC Educational Resources Information Center

    Bacon, Ansley; Walker, Hill M.; Schwartz, Allen A.; O'Hara, David M.; Calkins, Carl; Wehmeyer, Michael L.

    2011-01-01

    The public's increasing demands for greater accountability and a better return on investment from research supported by federal funding requires that organizations studying and solving problems in areas like health, education, disability, and child mental health document the impact of their work. Human service and educational professionals agree…

  20. Forgiveness as an HRD Intervention: The Literature and a Proposed Framework

    ERIC Educational Resources Information Center

    Madsen, Susan R.; Gygi, Janice; Hammond, Scott C.; Plowman, Suzanne

    2008-01-01

    The purpose of this review is to explore the literature related to interpersonal forgiveness in organizations and its possible implications for HRD (human resource development) theory and practice. It defines forgiveness and provides a theoretical framework for its consideration within the workplace environment. It also reviews and discusses the…

  1. The Effect of Formal Mentoring Program Characteristics on Organizational Attraction

    ERIC Educational Resources Information Center

    Horvath, Michael; Wasko, Laurie E.; Bradley, Jessica L.

    2008-01-01

    Although the extant mentoring literature describes the post-hire benefits of mentoring programs, less is known about how mentoring programs affect pre-hire perceptions of organizations--perceptions that may have subsequent implications for the success of mentoring programs and other HRD practices. To explore this issue, we used a policy-capturing…

  2. Implications of the Concept of the Schema for Public Relations.

    ERIC Educational Resources Information Center

    Schneider, Larissa A.

    Understanding the cognitive principles inherent in schematic concepts can enhance the practice of fundamental public relations activities. Schemata dictate what information will be attended to, what interpretations will be made of it, and how it will be remembered. Both self-schemata and other-schemata help individuals organize and interpret their…

  3. The Benefits of Collective Pedagogical Teacher Culture for Diverse Students' Mathematics Achievement by Academic Engagement

    ERIC Educational Resources Information Center

    Moller, Stephanie; Mickelson, Roslyn Arlin; Stearns, Elizabeth; Bottia, Martha; Banerjee, Neena

    2011-01-01

    Most studies of educational organizations have focused on structural features of schools, such as size, resources, and infrastructure. Research on schools' organizational culture is more sparse. Yet, these studies have suggested that the organizational culture of schools can have important implications for teaching practices and student outcomes.…

  4. Social Work Education and Global Issues: Implications for Social Work Practice

    ERIC Educational Resources Information Center

    Edwards, Beverly L.

    2011-01-01

    If social workers are to become more effectively involved in international organizations and global issues, the international dimension of social work education must be strengthened. Educational programs for social workers around the world give only limited attention to social issues that extend beyond national boundaries. Schools of social work…

  5. Canada's Families Today: Some Policy Implications of Changing Forms and Patterns.

    ERIC Educational Resources Information Center

    Glossop, Robert

    A summary review of facts, figures, and trends concerning family life in Canada reveals patterns of continuity and patterns of change. Generalizations about the average family no longer suffice (if ever they did) as the basis for government policies and programs, corporate personnel practices, and the organization and administration of schools.…

  6. An integrative discourse perspective on positive leadership in public health care.

    PubMed

    Pietiläinen, Ville; Salmi, Ilkka

    2017-02-06

    Purpose This study aims to take a discursive view on positive leadership (PL). A positive approach has gained momentum in recent years as appropriate leadership practices are implemented in organizations. Despite the turn toward discursive approaches in organization studies, there is insufficient evidence supporting PL as a socially constructed experience. Design/methodology/approach The present study addresses an integrative discourse perspective for capturing the PL concept as a social process within the public health-care context. Findings Four meanings of PL are highlighted: role-taking, servicing, balancing and deciphering. Research limitations/implications The meanings shift the emphasis of certain PL definitions to a contextual interpretation. For scholars, the perspective demonstrates a multidimensional process approach in the desired organizational context as a counterbalance to one unanimously agreed-upon PL definition. Practical implications For leaders, an integrative discourse perspective offers tools for comprehending PL as a process: how to identify, negotiate and reconcile various PL meanings. Originality/value An integrative discourse perspective provides a novel perspective capturing the PL concept within the public health-care field.

  7. Managed care. What is its impact on nursing education and practice?

    PubMed

    Malloy, C

    1997-08-01

    Market forces present the nursing profession with an urgency to prepare gerontological nurses to assume significant roles in the managed care industry. An understanding of the current managed care environment underscores the need for training. Nurses require a "managed care" skill-set encompassing a firm grasp of the organization, financing, delivery, and policy implications of managed care as well as advanced practice clinical skills and a sound business orientation. The importance of the consumer as a significant player in managed care is highlighted.

  8. Transfusion medicine and solid organ transplant - Update and review of some current issues.

    PubMed

    Sarkar, R S; Philip, J; Yadav, Pramod

    2013-04-01

    Transfusion medicine holds a place of prime importance in organ transplant surgeries. There is a huge demand of organs worldwide with long waiting periods before the organ is available for transplant. Currently the dependency on ABO and HLA matching has decreased considerably with the use of modern immunosuppressant drugs and transplant techniques. The greatest advance in clinical implementation of ABO-incompatible transplants came about through desensitization and isoagglutinin elimination techniques with immunoadsorption and anti-CD20 antibodies becoming the norm, and spleenectomy fading out. The implications and practices of transfusion medicine in organ transplant are also undergoing drastic changes. The practice of infusion of one unit of donor's blood preoperatively for immunomodulation is no longer practiced. Use of leuco-reduced products has shown decreasing trends of alloimmunization and graft rejection in cases of multiple surgeries related to organ transplants. Worldwide donor and recipient registry programmes are being setup and existing ones are being upgraded. Such a registry system has been opened in India for kidney transplant cases very recently. Due to such registry programmes the dependency on siblings and directed donations have decreased considerably. This review deals with some of the current issues contributing to the successful outcome of mismatched transplants and the changing concepts of transfusion medicine related to it.

  9. Increasing consolidation in healthcare markets: what are the antitrust policy implications?

    PubMed Central

    Haas-Wilson, D; Gaynor, M

    1998-01-01

    OBJECTIVE: To discuss the implications of the rapid transformation of the healthcare financing and delivery system for competition, social welfare, and antitrust policy. PRINCIPAL FINDING: Horizontal and vertical consolidations can enhance efficiency but can also be anticompetitive in markets characterized by entry barriers. RECOMMENDATION: Active enforcement of the antitrust laws is essential to ensure that competition in healthcare markets will lead to procompetitive, rather than anticompetitive effects. However, healthcare antitrust enforcement policy must be flexible enough to allow efficient new forms of organization and practice to emerge. PMID:9865226

  10. The OPTN Deceased Donor Potential Study: Implications for Policy and Practice.

    PubMed

    Klassen, D K; Edwards, L B; Stewart, D E; Glazier, A K; Orlowski, J P; Berg, C L

    2016-06-01

    The Organ Procurement and Transplantation Network (OPTN) Deceased Donor Potential Study, funded by the Health Resources and Services Administration, characterized the current pool of potential deceased donors and estimated changes through 2020. The goal was to inform policy development and suggest practice changes designed to increase the number of donors and organ transplants. Donor estimates used filtering methodologies applied to datasets from the OPTN, the National Center for Health Statistics, and the Agency for Healthcare Research and Quality and used these estimates with the number of actual donors to estimate the potential donor pool through 2020. Projected growth of the donor pool was 0.5% per year through 2020. Potential donor estimates suggested unrealized donor potential across all demographic groups, with the most significant unrealized potential (70%) in the 50-75-year-old age group and potential Donation after Circulatory Death (DCD) donors. Actual transplants that may be realized from potential donors in these categories are constrained by confounding medical comorbidities not identified in administrative databases and by limiting utilization practices for organs from DCD donors. Policy, regulatory, and practice changes encouraging organ procurement and transplantation of a broader population of potential donors may be required to increase transplant numbers in the United States. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  11. Examining the impact of succession management practices on organizational performance: A national study of U.S. hospitals.

    PubMed

    Groves, Kevin S

    2017-08-03

    Spearheaded by the industry's transition from volume- to value-based care, the health care reform movement has spurred both unprecedented challenges and opportunities for developing more effective and sustainable health care delivery organizations. Whereas the formidable challenges of leading hospitals and health systems have been widely discussed, including reimbursement degradation, the rapidly aging workforce, and the imminent wave of executive retirements, the opportunity to leverage succession management and talent development capabilities to overcome these challenges has been largely overlooked. To address this key research and practice need, this multiphase study develops and validates an assessment of succession management practices for health care organizations. Utilizing data collected from two national samples of hospital organizations, the results provide a 32-item succession management assessment comprising seven distinct sets of succession management practices. The results indicate that succession management practices are strongly associated with multiple hospital performance metrics, including patient satisfaction and Medicare Spending per Beneficiary, leadership bench strength, and internal/external placement rate for executive level positions. The author concludes this article with a discussion of several practical implications for health care executives and boards, including employing the succession management assessment for diagnosing development opportunities, benchmarking succession planning and talent development practices against similar hospitals or health systems, and elevating the profile of succession management as a strategic priority in today's increasingly uncertain health care landscape.

  12. Linking molar organizational climate and strategic implementation climate to clinicians' use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study.

    PubMed

    Williams, Nathaniel J; Ehrhart, Mark G; Aarons, Gregory A; Marcus, Steven C; Beidas, Rinad S

    2018-06-25

    Behavioral health organizations are characterized by multiple organizational climates, including molar climate, which encompasses clinicians' shared perceptions of how the work environment impacts their personal well-being, and strategic implementation climate, which includes clinicians' shared perceptions of the extent to which evidence-based practice implementation is expected, supported, and rewarded by the organization. Theory suggests these climates have joint, cross-level effects on clinicians' implementation of evidence-based practice and that these effects may be long term (i.e., up to 2 years); however, no empirical studies have tested these relationships. We hypothesize that molar climate moderates implementation climate's concurrent and long-term relationships with clinicians' use of evidence-based practice such that strategic implementation climate will have its most positive effects when it is accompanied by a positive molar climate. Hypotheses were tested using data collected from 235 clinicians in 20 behavioral health organizations. At baseline, clinicians reported on molar climate and implementation climate. At baseline and at a 2-year follow-up, all clinicians who were present in the organizations reported on their use of cognitive-behavioral psychotherapy techniques, an evidence-based practice for youth psychiatric disorders. Two-level mixed-effects regression models tested whether baseline molar climate and implementation climate interacted in predicting clinicians' evidence-based practice use at baseline and at 2-year follow-up. In organizations with more positive molar climates at baseline, higher levels of implementation climate predicted increased evidence-based practice use among clinicians who were present at baseline and among clinicians who were present in the organizations at 2-year follow-up; however, in organizations with less positive molar climates, implementation climate was not related to clinicians' use of evidence-based practice at either time point. Optimizing clinicians' implementation of evidence-based practice in behavioral health requires attention to both molar climate and strategic implementation climate. Strategies that focus exclusively on implementation climate may not be effective levers for behavior change if the organization does not also engender a positive molar climate. These findings have implications for the development of implementation theory and effective implementation strategies.

  13. Green supply chain management in China

    NASA Astrophysics Data System (ADS)

    Zhu, Qinghua; Sarkis, Joseph

    2004-02-01

    Globalization results in both pressure and drivers for Chinese enterprise to improve their environmental performance. As a developing country, China has to balance economic and environmental performance. Green supply chain management (GSCM) is emerging to be an important approach for Chinese enterprises to improve performance, possibly on both these dimensions. Using empirical results from 89 respondents on GSCM practice in Chinese manufacturing enterprises, we examine the relationships between pressures, practice and performance. The results will look at multiple dimensions of GSCM practice and performance, as well as various pressures they face. Discussion of the results will include practical implications for organizations, not only in China, but internationally who face similar pressures and seek to implement similar programs.

  14. Introduction to Genetics and Childhood Obesity: Relevance to Nursing Practice

    PubMed Central

    Seal, Nuananong

    2013-01-01

    Purpose The aims for this article are to provide an overview of the current state of research on genetic contributions to the development of childhood obesity and to suggest genetic-focused nursing practices to prevent childhood obesity. Organizing Constructs Genetic epidemiology of childhood obesity, modes to identifying obesity genes, types of human obesity genes, and nursing implications are discussed. Clinical Relevance The successful integration of genetics into nursing practice will provide opportunities for nurses to participate fully as major agents and collaborators in the health care revolution. Conclusions Practicing nurses across the profession will need to become knowledgeable about genetics and take part in obesity prevention through genetic assessment of susceptibility and appropriate environmental interventions. PMID:20798151

  15. Measuring Changes in the Economics of Medical Practice.

    PubMed

    Fleming, Christopher; Rich, Eugene; DesRoches, Catherine; Reschovsky, James; Kogan, Rachel

    2015-08-01

    For the latter third of the twentieth century, researchers have estimated production and cost functions for physician practices. Today, those attempting to measure the inputs and outputs of physician practice must account for many recent changes in models of care delivery. In this paper, we review practice inputs and outputs as typically described in research on the economics of medical practice, and consider the implications of the changing organization of medical practice and nature of physician work. This evolving environment has created conceptual challenges in what are the appropriate measures of output from physician work, as well as what inputs should be measured. Likewise, the increasing complexity of physician practice organizations has introduced challenges to finding the appropriate data sources for measuring these constructs. Both these conceptual and data challenges pose measurement issues that must be overcome to study the economics of modern medical practice. Despite these challenges, there are several promising initiatives involving data sharing at the organizational level that could provide a starting point for developing the needed new data sources and metrics for physician inputs and outputs. However, additional efforts will be required to establish data collection approaches and measurements applicable to smaller and single specialty practices. Overcoming these measurement and data challenges will be key to supporting policy-relevant research on the changing economics of medical practice.

  16. Organizing for the Third Mission: Structural Conditions for Outreach and Relevance at Two Swedish HEIs

    ERIC Educational Resources Information Center

    Hellstrom, Tomas; Jacob, Merle; Wigren-Kristoferson, Caroline

    2013-01-01

    The authors investigate how Third Mission activities at universities, such as the outreach and technology transfer functions, are anchored in organizational structures and practices, and discuss the implications of this relationship for the success of the activities. They draw on case studies of two Swedish university colleges to illustrate the…

  17. Dissecting a Gendered Organization: Implications for Career Trajectories for Mid-Career Faculty Women in STEM

    ERIC Educational Resources Information Center

    Hart, Jeni

    2016-01-01

    This paper traces the workplace practices within which mid-career women faculty in science, technology, engineering, and mathematics (STEM) carry out their careers. Findings from this case study of 25 faculty at one research university revealed three institutional processes that constrained their careers: (a) access to and integration into career…

  18. The glass ceiling in nursing management.

    PubMed

    Crawford, D I

    1993-01-01

    Women managers in business and health care have experienced discrimination related to advancement in management. Nurse executives must understand the strategies to overcome the barriers, the "glass ceiling," as well as implications for future practice. Women executives need an organized blueprint and the tools to dismantle the glass ceiling and overcome the political and discriminatory barriers to success.

  19. Impact of biosolids and tillage on soil organic matter fractions: Implications of carbon saturation for conservation management in the Virginia Coastal Plain

    USDA-ARS?s Scientific Manuscript database

    Long-term soil conservation management decreases soil bulk density, increases water infiltration and water holding capacity. In the Virginia Coastal Plain, growers have been practicing rotational no-tillage and continuous no-tillage with and without biosolid application over 20 years to improve soi...

  20. How frontline staff manage paperwork in group homes for people with intellectual disability: Implications for practice.

    PubMed

    Quilliam, Claire; Bigby, Christine; Douglas, Jacinta

    2018-05-08

    Paperwork is a key tool that transforms organizational intentions into actions in group homes, although prescriptive procedures may limit how frontline staff use it in practice. The aim of this study was to explore how frontline staff use paperwork in group homes for people with intellectual disability and identify practice implications. Constructivist grounded theory methodology guided the research. Data collection included semi-structured interviews and participant observations. Coding, comparison and sorting methods were adopted to analyse how staff used paperwork. Staff followed organizational paperwork rules when they aligned with their resident-focused approach to work. When they perceived rules to misalign with this approach, they managed paperwork by adjusting the time and place of completion, managing content, creating alternative tools and refusing completion. Staff purposefully managed paperwork rather than simply following procedures. Disability service organizations could develop flexible paperwork procedures and include frontline perspectives in paperwork development. © 2018 John Wiley & Sons Ltd.

  1. Leading change: introducing an electronic medical record system to a paramedic service.

    PubMed

    Baird, Shawn; Boak, George

    2016-05-03

    Purpose Leaders in health-care organizations introducing electronic medical records (EMRs) face implementation challenges. The adoption of EMR by the emergency medical and ambulance setting is expected to provide wide-ranging benefits, but there is little research into the processes of adoption in this sector. The purpose of this study is to examine the introduction of EMR in a small emergency care organization and identify factors that aided adoption. Design/methodology/approach Semi-structured interviews with selected paramedics were followed up with a survey issued to all paramedics in the company. Findings The user interfaces with the EMR, and perceived ease of use, were important factors affecting adoption. Individual paramedics were found to have strong and varied preferences about how and when they integrated the EMR into their practice. As company leadership introduced flexibility of use, this enhanced both individual and collective ability to make sense of the change and removed barriers to acceptance. Research limitations/implications This is a case study of one small organization. However, there may be useful lessons for other emergency care organizations adopting EMR. Practical implications Leaders introducing EMR in similar situations may benefit from considering a sense-making perspective and responding promptly to feedback. Originality/value The study contributes to a wider understanding of issues faced by leaders who seek to implement EMRs in emergency medical services, a sector in which there has been to date very little research on this issue.

  2. Analysing hierarchy in the organization of biological and physical systems.

    PubMed

    Jagers op Akkerhuis, Gerard A J M

    2008-02-01

    A structured approach is discussed for analysing hierarchy in the organization of biological and physical systems. The need for a structured approach follows from the observation that many hierarchies in the literature apply conflicting hierarchy rules and include ill-defined systems. As an alternative, we suggest a framework that is based on the following analytical steps: determination of the succession stage of the universe, identification of a specific system as part of the universe, specification of external influences on a system's creation and analysis of a system's internal organization. At the end, the paper discusses practical implications of the proposed method for the analysis of system organization and hierarchy in biology, ecology and physics.

  3. Health workforce needs: projections complicated by practice and technology changes.

    PubMed

    Cunningham, Rob

    2013-10-22

    As population growth and the aging of the overall population increase demand for health care, policymakers and analysts posit whether sufficient health care providers will be able to meet that demand. Some argue there are too few providers already; others say our current supply-demand problems lie with efficiency. But suppose both are correct? Perhaps the real challenge is to understand how physician practices are changing in response to market forces such as payment changes, provider distributions, and technology innovations. This issue brief reviews what is known about evolving practice organizations, professional mixes, information technology support, and the implications of these and other factors for public workforce policies.

  4. Religious networking organizations and social justice: an ethnographic case study.

    PubMed

    Todd, Nathan R

    2012-09-01

    The current study provides an innovative examination of how and why religious networking organizations work for social justice in their local community. Similar to a coalition or community coordinating council, religious networking organizations are formal organizations comprised of individuals from multiple religious congregations who consistently meet to organize around a common goal. Based on over a year and a half of ethnographic participation in two separate religious networking organizations focused on community betterment and social justice, this study reports on the purpose and structure of these organizations, how each used networking to create social capital, and how religion was integrated into the organizations' social justice work. Findings contribute to the growing literature on social capital, empowering community settings, and the unique role of religious settings in promoting social justice. Implications for future research and practice also are discussed.

  5. The Information and Communication Technology User Role: Implications for the Work Role and Inter-Role Spillover

    PubMed Central

    Piszczek, Matthew M.; Pichler, Shaun; Turel, Ofir; Greenhaus, Jeffrey

    2016-01-01

    Management and organization research has traditionally focused on employees’ work role and the interface between their work and family roles. We suggest that persons assume a third role in modern society that is relevant to work and organizations, namely the Information and Communication Technology User (ICTU) role. Based on role theory and boundary theory, we develop propositions about the characteristics of this role, as well as how ICTU role characteristics are related to boundary spanning activity, inter-role spillover with the work role, and work role performance. To this end, we first conceptualize the ICTU role and its associations with work and family roles. We then apply identity theory and boundary management theory to advance our understanding of how the ICTU role is related to criteria that are important to individuals and to organizations, namely self-selection into certain types of work roles and positive and negative inter-role spillover. The implications of this role for theory, research, and practice in management and organizations are discussed. PMID:28082936

  6. Evaluation utilization research--developing a theory and putting it to use.

    PubMed

    Neuman, Ari; Shahor, Neria; Shina, Ilan; Sarid, Anat; Saar, Zehava

    2013-02-01

    This article presents the findings of a two-stage study that had two key objectives: to develop a theory about evaluation utilization in an educational organization and to apply this theory to promote evaluation utilization within the organization. The first stage involved a theoretical conceptualization using a participatory method of concept mapping. This process identified the modes of evaluation utilization within the organization, produced a representation of the relationship between them and led to a theory. The second stage examined the practical implications of this conceptualization in terms of how different stakeholders in the organization perceive the actual and preferable state of evaluation utilization within the organization (i.e. to what extent is evaluation utilized and to what extent should it be utilized). The participatory process of the study promoted the evaluation utilization by involving stakeholders, thus giving them a sense of ownership and improving communication between the evaluation unit and the stakeholders. In addition, understanding the evaluation needs of the stakeholders in the organization helped generate relevant and realizable evaluation processes. On a practical level, the results are currently shaping the evaluation plan and the place of evaluations within the organization. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Ethical dilemmas among nurses as they transition to hospital case management: implications for organizational ethics, part I.

    PubMed

    O'Donnell, Lolita T

    2007-01-01

    To describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute hospital setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice in case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the organizations that employ them and the healthcare needs of the patients that they advocate for. 3. Aside from the importance of linking patient care outcomes with accountability, nurse case managers may need to advocate for policy change and system reform.

  8. How do health care organizations take on best practices? A scoping literature review.

    PubMed

    Innis, Jennifer; Dryden-Palmer, Karen; Perreira, Tyrone; Berta, Whitney

    2015-12-01

    The aims of this scoping literature review are to examine and summarize the organizational-level factors, context, and processes that influence the use of evidence-based practice in healthcare organizations. A scoping literature review was done to answer the question: What is known from the existing empirical literature about factors, context, and processes that influence the uptake, implementation, and sustainability of evidence-based practice in healthcare organizations? This review used the Arksey and O'Malley framework to describe findings and to identify gaps in the existing research literature. Inclusion and exclusion criteria were developed to screen studies. Relevant studies published between January 1991 and March 2014 were identified using four electronic databases. Study abstracts were screened for eligibility by two reviewers. Following this screening process, full-text articles were reviewed to determine the eligibility of the studies by the primary author. Eligible studies were then analyzed by coding findings with descriptive labels to distinguish elements that appeared relevant to this literature review. Coding was used to form categories, and these categories led to the development of themes. Thirty studies met the eligibility criteria for this literature review. The themes identified were: the process organizations use to select evidence-based practices for adoption, use of a needs assessment, linkage to the organization's strategic direction, organizational culture, the organization's internal social networks, resources (including education and training, presence of information technology, financial resources, resources for patient care, and staff qualifications), leadership, the presence of champions, standardization of processes, role clarity of staff, and the presence of social capital. Several gaps were identified by this review. There is a lack of research on how evidence-based practices may be sustained by organizations. Most of the research done to date has been cross-sectional. Longitudinal research would give insight into the relationship between organizational characteristics and the uptake, implementation, and sustainability of evidence-based practice. In addition, although it is clear that financial resources are required to implement evidence-based practice, existing studies contain a lack of detail about the cost of adopting and using new practices. This scoping review contains a number of implications for healthcare administrators, managers, and providers to consider when adopting and implementing evidence-based practices in healthcare organizations.

  9. A multi-level examination of how the organizational context relates to readiness to implement prevention and evidence-based programming in community settings.

    PubMed

    Chilenski, Sarah M; Olson, Jonathan R; Schulte, Jill A; Perkins, Daniel F; Spoth, Richard

    2015-02-01

    Prior theoretical and empirical research suggests that multiple aspects of an organization's context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown. Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization's readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization's readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization's morale was also found to be a strong predictor of an organization's readiness. The findings of the current study are discussed in terms of implications for prevention and intervention.

  10. Considerations in pharmaceutical conversion: focus on antihistamines.

    PubMed

    Garbus, S B; Moulton, B W; Meltzer, E O; Reich, P R; Weinreb, L F; Friedman, J A; Orland, B I

    1997-04-01

    The practice of pharmaceutical conversion, which encompasses three types of drug interchange (generic, brand, and therapeutic substitution), is increasing in managed care settings. Pharmaceutical conversion has numerous implications for managed care organizations, their healthcare providers, and their customers. Although drug cost may be a driving consideration in pharmaceutical conversion, a number of other considerations are of equal or greater importance in the decision-making process may affect the overall cost of patient care. Among these considerations are clinical, psychosocial, and safety issues; patient adherence; patient satisfaction; and legal implications of pharmaceutical conversion. Patient-centered care must always remain central to decisions about pharmaceutical conversion. This article discusses the issues related to, and implications of, pharmaceutical conversion utilizing the antihistamines class of drugs as the case situation.

  11. Organizational Conspiracy Beliefs: Implications for Leadership Styles and Employee Outcomes.

    PubMed

    van Prooijen, Jan-Willem; de Vries, Reinout E

    2016-01-01

    Belief in conspiracy theories about societal events is widespread among citizens. The extent to which conspiracy beliefs about managers and supervisors matter in the micro-level setting of organizations has not yet been examined, however. We investigated if leadership styles predict conspiracy beliefs among employees in the context of organizations. Furthermore, we examined if such organizational conspiracy beliefs have implications for organizational commitment and turnover intentions. We conducted a survey among a random sample of the US working population ( N  = 193). Despotic, laissez-faire, and participative leadership styles predicted organizational conspiracy beliefs, and the relations of despotic and laissez-faire leadership with conspiracy beliefs were mediated by feelings of job insecurity. Furthermore, organizational conspiracy beliefs predicted, via decreased organizational commitment, increased turnover intentions. Organizational conspiracy beliefs matter for how employees perceive their leaders, how they feel about their organization, and whether or not they plan to quit their jobs. A practical implication, therefore, is that it would be a mistake for managers to dismiss organizational conspiracy beliefs as innocent rumors that are harmless to the organization. Three novel conclusions emerge from this study. First, organizational conspiracy beliefs occur frequently among employees. Second, participative leadership predicts decreased organizational conspiracy beliefs; despotic and laissez-faire leadership predict increased organizational conspiracy beliefs due to the contribution of these destructive leadership styles to an insecure work environment. Third, organizational conspiracy beliefs harm organizations by influencing employee commitment and, indirectly, turnover intentions.

  12. Critical Thinking about Critical Periods. A Series from the National Center for Early Development and Learning.

    ERIC Educational Resources Information Center

    Bailey, Donald B., Jr., Ed.; Bruer, John T., Ed.; Symons, Frank J., Ed.; Lichtman, Jeff W., Ed.

    The concept of critical or sensitive periods in child development provides an example around which to organize discussion of what is known and not known about brain development and the implications of brain science on early childhood policy and practice. This book reviews the early history of critical periods and evidence for their existence in…

  13. An Investigation of Strategies for Preparing Teenagers for Cross-Age and Peer Teaching Roles: Implications for Linking Research and Practice.

    ERIC Educational Resources Information Center

    Lee, Faye C. H.; Murdock, Shelley; Paterson, Carole

    In the San Francisco Bay Area (California), community agencies and organizations routinely use teenagers as mentors and teachers of peers and younger children. Despite the literature indicating that teens should derive many benefits from these roles, agency staff have observed teen teachers who appear frustrated, bored, or disengaged, or who have…

  14. Do Not Enter: What Are the Risks of Gatekeeping Child and Youth Care?

    ERIC Educational Resources Information Center

    Vachon, Wolfgang

    2013-01-01

    There are multiple organizations striving to professionalize child and youth care (CYC) across North America. Two voices that appear to have been excluded from this dialogue are the young people CYCs work with and those who come to work in the field outside of formal training. This article asks who defines CYC practice, what the implications are…

  15. Implications of Physical Literacy for Research and Practice: A Commentary

    ERIC Educational Resources Information Center

    Corbin, Charles B.

    2016-01-01

    Physical literacy is a term that has increasingly gained popularity in recent years. A variety of individuals and organizations have promoted the use of the term internationally, and a variety of claims have been made for the benefits of using the term. A historical overview allows the reader to consider physical literacy as one of many terms that…

  16. Future Organization of Oral Health Services Delivery: From 2012 to 2042.

    PubMed

    Brown, L Jackson

    2017-09-01

    The United States is currently experiencing a vortex of change in both general health and oral health care delivery, the ultimate outcome of which is still not well understood. The specific focus of this article is to examine the future organization of the oral health services delivery system (OHSDS) in the U.S., with special attention given to the role of large group dental practices (LGDPs) in that future. The article describes the various types of LGDPs and their ability to change the economic characteristics of the OHSDS. Large geographically distributed corporate group dental practices (LGDCGDPs) are the type that may expand their market share to the extent that they could change the economic characteristics of the OHSDS. A wide range of scenarios is used to project the expansion of LGDCGDPs into the future. The scenarios modeled are not intended as predictions but rather to present a range of possible OHSDS market structures that may emerge over the next 30 years. The implications of each scenario for the economic competition within the OHSDS are described. Possible implications of these trends for dental education are also discussed. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  17. Anthropology, organ transplantation and the immune system: resituating commodity and gift exchange.

    PubMed

    Kierans, Ciara

    2011-11-01

    This article reflects on contributions from medical anthropology to our understanding of the bio-social and bio-political implications of renal transplantation. Taking up the idea of transplantation as a 'complex', a vast assemblage of people, places, practices and procedures which intersect medical, social and cultural domains, I point to a reliance in the anthropological literature on overly pre-determined conceptual frameworks, organised around a distinct polarisation between organ giving and receiving, where one side (supply) takes analytical, and indeed moral, precedence over the other (receipt). These frameworks tend to fail us when it comes to thinking about the wider social, cultural and political implications of transplant technologies. In an attempt to offer a less polarised view, I draw attention to the material and symbolic role of the immune system in transplantation and the ways in which it simultaneously shapes opportunities for procurement and the lived realities of recipiency. This helps us see the many complex ways in which suffering and inequality are constituted all along the variegated chains of supply and demand that are internal to, and made possible by, transplantation practices themselves. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Contradictions and dilemmas within the practice of immigration medicine.

    PubMed

    Bisaillon, Laura

    2013-01-08

    To identify, explore and critique features of how practices associated with immigration medicine are socially organized. Specifically, how the work of designated medical practitioners (DMP) - physicians who conduct immigration medical examinations of prospective immigrants to Canada as contractors to the Canadian government department of Citizenship and Immigration Canada - is organized to occur in interactions with applicants who are diagnosed with the human immunodeficiency virus during the immigration medical examination. Findings from a theoretically informed empirical study using institutional and political activist ethnography inform this article. Data collection and analytic activities spanning 18 months included observational work in institutional settings, textual review, 61 interviews, and 2 focus groups in three Canadian cities. The medical examination of prospective immigrants to Canada is not organized as a therapeutic relation of care and has little to do with medicine per se. The rationale structuring the work of DMPs is actually administrative responsibilities. The work achieved by the DMP positions her/him as a key figure and important decision-maker within the Canadian immigration system. The work of doctors who practice immigration medicine gives rise to contradictions and ethical problems. These are largely unresolvable because of the way in which the labour process in which the DMP is implicated is coordinated. The social organization of immigration doctoring practices has serious consequences for prospective immigrants to Canada, for doctors themselves, and for the Canadian immigration system more broadly.

  19. Bring Your Own Device and Nurse Managers' Decision Making.

    PubMed

    Martinez, Karen; Borycki, Elizabeth; Courtney, Karen L

    2017-02-01

    The Bring Your Own Device phenomenon is important in the healthcare environment because this trend is changing the workplace in healthcare organizations, such as British Columbia. At present, there is little research that exists in Canada to provide a distinct understanding of the complexities and difficulties unique to this phenomenon within the nursing practice. This study focused on the experiences and perceptions of nurse managers regarding how they make decisions on the use of personal handheld devices in the workplace. Telephone interviews (N = 10) and qualitative descriptive analysis were used. Four major themes emerged: (1) management perspective, (2) opportunities, (3) disadvantages, and (4) solutions. Nurse managers and other executives in healthcare organizations and health information technology departments need to be aware of the practice and organizational implications of the Bring Your Own Device movement.

  20. Female science teacher beliefs and attitudes: implications in relation to gender and pedagogical practice

    NASA Astrophysics Data System (ADS)

    Zapata, Mara; Gallard, Alejandro J.

    2007-10-01

    Beliefs and attitudes resulting from the unique life experiences of teachers frame interactions with learners promoting gender equity or inequity and the reproduction of social views about knowledge and power as related to gender. This study examines the enactment of a female science teacher's pedagogy (Laura), seeking to understand the implications of her beliefs and attitudes, as framed by her interpretations and daily manifestations, as she interacts with students. Distinct influences inform the conceptual framework of this study: (a) the social organization of society at large, governed by understood and unspoken patriarchy, present both academically and socially; (b) the devaluing of women as "knowers" of scientific knowledge as defined by a western and male view of science; (c) the marginalization or "feminization" of education and pedagogical knowledge. The findings reflect tensions between attitudes and beliefs and actual teacher practice suggesting the need for awareness within existing or new teachers about their positions as social agents and the sociological implications related to issues of gender within which we live and work, inclusive of science teaching and learning.

  1. 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.

  2. Realizing good care within a context of cross-cultural diversity: an ethical guideline for healthcare organizations in Flanders, Belgium.

    PubMed

    Denier, Yvonne; Gastmans, Chris

    2013-09-01

    In our globalizing world, health care professionals and organizations increasingly experience cross-cultural challenges in care relationships, which give rise to ethical questions regarding "the right thing to do" in such situations. For the time being, the international literature lacks examples of elaborated ethical guidelines for cross-cultural healthcare on the organizational level. As such, the ethical responsibility of healthcare organizations in realizing cross-cultural care remains underexposed. This paper aims to fill this gap by offering a case-study that illustrates the bioethical practice on a large-scale organizational level by presenting the ethical guideline developed in the period 2007-2011 by the Ethics Committee of Zorgnet Vlaanderen, a Christian-inspired umbrella organization for over 500 social profit healthcare organizations in Flanders, Belgium. The guideline offers an ethical framework within which fundamental ethical values are being analyzed within the context of cross-cultural care. The case study concludes with implications for healthcare practice on four different levels: (1) the level of the healthcare organization, (2) staff, (3) care receivers, and (4) the level of care supply. The study combines content-based ethics with process-based benchmarks. Copyright © 2013. Published by Elsevier Ltd.

  3. Nursing intellectual capital theory: implications for research and practice.

    PubMed

    Covell, Christine L; Sidani, Souraya

    2013-05-31

    Due to rising costs of healthcare, determining how registered nurses and knowledge resources influence the quality of patient care is critical. Studies that have investigated the relationship between nursing knowledge and outcomes have been plagued with conceptual and methodological issues. This has resulted in limited empirical evidence of the impact of nursing knowledge on patient or organizational outcomes. The nursing intellectual capital theory was developed to assist with this area of inquiry. Nursing intellectual capital theory conceptualizes the sources of nursing knowledge available within an organization and delineates its relationship to patient and organizational outcomes. In this article, we review the nursing intellectual capital theory and discuss its implications for research and practice. We explain why the theory shows promise for guiding research on quality work environments and how it may assist with administrative decision-making related to nursing human resource management and continuing professional development.

  4. Lessons from America? US magnet hospitals and their implications for UK nursing.

    PubMed

    Buchan, J

    1994-02-01

    This paper examines possible implications of the US 'magnet hospital' concept for the UK nursing labour market. Magnet hospitals have been researched in the US and have been demonstrated to exhibit lower nurse turnover and higher levels of reported job satisfaction than other hospitals. Key characteristics include a decentralized organizational structure, a commitment to flexible working hours, an emphasis on professional autonomy and development, and systematic communication between management and staff. The paper examines the labour market characteristics of UK nurses and US nurses and finds many similarities. Detailed case studies of employment practice in 10 US hospitals and 10 Scottish hospitals are reported, with specific attention to remuneration practice, methods of organizing nursing care, establishment-setting and flexible hours. The paper concludes that there are features of the magnet hospital concept which are of relevance and applicable to the UK nursing labour market, but that piecemeal importation of ideas is unlikely to be beneficial.

  5. Antenatal Breastfeeding Education and Support: Summary and Analysis of 2 Cochrane Publications.

    PubMed

    Jacobsen, Noelle

    Key breastfeeding outcomes identified by the World Health Organization, the United Nations Children's Fund, the American Academy of Pediatrics, and Healthy People 2020 include early initiation, any such feeding at 6 months of age, and exclusivity. Broader themes in the current literature include infants who ever breastfed and overall duration. Healthcare providers need to know what current practices demonstrate effectiveness. A review of 2 Cochrane articles on which interventions impact these selected outcomes does not reveal any significant implications for clinical practice. Scant evidence exists to support any specific support efforts or educational outreach to improve these outcomes. A discussion of potential strategies to consider for future research and clinical practice is put forth.

  6. Social Worker Identity: A Profession in Context.

    PubMed

    Forenza, Brad; Eckert, Caitlin

    2018-01-01

    Social work is a broad field encompassing micro, mezzo, and macro areas of practice. Consequently, the field lacks a unifying professional identity due to the expansiveness of the profession. Professional identity is conceptualized as an extension of social identity, vis-à-vis the embodiment of three qualities: connectedness, expansiveness, and effectiveness. This study used 12 in-depth, individual interviews with practicing social workers to explore these qualities. Findings from interviews reveal six primary themes and 21 subthemes pertaining to social worker identity. Themes and subthemes are organized according to three broad families (social work in context, professional trajectories, and external influences). Implications for policy, practice, and future research are presented. © 2017 National Association of Social Workers.

  7. Occupational Factors, Fatigue, and Cardiovascular Disease

    PubMed Central

    2009-01-01

    Purpose: Briefly identify the epidemiological evidence, propose pertinent mechanisms, and discuss physical therapy practice as well as research implications of a causal association between occupational factors and cardiovascular disease. Summary of Key Points: There is evidence that occupational metabolic demands and work organizations characterized by reduced worker control are associated with increased risk of cardiovascular disease. It is biologically plausible that these two factors interact to create a preclinical, intermediate state of fatigue (burnout) that is a critical component in the causal path from occupational factors to CVD. Physical therapists are uniquely qualified to contribute to an understanding of these mechanisms and their resultant implications for work organization, rehabilitation, and health promotion. Statement of Recommendations: Physical therapists engaged in ergonomic job analysis should consider work related metabolic demands, worker control, and fatigue in their assessment of risk for injury and illness, in recommendations for return to work, and in the prescription of health promotion leisure time physical activity PMID:20467535

  8. Emerging Designs for Education: Program, Organization, Operation and Finance. Reports Prepared for an Area Conference (Albuquerque, New Mexico, March 21-22, 1968).

    ERIC Educational Resources Information Center

    Morphet, Edgar L., Ed.; Jesser, David L., Ed.

    The fifth in a series of reports related to long-range educational planning includes five papers presented at a conference in Albuquerque March 21-22, 1968. The first paper outlines the primary goals of an educational program and considers implications of the program for the curriculum, instructional practices, supporting services, evaluation,…

  9. Formal and Informal Neighborhood Social Organization: Which Promotes Better Resident Health?

    PubMed

    Gilster, Megan E; Meier, Cristian L

    2016-08-01

    Neighborhood social organization captures how neighborhood residents differently organize to exert social control and enact their vision of their community. Whereas structural aspects of neighborhoods have been found to predict the health of neighborhood residents, we know less about whether neighborhood social characteristics, like social organization, matter for resident health. In their study, authors tested whether two types of social organization-formal and informal-were more predictive of resident self-rated health in a diverse sample of Chicago residents. They used multilevel models with survey weights, ordered dependent variables, and multiple imputation. They found that one measure of formal social organization, organizational participation, was significantly associated with self-rated health even when controlling for other types of social organization and individual participation. The article concludes with a discussion of the implications for macro social work practice to address social determinants of health and improve community health. © 2016 National Association of Social Workers.

  10. Recovery as a model of care? Insights from an Australian case study.

    PubMed

    Hungerford, Catherine

    2014-03-01

    The terms "model of health care," "service model." and "nursing model of practice" are often used interchangeably in practice, policy, and research, despite differences in definitions. This article considers these terms in the context of consumer-centred recovery and its implementation into a publicly-funded health service organization in Australia. Findings of a case study analysis are used to inform the discussion, which considers the diverse models of health care employed by health professionals; together with the implications for organizations worldwide that are responsible for operationalizing recovery approaches to health care. As part of the discussion, it is suggested that the advent of recovery-oriented services, rather than recovery models of health care, presents challenges for the evaluation of the outcomes of these services. At the same time, this situation provides opportunities for mental health nurses to lead the way, by developing rigorous models of practice that support consumers who have acute, chronic, or severe mental illness on their recovery journey; and generate positive, measureable outcomes.

  11. Community mental health nurses' and compassion: an interpretative approach.

    PubMed

    Barron, K; Deery, R; Sloan, G

    2017-05-01

    WHAT IS KNOWN ON THE SUBJECT?: The concept of compassion is well documented in the healthcare literature but has received limited attention in mental health nursing. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Mental health nurses struggle with defining compassion. The study, with its limitations, brings greater clarity to the meaning of compassion for community mental health nurses and NHS organizations. Mental health nurses need time to reflect on their provision of compassionate care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study has shown that compassion is important for NHS healthcare management, frontline mental health nurses and policy-makers in UK, and there is potential for sharing practice and vision across NHS organisations. Mental health nurses could benefit from training to facilitate their understanding of compassionate practices. Emphasis should be placed on the importance of self-compassion and how this can be nurtured from the secure base of clinical supervision. Introduction There is increasing emphasis in policy, research and practice in the UK and internationally on the importance of caring in health care. Compassion needs to be at the core of all healthcare professionals' practice. Recently, health care has received negative attention through media and government reports which cite a lack of compassion in care. Rationale The concept of compassion has received limited attention in community mental health nursing. Aim Based on data taken from semi-structured interviews with community mental health nurses, this paper aims to describe interpretations and perspectives of compassion to gain insight and development of its meaning. Method A naturalistic, interpretive approach was taken to the study. Semi-structured interviews with nine mental health nurses were analysed using Burnard's 14-step model of thematic analysis. Findings The research illuminates the complexity of compassion and how its practice impacts on emotional responses and relationships with self, patients, colleagues and the employing organization. Participants identified difficulties engaging with compassionate practice whilst recognizing it as a driving force underpinning provision of care. Implications for practice Mental health nurses need to be supported to work towards a greater understanding of compassionate care for clinical practice and the need for self-compassion. © 2017 John Wiley & Sons Ltd.

  12. The updated concept of genome and its implications in biotechnological research and molecular diagnostics.

    PubMed

    Xiao, Li; Saldivar, Juan-Sebastian; Zhou, Cuilan; Chen, Chengli; Zhang, Jia; Sirois, Pierre; Li, Kai

    2009-02-01

    We propose a short definition of The full complement of genetic materials possessed by an intracellular parasite, a cell, or an organism. Accordingly, the human genome is the entire complement of inherited genetic materials possessed by an individual person, or possessed by a cell in an individual person. For higher species, the genomic makeup includes DNA in the nucleus and in the organelles regardless of the number of chromosomes and the homoplasmic or heteroplasmic status of the mitochondrial or chloroplastic DNA. Practically, GENOME can be referred to at the molecular, cellular, individual, and species levels, which has various implications in biotechnological research and molecular diagnostics.

  13. Show me the money: the implications of Schedule H.

    PubMed

    Salinsky, Eileen

    2009-04-21

    Responding to policymakers' concerns, the Internal Revenue Service (IRS) implemented significant new hospital community benefit reporting under Schedule H of its revised Form 990, the return used by tax-exempt organizations. This issue brief considers the policy implications of the quantitative and qualitative information that hospitals are now mandated to report through Schedule H, including the costs associated with charity care, bad debt, and the unreimbursed costs of Medicaid and Medicare. The paper examines unresolved issues related to the new reporting requirements, such as controversies regarding the scope of Schedule H, and considers the potential for these reports to influence IRS oversight activities, legislative action, and hospital policies and practices.

  14. Aligning for accountable care: Strategic practices for change in accountable care organizations.

    PubMed

    Hilligoss, Brian; Song, Paula H; McAlearney, Ann Scheck

    Alignment within accountable care organizations (ACOs) is crucial if these new entities are to achieve their lofty goals. However, the concept of alignment remains underexamined, and we know little about the work entailed in creating alignment. The aim of this study was to develop the concept of aligning by identifying and describing the strategic practices administrators use to align the structures, processes, and behaviors of their organizations and individual providers in pursuit of accountable care. We conducted 2-year qualitative case studies of four ACOs that have assumed full risk for the costs and quality of care for defined populations. Five strategic aligning practices were used by all four ACOs. Informing both aligns providers' understandings with the goals and value proposition of the ACO and aligns the providers' attention with the drivers of performance. Involving both aligns ACO leaders' understandings with the realities facing providers and aligns the policies of the ACO with the needs of providers. Enhancing both aligns the operations of individual provider practices with the operations of the ACO and aligns the trust of providers with the ACO. Motivating aligns what providers value with the goals of the ACO. Finally, evolving is a metapractice of learning and adapting that guides the execution of the other four practices. Our findings suggest that there are second-order cognitive (e.g., understandings and attention) and cultural (e.g., trust and values) levels of alignment, as well as a first-order operational level (organizational structures, processes, and incentives). A well-aligned organization may require ongoing repositioning at each of these levels, as well as attention to both cooperative and coordinative dimensions of alignment. Implications for research and practice are discussed.

  15. Understanding quality patient care and the role of the practicing nurse.

    PubMed

    Owens, Laura D; Koch, Robert W

    2015-03-01

    Nurses play a vital role in improving the safety and quality of patient care. The authors provide the front-line nurse providers with an overview of critical concepts related to quality management of patient care. A historical approach provides the reader with an overview of the trajectory or the quality in health care movement. Furthermore, the article provides the nurse with a basic understanding of national and international organizations that focus on quality patient care. A brief introduction of measures of quality care is presented as well as implications for nursing practice. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. The evolution of public relations and the use of the internet: the implications for health care organizations.

    PubMed

    Berkowitz, Eric N

    2007-01-01

    Over the past several years the discipline and practice of public relations has evolved. Historically, this field within health care organizations was a one-way management of communications and often was reactive in nature dealing with a crisis situation with an organization. Recent theoretical development within the discipline suggests that public relations involves more relationship building with key constituencies and on-going-dialogue. Concomitant with this evolution is the technological development of the internet. Most particularly is the use of podcasting and blogging as key tools which have been underutilized by health car providers but have significant potential in both communication and relationship opportunities as discussed in this article.

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

    PubMed

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

    2013-01-01

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

  18. Role of organic acids on the bioavailability of selenium in soil: A review.

    PubMed

    Dinh, Quang Toan; Li, Zhe; Tran, Thi Anh Thu; Wang, Dan; Liang, Dongli

    2017-10-01

    Organic Acids (OAs) are important components in the rhizosphere soil and influence Se bioavailability in soil. OAs have a bidirectional contrasting effect on Se bioavailability. Understanding the interaction of OAs with Se is essential to assessing Se bioavailability in soil and clarifying the role of OAs in controlling the behavior and fate of Se in soil. This review examines the mechanisms for the (im)mobilization of Se by OAs and discusses the practical implications of these mechanisms in relation to sequestration and bioavailability of Se in soil. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. General practices as emergent research organizations: a qualitative study into organizational development.

    PubMed

    Macfarlane, Fraser; Shaw, Sara; Greenhalgh, Trisha; Carter, Yvonne H

    2005-06-01

    An increasing proportion of research in primary care is locally undertaken in designated research practices. Capacity building to support high quality research at these grass roots is urgently needed and is a government priority. There is little previously published research on the process by which GP practices develop as research organizations or on their specific support needs at organizational level. Using in-depth qualitative interviews with 28 key informants in 11 research practices across the UK, we explored their historical accounts of the development of research activity. We analysed the data with reference to contemporary theories of organizational development. Participants identified a number of key events and processes, which allowed us to produce a five-phase model of practice development in relation to research activity (creative energy, concrete planning, transformation/differentiation, consolidation and collaboration). Movement between these phases was not linear or continuous, but showed emergent and adaptive properties in which specific triggers and set-backs were often critical. This developmental model challenges previous categorical taxonomies of research practices. It forms a theory-driven framework for providing appropriate support at the grass roots of primary care research, based on the practice's phase of development and the nature of external triggers and potential setbacks. Our findings have important implications for the strategic development of practice-based research in the UK, and could serve as a model for the wider international community.

  20. Organic Food in the Diet: Exposure and Health Implications.

    PubMed

    Brantsæter, Anne Lise; Ydersbond, Trond A; Hoppin, Jane A; Haugen, Margaretha; Meltzer, Helle Margrete

    2017-03-20

    The market for organic food products is growing rapidly worldwide. Such foods meet certified organic standards for production, handling, processing, and marketing. Most notably, the use of synthetic fertilizers, pesticides, and genetic modification is not allowed. One major reason for the increased demand is the perception that organic food is more environmentally friendly and healthier than conventionally produced food. This review provides an update on market data and consumer preferences for organic food and summarizes the scientific evidence for compositional differences and health benefits of organic compared with conventionally produced food. Studies indicate some differences in favor of organic food, including indications of beneficial health effects. Organic foods convey lower pesticide residue exposure than do conventionally produced foods, but the impact of this on human health is not clear. Comparisons are complicated by organic food consumption being strongly correlated with several indicators of a healthy lifestyle and by conventional agriculture "best practices" often being quite close to those of organic.

  1. Organ donation on Web 2.0: content and audience analysis of organ donation videos on YouTube.

    PubMed

    Tian, Yan

    2010-04-01

    This study examines the content of and audience response to organ donation videos on YouTube, a Web 2.0 platform, with framing theory. Positive frames were identified in both video content and audience comments. Analysis revealed a reciprocity relationship between media frames and audience frames. Videos covered content categories such as kidney, liver, organ donation registration process, and youth. Videos were favorably rated. No significant differences were found between videos produced by organizations and individuals in the United States and those produced in other countries. The findings provide insight into how new communication technologies are shaping health communication in ways that differ from traditional media. The implications of Web 2.0, characterized by user-generated content and interactivity, for health communication and health campaign practice are discussed.

  2. Coordination of care by primary care practices: strategies, lessons and implications.

    PubMed

    O'Malley, Ann S; Tynan, Ann; Cohen, Genna R; Kemper, Nicole; Davis, Matthew M

    2009-04-01

    Despite calls from numerous organizations and payers to improve coordination of care, there are few published accounts of how care is coordinated in real-world primary care practices. This study by the Center for Studying Health System Change (HSC) documents strategies that a range of physician practices use to coordinate care for their patients. While there was no single recipe for coordination given the variety of patient, physician, practice and market factors, some cross-cutting lessons were identified, such as the value of a commitment to interpersonal continuity of care as a foundation for coordination. Respondents also identified the importance of system support for the standardization of office processes to foster care coordination. While larger practices may have more resources to invest, many of the innovations described could be scaled to smaller practices. Some coordination strategies resulted in improved efficiency over time for practices, but by and large, physician practices currently pursue these efforts at their own expense. In addition to sharing information on effective strategies among practices, the findings also provide policy makers with a snapshot of the current care coordination landscape and implications for initiatives to improve coordination. Efforts to provide technical support to practices to improve coordination, for example, through medical-home initiatives, need to consider the baseline more typical practices may be starting from and tailor their support to practices ranging widely in size, resources and presence of standardized care processes. If aligned with payment incentives, some of these strategies have the potential to increase quality and satisfaction among patients and providers by helping to move the health care delivery system toward better coordinated care.

  3. Predicting Intentions to Breastfeed for Three Months, Six Months, and One Year Using the Theory of Planned Behavior and Body Satisfaction.

    PubMed

    Johnson-Young, Elizabeth A

    2018-02-27

    Breastfeeding is one of the top maternal priorities for many organizations, including the World Health Organization (WHO), The American Academy of Pediatrics (AAP), and the Center for Disease Control (CDC). Focusing on the goals of Healthy People 2020, as well as the recommendations of other organizations, this paper investigates the impacts on women's intentions to breastfeed newborns for 3 months, 6 months, and 1 year. This research used the theory of planned behavior (TPB) as a model to predict intentions for each duration of time. Body satisfaction was included as a moderating variable given research demonstrating a possible connection of body satisfaction to breastfeeding. A survey of 156 pregnant women was conducted. Results demonstrated the importance of the three TPB measures in predicting intentions. Further, significant interactions between body satisfaction and attitudes, as well as body satisfaction and subjective norms were present in predicting intentions to exclusively breastfeed one's baby from infant to 6 months of age. Theoretical implications are discussed, as well as practical implications for breastfeeding interventions and campaigns.

  4. Formal and Informal Neighborhood Social Organization: Which Promotes Better Resident Health?

    PubMed Central

    Gilster, Megan E.; Meier, Cristian L.

    2016-01-01

    Neighborhood social organization captures how neighborhood residents differently organize to exert social control and enact their vision of their community. Whereas structural aspects of neighborhoods have been found to predict the health of neighborhood residents, we know less about whether neighborhood social characteristics, like social organization, matter for resident health. In their study, authors tested whether two types of social organization—formal and informal—were more predictive of resident self-rated health in a diverse sample of Chicago residents. They used multilevel models with survey weights, ordered dependent variables, and multiple imputation. They found that one measure of formal social organization, organizational participation, was significantly associated with self-rated health even when controlling for other types of social organization and individual participation. The article concludes with a discussion of the implications for macro social work practice to address social determinants of health and improve community health. PMID:29206950

  5. [Trust in organizations concerned with risks of the Great East Japan Earthquake].

    PubMed

    Nakayachi, Kazuya; Kudo, Daisuke; Ozaki, Taku

    2014-06-01

    This study investigated the levels of public trust in organizations associated with the Great East Japan Earthquake. In Study 1 (N = 639), the levels of trust in eight organizations as well as the determinants of trust--perceived salient value similarity (SVS), ability, and motivation--were measured twice, first immediately after the earthquake and then a year later. The results indicated that the trust levels for six of the eight organizations had been preserved, supporting the double asymmetric effect of trust. The results of structural equation modeling (SEM) revealed that SVS explained trust more when the organization had been less trusted. Trust in the organization explains well the perceived reduction of the target risk. The results of SEM in Study 2 (N = 1,030) replicated those of Study 1, suggesting the stability of the explanatory power of the determinants of trust. Implications of the study for risk management practices are discussed.

  6. Longitudinal Study Transformed Onboarding Nurse Graduates.

    PubMed

    Slate, Kimberly A; Stavarski, Debra H; Romig, Barbara J; Thacker, Karen S

    The outcomes of a longitudinal research study on a nurse residency program indicated improvement in the onboarding experience for new graduate nurses. Practice changes and implications for nursing professional development practitioners resulting from the study include the number and orientation of preceptors, program length standardization, and improvement of emergency clinical response education. Additional research studies were implemented to further explore issues novice nurses and their proficient registered nurse colleagues experience throughout the organization.

  7. Personality and Psychological Well-Being of Canadian Forces Officer Candidates: The Role of Coping

    DTIC Science & Technology

    2011-04-01

    psychological well-being has important practical implications for military organizations, including reduced costs of selection, reduced attrition, and...seeking behaviour and the effectiveness of using it. In addition, as a part of the BOTC, trainees provide peer-review assessments of leadership ...qualities. OCdts may be less likely to seek social support or otherwise display “weakness” while being evaluated for their leadership qualities. It seems

  8. Nursing Shortage: Strategies for Nursing Practice and Education. Report of the National Invitational Workshop (Washington, D.C., February 22-24, 1988).

    ERIC Educational Resources Information Center

    Circle, Inc., McLean, VA.

    This document reports the proceedings of a conference held in response to concerns about the nursing shortage and its implications for health care in the United States. Following a keynote address ("Nursing and Shortage: Part of the Problem or Part of the Solution?") by Dona Diers, the document is organized in five sections, with each section…

  9. What part of the total care consumed by type 2 diabetes patients is directly related to diabetes? Implications for disease management programs.

    PubMed

    van Dijk, Christel E; Verheij, Robert A; Swinkels, Ilse C S; Rijken, Mieke; Schellevis, François G; Groenewegen, Peter P; de Bakker, Dinny H

    2011-10-01

    Disease management programs (DMP) aim at improving coordination and quality of care and reducing healthcare costs for specific chronic diseases. This paper investigates to what extent total healthcare utilization of type 2 diabetes patients is actually related to diabetes and its implications for diabetes management programs. Healthcare utilization for diabetes patients was analyzed using 2008 self-reported data (n=316) and data from electronic medical records (EMR) (n=9023), and divided whether or not care was described in the Dutch type 2 diabetes multidisciplinary healthcare standard. On average 4.3 different disciplines of healthcare providers were involved in the care for diabetes patients. Ninety-six percent contacted a GP-practice and 63% an ophthalmologist, 24% an internist, 32% a physiotherapist and 23% a dietician. Diabetes patients had on average 9.3 contacts with GP-practice of which 53% were included in the healthcare standard. Only a limited part of total healthcare utilization of diabetes patients was included in the healthcare standard and therefore theoretically included in DMPs. Organizing the care for diabetics in a DMP might harm the coordination and quality of all healthcare for diabetics. DMPs should be integrated in the overall organization of care.

  10. Non-hemodynamic effects of organic nitrates and the distinctive characteristics of pentaerithrityl tetranitrate.

    PubMed

    Gori, Tommaso; Daiber, Andreas

    2009-01-01

    Organic nitrates are among the oldest and yet most commonly employed drugs in the long-term therapy of coronary artery disease and congestive heart failure. While they have long been used in clinical practice, our understanding of their mechanism of action and side effects remains incomplete. For instance, recent findings provide evidence of previously unanticipated, non-hemodynamic properties that include potentially beneficial mechanisms (such as the induction of a protective phenotype that mimics ischemic preconditioning), but also toxic effects (such as endothelial and autonomic dysfunction, rebound angina, tolerance). To date, the most commonly employed organic nitrates are isosorbide mononitrate, isosorbide dinitrate, and nitroglycerin (glyceryl trinitrate). Another organic nitrate, pentaerithrityl tetranitrate (PETN), has long been employed in eastern European countries and is currently being reintroduced in Western countries. In light of their wide use, and of the (re)introduction of PETN in Western markets, the present review focuses on the novel effects of organic nitrates, describing their potential clinical implications and discussing differences among different compounds. We believe that these recent findings have important clinical implications. Since the side effects of organic nitrates such as nitroglycerin and isosorbides appear to be mediated by reactive oxygen species, care should be taken that drugs with antioxidant properties are co-administered. On the other hand, efforts should be made to clinically exploit the preconditioning effects of these drugs.

  11. Ergonomics and education as a strategy for sustainable development in business.

    PubMed

    Silveira, Dierci Marcio; Brandão, Erico Lourenço

    2012-01-01

    It is part of the vocabulary of organizations, and the agendas discussed the subject of "Sustainability", but there are few companies that implement practices or even know the means of implementing sustainable practices. The objective of this paper is to discuss an approach to education for sustainable development (ESD) based on the concepts and practice of ergonomics, as a consequence of this approach allows the implementation of integration initiatives focused on sustainability, such as eg. energy efficiency and consumer awareness thus allowing a means of reducing costs and operating expenses, increased competitiveness and significant contributions to corporate sustainability. There is also the inclusion of sustainability in corporate strategic planning, and their implications in the different spheres of the market.

  12. Utilizing a 'systems' approach to improve the management of waste from healthcare facilities: best practice case studies from England and Wales.

    PubMed

    Tudor, Terry L; Woolridge, Anne C; Bates, Margaret P; Phillips, Paul S; Butler, Sharon; Jones, Keith

    2008-06-01

    Changes in environmental legislation and standards governing healthcare waste, such as the Hazardous Waste Regulations are expected to have a significant impact on healthcare waste quantities and costs in England and Wales. This paper presents findings from two award winning case study organizations, the Cardiff and Vale NHS Trust and the Cornwall NHS Trust on 'systems' they have employed for minimizing waste. The results suggest the need for the development and implementation of a holistic range of systems in order to develop best practice, including waste minimization strategies, key performance indicators, and staff training and awareness. The implications for the sharing of best practice from the two case studies are also discussed.

  13. Ethical dilemmas among nurses as they transition to hospital case management: implications for organizational ethics, part II.

    PubMed

    O'Donnell, Lolita T

    2007-01-01

    The purpose of this study was to describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute care setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice of case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the organizations that employ them and the healthcare needs of the patients that they advocate for. 3. Aside from the importance of linking patient care outcomes with accountability, nurse case managers may need to advocate for policy change and system reform.

  14. A grey DEMATEL-based approach for modeling enablers of green innovation in manufacturing organizations.

    PubMed

    Gupta, Himanshu; Barua, Mukesh Kumar

    2018-04-01

    Incorporating green practices into the manufacturing process has gained momentum over the past few years and is a matter of great concern for both manufacturers as well as researchers. Regulatory pressures in developed countries have forced the organizations to adopt green practices; however, this issue still lacks attention in developing economies like India. There is an urgent need to identify enablers of green innovation for manufacturing organizations and also to identify prominent enablers among those. This study is an attempt to first identify enablers of green innovation and then establish a causal relationship among them to identify the enablers that can drive others. Grey DEMATEL (Decision Making Trial and Evaluation Laboratory) methodology is used for establishing the causal relationship among enablers. The novelty of this study lies in the fact that no study has been done in the past to identify the enablers of green innovation and then establishing the causal relationship among them. A total of 21 enablers of green innovation have been identified; research indicates developing green manufacturing capabilities, resources for green innovation, ease of getting loans from financial institutions, and environmental regulations as the most influential enablers of green innovation. Managerial and practical implications of the research are also presented to assist managers of the case company in adopting green innovation practices at their end.

  15. The value of microgrants for community-based health promotion: two models for practice and policy.

    PubMed

    Hartwig, Kari A; Bobbitt-Cooke, Mary; Zaharek, Margot M; Nappi, Susan; Wykoff, Randolph F; Katz, David L

    2006-01-01

    In 2001, the Office of Disease Prevention and Health Promotion in the US Department of Health and Human Services announced its intention to (1) identify innovative ways to increase public awareness and focus on Healthy People 2010 objectives and (2) broaden the participation of community-based organizations, including agencies new to public health. The mechanism selected, microfinancing, was modeled after small venture loans for economic stimulus in developing countries. The Office of Disease Prevention and Health Promotion selected one state health department and one academic research organization from 80 applicants to test models of awarding "microgrants" of 2,010 dollars to community agencies. This article describes the two models, the types of agencies that were funded, the primary Healthy People 2010 objectives targeted, examples of how the monies were used and leveraged by grantees, and the implications of microgrants for public health practice and policy.

  16. Prioritizing lean management practices in public and private hospitals.

    PubMed

    Hussain, Matloub; Malik, Mohsin

    2016-05-16

    Purpose - The purpose of this paper is to prioritize 21 healthcare wastes in public and private hospitals of United Arab Emirates (UAE). Design/methodology/approach - Seven healthcare wastes linked with lean management are further decomposed in to sub-criteria and to deal with this complexity of multi criteria decision-making process, analytical hierarchical process (AHP) method is used in this research. Findings - AHP framework for this study resulted in a ranking of 21 healthcare wastes in public and private hospitals of UAE. It has been found that management in private healthcare systems of UAE is putting more emphasis on the inventory waste. On the other hand, over processing waste has got highest weight in public hospitals of UAE. Research limitations/implications - The future directions of this research would be to apply a lean set of tools for the value stream optimization of the prioritized key improvement areas. Practical implications - This is a contribution to the continuing research into lean management, giving practitioners and designers a practical way for measuring and implementing lean practices across health organizations. Originality/value - The contribution of this research, through successive stages of data collection, measurement analysis and refinement, is a set of reliable and valid framework that can be subsequently used in conceptualization, prioritization of the waste reduction strategies in healthcare management.

  17. Implications of complex adaptive systems theory for the design of research on health care organizations.

    PubMed

    McDaniel, Reuben R; Lanham, Holly Jordan; Anderson, Ruth A

    2009-01-01

    Because health care organizations (HCOs) are complex adaptive systems (CASs), phenomena of interest often are dynamic and unfold in unpredictable ways, and unfolding events are often unique. Researchers of HCOs may recognize that the subject of their research is dynamic; however, their research designs may not take this into account. Researchers may also know that unfolding events are often unique, but their design may not have the capacity to obtain information from meager evidence. These two concerns led us to examine two ideas from organizational theory: (a) the ideas of K. E. Weick (1993) on organizational design as a verb and (b) the ideas of J. G. March, L. S. Sproull, and M. Tamuz (1991) on learning from samples of one or fewer. In this article, we applied these ideas to develop an enriched perspective of research design for studying CASs. We conducted a theoretical analysis of organizations as CASs, identifying relevant characteristics for research designs. We then explored two ideas from organizational theory and discussed the implications for research designs. Weick's idea of "design as a verb" helps in understanding dynamic and process-oriented research design. The idea of "learning from samples of one or fewer" of March, Sproull, and Tamuz provides strategies for research design that enables learning from meager evidence. When studying HCOs, research designs are likely to be more effective when they (a) anticipate change, (b) include tension, (c) capitalize on serendipity, and (d) use an "act-then-look" mind set. Implications for practice are discussed. Practitioners who understand HCOs as CASs will be cautious in accepting findings from studies that treat HCOs mechanistically. They will consider the characteristics of CAS when evaluating the evidence base for practice. Practitioners can use the strategies proposed in this article to stimulate discussion with researchers seeking to conduct research in their HCO.

  18. THE INTERNATIONAL IMPLICATIONS OF QUALITY-OF-LIFE POLICING AS PRACTICED IN NEW YORK CITY

    PubMed Central

    Johnson, Bruce D.; Golub, Andrew; McCabe, James

    2008-01-01

    The New York City Police Department (NYPD) has made enforcement of laws against disorder and quality-of-life offenses a central part of their policing strategy. Concomitantly, New York City (NYC) experienced a renaissance in orderliness, cleanliness, tourism, real estate value, and crime reduction, although other problems such as poverty, unemployment, drug abuse, racial tensions and homelessness persist. This paper examines quality-of-life policing practices in NYC, describes the philosophical underpinnings, explores the critical response to the program and presents lessons of potential relevance to other policing organizations in the U.S. and around the world. PMID:20368765

  19. 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.

  20. Organizational climate in primary care settings: implications for nurse practitioner practice.

    PubMed

    Poghosyan, Lusine; Nannini, Angela; Clarke, Sean

    2013-03-01

    The purpose of this review is to investigate literature related to organizational climate, define organizational climate, and identify its domains for nurse practitioner (NP) practice in primary care settings. A search was conducted using MEDLINE, PubMed, HealthSTAR/Ovid, ISI Web of Science, and several other health policy and nursingy databases. In primary care settings, organizational climate for NPs is a set of organizational attributes, which are perceived by NPs about their practice setting, emerge from the way the organization interacts with NPs, and affect NP behaviors and outcomes. Autonomy, NP-physician relations, and professional visibility were identified as organizational climate domains. NPs should be encouraged to assess organizational climate in their workplace and choose organizations that promote autonomy, collegiality between NPs and physicians, and encourage professional visibility. Organizational and NP awareness of qualities that foster NP practice will be a first step for developing strategies to creating an optimal organizational climate for NPs to deliver high-quality care. More research is needed to develop a comprehensive conceptual framework for organizational climate and develop new instruments to accurately measure organizational climate and link it to NP and patient outcomes. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  1. Implications of global climate change for the assessment and management of human health risks of chemicals in the natural environment.

    PubMed

    Balbus, John M; Boxall, Alistair B A; Fenske, Richard A; McKone, Thomas E; Zeise, Lauren

    2013-01-01

    Global climate change (GCC) is likely to alter the degree of human exposure to pollutants and the response of human populations to these exposures, meaning that risks of pollutants could change in the future. The present study, therefore, explores how GCC might affect the different steps in the pathway from a chemical source in the environment through to impacts on human health and evaluates the implications for existing risk-assessment and management practices. In certain parts of the world, GCC is predicted to increase the level of exposure of many environmental pollutants due to direct and indirect effects on the use patterns and transport and fate of chemicals. Changes in human behavior will also affect how humans come into contact with contaminated air, water, and food. Dietary changes, psychosocial stress, and coexposure to stressors such as high temperatures are likely to increase the vulnerability of humans to chemicals. These changes are likely to have significant implications for current practices for chemical assessment. Assumptions used in current exposure-assessment models may no longer apply, and existing monitoring methods may not be robust enough to detect adverse episodic changes in exposures. Organizations responsible for the assessment and management of health risks of chemicals therefore need to be more proactive and consider the implications of GCC for their procedures and processes. Copyright © 2012 SETAC.

  2. The ethical implications and religious significance of organ transplantation payment systems.

    PubMed

    Smith, Hunter Jackson

    2016-03-01

    One of the more polarizing policies proposed to alleviate the organ shortage is financial payment of donors in return for organs. A priori and empirical investigation concludes that such systems are ethically inadequate. A new methodological approach towards policy formation and implementation is proposed which places ethical concerns at its core. From a hypothetical secular origin, the optimal ethical policy structure concerning organ donation is derived. However, when applied universally, it does not yield ideal results for every culture and society due to region-specific variation. Since religion holds significant influence in the organ donation debate, three religions-Catholicism, Islam, and Shinto-were examined in order to illustrate this variation. Although secular ethical concerns should rest at the core of policy construction, certain region-specific contexts require cultural and religious competence and necessitate the adjustment of the optimal template policy accordingly to yield the best moral and practical results.

  3. Service quality and maturity of health care organizations through the lens of Complexity Leadership Theory.

    PubMed

    Horvat, Ana; Filipovic, Jovan

    2018-02-01

    This research focuses on Complexity Leadership Theory and the relationship between leadership-examined through the lens of Complexity Leadership Theory-and organizational maturity as an indicator of the performance of health organizations. The research adopts a perspective that conceptualizes organizations as complex adaptive systems and draws upon a survey of opinion of 189 managers working in Serbian health organizations. As the results indicate a dependency between functions of leadership and levels of the maturity of health organizations, we propose a model that connects the two. The study broadens our understanding of the implications of complexity thinking and its reflection on leadership functions and overall organizational performance. The correlations between leadership functions and maturity could have practical applications in policy processing, thus improving the quality of outcomes and the overall level of service quality. © 2017 John Wiley & Sons, Ltd.

  4. Ethical issues in patient safety: Implications for nursing management.

    PubMed

    Kangasniemi, Mari; Vaismoradi, Mojtaba; Jasper, Melanie; Turunen, Hannele

    2013-12-01

    The purpose of this article is to discuss the ethical issues impacting the phenomenon of patient safety and to present implications for nursing management. Previous knowledge of this perspective is fragmented. In this discussion, the main drivers are identified and formulated in 'the ethical imperative' of patient safety. Underlying values and principles are considered, with the aim of increasing their visibility for nurse managers' decision-making. The contradictory nature of individual and utilitarian safety is identified as a challenge in nurse management practice, together with the context of shared responsibility and identification of future challenges. As a conclusion, nurse managers play a strategic role in patient safety. Their role is to incorporate ethical values of patient safety into decision-making at all levels in an organization, and also to encourage clinical nurses to consider values in the provision of care to patients. Patient safety that is sensitive to ethics provides sustainable practice where the humanity and dignity of all stakeholders are respected.

  5. The neurophysiology of pain perception and hypnotic analgesia: implications for clinical practice.

    PubMed

    Jensen, Mark P

    2008-10-01

    Although there remains much to be learned, a great deal is now known about the neurophysiological processes involved in the experience of pain. Research confirms that there is no single focal "center" in the brain responsible for the experience of pain. Rather, pain is the end product of a number of integrated networks that involve activity at multiple cortical and subcortical sites. Our current knowledge about the neurophysiological mechanisms of pain has important implications for understanding the mechanisms underlying the effects of hypnotic analgesia treatments, as well as for improving clinical practice. This article is written for the clinician who uses hypnotic interventions for pain management. It begins with an overview of what is known about the neurophysiological basis of pain and hypnotic analgesia, and then discusses how clinicians can use this knowledge for (1) organizing the types of suggestions that can be used when providing hypnotic treatment, and (2) maximizing the efficacy of hypnotic interventions in clients presenting with pain problems.

  6. Bridging the Gap Between Micro and Macro Practice to Address Homelessness in the U.S.-Mexico Border Region: Implications for Practitioners and Community Stakeholders

    PubMed Central

    Moya, Eva M.; Chavez-Baray, Silvia Maria; Martinez, Omar; Mattera, Brian; Adcox, Courtney

    2018-01-01

    Research and scholarship efforts continue to promote the integration of micro and macro practice in social work practice and education. Despite this, scholarship has documented persistent challenges in the fluid integration between the domains of micro-level service provision and macro-level social change efforts in practice and academic programs. This paper outlines a successful bridge between the micro-macro divide in the form of community-engaged practice to address homelessness and social work education in the U.S.-Mexico border region. MSW students enrolled in a macro-level course at the University of Texas at El Paso’s College of Health Sciences successfully partnered with the Opportunity Center for the Homeless, a grassroots community-based organization serving individuals experiencing homelessness. The narrative describes how students were effectively able to apply both micro- and macro-level skills learned in the classroom to an experiential learning environment while providing much-needed assistance to an underfunded community-based organization. A set of challenges and recommendations are also discussed. Research initiatives are needed to evaluate and test clinical and community work initiatives, including the use of photovoice methodology to address homelessness, while being responsive to community needs and challenges. PMID:29809204

  7. Bridging the Gap Between Micro and Macro Practice to Address Homelessness in the U.S.-Mexico Border Region: Implications for Practitioners and Community Stakeholders.

    PubMed

    Moya, Eva M; Chavez-Baray, Silvia Maria; Martinez, Omar; Mattera, Brian; Adcox, Courtney

    2018-01-01

    Research and scholarship efforts continue to promote the integration of micro and macro practice in social work practice and education. Despite this, scholarship has documented persistent challenges in the fluid integration between the domains of micro-level service provision and macro-level social change efforts in practice and academic programs. This paper outlines a successful bridge between the micro-macro divide in the form of community-engaged practice to address homelessness and social work education in the U.S.-Mexico border region. MSW students enrolled in a macro-level course at the University of Texas at El Paso's College of Health Sciences successfully partnered with the Opportunity Center for the Homeless, a grassroots community-based organization serving individuals experiencing homelessness. The narrative describes how students were effectively able to apply both micro- and macro-level skills learned in the classroom to an experiential learning environment while providing much-needed assistance to an underfunded community-based organization. A set of challenges and recommendations are also discussed. Research initiatives are needed to evaluate and test clinical and community work initiatives, including the use of photovoice methodology to address homelessness, while being responsive to community needs and challenges.

  8. Chemical coagulation-based processes for trace organic contaminant removal: current state and future potential.

    PubMed

    Alexander, Jonathan T; Hai, Faisal I; Al-Aboud, Turki M

    2012-11-30

    Trace organic contaminants have become an increasing cause of concern for governments and water authorities as they attempt to respond to the potential challenges posed by climate change by implementing sustainable water cycle management practices. The augmentation of potable water supplies through indirect potable water reuse is one such method currently being employed. Given the uncertainty surrounding the potential human health impacts of prolonged ingestion of trace organic contaminants, it is vital that effective and sustainable treatment methods are utilized. The purpose of this article is to provide a comprehensive literature review of the performance of the chemical coagulation process in removing trace organic contaminants from water. This study evaluated the removal data collated from recent research relating to various trace organic contaminants during the coagulation process. It was observed that there is limited research data relating to the removal of trace organic contaminants using coagulation. The findings of this study suggest that there is a gap in the current research investigating the potential of new types of coagulants and exploring coagulation-based hybrid processes to remove trace organic contaminants from water. The data analysed in this study regarding removal efficiency suggests that, even for the significantly hydrophobic compounds, hydrophobicity is not the sole factor governing removal of trace organic contaminants by coagulation. This has important implications in that the usual practice of screening coagulants based on turbidity (suspended solid) removal proves inadequate in the case of trace organic contaminant removal. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. New federal guidelines for physician-pharmaceutical industry relations: the politics of policy formation.

    PubMed

    Chimonas, Susan; Rothman, David J

    2005-01-01

    In October 2002 the federal government issued a draft "Compliance Program Guidance for Pharmaceutical Manufacturers." The draft Guidance questioned the legality of many arrangements heretofore left to the discretion of physicians and drug companies, including industry-funded educational and research grants, consultantcies, and gifts. Medical organizations and drug manufacturers proposed major revisions to the draft, arguing that current practices were in everyone's best interest. To evaluate the impact of their responses, we compare the draft, the changes requested by industry and organized medicine, and the final Guidance document (issued in April 2003). We also explore the implications--some intended, others unanticipated--of the final document.

  10. Building without a plan: the career experiences of Australian strength and conditioning coaches.

    PubMed

    Dawson, Andrew J; Leonard, Zane M; Wehner, Kylie A; Gastin, Paul B

    2013-05-01

    The purpose of this investigation was to explore the career experiences of Australian strength and conditioning coaches. Six Australian strength and conditioning coaches (mean age = 33.7 years, SD = 6.0 years) with a mean of 10.4 (SD = 4.9) years experience working with elite Olympic and professional athletes were interviewed about their experiences of career development. Each interview was transcribed verbatim and analyzed to produce key themes and subthemes relating to (a) work environments, (b) sport management practice, (c) career development processes, and (d) career building strategies. The work environments of Australian strength and conditioning coaches were found to be poor because of long working hours and irregular human resource policy and management practices of sport organizations. Because of the volatile and unpredictable nature of their working conditions, the coaches interviewed have only a short-term view of their career creating considerable stress in their lives. The coaches interviewed found it difficult to develop their careers because their only options were self-supported and self-funded professional development activities. The coaches in this study believed that more needed to be done at a policy and management level by sport organizations and their professional body to enhance the career development of strength and conditioning coaches because they play a key role in both athlete and sport organization performance. These results may help sport organizations develop policies and management practices that enhance the careers of strength and conditioning coaches and will have important practical implications for the education and development of sport professionals.

  11. Implementing quality initiatives in healthcare organizations: drivers and challenges.

    PubMed

    Abdallah, Abdallah

    2014-01-01

    Various quality initiatives seem to have successful implementation in some healthcare organizations yet fail in others. This paper sets out to study the literature trying to understand drivers and challenges facing quality initiatives implementation in healthcare organizations then compare findings from literature with those of a structured questionnaire answered by 60 representatives from 18 hospitals. Finally it proposes a framework that mitigates challenges and utilizes drivers to ensure best implementation results. Literature regarding implementing various quality initiatives in the healthcare sector was reviewed. Representatives from several healthcare organizations were surveyed. Results from both approaches are compared to highlight the key challenges and drivers facing implementers. This research reveals that internal factors related to leadership and employees greatly affect quality initiative success or failure. Design and relevance play a major role in successful implementation. PRACTICAL IMPLICATIONs: This research offers healthcare professionals greater success when implementing certain quality initiatives by taking success/failure factors into consideration. A general framework for successful implementation in the healthcare sector is provided. This article uncovers reasons behind success or failure in a comprehensive and practical way. It also explores how most popular quality initiatives are applied in hospitals.

  12. If we only knew what we know: principles for knowledge sharing across people, practices, and platforms.

    PubMed

    Dearing, James W; Greene, Sarah M; Stewart, Walter F; Williams, Andrew E

    2011-03-01

    The improvement of health outcomes for both individual patients and entire populations requires improvement in the array of structures that support decisions and activities by healthcare practitioners. Yet, many gaps remain in how even sophisticated healthcare organizations manage knowledge. Here we describe the value of a trans-institutional network for identifying and capturing how-to knowledge that contributes to improved outcomes. Organizing and sharing on-the-job experience would concentrate and organize the activities of individual practitioners and subject their rapid cycle improvement testing and refinement to a form of collective intelligence for subsequent diffusion back through the network. We use the existing Cancer Research Network as an example of how a loosely structured consortium of healthcare delivery organizations could create and grow an implementation registry to foster innovation and implementation success by communicating what works, how, and which practitioners are using each innovation. We focus on the principles and parameters that could be used as a basis for infrastructure design. As experiential knowledge from across institutions builds within such a system, the system could ultimately motivate rapid learning and adoption of best practices. Implications for research about healthcare IT, invention, and organizational learning are discussed.

  13. Does ethical membership matter? Moral identification and its organizational implications.

    PubMed

    May, Douglas R; Chang, Young K; Shao, Ruodan

    2015-05-01

    This research meaningfully connects the literatures on identification and business ethics by proposing the new construct of moral identification. Moral identification is defined here as the perception of oneness or belongingness associated with an organization that exhibits ethical traits (e.g., care, kindness, and compassion), which also involves a deliberate concern of the membership with an ethical organization. Integrating social identity theory with theory on the moral self, this research examines an overall theoretical model where moral identification plays a significant role in explaining employee attraction, motivation, and retention (i.e., 3 components of the overall theoretical framework). These components were examined separately in 3 empirical studies and findings from these studies first revealed that moral identification explained why job seekers with strong (vs. weak) moral identities were more attracted to a socially responsible organization (Study 1). Second, moral identification was associated with lower employee unethical proorganizational behavior (Study 2). Finally, moral identification was negatively related to employees' turnover intentions. Organizations' legal compliance moderated this relation such that it was stronger when organizations have higher (vs. lower) levels of legal compliance (Study 3). Taken together, these studies suggest that moral identification offers new insights in explaining both potential and current employees' behaviors when morality is contextually relevant and subjectively meaningful. Theoretical contributions and practical implications are discussed. (c) 2015 APA, all rights reserved.

  14. 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.

  15. Provider-agency fit in substance abuse treatment organizations: implications for learning climate, morale, and evidence-based practice implementation.

    PubMed

    Ramsey, Alex T; van den Berk-Clark, Carissa

    2015-05-12

    Substance abuse agencies have been slow to adopt and implement evidence-based practices (EBPs), due in part to poor provider morale and organizational climates that are not conducive to successful learning and integration of these practices. Person-organization fit theory suggests that alignment, or fit, between provider- and agency-level characteristics regarding the implementation of EBPs may influence provider morale and organizational learning climate and, thus, implementation success. The current study hypothesized that discrepancies, or lack of fit, between provider- and agency-level contextual factors would negatively predict provider morale and organizational learning climate, outcomes shown to be associated with successful EBP implementation. Direct service providers (n = 120) from four substance abuse treatment agencies responded to a survey involving provider morale, organizational learning climate, agency expectations for EBP use, agency resources for EBP use, and provider attitudes towards EBP use. Difference scores between combinations of provider- and agency-level factors were computed to model provider-agency fit. Quadratic regression analyses were conducted to more adequately and comprehensively model the level of the dependent variables across the entire "fit continuum". Discrepancies, or misfit, between agency expectations and provider attitudes and between agency resources and provider attitudes were associated with poorer provider morale and weaker organizational learning climate. For all hypotheses, the curvilinear model of provider-agency discrepancies significantly predicted provider morale and organizational learning climate, indicating that both directions of misfit (provider factors more favorable than agency factors, and vice-versa) were detrimental to morale and climate. However, outcomes were most negative when providers viewed EBPs favorably, but perceived that agency expectations and resources were less supportive of EBP use. The current research benefits from a strong theoretical framework, consistent findings, and significant practical implications for substance abuse treatment agencies. Comprehensive attempts to strengthen outcomes related to EBP implementation must consider both provider- and agency-level characteristics regarding EBP use. Organizational efforts to more closely align provider attitudes and agency priorities will likely constitute a key strategy in fostering the implementation of EBPs in substance abuse treatment organizations.

  16. Implications of design on infection prevention and control practice in a novel hospital unit: the Medical Ward of the 21st Century.

    PubMed

    VanSteelandt, Amanda; Conly, John; Ghali, William; Mather, Charles

    2015-01-01

    The physical design of hospital wards is associated with transmission of pathogenic organisms and hospital-acquired infections. A novel hospital unit, the Medical Ward of the 21st Century (W21C), optimizes features for infection prevention and control practices. Ethnographic research on the W21C versus conventional hospital wards examined the experiential and behavioural elements of the different designs. Three recurring themes emerged regarding the design features on the W21C and included visual cues, 'having a place for things', and less sharing of spaces and materials. Observational data of healthcare worker practices demonstrated significantly higher compliance with hand hygiene opportunities on the W21C compared with older hospital units. These findings suggest how the physical design of a hospital ward may enhance infection prevention and control practices.

  17. Best clinical trials reported in 2010.

    PubMed

    Garner, John B; Grayburn, Paul A; Yancy, Clyde W

    2011-07-01

    Each year, a number of clinical trials emerge with data sufficient to change clinical practice. Determining which findings will result in practice change and which will provide only incremental benefit can be a dilemma for clinicians. The authors review selected clinical trials reported in 2010 in journals, at society meetings, and at conferences, focusing on those studies that have the potential to change clinical practice. This review offers 3 separate means of analysis: an abbreviated text summary, organized by subject area; a comprehensive table of relevant clinical trials that provides a schematic review of the hypotheses, interventions, methods, primary end points, results, and implications; and a complete bibliography for further reading as warranted. It is hoped that this compilation of relevant clinical trials and their important findings released in 2010 will be of benefit in the everyday practice of cardiovascular medicine. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. "The difference is in the tomato at the end": Understanding the motivations and practices of cannabis growers operating within Belgian Cannabis Social Clubs.

    PubMed

    Pardal, Mafalda

    2018-03-11

    In Belgium, Cannabis Social Clubs (CSCs) collectively organize the cultivation and distribution of cannabis for the personal use of their members. In this paper we seek to improve understanding of the motivations and practices of cannabis growers operating within CSCs, shedding light on the cultivation process. We draw on data gathered through face-to-face semi-structured interviews with the directors of seven active Belgian CSCs (n = 21) and CSC growers (n = 23). These data are complemented by additional fieldwork and a review of policies relating to CSCs', including bylaws and growing protocols. The Belgian CSCs rely on single and multiple in-house grower arrangements. Most CSC growers had been cultivating cannabis prior to joining their current CSC, albeit growing in different contexts (non-commercial and commercial). The CSC growers discussed both ideological and pragmatic motives for operating within a CSC. Cultivation took place indoors and followed organic practices. Despite their small-scale (20 plants on average), the grow sites used specialized equipment. The growers reported receiving financial compensation to cover production costs. This paper offers new insights into a particular sector of domestic cannabis cultivation - CSC growers and their practices within those collectives - which has not been studied previously. The Belgian CSCs have decentralized production among small-scale grow sites, at a size comparable to that found in other small-scale cultivation studies. In terms of motivations and practices, CSC growers share some features typically ascribed to small-scale cannabis cultivators. At the same time, CSC growers seemed particularly engaged with the CSC model and willing to adhere to the (self-)regulated practices developed by the organizations. This had implications for the way cultivation was organized and for the role of the grower within the CSC. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. From self-organization to self-assembly: a new materialism?

    PubMed

    Vincent, Bernadette Bensaude

    2016-09-01

    While self-organization has been an integral part of academic discussions about the distinctive features of living organisms, at least since Immanuel Kant's Critique of Judgement, the term 'self-assembly' has only been used for a few decades as it became a hot research topic with the emergence of nanotechnology. Could it be considered as an attempt at reducing vital organization to a sort of assembly line of molecules? Considering the context of research on self-assembly I argue that the shift of attention from self-organization to self-assembly does not really challenge the boundary between chemistry and biology. Self-assembly was first and foremost investigated in an engineering context as a strategy for manufacturing without human intervention and did not raise new perspectives on the emergence of vital organization itself. However self-assembly implies metaphysical assumptions that this paper tries to disentangle. It first describes the emergence of self-assembly as a research field in the context of materials science and nanotechnology. The second section outlines the metaphysical implications and will emphasize a sharp contrast between the ontology underlying two practices of self-assembly developed under the umbrella of synthetic biology. And unexpectedly, we shall see that chemists are less on the reductionist side than most synthetic biologists. Finally, the third section ventures some reflections on the kind of design involved in self-assembly practices.

  20. Understanding the Role of an International Convention on the Human Rights of People with Disabilities: An Analysis of the Legal, Social, and Practical Implications for Policy Makers and Disability and Human Rights Advocates in the United States. White Paper.

    ERIC Educational Resources Information Center

    Lord, Janet E.

    This White Paper by the National Council on Disability urges the support and participation of American policymakers and organizations representing people with disabilities in the drafting of an international human rights treaty specifically addressing the rights of people with disabilities. Following an executive summary and an introductory…

  1. [What did bachelard mean by "applied rationalism" ?].

    PubMed

    Tiles, Mary

    2013-01-01

    Bachelard was concerned with the processes whereby scientific knowledge is acquired, including the activity of knowing subjects. He did not equate reasoning with logic but rather argued that reasoning resulted from the use of mathematics in organizing both thought and experimental practices, which is why he conceived science as applied mathematics. This had material and technical implications, for Bachelard was concerned with the element of reason inherent in technical materialism as well as the concrete reality inherent in applied rationalism.

  2. Consumer responses to communication about food risk management.

    PubMed

    van Dijk, Heleen; Houghton, Julie; van Kleef, Ellen; van der Lans, Ivo; Rowe, Gene; Frewer, Lynn

    2008-01-01

    Recent emphasis within policy circles has been on transparent communication with consumers about food risk management decisions and practices. As a consequence, it is important to develop best practice regarding communication with the public about how food risks are managed. In the current study, the provision of information about regulatory enforcement, proactive risk management, scientific uncertainty and risk variability were manipulated in an experiment designed to examine their impact on consumer perceptions of food risk management quality. In order to compare consumer reactions across different cases, three food hazards were selected (mycotoxins on organically grown food, pesticide residues, and a genetically modified potato). Data were collected from representative samples of consumers in Germany, Greece, Norway and the UK. Scores on the "perceived food risk management quality" scale were subjected to a repeated-measures mixed linear model. Analysis points to a number of important findings, including the existence of cultural variation regarding the impact of risk communication strategies-something which has obvious implications for pan-European risk communication approaches. For example, while communication of uncertainty had a positive impact in Germany, it had a negative impact in the UK and Norway. Results also indicate that food risk managers should inform the public about enforcement of safety laws when communicating scientific uncertainty associated with risks. This has implications for the coordination of risk communication strategies between risk assessment and risk management organizations.

  3. Applicant attraction to organizations and job choice: a meta-analytic review of the correlates of recruiting outcomes.

    PubMed

    Chapman, Derek S; Uggerslev, Krista L; Carroll, Sarah A; Piasentin, Kelly A; Jones, David A

    2005-09-01

    Attracting high-performing applicants is a critical component of personnel selection and overall organizational success. In this study, the authors meta-analyzed 667 coefficients from 71 studies examining relationships between various predictors with job-organization attraction, job pursuit intentions, acceptance intentions, and job choice. The moderating effects of applicant gender, race, and applicant versus nonapplicant status were also examined. Results showed that applicant attraction outcomes were predicted by job-organization characteristics, recruiter behaviors, perceptions of the recruiting process, perceived fit, and hiring expectancies, but not recruiter demographics or perceived alternatives. Path analyses showed that applicant attitudes and intentions mediated the predictor-job choice relationships. The authors discuss the implications of these findings for recruiting theory, research, and practice. Copyright 2005 APA, all rights reserved.

  4. You've got mail! An examination of a statewide direct-mail marketing campaign to promote deceased organ donor registrations.

    PubMed

    Quick, Brian L; LaVoie, Nicole R; Morgan, Susan E; Bosch, Dave

    2015-11-01

    This study extends previous direct-mail campaigns by evaluating the effectiveness of a marketing campaign promoting organ donation message strategies from the vantage point of organ donors, organ recipients, individuals on the waiting list, or a combination of these three frames. Illinois residents were randomly assigned to one of four organ donation brochures disseminated via U.S. postal mail. Registrations occurred via the Internet and U.S. postal mail. Individuals register at a greater rate following exposure to the combination framed message compared to organ donor, organ recipient, and waiting list narratives. The campaign revealed that individuals are more likely to register via U.S. postal mail than the Internet. Direct-mail marketing efforts were shown to be an effective approach to promote organ and tissue donation registrations. The results demonstrated a preference for the combination framed brochure. The results are discussed with an emphasis on the practical implications of utilizing direct-mail marketing efforts to promote organ donation among young adults. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. How do leaders react when treated unfairly? Leader narcissism and self-interested behavior in response to unfair treatment.

    PubMed

    Liu, Haiyang; Chiang, Jack Ting-Ju; Fehr, Ryan; Xu, Minya; Wang, Siting

    2017-11-01

    In this article we employ a trait activation framework to examine how unfairness perceptions influence narcissistic leaders' self-interested behavior, and the downstream implications of these effects for employees' pro-social and voice behaviors. Specifically, we propose that narcissistic leaders are particularly likely to engage in self-interested behavior when they perceive that their organizations treat them unfairly, and that this self-interested behavior in turn decreases followers' pro-social behavior and voice. Data from a multisource, time-lagged survey of 211 team leaders and 1,205 subordinates provided support for the hypothesized model. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. 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

  7. Exploring cultural tensions in cross-cultural social work practice.

    PubMed

    Yan, Miu Chung

    2008-10-01

    Discussion of cultural tension in the social work literature is piecemeal. As part of a grounded theory study, this article reports some major findings on cultural tensions experienced by 30 frontline social workers. Cultural tensions caused by cultural similarities and differences among social workers, clients, organizations, and society are multifaceted. Social workers, however, are always at the center of the tensions. Findings indicate that the social work profession may need to consider the neutrality claim of the profession, the different experience of ethnic minority social workers, and the need of critical reflexivity for reflective practitioners. Implications for social work practice, social work education for ethnic minority social workers, and social work research are discussed.

  8. Cancer screening and early detection in the 21st century

    PubMed Central

    Murphy, Jeanne

    2017-01-01

    Objective To review the trends in and principles of cancer screening and early detection. Data Sources Journal articles, United States Preventive Services Task Force (U SPSTF) publications, professional organization position statements, evidence-based summaries Conclusion Cancer screening has contributed to decreasing the morbidity and mortality of cancer. Efforts to improve the selection of candidates for cancer screening, to understand the biological basis of carcinogenesis, and the development of new technologies for cancer screening will allow for improvements in the cancer screening over time. Implications for Nursing Practice Nurses are well-positioned to lead the implementation of cancer screening recommendations in the 21st Century through their practice, research, educational efforts and advocacy. PMID:28343835

  9. The forensic evaluation and report: an agenda for research.

    PubMed

    Buchanan, Alec; Norko, Michael

    2013-01-01

    The written report is a central component of forensic psychiatric practice. In the report, an evaluator assembles and organizes data, interprets results of an evaluation, and offers an opinion in response to legal questions. The past 30 years have seen substantial development in principles and practice of forensic report writing. Drawing on recent advances in the psychiatric report, the authors explore topics including narrative, forensic ethics, coercion within the justice system, and implications of limitations on data in forming forensic opinions. They offer an analysis of unanswered questions in these areas, suggesting opportunities for further empirical study and theoretical development. This proposed agenda is important in training, in the development of policy, and in establishing professional guidelines.

  10. Attitudes vs. Purchase Behaviors as Experienced Dissonance: The Roles of Knowledge and Consumer Orientations in Organic Market.

    PubMed

    Hidalgo-Baz, María; Martos-Partal, Mercedes; González-Benito, Óscar

    2017-01-01

    This research focuses on the incongruity between positive attitudinal responses but a lack of purchase behavior in organic markets. According to cognitive dissonance theory, consumer orientations toward the benefits attributed to organic products (environmental protection, health, hedonic) relieve the dissonance that results from this attitude-behavior incongruity. Knowledge also functions as a transmitter, from positive attitudes to purchase behaviors, thereby reducing the incongruity. Using quota sampling in a survey study, this paper tests the hypotheses from linear regression models. The results show that orientations and knowledge improve the congruity between attitudes and purchase behaviors toward organic products. Moreover, interaction effects arise between the environmental protection orientation and knowledge and between the hedonic orientation and knowledge. Increasing knowledge mitigates the difference between attitudes and purchase behaviors, especially for consumers with environmental protection or hedonic orientations. These findings have several important implications for research and practice.

  11. Attitudes vs. Purchase Behaviors as Experienced Dissonance: The Roles of Knowledge and Consumer Orientations in Organic Market

    PubMed Central

    Hidalgo-Baz, María; Martos-Partal, Mercedes; González-Benito, Óscar

    2017-01-01

    This research focuses on the incongruity between positive attitudinal responses but a lack of purchase behavior in organic markets. According to cognitive dissonance theory, consumer orientations toward the benefits attributed to organic products (environmental protection, health, hedonic) relieve the dissonance that results from this attitude–behavior incongruity. Knowledge also functions as a transmitter, from positive attitudes to purchase behaviors, thereby reducing the incongruity. Using quota sampling in a survey study, this paper tests the hypotheses from linear regression models. The results show that orientations and knowledge improve the congruity between attitudes and purchase behaviors toward organic products. Moreover, interaction effects arise between the environmental protection orientation and knowledge and between the hedonic orientation and knowledge. Increasing knowledge mitigates the difference between attitudes and purchase behaviors, especially for consumers with environmental protection or hedonic orientations. These findings have several important implications for research and practice. PMID:28286489

  12. [Influence of the recording interval and a graphic organizer on the writing process/product and on other psychological variables].

    PubMed

    García Sánchez, Jesús N; Rodríguez Pérez, Celestino

    2007-05-01

    An experimental study of the influence of the recording interval and a graphic organizer on the processes of writing composition and on the final product is presented. We studied 326 participants, age 10 to 16 years old, by means of a nested design. Two groups were compared: one group was aided in the writing process with a graphic organizer and the other was not. Each group was subdivided into two further groups: one with a mean recording interval of 45 seconds and the other with approximately 90 seconds recording interval in a writing log. The results showed that the group aided by a graphic organizer obtained better results both in processes and writing product, and that the groups assessed with an average interval of 45 seconds obtained worse results. Implications for educational practice are discussed, and limitations and future perspectives are commented on.

  13. Understanding human resource management practices in Botswana's public health sector.

    PubMed

    Seitio-Kgokgwe, Onalenna Stannie; Gauld, Robin; Hill, Philip C; Barnett, Pauline

    2016-11-21

    Purpose The purpose of this paper is to assess the management of the public sector health workforce in Botswana. Using institutional frameworks it aims to document and analyse human resource management (HRM) practices, and make recommendations to improve employee and health system outcomes. Design/methodology/approach The paper draws from a large study that used a mixed methods approach to assess performance of Botswana's Ministry of Health (MOH). It uses data collected through document analysis and in-depth interviews of 54 key informants comprising policy makers, senior staff of the MOH and its stakeholder organizations. Findings Public health sector HRM in Botswana has experienced inadequate planning, poor deployment and underutilization of staff. Lack of comprehensive retention strategies and poor working conditions contributed to the failure to attract and retain skilled personnel. Relationships with both formal and informal environments affected HRM performance. Research limitations/implications While document review was a major source of data for this paper, the weaknesses in the human resource information system limited availability of data. Practical implications This paper presents an argument for the need for consideration of formal and informal environments in developing effective HRM strategies. Originality/value This research provides a rare system-wide approach to health HRM in a Sub-Saharan African country. It contributes to the literature and evidence needed to guide HRM policy decisions and practices.

  14. 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…

  15. IMPLICATIONS OF GLOBAL CLIMATE CHANGE FOR THE ASSESSMENT AND MANAGEMENT OF HUMAN HEALTH RISKS OF CHEMICALS IN THE NATURAL ENVIRONMENT

    PubMed Central

    Balbus, John M; Boxall, Alistair BA; Fenske, Richard A; McKone, Thomas E; Zeise, Lauren

    2013-01-01

    Global climate change (GCC) is likely to alter the degree of human exposure to pollutants and the response of human populations to these exposures, meaning that risks of pollutants could change in the future. The present study, therefore, explores how GCC might affect the different steps in the pathway from a chemical source in the environment through to impacts on human health and evaluates the implications for existing risk-assessment and management practices. In certain parts of the world, GCC is predicted to increase the level of exposure of many environmental pollutants due to direct and indirect effects on the use patterns and transport and fate of chemicals. Changes in human behavior will also affect how humans come into contact with contaminated air, water, and food. Dietary changes, psychosocial stress, and coexposure to stressors such as high temperatures are likely to increase the vulnerability of humans to chemicals. These changes are likely to have significant implications for current practices for chemical assessment. Assumptions used in current exposure-assessment models may no longer apply, and existing monitoring methods may not be robust enough to detect adverse episodic changes in exposures. Organizations responsible for the assessment and management of health risks of chemicals therefore need to be more proactive and consider the implications of GCC for their procedures and processes. Environ. Toxicol. Chem. 2013;32:62–78. © 2012 SETAC PMID:23147420

  16. [Incorporation of the Hazard Analysis and Critical Control Point system (HACCP) in food legislation].

    PubMed

    Castellanos Rey, Liliana C; Villamil Jiménez, Luis C; Romero Prada, Jaime R

    2004-01-01

    The Hazard Analysis and Critical Control Point system (HACCP), recommended by different international organizations as the Codex Alimentarius Commission, the World Trade Organization (WTO), the International Office of Epizootics (OIE) and the International Convention for Vegetables Protection (ICPV) amongst others, contributes to ensuring the innocuity of food along the agro-alimentary chain and requires of Good Manufacturing Practices (GMP) for its implementation, GMP's which are legislated in most countries. Since 1997, Colombia has set rules and legislation for application of HACCP system in agreement with international standards. This paper discusses the potential and difficulties of the legislation enforcement and suggests some policy implications towards food safety.

  17. The decision to adopt evidence-based and other innovative mental health practices: risky business?

    PubMed

    Panzano, Phyllis C; Roth, Dee

    2006-08-01

    A risk-based decision-making framework was used to examine the decision to adopt innovative mental health practices, including both evidence-based and other research-guided practices. Seventy-eight projects involving decisions to adopt one of four innovative mental health practices were the focus of this study. Key informants with direct knowledge about the adoption decision provided data for hypothesis testing. As predicted, the propensity to adopt an innovative practice-as measured by decision stage-was negatively related to the perceived risk of adopting the practice, positively related to expected capacity to manage risk, and positively related to an organization's past propensity to take risks. Further, perceived risk, anticipated resource availability, and exposure to field-based evidence explained a substantial part of what differentiated adopters from nonadopters. Finally, several features of innovations known to influence innovation adoption decisions were found to be related in expected ways to perceived risk, capacity to manage risk, and risk propensity. This research supports the view that the decision to adopt an innovative mental health practice is a decision made in consideration of risk. Contrary to popular views that early adopters of innovations are willing to take enormous risks, these data offer the novel idea that early adopters act because they see the risks associated with adopting as lower than their nonadopter counterparts, partly because the risks are seen as more manageable. Implications of results are discussed for organizations considering adoption of innovative health care practices and for state or local mental health authorities hoping for a higher level of adoption in their areas.

  18. Facilitators and Barriers to Care Coordination in Patient-centered Medical Homes (PCMHs) from Coordinators’ Perspectives

    PubMed Central

    Friedman, Asia; Howard, Jenna; Shaw, Eric K.; Cohen, Deborah J.; Shahidi, Laleh; Ferrante, Jeanne M.

    2016-01-01

    Background Care coordinators are increasingly featured in patient-centered medical home (PCMH) projects, yet little research examines how coordinators themselves define and experience their role. This is the first study describing experiences of care coordinators across the US from their own perspectives. Methods This qualitative study used a 5-month private, online discussion forum to gather data from 25 care coordinators from PCMH practices representing diversity in practice size, setting, and type. Participants answered questions and interacted with one another, creating an online social learning collaborative while allowing for data collection for research. Results Coordinators identified barriers and facilitators in their work at the organization/system level, the interpersonal level, and the individual level. Some factors emerged as both barriers and facilitators, including the functionality of clinical information technology; the availability of community resources; interactions with clinicians and other health care facilities; interactions with patients; and self-care practices for mental health and wellness. Colocation and full integration into practices were other key facilitators, whereas excessive case loads and data management responsibilities were felt to be important barriers. Conclusions While all the barriers and facilitators were important to performing coordinators’ roles, relationship building materialized as key to effective care coordination, whether with clinicians, patients, or outside organizations. We discuss implications for practice and provide suggestions for further research. PMID:26769881

  19. Worker Perspectives on Contemporary Milieu Therapy: A Cross-Site Ethnographic Study

    PubMed Central

    Smith, Yvonne; Spitzmueller, Matthew C.

    2016-01-01

    The term “milieu therapy” (MT) is commonly used in mental health literatures. However, because MT has historically encompassed a wide range of practices, it has invited the criticism that it is simply an attractive theoretical packaging of the time clients spend between other specified interventions, such as individual and group therapies. Some have suggested that, because of its conceptual ambiguity, MT should be abandoned altogether. Despite these challenges, MT endures as a common approach to social work practice in a range of clinical settings. This article describes a study that used ethnography to investigate the perspectives of workers from two mental health organizations that claim to provide MT. By analyzing four themes common to both sites, this article brings exploratory empirical findings to bear on the question of what constitutes MT in contemporary mental health organizations. Participants reported that (a) everything in the physical and social milieu has the potential to affect therapeutic change; (b) the milieu itself functions as a therapeutic agent; (c) the milieu provides a context for modeling and practicing desired behaviors; and (d) MT is a principle-based ethos, rather than a set of specific interventions. Implications of these findings for social work research, practice, and funding are discussed. PMID:27257364

  20. Individual need satisfaction, organizational practices, and job satisfaction among laboratory professionals.

    PubMed

    Matteson, M T; Ivancevich, J M; McMahon, J T

    1977-08-01

    This study examines the role of 1) personal job-related needs and 2) certain organizational characteristics in affecting overall job satisfaction for a sample of 259 laboratory professionals, primarily medical technologists. Specific individual needs and specific organizational characteristics were found to be related to three measures of overall job satisfaction. Additional comparisons were made for administrators versus non-administrators and for differences associated with different sized organizations. Implications for the managers of medical technologists and other laboratory professionals are discussed.

  1. Functional dyspepsia pathogenesis and therapeutic options--implications for management.

    PubMed

    Smith, M Lancaster

    2005-08-01

    Functional dyspepsia is far more common than dyspepsia due to organic disease, both in the community and general practice. Proposed aetiopathogenic factors include gastric acid, Helicobacter pylori infection, delayed emptying, hypersensitivity or impaired accommodation of the stomach, dysfunction of the duodenum or brain-gut axis, psychosocial morbidity and post-infective mucosal damage. More effective therapy will depend on the development of drugs targeted at these putative pathophysiological mechanisms. On current evidence tricyclic antidepressants appear to be more effective than either acid suppressants or H. pylori eradication.

  2. Summary Record of the GFF Community of Interest on the Practice and Organization of Intelligence Ottawa Roundtable: What Can the Cognitive and Behavioural Sciences Contribute to Intelligence Analysis? Towards a Collaborative Agenda for the Future

    DTIC Science & Technology

    2010-01-01

    Discussion..................................... 14 5 Dinner Lecture: What Can Jazz Contribute to Intelligence Analysis...trade-offs. The implications of low integrative complexity include a limited information search, rigid following of established plans, black -white...also scientists can be of help. DRDC Toronto CR 2010-012 17 5 Dinner Lecture: What Can Jazz Contribute to Intelligence Analysis

  3. Implications of complex adaptive systems theory for interpreting research about health care organizations.

    PubMed

    Jordon, Michelle; Lanham, Holly Jordan; Anderson, Ruth A; McDaniel, Reuben R

    2010-02-01

    Data about health care organizations (HCOs) are not useful until they are interpreted. Such interpretations are influenced by the theoretical lenses used by the researcher. Our purpose was to suggest the usefulness of theories of complex adaptive systems (CASs) in guiding research interpretation. Specifically, we addressed two questions: (1) What are the implications for interpreting research observations in HCOs of the fact that we are observing relationships among diverse agents? (2) What are the implications for interpreting research observations in HCOs of the fact that we are observing relationships among agents that learn? We defined diversity and learning and the implications of the non-linear relationships among agents from a CAS perspective. We then identified some common analytical practices that were problematic and may lead to conceptual and methodological errors. Then we described strategies for interpreting the results of research observations. We suggest that the task of interpreting research observations of HCOs could be improved if researchers take into account that the systems they study are CASs with non-linear relationships among diverse, learning agents. Our analysis points out how interpretation of research results might be shaped by the fact that HCOs are CASs. We described how learning is, in fact, the result of interactions among diverse agents and that learning can, by itself, reduce or increase agent diversity. We encouraged researchers to be persistent in their attempts to reason about complex systems and learn to attend not only to structures, but also to processes and functions of complex systems.

  4. The "wins" of change: evaluating the impact of predicted changes on case management practice.

    PubMed

    Stanton, Marietta P; Barnett Lammon, Carol Ann

    2008-01-01

    A variety of strategies were employed to identify current and future trends that would impact the practice of case management. Historical review, consultation with case management experts, literature review, and environmental scanning by practicing case managers were strategies employed to determine the impact of current and future trends on case management. The trends identified in this article have implications for case managers in a variety of settings. Case managers participating in the environmental scanning process to evaluate the impact of the identified trends on their organization included representation from acute care, home care, behavioral health, workers' compensation, and private insurance settings. The top 7 trends identified by experts in the field of case management included pay for performance, recovery audit contractors, Medicare demonstration projects, transitions of care, informatics in healthcare and case management, metrics for case management, and the impact of an aging population in case management. Practicing case managers were asked to react to these trends in terms of likelihood of occurrence in their organization and impact of these trends on their case management practice. Case management will ultimately have a higher degree of accountability for its practice if metrics to evaluate and reimbursement for case management become a reality. A multitude of performance measures exist that will be monitored and be tied to reimbursement. To ensure that agencies are accomplishing these performance measures, case management will potentially have a growing importance. Case managers perceive that these trends have a predominantly positive impact on case management.

  5. Transplant tourism and organ trafficking: Ethical implications for the nursing profession.

    PubMed

    Corfee, Floraidh Ar

    2016-11-01

    Organ availability for transplantation has become an increasingly complex and difficult question in health economics and ethical practice. Advances in technology have seen prolonged life expectancy, and the global push for organs creates an ever-expanding gap between supply and demand, and a significant cost in bridging that gap. This article will examine the ethical implications for the nursing profession in regard to the procurement of organs from an impoverished seller's market, also known as 'Transplant Tourism'. This ethical dilemma concerns itself with resource allocation, informed consent and the concepts of egalitarianism and libertarianism. Transplant Tourism is an unacceptable trespass against human dignity and rights from both a nursing and collective viewpoint. Currently, the Australian Nursing and Midwifery Council, the Royal college of Nursing Australia, The Royal College of Nursing (UK) and the American Nurses Association do not have position statements on transplant tourism, and this diminishes us as a force for change. It diminishes our role as advocates for the most marginalised in our world to have access to care and to choice and excludes us from a very contemporary real debate about the mismatch of organ demand and supply in our own communities. As a profession, we must have a voice in health policy and human rights, and according to our Code of Ethics in Australia and around the world, act to promote and protect the fundamental human right to healthcare and dignity. © The Author(s) 2015.

  6. Effects of classroom organization on letter-word reading in first grade.

    PubMed

    Cameron, Claire E; Connor, Carol McDonald; Morrison, Frederick J; Jewkes, Abigail M

    2008-04-01

    Teacher organization is a crucial part of classroom functioning; however, its relation to student achievement has not been investigated as extensively as that of instruction. In this study, organization is defined as the amount of time teachers spend explaining the purpose and procedures of learning activities and daily routines. Data from first-grade classrooms (N=44) observed three times during the school year (fall, winter, and spring) are analyzed, along with students' (N=108) literacy skills at fall and spring. Hierarchical Linear Modeling reveals that, controlling for students' fall word reading and vocabulary skills, as well as amount of language arts instruction they receive, both amount and change in amount over time in classroom organization significantly predicts spring word reading skills. Specifically, children in classrooms observed in higher amounts of classroom time in organization at the beginning of the school year, followed by sharp decreases over the school year, demonstrated stronger letter and word reading skills by spring, and this was a main effect (p<.05). Practical and research implications are discussed.

  7. The epidemiology of a specialist neurorehabilitation clinic: implications for clinical practice and regional service development.

    PubMed

    Seeley, Helen; Pickard, John; Allanson, Judith; Hutchinson, Peter

    2014-01-01

    To examine the epidemiology of referrals to a specialist neurotrauma clinic and explore and highlight implications for clinical practice and service development for persons with head injury/traumatic brain injury (HI/TBI). A retrospective population-based cohort study of all referrals to a specialist neurotrauma clinic over a 9-year period. Data from a specialist head injury database (which included all persons presenting to hospital with traumatic brain injury) were analysed. In total, 1235 new patients of all ages, severities of injury, both admitted and non-admitted were referred. Referrals have increased due to successful integration with new service developments and resulting optimization of resources. Data gathered from the cohort gives increased understanding of the characteristics and numbers of patients requiring rehabilitation and adds to the evidence-base. Integration with new and complementary service developments has optimized the function/aims of the clinic and enhanced its role in terms of patient service and outcome and as a research resource. The model provides principles which may be applied to planning, organizing and providing follow-up/rehabilitation services for HI/TBI.

  8. The identification of knowledge content and function in manual labour.

    PubMed

    Shalin, Valerie; Verdile, Charles

    2003-06-10

    Calls for an alternative conceptualization of cognition for applied concerns retain the core commitment of the basic research community to abstract cognition detached from a physical environment. The present paper attempts to break out of the dominant, narrow view of cognition and cognitive domains, with a cognitive analysis of digging ditches for the utility industry. To illustrate knowledge-based cognition in manual labour excerpts are presented from the journal entries of a moderately experienced student working a summer job, organized with a representation that distinguishes between the goals and methods of work. The journal entries illustrate the functions of knowledge for interacting with a physical environment; knowledge enables the selection, execution and monitoring of work methods, the interpretation of perceptual information, the application of task completion criteria and the ability for explanation and generalization. To emphasize the generality of the functions of cognition in ditch digging, comparable functions are indicated in a domain rarely regarded as a form of manual labour: the practice of internal medicine. Discussion of the results includes the implications for cognitive theory as well as practical implications for productivity, training and task analysis.

  9. Managing healthcare information: analyzing trust.

    PubMed

    Söderström, Eva; Eriksson, Nomie; Åhlfeldt, Rose-Mharie

    2016-08-08

    Purpose - The purpose of this paper is to analyze two case studies with a trust matrix tool, to identify trust issues related to electronic health records. Design/methodology/approach - A qualitative research approach is applied using two case studies. The data analysis of these studies generated a problem list, which was mapped to a trust matrix. Findings - Results demonstrate flaws in current practices and point to achieving balance between organizational, person and technology trust perspectives. The analysis revealed three challenge areas, to: achieve higher trust in patient-focussed healthcare; improve communication between patients and healthcare professionals; and establish clear terminology. By taking trust into account, a more holistic perspective on healthcare can be achieved, where trust can be obtained and optimized. Research limitations/implications - A trust matrix is tested and shown to identify trust problems on different levels and relating to trusting beliefs. Future research should elaborate and more fully address issues within three identified challenge areas. Practical implications - The trust matrix's usefulness as a tool for organizations to analyze trust problems and issues is demonstrated. Originality/value - Healthcare trust issues are captured to a greater extent and from previously unchartered perspectives.

  10. Web-based recruitment: effects of information, organizational brand, and attitudes toward a Web site on applicant attraction.

    PubMed

    Allen, David G; Mahto, Raj V; Otondo, Robert F

    2007-11-01

    Recruitment theory and research show that objective characteristics, subjective considerations, and critical contact send signals to prospective applicants about the organization and available opportunities. In the generating applicants phase of recruitment, critical contact may consist largely of interactions with recruitment sources (e.g., newspaper ads, job fairs, organization Web sites); however, research has yet to fully address how all 3 types of signaling mechanisms influence early job pursuit decisions in the context of organizational recruitment Web sites. Results based on data from 814 student participants searching actual organization Web sites support and extend signaling and brand equity theories by showing that job information (directly) and organization information (indirectly) are related to intentions to pursue employment when a priori perceptions of image are controlled. A priori organization image is related to pursuit intentions when subsequent information search is controlled, but organization familiarity is not, and attitudes about a recruitment source also influence attraction and partially mediate the effects of organization information. Theoretical and practical implications for recruitment are discussed. (c) 2007 APA

  11. The inclusive workplace: an ecosystems approach to diversity management.

    PubMed

    Barak, M E

    2000-07-01

    This article's main argument is that organizations need to expand their notion of diversity to include not only the organization itself, but also the larger systems that constitute its environment. The concept of "the inclusive workplace," introduced here, refers to a work organization that is not only accepting and using the diversity of its own work force, but also is active in the community, participates in state and federal programs to include working poor people, and collaborates across cultural and national boundaries with a focus on global mutual interests. Using an ecosystems perspective, the article outlines a value-based model and a practice-based model of the inclusive workplace as they pertain to the different organizational levels, from the micro to the macro. Finally, implications for the social work profession are drawn with specific case examples for each system level.

  12. Employee Trust in Supervisors and Affective Commitment: The Moderating Role of Authentic Leadership.

    PubMed

    Xiong, Kehan; Lin, Weipeng; Li, Jenny C; Wang, Lei

    2016-06-01

    Although previous research has examined the main/direct effects of subordinates' trust in their supervisors on the levels of subordinates' affective commitment towards the organizations, little attention has been paid to explore the boundary conditions of this relationship. Two studies were conducted to examine the moderating effect of authentic leadership on the relationship between subordinates' trust in supervisor and their levels of affective commitment towards the organization. In line with the hypothesized model, both Study 1 (cross-sectional design, n = 138) and Study 2 (lagged design, n = 154) demonstrated that authentic leadership moderated the relationship between employees' trust in supervisor and their levels of affective commitment towards their organizations. Specifically, the positive relationship was stronger for employees under higher levels of authentic leadership. The implications for theory and practice are discussed. © The Author(s) 2016.

  13. Promoting Usability in Organizations with a New Health Usability Model: Implications for Nursing Informatics

    PubMed Central

    Staggers, Nancy; Rodney, Melanie

    2012-01-01

    Usability issues with products such as Electronic Health Records (EHRs) are of global interest to nursing informaticists. Although improvements in patient safety, clinical productivity and effectiveness are possible when usability principles and practices are in place, most organizations do not embrace usability. This paper presents a new Health Usability Maturity Model consisting of 5 phases: unrecognized, preliminary, implemented, integrated and strategic. Within each level various aspects are discussed including focus on users, management, education, resources, processes and infrastructure. Nurse informaticists may use this new model as a guide for assessing their organization’s level of usability and transitioning to the next level. Using tactics outlined here, nurse informaticists may also serve as catalysts for change and lead efforts to improve the user experience in organizations across industry, academe and healthcare settings. PMID:24199128

  14. Positive attitudes toward organic, local, and sustainable foods are associated with higher dietary quality among young adults

    PubMed Central

    Laska, Melissa N.; Neumark-Sztainer, Dianne; Story, Mary

    2012-01-01

    Scant evidence is available on the relationship between preferences for organic, local, sustainable, and non-processed foods (i.e., alternative food production practices) and dietary quality. This cross-sectional study examined the characteristics and dietary behaviors (e.g., consumption of fruit, vegetables, fast food, etc.) of young adults who reported placing low, moderate, or high importance on alternative food production practices. A diverse sample of 1,201 students at a two-year community college and a four-year public university in the Twin Cities, MN, completed the Student Health and Wellness Study survey in spring 2010. Chi-square tests examined differences in attitudes across demographic characteristics. Linear regression adjusted dietary intake across attitudes. About half (49%) of young adults placed moderate to high importance on alternative production practices, and few demographic differences across attitudes were found. Young adults who placed high importance on alternative production practices consumed 1.3 greater servings of fruits and vegetables (p<0.001), more dietary fiber (p<0.001), fewer added sugars (p<0.001) and less fat (p=0.025) than those who placed low importance on these practices. Young adults who placed high importance on alternative food production practices also consumed breakfast about one more day per week and fast food half as often as those who placed low importance on these practices (p<0.001). Study findings suggest that nutrition messaging around social and environmental implications of food production practices may be well received by this age group. Experimental studies are needed to investigate whether attitudes toward alternative production practices can be manipulated to improve dietary quality. PMID:23260729

  15. Medicare and Medicaid fraud and abuse regulations.

    PubMed

    Liang, F Z; Black, B L

    1991-11-01

    Specific business arrangements that are protected under legislation and regulations governing parties doing business with Medicare or Medicaid are discussed. Regulations implementing the Medicare and Medicaid Patient Protection Act of 1987 specify practices and activities that are not subject to criminal penalties under the antikickback provisions of the Social Security Act or to exclusion from Medicare or state health-care programs. As of July 29, 1991, all organized health-care settings that receive payments from either Medicare or state health-care programs must comply with these regulations. The final rule sets forth "safe harbors"--exceptions to prohibitions against (1) kickbacks, bribes, rebates, and other illegal activities involving remunerations for patient referrals and (2) inducements to purchase or lease goods paid for by Medicare or state health-care programs. The safe harbors comprise 11 broad categories--investment interests, space rental, equipment rental, personal services and management contracts, purchase of a medical practice, referral services, warranties, discounts, employees, group purchasing organizations, and waiver of deductibles and coinsurance. Implications for pharmacy are discussed. These regulations will affect the purchase of pharmaceuticals by institutional pharmacies. Each institution should review its current practices to determine whether they are within the safe harbors.

  16. Waiting for transplant: physical, psychosocial, and nutritional status considerations for pediatric candidates and implications for care.

    PubMed

    Anthony, Samantha J; Annunziato, Rachel A; Fairey, Elise; Kelly, Vicky L; So, Stephanie; Wray, Jo

    2014-08-01

    The waiting period for an organ transplant has been described as a time of tremendous uncertainty and vulnerability, posing unique challenges and stressors for pediatric transplant candidates and their families. It has been identified as the most stressful stage of the transplant journey, yet little attention has been given to the physical, psychological, or social impact of the waiting period in the literature. In this review, we discuss the physical, nutritional, and psychosocial implications of the waiting period for child and adolescent transplant candidates and the impact on their parents and siblings. We identify areas for future research and provide recommendations for clinical practice to support children, adolescents, and families during the waiting period. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. The physician leader as logotherapist.

    PubMed

    Washburn, E R

    1998-01-01

    Today's physicians feel helpless and angry about changing conditions in the medical landscape. This is due, in large part, to our postmodernist world view and the influence of corporations on medical practice. The life and work of existentialist psychiatrist Viktor Frankl is proposed as a role model for physicians to take back control of their profession. Physician leaders are in the best position to bring the teachings and insight of Frankl's logotherapy to rank-and-file physicians in all practice settings, as well as into the board rooms of large medical corporations. This article considers the spiritual and moral troubles of American medicine, Frankl's answer to that affliction, and the implications of logotherapy for physician organizations and leadership. Physician executives are challenged to take up this task.

  18. The research subject as wage earner.

    PubMed

    Anderson, James A; Weijer, Charles

    2002-01-01

    The practice of paying research subjects for participating in clinical trials has yet to receive an adequate moral analysis. Dickert and Grady argue for a wage payment model in which research subjects are paid an hourly wage based on that of unskilled laborers. If we accept this approach, what follows? Norms for just working conditions emerge from workplace legislation and political theory. All workers, including paid research subjects under Dickert and Grady's analysis, have a right to at least minimum wage, a standard work week, extra pay for overtime hours, a safe workplace, no fault compensation for work-related injury, and union organization. If we accept that paid research subjects are wage earners like any other, then the implications for changes to current practice are substantial.

  19. Saying goodbye: The nature, causes, and consequences of employee resignation styles.

    PubMed

    Klotz, Anthony C; Bolino, Mark C

    2016-10-01

    Although much is known about why employees decide to resign from their jobs, scant research has examined what occurs after employees decide to leave their jobs but before they exit their organizations. As such, employee resignations are not well understood. This is unfortunate, because the manner in which employees resign from their jobs may have important implications for both individuals and organizations. In this paper, we use social exchange theory to argue that exchange-based correlates of employee turnover influence the manner in which employees resign, and that resignation styles affect managers' emotional reactions to employee resignation. We test our hypotheses in 4 studies. In Study 1, we inductively identify a taxonomy of resignation styles among full-time MBA students who have recently resigned from a job. In Study 2, we qualitatively examine the extent to which this taxonomy of resignation styles is represented in the accounts of supervisors of recently resigned employees. In Study 3, using a sample of recently resigned professionals, we demonstrate that employees' exchange relationships with their organizations and their supervisors influence their resignation styles. Finally, in Study 4, we provide evidence that resignation styles affect supervisors' emotional reactions in a sample of managers. Directions for future research on resignation and practical implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Mobile text messaging for health: a systematic review of reviews.

    PubMed

    Hall, Amanda K; Cole-Lewis, Heather; Bernhardt, Jay M

    2015-03-18

    The aim of this systematic review of reviews is to identify mobile text-messaging interventions designed for health improvement and behavior change and to derive recommendations for practice. We have compiled and reviewed existing systematic research reviews and meta-analyses to organize and summarize the text-messaging intervention evidence base, identify best-practice recommendations based on findings from multiple reviews, and explore implications for future research. Our review found that the majority of published text-messaging interventions were effective when addressing diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence for antiretroviral therapy. However, we found limited evidence across the population of studies and reviews to inform recommended intervention characteristics. Although strong evidence supports the value of integrating text-messaging interventions into public health practice, additional research is needed to establish longer-term intervention effects, identify recommended intervention characteristics, and explore issues of cost-effectiveness.

  1. The role of locally-designed organizational artifacts in supporting nurses’ work: an ethnographic study on the wards

    PubMed

    Talamo, Alessandra; Mellini, Barbara; Barbieri, Barbara

    2017-01-01

    This paper aims to describe how nurses' planning and coordination work is performed through the use of locally designed tools (i.e., diaries, planners, reminders, and organizers). These tools are investigated as the materialization of organizational work, thus offering a complementary perspective on nursing practice to that proposed by the professional mandate and supported by official artifacts in use. Ethnographic study. By analyzing locally designed artifacts, the rationale that enables nurses to make the flow of activities work is highlighted and explained. Evidence is provided by a description of how nurses' tacit knowledge is reified and embedded into objects produced by the nurses themselves. Implications for the design of digital systems supporting nursing practice are discussed. The analysis of these artifacts has allowed an understanding of practices used by the nurses to manage the workflow in the wards.

  2. Mobile Text Messaging for Health: A Systematic Review of Reviews

    PubMed Central

    Hall, Amanda K.; Cole-Lewis, Heather; Bernhardt, Jay M.

    2015-01-01

    The aim of this systematic review of reviews is to identify mobile text-messaging interventions designed for health improvement and behavior change and to derive recommendations for practice. We have compiled and reviewed existing systematic research reviews and meta-analyses to organize and summarize the text-messaging intervention evidence base, identify best-practice recommendations based on findings from multiple reviews, and explore implications for future research. Our review found that the majority of published text-messaging interventions were effective when addressing diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence for antiretroviral therapy. However, we found limited evidence across the population of studies and reviews to inform recommended intervention characteristics. Although strong evidence supports the value of integrating text-messaging interventions into public health practice, additional research is needed to establish longer-term intervention effects, identify recommended intervention characteristics, and explore issues of cost-effectiveness. PMID:25785892

  3. Perceptions of work stress causes and effective interventions in employees working in public, private and non-governmental organisations: a qualitative study

    PubMed Central

    Bhui, Kamaldeep; Dinos, Sokratis; Galant-Miecznikowska, Magdalena; de Jongh, Bertine; Stansfeld, Stephen

    2016-01-01

    Aims and method To identify causes of stress at work as well as individual, organisational and personal interventions used by employees to manage stress in public, private and non-governmental organizations (NGOs). Qualitative interviews were conducted with 51 employees from a range of organisations. Results Participants reported adverse working conditions and management practices as common causes of work stress. Stress-inducing management practices included unrealistic demands, lack of support, unfair treatment, low decision latitude, lack of appreciation, effort–reward imbalance, conflicting roles, lack of transparency and poor communication. Organisational interventions were perceived as effective if they improved management styles, and included physical exercise, taking breaks and ensuring adequate time for planning work tasks. Personal interventions used outside of work were important to prevent and remedy stress. Clinical implications Interventions should improve management practices as well as promoting personal interventions outside of the work setting. PMID:28377811

  4. Functions and responsibilities of organizations dealing with surrogate motherhood in the UK.

    PubMed

    van Den Akker, Olga B. A.

    1998-01-01

    The separation of maternity from social motherhood and progress in reproductive technology raise many social, psychological, medical and legal issues (van den Akker, 1994). The most recent British Medical Association report (BMA, 1996) acknowledged the practice of surrogacy and issued new guidelines for good practice and support for those involved. Surrogate motherhood services have increased around the country over the last decade, even before the formal British Medical Association acknowledgement of their necessity and existence (BMA, 1996). The present survey investigated the incidence, accessibility, and functions of such organizations, specifically, the legal, medical and psychological problems encountered and how they were dealt with, to discover what advice and support is given. Ten centres were interviewed. The incidence of surrogacy conducted through these organizations is widespread, but the processes involved and therefore the implications of the types of surrogacy dealt with are very different. The two major surrogacy agencies deal primarily with partial surrogacy, whereas the clinics are concerned almost exclusively with full (IVF) surrogacy. Information about the procedures involved appears to rely on experience; screening is generally carried out 'in house', and psychological factors are dealt with by counsellors on request by the couples. In general, although the roles of the organizations are disparate and clearly defined, no holistic or long-term care is provided by any of the organizations involved with surrogacy in the UK. The reasons for this are clear cut and stem from the nature of the organizations, and the behaviour of the clients. The data indicate that the current procedures used by the organizations are adequate but could be improved and standardized.

  5. Managerial attitudes and perceived barriers regarding evidence-based practice: An international survey

    PubMed Central

    Jepsen, Denise M.; Houghton, Edward; ten Have, Steven

    2017-01-01

    Evidence-based practice (EBP) in management is still in its infancy. Several studies suggest that managers in businesses and other organizations do not consult the scientific evidence when making decisions. To facilitate its uptake, we need to better understand practitioner attitudes and perceived barriers related to EBP. In medicine and nursing, an abundance of research exists on this subject, although such studies are rare in management. To address this gap, we surveyed 2,789 management practitioners in Belgium, the Netherlands, the United States, the United Kingdom and Australia. Our findings indicate that most managers we studied have positive attitudes towards EBP. However, lack of time and a limited understanding of scientific research are perceived as major barriers to the uptake and implementation of EBP in management. Studies in other professions where EBP is far more established also report similar barriers. We discuss the implications of our findings for practice, education and research, providing suggestions to enhance use of EBP in management practice. PMID:28972977

  6. Tissue adaptation to physical stress: a proposed "Physical Stress Theory" to guide physical therapist practice, education, and research.

    PubMed

    Mueller, Michael J; Maluf, Katrina S

    2002-04-01

    The purpose of this perspective is to present a general theory--the Physical Stress Theory (PST). The basic premise of the PST is that changes in the relative level of physical stress cause a predictable adaptive response in all biological tissue. Specific thresholds define the upper and lower stress levels for each characteristic tissue response. Qualitatively, the 5 tissue responses to physical stress are decreased stress tolerance (eg, atrophy), maintenance, increased stress tolerance (eg, hypertrophy), injury, and death. Fundamental principles of tissue adaptation to physical stress are described that, in the authors' opinion, can be used to help guide physical therapy practice, education, and research. The description of fundamental principles is followed by a review of selected literature describing adaptation to physical stress for each of the 4 main organ systems described in the Guide to Physical Therapist Practice (ie, cardiovascular/pulmonary, integumentary, musculoskeletal, neuromuscular). Limitations and implications of the PST for practice, research, and education are presented.

  7. An integrative model linking feedback environment and organizational citizenship behavior.

    PubMed

    Peng, Jei-Chen; Chiu, Su-Fen

    2010-01-01

    Past empirical evidence has suggested that a positive supervisor feedback environment may enhance employees' organizational citizenship behavior (OCB). In this study, we aim to extend previous research by proposing and testing an integrative model that examines the mediating processes underlying the relationship between supervisor feedback environment and employee OCB. Data were collected from 259 subordinate-supervisor dyads across a variety of organizations in Taiwan. We used structural equation modeling to test our hypotheses. The results demonstrated that supervisor feedback environment influenced employees' OCB indirectly through (1) both positive affective-cognition and positive attitude (i.e., person-organization fit and organizational commitment), and (2) both negative affective-cognition and negative attitude (i.e., role stressors and job burnout). Theoretical and practical implications are discussed.

  8. Kidney transplantation in the elderly.

    PubMed

    Singh, Neeraj; Nori, Uday; Pesavento, Todd

    2009-08-01

    Recent outcome data, ongoing organ shortage and proposed changes in allocation policies are driving the need to review current practices and possible future course of kidney transplantation in the elderly patients. A proposed new kidney allocation system based on matching donor and recipient characteristics to enable 'age-matched' kidney allocation is currently being discussed in the USA. While this system benefits younger recipients, implications for elderly recipients receiving older grafts remain a matter of debate. Despite improved outcomes, there remain significant challenges to kidney transplantation in the elderly, including organ shortage, poor transplant rate, evolving allocation policies, high wait-list mortality and nonstandardized immunosuppression. Prospective studies are needed to evaluate the strategies to meet these challenges and to study the impact of proposed new allocation system.

  9. Medical humanities and their discontents: definitions, critiques, and implications.

    PubMed

    Shapiro, Johanna; Coulehan, Jack; Wear, Delese; Montello, Martha

    2009-02-01

    The humanities offer great potential for enhancing professional and humanistic development in medical education. Yet, although many students report benefit from exposure to the humanities in their medical education, they also offer consistent complaints and skepticism. The authors offer a pedagogical definition of the medical humanities, linking it to medicine as a practice profession. They then explore three student critiques of medical humanities curricula: (1) the content critique, examining issues of perceived relevance and intellectual bait-and-switch, (2) the teaching critique, which examines instructor trustworthiness and perceived personal intrusiveness, and (3) the structural/placement critique, or how and when medical humanities appear in the curriculum. Next, ways are suggested to tailor medical humanities to better acknowledge and reframe the needs of medical students. These include ongoing cross-disciplinary reflective practices in which intellectual tools of the humanities are incorporated into educational activities to help students examine and, at times, contest the process, values, and goals of medical practice. This systematic, pervasive reflection will organically lead to meaningful contributions from the medical humanities in three specific areas of great interest to medical educators: professionalism, "narrativity," and educational competencies. Regarding pedagogy, the implications of this approach are an integrated required curriculum and innovative concepts such as "applied humanities scholars." In turn, systematic integration of humanities perspectives and ways of thinking into clinical training will usefully expand the range of metaphors and narratives available to reflect on medical practice and offer possibilities for deepening and strengthening professional education.

  10. Waiting to see the doctor. The impact of organizational structure on medical practice.

    PubMed

    Wolinsky, F D; Marder, W D

    1983-05-01

    In this article it is assessed whether or not the scheduling and office visit queues a patient faces depend upon the organizational structure of the physician's practice (i.e., does the physician practice in the fee-for-service system or in a health maintenance organization [HMO], and if in an HMO, in what type of an HMO). Data pooled from two national studies (N = 2448) reveal two major findings. First, although scheduling queues may be predicted from the organizational structure of physicians' practices and other factors, office queues appear to be more of a random phenomenon. Second, a distinct pattern emerges among the effects of the organizational structure of physicians' practices on patient queues, including 1) physicians in solo practice offer their patients the shortest queues, 2) physicians in group model HMOs maximize scheduling queues but minimize waiting room queues, 3) patient queues for physicians practicing in IPAs are no different from those of their counterparts in group-practice fee-for-service settings, and 4) patient queues for salaried physicians practicing in a predominantly salaried environment are among the longest. The implications of these findings are discussed with special reference to extent and future studies of the effects of organizational structure on medical practice.

  11. [Back to units for nursing students' education? The Dedicated Education Units (DEU)].

    PubMed

    Randon, Giulia; Bortolami, Elena; Grosso, Silvia

    2017-01-01

    . Back to units for nursing students' education? The Dedicated Education Units (DEU). The reorganization and rationalization of resources and cost containment in health care put a strain on the sustainability of practical training of student nurses. The Dedicated Education Units (DEU), where ward staff, in collaboration with university teachers, receive large numbers of students, integrating the caring and teaching missions, are a possible answer. To describe the main characteristics of DEUs. A literature search was conducted in Pubmed with the following key-words Dedicated Education Unit, Education Unit and Nursing Education, up to January 30, 2017. Several models of DEU were identified with differences in contexts, professional roles involved, type of organizations (number of students, length of practical training). The students perceive a welcoming climate that promotes learning and allows time and space for reflection; they develop a professional group identity and learn to recognize and implement the presponsibilities related to the professional role. The students express satisfaction for the relationship with professionals involved in their education due to the clear definition of roles and responsibilities, of their learning needs and feel supported in the connections of theory and practice. The DEU, receiving large number of students optimize the use of resources. The DEU represent one of the possible models of organization of the practical training, able to ensure a high quality learning environment. The practical implications of its implementation in the italian context on skills acquisition and sustainability need a thorough assessment.

  12. Organizational theory for dissemination and implementation research.

    PubMed

    Birken, Sarah A; Bunger, Alicia C; Powell, Byron J; Turner, Kea; Clary, Alecia S; Klaman, Stacey L; Yu, Yan; Whitaker, Daniel J; Self, Shannon R; Rostad, Whitney L; Chatham, Jenelle R Shanley; Kirk, M Alexis; Shea, Christopher M; Haines, Emily; Weiner, Bryan J

    2017-05-12

    Even under optimal internal organizational conditions, implementation can be undermined by changes in organizations' external environments, such as fluctuations in funding, adjustments in contracting practices, new technology, new legislation, changes in clinical practice guidelines and recommendations, or other environmental shifts. Internal organizational conditions are increasingly reflected in implementation frameworks, but nuanced explanations of how organizations' external environments influence implementation success are lacking in implementation research. Organizational theories offer implementation researchers a host of existing, highly relevant, and heretofore largely untapped explanations of the complex interaction between organizations and their environment. In this paper, we demonstrate the utility of organizational theories for implementation research. We applied four well-known organizational theories (institutional theory, transaction cost economics, contingency theories, and resource dependency theory) to published descriptions of efforts to implement SafeCare, an evidence-based practice for preventing child abuse and neglect. Transaction cost economics theory explained how frequent, uncertain processes for contracting for SafeCare may have generated inefficiencies and thus compromised implementation among private child welfare organizations. Institutional theory explained how child welfare systems may have been motivated to implement SafeCare because doing so aligned with expectations of key stakeholders within child welfare systems' professional communities. Contingency theories explained how efforts such as interagency collaborative teams promoted SafeCare implementation by facilitating adaptation to child welfare agencies' internal and external contexts. Resource dependency theory (RDT) explained how interagency relationships, supported by contracts, memoranda of understanding, and negotiations, facilitated SafeCare implementation by balancing autonomy and dependence on funding agencies and SafeCare developers. In addition to the retrospective application of organizational theories demonstrated above, we advocate for the proactive use of organizational theories to design implementation research. For example, implementation strategies should be selected to minimize transaction costs, promote and maintain congruence between organizations' dynamic internal and external contexts over time, and simultaneously attend to organizations' financial needs while preserving their autonomy. We describe implications of applying organizational theory in implementation research for implementation strategies, the evaluation of implementation efforts, measurement, research design, theory, and practice. We also offer guidance to implementation researchers for applying organizational theory.

  13. Sources of avoidance motivation: Valence effects from physical effort and mental rotation.

    PubMed

    Morsella, Ezequiel; Feinberg, Giles H; Cigarchi, Sepeedeh; Newton, James W; Williams, Lawrence E

    2011-09-01

    When reaching goals, organisms must simultaneously meet the overarching goal of conserving energy. According to the law of least effort, organisms will select the means associated with the least effort. The mechanisms underlying this bias remain unknown. One hypothesis is that organisms come to avoid situations associated with unnecessary effort by generating a negative valence toward the stimuli associated with such situations. Accordingly, merely using a dysfunctional, 'slow' computer mouse causes participants to dislike ambient neutral images (Study 1). In Study 2, nonsense shapes were liked less when associated with effortful processing (135° of mental rotation) versus easier processing (45° of rotation). Complementing 'fluency' effects found in perceptuo-semantic research, valence emerged from action-related processing in a principled fashion. The findings imply that negative valence associations may underlie avoidance motivations, and have practical implications for educational/workplace contexts in which effort and positive affect are conducive to success.

  14. Help Others and Yourself Eventually: Exploring the Relationship between Help-Giving and Employee Creativity under the Model of Perspective Taking.

    PubMed

    Li, Si; Liao, Shudi

    2017-01-01

    Although a plethora of studies have examined the antecedents of creativity, empirical studies exploring the role of individual behaviors in relation to creativity are relatively scarce. Drawing on the model of perspective taking, this study examines the relationship between help-giving during creative problem solving process and employee creativity. Specifically, we test perspective taking as an explanatory mechanism and propose organization-based self-esteem as the moderator. In a sample collected from a field survey of 247 supervisor-subordinate dyads from 2 large organizations in China at 3 time points, we find that help-giving during creative problem solving process positively related with perspective taking; perspective taking positively related with employees' creativity; employees' organization-based self-esteem strengthened the link between perspective taking and creativity; besides, there existed a moderated mediation effect. We conclude this paper with discussions on the implications for theory, research, and practice.

  15. [Creation and management of organizational knowledge].

    PubMed

    Shinyashiki, Gilberto Tadeu; Trevizan, Maria Auxiliadora; Mendes, Isabel Amélia

    2003-01-01

    With a view to creating and establishing a sustainable position of competitive advantage, the best organizations are increasingly investing in the application of concepts such as learning, knowledge and competency. The organization's creation or acquisition of knowledge about its actions represents an intangible resource that is capable of conferring a competitive advantage upon them. This knowledge derives from interactions developed in learning processes that occur in the organizational environment. The more specific characteristics this knowledge demonstrates in relation to the organization, the more it will become the foundation of its core competencies and, consequently, an important strategic asset. This article emphasizes nurses' role in the process of knowledge management, placing them in the intersection between horizontal and vertical information levels as well as in the creation of a sustainable competitive advantage. Authors believe that this contribution may represent an opportunity for a reflection about its implications for the scenarious of health and nursing practices.

  16. Can Regional Climate Modeling Capture the Observed Changes in Spatial Organization of Extreme Storms at Higher Temperatures?

    NASA Astrophysics Data System (ADS)

    Li, J.; Wasko, C.; Johnson, F.; Evans, J. P.; Sharma, A.

    2018-05-01

    The spatial extent and organization of extreme storm events has important practical implications for flood forecasting. Recently, conflicting evidence has been found on the observed changes of storm spatial extent with increasing temperatures. To further investigate this question, a regional climate model assessment is presented for the Greater Sydney region, in Australia. Two regional climate models were considered: the first a convection-resolving simulation at 2-km resolution, the second a resolution of 10 km with three different convection parameterizations. Both the 2- and the 10-km resolutions that used the Betts-Miller-Janjic convective scheme simulate decreasing storm spatial extent with increasing temperatures for 1-hr duration precipitation events, consistent with the observation-based study in Australia. However, other observed relationships of extreme rainfall with increasing temperature were not well represented by the models. Improved methods for considering storm organization are required to better understand potential future changes.

  17. Food allergies developing after solid organ transplant.

    PubMed

    Needham, J M; Nicholas, S K; Davis, C M

    2015-12-01

    The development of food allergy is an increasingly recognized form of morbidity after solid organ transplant. It occurs more commonly in liver transplant recipients, although it has also been reported in heart, lung, kidney, and intestinal transplants. Pediatric transplant recipients are more likely to develop symptoms compared to adults, and reports of frequency vary widely from 5% to 38% in pediatric liver transplant recipients. Multiple mechanisms have been proposed in the literature, although no single mechanism can yet account for all reported observations. As food allergy can have at worst potentially fatal consequences, and at best require lifestyle adjustment through food avoidance, it is important for recipients to be aware of the donor's food allergies and particularly in pediatrics, the possibility of completely de novo allergies. This review explores the recent reports surrounding food allergy after solid organ transplant, including epidemiology, proposed mechanisms, and implications for practice. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. A mass mediated intervention on Hispanic live kidney donation.

    PubMed

    Alvaro, Eusebio M; Siegel, Jason T; Crano, William D; Dominick, Alexander

    2010-06-01

    This research examines the impact of a Spanish language mass media campaign on living organ donation attitudes and behavioral intentions among Spanish dominant Hispanics in Tucson, Arizona. Impact was assessed via a pretest/posttest control group quasiexperimental design with Tucson, Arizona, as the intervention community and Phoenix, Arizona, as the control. Preintervention focus groups provided qualitative data to guide intervention development, while telephone surveys in both communities provided quantitative data to assess campaign impact. Analyses reveal pretest/posttest differences in the intervention community such that posttest intentions regarding living organ donation behaviors increased from pretest. No such differences were observed in the control community. Subsequent analyses revealed differences between respondents in the intervention community exposed to the campaign vs. those in the same community not exposed to the campaign. Exposed respondents reported more positive living organ donation behavioral intentions than nonexposed respondents. Implications for research and practice are discussed.

  19. Exploring engagement in a virtual community of practice in pediatric rehabilitation: who are non-users, lurkers, and posters?

    PubMed

    Hurtubise, Karen; Pratte, Gabrielle; Rivard, Lisa; Berbari, Jade; Héguy, Léa; Camden, Chantal

    2017-12-20

    Communities of practice are increasingly recognized in rehabilitation as useful knowledge transfer tools; however, little is known about their users. This exploratory study describes the characteristics of participants and non-participants invited to engage in a pediatric rehabilitation virtual community of practice. In addition, we explored virtual community of practice utilization behaviors, engagement predictors, and the impact of strategies designed to foster engagement. Participants' demographics including information-seeking style and organization e-readiness, as well as online platform frequency of use data were collected and analyzed using descriptive, comparative, and predictive statistics. Seventy-four percent of those invited used the virtual community of practice. Users had less years of experience in pediatric rehabilitation than non-users. Among the users, 71% were classified as "lurkers," who engaged through reading content only; while 29% were classified as "posters," editing online content. Predictive factors were not uncovered, however an increased number of forum visits correlated with being a poster, a non-information seeker, an employee of an organization demonstrating e-readiness, and regularly working with children with the virtual community of practice specific condition. User-engagement strategies increased visits to the forum. These findings will assist rehabilitation leaders in leveraging rehabilitation-specific virtual community of practice to improve knowledge transfer and practice in pediatric rehabilitation and disability management. Implications for Rehabilitation Communities of practice are increasingly recognized as useful knowledge transfer tools for rehabilitation professionals and are made more accessible thanks to virtual technologies. Our virtual community of practice was found to be optimized in health care organizations with an electronic culture, when the topic area had daily relevance to its target audience, and was particularly beneficial for those who have limited years of experience in pediatric rehabilitation. A strongly committed, selected leadership team with the technological skills, content expertise, and designated time to maintain the site and to nurture discussion was deemed vital in fostering knowledge exchange in this context. User-focused engagement strategies showed promise in increasing visits to the virtual community of practice. Our study supports the importance of multi-pronged approaches in enhancing health care professional knowledge and skills Findings from this study will assist rehabilitation leaders in optimally leveraging rehabilitation-specific virtual community of practice to improve knowledge transfer in pediatric rehabilitation and disability management.

  20. Identity threat and stigma in cancer patients

    PubMed Central

    Marziliano, Allison; Moyer, Anne

    2014-01-01

    Cancer stigma has undergone an important transformation in recent decades. In general, this disease no longer fits squarely into Goffman’s classic taxonomy of stigmatized conditions. This review will demonstrate that, with important adaptations, an identity-threat model of stigma can be used to organize cancer stigma research post-Goffman. This adapted model postulates that one’s personal attributions, responses to situational threat, and disease/treatment characteristics can be used to predict identity threat and well-being of individuals with cancer. Implications for further research and clinical practice are discussed. PMID:28070343

  1. Quality Measures in Stroke

    PubMed Central

    Poisson, Sharon N.; Josephson, S. Andrew

    2011-01-01

    Stroke is a major public health burden, and accounts for many hospitalizations each year. Due to gaps in practice and recommended guidelines, there has been a recent push toward implementing quality measures to be used for improving patient care, comparing institutions, as well as for rewarding or penalizing physicians through pay-for-performance. This article reviews the major organizations involved in implementing quality metrics for stroke, and the 10 major metrics currently being tracked. We also discuss possible future metrics and the implications of public reporting and using metrics for pay-for-performance. PMID:23983840

  2. A Holistic Theoretical Approach to Intellectual Disability: Going Beyond the Four Current Perspectives.

    PubMed

    Schalock, Robert L; Luckasson, Ruth; Tassé, Marc J; Verdugo, Miguel Angel

    2018-04-01

    This article describes a holistic theoretical framework that can be used to explain intellectual disability (ID) and organize relevant information into a usable roadmap to guide understanding and application. Developing the framework involved analyzing the four current perspectives on ID and synthesizing this information into a holistic theoretical framework. Practices consistent with the framework are described, and examples are provided of how multiple stakeholders can apply the framework. The article concludes with a discussion of the advantages and implications of a holistic theoretical approach to ID.

  3. 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.)

  4. Can the Brain-Dead Be Harmed or Wronged?: On the Moral Status of Brain Death and its Implications for Organ Transplantation.

    PubMed

    Nair-Collins, Michael

    2017-01-01

    The majority of transplantable human organs are retrieved from patients declared dead by neurological criteria, or "brain-dead." Since brain death is considered to be sufficient for death, the procurement of vital organs is not considered to harm or wrong such patients. In this essay I argue that this is not the case. After distinguishing welfare, experiential, and investment interests, and defining precedent autonomy and surviving interests, I argue that brain-dead patients can be, and many are, harmed and wronged by organ procurement as currently practiced. Indeed, with respect to precedent autonomy and surviving investment interests, the brain-dead are morally equivalent to patients with severe dementia, and thus can be harmed and wronged if and only if, and to the extent that, patients with severe dementia can. The "bright line" that separates brain death from all other conditions for clinical and legal purposes is not justified by any morally relevant distinctions.

  5. It's up to you: a multi-message, phased driver facility campaign to increase organ donation registration rates in Illinois.

    PubMed

    Quick, Brian; Harrison, Tyler R; King, Andy J; Bosch, Dave

    2013-01-01

    The present project applied successful strategies employed in previous driver facility campaigns occurring during the inception of a registry to examine whether these approaches are effective in growing a mature registry, a registry where the majority of individuals have had the opportunity to register as an organ donor. Driver facilities (N = 40) in Illinois with high (n = 20) and low (n = 20) organ donation registration percentages were selected and served as either intervention or control sites for the campaign. Among facilities with historically high and low registration percentages, support for the campaign was found with the intervention facilities experiencing higher organ donation registration rates compared with control facilities. In addition, the results provide partial support for the effectiveness of employing a multi-message, phased driver facility intervention in states with a mature registry. The practical implications of utilizing driver facility campaigns in states with an established first-person consent registry also are discussed. © 2013 John Wiley & Sons A/S.

  6. Transplant tourism: a modern iteration of an ancient problem.

    PubMed

    Khamash, Hasan A; Gaston, Robert S

    2008-08-01

    To explore the scope and implications of emerging global problem of transplant tourism, a practice in which patients seek transplant services (most commonly kidney allografts) in countries other than their permanent residence. Potential remedies that must be implemented if abuses are to be curbed are also offered. Although traveling abroad for medical services may not be problematic from a number of perspectives, what makes transplant tourism so troubling is its link with organ trafficking and transplant commercialism. Unlike many illegal markets, however, this one is driven by the need of patients with irreversible kidney failure, who, along with kidney vendors, are the most vulnerable participants in the process in terms of medical and financial outcomes. This review explores the scope and implications of transplant tourism, and offers potential remedies that must be implemented if abuses are to be curbed.

  7. Healthcare waste management: an interpretive structural modeling approach.

    PubMed

    Thakur, Vikas; Anbanandam, Ramesh

    2016-06-13

    Purpose - The World Health Organization identified infectious healthcare waste as a threat to the environment and human health. India's current medical waste management system has limitations, which lead to ineffective and inefficient waste handling practices. Hence, the purpose of this paper is to: first, identify the important barriers that hinder India's healthcare waste management (HCWM) systems; second, classify operational, tactical and strategical issues to discuss the managerial implications at different management levels; and third, define all barriers into four quadrants depending upon their driving and dependence power. Design/methodology/approach - India's HCWM system barriers were identified through the literature, field surveys and brainstorming sessions. Interrelationships among all the barriers were analyzed using interpretive structural modeling (ISM). Fuzzy-Matrice d'Impacts Croisés Multiplication Appliquée á un Classement (MICMAC) analysis was used to classify HCWM barriers into four groups. Findings - In total, 25 HCWM system barriers were identified and placed in 12 different ISM model hierarchy levels. Fuzzy-MICMAC analysis placed eight barriers in the second quadrant, five in third and 12 in fourth quadrant to define their relative ISM model importance. Research limitations/implications - The study's main limitation is that all the barriers were identified through a field survey and barnstorming sessions conducted only in Uttarakhand, Northern State, India. The problems in implementing HCWM practices may differ with the region, hence, the current study needs to be replicated in different Indian states to define the waste disposal strategies for hospitals. Practical implications - The model will help hospital managers and Pollution Control Boards, to plan their resources accordingly and make policies, targeting key performance areas. Originality/value - The study is the first attempt to identify India's HCWM system barriers and prioritize them.

  8. Development of a comprehensive model for stakeholder management in mental healthcare.

    PubMed

    Bierbooms, Joyce; Van Oers, Hans; Rijkers, Jeroen; Bongers, Inge

    2016-06-20

    Purpose - Stakeholder management is not yet incorporated into the standard practice of most healthcare providers. The purpose of this paper is to assess the applicability of a comprehensive model for stakeholder management in mental healthcare organization for more evidence-based (stakeholder) management. Design/methodology/approach - The assessment was performed in two research parts: the steps described in the model were executed in a single case study at a mental healthcare organization in the Netherlands; and a process and effect evaluation was done to find the supporting and impeding factors with regard to the applicability of the model. Interviews were held with managers and directors to evaluate the effectiveness of the model with a view to stakeholder management. Findings - The stakeholder analysis resulted in the identification of eight stakeholder groups. Different expectations were identified for each of these groups. The analysis on performance gaps revealed that stakeholders generally find the collaboration with a mental healthcare provider "sufficient." Finally a prioritization showed that five stakeholder groups were seen as "definite" stakeholders by the organization. Practical implications - The assessment of the model showed that it generated useful knowledge for more evidence-based (stakeholder) management. Adaptation of the model is needed to increase its feasibility in practice. Originality/value - Provided that the model is properly adapted for the specific field, the analysis can provide more knowledge on stakeholders and can help integrate stakeholder management as a comprehensive process in policy planning.

  9. 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…

  10. The management of advanced practitioner preparation: a work-based challenge.

    PubMed

    Livesley, Joan; Waters, Karen; Tarbuck, Paul

    2009-07-01

    This paper explores the collaborative development of a Master's level advanced practice programme in the context of the radical reform and remodelling of the UK's National Health Service. Some of the educational, managerial and practice challenges are discussed. Changes to education and training in response to key strategic reviews undertaken by the Greater Manchester Strategic Health Authority (North West of England) established a need to develop nurses and allied health care practitioners to advanced practitioner level. This paper considers how employers, commissioners and educationalists worked together to produce a Master's level programme to prepare nurses and other health care practitioners for sustainable advanced practice roles. Developing innovative and effective curricula to meet the needs of post graduate students from varied backgrounds preparing to practice in different contexts with different client groups is challenging. However, the development of individual learning pathways and work-based learning ensures that the student's work and intended advanced practice role remains at the centre of their learning. Analysis of each student's knowledge and skill deficits alongside an analysis of the organization's readiness to support them as qualified advanced practitioners (APs) is instrumental in ensuring that organizations are ready to support practitioners in new roles. Work-based learning and collaboration between students, employers and higher education institutions can be used to enable managers and students to unravel the network of factors which affect advanced practice in health and social care. Additionally, collaborative working can help to create opportunities to develop strategies that will facilitate change. Implications for nursing management Sustainable change concerned with the introduction of advanced practitioner roles present a real challenge for managers at a strategic and operational level. Commissioning flexible, collaborative and service-led educational programmes can assist in ensuring that change is sustainable and produce practitioners who are fit for practice, purpose and award.

  11. Discourses in stroke rehabilitation as they present themselves in current physiotherapy and occupational therapy.

    PubMed

    Kristensen, Hanne Kaae; Præstegaard, Jeanette; Ytterberg, Charlotte

    2017-02-01

    Aim This study aims to discuss current perceptions of rehabilitation and how present rehabilitation practice is affected by dominating discourses in Danish society by exploring discourses expressed in official publications and the constructed journal notes of occupational and physiotherapists' practice of stroke rehabilitation. Method The frame of reference is Fairclough's critical discourse analysis. The analysis comprises seven official documents relevant to stroke rehabilitation provided in Danish health services in 2012-2013. Also, notes written by occupational therapists and physiotherapists in medical records of 10 patients with a stroke diagnosis admitted to hospital in 2012. The documents included were read thoroughly. The texts were analyzed deductively, focusing on discursive practice on articulated understandings of rehabilitation, health practice approaches, and social practice. Results The dominating discourses seem to be Western neoliberalism organizational, medical and ethical discourses. The macro level of discourses consisted of political documents addressing rehabilitation nationally. The meso level mainly concerned medical discourses within stroke rehabilitation whereas the micro level represented local medical and ethical discourses. Conclusion The neoliberal discourse supports the medical discourse with strong emphasis on evidence-based interventions. In contrast to ethical discourses, documentation of rehabilitation practice marked more attention being paid to facilitating the patient's independence than to enabling the regaining of meaningful activities and participation. Implications for Rehabilitation Individualized rehabilitation must be organized with flexibility as it is a complex process Critical reflectiveness among health professionals is needed to provide individualized rehabilitation of high quality A broader range of stake holders, including patient organizations, are in demand within health policy making The discourses that construct rehabilitation policy and practices are sometimes in conflict, which may impact on, and impede, the rehabilitation for the individual patient.

  12. Socio-hydrological implications of water management in the dry zone of Sri Lanka

    NASA Astrophysics Data System (ADS)

    Upeksha Gamage, Isurun; Arachchige Hemachandra Jayasena, Hetti

    2018-06-01

    Water management plays a vital role in the agricultural economy and living conditions of people in Sri Lanka. Though government and non-government organizations have been readily contributing to water management, it is still inefficient, especially in terms of water allocation, consumption and conservation. To identify factors which could be used to implement integrated water resources management (IWRM), a socio-hydrological study was performed in five areas within the dry zone in Sri Lanka. The study covers a comprehensive analysis of how the household income, demography and education level correlating to water usage, purification and disposal methods. The average household income ranges from LKR 2500 to 15 000 per month. The results show that the average daily usage for drinking, cooking, washing, toiletries and bathing are 3, 5, 10, 7, and 85 L per person, respectively. Majority of the families use dug wells and pipe-borne water as the primary source. Correlation coefficients suggest that higher household income or level of education leads to increased water consumption (R = 0.91, 0.94). There is no linear relationship between the level of education with the good practices of water purification and disposal. Though these results indicate preliminary assessments based on the dry zone practices, efficient water management could be enhanced by strong socio-hydrological implications through educating people on conservation, usage, disposal practices and health concerns.

  13. Establishing the boundaries and building bridges: a literature review on ecological theory: implications for research into the refugee parenting experience.

    PubMed

    Williams, Nombasa

    2010-03-01

    Currently an ecological model for conceptualizing and capturing the refugee parenting experience is lacking. After an extensive review of the literature related to the usages of Bronfenbrenner's ecological model of child development, a gap was found in knowledge and research centred on describing the environment of pre-resettlement (i.e. pre-flight, flight, migration, camp) contexts and their impact on refugee parents and carer experiences. The culture of the refugee parenting experience may be characterized by disruptions in and alterations to family structure and organization; values and norms; and gender roles. This paper begins by examining the definition and usages of existing ecological frameworks in the 20th and 21st century. Particular attention is drawn to the gaps in the existing literature and an ecological model is offered. The paper concludes with a discussion of the implications for practice. The outcomes of this paper suggest the need for practitioners, policymakers and researchers to engage and develop culturally competent, relevant and appropriate interventions (i.e. reconciling differing beliefs and behaviours concerning child-rearing practices; affirming positive parenting practices of these families during engagement protocols and processes; adopting a strengths-based orientation) in the area of child protection whilst at the same time safeguarding and promoting the welfare of children within pre- and post-resettlement contexts.

  14. Trayvon Martin: Racial Profiling, Black Male Stigma, and Social Work Practice.

    PubMed

    Teasley, Martell Lee; Schiele, Jerome H; Adams, Charles; Okilwa, Nathern S

    2018-01-01

    To address a critical gap in the social work literature, this article examines the deleterious effects of racial profiling as it pertains to police targeting of male African Americans. The authors use the Trayvon Martin court case to exemplify how racial profiling and black male stigma help perpetuate social inequality and injustice for black men. A racism-centered perspective is examined historically and contemporarily as a theoretical approach to understanding the role that race plays in social injustice through racial profiling. Implications for social work research design and practice aimed at increasing the social work knowledge base on racial profiling are discussed. The authors call for attention and advocacy by major social work organizations in the reduction of black male stigma and racial profiling. © 2017 National Association of Social Workers.

  15. Rewards.

    PubMed

    Gunderman, Richard B; Kamer, Aaron P

    2011-05-01

    For much of the 20th century, psychologists and economists operated on the assumption that work is devoid of intrinsic rewards, and the only way to get people to work harder is through the use of rewards and punishments. This so-called carrot-and-stick model of workplace motivation, when applied to medical practice, emphasizes the use of financial incentives and disincentives to manipulate behavior. More recently, however, it has become apparent that, particularly when applied to certain kinds of work, such approaches can be ineffective or even frankly counterproductive. Instead of focusing on extrinsic rewards such as compensation, organizations and their leaders need to devote more attention to the intrinsic rewards of work itself. This article reviews this new understanding of rewards and traces out its practical implications for radiology today. Copyright © 2011. Published by Elsevier Inc.

  16. 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.

  17. 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…

  18. Organic synthesis: march of the machines.

    PubMed

    Ley, Steven V; Fitzpatrick, Daniel E; Ingham, Richard J; Myers, Rebecca M

    2015-03-09

    Organic synthesis is changing; in a world where budgets are constrained and the environmental impacts of practice are scrutinized, it is increasingly recognized that the efficient use of human resource is just as important as material use. New technologies and machines have found use as methods for transforming the way we work, addressing these issues encountered in research laboratories by enabling chemists to adopt a more holistic systems approach in their work. Modern developments in this area promote a multi-disciplinary approach and work is more efficient as a result. This Review focuses on the concepts, procedures and methods that have far-reaching implications in the chemistry world. Technologies have been grouped as topics of opportunity and their recent applications in innovative research laboratories are described. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Endoscopic ultrasound in gastroenterology: from diagnosis to therapeutic implications.

    PubMed

    Mekky, Mohamed A; Abbas, Wael A

    2014-06-28

    Since its advent in 1980, the scope of endoscopic ultrasound (EUS) has grown to include a wide range of indications, and it is now being incorporated as an integral part of everyday practice in the field of gastroenterology. Its use is extending from an adjuvant imaging aid to utilization as a therapeutic tool for various gastrointestinal disorders. EUS was first used to visualize remote organs, such as the pancreas and abdominal lymph nodes. When fine needle aspiration was introduced, the indications for EUS expanded to include tissue sampling for diagnostic purposes. At the same time, the needle can be used to convey a potential therapy to the internal organs, allowing access to remote sites. In this review, we aim to highlight the expanding spectrum of EUS indications and uses in the field of gastroenterology.

  20. From boundaries to boundary work: middle managers creating inter-organizational change.

    PubMed

    Oldenhof, Lieke; Stoopendaal, Annemiek; Putters, Kim

    2016-11-21

    Purpose In healthcare, organizational boundaries are often viewed as barriers to change. The purpose of this paper is to show how middle managers create inter-organizational change by doing boundary work: the dual act of redrawing boundaries and coordinating work in new ways. Design/methodology/approach Theoretically, the paper draws on the concept of boundary work from Science and Technology Studies. Empirically, the paper is based on an ethnographic investigation of middle managers that participate in a Dutch reform program across health, social care, and housing. Findings The findings show how middle managers create a sense of urgency for inter-organizational change by emphasizing "fragmented" service provision due to professional, sectoral, financial, and geographical boundaries. Rather than eradicating these boundaries, middle managers change the status quo gradually by redrawing composite boundaries. They use boundary objects and a boundary-transcending vocabulary emphasizing the need for societal gains that go beyond production targets of individual organizations. As a result, work is coordinated in new ways in neighborhood teams and professional expertise is being reconfigured. Research limitations/implications Since boundary workers create incremental change, it is necessary to follow their work for a longer period to assess whether boundary work contributes to paradigm change. Practical implications Organizations should pay attention to conditions for boundary work, such as legitimacy of boundary workers and the availability of boundary spaces that function as communities of practice. Originality/value By shifting the focus from boundaries to boundary work, this paper gives valuable insights into "how" boundaries are redrawn and embodied in objects and language.

  1. Similarities and differences in neuroplasticity mechanisms between brain gliomas and nonlesional epilepsy.

    PubMed

    Bourdillon, Pierre; Apra, Caroline; Guénot, Marc; Duffau, Hugues

    2017-12-01

    To analyze the conceptual and practical implications of a hodotopic approach in neurosurgery, and to compare the similarities and the differences in neuroplasticity mechanisms between low-grade gliomas and nonlesional epilepsy. We review the recent data about the hodotopic organization of the brain connectome, alongside the organization of epileptic networks, and analyze how these two structures interact, suggesting therapeutic prospects. Then we focus on the mechanisms of neuroplasticity involved in glioma natural course and after glioma surgery. Comparing these mechanisms with those in action in an epileptic brain highlights their differences, but more importantly, gives an original perspective to the consequences of surgery on an epileptic brain and what could be expected after pathologic white matter removal. The organization of the brain connectome and the neuroplasticity is the same in all humans, but different pathologic mechanisms are involved, and specific therapeutic approaches have been developed in epilepsy and glioma surgery. We demonstrate that the "connectome" point of view can enrich epilepsy care. We also underscore how theoretical and practical tools commonly used in epilepsy investigations, such as invasive electroencephalography, can be of great help in awake surgery in general. Putting together advances in understanding of connectomics and neuroplasticity, leads to significant conceptual improvements in epilepsy surgery. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  2. Government and voluntary sector differences in organizational capacity to do and use evaluation.

    PubMed

    Cousins, J Bradley; Goh, Swee C; Elliott, Catherine; Aubry, Tim; Gilbert, Nathalie

    2014-06-01

    Research on evaluation capacity is limited although a recent survey article on integrating evaluation into the organizational culture (Cousins, Goh, Clark, & Lee, 2004) revealed that interest in the topic is increasing. While knowledge about building the capacity to do evaluation has developed considerably, less is understood about building the organizational capacity to use evaluation. This article reports on the results of a pan-Canadian survey of evaluators working in organizations (internal evaluators or organization members with evaluation responsibility) conducted in 2007. Reliability across all constructs was high. Responses from government evaluators (N=160) were compared to responses from evaluators who work in the voluntary sector (N=89). The former were found to self-identify more highly as 'evaluators' (specialists) whereas the latter tended to identify as 'managers' (non-specialists). As a result, government evaluators had significantly higher self-reported levels of evaluation knowledge (both theory and practice); and they spent more time performing evaluation functions. However, irrespective of role, voluntary sector respondents rated their organizations more favorably than did their government sector counterparts with respect to the antecedents or conditions supporting evaluation capacity, and the capacity to use evaluation. Results are discussed in terms of their implications for evaluation practice and ongoing research. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Absence of significant dissent should be sufficient for deceased donor organ procurement in New Zealand.

    PubMed

    Douglas, Thomas M; Douglas, Nicholas M

    2009-10-01

    New Zealand's organ donation rates are among the lowest in the OECD. In a bid to increase organ availability, the New Zealand Human Tissue Act 2008 introduces new consent arrangements for deceased donor organ procurement. This article assesses these new arrangements and presents the case for further reform. Our assessment and arguments are based on philosophical analysis informed by empirical data on the effectiveness of alternative consent systems. We: 1) Identify widely held ethical judgments about policies and practices relevant to organ donation (e.g. those relating to coronial post-mortems), 2) Assess the implications of these judgments for the Human Tissue Act and the assumptions that underpin it, and 3) Derive policy recommendations that are consistent with the judgments. The Human Tissue Act 2008 retains a strong consent requirement for organ procurement: organs may not be transplanted unless either the deceased or the family consents. We argue that organ availability could and should be increased by shifting from a model that requires consent to one that requires the absence of significant dissent. We recommend that New Zealand adopt either 1) an organ donation system similar to the existing system for ordering coronial post-mortems, or 2) a variant of the 'opt-out' system already in place in several other countries.

  4. An investigation into mature adults' attitudinal reluctance to register as organ donors.

    PubMed

    Quick, Brian L; Reynolds-Tylus, Tobias; Fico, Ashley E; Feeley, Thomas Hugh

    2016-10-01

    Mature adults (age 50-64) make up a large proportion of organ transplant recipients, and waiting list candidates yet are underrepresented in terms of actual donors. Understanding the reasons why mature adults fail to register as deceased organ donors is critical in achieving the goal of increasing the actionable supply of organs available for transplant. Conceptual models propose certain factors such as bodily integrity, ick (i.e., disgust), jinx (i.e., superstition), medical mistrust, salience, self-efficacy, and stake are associated with organ donation registration attitudes. Moreover, the age myth, or the belief that one's age prevents them from becoming an organ donor, was examined among mature adults between the ages of 50-64. An online survey was disseminated to mature adults (N=709). Results indicated jinx, salience, self-efficacy, and stake each predicted organ donation attitudes among mature adults. Moreover, results indicated that age myth accounted for attitudes toward registering as an organ donor among non-registered mature adults after controlling for non-cognitive and vested interest constructs. This study demonstrates the age myth is negatively associated with attitudes toward registering as organ donors. The results are discussed with an emphasis on both the theoretical and practical implications of study findings. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Practice Location Characteristics of Non-Traditional Dental Practices.

    PubMed

    Solomon, Eric S; Jones, Daniel L

    2016-04-01

    Current and future dental school graduates are increasingly likely to choose a non-traditional dental practice-a group practice managed by a dental service organization or a corporate practice with employed dentists-for their initial practice experience. In addition, the growth of non-traditional practices, which are located primarily in major urban areas, could accelerate the movement of dentists to those areas and contribute to geographic disparities in the distribution of dental services. To help the profession understand the implications of these developments, the aim of this study was to compare the location characteristics of non-traditional practices and traditional dental practices. After identifying non-traditional practices across the United States, the authors located those practices and traditional dental practices geographically by zip code. Non-traditional dental practices were found to represent about 3.1% of all dental practices, but they had a greater impact on the marketplace with almost twice the average number of staff and annual revenue. Virtually all non-traditional dental practices were located in zip codes that also had a traditional dental practice. Zip codes with non-traditional practices had significant differences from zip codes with only a traditional dental practice: the populations in areas with non-traditional practices had higher income levels and higher education and were slightly younger and proportionally more Hispanic; those practices also had a much higher likelihood of being located in a major metropolitan area. Dental educators and leaders need to understand the impact of these trends in the practice environment in order to both prepare graduates for practice and make decisions about planning for the workforce of the future.

  6. Linking Nurse Leadership and Work Characteristics to Nurse Burnout and Engagement.

    PubMed

    Lewis, Heather Smith; Cunningham, Christopher J L

    2016-01-01

    Burnout and engagement are critical conditions affecting patient safety and the functioning of healthcare organizations; the areas of worklife model suggest that work environment characteristics may impact employee burnout and general worklife quality. The purpose was to present and test a conditional process model linking perceived transformational nurse leadership to nurse staff burnout and engagement via important work environment characteristics. Working nurses (N = 120) provided perceptions of the core study variables via Internet- or paper-based survey. The hypothesized model was tested using the PROCESS analysis tool, which enables simultaneous testing of multiple, parallel, indirect effects within the SPSS statistical package. Findings support the areas of worklife model and suggest that transformational leadership is strongly associated with work environment characteristics that are further linked to nurse burnout and engagement. Interestingly, different work characteristics appear to be critical channels through which transformational leadership impacts nurse burnout and engagement. There are several methodological and practical implications of this work for researchers and practitioners interested in preventing burnout and promoting occupational health within healthcare organizations. These implications are tied to the connections observed between transformational leadership, specific work environment characteristics, and burnout and engagement outcomes.

  7. Sport medicine and sport science practitioners' experiences of organizational change.

    PubMed

    Wagstaff, C R D; Gilmore, S; Thelwell, R C

    2015-10-01

    Despite the emergence of and widespread uptake of a growing range of medical and scientific professions in elite sport, such environs present a volatile professional domain characterized by change and unprecedentedly high turnover of personnel. This study explored sport medicine and science practitioners' experiences of organizational change using a longitudinal design over a 2-year period. Specifically, data were collected in three temporally defined phases via 49 semi-structured interviews with 20 sport medics and scientists employed by three organizations competing in the top tiers of English football and cricket. The findings indicated that change occurred over four distinct stages; anticipation and uncertainty, upheaval and realization, integration and experimentation, normalization and learning. Moreover, these data highlight salient emotional, behavioral, and attitudinal experiences of medics and scientists, the existence of poor employment practices, and direct and indirect implications for on-field performance following organizational change. The findings are discussed in line with advances to extant change theory and applied implications for prospective sport medics and scientists, sport organizations, and professional bodies responsible for the training and development of neophyte practitioners. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Revenue sources for essential services in Florida: findings and implications for organizing and funding public health.

    PubMed

    Livingood, William C; Morris, Michael; Sorensen, Bonita; Chapman, Karen; Rivera, Lillian; Beitsch, Les; Street, Phil; Coughlin, Susan; Smotherman, Carmen; Wood, David

    2013-01-01

    The Florida Public Health Practice-Based Research Network conducted the study of Florida county health departments (CHDs) to assess relationships between self-assessed performance on essential services (ESs) and sources of funding. Primary data were collected using an online survey based on Public Health Accreditation Board standards for ES. Bivariate and multivariate analyses were conducted to assess the relationship of sources and amounts of revenue obtained from the Florida Department of Health financial system to responses to the survey of CHD capacity for ESs. Self-assessed CHD performance for each ES varied extensively among the CHDs and across the 10 ESs, ranging from a high of 98% CHDs completely or almost completely meeting the standards for ES 2 (Investigating Problems and Hazards) to a low of 32% completely or almost completely meeting standards for ES 10 (Research/Evidence). Medicaid revenue and fees were positively correlated with some ESs. Per capita revenue support varied extensively among the CHDs. Revenue for ES is decreasing and is heavily reliant on noncategorical (discretionary) revenue. This study has important implications for continued reliance on ES as an organizing construct for public health.

  9. 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

  10. Implications of Placebo and Nocebo Effects for Clinical Practice: Expert Consensus.

    PubMed

    Evers, Andrea W M; Colloca, Luana; Blease, Charlotte; Annoni, Marco; Atlas, Lauren Y; Benedetti, Fabrizio; Bingel, Ulrike; Büchel, Christian; Carvalho, Claudia; Colagiuri, Ben; Crum, Alia J; Enck, Paul; Gaab, Jens; Geers, Andrew L; Howick, Jeremy; Jensen, Karin B; Kirsch, Irving; Meissner, Karin; Napadow, Vitaly; Peerdeman, Kaya J; Raz, Amir; Rief, Winfried; Vase, Lene; Wager, Tor D; Wampold, Bruce E; Weimer, Katja; Wiech, Katja; Kaptchuk, Ted J; Klinger, Regine; Kelley, John M

    2018-06-12

    Placebo and nocebo effects occur in clinical or laboratory medical contexts after administration of an inert treatment or as part of active treatments and are due to psychobiological mechanisms such as expectancies of the patient. Placebo and nocebo studies have evolved from predominantly methodological research into a far-reaching interdisciplinary field that is unravelling the neurobiological, behavioural and clinical underpinnings of these phenomena in a broad variety of medical conditions. As a consequence, there is an increasing demand from health professionals to develop expert recommendations about evidence-based and ethical use of placebo and nocebo effects for clinical practice. A survey and interdisciplinary expert meeting by invitation was organized as part of the 1st Society for Interdisciplinary Placebo Studies (SIPS) conference in 2017. Twenty-nine internationally recognized placebo researchers participated. There was consensus that maximizing placebo effects and minimizing nocebo effects should lead to better treatment outcomes with fewer side effects. Experts particularly agreed on the importance of informing patients about placebo and nocebo effects and training health professionals in patient-clinician communication to maximize placebo and minimize nocebo effects. The current paper forms a first step towards developing evidence-based and ethical recommendations about the implications of placebo and nocebo research for medical practice, based on the current state of evidence and the consensus of experts. Future research might focus on how to implement these recommendations, including how to optimize conditions for educating patients about placebo and nocebo effects and providing training for the implementation in clinical practice. © 2018 S. Karger AG, Basel.

  11. 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.

  12. Seizing opportunities for change at the operational level.

    PubMed

    Restrepo, Diana; Charron-Latour, Julie; Pourmonet, Hugo; Bassetto, Samuel

    2016-04-18

    Purpose - This paper presents a method for handling everyday opportunities for improvement, led by floor staff in healthcare institutions. More than 400,000 incidents and accidents were recorded in Quebec healthcare institutions in 2013. The burden of treatment falls on hospital floor staff. The purpose of this paper is to raise the visibility of this problem and support staff better in their efforts to handle opportunities for improvement. Design/methodology/approach - Based on issues identified in the literature, which have been found to exist in various organizations, the method involved reviewing practices in the field, proposing a solution, and testing it to assess its relevance and limitations. The method was tested in partnership with the Centre Hospitalier de l'Université de Montréal, in the internal medicine unit at Hôtel-Dieu campus. The test lasted three months. Indicators from this test have been compared to results in the literature. Findings - The proposed method presents a 68 per cent increase in ideas generated per person and per week compared to the reference study. The mean time for closing actions was about 41 per cent better (lower) than in the reference case. Research limitations/implications - The test lasted 15 weeks; a longer test is needed to collect more data. Practical implications - The first practical implication of this study was the creation of a method allowing employees to seize opportunities for improvement in their daily work. The application of this method revealed: first, the operational nature of the proposal (empowerment of the work team); second, the operationalization of continuous improvement (71 per cent of ideas were finalized while the initiative was monitored); third, the smooth operation of the mechanism for facilitating continuous improvement (organization of weekly meetings and team participation in these meetings in 90 per cent of cases); and fourth, a shared feeling that intra- and inter-team communication had been strengthened. Originality/value - The main value of this paper is that it proposes a simple problem-solving process that gives employees an opportunity to improve their daily work. The originality of this paper resides in comparing results to a standard case and observing an improvement. This paper proposes a new problem-solving structure and tests it scientifically.

  13. 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…

  14. 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…

  15. Managing health and safety risks: Implications for tailoring health and safety management system practices.

    PubMed

    Willmer, D R; Haas, E J

    2016-01-01

    As national and international health and safety management system (HSMS) standards are voluntarily accepted or regulated into practice, organizations are making an effort to modify and integrate strategic elements of a connected management system into their daily risk management practices. In high-risk industries such as mining, that effort takes on added importance. The mining industry has long recognized the importance of a more integrated approach to recognizing and responding to site-specific risks, encouraging the adoption of a risk-based management framework. Recently, the U.S. National Mining Association led the development of an industry-specific HSMS built on the strategic frameworks of ANSI: Z10, OHSAS 18001, The American Chemistry Council's Responsible Care, and ILO-OSH 2001. All of these standards provide strategic guidance and focus on how to incorporate a plan-do-check-act cycle into the identification, management and evaluation of worksite risks. This paper details an exploratory study into whether practices associated with executing a risk-based management framework are visible through the actions of an organization's site-level management of health and safety risks. The results of this study show ways that site-level leaders manage day-to-day risk at their operations that can be characterized according to practices associated with a risk-based management framework. Having tangible operational examples of day-to-day risk management can serve as a starting point for evaluating field-level risk assessment efforts and their alignment to overall company efforts at effective risk mitigation through a HSMS or other processes.

  16. Do senior management cultures affect performance? Evidence from Italian public healthcare organizations.

    PubMed

    Prenestini, Anna; Lega, Federico

    2013-01-01

    Healthcare organizations are often characterized by diffuse power, ambiguous goals, and a plurality of actors. In this complex and pluralistic context, senior healthcare managers are expected to provide strategic direction and lead their organizations toward their goals and performance targets. The present work explores the relationship between senior management team culture and performance by investigating Italian public healthcare organizations in the Tuscany region. Our assessment of senior management culture was accomplished through the use of an established framework and a corresponding tool, the competing values framework, which supports the idea that specific aspects of performance are related to a dominant management culture. Organizational performance was assessed using a wide range of measures collected by a multidimensional performance evaluation system, which was developed in Tuscany to measure the performance of its 12 local health authorities (LHAs) and four teaching hospitals (THs). Usable responses were received from 80 senior managers of 11 different healthcare organizations (two THs and nine LHAs). Our findings show that Tuscan healthcare organizations are characterized by various dominant cultures: developmental, clan, rational, and hierarchical. These variations in dominant culture were associated with performance measures. The implications for management theory, professional practice, and public policy are discussed.

  17. Can branding by health care provider organizations drive the delivery of higher technical and service quality?

    PubMed

    Snihurowych, Roman R; Cornelius, Felix; Amelung, Volker Eric

    2009-01-01

    Despite the widespread use of branding in nearly all other major industries, most health care service delivery organizations have not fully embraced the practices and processes of branding. Facilitating the increased and appropriate use of branding among health care delivery organizations may improve service and technical quality for patients. This article introduces the concepts of branding, as well as making the case that the use of branding may improve the quality and financial performance of organizations. The concepts of branding are reviewed, with examples from the literature used to demonstrate their potential application within health care service delivery. The role of branding for individual organizations is framed by broader implications for health care markets. Branding strategies may have a number of positive effects on health care service delivery, including improved technical and service quality. This may be achieved through more transparent and efficient consumer choice, reduced costs related to improved patient retention, and improved communication and appropriateness of care. Patient satisfaction may be directly increased as a result of branding. More research into branding could result in significant quality improvements for individual organizations, while benefiting patients and the health system as a whole.

  18. The impact of biotechnology on agricultural worker safety and health.

    PubMed

    Shutske, J M; Jenkins, S M

    2002-08-01

    Biotechnology applications such as the use and production of genetically modified organisms (GMOs) have been widely promoted, adopted, and employed by agricultural producers throughout the world. Yet, little research exists that examines the implications of agricultural biotechnology on the health and safety of workers involved in agricultural production and processing. Regulatory frameworks do exist to examine key issues related to food safety and environmental protection in GMO applications. However, based on the lack of research and regulatory oversight, it would appear that the potential impact on the safety and health of workers is of limited interest. This article examines some of the known worker health and safety implications related to the use and production of GMOs using the host, agent, and environment framework. The characteristics of employers, workers, inputs, production practices, and socio-economic environments in which future agricultural workers perform various tasks is likely to change based on the research summarized here.

  19. Values, attitudes and perceptions of managers as predictors of corporate environmental responsiveness.

    PubMed

    Papagiannakis, Giorgos; Lioukas, Spyros

    2012-06-15

    We examine whether managers' values, attitudes, and perceptions influence the greening of organizations. To that purpose, we specify and test a model of corporate environmental responsiveness (CER), drawing upon a modified version of the theory of planned behavior and the value-belief-norm theory. Based on survey data from 142 Greek companies, we find that top managers' personal values influence responses indirectly, through shaping their environmental attitudes, while direct relationship is not significant. Subjective norms, expressing stakeholder expectations, do affect CER, with their effect being stronger than that of attitudes. Managers' perceived ability to handle environmental issues also appears to influence responses. Results have theoretical implications, indicating the significant role of managers' values, attitudes and perceptions in a firm's environmental response. Practical implications are discussed in relation to selection of managers and training. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Use of Bloodborne Pathogens Exposure Control Plans in Private Dental Practices: Results and Clinical Implications of a National Survey

    PubMed Central

    Laramie, Angela K.; Bednarsh, Helene; Isman, Beverly; Boiano, James M.; McCrone, Susan H.

    2018-01-01

    Dental healthcare workers (DHWs) are at risk for occupational exposure to bloodborne pathogens (BBPs). The Occupational Safety and Health Administration Bloodborne Pathogens Standard requires employers to have a written exposure control plan (ECP) detailing methods and means to reduce and manage occupational BBP exposures. Because little information is available on whether ECPs are created and used, the National Institute for Occupational Safety and Health and the Organization for Safety, Asepsis and Prevention conducted an online survey to determine if dental practices had an ECP, whether present ECPs had the necessary components, and if impediments existed to prevent having an ECP in place. Respondents were primarily from nonfranchised practices (69%) and dentists who owned the practice (63%). Seventy-two percent of survey participants had an ECP and 20% were unaware of any federal requirements for an ECP prior to the survey. Engineering controls were used by many practices, although the type varied. Fifteen percent of practices did not offer the hepatitis B vaccine for employees. The survey revealed many dental practices were unaware of or were lacking required elements of the ECP Findings from this survey indicate DHWs would benefit from increased education regarding methods to prevent occupational exposures to BBPs. PMID:28570085

  1. Representing complexity well: a story about teamwork, with implications for how we teach collaboration.

    PubMed

    Lingard, Lorelei; McDougall, Allan; Levstik, Mark; Chandok, Natasha; Spafford, Marlee M; Schryer, Catherine

    2012-09-01

    In order to be relevant and impactful, our research into health care teamwork needs to better reflect the complexity inherent to this area. This study explored the complexity of collaborative practice on a distributed transplant team. We employed the theoretical lenses of activity theory to better understand the nature of collaborative complexity and its implications for current approaches to interprofessional collaboration (IPC) and interprofessional education (IPE). Over 4 months, two trained observers conducted 162 hours of observation, 30 field interviews and 17 formal interviews with 39 members of a solid organ transplant team in a Canadian teaching hospital. Participants included consultant medical and surgical staff and postgraduate trainees, the team nurse practitioner, social worker, dietician, pharmacist, physical therapist, bedside nurses, organ donor coordinators and organ recipient coordinators. Data collection and inductive analysis for emergent themes proceeded iteratively. Daily collaborative practice involves improvisation in the face of recurring challenges on a distributed team. This paper focuses on the theme of 'interservice' challenges, which represent instances in which the 'core' transplant team (those providing daily care for transplant patients) work to engage the expertise and resources of other services in the hospital, such as those of radiology and pathology departments. We examine a single story of the core team's collaboration with cardiology, anaesthesiology and radiology services to decide whether a patient is appropriate for transplantation and use this story to consider the team's strategies in the face of conflicting expectations and preferences among these services. This story of collaboration in a distributed team calls into question two premises underpinning current models of IPC and IPE: the notion that stable professional roles exist, and the ideal of a unifying objective of 'caring for the patient'. We suggest important elaborations to these premises as they are used to conceptualise and teach IPC in order to better represent the intricacy of everyday collaborative work in health care. © Blackwell Publishing Ltd 2012.

  2. Diagnosing Organization-Environment "Fit": Implications for Organization Development

    ERIC Educational Resources Information Center

    Gabarro, John J.

    1974-01-01

    This article has attempted to: (1) describe several dimensions of organization-environment fit; (2) describe some concepts which can be used in diagnosing the degree to which a school system's organization matches the demands and needs of its environment; (3) present some implications of such a diagnosis for OD [organizational development]…

  3. 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.

  4. Scaling up Evidence-based Practices for Children and Families in New York State: Towards Evidence-based Policies on Implementation for State Mental Health Systems

    PubMed Central

    Hoagwood, Kimberly Eaton; Olin, S. Serene; Horwitz, Sarah; McKay, Mary; Cleek, Andrew; Gleacher, Alissa; Lewandowski, Eric; Nadeem, Erum; Acri, Mary; Chor, Ka Ho Brian; Kuppinger, Anne; Burton, Geraldine; Weiss, Dara; Frank, Samantha; Finnerty, Molly; Bradbury, Donna M.; Woodlock, Kristin M.; Hogan, Michael

    2014-01-01

    Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling-out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policy-makers, providers and family support specialists have worked in partnership since 2002 to redesign and evaluate the children’s mental health system. Five system strategies driven by empirically-based practices and organized within a state-supported infrastructure have been used in the child and family service system with over 2,000 providers: (a) business practices; (b) use of health information technologies in quality improvement; (c) specific clinical interventions targeted at common childhood disorders; (d) parent activation; and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems. PMID:24460518

  5. Understanding collective agency in bioethics.

    PubMed

    Beier, Katharina; Jordan, Isabella; Wiesemann, Claudia; Schicktanz, Silke

    2016-09-01

    Bioethicists tend to focus on the individual as the relevant moral subject. Yet, in highly complex and socially differentiated healthcare systems a number of social groups, each committed to a common cause, are involved in medical decisions and sometimes even try to influence bioethical discourses according to their own agenda. We argue that the significance of these collective actors is unjustifiably neglected in bioethics. The growing influence of collective actors in the fields of biopolitics and bioethics leads us to pursue the question as to how collective moral claims can be characterized and justified. We pay particular attention to elaborating the circumstances under which collective actors can claim 'collective agency.' Specifically, we develop four normative-practical criteria for collective agency in order to determine the conditions that must be given to reasonably speak of 'collective autonomy'. For this purpose, we analyze patient organizations and families, which represent two quite different kinds of groups and can both be conceived as collective actors of high relevance for bioethical practice. Finally, we discuss some practical implications and explain why the existence of a shared practice of trust is of immediate normative relevance in this respect.

  6. Female Genital Mutilation Is a Violation of Reproductive Rights of Women: Implications for Health Workers.

    PubMed

    Jungari, Suresh Banayya

    2016-02-01

    Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia or other injury to the female genital organs for nonmedical reasons. This coercive practice is still prevalent in many parts of the world, in both developed and developing countries. However, FGM is more prevalent in African countries and some Asian countries. In this study, an attempt has been made to understand the prevalence and practice of FGM worldwide and its adverse effects on women's reproductive health. To fulfill the study objectives, the author collected evidence from various studies conducted by international agencies. Many studies found that FGM has no health benefits; is mostly carried out on girls before they reach the age of 15 years; can cause severe bleeding, infections, psychological illness, and infertility; and, most important, can have serious consequences during childbirth. The practice is mainly governed by the traditions and cultures of the communities without having any scientific or medical benefit. In conclusion, FGM is a practice that violates the human and reproductive rights of women.

  7. Reciprocity of temporary and permanent workers: an exploratory study in an industrial company.

    PubMed

    Lopes, Silvia; Chambel, Maria José

    2012-11-01

    The increasing use of temporary work prompts the need to understand to what degree workers with this type of contract differ from permanent workers as to the relationship they establish with the organization they work for. This study used a sample of temporary workers (N = 78) and permanent workers (N = 196) within the same company of electronics in Portugal. The results show that, regardless of the type of contract, the perception of human resource practices was related to the perception of psychological contract fulfillment by the company. Additionally and according to the norm of reciprocity, we verified that when workers thought the company was fulfilling its obligations they responded favorably showing more affective commitment towards the company. However, we found differences between these two groups of workers: for the permanent performance appraisal, training and rewards were human resources practices that were significantly related to psychological contract fulfillment, while for the temporary ones there weren't any specific practices that had a significant relationship with that variable. The practical implications of these findings for the management of temporary workers are discussed.

  8. Health promotion in the digital era: a critical commentary.

    PubMed

    Lupton, Deborah

    2015-03-01

    A range of digitized health promotion practices have emerged in the digital era. Some of these practices are voluntarily undertaken by people who are interested in improving their health and fitness, but many others are employed in the interests of organizations and agencies. This article provides a critical commentary on digitized health promotion. I begin with an overview of the types of digital technologies that are used for health promotion, and follow this with a discussion of the socio-political implications of such use. It is contended that many digitized health promotion strategies focus on individual responsibility for health and fail to recognize the social, cultural and political dimensions of digital technology use. The increasing blurring between voluntary health promotion practices, professional health promotion, government and corporate strategies requires acknowledgement, as does the increasing power wielded by digital media corporations over digital technologies and the data they generate. These issues provoke questions for health promotion as a practice and field of research that hitherto have been little addressed. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Ethical and Legal Implications of Elective Ventilation and Organ Transplantation: “Medicalization” of Dying versus Medical Mission

    PubMed Central

    Frati, Paola; Montanari Vergallo, Gianluca; Di Luca, Natale Mario; Turillazzi, Emanuela

    2014-01-01

    A critical controversy surrounds the type of allowable interventions to be carried out in patients who are potential organ donors, in an attempt to improve organ perfusion and successful transplantation. The main goal is to transplant an organ in conditions as close as possible to its physiological live state. “Elective ventilation” (EV), that is, the use of ventilation for the sole purpose of retrieving the organs of patients close to death, is an option which offsets the shortage of organ donation. We have analyzed the legal context of the dying process of the organ donor and the feasibility of EV in the Italian context. There is no legal framework regulating the practice of EV, neither is any real information given to the general public. A public debate has yet to be initiated. In the Italian cultural and legislative scenario, we believe that, under some circumstances (i.e., the expressed wishes of the patient, even in the form of advance directives), the use of EV does not violate the principle of beneficence. We believe that the crux of the matter lies in the need to explore the real determination and will of the patient and his/her orientation towards the specific aim of organ donation. PMID:25126582

  10. The effects of leadership competencies and quality of work on the perceived readiness for organizational change among nurse managers.

    PubMed

    Al-Hussami, Mahmoud; Hamad, Sawsan; Darawad, Muhammad; Maharmeh, Mahmoud

    2017-10-02

    Purpose This paper aims to set a leadership guidance program that can promote nurses' knowledge of leadership and, at the same time, to enhance their leadership competencies and quality of work to promote their readiness for change in healthcare organizations. Design/methodology/approach A pre-experimental, one-group pretest-posttest design was utilized. Out of 90 invited to participate in this study, 61 nurses were accepted to participate. Findings The statistical analyses suggested several significant differences between pre- and in-service nurse managers about leadership competencies, quality of work and readiness for change. Yet, findings from the background characteristics were not found to be significant and had no effects on the perceived readiness for change. Research limitations/implications The present study highlights the importance of leadership competencies and quality of work that healthcare policymakers identify for the success of organizational change efforts. Practical implications Healthcare policymakers, including directors of nursing, should focus on applications that increase leadership competencies and overall satisfaction of the nurse managers to support the changes in hospitals and supporting learning organization. Hence, they should establish policies that decrease the possible negative impact of planned change efforts. Originality/value Competent nurse managers enhance their readiness for change, which in turn helps nurses in constructive change processes. A leadership guidance program should be set for nurse managers. This study has important implications for hospital administrators and directors of nursing.

  11. Best practices for community gardening in a US-Mexico border community.

    PubMed

    Mangadu, Thenral; Kelly, Michael; Orezzoli, Max C E; Gallegos, Rebecca; Matharasi, Pracheta

    2017-12-01

    Minority communities such as those on the US-Mexico border are placed at disproportionate high risk for child and adult obesity, diabetes and cardiovascular diseases. A built environment characterized by an arid desert climate, lack of access to healthy foods, barriers to increasing physical activity, cultural and community norms which deter healthy eating and sustainable food production, shape obesity-related health disparities in these communities. Three pilot community gardens (implemented by two local governmental organizations and one community-based organization) were funded through the local Healthy Eating Active Living (HEAL) initiative in El Paso, Texas, and Las Cruces and Anthony, New Mexico (US-MX border communities with high obesity rates) in order to encourage healthy lifestyles among families in the region. A mixed-methods evaluation (n = 223) examined the implementation process, immediate outcomes and best practices of implementing and sustaining community gardens in these minority binational communities. In addition to nutrition-related outcomes, the potential for psychosocial outcomes from participating in community and school garden projects were observed. The best practices in relation to (i) assessing community norms related to growing food, (ii) increasing access to land and water for community/school gardening and (iii) enhancing social support for gardening are discussed. The implications of these best practices for obesity prevention and implementing community gardens in a minority US-MX border community characterized by cultural, geographical and socioeconomic barriers are examined. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. The benefits of sexual orientation diversity in sport organizations.

    PubMed

    Cunningham, George B; Melton, E Nicole

    2011-01-01

    While sexual orientation diversity can potentially serve as a source of competitive advantage, researchers have largely failed to fully articulate the theoretical linkage between this diversity form and organizational effectiveness. As such, we propose a theoretical framework to understand these dynamics. Sexual orientation diversity is posited to positively contribute to organizational effectiveness through three mechanisms: enhanced decision making capabilities, improved marketplace understanding, and goodwill associated with engaging in socially responsible practices. We also propose two approaches to leveraging the benefits of sexual orientation diversity: targeting the categorization process and creating a proactive and inclusive diversity culture. Contributions and implications are discussed.

  13. Can Random Mutation Mimic Design?: A Guided Inquiry Laboratory for Undergraduate Students

    PubMed Central

    Kalinowski, Steven T.; Taper, Mark L.; Metz, Anneke M.

    2006-01-01

    Complex biological structures, such as the human eye, have been interpreted as evidence for a creator for over three centuries. This raises the question of whether random mutation can create such adaptations. In this article, we present an inquiry-based laboratory experiment that explores this question using paper airplanes as a model organism. The main task for students in this investigation is to figure out how to simulate paper airplane evolution (including reproduction, inheritance, mutation, and selection). In addition, the lab requires students to practice analytic thinking and to carefully delineate the implications of their results. PMID:16951065

  14. Mindsets of commitment and motivation: interrelationships and contribution to work outcomes.

    PubMed

    Battistelli, Adalgisa; Galletta, Maura; Portoghese, Igor; Vandenberghe, Christian

    2013-01-01

    Two studies are reported that investigate the relationships among commitment and motivation mindsets and their contribution to work outcomes. Study 1 involved 487 nurses from a hospital in the center of Italy. Results showed that commitment's facets were related to parallel dimensions of work motivation. Study 2 involved 593 nurses from a hospital in the north of Italy. Analyses indicated that commitment and motivation were important antecedents of working attitudes and behaviors. Moreover, self-determined motivation played a critical mediating role in positive behaviors. Findings are discussed in terms of their practical implications for organizations and employees.

  15. Urban tree-planting programs — A model for encouraging environmentally protective behavior

    NASA Astrophysics Data System (ADS)

    Summit, Joshua; Sommer, Robert

    Efforts to increase environmentally sound behaviors and practices have in the past often focussed on consciousness-raising and attitude change. Research indicates that such efforts are less effective than interventions designed to make environmentally sound behaviors easier to engage in, or to make personal advantages resulting from such behaviors more clear to individuals. Four nonprofit tree planting organizations were studied as examples of successful environmental interventions. From these studies, as well as a review of the literature, several principles underlying successful behavioral interventions are identified. Implications of these principles for future environmental programs are discussed.

  16. Psychosocial correlates of delayed decisions to abort.

    PubMed

    Bracken, M B; Kasl, S V

    1976-01-01

    Two samples of women aborting in New York and Connecticut during 1972 and 1973 were studied. In all, six hundred and fifty eight women about to undergo first and second trimester procedures completed a self-administered questionnaire. Items include: demographic, psychosocial and personality parameters, and a detailed review of the decision process leading to abortion. Analyses of the correlates of delay are organized around four components: acknowledgment of pregnancy; seeing a physician ; deciding to abort; and locating a clinic. Other analyses focus on the role of decisional conflict in delay. Methodological issues, implications for educational practice and for theory of decision-making are discussed.

  17. How mothers talk about placement of their child with autism outside the home.

    PubMed

    Corman, Michael K

    2013-10-01

    In this article I use insights offered by the poststructural shift and linguistic turn in social scientific inquiry, specifically discourse analysis, to explore mothers' talk about the placement of their child with autism outside of the home. By viewing mothers' talk as data, I bring to light the discourses and interpretive practices that mothers drew on to organize their talk of placement. In doing so, I provide insights into how mothers gave meaning to processes of placement while also expanding on commonsensical discursive notions of "good" mothering, caregiving, and family. Implications of the findings are discussed.

  18. Interdisciplinary team communication among forensic nurses and rape victim advocates.

    PubMed

    Patterson, Debra

    2014-01-01

    Victim advocates and forensic nurses provide integrated care to address the complex legal, medical, and mental health needs of rape survivors. Research suggests that conflict exists between nurses and advocates, but it remains unknown how their communication patterns contribute to or resolve these conflicts. Utilizing a qualitative case study approach, the current study interviewed 24 nurses and advocates from a Midwest organization to better understand team communication patterns when addressing conflicts. The findings suggest that most nurses communicate concerns directly while advocates avoid direct communication. Factors that influenced direct and indirect communication and their implications for practice will be discussed.

  19. The generation time, lag time, and minimum temperature of growth of coliform organisms on meat, and the implications for codes of practice in abattoirs.

    PubMed Central

    Smith, M. G.

    1985-01-01

    The growth of coliform organisms on meat tissue from sheep carcasses processed in a commercial abattoir was investigated. The results indicated that for practical purposes the minimum temperature of growth of these organisms on meat may be taken as 8 degrees C. Equations were derived relating the generation time and the lag time of coliform organisms in raw blended mutton to the temperature at which the meat is held. Estimates of growth obtained with these equations were found to agree closely with the experimental results, especially at temperatures above 10 degrees C, and allowed the generation times and the lag times for all temperatures up to 40 degrees C to be calculated. These times were also found to agree closely with the times determined using a strain of Escherichia coli inoculated into blended mutton tissue. A strain of Salmonella typhimurium inoculated in the same way into blended mutton tissue gave longer generation and lag times at temperatures below 15 degrees C. Therefore, it is believed that the calculated tables of lag and generation times included in this paper can be used to determine the length of time raw chilled meat may be held afterwards at temperatures above the minimum temperature of growth without an increase in the number of any salmonella organisms present, and these times include a safety margin at each temperature. The study indicates that the mandatory codes of practice presently applied in commercial abattoirs are too stringent. Maintaining the temperature of boning rooms at 10 degrees C or less does not appear to be necessary providing the meat is processed within the calculated time limits. A relaxation of the restrictions on boning room temperatures would decrease costs, increase worker comfort and safety and would not compromise the bacteriological safety of the meat produced. PMID:3891847

  20. 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

  1. Translating knowledge into practice: An exploratory study of dementia-specific training for community-based service providers.

    PubMed

    O'Sullivan, Grace; Hocking, Clare; McPherson, Kathryn

    2017-08-01

    Objective To develop, deliver, and evaluate dementia-specific training designed to inform service delivery by enhancing the knowledge of community-based service providers. Methods This exploratory qualitative study used an interdisciplinary, interuniversity team approach to develop and deliver dementia-specific training. Participants included management, care staff, and clients from three organizations funded to provide services in the community. Data on the acceptability, applicability, and perceived outcomes of the training were gathered through focus group discussions and individual interviews. Transcripts were analyzed to generate open codes which were clustered into themes and sub-themes addressing the content, delivery, and value of the training. Findings Staff valued up-to-date knowledge and "real stories" grounded in practice. Clients welcomed the strengths-based approach. Contractual obligations impact on the application of knowledge in practice. Implications The capacity to implement new knowledge may be limited by the legislative policies which frame service provision, to the detriment of service users.

  2. How does land use link terrestrial and aquatic carbon in western North America?: Implications from an agricultural case study in central Montana

    NASA Astrophysics Data System (ADS)

    Ewing, S. A.; Sigler, W. A.

    2014-12-01

    The fate of soil organic matter with expanding human land use is of increasing concern for planetary health and ecological sustainability. In North American grasslands, cultivation has commonly resulted in loss of stored soil organic carbon to dissolved phases in groundwater and surface water, as well as to atmospheric CO2 via decomposition. In addition, cultivation has released nutrients stored in organic matter and facilitated water movement through soils to benefit crops, increasing groundwater recharge rates. This has altered groundwater chemistry both by changing biogeochemistry of the terrestrial-aquatic interface and by increasing addition of nutrients, herbicides, and pesticides to these systems. In this presentation, we consider the effects of food production practices on terrestrial-aquatic carbon linkages in former grassland ecosystems of western North America. Our data from an agricultural area in central Montana begin to reveal how elevated nitrate and pesticide levels in groundwater on an isolated landform reflect transformation over the last century of a temperate grassland ecosystem for wheat and cattle production. Rates and pathways of carbon and nitrogen loss are inferred from the concentration and isotopic character of both water and carbon and nitrogen over three years in soils, shallow groundwater, emergent springs and surface waters. In this semi-arid, non-irrigated context, the fate of soil organic matter is linked with redistribution of pedogenic carbonate as well as other soil and rock derived solutes. We consider implications for future trends in dissolved carbon and nitrogen in surface waters in the region.

  3. The institution of the institutional practice of psychology: health care reform and psychology's future workforce.

    PubMed

    Rozensky, Ronald H

    2011-11-01

    Implications for the future of professional psychology are discussed and related to the Patient Protection and Affordable Care Act, patient-centered health care homes and accountable care organizations, and the growing importance of interprofessional competencies in health care. The need for increased information about the psychology workforce is related to the history of the institutional practice of psychology and how that data must be used to plan for the supply of psychologists required to meet the service demands of the changing health care system. Several challenges to the field of psychology are offered, along with steps that must be taken by the profession to prepare for increased institutionally based health care services in the future. (PsycINFO Database Record (c) 2011 APA, all rights reserved). 2011 APA, all rights reserved

  4. Missing link in the service profit chain: a meta-analytic review of the antecedents, consequences, and moderators of service climate.

    PubMed

    Hong, Ying; Liao, Hui; Hu, Jia; Jiang, Kaifeng

    2013-03-01

    Service climate captures employees' consensual perceptions of organizations' emphasis on service quality. Although many studies have examined the foundation issues and outcomes of service climate, there is a lack of a comprehensive model explicating the antecedents, outcomes, and moderators of service climate. The current study fills this void in the literature. By conducting a meta-analysis of 58 independent samples (N = 9,363), we found support for service climate as a critical linkage between internal and external service parameters. In addition, we found differential effects of service-oriented versus general human resource practices and leadership on service climate, as well as disparate impacts of service climate contingent on types of service, measures of service climate, and sources of rating. Research and practical implications are discussed.

  5. Twelve tips for applying the science of learning to health professions education.

    PubMed

    Gooding, H C; Mann, K; Armstrong, E

    2017-01-01

    Findings from the science of learning have clear implications for those responsible for teaching and curricular design. However, this data has been historically siloed from educators in practice, including those in health professions education. In this article, we aim to bring practical tips from the science of learning to health professions educators. We have chosen to organize the tips into six themes, highlighting strategies for 1) improving the processing of information, 2) promoting effortful learning for greater retention of knowledge over time, 3) applying learned information to new and varied contexts, 4) promoting the development of expertise, 5) harnessing the power of emotion for learning, and 6) teaching and learning in social contexts. We conclude with the importance of attending to metacognition in our learners and ourselves. Health professions education can be strengthened by incorporating these evidence-based techniques.

  6. Roles of scholars in the practice of combating-desertification: a case study in northwest China.

    PubMed

    Yang, Lihua; Lan, Zhiyong; Wu, Jianguo

    2010-08-01

    This study investigated the perceived importance of scholars' participation in combating-desertification programs in northwest China and analyzed the underlying factors and mechanisms. Our results show that, while various experts, professors, and researchers have participated in combating-desertification programs, their actions were often not effective. Only those scholars who understood the local situations adequately had important and positive impacts. These scholars served as information brokers between the governments and other stakeholders, entrepreneurial activity organizers for farmers, governmental representatives, or advocators for local affairs themselves. They played indispensible roles in facilitating efforts in combating desertification. The study also identified key factors that led to the success of scholars' participation in combating-desertification activities. Our findings have practical implications for improving the effectiveness of scholars' participation in land restoration and environmental management.

  7. Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange.

    PubMed

    Vest, Joshua R

    The United States has invested nearly a billion dollars in creating community health information organizations (HIOs) to foster health information exchange. Community HIOs provide exchange services to health care organizations within a distinct geographic area. While geography is a key organizing principle for community HIOs, it is unclear if geography is an effective method for organization or what challenges are created by a geography-based approach to health information exchange. This study describes the extent of reported community HIO coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Furthermore, because self-reported service areas may not accurately reflect the true extent of HIOs activities, this study maps the actual markets for health services included in each HIO. An inventory of operational community HIOs that included self-reported geographic markets and participating organizations was face-validated using a crowd-sourcing approach. Aggregation of the participating hospitals' individual health care markets provided the total geographic market served by each community HIO. Mapping and overlay analyses using geographic information system methods described the extent of community HIO activity in the United States. Evidence suggests that community HIOs may be inefficiently distributed. Parts of the United States have multiple, overlapping HIOs, while others do not have any providing health information exchange services. In markets served by multiple community HIOs, 45% of hospitals were participants of only one HIO. The current geography of community HIO activity does not provide comprehensive patient information to providers, nor community-wide information for public health agencies. The discord between the self-reported and market geography of community HIOs raises concerns about the potential effectiveness of health information exchange, illustrates the limitations of geography as an organizing principle, and indicates operational challenges facing those leading and working with community HIOs.

  8. Measuring the authority of local public health directors in the context of organizational structure: an exploratory, multimodal approach.

    PubMed

    Miner Gearin, Kimberly J; Thrash, Allison M Rick; Frauendienst, Renee; Myhre, Julie; Gyllstrom, M Elizabeth; Riley, William J; Schroeder, Janelle

    2012-11-01

    Studies have reported a relationship between the organization of public health services and variability in public health practice at the local and state levels. A national research agenda has prioritized practice-based research to understand pathways that lead to this variation and examine the impact of these differences on outcomes. To measure the extent to which Minnesota local health directors report having key authorities and examine the relationship between organizational structure and authority of local health directors. : Multimodal. Minnesota local health departments. Directors of Minnesota local health departments. Director authorities. Most Minnesota local health directors reported having 6 key authorities related to budget preparation and modification and interaction with local elected officials (n = 51, 71%). Twelve directors (16%) reported that they have 4 or fewer of the 6 authorities. The authority most commonly reported as lacking was the authority to initiate communication with locally elected officials (n = 15, 21%). The percentage of directors who reported having all 6 authorities was higher among those in stand-alone departments (82%) than those in combined organizations (50%). This descriptive study illustrates that emerging practice-based research networks can successfully collaborate on small-scale research projects with immediate application for systems development. Study findings are being used by local public health officials to help articulate their role, aid in succession planning, and inform elected officials, who need to consider the public health implications of potential changes to local public health governance and organization. More studies are needed to refine measurement of authority and structure.

  9. Fads, fashions, and bandwagons in health care strategy.

    PubMed

    Kaissi, Amer A; Begun, James W

    2008-01-01

    Many observers have alleged that "fads," "fashions," and "bandwagons" (imitation strategies) are prominent feature of the health care organizational strategy landscape. "Imitation behavior" may fulfill symbolic functions such as signaling innovativeness but results in the adoption of strategies that are effective for some organizations but not for many organizations that adopt them. We seek to identify and recognize the extent of fads, fashions, and bandwagons in health care strategy, understand the rationale for such imitation behavior, and draw implications for practice, education, and research. We examine theoretical arguments for imitation and evidence on imitation strategies in health care organizations, based on literature review, interviews with health care managers in two different metropolitan areas, and a case example of the purchase of medical group practices by hospitals. Fads, fashions, and bandwagons can be distinguished from strategic responses to regulatory requirements and efficient strategic choices that are the result of systematic analysis. There are substantial theoretical reasons to expect imitation behavior. Imitation strategies can derive from copying the behavior of "exemplar" organizations or from "keeping up" with competitive rivals. Anecdotal and empirical evidence points to a significant amount of imitation behavior in health care strategy. The performance effects of imitation behavior have not been investigated in past research. The widespread existence of fads and fashions is an argument for evidence-based management. Although it is essential to learn about strategies that have worked for other organizations, managers should carefully take account of the quality of evidence for the strategy and their organizations' distinctive local conditions. Managers should beware of the tendency of individuals and groups to move too readily to the solution stage of problem solving.

  10. Evaluating programs that address ideological issues: ethical and practical considerations for practitioners and evaluators.

    PubMed

    Lieberman, Lisa D; Fagen, Michael C; Neiger, Brad L

    2014-03-01

    There are important practical and ethical considerations for organizations in conducting their own, or commissioning external, evaluations and for both practitioners and evaluators, when assessing programs built on strongly held ideological or philosophical approaches. Assessing whether programs "work" has strong political, financial, and/or moral implications, particularly when expending public dollars, and may challenge objectivity about a particular program or approach. Using a case study of the evaluation of a school-based abstinence-until-marriage program, this article discusses the challenges, lessons learned, and ethical responsibilities regarding decisions about evaluation, specifically associated with ideologically driven programs. Organizations should consider various stakeholders and views associated with their program to help identify potential pitfalls in evaluation. Once identified, the program or agency needs to carefully consider its answers to two key questions: Do they want the answer and are they willing to modify the program? Having decided to evaluate, the choice of evaluator is critical to assuring that ethical principles are maintained and potential skepticism or criticism of findings can be addressed appropriately. The relationship between program and evaluator, including agreements about ownership and eventual publication and/or promotion of data, should be addressed at the outset. Programs and organizations should consider, at the outset, their ethical responsibility when findings are not expected or desired. Ultimately, agencies, organizations, and programs have an ethical responsibility to use their data to provide health promotion programs, whether ideologically founded or not, that appropriately and effectively address the problems they seek to solve.

  11. Molecular characterization of macrophyte-derived dissolved organic matters and their implications for lakes

    USDA-ARS?s Scientific Manuscript database

    Chemical properties of whole organic matter (OM) and its dissolved organic matter (DOM) fraction from six dominant macrophytes in Lake Dianchi were comparatively characterized, and their environmental implications were discussed. Significant differences in chemical composition of the OM samples were...

  12. Field Birding and Digital Objects: Immaterial Technologies and Their Implications for One Practice of Coming to Know the More-than-Human

    ERIC Educational Resources Information Center

    Watson, Gavan Peter Longley

    2011-01-01

    This paper focuses on the implications of two emerging digital technologies on the act of field birding, and the implications of these objects for thinking about wild birds. While the adoption of new immaterial technologies promises to improve the ease with which birding is practiced, their use leads to new ethical considerations. Using the…

  13. Stem cell terminology: practical, theological and ethical implications.

    PubMed

    Shanner, Laura

    2002-01-01

    Stem cell policy discussions frequently confuse embryonic and fetal sources of stem cells, and label untested, non-reproductive cloning as "therapeutic." Such misnomers distract attention from significant practical and ethical implications: accelerated research agendas tend to be supported at the expense of physical risks to women, theological implications in a multi-faith community, informed consent for participation in research, and treatment decisions altered by unrealistic expectations.

  14. 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).

  15. Creative benefits from well-connected leaders: leader social network ties as facilitators of employee radical creativity.

    PubMed

    Venkataramani, Vijaya; Richter, Andreas W; Clarke, Ronald

    2014-09-01

    Employee radical creativity critically depends on substantive informational resources from others across the wider organization. We propose that the social network ties of employees' immediate leaders assume a central role in garnering these resources, thereby fostering their employees' radical creativity both independent of and interactively with employees' own network ties. Drawing on data from 214 employees working in 30 teams of a public technology and environmental services organization, we find that team leaders' betweenness centrality in the idea network within their teams as well as among their peer leaders provides creative benefits beyond employees' own internal and external ties. Further, employees' and leaders' ties within and external to the team interactively predict employee radical creativity. Implications for theory and practice are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  16. Combined effects of positive and negative affectivity and job satisfaction on job performance and turnover intentions.

    PubMed

    Bouckenooghe, Dave; Raja, Usman; Butt, Arif Nazir

    2013-01-01

    Capturing data from employee-supervisor dyads (N = 321) from eight organizations in Pakistan, including human service organizations, an electronics assembly plant, a packaging material manufacturing company, and a small food processing plant, we used moderated regression analysis to examine whether the relationships between trait affect (positive affectivity [PA] and negative affectivity [NA]) and two key work outcome variables (job performance and turnover) are contingent upon the level of job satisfaction. We applied the Trait Activation Theory to explain the moderating effect of job satisfaction on the relationship between affect and performance and between affect and turnover. Overall, the data supported our hypotheses. Positive and negative affectivity influenced performance and the intention to quit, and job satisfaction moderated these relationships. We discuss in detail the results of these findings and their implications for research and practice.

  17. Workplace accidents and self-organized criticality

    NASA Astrophysics Data System (ADS)

    Mauro, John C.; Diehl, Brett; Marcellin, Richard F.; Vaughn, Daniel J.

    2018-09-01

    The occurrence of workplace accidents is described within the context of self-organized criticality, a theory from statistical physics that governs a wide range of phenomena across physics, biology, geosciences, economics, and the social sciences. Workplace accident data from the U.S. Bureau of Labor Statistics reveal a power-law relationship between the number of accidents and their severity as measured by the number of days lost from work. This power-law scaling is indicative of workplace accidents being governed by self-organized criticality, suggesting that nearly all workplace accidents have a common underlying cause, independent of their severity. Such power-law scaling is found for all labor categories documented by the U.S. Bureau of Labor Statistics. Our results provide scientific support for the Heinrich accident triangle, with the practical implication that suppressing the rate of severe accidents requires changing the attitude toward workplace safety in general. By creating a culture that values safety, empowers individuals, and strives to continuously improve, accident rates can be suppressed across the full range of severities.

  18. 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

  19. Multisource feedback, human capital, and the financial performance of organizations.

    PubMed

    Kim, Kyoung Yong; Atwater, Leanne; Patel, Pankaj C; Smither, James W

    2016-11-01

    We investigated the relationship between organizations' use of multisource feedback (MSF) programs and their financial performance. We proposed a moderated mediation framework in which the employees' ability and knowledge sharing mediate the relationship between MSF and organizational performance and the purpose for which MSF is used moderates the relationship of MSF with employees' ability and knowledge sharing. With a sample of 253 organizations representing 8,879 employees from 2005 to 2007 in South Korea, we found that MSF had a positive effect on organizational financial performance via employees' ability and knowledge sharing. We also found that when MSF was used for dual purpose (both administrative and developmental purposes), the relationship between MSF and knowledge sharing was stronger, and this interaction carried through to organizational financial performance. However, the purpose of MSF did not moderate the relationship between MSF and employees' ability. The theoretical relevance and practical implications of the findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Help Others and Yourself Eventually: Exploring the Relationship between Help-Giving and Employee Creativity under the Model of Perspective Taking

    PubMed Central

    Li, Si; Liao, Shudi

    2017-01-01

    Although a plethora of studies have examined the antecedents of creativity, empirical studies exploring the role of individual behaviors in relation to creativity are relatively scarce. Drawing on the model of perspective taking, this study examines the relationship between help-giving during creative problem solving process and employee creativity. Specifically, we test perspective taking as an explanatory mechanism and propose organization-based self-esteem as the moderator. In a sample collected from a field survey of 247 supervisor-subordinate dyads from 2 large organizations in China at 3 time points, we find that help-giving during creative problem solving process positively related with perspective taking; perspective taking positively related with employees’ creativity; employees’ organization-based self-esteem strengthened the link between perspective taking and creativity; besides, there existed a moderated mediation effect. We conclude this paper with discussions on the implications for theory, research, and practice. PMID:28690566

  1. Organizational identification and commitment: correlates of sense of belonging and affective commitment.

    PubMed

    Dávila, Ma Celeste; Jiménez García, Gemma

    2012-03-01

    The general purpose of this work is to analyze the overlap between organizational identification and commitment. Specifically, our study focuses on the analysis of the differences and similarities between sense of belonging (a dimension of organizational identification) and affective commitment (a dimension of organizational commitment). In order to do this, we analyzed their discriminant validity and raised their relationship with variables that previous research had showed like precedent and subsequent variables of them: value congruence, perceived support, organizational citizenship behavior, and intention to continue in the organization. A total of 292 people at one organization completed surveys measuring the variables previously described. The results showed that sense of belonging and affective commitment are different concepts and they have different relationships with relation to precedent and subsequent variables. Affective commitment seems to be more useful than sense of belonging to predict organizational citizenship behavior aimed at the organization and intention to continue. Some practical implications are described.

  2. Global megatrends and their implications for environmental assessment practice

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

    Retief, Francois, E-mail: francois.retief@nwu.ac.za; Bond, Alan; Research Unit for Environmental Sciences and Management, North-West University

    This paper addresses the future of environmental assessment (EA) practice in light of a rapidly changing world. We apply a literature review-based methodology to firstly identify key global megatrends and then reflect upon the implications for EA practice based on some known challenges. The key megatrends identified are synthesised into six categories: i) demographics, ii) urbanization, iii) technological innovation, iv) power shifts, v) resource scarcity and vi) climate change. We then discuss the implications of these megatrends for EA practice against four known EA challenges namely: dealing with i) complexity and uncertainty, ii) efficiency, iii) significance and iv) communication andmore » participation. Our analysis suggests important implications for EA practice such as: increased difficulties with accuracy of prediction; the need for facilitative adaptation; an increase in the occurrence of unexpected events; higher expectations for procedural efficiency; challenges with information and communication management; dealing with significance judgements; and mitigation amidst resource scarcity and increasing pressures on earth systems. The megatrends underscore the need for continued evolution of EA thinking and practice, especially moving away from seeking a predictable single future or outcome towards the possibility of multiple scenarios with associated adaptability and enhanced system resilience capable of responding to rapid change.« less

  3. What roles do middle managers play in implementation of innovative practices?

    PubMed Central

    Engle, Ryann L.; Lopez, Emily R.; Gormley, Katelyn E.; Chan, Jeffrey A.; Charns, Martin P.; Lukas, Carol VanDeusen

    2017-01-01

    Background: Middle managers play key roles in hospitals as the bridge between senior leaders and frontline staff. Yet relatively little research has focused on their role in implementing new practices. Purpose: The aim of this study was to expand the understanding of middle managers’ influence in organizations by looking at their activities through the lens of two complementary conceptual frameworks. Methodology/Approach: We analyzed qualitative data from 17 Veterans Affairs Medical Centers with high and low potential to change organizational practices. We analyzed 98 interviews with staff ranging from senior leaders to frontline staff to identify themes within an a priori framework reflecting middle manager activities. Findings: Analyses yielded 14 emergent themes that allowed us to classify specific expressions of middle manager commitment to implementation of innovative practices (e.g., facilitate improvement innovation, garner staff buy-in). In comparing middle manager behaviors in high and low change potential sites, we found that most emergent themes were present in both groups. However, the activities and interactions described differed between the groups. Practice Implications: Middle managers can use the promising strategies identified by our analyses to guide and improve their effectiveness in implementing new practices. These strategies can also inform senior leaders striving to guide middle managers in those efforts. PMID:26488239

  4. Spatial and temporal variation of nitrogen concentration and speciation in runoff and storm water in the Indian River watershed, South Florida.

    PubMed

    Li, Liguang; He, Zhenli; Li, Zhigang; Zhang, Songhe; Li, Suli; Wan, Yongshan; Stoffella, Peter J

    2016-10-01

    Nitrogen (N) is considered as a key element that triggers algal boom in the Indian River Lagoon (IRL), South Florida. Intensive agriculture may have contributed to increased N input into the IRL. Runoff and storm water samples were collected in representative agricultural fields and along waterways that connect lands to the IRL from April 2013 to December 2014. Concentrations of different N species (particulate N, dissolved organic N, dissolved NH4 (+)-N, and NO3 (-)-N) and related water physical-chemical properties were measured. Total N (TN) concentrations generally decreased from agricultural field furrows to discharging point of the waterways but were generally above the US EPA critical level (0.59 mg L(-1)) for surface water. Organic N was the dominant form of dissolved N, followed by NO3 (-)-N, and dissolved NH4 (+)-N. Concentrations and speciation of N in water varied with sites and sampling times but were generally higher in summer and fall and lower in spring and winter, as affected by the seasonality of regional hydrology and agricultural practices. Correlations occurred between N concentration, water physical properties, and rainfall. This information has important implications in the development of best management practices to minimize the impacts of agricultural practice on N loading in the Indian River Lagoon.

  5. Does consideration and assessment of effects on health equity affect the conclusions of systematic reviews? A methodology study.

    PubMed

    Welch, Vivian; Petticrew, Mark; Ueffing, Erin; Benkhalti Jandu, Maria; Brand, Kevin; Dhaliwal, Bharbhoor; Kristjansson, Elizabeth; Smylie, Janet; Wells, George Anthony; Tugwell, Peter

    2012-01-01

    Tackling health inequities both within and between countries remains high on the agenda of international organizations including the World Health Organization and local, regional and national governments. Systematic reviews can be a useful tool to assess effects on equity in health status because they include studies conducted in a variety of settings and populations. This study aims to describe the extent to which the impacts of health interventions on equity in health status are considered in systematic reviews, describe methods used, and assess the implications of their equity related findings for policy, practice and research. We conducted a methodology study of equity assessment in systematic reviews. Two independent reviewers extracted information on the reporting and analysis of impacts of health interventions on equity in health status in a group of 300 systematic reviews collected from all systematic reviews indexed in one month of MEDLINE, using a pre-tested data collection form. Any differences in data extraction were resolved by discussion. Of the 300 systematic reviews, 224 assessed the effectiveness of interventions on health outcomes. Of these 224 reviews, 29 systematic reviews assessed effects on equity in health status using subgroup analysis or targeted analyses of vulnerable populations. Of these, seven conducted subgroup analyses related to health equity which were reported in insufficient detail to judge their credibility. Of these 29 reviews, 18 described implications for policy and practice based on assessment of effects on health equity. The quality and completeness of reporting should be enhanced as a priority, because without this policymakers and practitioners will continue lack the evidence base they need to inform decision-making about health inequity. Furthermore, there is a need to develop methods to systematically consider impacts on equity in health status that is currently lacking in systematic reviews.

  6. Job attitudes among workers with disabilities: The importance of family support in addition to organizational support.

    PubMed

    Pérez, Vanesa; Alcover, Carlos-María; Chambel, Maria José

    2015-01-01

    In the case of workers with disabilities, family support is often essential to gain access to the labor market and achieve personal autonomy and financial independence, in addition to fostering job satisfaction and permanence in the organization. Moreover, the support offered by organizations is particularly valued by workers with disabilities, as the organizations that hire such people generally go to considerable lengths to ensure their adaptation and integration in the workplace, contributing to job satisfaction and permanence in the organization. The aim of this study is to investigate the relationships between organizational support and family support with job satisfaction and intention to quit the organization among workers with disabilities employed in ordinary firms. Our study surveyed 204 workers using a questionnaire, and we used Structural Equation Modeling (SEM) analyses to test these relationships. Our results show that organizational support is a significant explanatory factor in the levels of job satisfaction. Moreover, our results indicate that the participants perceived high levels of support from their families, facilitating the conciliation of work and family life. Our results have practical implications in order to improve full integration and normalization of workers with disabilities in ordinary jobs.

  7. Australian perioperative nurses' experiences of assisting in multi-organ procurement surgery: a grounded theory study.

    PubMed

    Smith, Zaneta; Leslie, Gavin; Wynaden, Dianne

    2015-03-01

    Multi-organ procurement surgical procedures through the generosity of deceased organ donors, have made an enormous impact on extending the lives of recipients. There is a dearth of in-depth knowledge relating to the experiences of perioperative nurses working closely with organ donors undergoing multi-organ procurement surgical procedures. The aim of this study was to address this gap by describing the perioperative nurses experiences of participating in multi-organ procurement surgical procedures and interpreting these findings as a substantive theory. This qualitative study used grounded theory methodology to generate a substantive theory of the experiences of perioperative nurses participating in multi-organ procurement surgery. Recruitment of participants took place after the study was advertised via a professional newsletter and journal. The study was conducted with participants from metropolitan, rural and regional areas of two Australian states; New South Wales and Western Australia. Thirty five perioperative nurse participants with three to 39 years of professional nursing experience informed the study. Semi structured in-depth interviews were undertaken from July 2009 to April 2010 with a mean interview time of 60 min. Interview data was transcribed verbatim and analysed using the constant comparative method. The study results draw attention to the complexities that exist for perioperative nurses when participating in multi-organ procurement surgical procedures reporting a basic social psychological problem articulated as hiding behind a mask and how they resolved this problem by the basic social psychological process of finding meaning. This study provides a greater understanding of how these surgical procedures impact on perioperative nurses by providing a substantive theory of this experience. The findings have the potential to guide further research into this challenging area of nursing practice with implications for clinical initiatives, management practices and education. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Unconventional eating practices and their health implications.

    PubMed

    Hanning, R M; Zlotkin, S H

    1985-04-01

    The authors discuss a number of unconventional or faddist foods and eating practices and their health implications. Among the topics included are vegetarianism, Zen macrobiotic diets, fast foods, junk foods, megavitamins and their toxicity, health foods, fad diets in infancy, and elimination diets.

  9. 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.

  10. Lean in healthcare from employees' perspectives.

    PubMed

    Drotz, Erik; Poksinska, Bozena

    2014-01-01

    The purpose of this paper is to contribute toward a deeper understanding of the new roles, responsibilities, and job characteristics of employees in Lean healthcare organizations. The paper is based on three cases studies of healthcare organizations that are regarded as successful examples of Lean applications in the healthcare context. Data were collected by methods including interviews, observations, and document studies. The implementation of Lean in healthcare settings has had a great influence on the roles, responsibilities, and job characteristics of the employees. The focus has shifted from healthcare professionals, where clinical autonomy and professional skills have been the guarding principles of patient care, to process improvement and teamwork. Different job characteristics may make it difficult to implement certain Lean practices in healthcare. Teamwork and decentralization of authority are examples of Lean practices that could be considered countercultural because of the strong professional culture and uneven power distribution, with doctors as the dominant decision makers. Teamwork, value flow orientation, and company-wide involvement in CI were associated with positive effects on the organizations' working environment, staff development, and organizational performance. In order to succeed with Lean healthcare, it is important to understand and recognize the differences in job characteristics between Lean manufacturing and healthcare. This paper provides insights into how Lean implementation changes the roles, responsibilities, and job characteristics of healthcare staff and the challenges and implications that may follow from this.

  11. Organizing for teamwork in healthcare: an alternative to team training?

    PubMed

    Rydenfält, Christofer; Odenrick, Per; Larsson, Per Anders

    2017-05-15

    Purpose The purpose of this paper is to explore how organizational design could support teamwork and to identify organizational design principles that promote successful teamwork. Design/methodology/approach Since traditional team training sessions take resources away from production, the alternative approach pursued here explores the promotion of teamwork by means of organizational design. A wide and pragmatic definition of teamwork is applied: a team is considered to be a group of people that are set to work together on a task, and teamwork is then what they do in relation to their task. The input - process - output model of teamwork provides structure to the investigation. Findings Six teamwork enablers from the healthcare team literature - cohesion, collaboration, communication, conflict resolution, coordination, and leadership - are discussed, and the organizational design measures required to implement them are identified. Three organizational principles are argued to facilitate the teamwork enablers: team stability, occasions for communication, and a participative and adaptive approach to leadership. Research limitations/implications The findings could be used as a foundation for intervention studies to improve team performance or as a framework for evaluation of existing organizations. Practical implications By implementing these organizational principles, it is possible to achieve many of the organizational traits associated with good teamwork. Thus, thoughtful organization for teamwork can be used as an alternative or complement to the traditional team training approach. Originality/value With regards to the vast literature on team training, this paper offers an alternative perspective on how to improve team performance in healthcare.

  12. Rethinking critical reflection on care: late modern uncertainty and the implications for care ethics.

    PubMed

    Vosman, Frans; Niemeijer, Alistair

    2017-12-01

    Care ethics as initiated by Gilligan, Held, Tronto and others (in the nineteen eighties and nineties) has from its onset been critical towards ethical concepts established in modernity, like 'autonomy', alternatively proposing to think from within relationships and to pay attention to power. In this article the question is raised whether renewal in this same critical vein is necessary and possible as late modern circumstances require rethinking the care ethical inquiry. Two late modern realities that invite to rethink care ethics are complexity and precariousness. Late modern organizations, like the general hospital, codetermined by various (control-, information-, safety-, accountability-) systems are characterized by complexity and the need for complexity reduction, both permeating care practices. By means of a heuristic use of the concept of precariousness, taken as the installment of uncertainty, it is shown that relations and power in late modern care organizations have changed, precluding the use of a straightforward domination idea of power. In the final section a proposition is made how to rethink the care ethical inquiry in order to take late modern circumstances into account: inquiry should always be related to the concerns of people and practitioners from within care practices.

  13. Cognitive load in distributed and massed practice in virtual reality mastoidectomy simulation.

    PubMed

    Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

    2016-02-01

    Cognitive load theory states that working memory is limited. This has implications for learning and suggests that reducing cognitive load (CL) could promote learning and skills acquisition. This study aims to explore the effect of repeated practice and simulator-integrated tutoring on CL in virtual reality (VR) mastoidectomy simulation. Prospective trial. Forty novice medical students performed 12 repeated virtual mastoidectomy procedures in the Visible Ear Simulator: 21 completed distributed practice with practice blocks spaced in time and 19 participants completed massed practice (all practices performed in 1 day). Participants were randomized for tutoring with the simulator-integrated tutor function. Cognitive load was estimated by measuring reaction time in a secondary task. Data were analyzed using linear mixed models for repeated measurements. The mean reaction time increased by 37% during the procedure compared with baseline, demonstrating that the procedure placed substantial cognitive demands. Repeated practice significantly lowered CL in the distributed practice group but not in massed practice group. In addition, CL was found to be further increased by 10.3% in the later and more complex stages of the procedure. The simulator-integrated tutor function did not have an impact on CL. Distributed practice decreased CL in repeated VR mastoidectomy training more consistently than was seen in massed practice. This suggests a possible effect of skills and memory consolidation occurring over time. To optimize technical skills learning, training should be organized as time-distributed practice rather than as a massed block of practice, which is common in skills-training courses. N/A. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Environmental issues in operations management

    NASA Astrophysics Data System (ADS)

    Muthulingam, Suresh

    Adoption of sustainable operating practices is becoming an increasingly important issue for many organizations in the world today. In this dissertation, I use empirical methods to investigate factors that influence the adoption of sustainable practices and also identify issues that may hinder the adoption of such practices. I explore these issues in two diverse settings. In Chapter 1, I investigate the adoption and non-adoption of energy efficiency initiatives using a database of over 100,000 recommendations provided to more than 13,000 small and medium sized manufacturing firms. Even though the average payback across all recommendations is just over one year, many of these profitable opportunities are not implemented. Using a probit instrumental variable model, I identify four biases in the adoption of these recommendations. First, managers are myopic as they miss out on many profitable opportunities. Second, managers are more influenced by upfront costs than by net benefits when evaluating such initiatives. Third, adoption of a recommendation depends not only on its characteristics but also on the sequence in which the recommendations are presented. Adoption rates are higher for initiatives appearing early in a list of recommendations. Finally, adoption is not influenced by the number of options provided to decision makers. This contributes to the debate about whether or not choice overload occurs. We highlight decision biases previously unobserved in the Operations Management literature using field data rather than experimental data. We draw implications for enhancing adoption of energy efficiency initiatives and for other decision contexts where a collection of process improvement recommendations are made to firms. In Chapter 2, I examine the depth of adoption of the voluntary LEED (Leadership in Energy and Environmental Design) standards for green buildings. Depth of adoption refers to the extent to which the buildings adopt practices related to the standard. The LEED standard is based on a point system where buildings are awarded different certification levels based on the number of points they achieve. We use a database of 721 buildings certified to the LEED standard to investigate four issues related to the depth of adoption. First, I find that depth of adoption is influenced by the various certification levels (certified, silver, gold, platinum) incorporated into the LEED standards. In the distribution of points achieved by buildings, this results in large "spikes" at the cutoffs for the various certification levels. Second, we find that the depth of adoption of the LEED standard increases over time as the standard becomes more widely accepted. Third, we find that among organizations that adopt the LEED standard, nonprofit organizations adopt it more deeply than other types of organizations. Finally, we find that deeper adoption is associated with longer project completion times, consistent with the greater complexity involved. Our study contributes to the literature by highlighting that the structure of a standard can influence depth of adoption, that depth of adoption can evolve over time, and that depth of adoption is influenced by organization type. We draw implications for the design and future development of similar voluntary standards.

  15. The digital transformation of oral health care. Teledentistry and electronic commerce.

    PubMed

    Bauer, J C; Brown, W T

    2001-02-01

    Health care is being changed dramatically by the marriage of computers and telecommunications. Implications for hospitals and physicians already have received extensive media attention, but comparatively little has been said about the impact of information technology on dentistry. This article illustrates how the digital transformation will likely affect dentists and their patients. Based on recent experiences of hospitals and medical practices, dentists can expect to encounter revolutionary changes as a result of the digital transformation. The Internet, the World Wide Web and other developments of the information revolution will redefine patient care, referral relationships, practice management, quality, professional organizations and competition. To respond proactively to the digital transformation of oral health care, dentists must become familiar with its technologies and concepts. They must learn what new information technology can do for them and their patients and then develop creative applications that promote the profession and their approaches to care.

  16. Meso and micro level workforce challenges in psychiatric rehabilitation.

    PubMed

    Reifels, Lennart; Pirkis, Jane

    2012-01-01

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

  17. Stakeholder perceptions of job stress in an industrialized country: implications for policy and practice.

    PubMed

    Page, Kathryn M; LaMontagne, Anthony D; Louie, Amber M; Ostry, Aleck S; Shaw, Andrea; Shoveller, Jeannie A

    2013-08-01

    We used a secondary, qualitative analysis of stakeholder perceptions of work stress in Australia to characterize the context for policy and practice intervention. Themes included: Individual versus contextual descriptions of stress; perceived 'gender' differences in manifesting and reporting of stress; the work/home interface; and perceived sectoral and occupational differences in compensation claim rates. We found that people often still perceive stress as an individual rather than organizational problem and view work stress as a stereotypically feminine weakness that affects only certain people. Organizations downplay and overlook risks, increasing worker reluctance to report stressors, creating barriers to job stress interventions. Our study may be relevant to other industrial countries where researchers currently study job stress interventions to improve their effectiveness. Comprehensive approaches can increase knowledge and decrease stigma about job stress and mental illness, and target both work- and non-work-related influences on mental health.

  18. Conducting effective focus groups in the context of diversity: theoretical underpinnings and practical implications.

    PubMed

    Dreachslin, J L

    1998-11-01

    Demographic trends reveal that the socially and culturally relevant diversity of patients, caregivers, and managers in health care organizations will continue to increase. In addition, social attitudes are moving from a goal of assimilation or homogenization to one of differentiation and maintenance of subgroup identity. These shifts in demographics and social attitudes require the associated development of theory and practice guidelines for focus groups conducted in the context of diversity. Diversity has a profound impact on factors ranging from study design to the selection and training of facilitators and the analysis of results. Racial identity development theory, models of communication style differences, ethnographic studies of cultural archetypes or ethnic markers, and the author's experiences in facilitating focus groups that explore the sensitive topic of race/ethnicity provide insights for researchers and practitioners who want to ensure that focus groups conducted in the context of diversity produce valid results.

  19. Impact of organizational change on organizational culture: implications for introducing evidence-based practice.

    PubMed

    Austin, Michael J; Claassen, Jennette

    2008-01-01

    Evidence-based practice (EBP) seeks to integrate the expertise of individual practitioners with the best available evidence within the context of the values and expectations of clients. Prior to implementing EBP, it is important to understand the significance that organizational change and organizational culture play. This article seeks to explore the literature associated with both organizational change and organizational culture. The analysis of organizational culture and change draw upon findings from both the private, for-profit sector, and the public, non-profit field. It is divided into four sections: organizational change and innovation, organizational culture, managing organizational culture and change, and finally, applying the findings to the implementation of EBP. While the audience for this analysis is managers in public and nonprofit human service organizations who are considering implementing EBP into their work environment, it is not intended to provide a "how to" guide, but rather a framework for critical thinking.

  20. 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.

  1. Theoretical and practical issues in the definition of health: insights from Aboriginal Australia.

    PubMed

    Boddington, Paula; Räisänen, Ulla

    2009-02-01

    This paper discusses attempts to define health within a public policy arena and practical and conceptual difficulties that arise. An Australian Aboriginal definition of health is examined. Although there are certain difficulties of translation, this definition is prominent in current Australian health policy and discourse about health. The definition can be seen as broadly holistic in comparison to other holistic definitions such as that of the World Health Organization. The nature of this holism and its grounding within the context of Aboriginal Australia is discussed. In particular, its implications for the phenomenon of medicalization, which may be associated with a holistic notion of health, is critically explored, as is the link of notions of health to culture and the question of the possibility of a universal definition of health. The question of to what extent a definition of health is inspirational or operational is also raised.

  2. Implications of dual practice for universal health coverage.

    PubMed

    McPake, Barbara; Russo, Giuliano; Hipgrave, David; Hort, Krishna; Campbell, James

    2016-02-01

    Making progress towards universal health coverage (UHC) requires that health workers are adequate in numbers, prepared for their jobs and motivated to perform. In establishing the best ways to develop the health workforce, relatively little attention has been paid to the trends and implications of dual practice - concurrent employment in public and private sectors. We review recent research on dual practice for its potential to guide staffing policies in relation to UHC. Many studies describe the characteristics and correlates of dual practice and speculate about impacts, but there is very little evidence that is directly relevant to policy-makers. No studies have evaluated the impact of policies on the characteristics of dual practice or implications for UHC. We address this lack and call for case studies of policy interventions on dual practice in different contexts. Such research requires investment in better data collection and greater determination on the part of researchers, research funding bodies and national research councils to overcome the difficulties of researching sensitive topics of health systems functions.

  3. Drivers and challenges for implementing ISO 14001 environmental management systems in an emerging Gulf Arab country.

    PubMed

    Waxin, Marie-France; Knuteson, Sandra L; Bartholomew, Aaron

    2017-11-13

    Worldwide, ISO 14001 certification for organizations has become the norm, but the Arab world accounts for an insignificant portion of all the certified organizations. There is a dearth of research on environmental management systems (EMS) in Arab and emerging countries and in public organizations. The objectives of this research are to: (1) examine the key drivers and challenges related to implementation of ISO 14001 certified EMS in the United Arab Emirates, an emerging Arab country and (2) compare and contrast these drivers and challenges between private and public organizations. We adopt an explorative, qualitative methodology, using semi-structured interviews with environmental managers in 11 organizations (6 private and 5 public) from different industrial sectors. Drivers of EMS certification were mostly similar between private and public organizations, with some differences. Compliance with regulations and standards, and increasing environmental performance were the main drivers for ISO 14001 certification in both private and public organizations. Commitment to sustainability was more important for public organizations. Cost reduction, competitors, leadership commitment and customers' demands were shared drivers, but more stressed by private organizations. Local community and employees' pressures were reported by private organizations only. The challenges to ISO 14001 implementation were similar for private and public organizations. They were: a lack of qualified human resources, practical challenges associated with implementation, a lack of regulations, a lack of support from management, and high costs. Our findings have implications for managers, academics, consultants, and policy makers in the UAE and other emerging markets.

  4. A comparative study of production performance and animal health practices in organic and conventional dairy systems.

    PubMed

    Silva, Jenevaldo B; Fagundes, Gisele M; Soares, João P G; Fonseca, Adivaldo H; Muir, James P

    2014-10-01

    Health and production management strategies influence environmental impacts of dairies. The objective of this paper was to measure risk factors on health and production parameters on six organic and conventional bovine, caprine, and ovine dairy herds in southeastern Brazil over six consecutive years (2006-2011). The organic operations had lower milk production per animal (P ≤ 0.05), lower calf mortality (P ≤ 0.05), less incidence of mastitis (P ≤ 0.05), fewer rates of spontaneous abortions (P ≤ 0.05), and reduced ectoparasite loads (P ≤ 0.05) compared to conventional herds and flocks. Organic herds, however, had greater prevalence of internal parasitism (P ≤ 0.05) than conventional herds. In all management systems, calves, kids, and lambs had greater oocyte counts than adults. However, calves in the organic group showed lower prevalence of coccidiosis. In addition, animals in the organic system exhibited lower parasitic resistance to anthelmintics. Herd genetic potential, nutritive value of forage, feed intake, and pasture parasite loads, however, may have influenced productive and health parameters. Thus, although conventional herds showed greater milk production and less disease prevalence, future research might quantify the potential implications of these unreported factors.

  5. Estimating the Number of Organ Donors in Australian Hospitals—Implications for Monitoring Organ Donation Practices

    PubMed Central

    Pilcher, David; Gladkis, Laura; Arcia, Byron; Bailey, Michael; Cook, David; Cass, Yael; Opdam, Helen

    2015-01-01

    Background The Australian DonateLife Audit captures information on all deaths which occur in emergency departments, intensive care units and in those recently discharged from intensive care unit. This information provides the opportunity to estimate the number of donors expected, given present consent rates and contemporary donation practices. This may then allow benchmarking of performance between hospitals and jurisdictions. Our aim was to develop a method to estimate the number of donors using data from the DonateLife Audit on the basis of baseline patient characteristics alone. Methods All intubated patient deaths at contributing hospitals were analyzed. Univariate comparisons of donors to nondonors were performed. A logistic regression model was developed to estimate expected donor numbers from data collected between July 2012 and December 2013. This was validated using data from January to April 2014. Results Between July 2012 and April 2014, 6861 intubated patient deaths at 68 hospitals were listed on the DonateLife Audit of whom 553 (8.1%) were organ donors. Factors independently associated with organ donation included age, brain death, neurological diagnoses, chest x-ray findings, PaO2/FiO2, creatinine, alanine transaminase, cancer, cardiac arrest, chronic heart disease, and peripheral vascular disease. A highly discriminatory (area under the receiver operatory characteristic, 0.940 [95% confidence interval, 0.924-0.957]) and well-calibrated prediction model was developed which accurately estimated donor numbers. Three hospitals appeared to have higher numbers of actual donors than expected. Conclusions It is possible to estimate the expected number of organ donors. This may assist benchmarking of donation outcomes and interpretation of changes in donation rates over time. PMID:25919766

  6. 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.

  7. The Patient Protection and Affordable Care Act: implications for pediatric pharmacy practice.

    PubMed

    Vallejos, Ximena; Benavides, Sandra

    2013-01-01

    The impact of the Patient Protection and Affordable Care Act on the pediatric health care landscape includes expanded health insurance coverage and health care delivery improvements by increasing implementation of patient-centered medical homes and accountable care organizations. These offer opportunities for pharmacists to assume responsibility for the medication-related needs of pediatric patients through pharmacotherapy selection, medication therapy management performance, and medication reconciliation at each transition of care. Medically complex children with at least 2 chronic disease states may be the target population. Studies demonstrating the positive outcomes and cost-effectiveness of pharmacists in pediatric ambulatory care settings are needed.

  8. Influence of employees' attachment styles on their life satisfaction as mediated by job satisfaction and burnout.

    PubMed

    Reizer, Abira

    2015-01-01

    The aim of this study was to obtain better insight into the associations between attachment styles and employees' life satisfaction. This was achieved by examining the mediating roles of burnout and job satisfaction. Three hundred and thirty-nine employees, from a convenience community sample, participated in the current study. Results of the mediation model indicated that the associations between avoidance and life satisfaction were mediated by burnout and job satisfaction. However, the associations between attachment anxiety and life satisfaction were mediated by burnout but not by job satisfaction. Theoretical and practical implications for organizations and for attachment theory at work are discussed.

  9. The Role of Bacteria, Probiotics and Diet in Irritable Bowel Syndrome

    PubMed Central

    Harper, Ashton; Naghibi, Malwina M.; Garcha, Davinder

    2018-01-01

    Irritable bowel syndrome is a highly prevalent gastrointestinal disorder that threatens the quality of life of millions and poses a substantial financial burden on healthcare systems around the world. Intense research into the human microbiome has led to fascinating discoveries which directly and indirectly implicate the diversity and function of this occult organ in irritable bowel syndrome (IBS) pathophysiology. The benefit of manipulating the gastrointestinal microbiota with diet and probiotics to improve symptoms has been demonstrated in a wealth of both animal and human studies. The positive and negative mechanistic roles bacteria play in IBS will be explored and practical probiotic and dietary choices offered. PMID:29373532

  10. Individual reactions to high involvement work processes: investigating the role of empowerment and perceived organizational support.

    PubMed

    Butts, Marcus M; Vandenberg, Robert J; DeJoy, David M; Schaffer, Bryan S; Wilson, Mark G

    2009-04-01

    This study sought to understand how high involvement work processes (HIWP) are processed at the employee level. Using structural equation modeling techniques, the authors tested and supported a model in which psychological empowerment mediated the effects of HIWP on job satisfaction, organizational commitment, job performance, and job stress. Furthermore, perceived organizational support (POS) was hypothesized to moderate the relationships between empowerment and these outcomes. With exception for the empowerment-job satisfaction association, support was found for our predictions. Future directions for research and the practical implications of our findings for both employees and organizations are discussed.

  11. Applying a cultural lens to the concept of burnout.

    PubMed

    Raiger, Janet

    2005-01-01

    Burnout is a unique type of stress syndrome that is pervasively affecting the nursing profession. The literature on burnout is reviewed, and a conceptual framework using Maslach's Burnout Inventory is provided. The culture of organizations is examined with regard to its contribution to the antecedents and consequences of burnout. Leininger's cultural care theory and its relevance to the concept of burnout and culture is discussed. Implications for the amelioration of burnout from the perspective of culture are discussed to stimulate future changes in nursing administration, practice, and education. A culture of trust, support, open communication, and respect can foster healthy work environments and protect against burnout.

  12. Social Media and Nurses: Insights for Promoting Health for Individual and Professional Use.

    PubMed

    Jackson, Jennifer; Fraser, Robert; Ash, Peter

    2014-09-30

    Social media use can have a significant impact on the health of nurses, both at the individual level and in the workplace. There are positive and negative consequences of social media use for nurses, including potential health consequences. This article provides a brief overview of social media and then explores nursing health and social media and risks for nurses. Social media use also extends to healthcare organizations; with implications for consumers of healthcare delivery. A variety of emerging best practices can guide social media use for nurses. The authors also discuss suggestions for using social media carefully, and future directions for research.

  13. 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

  14. 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.

  15. Mobility, Latino Migrants, and the Geography of Sex Work: Using Ethnography in Public Health Assessments.

    PubMed

    Sangaramoorthy, Thurka; Kroeger, Karen

    2013-01-01

    Recent studies have documented frequent use of female sex workers among Latino migrant men in the southeastern United States, yet little is known about the context in which sex work takes place, or the women who provide these services. As anthropologists working in applied public health, we use rapid ethnographic assessment as a technical assistance tool to document local understandings of the organization and typology of sex work and patterns of mobility among sex workers and their Latino migrant clients. By incorporating ethnographic methods in traditional public health needs assessments, we were able to highlight the diversity of migrant experiences and better understand the health needs of mobile populations more broadly. We discuss the findings in terms of their practical implications for HIV/STD prevention and call on public health to incorporate the concept of mobility as an organizing principle for the delivery of health care services.

  16. Harnessing demographic differences in organizations: What moderates the effects of workplace diversity?

    PubMed

    Guillaume, Yves R F; Dawson, Jeremy F; Otaye-Ebede, Lilian; Woods, Stephen A; West, Michael A

    2017-02-01

    To account for the double-edged nature of demographic workplace diversity (i.e,. relational demography, work group diversity, and organizational diversity) effects on social integration, performance, and well-being-related variables, research has moved away from simple main effect approaches and started examining variables that moderate these effects. While there is no shortage of primary studies of the conditions under which diversity leads to positive or negative outcomes, it remains unclear which contingency factors make it work. Using the Categorization-Elaboration Model as our theoretical lens, we review variables moderating the effects of workplace diversity on social integration, performance, and well-being outcomes, focusing on factors that organizations and managers have control over (i.e., strategy, unit design, human resource, leadership, climate/culture, and individual differences). We point out avenues for future research and conclude with practical implications. © 2015 The Authors. Journal of Organizational Behavior published by John Wiley & Sons, Ltd.

  17. Mentoring and its impact on intellectual capital: through the eyes of the mentee.

    PubMed

    Thomka, Lisa A

    2007-01-01

    Recently, the concept of mentoring, and the use of mentorship programs, is being touted as a strategic means within healthcare organizations to address the nursing shortage that promises to continue well into the future. Mentoring, on the surface, could also be considered as an excellent means of supporting the development and retention of intellectual capital and succession planning within nursing. However, without a better understanding of the concept of mentoring, nurse leaders can never really know the full impact of mentoring in order to achieve such goals within the organization. Several key results from a study of mentorship in nursing support the concept of ongoing knowledge sharing within the discipline, as seen through the eyes of the mentee. The implications for nurse leaders shift the focus from formal mentoring programs to the creation of practice settings that foster the development of mentoring relationships.

  18. Strategic issues in performance appraisal: theory and practice.

    PubMed

    Fombrun, C J; Laud, R L

    1983-01-01

    Performance appraisal systems have tremendous strategic potential for governing employee behavior and thus corporate direction through their links to selection, training and career planning, and reward systems. Authors Charles J. Fombrun, assistant professor of management at the University of Pennsylvania's Wharton School, and Robert P. Laud, senior vice-president of Drake Beam Morin, Inc., surveyed appraisal systems of Fortune 1300 corporations to find out how well companies are realizing this potential. Among their conclusions: (1) In most organizations, the typical performance appraisal system is focused on short-term goals. Strengthening the linkage between the appraisal system and the long-term implications of strategic planning could improve organizational effectiveness in the future. (2) The performance appraisal system's most prevalent use is as a feedback mechanism rather than as a management tool. Thus, the authors conclude, the role of the performance appraisal system as a strategic organizational tool is largely unappreciated by U.S. organizations.

  19. The relationship among work-family conflict and enhancement, organizational work-family culture, and work outcomes for older working women.

    PubMed

    Gordon, Judith R; Whelan-Berry, Karen S; Hamilton, Elizabeth A

    2007-10-01

    This article examines the relationship among work-family conflict and enhancement, organizational work-family culture, and four work outcomes for 489 working women over the age of 50. Survey results from two U.S. health care organizations and one U.S. financial services organization indicate that older working women experience differing amounts of work-to-family conflict, family-to-work conflict, work-to-family enhancement, and family-to-work enhancement. Hypotheses relating organizational work-family culture to work-family conflict and enhancement were partially supported, and hypotheses relating conflict and enhancement to four work outcomes were partially supported. Work-to-family conflict and work-to-family enhancement partially mediate the relationship between organizational work-family culture and selected work outcomes. Implications for theory and practice, limitations of this study, and directions for future research are also presented.

  20. Social psychology, terrorism, and identity: a preliminary re-examination of theory, culture, self, and society.

    PubMed

    Arena, Michael P; Arrigo, Bruce A

    2005-01-01

    This article relies upon structural symbolic interactionism and five of its organizing concepts (i.e. symbols, the definition of the situation, roles, socialization and role-taking, and the self) to put forth a novel conceptual framework for understanding the terrorist identity. In order to demonstrate the practical utility of the framework, applications to various terrorist groups around the globe are incorporated into the analysis. Overall, both the theoretical and application work help reorient the academic and practitioner behavioral science communities to the importance of culture, self, and society when investigating one's membership in and identity through militant extremist organizations. Given the unique approach taken by this article, several provisional implications are delineated. In particular, future research on terrorism, strategies linked to counter-terrorism, legal and public policy reform, and the relevance of utilizing a sociologically animated social psychology in the assessment of other forms of criminal behavior are all very tentatively explored.

  1. Financial management services in consumer-directed programs.

    PubMed

    Scherzer, Teresa; Wong, Alice; Newcomer, Robert

    2007-01-01

    Shifting from an agency-based model of personal assistance services to consumer direction has important consequences for both recipients and workers. In consumer direction, recipients assume the responsibilities of employing their attendants--for both self-directing their supportive services and being responsible for numerous fiscal responsibilities. Many states have eased these fiscal responsibilities among recipients in publicly financed personal care programs by using Financial Management Services (also known as fiscal intermediaries). This article introduces the major types of Financial Management Services organizations used by Medicaid consumer-directed personal care programs, and examines the extent to which the varied approaches can and do serve the needs of both recipients and workers. Despite the expansion of consumer-directed programs and the accompanying emergence of Financial Management Services, these organizations have not been extensively studied or evaluated. The paper concludes with a discussion of the challenges, opportunities, and policy implications of the current practice; and suggests directions for future research.

  2. Transformational leadership: implications for nursing leaders in facilities seeking magnet designation.

    PubMed

    Schwartz, Diane Brady; Spencer, Tammy; Wilson, Brigitte; Wood, Kim

    2011-06-01

    A perioperative nurse leader's ability to effect positive change and inspire others to higher levels of achievement is related to his or her leadership style in the practice setting and the leadership style that is present across the organization. The American Nurses Credentialing Center's Magnet™ designation and redesignation process requires the demonstration of transformational leadership as one of the components of excellence. Transformational leadership can increase nurses' job satisfaction and commitment to the organization and organizational culture. Engaging staff members in the transition to transformational leadership and developing a common mission, vision, and goals are keys to success in the surgical setting. Bass's four interrelated leadership components-idealized influence, inspirational motivation, intellectual stimulation, and individual consideration-and associated behaviors were used by surgical services leaders in an East Coast, two-hospital system to successfully achieve redesignation as a Magnet facility. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  3. More than just the mean: moving to a dynamic view of performance-based compensation.

    PubMed

    Barnes, Christopher M; Reb, Jochen; Ang, Dionysius

    2012-05-01

    Compensation decisions have important consequences for employees and organizations and affect factors such as retention, motivation, and recruitment. Past research has primarily focused on mean performance as a predictor of compensation, promoting the implicit assumption that alternative aspects of dynamic performance are not relevant. To address this gap in the literature, we examined the influence of dynamic performance characteristics on compensation decisions in the National Basketball Association (NBA). We predicted that, in addition to performance mean, performance trend and variability would also affect compensation decisions. Results revealed that performance mean and trend, but not variability, were significantly and positively related to changes in compensation levels of NBA players. Moreover, trend (but not mean or variability) predicted compensation when controlling for future performance, suggesting that organizations overweighted trend in their compensation decisions. Theoretical and practical implications are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  4. Organizational change for services integration in public human service organizations: experiences in seven counties.

    PubMed

    Packard, Thomas; Patti, Rino; Daly, Donna; Tucker-Tatlow, Jennifer

    2012-01-01

    This is a study of organizational change strategies employed in seven county human service agencies to improve the coordination of services through the structural integration of previously free standing organizations or the development of voluntary interagency collaborative service delivery systems. The central question involves the identification of organizational change tactics which contributed to the success of the organizational change initiatives. The literature on organizational change is reviewed, with particular attention to a framework developed by Fernandez and Rainey based on their extensive review and synthesis of the research on successful change strategies in the public and business sectors. Qualitative and quantitative data were gathered from over 250 individuals and from agency documents. Findings are compared with the success factors identified by Fernandez and Rainey, and refinements to their propositions are suggested. More precise methods for measuring successful and unsuccessful change initiatives are suggested. Implications for practice and research are presented.

  5. The effect of work motivation on a sample of nurses in an Italian healthcare setting.

    PubMed

    Galletta, Maura; Portoghese, Igor; Pili, Sergio; Piazza, Maria Francesca; Campagna, Marcello

    2016-06-08

    Research in Human Resources Management has highlighted that implementing strategies for increasing employees' motivation can be an advantage for organizations because this improves their performance. Self Determination Theory (SDT) was used to analyze the mediating role of autonomous vs. controlled motivation on the relationship between organizational factors (perceived organizational support and job autonomy) and work outcomes (affective commitment, job satisfaction, and intent to quit). A total of 304 nurses from an Italian hospital participated in the study. The results supported the importance of the mediating role of autonomous motivation on the relationship between both perceived organizational support (POS) and job autonomy, and work outcomes. Conversely, controlled motivation did not show mediating effects on that relationship. POS was directly related to affective commitment and job satisfaction. Practical implications for organizations and employees are discussed along with a call for further research in this area.

  6. Harnessing demographic differences in organizations: What moderates the effects of workplace diversity?

    PubMed Central

    Dawson, Jeremy F.; Otaye‐Ebede, Lilian; Woods, Stephen A.; West, Michael A.

    2015-01-01

    Summary To account for the double‐edged nature of demographic workplace diversity (i.e,. relational demography, work group diversity, and organizational diversity) effects on social integration, performance, and well‐being‐related variables, research has moved away from simple main effect approaches and started examining variables that moderate these effects. While there is no shortage of primary studies of the conditions under which diversity leads to positive or negative outcomes, it remains unclear which contingency factors make it work. Using the Categorization‐Elaboration Model as our theoretical lens, we review variables moderating the effects of workplace diversity on social integration, performance, and well‐being outcomes, focusing on factors that organizations and managers have control over (i.e., strategy, unit design, human resource, leadership, climate/culture, and individual differences). We point out avenues for future research and conclude with practical implications. © 2015 The Authors. Journal of Organizational Behavior published by John Wiley & Sons, Ltd PMID:28239234

  7. Success, failures and costs of implementing standards in the USA--lessons for infection control.

    PubMed

    McGowan, J E

    1995-06-01

    In the US, extensive standards for performance and 'guidelines for practice' have been instituted by a number of governmental and non-governmental agencies. New governmental plans for health care depend heavily on practice guidelines, and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has been especially enthusiastic about continuous quality improvement. Monitoring the appropriateness of care and altering physician practice appeals to insurance carriers and health care management organizations. Some initial data exist to show that the quality of health care has been enhanced by these regulations. The total cost for health care administration in 1990 in the USA was 24.8% of each hospital's spending for health care. Much of this was associated with spending for new initiatives in practice guidelines, physician profiling, quality assurance, and the like. Few data exist to show that the quality of health care or hospital infection control has been enhanced by these expenditures. Regulations and guidelines also have proliferated in infection control. Guides from the JCAHO have been expanded, and recent mandates from the Occupational Health and Safety Administration (OSHA) for protecting employees from blood-borne and respiratory pathogens promise to be especially costly for health care organizations to implement. Little data exist to show that the quality of infection control has been enhanced by these regulations. Standards are difficult to develop, because the science to back them up often is lacking, interpretation of validating data is imprecise, and inherent biological variation makes exceptions common. Seven lessons are important for those developing standards today. These include focusing on objective measures of the impact of the standard, clearly indicating the degree of scientific validity, making the development process inclusive, allowing for local variation, making sure that funding is provided for mandated standards, considering non-scientific implications of standards, and remaining involved in the process after the guideline is developed. Infection control workers should make sure that standards developed take the lessons above into account before they are promulgated.

  8. The Potential Value of the U.N. Convention on the Rights of the Child in Pediatric Bioethics Settings.

    PubMed

    Silva, Michael Da; Lew, Cheryl D; Lundy, Laura; Lang, Kellie R; Melamed, Irene; Shaul, Randi Zlotnik

    2016-01-01

    This article provides support for the use of a particular international human rights law document, the U.N. Convention on the Rights of the Child (CRC), in contemporary pediatric bioethics practice without relying on the legally binding force of the document. It first demonstrates that the CRC's core commitments and values substantially overlap with the core commitments and values of mainstream bioethics and with the laws of many domestic jurisdictions where mainstream bioethics are currently practiced. It then explores some implications of this overlap. For instance, the substantial international human rights law scholarship on how to understand these commitments and values can be helpful in suggesting ways to operationalize them in domestic bioethics practice and can offer insightful, internationally generated ethical perspectives that may not have been considered. The article also argues that the CRC can help health-care organizations develop policies consistent with the best interests of children and that the CRC can serve as a common language of values for transnational health-care collaborations. However, as a final case discussion demonstrates, whatever the merits of the CRC, one may face practical difficulties in trying to use it.

  9. Effective Practices for Sexually Traumatized Girls: Implications for Counseling and Education

    ERIC Educational Resources Information Center

    Underwood, Lee; Stewart, Sarah E.; Castellanos, Anita M.

    2007-01-01

    The sexual traumatization of female adolescents is becoming increasingly visible in the counseling field. This paper will outline the prevalence of sexual abuse on female adolescents with emphasis on effective practices used in the field. In addition, implications for counselors and counselor educators will be discussed. Multicultural…

  10. Observations of a Working Class Family: Implications for Self-Regulated Learning Development

    ERIC Educational Resources Information Center

    Vassallo, Stephen

    2012-01-01

    Guardians have been implicated in the development of children's academic self-regulation. In this case study, which involved naturalistic observations and interviews, the everyday practices of a working class family were considered in the context of self-regulated learning development. The family's practices, beliefs, dispositions and home…

  11. Educational Psychologists' Constructions of Sexuality and the Implications for Practice

    ERIC Educational Resources Information Center

    Marks, Chloe

    2012-01-01

    Despite an underlying inclusion agenda, sexuality equality remains a low priority in education. Review of literature suggests the marginalization of sexual minority young people (SMYP) in schools. This study explores educational psychologists' (EPs') constructions of sexuality and the implications for practice. Discursive psychology was used to…

  12. Teaching and Learning Intuition: Some Implications for HRD and Coaching Practice

    ERIC Educational Resources Information Center

    Mavor, Penny; Sadler-Smith, Eugene; Gray, David E.

    2010-01-01

    Purpose: The purpose of this paper is to examine conceptual and theoretical links between intuition and coaching; investigate accomplished coaches' practical experiences of intuition; identify skill set of an intuitive coach; discuss implications of findings for coaches', HRD professionals', and line managers' learning and development.…

  13. Marketing in the Islamic Context.

    ERIC Educational Resources Information Center

    Hashmi, Mahmud S.

    The implications of the Islamic religion and culture for marketing strategies and practices are discussed. An introductory section describes the Islamic population and its segments, and gives some historical background about the religion. A list of the principal tenets and practices of the Islamic faith, and the specific marketing implications of…

  14. Identifying the conditions needed for integrated knowledge translation (IKT) in health care organizations: qualitative interviews with researchers and research users.

    PubMed

    Gagliardi, Anna R; Dobrow, Mark J

    2016-07-12

    Collaboration among researchers and research users, or integrated knowledge translation (IKT), enhances the relevance and uptake of evidence into policy and practice. However, it is not widely practiced and, even when well-resourced, desired impacts may not be achieved. Given that large-scale investment is not the norm, further research is needed to identify how IKT can be optimized. Interviews were conducted with researchers and research users (clinicians, managers) in a health care delivery (HCDO) and health care monitoring (HCMO) organization that differed in size and infrastructure, and were IKT-naïve. Basic qualitative description was used. Participants were asked about IKT activities and challenges, and recommendations for optimizing IKT. Data were analysed inductively using constant comparative technique. Forty-three interviews were conducted (28 HCDO, 15 HCMO) with 13 researchers, 8 clinicians, and 22 managers. Little to no IKT took place. Participants articulated similar challenges and recommendations revealing that a considerable number of changes were needed at the organizational, professional and individual levels. Given the IKT-absent state of participating organizations, this research identified a core set of conditions which must be addressed to prepare an environment conducive to IKT. These conditions were compiled into a framework by which organizations can plan for, or evaluate their capacity for IKT. The IKT capacity framework is relevant for organizations in which there is no current IKT activity. Use of the IKT framework may result in more organizations that are ready to initiate and establish IKT, perhaps ultimately leading to more, and higher-quality collaboration for health system innovation. Further research is needed to confirm these findings in other organizations not yet resourced for, or undertaking IKT, and to explore the resource implications and mechanisms for establishing the conditions identified here as essential to preparing for IKT.

  15. Contributions of Relational Coordination to Care Management in ACOs: Views of Managerial and Clinical Leaders

    PubMed Central

    Rundall, Thomas G.; Wu, Frances M.; Lewis, Valerie A.; Schoenherr, Karen E.; Shortell, Stephen M.

    2017-01-01

    Background The accountable care organization (ACO) is a new type of health care organization incentivized to improve quality of care, improve population health, and reduce the total cost of care. An ACO’s success in meeting these objectives will depend greatly upon its ability to improve patient care management. Numerous studies have found relational coordination to be positively associated with key measures of organizational performance in health care organizations, including quality and efficiency. Purpose The purpose of this paper is twofold: (1) identify the extent to which ACO leaders are aware of the dimensions of relational coordination, and (2) identify the ways these leaders believe the dimensions influenced care management practices in their organization. Methodology/Approach We performed content analysis of interviews with managerial and clinical leaders from a diverse group of 11 ACOs to assess awareness of relational coordination and identify the ways that dimensions of relational coordination were perceived to influence development of care management practices. Findings ACO leaders mentioned four relational coordination dimensions: shared goals, frequency of communication, timeliness of communication, and problem solving communication. Three dimensions – shared knowledge of team members’ tasks, mutual respect, and accuracy of communication – were not mentioned. Our analysis identified numerous ways leaders believed the four mentioned dimensions contributed to the development of care management, including contributions to standardization of care, patient engagement, coordination of care, and care planning. Discussion We propose two hypotheses for future research on relational coordination and care management. Practice Implications If relational coordination is to have a beneficial influence on ACO performance, organizational leaders must become more aware of relational coordination and its various dimensions and become cognizant of relational coordination’s influence on care management in their ACO. We suggest a number of means by which ACO leaders could become more aware of relational coordination and its potential effects. PMID:25978003

  16. From workshop to work practice: An exploration of context and facilitation in the development of evidence-based practice.

    PubMed

    Ellis, Isabelle; Howard, Peter; Larson, Ann; Robertson, Jeanette

    2005-01-01

    This article examines the process of translating evidence into practice using a facilitation model developed by the Western Australian Centre for Evidence Based Nursing and Midwifery. Using the conceptual framework Promoting Action on Research Implementation in Health Services (PARIHS), the aims of the study were (1) to explore the relative and combined importance of context and facilitation in the successful implementation of a new evidence-based clinical practice protocol and (2) to examine the establishment of more lasting change to individuals and organizations that resulted in greater incorporation of the principles of evidence-based practice (EBP). A pre-workshop, semi-structured telephone survey with 16 nurse managers in six rural hospitals; a summative evaluation immediately post-workshop with 54 participants; and follow-up, semi-structured interviews with 23 workshop participants. The contexts in each of the participating hospitals were very different; of the six hospitals, only one had not implemented the new protocol. Five had reviewed their practices and brought them in line with the protocol developed at the workshop. The rate of adoption varied considerably from 2 weeks to months. The participants reported being better informed about EBP in general and were positive about their ability to improve their practice and search more efficiently for best practice information. Underlying motivations for protocol development should be included in the PARIHS framework. IMPLICATIONS FOR EDUCATION: Good facilitation appears to be more influential than context in overcoming the barriers to the uptake of EBP.

  17. Meeting patient expectations: healthcare professionals and service re-engineering.

    PubMed

    Laing, Angus

    2002-08-01

    A central theme underpinning the reform of healthcare systems in western economies since the 1980s has been the emphasis on reorienting service provision around the patient. Healthcare organizations have been forced to re-appraise the design of the service delivery process, specifically the service encounter, to take account of these changing patient expectations. This reorientation of healthcare services around the patient has fundamental implications for healthcare professionals, specifically challenging the dominance of service professionals in the design and delivery of health services. Utilizing a qualitative methodological framework, this paper explores the responses of healthcare professionals to service redesign initiatives implemented in acute NHS hospitals in Scotland and considers the implications of such professional responses for the development of patient-focused service delivery. Within this, it specifically examines evolving professional perspectives on the place of a service user focus in a publicly funded healthcare system, professional attitudes towards private sector managerial practices, and the dynamics of changing professional behaviour.

  18. Restructuring patient flow logistics around patient care needs: implications and practicalities from three critical cases.

    PubMed

    Villa, Stefano; Barbieri, Marta; Lega, Federico

    2009-06-01

    To make hospitals more patient-centered it is necessary to intervene on patient flow logistics. The study analyzes three innovative redesign projects implemented at three Italian hospitals. The three hospitals have reorganized patient flow logistics around patient care needs using, as proxies, the expected length of stay and the level of nursing assistance. In order to do this, they have extensively revised their logistical configuration changing: (1) the organization of wards, (2) the hospital's physical lay-out, (3) the capacity planning system, and (4) the organizational roles supporting the patient flow management. The study describes the changes implemented as well as the results achieved and draws some general lessons that provide useful hints for those other hospitals involved in such type of redesign projects. The paper ends by discussing some policy implications. In fact, the results achieved in the three cases investigated provide interesting material for further discussion on clinical, operational, and economic issues.

  19. Just Doing Business: Modern Racism and Obedience to Authority as Explanations for Employment Discrimination.

    PubMed

    Brief; Dietz; Cohen; Pugh; Vaslow

    2000-01-01

    In two experiments, we investigated the effects of prejudice (in the form of modern racism) and business justifications by authority figures (i.e., organizational superiors) to discriminate against minorities (Blacks in our research) in hiring situations. As expected, business justifications by legitimate authority figures led to participants' obedience in the form of discrimination relative to a no-justification condition and, in the second experiment, also relative to a condition in which the business justification came from an illegitimate authority figure. Moreover, in both experiments, as expected, modern racism did not have a main effect on discrimination, but interacted with business justifications such that modern racism predicted discrimination when a legitimate authority figure provided a business-related justification for such discrimination but not in the absence of such a justification. These results are discussed in terms of their theoretical implications for understanding prejudice and obedience to authority in organizations and in terms of their practical implications for addressing the problem of discrimination in the workplace. Copyright 2000 Academic Press.

  20. 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.

  1. Application of a Sensemaking Approach to Ethics Training in the Physical Sciences and Engineering

    NASA Astrophysics Data System (ADS)

    Kligyte, Vykinta; Marcy, Richard T.; Waples, Ethan P.; Sevier, Sydney T.; Godfrey, Elaine S.; Mumford, Michael D.; Hougen, Dean F.

    2008-06-01

    Integrity is a critical determinant of the effectiveness of research organizations in terms of producing high quality research and educating the new generation of scientists. A number of responsible conduct of research (RCR) training programs have been developed to address this growing organizational concern. However, in spite of a significant body of research in ethics training, it is still unknown which approach has the highest potential to enhance researchers' integrity. One of the approaches showing some promise in improving researchers' integrity has focused on the development of ethical decision-making skills. The current effort proposes a novel curriculum that focuses on broad metacognitive reasoning strategies researchers use when making sense of day-to-day social and professional practices that have ethical implications for the physical sciences and engineering. This sensemaking training has been implemented in a professional sample of scientists conducting research in electrical engineering, atmospheric and computer sciences at a large multi-cultural, multi-disciplinary, and multi-university research center. A pre-post design was used to assess training effectiveness using scenario-based ethical decision-making measures. The training resulted in enhanced ethical decision-making of researchers in relation to four ethical conduct areas, namely data management, study conduct, professional practices, and business practices. In addition, sensemaking training led to researchers' preference for decisions involving the application of the broad metacognitive reasoning strategies. Individual trainee and training characteristics were used to explain the study findings. Broad implications of the findings for ethics training development, implementation, and evaluation in the sciences are discussed.

  2. Application of a sensemaking approach to ethics training in the physical sciences and engineering.

    PubMed

    Kligyte, Vykinta; Marcy, Richard T; Waples, Ethan P; Sevier, Sydney T; Godfrey, Elaine S; Mumford, Michael D; Hougen, Dean F

    2008-06-01

    Integrity is a critical determinant of the effectiveness of research organizations in terms of producing high quality research and educating the new generation of scientists. A number of responsible conduct of research (RCR) training programs have been developed to address this growing organizational concern. However, in spite of a significant body of research in ethics training, it is still unknown which approach has the highest potential to enhance researchers' integrity. One of the approaches showing some promise in improving researchers' integrity has focused on the development of ethical decision-making skills. The current effort proposes a novel curriculum that focuses on broad metacognitive reasoning strategies researchers use when making sense of day-to-day social and professional practices that have ethical implications for the physical sciences and engineering. This sensemaking training has been implemented in a professional sample of scientists conducting research in electrical engineering, atmospheric and computer sciences at a large multi-cultural, multi-disciplinary, and multi-university research center. A pre-post design was used to assess training effectiveness using scenario-based ethical decision-making measures. The training resulted in enhanced ethical decision-making of researchers in relation to four ethical conduct areas, namely data management, study conduct, professional practices, and business practices. In addition, sensemaking training led to researchers' preference for decisions involving the application of the broad metacognitive reasoning strategies. Individual trainee and training characteristics were used to explain the study findings. Broad implications of the findings for ethics training development, implementation, and evaluation in the sciences are discussed.

  3. Physician leadership in e-health? A systematic literature review.

    PubMed

    Keijser, Wouter; Smits, Jacco; Penterman, Lisanne; Wilderom, Celeste

    2016-07-04

    Purpose This paper aims to systematically review the literature on roles of physicians in virtual teams (VTs) delivering healthcare for effective "physician e-leadership" (PeL) and implementation of e-health. Design/methodology/approach The analyzed studies were retrieved with explicit keywords and criteria, including snowball sampling. They were synthesized with existing theoretical models on VT research, healthcare team competencies and medical leadership. Findings Six domains for further PeL inquiry are delineated: resources, task processes, socio-emotional processes, leadership in VTs, virtual physician-patient relationship and change management. We show that, to date, PeL studies on socio-technical dynamics and their consequences on e-health are found underrepresented in the health literature; i.e. no single empirical, theoretic or conceptual study with a focus on PeL in virtual healthcare work was identified. Research limitations/implications E-health practices could benefit from organization-behavioral type of research for discerning effective physicians' roles and inter-professional relations and their (so far) seemingly modest but potent impact on e-health developments. Practical implications Although best practices in e-health care have already been identified, this paper shows that physicians' roles in e-health initiatives have not yet received any in-depth study. This raises questions such as are physicians not yet sufficiently involved in e-health? If so, what (dis)advantages may this have for current e-health investments and how can they best become involved in (leading) e-health applications' design and implementation in the field? Originality/value If effective medical leadership is being deployed, e-health effectiveness may be enhanced; this new proposition needs urgent empirical scrutiny.

  4. A perspective on medical school admission research and practice over the last 25 years.

    PubMed

    Kreiter, Clarence D; Axelson, Rick D

    2013-01-01

    Over the last 25 years a large body of research has investigated how best to select applicants to study medicine. Although these studies have inspired little actual change in admission practice, the implications of this research are substantial. Five areas of inquiry are discussed: (1) the interview and related techniques, (2) admission tests, (3) other measures of personal competencies, (4) the decision process, and (5) defining and measuring the criterion. In each of these areas we summarize consequential developments and discuss their implication for improving practice. (1) The traditional interview has been shown to lack both reliability and validity. Alternatives have been developed that display promising measurement characteristics. (2) Admission test scores have been shown to predict academic and clinical performance and are generally the most useful measures obtained about an applicant. (3) Due to the high-stakes nature of the admission decision, it is difficult to support a logical validity argument for the use of personality tests. Although standardized letters of recommendation appear to offer some promise, more research is needed. (4) The methods used to make the selection decision should be responsive to validity research on how best to utilize applicant information. (5) Few resources have been invested in obtaining valid criterion measures. Future research might profitably focus on composite score as a method for generating a measure of a physician's career success. There are a number of social and organization factors that resist evidence-based change. However, research over the last 25 years does present important findings that could be used to improve the admission process.

  5. Interprofessional primary care in academic family medicine clinics: implications for education and training.

    PubMed

    Drummond, Neil; Abbott, Karen; Williamson, Tyler; Somji, Behnaz

    2012-08-01

    To explore the status and processes of interprofessional work environments and the implications for interprofessional education in a sample of family medicine teaching clinics. Focus group interviews using a purposive sampling procedure. Four academic family medicine clinics in Alberta. Seven family physicians, 9 registered nurses, 5 licensed practical nurses, 2 residents, 1 psychologist, 1 informatics specialist, 1 pharmacist, 1 dietitian, 1 nurse practitioner, 1 receptionist, and 1 respiratory therapist. Assessment of clinic status and performance in relation to established principles of interprofessional work and education was explored using semistructured focus group interviews. Our data supported the D'Amour and Oandasan model of successful interprofessional collaborative practice in terms of the model's main "factors" (ie, shared goals and vision, sense of belonging, governance, and the structuring of clinical care) and their constituent "elements." It is reasonable to conclude that the extent to which these factors and elements are both present and positively oriented in academic clinic settings is an important contributory factor to the establishment of interprofessional collaborative practice in primary care. Using this model, 2 of the 4 clinics were rated as expressing substantial progress in relation to interprofessional work, while the other 2 clinics were rated as less successful on that dimension. None of the clinics was identified as having a clear and explicit focus on providing interprofessional education. The key factor in relation to the implementation of interprofessional work in primary care appears to be the existence of clear and explicit leadership in that direction. Substantial scope exists for improvement in the organization, conduct, and promotion of interprofessional education for Canadian primary care.

  6. Improving care transitions through meaningful use stage 2: continuity of care document.

    PubMed

    Murphy, Lyn Stankiewicz; Wilson, Marisa L; Newhouse, Robin P

    2013-02-01

    In this department, Drs Murphy, Wilson, and Newhouse highlight hot topics in nursing outcomes, research, and evidence-based practice relevant to the nurse administrator. The goal is to discuss the practical implications for nurse leaders in diverse healthcare settings. Content includes evidence-based projects and decision making, locating measurement tools for quality improvement and safety projects, using outcome measures to evaluate quality, practice implications of administrative research, and exemplars of projects that demon strate innovative approaches to organizational problems. In this article, the authors describe the elements of continuity of care documentation, how sharing information can improve the quality and safety of care transitions and the implications for nurse executives.

  7. High-performance workplace practices in nursing homes: an economic perspective.

    PubMed

    Bishop, Christine E

    2014-02-01

    To develop implications for research, practice and policy, selected economics and human resources management research literature was reviewed to compare and contrast nursing home culture change work practices with high-performance human resource management systems in other industries. The organization of nursing home work under culture change has much in common with high-performance work systems, which are characterized by increased autonomy for front-line workers, self-managed teams, flattened supervisory hierarchy, and the aspiration that workers use specific knowledge gained on the job to enhance quality and customization. However, successful high-performance work systems also entail intensive recruitment, screening, and on-going training of workers, and compensation that supports selective hiring and worker commitment; these features are not usual in the nursing home sector. Thus despite many parallels with high-performance work systems, culture change work systems are missing essential elements: those that require higher compensation. If purchasers, including public payers, were willing to pay for customized, resident-centered care, productivity gains could be shared with workers, and the nursing home sector could move from a low-road to a high-road employment system.

  8. Speaking of home truth: (re)productions of dyadic-containment in non-monogamous relationships.

    PubMed

    Finn, Mark; Malson, Helen

    2008-09-01

    This paper is a critical exploration of the discursive and socio-historical practice of 'dyadic-containment' as a principle index for how we know, experience, and authenticate romantic relationships. Making intelligible an 'authentic' relationship as something which is fixed, enclosed and exclusive, the pervasive principle of dyadic-containment has considerable implications for what it means to live out 'authentic' but ostensibly liberated relationships. Using post-structuralist discourse analysis to explore ways in which people can account for their consensual non-monogamous relationships (same and cross-sex, dyadic and non-dyadic), we critique the liberal-humanist framework from which such relationships can be played out. In that dyadic-containment as an aspect of an ontology of interiorized and contained 'realness' can be viewed as serving to characterize and authorize monogamous relationships (as we illustrate), practices of consensual non-monogamy that reproduce dyadic-containment as an organizing and authenticating principle are problematized. Limits to understandings and practices of some 'alternative' romantic relationships are therefore expounded and consideration is given to how relational difference might be otherwise premised.

  9. Identifying the critical factors of green supply chain management: Environmental benefits in Pakistan.

    PubMed

    Mumtaz, Ubaidullah; Ali, Yousaf; Petrillo, Antonella; De Felice, Fabio

    2018-05-30

    Pakistan is a developing country characterized by a growing industrialization, which is the major cause of environmental pollution in the country. To control the significant increase in pollution a green incentive has started, aiming to moderate the adverse effects of environmental pollution. Thus, Green Supply Chain Management (GSCM) plays an important role in influencing the total environment impact of any organizations. This study considers ten Pakistani industries that have implemented GSCM practices. The Decision-Making Trial and Evaluation Laboratory technique (DEMATEL) is used to find influential factors in selecting GSCM criteria. The results show that organizational involvement is the most important dimension useful to implement GSCM practices. In addition, commitment from senior managers, ISO 14000 certification of suppliers and recycle of waste heat are considered significant factors. The paper also signifies the casual relationship among the dimensions and the factors in the form of diagraphs. The main management implication of the paper is to help decision makers to focus on the critical dimensions/factors in order to implement the GSCM practices more effectively in Pakistan. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Building Systemwide Improvement Capability: Does an Organization's Strategy for Quality Improvement Matter?

    PubMed

    Babich, Lauren P; Charns, Martin P; McIntosh, Nathalie; Lerner, Barbara; Burgess, James F; Stolzmann, Kelly L; VanDeusen Lukas, Carol

    2016-01-01

    Health care organizations have used different strategies to implement quality improvement (QI) programs but with only mixed success in implementing and spreading QI organization-wide. This suggests that certain organizational strategies may be more successful than others in developing an organization's improvement capability. To investigate this, our study examined how the primary focus of grant-funded QI efforts relates to (1) key measures of grant success and (2) organization-level measures of success in QI and organizational learning. Using a mixed-methods design, we conducted one-way analyses of variance to relate Veterans Affairs administrative survey data to data collected as part of a 3.5-year evaluation of 29 health care organization grant recipients. We then analyzed qualitative evidence from the evaluation to explain our results. We found that hospitals that focused on developing organizational infrastructure to support QI implementation compared with those that focused on training or conducting projects rated highest (at α = .05) on all 4 evaluation measures of grant success and all 3 systemwide survey measures of QI and organizational learning success. This study adds to the literature on developing organizational improvement capability and has practical implications for health care leaders. Focusing on either projects or staff training in isolation has limited value. Organizations are more likely to achieve systemwide transformation of improvement capability if their strategy emphasizes developing or strengthening organizational systems, structures, or processes to support direct improvement efforts.

  11. Impact of managed MediCal on California family practice programs.

    PubMed

    Zweifler, J A

    2001-05-01

    An important source of patients for California's family practice program is MediCal. During the past 5 years, MediCal has established a variety of capitated managed care plans. To assess the impact of California's managed MediCal program on the state's 38 family practice training programs. A cross-sectional, retrospective descriptive survey. A 3-page, 11-question survey was developed by family practice residency directors and staff from the California Academy of Family Physicians, San Francisco. The 38 family practice programs in existence in California in September 1997 were stratified by type of managed MediCal in their county and by type of sponsoring institution--university, county, community based, staff-model health maintenance organization, or managed care system. Of the 38 family practice programs, 27 responded; 19 of 27 programs participated in managed MediCal. The total number of family health center patients, and the percentage of MediCal patients (48%-60%) at family practice programs was similar when stratified by programs with and without managed MediCal and by type of sponsorship. Most programs reported that they were able to compete effectively, although most also reported increased administrative, nursing, and front office costs. Managed MediCal patients were directly assigned to residents in only 3 of 19 programs. The introduction of managed MediCal has not adversely affected the number of patients cared for in California's family practice programs. Continued vigilance regarding California family practice programs' involvement in managed MediCal, including collection of accurate data on the number of MediCal patients and the financial and educational implications for California's family practice programs, is warranted.

  12. Policy implications of medical tourism development in destination countries: revisiting and revising an existing framework by examining the case of Jamaica.

    PubMed

    Johnston, Rory; Crooks, Valorie A; Ormond, Meghann

    2015-07-04

    Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in locations where it is not yet established. Numerous governments and private hospitals in the Caribbean have recently identified medical tourism as a priority for economic development. We explore here the projects, activities, and outlooks surrounding medical tourism and their anticipated economic and health sector policy implications in the Caribbean country of Jamaica. Specifically, we apply Pocock and Phua's previously-published conceptual framework of policy implications raised by medical tourism to explore its relevance in this new context and to identify additional considerations raised by the Jamaican context. Employing case study methodology, we conducted six weeks of qualitative fieldwork in Jamaica between October 2012 and July 2013. Semi-structured interviews with health, tourism, and trade sector stakeholders, on-site visits to health and tourism infrastructure, and reflexive journaling were all used to collect a comprehensive dataset of how medical tourism in Jamaica is being developed. Our analytic strategy involved organizing our data within Pocock and Phua's framework to identify overlapping and divergent issues. Many of the issues identified in Pocock and Phua's policy implications framework are echoed in the planning and development of medical tourism in Jamaica. However, a number of additional implications, such as the involvement of international development agencies in facilitating interest in the sector, cyclical mobility of international health human resources, and the significance of health insurance portability in driving the growth of international hospital accreditation, arise from this new context and further enrich the original framework. The framework developed by Pocock and Phua is a flexible common reference point with which to document issues raised by medical tourism in established and emerging destinations. However, the framework's design does not lend itself to explaining how the underlying health system factors it identifies work to facilitate medical tourism's development or how the specific impacts of the practice are likely to unfold.

  13. Understanding Homophobic Behavior and Its Implications for Policy and Practice

    ERIC Educational Resources Information Center

    Poteat, V. Paul; Russell, Stephen T.

    2013-01-01

    In this article, we consider recent advances in scholarship on homophobic bullying, and implications for policy and practice. We first consider toward whom homophobic behavior is directed, drawing attention to the nuances among LGBT youth, and the realities of homophobic bullying for heterosexual or straight youth. We review the correlates or…

  14. Awareness of the Social Implications of Clothing in Relation to Fashion Awareness and Clothing Economic Practices.

    ERIC Educational Resources Information Center

    Horridge, Patricia; Richards, Mary Lynne

    1986-01-01

    The Sproles Consumer Interests and Priorities questionnaire was administered to 3,036 home economists. Awareness of social implications of clothing, correlated positively with fashion awareness and clothing economic practices. Results suggest that persons exhibiting substantial awareness of social importance of clothing also tend to evidence…

  15. Understanding Parental Grief as a Response to Mental Illness: Implications for Practice

    ERIC Educational Resources Information Center

    Penzo, Jeanine A.; Harvey, Pat

    2008-01-01

    Parents who are raising children with mental illness struggle with feelings of grief and loss. Kubler-Ross' (1969) stages of grieving (denial, anger, bargaining, depression, and acceptance) are examined as experienced by parents raising children with chronic mental illness. Practice implications for social workers who are working with children and…

  16. Child Abuse and Neglect in Cambodian Refugee Families: Characteristics and Implications for Practice

    ERIC Educational Resources Information Center

    Chang, Janet; Rhee, Siyon; Berthold, S. Megan

    2008-01-01

    This study examines the characteristics and patterns of child maltreatment among Cambodian refugee families in Los Angeles and assesses the implications for child welfare practice with Cambodian refugee families. Data were extracted from 243 active Cambodian case files maintained by the Los Angeles County Department of Children and Family Services…

  17. Family Violence and Migrant Women: Implications for Practice. Migrant Clinicians Network Clinical Supplement.

    ERIC Educational Resources Information Center

    Rodriguez, Rachel; And Others

    1993-01-01

    This newsletter supplement is devoted to the theme of domestic violence affecting migrant women. It contains four articles describing programs providing violence prevention education to migrant women and children. "Family Violence and Migrant Women: Implications for Practice" (Rachel Rodriguez) discusses the social isolation of migrant women;…

  18. Attachment Theory and Religiosity: A Summary of Empirical Research with Implications for Counseling Christian Clients

    ERIC Educational Resources Information Center

    Reinert, Duane F.; Edwards, Carla E.; Hendrix, Rebecca R.

    2009-01-01

    The authors summarize the growing body of empirical research literature in the area of psychology of religion that has been guided by attachment theory and indicate implications for counseling, including practical suggestions for case conceptualization, possible spiritual interventions, and ethical guidelines for practice. Attachment theory…

  19. Addressing Cross-Cultural Teamwork Barriers: Implications for Industry Practice and Higher Education Curricula

    ERIC Educational Resources Information Center

    Levitt, Steven R.

    2016-01-01

    This study explores cultural factors affecting international team dynamics and the implications for industry practice and higher education. Despite decades of studying and experience with cultural diversity, international work groups continue to be challenged by ethnocentrism and prejudices. Central to the context is that cultural differences in…

  20. Position Statement on Motivations, Methodologies, and Practical Implications of Educational Neuroscience Research: fMRI Studies of the Neural Correlates of Creative Intelligence

    ERIC Educational Resources Information Center

    Geake, John

    2011-01-01

    In this position statement it is argued that educational neuroscience must necessarily be relevant to, and therefore have implications for, both educational theory and practice. Consequently, educational neuroscientific research necessarily must embrace educational research questions in its remit.

  1. Guattari's Ecosophy and Implications for Pedagogy

    ERIC Educational Resources Information Center

    Greenhalgh-Spencer, Heather

    2014-01-01

    Guattari's ecosophy has implications for many types of pedagogy practiced in the school. While Guattari never explicitly advocated the educational use of ecosophy, I explore in this article how it can be used as a lens to "read" pedagogy in nuanced ways, highlighting oppressive premises and practices. I first discuss Guattari's…

  2. Soviet Psycho-educational Research on Learning Disabilities: Implications for American Research and Practice.

    ERIC Educational Resources Information Center

    Wozniak, Robert H.

    The implications of Soviet psychoeducational research on learning disabilities (LD) and its relevance to American research and practice are discussed. The first section provides an overview of the general perspective of Soviet special education, with particular reference to LD and its relationship to Soviet psychology and philosophy. The second…

  3. "Further Education, Future Prosperity? The Implications of Marketisation on Further Education Working Practices"

    ERIC Educational Resources Information Center

    Illsley, Rachael; Waller, Richard

    2017-01-01

    This paper examines how the marketised funding system of vocational further education is affecting lecturers' working practices and professional integrity. Semi-structured interviews were conducted with a number of lecturing staff and managers within two vocational areas at an English FE college to examine the implications of working under the…

  4. When the customer shouldn't be king: antecedents and consequences of sexual harassment by clients and customers.

    PubMed

    Gettman, Hilary J; Gelfand, Michele J

    2007-05-01

    Much of the work in today's service industries requires women to deal with people outside of their organizations, namely, customers and clients, yet research on sexual harassment has focused almost exclusively on sexual harassment within organizations. Because the threat of harassment also operates at the boundaries of organizations, our existing models based solely on harassment inside organizations may be too restricted to adequately explain the harassment experiences of women in today's economy. To address this, the authors introduce a theoretical model of the antecedents and consequences of sexual harassment by clients and customers (CSH) and describe 2 field studies conducted to test components of the model. In Study 1, they developed a model of antecedents and consequences of CSH and illustrated that certain contextual factors (client power and gender composition of the client base) affect levels of CSH and that CSH is related to a number of job and psychological outcomes among professional women. Study 2 revealed that CSH is related to lower job satisfaction among nonprofessional women, above and beyond that which is accounted for by internal sexual harassment. Theoretical and practical implications are discussed. 2007 APA, all rights reserved

  5. Perceptions of Occupational Therapists on the Patient Protection and Affordable Care Act: Five Years After Its Enactment.

    PubMed

    Yuen, Hon K; Spicher, Hillary S; Semon, Madelyn R; Winwood, Leah M; Dudgeon, Brian J

    2017-01-01

    This study explored the perceptions of occupational therapists regarding the impact and implications of the Patient Protection and Affordable Care Act (PPACA or ACA) on occupational therapy practice. Fifteen occupational therapists participated in an interview to answer open-ended questions related to their thoughts and perceptions regarding the impact and implications of the ACA on their practice. The participants were practicing in eight different states and worked in five different settings with clinical experience ranging from 3 to 38 years; their positions ranged from staff therapist to owner of a free-standing outpatient clinic. Qualitative content analysis was used to synthesize the interview transcripts. Results showed that therapists did not have sufficient knowledge on the various mandates and provisions of the ACA, or were uncertain about what implications the ACA would have on practice, with the ACA affecting some settings more than others. Data revealed the perceived impacts of the ACA on occupational therapy practice include greater attention on documenting outcome-focused care, external accountability pressures on productivity, conscientiousness about clients' insurance coverage, uncertainty about collaborative care delivery, and survival of small businesses. Findings suggest training regarding knowledge about and implications of different elements of the ACA is needed as well as practices needing to promote the services that occupational therapists can provide to improve cost-effectiveness and outcomes in collaborative care environments.

  6. Cognitive foundations of organizational learning: re-introducing the distinction between declarative and non-declarative knowledge

    PubMed Central

    Kump, Barbara; Moskaliuk, Johannes; Cress, Ulrike; Kimmerle, Joachim

    2015-01-01

    Contemporary research into socio-cognitive foundations of organizational learning tends to disregard the distinction between declarative and non-declarative knowledge. By reviewing the literature from organizational learning research and cognitive psychology we explain that this distinction is crucial. We describe the foundations of organizational learning by referring to models that consider the interplay between individual and collective knowledge-related processes in organizations. We highlight the existence of a research gap resulting from the finding that these approaches have widely neglected the existence of different types of knowledge. We then elaborate on characteristics of declarative and non-declarative knowledge in general, consider organizations as structures of distributed cognition, and discuss the relationship between organizational knowledge and practice. Subsequently, we examine the role of declarative and non-declarative knowledge in the context of organizational learning. Here, we analyze (1) the cognitive and social mechanisms underlying the development of declarative and non-declarative knowledge within structures of distributed cognition; and (2) the relationship between alterations in declarative and non-declarative types of knowledge on the one hand and changes in organizational practice on the other. Concluding, we discuss implications of our analysis for organizational learning research. We explain how our integrative perspective may offer starting points for a refined understanding of the sub-processes involved in organizational learning and unlearning and may support a better understanding of practical problems related to organizational learning and change. PMID:26483739

  7. Broadening conceptions of learning science: A case study of Latina students in middle school

    NASA Astrophysics Data System (ADS)

    Czech, Maria Antonina

    2001-07-01

    Low representation of Latinas in science research and professions, have prompted studies that document forces that promote or deter Latinas' participation. Short-term intervention studies of minority girls in secondary school sciences corroborate these findings. However, few studies examine middle school Latinas' science learning experiences that consider their ethnicity, gender, socioeconomic status and language. This dissertation examines the social organization of learning in a gifted science teacher's eighth grade classroom, and the experiences of four eighth grade Latinas, as they develop their identity as science learners. Multiple ethnographic tools were utilized to collect data. The analysis of the organization of learning in the classroom, through the lenses of sociocultural and feminist theories, reflects a cohesive use of multiple social practices to promote scientific literacy. High interaction characterizes this classroom, providing positive results for the participants as science learners. The exceptionally talented science teacher scripted students' ideas on chart paper, used realia and experimentation, utilized the Spanish language as resource, maximized physical space for access to learning, and built caring relationships. The four case studies portray the diversity in the social organization of learning through the experiences of four Latinas. Individually, they developed their identity as science learners in unique ways---e.g., they utilized discourse, sought out mentoring, confronted their ethnic identity, expanded the notion of learning beyond traditional norms, became language brokers, all to achieve a level of scientific literacy. The implications of this study on research of Latinas in science education are (1) increase the use of social practice and identity in analysis, (2) include diverse groups, especially Latina scholars in research, (3) examine the benefits of primary language and translation in classrooms, (4) research mixed gender classes where discourse is encouraged, and (5) incorporate students' voice. The implications of this study on teaching are (1) develop a community of discourse and inquiry, (2) define "normal" learning in a classroom more broadly to include those labeled with learning disabilities, (3) foster caring relationships between teachers, students, and among students, (4) provide mentorship of girls and minorities within classrooms, and (5) produce assessments that align with classroom culture.

  8. The role of private non-profit healthcare organizations in NHS systems: Implications for the Portuguese hospital devolution program.

    PubMed

    Almeida, Álvaro S

    2017-06-01

    The national health services (NHS) of England, Portugal, Finland and other single-payer universalist systems financed by general taxation, are based on the theoretical principle of an integrated public sector payer-provider. However, in practice one can find different forms of participation of non-public healthcare providers in those NHS, including private for profit providers, but also third sector non-profit organizations (NPO). This paper reviews the role of non-public non-profit healthcare organizations in NHS systems. By crossing a literature review on privatization of national health services with a literature review on the comparative performance of non-profit and for-profit healthcare organizations, this paper assesses the impact of contracting private non-profit healthcare organizations on the efficiency, quality and responsiveness of services, in public universal health care systems. The results of the review were then compared to the existing evidence on the Portuguese hospital devolution to NPO program. The evidence in this paper suggests that NHS health system reforms that transfer some public-sector hospitals to NPO should deliver improvements to the health system with minimal downside risks. The very limited existing evidence on the Portuguese hospital devolution program suggests it improved efficiency and access, without sacrificing quality. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Integrating virtual reality video games into practice: clinicians' experiences.

    PubMed

    Levac, Danielle E; Miller, Patricia A

    2013-10-01

    The Nintendo Wii is a popular virtual reality (VR) video gaming system in rehabilitation practice and research. As evidence emerges related to its effectiveness as a physical therapy training method, clinicians require information about the pragmatics of its use in practice. The purpose of this descriptive qualitative study is to explore observations and insights from a sample of physical therapists (PTs) working with children with acquired brain injury regarding practical implications of using the Wii as a physical therapy intervention. Six PTs employed at a children's rehabilitation center participated in semi-structured interviews, which were transcribed and analyzed using content analysis. Two themes summarize the practical implications of Wii use: 1) technology meets clinical practice; and 2) onus is on the therapist. Therapists described both beneficial and challenging implications arising from the intersection of technology and practice, and reported the personal commitment required to orient oneself to the gaming system and capably implement this intervention. Findings include issues that may be relevant to professional development in a broader rehabilitation context, including suggestions for the content of educational initiatives and the need for institutional support from managers in the form of physical resources for VR implementation.

  10. Ninety to Nothing: a PDSA quality improvement project.

    PubMed

    Prybutok, Gayle Linda

    2018-05-14

    Purpose The purpose of this paper is to present a case study of a successful quality improvement project in an acute care hospital focused on reducing the time of the total patient visit in the emergency department. Design/methodology/approach A multidisciplinary quality improvement team, using the PDSA (Plan, Do, Study, Act) Cycle, analyzed the emergency department care delivery process and sequentially made process improvements that contributed to project success. Findings The average turnaround time goal of 90 minutes or less per visit was achieved in four months, and the organization enjoyed significant collateral benefits both internal to the organization and for its customers. Practical implications This successful PDSA process can be duplicated by healthcare organizations of all sizes seeking to improve a process related to timely, high-quality patient care delivery. Originality/value Extended wait time in hospital emergency departments is a universal problem in the USA that reduces the quality of the customer experience and that delays necessary patient care. This case study demonstrates that a structured quality improvement process implemented by a multidisciplinary team with the authority to make necessary process changes can successfully redefine the norm.

  11. Dissolved organic matter in the Florida everglades: Implications for ecosystem restoration

    USGS Publications Warehouse

    Aiken, G.R.; Gilmour, C.C.; Krabbenhoft, D.P.; Orem, W.

    2011-01-01

    Dissolved organic matter (DOM) in the Florida Everglades controls a number of environmental processes important for ecosystem function including the absorption of light, mineral dissolution/precipitation, transport of hydrophobic compounds (e.g., pesticides), and the transport and reactivity of metals, such as mercury. Proposed attempts to return the Everglades to more natural flow conditions will result in changes to the present transport of DOM from the Everglades Agricultural Area and the northern conservation areas to Florida Bay. In part, the restoration plan calls for increasing water flow throughout the Everglades by removing some of the manmade barriers to flow in place today. The land- and water-use practices associated with the plan will likely result in changes in the quality, quantity, and reactivity of DOM throughout the greater Everglades ecosystem. The authors discuss the factors controlling DOM concentrations and chemistry, present distribution of DOM throughout the Everglades, the potential effects of DOM on key water-quality issues, and the potential utility of dissolved organic matter as an indicator of success of restoration efforts. Copyright ?? 2011 Taylor & Francis Group, LLC.

  12. Facilitated transport in European soils from the Euro-soil project

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

    Dolfing, J.; Scheltens, S.D.

    1999-07-01

    The authors studied the response of five reference soils from the European Union (a vertic cambisol, rendzina, dystric cambisol, orthic luvisol, and orthic podzol, also known as Euro-soils 1 to 5) to the addition of HCl and NaOH. For all soils, which were incubated as soil slurries, the amount of organic carbon in solution remained essentially constant upon addition of HCl but increased upon addition of NaOH; that is, it was not the pH of the soil that determined changes in the solubilization of dissolved organic carbon but {Delta}pH. This observation has implications for the design of active soil managementmore » strategies, because increased amounts of dissolved organic carbon in the soil solution pose a risk for leaching of contaminants to deeper soil layers and eventually to the groundwater. In the past, much attention has been paid to the reaction of soils to acidification and changing land use as practiced when agricultural land is taken out of production. The observations reported here indicate that soil alkalization is not necessarily without environmental and toxicological risks.« less

  13. Will they stay or will they go? The role of job embeddedness in predicting turnover in individualistic and collectivistic cultures.

    PubMed

    Ramesh, Anuradha; Gelfand, Michele J

    2010-09-01

    Although turnover is an issue of global concern, paradoxically there have been few studies of turnover across cultures. We investigated the cross-cultural generalizability of the job embeddedness model (Mitchell & Lee, 2001) by examining turnover in an individualistic country (United States) and a collectivistic country (India). Using cross-cultural data from call centers (N = 797), we demonstrated that although organization job embeddedness predicted turnover in both countries, different dimensions of job embeddedness predicted turnover in the United States and India. As hypothesized, on the basis of individualism-collectivism theory, person-job fit was a significant predictor of lower turnover in the United States, whereas person-organization fit, organization links, and community links were significant predictors of lower turnover in India. We also explored whether a newly developed construct of embeddedness-family embeddedness-predicts turnover above and beyond job embeddedness and found initial support for its utility in both the United States and India. Theoretical and practical implications are discussed. Copyright 2010 APA, all rights reserved

  14. Amenable to reason: Aristotle's rhetoric and the moral psychology of practical ethics.

    PubMed

    London, A J

    2000-12-01

    An Aristotelian conception of practical ethics can be derived from the account of practical reasoning that Aristotle articulates in is Rhetoric and this has important implications for the way we understand the nature and limits of practical ethics. an important feature of this conception of practical ethics is its responsiveness to the complex ways in which agents form and maintain moral commitments, and this has important implications for the debate concerning methods of ethics in applied ethics. In particular, this feature enables us to understand casuistry, narrative, and principlism as mutually supportive modes of moral inquiry, rather than divergent and mutually exclusive methods of ethics. As a result, an Aristotelian conception of practical ethics clears the conceptual common ground upon which practical ethicists can forge a stable and realistic self-understanding.

  15. In their own words: describing Canadian physician leadership.

    PubMed

    Snell, Anita J; Dickson, Graham; Wirtzfeld, Debrah; Van Aerde, John

    2016-07-04

    Purpose This is the first study to compile statistical data to describe the functions and responsibilities of physicians in formal and informal leadership roles in the Canadian health system. This mixed-methods research study offers baseline data relative to this purpose, and also describes physician leaders' views on fundamental aspects of their leadership responsibility. Design/methodology/approach A survey with both quantitative and qualitative fields yielded 689 valid responses from physician leaders. Data from the survey were utilized in the development of a semi-structured interview guide; 15 physician leaders were interviewed. Findings A profile of Canadian physician leadership has been compiled, including demographics; an outline of roles, responsibilities, time commitments and related compensation; and personal factors that support, engage and deter physicians when considering taking on leadership roles. The role of health-care organizations in encouraging and supporting physician leadership is explicated. Practical implications The baseline data on Canadian physician leaders create the opportunity to determine potential steps for improving the state of physician leadership in Canada; and health-care organizations are provided with a wealth of information on how to encourage and support physician leaders. Using the data as a benchmark, comparisons can also be made with physician leadership as practiced in other nations. Originality/value There are no other research studies available that provide the depth and breadth of detail on Canadian physician leadership, and the embedded recommendations to health-care organizations are informed by this in-depth knowledge.

  16. Teachers' Organization of Participation Structures for Teaching Science with Computer Technology

    NASA Astrophysics Data System (ADS)

    Subramaniam, Karthigeyan

    2016-08-01

    This paper describes a qualitative study that investigated the nature of the participation structures and how the participation structures were organized by four science teachers when they constructed and communicated science content in their classrooms with computer technology. Participation structures focus on the activity structures and processes in social settings like classrooms thereby providing glimpses into the complex dynamics of teacher-students interactions, configurations, and conventions during collective meaning making and knowledge creation. Data included observations, interviews, and focus group interviews. Analysis revealed that the dominant participation structure evident within participants' instruction with computer technology was ( Teacher) initiation-( Student and Teacher) response sequences-( Teacher) evaluate participation structure. Three key events characterized the how participants organized this participation structure in their classrooms: setting the stage for interactive instruction, the joint activity, and maintaining accountability. Implications include the following: (1) teacher educators need to tap into the knowledge base that underscores science teachers' learning to teach philosophies when computer technology is used in instruction. (2) Teacher educators need to emphasize the essential idea that learning and cognition is not situated within the computer technology but within the pedagogical practices, specifically the participation structures. (3) The pedagogical practices developed with the integration or with the use of computer technology underscored by the teachers' own knowledge of classroom contexts and curriculum needs to be the focus for how students learn science content with computer technology instead of just focusing on how computer technology solely supports students learning of science content.

  17. Reflective practice and its implications for pharmacy education.

    PubMed

    Tsingos, Cherie; Bosnic-Anticevich, Sinthia; Smith, Lorraine

    2014-02-12

    Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.(1-2) Reflective practice activities encourage learning from the student's own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education.

  18. Reflective Practice and Its Implications for Pharmacy Education

    PubMed Central

    Bosnic-Anticevich, Sinthia; Smith, Lorraine

    2014-01-01

    Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.1-2 Reflective practice activities encourage learning from the student’s own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education. PMID:24558286

  19. The impact of corporate practices on health: implications for health policy.

    PubMed

    Freudenberg, Nicholas; Galea, Sandro

    2008-04-01

    Although corporate practices play a substantial role in shaping health and health behavior, public health researchers have rarely systematically studied these practices as a social determinant of health. We consider case studies of three products - trans fat, a food additive and a preservative; Vioxx, a pain killer; and sports utility vehicles - to illustrate the role of corporate policies and practices in the production of health and disease and the implications for health policy. In recent years, public health advocates, researchers, and lawyers have used strategies to reduce the adverse health impact of corporate practices. Systematic analysis of these experiences yields insights that can guide the development of health policies that increase opportunities for primary prevention by discouraging harmful corporate practices.

  20. Independent practice associations and physician-hospital organizations can improve care management for smaller practices.

    PubMed

    Casalino, Lawrence P; Wu, Frances M; Ryan, Andrew M; Copeland, Kennon; Rittenhouse, Diane R; Ramsay, Patricia P; Shortell, Stephen M

    2013-08-01

    Pay-for-performance, public reporting, and accountable care organization programs place pressures on physicians to use health information technology and organized care management processes to improve the care they provide. But physician practices that are not large may lack the resources and size to implement such processes. We used data from a unique national survey of 1,164 practices with fewer than twenty physicians to provide the first information available on the extent to which independent practice associations (IPAs) and physician-hospital organizations (PHOs) might make it possible for these smaller practices to share resources to improve care. Nearly a quarter of the practices participated in an IPA or a PHO that accounted for a significant proportion of their patients. On average, practices participating in these organizations provided nearly three times as many care management processes for patients with chronic conditions as nonparticipating practices did (10.4 versus 3.8). Half of these processes were provided only by IPAs or PHOs. These organizations may provide a way for small and medium-size practices to systematically improve care and participate in accountable care organizations.

  1. Human health implications of organic food and organic agriculture: a comprehensive review.

    PubMed

    Mie, Axel; Andersen, Helle Raun; Gunnarsson, Stefan; Kahl, Johannes; Kesse-Guyot, Emmanuelle; Rembiałkowska, Ewa; Quaglio, Gianluca; Grandjean, Philippe

    2017-10-27

    This review summarises existing evidence on the impact of organic food on human health. It compares organic vs. conventional food production with respect to parameters important to human health and discusses the potential impact of organic management practices with an emphasis on EU conditions. Organic food consumption may reduce the risk of allergic disease and of overweight and obesity, but the evidence is not conclusive due to likely residual confounding, as consumers of organic food tend to have healthier lifestyles overall. However, animal experiments suggest that identically composed feed from organic or conventional production impacts in different ways on growth and development. In organic agriculture, the use of pesticides is restricted, while residues in conventional fruits and vegetables constitute the main source of human pesticide exposures. Epidemiological studies have reported adverse effects of certain pesticides on children's cognitive development at current levels of exposure, but these data have so far not been applied in formal risk assessments of individual pesticides. Differences in the composition between organic and conventional crops are limited, such as a modestly higher content of phenolic compounds in organic fruit and vegetables, and likely also a lower content of cadmium in organic cereal crops. Organic dairy products, and perhaps also meats, have a higher content of omega-3 fatty acids compared to conventional products. However, these differences are likely of marginal nutritional significance. Of greater concern is the prevalent use of antibiotics in conventional animal production as a key driver of antibiotic resistance in society; antibiotic use is less intensive in organic production. Overall, this review emphasises several documented and likely human health benefits associated with organic food production, and application of such production methods is likely to be beneficial within conventional agriculture, e.g., in integrated pest management.

  2. Age differences in feedback reactions: The roles of employee feedback orientation on social awareness and utility.

    PubMed

    Wang, Mo; Burlacu, Gabriela; Truxillo, Donald; James, Keith; Yao, Xiang

    2015-07-01

    Organizations worldwide are currently experiencing shifts in the age composition of their workforces. The workforce is aging and becoming increasingly age-diverse, suggesting that organizational researchers and practitioners need to better understand how age differences may manifest in the workplace and the implications for human resource practice. Integrating socioemotional selectivity theory with the performance feedback literature and using a time-lagged design, the current study examined age differences in moderating the relationships between the characteristics of performance feedback and employee reactions to the feedback event. The results suggest that older workers had higher levels of feedback orientation on social awareness, but lower levels of feedback orientation on utility than younger workers. Furthermore, the positive associations between favorability of feedback and feedback delivery and feedback reactions were stronger for older workers than for younger workers, whereas the positive association between feedback quality and feedback reactions was stronger for younger workers than for older workers. Finally, the current study revealed that age-related differences in employee feedback orientation could explain the different patterns of relationships between feedback characteristics and feedback reactions across older and younger workers. These findings have both theoretical and practical implications for building theory about workplace aging and improving ways that performance feedback is managed across employees from diverse age groups. (c) 2015 APA, all rights reserved).

  3. Exploring the Role of Value Networks for Software Innovation

    NASA Astrophysics Data System (ADS)

    Morgan, Lorraine; Conboy, Kieran

    This paper describes a research-in-progress that aims to explore the applicability and implications of open innovation practices in two firms - one that employs agile development methods and another that utilizes open source software. The open innovation paradigm has a lot in common with open source and agile development methodologies. A particular strength of agile approaches is that they move away from 'introverted' development, involving only the development personnel, and intimately involves the customer in all areas of software creation, supposedly leading to the development of a more innovative and hence more valuable information system. Open source software (OSS) development also shares two key elements of the open innovation model, namely the collaborative development of the technology and shared rights to the use of the technology. However, one shortfall with agile development in particular is the narrow focus on a single customer representative. In response to this, we argue that current thinking regarding innovation needs to be extended to include multiple stakeholders both across and outside the organization. Additionally, for firms utilizing open source, it has been found that their position in a network of potential complementors determines the amount of superior value they create for their customers. Thus, this paper aims to get a better understanding of the applicability and implications of open innovation practices in firms that employ open source and agile development methodologies. In particular, a conceptual framework is derived for further testing.

  4. Duchenne Muscular Dystrophy: a Survey of Perspectives on Carrier Testing and Communication Within the Family.

    PubMed

    Hayes, Brenna; Hassed, Susan; Chaloner, Jae Lindsay; Aston, Christopher E; Guy, Carrie

    2016-06-01

    Carrier testing is widely available for multiple genetic conditions, and several professional organizations have created practice guidelines regarding appropriate clinical application and the testing of minors. Previous research has focused on carrier screening, predictive testing, and testing for X-linked conditions. However, family perspectives on carrier testing for X-linked lethal diseases have yet to be described. In this study, we explored communication within the family about carrier testing and the perspectives of mothers of sons with an X-linked lethal disease, Duchenne muscular dystrophy (DMD). Twenty-five mothers of sons with DMD participated in an anonymous online survey. Survey questions included multiple choice, Likert scale, and open ended, short answer questions. Analysis of the multiple choice and Likert scale questions revealed that most mothers preferred a gradual style of communication with their daughters regarding risk status. In addition, most participants reported having consulted with a genetic counselor and found it helpful. Comparisons between groups, analyzed using Fisher's exact tests, found no differences in preferred style due to mother's carrier status or having a daughter. Thematic analysis was conducted on responses to open ended questions. Themes identified included the impact of family implications, age and maturity, and a desire for autonomy regarding the decision to discuss and undergo carrier testing with at-risk daughters, particularly timing of these discussions. Implications for genetic counseling practice are discussed.

  5. Developing an organizing framework to guide nursing research in the Children’s Oncology Group (COG)

    PubMed Central

    Kelly, Katherine Patterson; Hooke, Mary C.; Ruccione, Kathleen; Landier, Wendy; Haase, Joan

    2014-01-01

    Objectives To describe the development and application of an organizing research framework to guide COG Nursing research. Data Sources Research articles, reports and meeting minutes Conclusion An organizing research framework helps to outline research focus and articulate the scientific knowledge being produced by nurses in the pediatric cooperative group. Implication for Nursing Practice The use of an organizing framework for COG nursing research can facilitate clinical nurses’ understanding of how children and families sustain or regain optimal health when faced with a pediatric cancer diagnosis through interventions designed to promote individual and family resilience. The Children’s Oncology Group (COG) is the sole National Cancer Institute (NCI)-supported cooperative pediatric oncology clinical trials group and the largest organization in the world devoted exclusively to pediatric cancer research. It was founded in 2000 following the merger of the four legacy NCI-supported pediatric clinical trials groups (Children’s Cancer Group [CCG], Pediatric Oncology Group [POG], National Wilms Tumor Study Group, and Intergroup Rhabdomyosarcoma Study Group). The COG currently has over 200 member institutions across North America, Australia, New Zealand and Europe and a multidisciplinary membership of over 8,000 pediatric, radiation, and surgical oncologists, nurses, clinical research associates, pharmacists, behavioral scientists, pathologists, laboratory scientists, patient/parent advocates and other pediatric cancer specialists. The COG Nursing Discipline was formed from the merger of the legacy CCG and POG Nursing Committees, and current membership exceeds 2000 registered nurses. The discipline has a well-developed infrastructure that promotes nursing involvement throughout all levels of the organization, including representation on disease, protocol, scientific, executive and other administrative committees (e.g., nominating committee, data safety monitoring boards). COG nurses facilitate delivery of protocol-based treatments for children enrolled on COG protocols, and Nursing Discipline initiatives support nursing research, professional and patient/family education, evidence-based practice, and a patient-reported outcomes resource center. The research agenda of the Nursing Discipline is enacted through a well-established nursing scholar program. PMID:24559776

  6. Safeguarding and Protecting Children in Maternity Services: Implications for Practice

    ERIC Educational Resources Information Center

    Lazenbatt, Anne; Greer, Jean

    2009-01-01

    This article debates the issues involved in safeguarding and protecting children in maternity services and offers implications for professional practice. Midwives and other staff who work as members of the maternity team have a safeguarding role to play in the identification of babies and children who have been abused, or are at risk of abuse, and…

  7. SOME IMPLICATIONS OF A CONCEPT OF GROWTH MOTIVATION FOR ADULT EDUCATION THEORY AND PRACTICE.

    ERIC Educational Resources Information Center

    NOREEN, DAVID SHELDON

    THIS STUDY EXAMINED GROWTH MOTIVATION AS A DEVELOPING CONCEPT AND AS A THEORETICAL CONSTRUCT, AND THE IMPLICATIONS OF THIS THEORY FOR ADULT EDUCATION THEORY AND PRACTICE. SPECIAL ATTENTION WAS GIVEN TO THE THEORETICAL CONSTRUCTS OF ABRAHAM MASLOW, TO THE NATURE OF GROWTH MOTIVATION CONCEPTS IN GENERAL, AND TO FORMS OF SELF UNDERSTANDING AND…

  8. Code Switching in English Language Teaching (ELT) Teaching Practice in Turkey: Student Teacher Practices, Beliefs and Identity

    ERIC Educational Resources Information Center

    Bilgin, Sezen Seymen

    2016-01-01

    Code switching involves the interplay of two languages and as well as serving linguistic functions, it has social and psychological implications. In the context of English language teaching, these psychological implications reveal themselves as teachers' thought processes. While the nature of code switching in language classrooms has been widely…

  9. Youth Work Transitions: A Review with Implications for Counselling and Career Practice

    ERIC Educational Resources Information Center

    Parada, Filomena; Young, Richard A.

    2013-01-01

    We critically review studies highlighting youth's work transitions and derive some implications for career and counselling theory and practice. We first discuss today's hypermodern world, specifically the meanings being conveyed by today's complex social realities and their impact on individuals' (work) lives. An overview of…

  10. The Control-Value Theory of Achievement Emotions: Assumptions, Corollaries, and Implications for Educational Research and Practice

    ERIC Educational Resources Information Center

    Pekrun, Reinhard

    2006-01-01

    This article describes the control-value theory of achievement emotions and its implications for educational research and practice. The theory provides an integrative framework for analyzing the antecedents and effects of emotions experienced in achievement and academic settings. It is based on the premise that appraisals of control and values are…

  11. Access to Print Literacy for Children and Young People with Visual Impairment: Implications for Policy and Practice

    ERIC Educational Resources Information Center

    Douglas, Graeme; McLinden, Mike; Farrell, Ann Marie; Ware, Jean; McCall, Steve; Pavey, Sue

    2011-01-01

    This article considers the concept of access in the education of visually impaired children and young people, with particular reference to print literacy. The article describes implications for teaching and policy at various levels of the educational process: classroom practice; broader teaching and curriculum requirements (including service…

  12. 16 CFR 0.9 - Organization structure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Organization structure. 0.9 Section 0.9 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.9 Organization structure. The Federal Trade Commission comprises the following principal units...

  13. Perceptions of occupational injury and illness costs by size of organization.

    PubMed

    Haslam, C; Haefeli, K; Haslam, R

    2010-09-01

    Little is known about how organizations perceive and monitor occupational injury and illness costs. To explore perceptions of injury and illness costs, the extent to which organizations monitor their impact, attitudes towards this practice and views on using cost information in health and safety campaigns. Interviews were conducted with 212 representatives from 49 small- and medium-sized enterprises (SMEs) and 80 large organizations from a range of industry sectors. Health and safety investments were driven by a range of factors, of which cost reduction was only one. Human costs were also considered important. Injuries were perceived to represent a substantial business cost by 10% of respondents from SMEs and 56% of those from large organizations. Most were uncertain about the financial impact of work-related illness. No organizations had attempted to monitor occupational illness costs. Injury costs had been assessed within 3 SMEs and 30 large organizations. Only 12% of SME representatives recognized the benefits of costing health and safety failures and around half were unreceptive to the use of cost information in health and safety promotions. Two-thirds of those from large organizations recognized some benefit in measuring costs, and over three-quarters welcomed the provision of industry-specific information. Provision of information that focuses solely on the economic implications of occupational injury and illness may be of limited value and agencies involved in the promotion of health and safety should incorporate a range of information, taking into account the needs and concerns of different sectors.

  14. Work-based learning in health care environments.

    PubMed

    Spouse, J

    2001-03-01

    In reviewing contemporary literature and theories about work-based learning, this paper explores recent trends promoting life-long learning. In the process the paper reviews and discusses some implications of implementing recent policies and fostering le arning in health care practice settings. Recent Government policies designed to provide quality health care services and to improve staffing levels in the nursing workforce, have emphasized the importance of life-long learning whilst learning-on-the-job and the need to recognize and credit experiential learning. Such calls include negotiation of personal development plans tailored to individual educational need and context-sensitive learning activities. To be implemented effectively, this policy cann ot be seen as a cheap option but requires considerable financial resourcing for preparation of staff and the conduct of such activities. Successful work-based learning requires investment in staff at all levels as well as changes to staffing structures in organizations and trusts; changes designed to free people up to work and learn collaboratively. Creating an organizational environment where learning is prized depends upon a climate of trust; a climate where investigation and speculation are fostered and where time is protected for engaging in discussions about practice. Such a change may be radical for many health care organizations and may require a review of current policies and practices ensuring that they include education at all levels. The nature of such education also requires reconceptualizing. In the past, learning in practice settings was seen as formal lecturing or demonstration, and relied upon behaviourist principles of learning. Contemporary thinking suggests effective learning in work-settings is multi-faceted and draws on previously acquired formal knowledge, contextualizes it and moulds it according to situations at hand. Thinking about work-based learning in this way raises questions about how such learning can be supported and facilitated.

  15. Innovative human resource practices in U.S. hospitals: an empirical study.

    PubMed

    Platonova, Elena A; Hernandez, S Robert

    2013-01-01

    Contemporary organizations increasingly recognize human resource (HR) capabilities as a source of sustained competitive advantage; about 80% of an organization's value is attributable to intangible assets, including human assets and capital. Some scholars consider effective human resource management (HRM) the single most important factor affecting organizational performance. This study examined (1) the extent to which HRM strategies were included in organizational strategic planning and (2) the association between the involvement of senior HR professionals in strategic planning and the use of innovative HR practices in U.S. hospitals employing strategic HRM theory. A survey was administered to 168 chief executive officers and HR executives from 85 hospitals during spring 2005. Binary logistic regression was conducted to determine whether HRM involvement was associated with the use of innovative HRM strategies in the hospitals. We found significant associations between HRM strategy inclusion in the strategic planning process and senior HR professionals' involvement in organizational strategic planning and in three innovative HR activities: finding talent in advance for key job openings (odds ratio [OR] = 4.61, 95% confidence interval [CI]: 1.10-7.38), stressing organizational culture and values in the selection process (OR = 3.97, 95% CI: 1.01-3.97), and basing individual or team compensation on goal-oriented results (OR = 6.17, 95% CI: 1.17-3.37). Our data indicate that innovative HR practices were underused in some U.S. hospitals despite their potential to improve overall hospital performance. Hospitals that emphasized effective HRM were more likely to use some of the innovative HR approaches. In this article, we discuss this research and the practical implications of the findings.

  16. Broadening participation in community problem solving: a multidisciplinary model to support collaborative practice and research.

    PubMed

    Lasker, Roz D; Weiss, Elisa S

    2003-03-01

    Over the last 40 years, thousands of communities-in the United States and internationally-have been working to broaden the involvement of people and organizations in addressing community-level problems related to health and other areas. Yet, in spite of this experience, many communities are having substantial difficulty achieving their collaborative objective, and many funders of community partnerships and participation initiatives are looking for ways to get more out of their investment. One of the reasons we are in this predicament is that the practitioners and researchers who are interested in community collaboration come from a variety of contexts, initiatives, and academic disciplines, and few of them have integrated their work with experiences or literatures beyond their own domain. In this article, we seek to overcome some of this fragmentation of effort by presenting a multidisciplinary model that lays out the pathways by which broadly participatory processes lead to more effective community problem solving and to improvements in community health. The model, which builds on a broad array of practical experience as well as conceptual and empirical work in multiple fields, is an outgrowth of a joint-learning work group that was organized to support nine communities in the Turning Point initiative. Following a detailed explication of the model, the article focuses on the implications of the model for research, practice, and policy. It describes how the model can help researchers answer the fundamental effectiveness and "how-to" questions related to community collaboration. In addition, the article explores differences between the model and current practice, suggesting strategies that can help the participants in, and funders of, community collaborations strengthen their efforts.

  17. Convolving engineering and medical pedagogies for training of tomorrow's health care professionals.

    PubMed

    Lee, Raphael C

    2013-03-01

    Several fundamental benefits justify why biomedical engineering and medicine should form a more convergent alliance, especially for the training of tomorrow's physicians and biomedical engineers. Herein, we review the rationale underlying the benefits. Biological discovery has advanced beyond the era of molecular biology well into today's era of molecular systems biology, which focuses on understanding the rules that govern the behavior of complex living systems. This has important medical implications. To realize cost-effective personalized medicine, it is necessary to translate the advances in molecular systems biology to higher levels of biological organization (organ, system, and organismal levels) and then to develop new medical therapeutics based on simulation and medical informatics analysis. Higher education in biological and medical sciences must adapt to a new set of training objectives. This will involve a shifting away from reductionist problem solving toward more integrative, continuum, and predictive modeling approaches which traditionally have been more associated with engineering science. Future biomedical engineers and MDs must be able to predict clinical response to therapeutic intervention. Medical education will involve engineering pedagogies, wherein basic governing rules of complex system behavior and skill sets in manipulating these systems to achieve a practical desired outcome are taught. Similarly, graduate biomedical engineering programs will include more practical exposure to clinical problem solving.

  18. Household-level dynamics of food waste production and related beliefs, attitudes, and behaviours in Guelph, Ontario.

    PubMed

    Parizeau, Kate; von Massow, Mike; Martin, Ralph

    2015-01-01

    It has been estimated that Canadians waste $27 billion of food annually, and that half of that waste occurs at the household level (Gooch et al., 2010). There are social, environmental, and economic implications for this scale of food waste, and source separation of organic waste is an increasingly common municipal intervention. There is relatively little research that assesses the dynamics of household food waste (particularly in Canada). The purpose of this study is to combine observations of organic, recyclable, and garbage waste production rates to survey results of food waste-related beliefs, attitudes, and behaviours at the household level in the mid-sized municipality of Guelph, Ontario. Waste weights and surveys were obtained from 68 households in the summer of 2013. The results of this study indicate multiple relationships between food waste production and household shopping practices, food preparation behaviours, household waste management practices, and food-related attitudes, beliefs, and lifestyles. Notably, we observed that food awareness, waste awareness, family lifestyles, and convenience lifestyles were related to food waste production. We conclude that it is important to understand the diversity of factors that can influence food wasting behaviours at the household level in order to design waste management systems and policies to reduce food waste. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Scarcity discourses and their impacts on renal care policy, practices, and everyday experiences in rural British Columbia

    PubMed Central

    Brassolotto, Julia; Daly, Tamara

    2017-01-01

    Drawing from a qualitative case study in rural British Columbia, Canada, this paper examines the discourse of kidney scarcity and its impact on renal care policies and practices. Our findings suggest that at different levels of care, there are different discourses and treatment foci. We have identified three distinct scarcity discourses at work. At the macro policy level, the scarcity of transplantable kidneys is the dominant discourse. At the meso health care institution level, we witnessed a discourse regarding the scarcity of health care and human resources. At the micro community level, there was a discourse of the scarcity of health and life-sustaining resources. For each form of scarcity, particular responses are encouraged. At the macro level, renal care and transplant organizations emphasize the benefits of kidney transplantation and procuring more donors. At the meso level, participants from the regional health care system increasingly encourage home hemodialysis and patient-led care. At the micro level, community health care professionals push for rural renal patients to attend dialysis and maintain their care plans. This work contributes to critical, interdisciplinary organ transfer discourse by contextualizing kidney scarcity. It reveals the tension between these discourses and the implications of pursuing kidney donations without addressing the conditions in which individuals experience kidney failure. PMID:26854624

  20. [Functional dyspepsia. New pathophysiologic knowledge with therapeutic implications].

    PubMed

    Hernando-Harder, Ana C; Franke, Andreas; Singer, Manfred V; Harder, Hermann

    2007-01-01

    Functional dyspepsia (FD) is a heterogeneous, highly prevalent symptom complex in the community and general practice. FD is defined as the presence of symptoms considered as originated in the gastroduodenal region, in the absence of any organic, systemic, or metabolic disease that is likely to explain the symptoms. Pathogenetic features include disturbed gastric accommodation and emptying, duodenal dysmotility, heightened sensitivity, notably psychosocial disturbances and an association with a postinfective state. Increasing efforts are made to determine the etiopathogenesis of the disease, including new molecular and genetic aspects. However, the exact etiopathologic mechanism that causes the symptoms in an individual patient remains to be identified. The new Rome III criteria redefine and sub-characterize FD patients according to their main symptoms and this can be of value for standardized research, development and control of new therapeutic strategies and calculated therapeutic recommendations in the clinical practice. Various treatment modalities have been employed including dietary modifications, pharmacological agents directed at different targets within the gastrointestinal tract and central nervous system and psychological therapies including hypnotherapy. Unfortunately, to date, all of these therapies have yielded only marginal results. After excluding organic diseases, it is essential that the patient be assured about the benign nature and prognosis of the disease, and this can be sometimes the most helpful inversion for the patient and his/her physician.

  1. Emergent modes of work and communities of practice.

    PubMed

    Iedema, Rick; Meyerkort, Shannon; White, Les

    2005-02-01

    This paper argues that the recent emphasis on teams in the health services research literature tends to be attributed to our rising recognition that flexible and self-organizing teams are in the best position to handle the increasing complexity and fragmentation of health services. With a brief review of two papers on health-care teams as its point of departure, this paper argues that the concern with teams harbours a realization that the organizational-managerial point of gravity of most clinical work lies with those who do the work. In the context of health reforms sweeping across most countries in the industrialized world, this means that teams are to embody dynamic self-organization as do 'communities of practice (CoPs)', and be the origin of the managerial and documentary realities that describe, define and validate them. Following through on this last point, the paper reflects on some of the constitutive facets of teams as CoPs, and proposes that in the context of health reform such emergent teamness encompass participating, knowledging and boundary spanning. Fusing contextual, attributional and processual dimensions of team conduct, these notions are elaborated to show how descriptions of teamness can be rendered sensitive to the prerogatives of health reform. The paper concludes with outlining some of the implications of this proposal for how we reconceptualize health services management.

  2. An Exploratory Descriptive Study of Registered Nurse Innovation: Implications for Levels of Adoption.

    PubMed

    Polster, Debra; Villines, Dana

    The aims of this study were to describe registered nurses' levels of personal innovativeness and registered nurses' perceived organizational innovativeness and determine the relationship between these 2 variables. There is limited research to describe the levels of innovation of nurses within a hospital. The levels of innovation can determine the likelihood of adoption of evidence-based practices at the bedside. As change agents, clinical nurse specialists can determine successful implementation strategies tailored to nurse levels of innovation. This was a descriptive study at a midwest, urban, teaching, 408-bed Magnet hospital. Surveys were completed by 217 nurses. The participants reported high personal innovativeness ((Equation is included in full-text article.)= 32.1; SD, 6.4), and the institution was perceived as innovative, with 90.3% of scores categorized as positive innovativeness. The statistically significant correlation was in the medical-surgical unit (r = -0.52, P < .01). There is no correlation between personal innovativeness and organizational innovativeness except for medical-surgical nurses (P = .03). They are likely to perceive the organization more innovative than themselves. Determining adopter characteristics can be valuable to the clinical nurse specialist by adapting strategic interventions to advance nursing practice. Exploring levels of adoption can be an innovative strategy to transform nursing at the bedside and throughout the organization.

  3. Sports teams as superorganisms: implications of sociobiological models of behaviour for research and practice in team sports performance analysis.

    PubMed

    Duarte, Ricardo; Araújo, Duarte; Correia, Vanda; Davids, Keith

    2012-08-01

    Significant criticisms have emerged on the way that collective behaviours in team sports have been traditionally evaluated. A major recommendation has been for future research and practice to focus on the interpersonal relationships developed between team players during performance. Most research has typically investigated team game performance in subunits (attack or defence), rather than considering the interactions of performers within the whole team. In this paper, we offer the view that team performance analysis could benefit from the adoption of biological models used to explain how repeated interactions between grouping individuals scale to emergent social collective behaviours. We highlight the advantages of conceptualizing sports teams as functional integrated 'super-organisms' and discuss innovative measurement tools, which might be used to capture the superorganismic properties of sports teams. These tools are suitable for revealing the idiosyncratic collective behaviours underlying the cooperative and competitive tendencies of different sports teams, particularly their coordination of labour and the most frequent channels of communication and patterns of interaction between team players. The principles and tools presented here can serve as the basis for novel approaches and applications of performance analysis devoted to understanding sports teams as cohesive, functioning, high-order organisms exhibiting their own peculiar behavioural patterns.

  4. The role of the positive emotional attractor in vision and shared vision: toward effective leadership, relationships, and engagement

    PubMed Central

    Boyatzis, Richard E.; Rochford, Kylie; Taylor, Scott N.

    2015-01-01

    Personal and shared vision have a long history in management and organizational practices yet only recently have we begun to build a systematic body of empirical knowledge about the role of personal and shared vision in organizations. As the introductory paper for this special topic in Frontiers in Psychology, we present a theoretical argument as to the existence and critical role of two states in which a person, dyad, team, or organization may find themselves when engaging in the creation of a personal or shared vision: the positive emotional attractor (PEA) and the negative emotional attractor (NEA). These two primary states are strange attractors, each characterized by three dimensions: (1) positive versus negative emotional arousal; (2) endocrine arousal of the parasympathetic nervous system versus sympathetic nervous system; and (3) neurological activation of the default mode network versus the task positive network. We argue that arousing the PEA is critical when creating or affirming a personal vision (i.e., sense of one’s purpose and ideal self). We begin our paper by reviewing the underpinnings of our PEA–NEA theory, briefly review each of the papers in this special issue, and conclude by discussing the practical implications of the theory. PMID:26052300

  5. Social media: A contextual framework to guide research and practice.

    PubMed

    McFarland, Lynn A; Ployhart, Robert E

    2015-11-01

    Social media are a broad collection of digital platforms that have radically changed the way people interact and communicate. However, we argue that social media are not simply a technology but actually represent a context that differs in important ways from traditional (e.g., face-to-face) and other digital (e.g., email) ways of interacting and communicating. As a result, social media is a relatively unexamined type of context that may affect the cognition, affect, and behavior of individuals within organizations. We propose a contextual framework that identifies the discrete and ambient stimuli that distinguish social media contexts from digital communication media (e.g., email) and physical (e.g., face-to-face) contexts. We then use this contextual framework to demonstrate how it changes more person-centered theories of organizational behavior (e.g., social exchange, social contagion, and social network theories). These theoretical insights are also used to identify a number of practical implications for individuals and organizations. This study's major contribution is creating a theoretical understanding of social media features so that future research may proceed in a theory-based, rather than platform-based, manner. Overall, we intend for this article to stimulate and broadly shape the direction of research on this ubiquitous, but poorly understood, phenomenon. (c) 2015 APA, all rights reserved).

  6. Internet use by physicians and its impact on medical practice-an exploratory study.

    PubMed

    Kwon, Ik-Whan G; Xie, Henry Yu

    2003-01-01

    Internet use by physicians has played a vital role in medical practices for many years. A number of related studies have emerged to examine the impact of Internet use on medical practice. However, there is yet to be a comprehensive study on the impact of Internet use by physicians on their medical practice. This study examines a preliminary step to explore the major implications of physicians' Internet use on the traditional areas, such as health education and learning, physician-patient relationship, and medical marketing. Barriers to Internet use are also investigated. Implication of use of the Internet in the medical practice and limitations of this study are discussed as well.

  7. District nursing: the cost benefits of a population-based practice.

    PubMed Central

    Dreher, M

    1984-01-01

    This paper presents some serendipitous findings from an ethnohistorical study of public health nursing in rural New England. In the course of that study, a model of population-based nursing revealed itself that some would condemn as antiquated; it may, however, hold great possibilities for addressing the nation's current and future health problems, particularly health maintenance of the elderly and care of the chronically ill. In keeping with the criteria used to evaluate primary health care, the model is examined for the extent to which it is accessible, available, accountable, acceptable, comprehensive, coordinated, and cost-effective. The policy implications of this model for the organization and financing of community health care are explored. PMID:6476165

  8. Inhomogeneous degradation in metal halide perovskites

    NASA Astrophysics Data System (ADS)

    Yang, Rong; Zhang, Li; Cao, Yu; Miao, Yanfeng; Ke, You; Wei, Yingqiang; Guo, Qiang; Wang, Ying; Rong, Zhaohua; Wang, Nana; Li, Renzhi; Wang, Jianpu; Huang, Wei; Gao, Feng

    2017-08-01

    Although the rapid development of organic-inorganic metal halide perovskite solar cells has led to certified power conversion efficiencies of above 20%, their poor stability remains a major challenge, preventing their practical commercialization. In this paper, we investigate the intrinsic origin of the poor stability in perovskite solar cells by using a confocal fluorescence microscope. We find that the degradation of perovskite films starts from grain boundaries and gradually extend to the center of the grains. Firmly based on our findings, we further demonstrate that the device stability can be significantly enhanced by increasing the grain size of perovskite crystals. Our results have important implications to further enhance the stability of optoelectronic devices based on metal halide perovskites.

  9. 'Knock, and it shall be opened': knocking out and knocking in to reveal mechanisms of disease and novel therapies.

    PubMed

    Hacking, Douglas F

    2008-12-01

    Recent significant advances in molecular biology have generated genetically modified bacteria, yeast, nematodes, fruit flies, and fish. However, it is the genetic modification of mammalian model organisms, particularly the mouse, that has the greatest potential to shed light on human development, physiology and pathology in ways that have significant implications for neonatal and paediatric clinical practice. Here, we review some of the techniques for knocking out (inactivating), mutating and knocking in (inserting) selected genes that are important to neonatology and show how this research will lead both to a better understanding of disease and to novel therapies for infants and children.

  10. Relationship quality and relationship context as antecedents of person- and task-focused interpersonal citizenship behavior.

    PubMed

    Settoon, Randall P; Mossholder, Kevin W

    2002-04-01

    A model hypothesizing relationship quality and relationship context as antecedents of two complementary forms of interpersonal citizenship behavior (ICB) was tested. Measures with coworkers as the frame of reference were used to collect data from 273 individuals working in 2 service-oriented organizations. As hypothesized, variables reflecting relationship quality were associated with person-focused ICB, as mediated by empathic concern. Also as hypothesized, a relationship context variable, network centrality, exhibited a direct relationship with task-focused ICB. Unexpectedly, network centrality was directly associated with person-focused ICB. and empathic concern was associated with task-focused ICB. The results are discussed, and implications for research and practice are offered.

  11. The Role of Organizational Control Systems in Employees' Organizational Trust and Performance Outcomes.

    PubMed

    Verburg, Robert M; Nienaber, Ann-Marie; Searle, Rosalind H; Weibel, Antoinette; Den Hartog, Deanne N; Rupp, Deborah E

    2018-04-01

    This study examined how organizational control is related to employees' organizational trust. We specifically focus on how different forms of control (process, outcome, and normative) relate to employees' trust in their employing organizations and examine whether such trust in turn relates positively to employee job performance (task performance and organizational citizenship behavior). In addition, and in response to the recommendations of past research, we examined these relationships in a high control and compliance-based cultural context. Using data from 105 employee-supervisor dyads from professional services firms in Singapore, we find support for our hypothesized model. The implications of the results for theory and practice, and directions for future research, are discussed.

  12. Understanding the independent influence of duty and achievement striving when predicting the relationship between conscientiousness and organizational cultural profiles and helping behaviors.

    PubMed

    Moon, Henry; Livne, Ephrat; Marinova, Sophia

    2013-01-01

    The theory that 2 facets of the factor conscientiousness, duty and achievement striving, are related to self- or other-centered motives, is supported in 2 studies. In Study 1 (N = 204 undergraduates), the self-centered facet of achievement striving was found to be the most important predictor of attraction toward organizational cultures that were outcome-based, aggressive, and emphasized rewards. Achievement strivers were less attracted to supportive and decisive organizations. In Study 2 (N = 189 part-time MBA students) the other-centered facet of duty was found to be predictive of helping behaviors. Theoretical and practical implications are discussed.

  13. The Role of Organizational Control Systems in Employees’ Organizational Trust and Performance Outcomes

    PubMed Central

    Verburg, Robert M.; Nienaber, Ann-Marie; Searle, Rosalind H.; Weibel, Antoinette; Den Hartog, Deanne N.; Rupp, Deborah E.

    2017-01-01

    This study examined how organizational control is related to employees’ organizational trust. We specifically focus on how different forms of control (process, outcome, and normative) relate to employees’ trust in their employing organizations and examine whether such trust in turn relates positively to employee job performance (task performance and organizational citizenship behavior). In addition, and in response to the recommendations of past research, we examined these relationships in a high control and compliance-based cultural context. Using data from 105 employee–supervisor dyads from professional services firms in Singapore, we find support for our hypothesized model. The implications of the results for theory and practice, and directions for future research, are discussed. PMID:29568213

  14. The new production theory for health care through clinical reengineering: a study of clinical guidelines--Part II.

    PubMed

    Sharp, J R

    1995-01-01

    In Part I of this two-part article, in the December 1994 issue of the journal, the author discussed the manufacturing theories of Peter Drucker in terms of their applicability for the health care field. He concluded that Drucker's four principles and practices of manufacturing--statistical quality control, manufacturing accounting, modular organization, and systems approach--do have application to the health care system. Clinical guidelines, a variation on the Drucker theory, are a specific example of the manufacturing process in health. The performance to date of some guidelines and their implications for the health care reform debate are discussed in Part II of the article.

  15. 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.

  16. A Constructive Reframing of Student Roles and Systems Learning in Medical Education Using a Communities of Practice Lens.

    PubMed

    Gonzalo, Jed D; Thompson, Britta M; Haidet, Paul; Mann, Karen; Wolpaw, Daniel R

    2017-12-01

    Health systems are in the midst of a transformation that is being driven by a variety of forces. This has important implications for medical educators because clinical practice environments play a key role in learning and professional development, and evolving health systems are beginning to demand that providers have "systems-ready" knowledge, attitudes, and skills. Such implications provide a clear mandate for medical schools to modify their goals and prepare physicians to practice flexibly within teams and effectively contribute to the improvement of health care delivery. In this context, the concepts of value-added medical education, authentic student roles, and health systems science are emerging as increasingly important. In this Article, the authors use a lens informed by communities of practice theory to explore these three concepts, examining the implications that the communities of practice theory has in the constructive reframing of educational practices-particularly common student roles and experiences-and charting future directions for medical education that better align with the needs of the health care system. The authors apply several key features of the communities of practice theory to current experiential roles for students, then propose a new approach to students' clinical experiences-value-added clinical systems learning roles-that provides students with opportunities to make meaningful contributions to patient care while learning health systems science at the patient and population level. Finally, the authors discuss implications for professional role formation and anticipated challenges to the design and implementation of value-added clinical systems learning roles.

  17. Chromatin Remodeling Function of BRCA1 and Its Implication in Regulation of DNA Replication

    DTIC Science & Technology

    2001-09-01

    Remodeling Function of BRCAI and its Implication in Regulation of DNA Replication PRINCIPAL INVESTIGATOR: Rong Li, Ph.D. CONTRACTING ORGANIZATION: University...of BRCAI and its Implication DAMD17-99-1-9572 in Regulation of DNA Replication 6. AUTHOR(S) Rong Li, Ph.D. 7. PERFORMING ORGANIZATION NAME(S) AND...1-mediated nuclear functions. 14. SUBJECT TERMS 15. NUMBER OF PAGES Breast Cancer, DNA replication , chromatin remodeling, transcription, 19 cell cycle

  18. Lifestyle segmentation of US food shoppers to examine organic and local food consumption.

    PubMed

    Nie, Cong; Zepeda, Lydia

    2011-08-01

    The food related lifestyle (FRL) model, widely used on European data, is applied to US data using a modified survey instrument to examine organic and local food consumption. Since empirical studies indicate these shoppers are motivated by environmental and health concerns and limited by access, the conceptual framework employs an environmental behavior model, Attitude Behavior Context (ABC), which is consistent with means-end chain theory, the Health Belief (HB) model, and the FRL model. ABC theory incorporates contextual factors that may limit consumers' ability to act on their intentions. US food shopper data was collected in 2003 (n=956) utilizing an instrument with variables adapted from the FRL, ABC, and HB models. Cluster analysis segmented food shoppers into four FRL groups: rational, adventurous, careless, and a fourth segment that had some characteristics of both conservative and uninvolved consumers. The segments exhibited significant differences in organic and local food consumption. These were correlated with consumers' environmental concerns, knowledge and practices, health concerns and practices, as well as some demographic characteristics (race, gender, age, education), income, and variables that measured access to these foods. Implications for marketing and public policy strategies to promote organic and local foods include: emphasizing taste, nutrition, value, children, and enjoyment of cooking for rational consumers; and emphasizing health, fitness, and freshness, and providing ethnic foods for adventurous consumers. While both careless and conservative/uninvolved consumers valued convenience, the former tended to be in the highest income group, while the latter were in the lowest, were more likely to be either in the youngest or oldest age groups, and were very concerned about food safety and health. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. End-of-life practices in patients with devastating brain injury in Spain: implications for organ donation.

    PubMed

    Domínguez-Gil, B; Coll, E; Pont, T; Lebrón, M; Miñambres, E; Coronil, A; Quindós, B; Herrero, J E; Liébanas, C; Marcelo, B; Sanmartín, A M; Matesanz, R

    2017-04-01

    To describe end-of-life care practices relevant to organ donation in patients with devastating brain injury in Spain. A multicenter prospective study of a retrospective cohort. 1 November 2014 to 30 April 2015. Sixty-eight hospitals authorized for organ procurement. Patients dying from devastating brain injury (possible donors). Age: 1 month-85 years. Type of care, donation after brain death, donation after circulatory death, intubation/ventilation, referral to the donor coordinator. A total of 1,970 possible donors were identified, of which half received active treatment in an Intensive Care Unit (ICU) until brain death (27%), cardiac arrest (5%) or the withdrawal of life-sustaining therapy (19%). Of the rest, 10% were admitted to the ICU to facilitate organ donation, while 39% were not admitted to the ICU. Of those patients who evolved to a brain death condition (n=695), most transitioned to actual donation (n=446; 64%). Of those who died following the withdrawal of life-sustaining therapy (n=537), 45 (8%) were converted into actual donation after circulatory death donors. The lack of a dedicated donation after circulatory death program was the main reason for non-donation. Thirty-seven percent of the possible donors were not intubated/ventilated at death, mainly because the professional in charge did not consider donation alter discarding therapeutic intubation. Thirty-six percent of the possible donors were never referred to the donor coordinator. Although deceased donation is optimized in Spain, there are still opportunities for improvement in the identification of possible donors outside the ICU and in the consideration of donation after circulatory death in patients who die following the withdrawal of life-sustaining therapy. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  20. 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.

  1. 77 FR 31041 - Draft Standards and Best Practices for Interaction Between Medical Examiner/Coroner and Organ and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-24

    ... Best Practices for Interaction Between Medical Examiner/Coroner and Organ and Tissue Procurement... titled ``Organ and Tissue Procurement Committee Standards and Best Practices for Interaction Between Medical Examiner/Coroner Offices and Organ Tissue Procurement Organizations'' from May 12, 2012, to June...

  2. Some Implications for Moral Education of the Confucian Principle of Harmony: Learning from Sustainability Education Practice in China

    ERIC Educational Resources Information Center

    Feng, Ling; Newton, Derek

    2012-01-01

    The concept of "harmony" was taught by the Chinese sages as the practice of acceptance, tolerance, mutual respect, equality and patience, and is now given great importance by the Chinese government in its attempts to promote the stability and sustainability of the country. The concept could have significant implications for moral…

  3. How the Government Defines "Rural" Has Implications for Education Policies and Practices. Issues & Answers. REL 2007-010

    ERIC Educational Resources Information Center

    Arnold, Michael L.; Biscoe, Belinda; Farmer, Thomas W.; Robertson, Dylan L.; Shapley, Kathy L.

    2007-01-01

    Clearly defining what rural means has tangible implications for public policies and practices in education, from establishing resource needs to achieving the goals of No Child Left Behind in rural areas. The word "rural" has many meanings. It has been defined in reference to population density, geographic features, and level of economic…

  4. In the "Best Interest" of the Student: Perceptions and Implications for Leadership Practices in Secondary Schools in Kenya

    ERIC Educational Resources Information Center

    Jwan, Julius Ouma

    2011-01-01

    This paper discusses the contrasting views of what constitutes the "best interests" of students and the implications of such perceptions for leadership practices in secondary schools in Kenya. The paper is based on a study conducted to establish the students', teachers' and principals' perceptions of democratic school leadership--in line…

  5. When Duty Calls: The Implications of Social Justice Work for Policy, Education, and Practice in the Mental Health Professions. Reactions

    ERIC Educational Resources Information Center

    Kiselica, Mark S.

    2004-01-01

    In reaction to the pioneering model of social justice education in counseling psychology described by Goodman, Liang, Helms, Latta, Sparks, and Weintraub, several implications of social justice work for policy, education, and practice in the mental health professions are suggested. Specifically, it is recommended that mental health scientists and…

  6. Kindergartners' Mental Models of the Day and Night Cycle: Implications for Instructional Practices in Early Childhood Classrooms

    ERIC Educational Resources Information Center

    Saçkes, Mesut

    2015-01-01

    This study aims to examine kindergarten children's mental models of the day and night cycle and provide implications for pedagogical practices targeting space science concepts in early childhood classrooms. A total of 46 kindergartners participated in the study, their age ranging from 60 to 75 months, including 22 boys and 24 girls.…

  7. "Forest Grove School District v. T.A." Supreme Court Case: Implications for School Psychology Practice

    ERIC Educational Resources Information Center

    Dixon, Shauna G.; Eusebio, Eleazar C.; Turton, William J.; Wright, Peter W. D.; Hale, James B.

    2011-01-01

    The 2009 "Forest Grove School District v. T.A." United States Supreme Court case could have significant implications for school psychology practice. The Court ruled that the parents of a student with a disability were entitled to private school tuition reimbursement even though T.A. had not been identified with a disability or previously…

  8. Learning Organization Practices.

    ERIC Educational Resources Information Center

    1997

    This document contains three papers from a symposium on learning organization practices. "Learning Lenses of Leading Organizations: Best Practices Survey" (Laurel S. Jeris) shows that successful learning organizations view learning initiatives through multiple lenses with a clear, sustained focus on strategic outcomes. "Dimensions…

  9. Perceptions of schizophrenia and coping styles in caregivers: comparison between India and Switzerland.

    PubMed

    Rexhaj, S; Jose, A E; Golay, P; Favrod, J

    2016-11-01

    WHAT IS KNOWN ON THE SUBJECT?: Negative perceptions of illnesses can increase caregivers' use of ineffective coping strategies, which may increase their burdens and distress. Scientific and theoretical framework showed that culture and health organization system influence perception of illnesses and thus also has an impact on the coping strategies used. There is a lack of data on comparative perceptions of illnesses and coping styles between India and Switzerland and that is why this hypothesis needs to be confirmed. The comparison between two countries with large cultural and socioeconomics differences will provide a more significant impact. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This cultural comparative study explores the associations between representations of illness and three forms of coping styles (i.e. problem-focused, emotion-focused and social support-focused coping) among caregivers of people diagnosed with schizophrenia spectrum disorders in Mangalore, India, and in French-speaking Switzerland. Results showed significant differences between Swiss and Indian caregivers practically in all illness' perceptions and coping styles, which is in accord with the theoretical framework. However, two results showed also similarities: the perception that schizophrenia can have cyclical episodes and that it can have negative consequences for caregivers. These differences and similarities allow to confirm the hypothesis that culture and health organization system influence illness' perception which impact the used coping styles. However, to develop specific nursing interventions for each culture, more research is needed to specify qualitatively the content of these differences and similarities. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Knowledge of how culture influences perceptions and coping styles is essential to develop quality interventions. Nurses should evaluate caregivers' perceptions and the causes they attribute to illnesses to help them maintain or develop efficient coping strategies. Knowledge of specific cultural differences and similarities can help nurses to provide individualized care that takes into account personal values to ensure recovery processes. Introduction Scientific and theoretical framework showed that culture and health organization system influence perception of illnesses and thus also has an impact on the coping strategies used. Aim/question This cultural comparative study explores illness' perception and coping styles among the caregivers of people diagnosed with schizophrenia spectrum disorders in Mangalore, India, and Lausanne, Switzerland. Method The answers of 92 Swiss caregivers, using paper or electronic surveys depending on the participants' preference, and 100 Indian caregivers via an interview with a nurse were examined. Results The results confirm the hypothesis that culture and health organization system influence illness' perception which impact the used coping styles. Significant differences between Swiss and Indian caregivers practically in all illness' perceptions and coping styles were present, which is in accord with the theoretical framework. However, two results showed also similarities: the perception that schizophrenia can have cyclical episodes and that it can have negative consequences for caregivers. Discussion These differences will affect the development of interventions for caregivers in both countries. Implications for Practice The cultural differences observed in this study not only will allow interventions to be adapted to the specific needs of the two populations but also to identify their shared needs. © 2016 John Wiley & Sons Ltd.

  10. Implications of the concept of minimal risk in research on informed choice in clinical practice

    PubMed Central

    Wada, Kyoko; Nisker, Jeff

    2015-01-01

    The concept of a minimal risk threshold in research, beneath which exception to informed consent and ethics review processes may occur, has been codified for over 30 years in many national research regulations and by the Council for International Organizations of Medical Sciences. Although minimal risk in research constitutes one of the criteria for allowing waiver of informed consent or modification to the consent process and a large body of literature exists, discussion of a minimal risk threshold in clinical practice has not occurred. One reason for lack of discussion may be that implicit consent is accepted for a wide range of routine clinical practices. Extending the role of minimal risk in research to clinical practice might assist clinicians in identifying circumstances for which implicit consent is indeed sufficient and circumstances in which it is not. Further, concepts from minimal risk in research might assist clinicians regarding when information provision in health promotion is required. We begin by reviewing concepts in both minimal risk in research and informed choice in clinical practice. We then explore how a clinical minimal risk concept may clarify recommendations for information provision in clinical practice and support the patient's informed choice regarding therapeutic and diagnostic procedures and also health promotion. Given that clinical practice involves a broad scope of health information, professional practice guidelines on information provision based on the application of the minimal risk threshold in research could be developed to guide clinicians in what information must be provided to their patients. PMID:26108215

  11. The incidence and clinical implication of sputum with positive acid-fast bacilli smear but negative in mycobacterial culture in a tertiary referral hospital in South Korea.

    PubMed

    Lee, Jae Seok; Kim, Eui-Chong; Joo, Sei Ick; Lee, Sang-Min; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Shim, Young-Soo; Yim, Jae-Joon

    2008-10-01

    Although it is not rare to find sputum that is positive acid-fast bacilli (AFB) smear but subsequent culture fails to isolate mycobacteria in clinical practice, the incidence and clinical implication of those sputa from new patients has not been clearly elucidated. The aim of this study was to determine the incidence and clinical implication of sputum with positive AFB smear but negative in mycobacterial culture. All sputa that were positive AFB smear requested during diagnostic work up for new patients visiting Seoul National University Hospital from 1 January 2005 through 31 December 2006 were included. Sputa producing a positive AFB smear but negative mycobacterial culture were classified into one of four categories: laboratory failure to isolate mycobacteria, false positive AFB smear, pathogen may show a positive AFB smear other than mycobacteria, and indeterminate results. Out of 447 sputa with a positive AFB smear, 29 (6.5%) failed to culture any organism. Among these 29 sputa, 18 were caused by laboratory failure to isolate mycobacteria, six were false positive smears, and five indeterminate. Although most sputum with a positive AFB smear but negative culture could be classified as a laboratory failure, clinicians should consider the possibility of false positive AFB smear.

  12. Implications of technology in music therapy practice and research for music therapy education: a review of literature.

    PubMed

    Crowe, Barbara J; Rio, Robin

    2004-01-01

    This article reviews the use of technology in music therapy practice and research for the purpose of providing music therapy educators and clinicians with specific and accurate accounts of the types and benefits of technology being used in various settings. Additionally, this knowledge will help universities comply with National Association of Schools of Music requirements and help to standardize the education and training of music therapists in this rapidly changing area. Information was gathered through a literature review of music therapy and related professional journals and a wide variety of books and personal communications. More data were gathered in a survey requesting information on current use of technology in education and practice. This solicitation was sent to all American Music Therapy Association approved universities and clinical training directors. Technology applications in music therapy are organized according to the following categories: (a) adapted musical instruments, (b) recording technology, (c) electric/electronic musical instruments, (d) computer applications, (e) medical technology, (f) assistive technology for the disabled, and (g) technology-based music/sound healing practices. The literature reviewed covers 177 books and articles from a span of almost 40 years. Recommendations are made for incorporating technology into music therapy course work and for review and revision of AMTA competencies. The need for an all-encompassing clinical survey of the use of technology in current music therapy practice is also identified.

  13. ASSESSING PARENTING IN THE CONTEXT OF REUNIFICATION OF INFANTS/TODDLERS AND THEIR FAMILIES: HOW TO FACE THE CHALLENGES?

    PubMed

    Vischer, Anne-Fleur W K; Grietens, Hans; Knorth, Erik J; Mulder, Hans

    2017-05-01

    Since a substantial portion of infants and toddlers reenter care after reunification, the question of whether family reunification is feasible needs to be answered very cautiously. How parenting is assessed is of major importance in answering this question, but the quality of these assessments is often poor. With an eye to improving current practice, we conducted an integrative review, in which we analyzed the challenges related to the assessment of parenting vis-à-vis reunification and linked relevant knowledge from research with significant know-how from practice. The challenges appear to be embedded in the struggle to define (especially good enough) parenting and the complex context of child protection. As an answer to the challenges, the integrative review resulted in a framework of four key components required for sufficient parenting-assessment practice: (a) the use and development of expertise; and (b) providing families aiming for reunification with an intervention that is intensive, (c) flexible, and (d) organized as teamwork. Providing families with such an intervention gives them the opportunity to make substantial changes in their parenting and helps professionals assess the capacity of parents to grow to an acceptable level of caretaking for their child. Further implications for research and practice are discussed. © 2017 Michigan Association for Infant Mental Health.

  14. Application of best practice approaches for designing decision support tools: The preparatory education about clinical trials (PRE-ACT) study

    PubMed Central

    Fleisher, Linda; Ruggieri, Dominique G.; Miller, Suzanne M.; Manne, Sharon; Albrecht, Terrance; Buzaglo, Joanne; Collins, Michael A.; Katz, Michael; Kinzy, Tyler G.; Liu, Tasnuva; Manning, Cheri; Charap, Ellen Specker; Millard, Jennifer; Miller, Dawn M.; Poole, David; Raivitch, Stephanie; Roach, Nancy; Ross, Eric A.; Meropol, Neal J.

    2014-01-01

    Objective This article describes the rigorous development process and initial feedback of the PRE-ACT (Preparatory Education About Clinical Trials) web-based- intervention designed to improve preparation for decision making in cancer clinical trials. Methods The multi-step process included stakeholder input, formative research, user testing and feedback. Diverse teams (researchers, advocates and developers) participated including content refinement, identification of actors, and development of video scripts. Patient feedback was provided in the final production period and through a vanguard group (N = 100) from the randomized trial. Results Patients/advocates confirmed barriers to cancer clinical trial participation, including lack of awareness and knowledge, fear of side effects, logistical concerns, and mistrust. Patients indicated they liked the tool’s user-friendly nature, the organized and comprehensive presentation of the subject matter, and the clarity of the videos. Conclusion The development process serves as an example of operationalizing best practice approaches and highlights the value of a multi-disciplinary team to develop a theory-based, sophisticated tool that patients found useful in their decision making process. Practice implications Best practice approaches can be addressed and are important to ensure evidence-based tools that are of value to patients and supports the usefulness of a process map in the development of e-health tools. PMID:24813474

  15. Practice assistants in primary care in Germany - associations with organizational attributes on job satisfaction.

    PubMed

    Gavartina, Amina; Zaroti, Stavria; Szecsenyi, Joachim; Miksch, Antje; Ose, Dominik; Campbell, Stephen M; Goetz, Katja

    2013-08-05

    Job satisfaction and organizational attributes in primary care teams are important issues as they affect clinical outcomes and the quality of health care provided. As practice assistants are an integral part of these teams it is important to gain insight into their views on job satisfaction and organizational attributes. The aim of this study was to evaluate the job satisfaction of practice assistants and the organizational attributes within their general practices in Germany and to explore the existence of possible associations. This observational study was based on a job satisfaction survey and measurement of organizational attributes in general practices in the German federal state of Baden-Wuerttemberg. Job satisfaction was measured with the 10-item 'Warr-Cook-Wall job satisfaction scale'. Organizational attributes were evaluated with the 21-items 'survey of organizational attributes for primary care' (SOAPC). Linear regression analyses were performed in which each of SOAPC scales and the overall score of SOAPC was treated as outcome variables. 586 practice assistants out of 794 respondents (73.8%) from 234 general practices completed the questionnaire. Practice assistants were mostly satisfied with their colleagues and least of all satisfied with their income and recognition for their work. The regression analysis showed that 'freedom of working method' and 'recognition of work', the employment status of practice assistants and the mode of practice were almost always significantly associated with each subscale and overall score of SOAPC. Job satisfaction is highly associated with different aspects of organizational attributes for primary care ('communication', 'decision-making' and 'stress'). Consequently, improved job satisfaction could lead to a better-organized primary care team. This implication should be investigated directly in further intervention studies with a special focus on improving the recognition for work and income.

  16. 7 CFR 205.240 - Pasture practice standard.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Organic Production and Handling Requirements § 205.240 Pasture practice standard. The producer of an organic livestock operation must, for all ruminant livestock on the operation...

  17. 7 CFR 205.240 - Pasture practice standard.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Organic Production and Handling Requirements § 205.240 Pasture practice standard. The producer of an organic livestock operation must, for all ruminant livestock on the operation...

  18. 7 CFR 205.240 - Pasture practice standard.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Organic Production and Handling Requirements § 205.240 Pasture practice standard. The producer of an organic livestock operation must, for all ruminant livestock on the operation...

  19. 7 CFR 205.240 - Pasture practice standard.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Organic Production and Handling Requirements § 205.240 Pasture practice standard. The producer of an organic livestock operation must, for all ruminant livestock on the operation...

  20. Is the tobacco control movement misrepresenting the acute cardiovascular health effects of secondhand smoke exposure? An analysis of the scientific evidence and commentary on the implications for tobacco control and public health practice

    PubMed Central

    Siegel, Michael

    2007-01-01

    While chronic exposure to secondhand smoke has been well recognized as a cause of heart disease in nonsmokers, there has been recent speculation about the potential acute cardiovascular effects of transient exposure to secondhand smoke among nonsmokers; in particular, the possibility that such exposure could increase the risk of acute myocardial infarction even in an otherwise healthy nonsmoker. This paper reviews the claims being made by a number of anti-smoking and public health groups regarding the acute cardiovascular effects of secondhand smoke exposure among otherwise healthy adults, analyzes the validity of these claims based on a review of the scientific evidence, and discusses the implications of the findings for tobacco control and public health practice. Based on the analysis, it appears that a large number of anti-smoking organizations are making inaccurate claims that a single, acute, transient exposure to secondhand smoke can cause severe and even fatal cardiovascular events in healthy nonsmokers. The dissemination of inaccurate information by anti-smoking groups to the public in support of smoking bans is unfortunate because it may harm the tobacco control movement by undermining its credibility, reputation, and effectiveness. Disseminating inaccurate information also represents a violation of basic ethical principles that are a core value of public health practice that cannot and should not be sacrificed, even for a noble end such as protecting nonsmokers from secondhand smoke exposure. How the tobacco control movement responds to this crisis of credibility will go a long way towards determining the future effectiveness of the movement and its ability to continue to save lives and protect the public's health. PMID:17927828

  1. Resource depletion promotes automatic processing: implications for distribution of practice.

    PubMed

    Scheel, Matthew H

    2010-12-01

    Recent models of cognition include two processing systems: an automatic system that relies on associative learning, intuition, and heuristics, and a controlled system that relies on deliberate consideration. Automatic processing requires fewer resources and is more likely when resources are depleted. This study showed that prolonged practice on a resource-depleting mental arithmetic task promoted automatic processing on a subsequent problem-solving task, as evidenced by faster responding and more errors. Distribution of practice effects (0, 60, 120, or 180 sec. between problems) on rigidity also disappeared when groups had equal time on resource-depleting tasks. These results suggest that distribution of practice effects is reducible to resource availability. The discussion includes implications for interpreting discrepancies in the traditional distribution of practice effect.

  2. Decoding the Disciplines as a Hermeneutic Practice

    ERIC Educational Resources Information Center

    Yeo, Michelle

    2017-01-01

    This chapter argues that expert practice is an inquiry that surfaces a hermeneutic relationship between theory, practice, and the world, with implications for new lines of questioning in the Decoding interview.

  3. Bridge to the future: nontraditional clinical settings, concepts and issues.

    PubMed

    Faller, H S; Dowell, M A; Jackson, M A

    1995-11-01

    Healthcare restructuring in the wake of healthcare reform places greater emphasis on primary healthcare. Clinical education in acute care settings and existing community health agencies are not compatible with teaching basic concepts, principles and skills fundamental to nursing. Problems of clients in acute care settings are too complex and clients in the community are often too dispersed for necessary faculty support and supervision of beginning nursing students. Nontraditional learning settings offer the baccalaureate student the opportunity to practice fundamental skills of care and address professional skills of negotiation, assertiveness, organization, collaboration and leadership. An overview of faculty designed clinical learning experiences in nontraditional sites such as McDonald's restaurants, inner city churches, YWCA's, the campus community and homes are presented. The legal, ethical and academic issues associated with nontraditional learning settings are discussed in relation to individual empowerment, decision making and evaluation. Implications for the future address the role of the students and faculty as they interact with the community in which they live and practice.

  4. Advanced nursing practice and Newton's three laws of motion.

    PubMed

    Sturgeon, David

    This article considers the reasons for the development of advanced practice roles among nurses and other healthcare professions. It explores the implications of financial constraints, consumer preferences and the development of new healthcare services on the reorganization of professional boundaries. It makes use of Sir Isaac Newton's three laws of motion to demonstrate how professional development in nursing has taken place in response to a number of external influences and demands. It also considers the significance of skill mix for the nursing profession, in particular the development and likely expansion of the physician assistant role. The application of different professionals and grades within a healthcare team or organization is central to the Government's Agenda for Change proposals and nurses have successfully adopted a number of roles traditionally performed by doctors. Nurses have demonstrated that they are capable of providing high quality care and contributing directly to positive patient outcome. Advanced nursing roles should not only reflect the changing nature of healthcare work, they should also be actively engaged in reconstructing healthcare boundaries.

  5. 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).

  6. Opportunities and challenges for public libraries to enhance community resilience.

    PubMed

    Veil, Shari R; Bishop, Bradley Wade

    2014-04-01

    This study bridges a gap between public library and emergency management policy versus practice by examining the role of public libraries in the community resource network for disaster recovery. Specifically, this study identifies the opportunities and challenges for public libraries to fulfill their role as a FEMA-designated essential community organization and enhance community resilience. The results indicate there are several opportunities for libraries to enhance community resilience by offering technology resources and assistance; providing office, meeting, and community living room space; serving as the last redundant communication channel and a repository for community information and disaster narratives; and adapting or expanding services already offered to meet the changing needs of the community. However, libraries also face challenges in enhancing community resilience, including the temptation to overcommit library capacity and staff capability beyond the library mission and a lack of long-term disaster plans and collaboration with emergency managers and government officials. Implications for library and emergency management practice and crisis research are discussed. © 2013 Society for Risk Analysis.

  7. [Bacterial identification methods in the microbiology laboratory].

    PubMed

    Bou, Germán; Fernández-Olmos, Ana; García, Celia; Sáez-Nieto, Juan Antonio; Valdezate, Sylvia

    2011-10-01

    In order to identify the agent responsible of the infectious process and understanding the pathogenic/pathological implications, clinical course, and to implement an effective antimicrobial therapy, a mainstay in the practice of clinical microbiology is the allocation of species to a microbial isolation. In daily routine practice microbiology laboratory phenotypic techniques are applied to achieve this goal. However, they have some limitations that are seen more clearly for some kinds of microorganism. Molecular methods can circumvent some of these limitations, although its implementation is not universal. This is due to higher costs and the level of expertise required for thei implementation, so molecular methods are often centralized in reference laboratories and centers. Recently, proteomics-based methods made an important breakthrough in the field of diagnostic microbiology and will undoubtedly have a major impact on the future organization of the microbiology services. This paper is a short review of the most noteworthy aspects of the three bacterial identification methods described above used in microbiology laboratories. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  8. Using chaos theory: the implications for nursing.

    PubMed

    Haigh, Carol

    2002-03-01

    The purpose of this paper is to review chaos theory and to examine the role that it may have in the discipline of nursing. In this paper, the fundamental ingredients of chaotic thinking are outlined. The earlier days of chaos thinking were characterized by an almost exclusively physiological focus. By the 21st century, nurse theorists were applying its principles to the organization and evaluation of care delivery with varying levels of success. Whilst the biological use of chaos has focused on pragmatic approaches to knowledge enhancement, nursing has often focused on the mystical aspects of chaos as a concept. The contention that chaos theory has yet to find a niche within nursing theory and practice is examined. The application of chaotic thinking across nursing practice, nursing research and statistical modelling is reviewed. The use of chaos theory as a way of identifying the attractor state of specific systems is considered and the suggestion is made that it is within statistical modelling of services that chaos theory is most effective.

  9. Building organizational supports for research-minded practitioners.

    PubMed

    Austin, Michael J; Dal Santo, Teresa S; Lee, Chris

    2012-01-01

    One of the biggest challenges facing human service organizations is the proliferation of information from inside and outside the agency that needs to be managed if it is to be of use. The concepts of tacit and explicit knowledge can inform an approach to this challenge. Tacit knowledge is stored in the minds of practitioners (often called practice wisdom) and the explicit knowledge is often found in organizational procedure manuals and educational and training materials. Building on this perspective, this analysis provides a preliminary definition of research-minded practitioners by explicating the elements of curiosity, critical reflection, and critical thinking. The organizational implications of developing a cadre of research-minded practitioners include the commitment of top management to support "link officers", evidence request services, research and development units, and service standards. The challenges include the capacity to identify/support research-minded practitioners, promote an organizational culture of evidence-informed practice, redefine staff development and training, redefine job descriptions, and specify the nature of managerial leadership. Copyright © Taylor & Francis Group, LLC

  10. Best practices for developmental toxicity assessment for classification and labeling.

    PubMed

    Daston, George; Piersma, Aldert; Attias, Leonello; Beekhuijzen, Manon; Chen, Connie; Foreman, Jennifer; Hallmark, Nina; Leconte, Isabelle

    2018-05-14

    Many chemicals are going through a hazard-based classification and labeling process in Europe. Because of the significant public health implications, the best science must be applied in assessing developmental toxicity data. The European Teratology Society and Health and Environmental Sciences Institute co-organized a workshop to consider best practices, including data quality and consistency, interpretation of developmental effects in the presence of maternal toxicity, human relevance of animal data, and limits of chemical classes. Recommendations included larger historical control databases, more pharmacokinetic studies in pregnant animals for dose setting and study interpretation, generation of mechanistic data to resolve questions about whether maternal toxicity is causative of developmental toxicity, and more rigorous specifications for what constitutes a chemical class. It is our hope that these recommendations will form the basis for subsequent consensus workshops and other scientific activities designed to improve the scientific robustness of data interpretation for classification and labeling. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Accounting for health-care outcomes: implications for intensive care unit practice and performance.

    PubMed

    Sorensen, Roslyn; Iedema, Rick

    2010-08-01

    The aim of this study was to understand the environment of health care, and how clinicians and managers respond in terms of performance accountability. A qualitative method was used in a tertiary metropolitan teaching intensive care unit (ICU) in Sydney, Australia, including interviews with 15 clinical managers and focus groups with 29 nurses of differing experience. The study found that a managerial focus on abstract goals, such as budgets detracted from managing the core business of clinical work. Fractures were evident within clinical units, between clinical units and between clinical and managerial domains. These fractures reinforced the status quo where seemingly unconnected patient care activities were undertaken by loosely connected individual clinicians with personalized concepts of accountability. Managers must conceptualize health services as an interconnected entity within which self-directed teams negotiate and agree objectives, collect and review performance data and define collective practice. Organically developing regimens of care within and across specialist clinical units, such as in ICUs, directly impact upon health service performance and accountability.

  12. Beyond Positivism: Understanding and addressing childhood obesity disparities through a Critical Theory perspective

    PubMed Central

    Schroeder, Krista; Kulage, Kristine M.; Lucero, Robert

    2016-01-01

    Purpose We apply Critical Theory to examine menu labeling with the aim of uncovering important implications for nursing practice, research, and policy. Conclusions Our critical analysis uncovers barriers to menu labeling's effectiveness, particularly for vulnerable populations. Nurses must work to minimize the impact of these barriers and optimize the effectiveness of menu labeling, in order to strengthen the fight against obesity. Practice implications We suggest changes, guided by this critical analysis,that can be implemented by nurses working in clinical practice, research, and policy. PMID:26112774

  13. The down syndrome behavioral phenotype: implications for practice and research in occupational therapy.

    PubMed

    Daunhauer, Lisa A; Fidler, Deborah J

    2011-01-01

    ABSTRACT Down syndrome (DS) is the most common chromosomal cause of intellectual disability. The genetic causes of DS are associated with characteristic outcomes, such as relative strengths in visual-spatial skills and relative challenges in motor planning. This profile of outcomes, called the DS behavioral phenotype, may be a critical tool for intervention planning and research in this population. In this article, aspects of the DS behavioral phenotype potentially relevant to occupational therapy practice are reviewed. Implications and challenges for etiology-informed research and practice are discussed.

  14. Practical and Scholarly Implications of Information Behaviour Research: A Pilot Study of Research Literature

    ERIC Educational Resources Information Center

    Koh, Kyungwon; Rubenstein, Ellen; White, Kelvin

    2015-01-01

    Introduction: This pilot study examined how current information behaviour research addresses the implications and potential impacts of its findings. The goal was to understand what implications and contributions the field has made and how effectively authors communicate implications of their findings. Methods: We conducted a content analysis of 30…

  15. Stories of pain and health by elderly Pakistani women in Norway.

    PubMed

    Sverre, Beate Lie; Solbrække, Kari Nyheim; Eilertsen, Grethe

    2014-11-01

    This ethnographic study investigates the stories of elderly Pakistani women living in Norway. Migration studies indicate that elderly migrant women are passive, ill victims caught in a marginalized position due to age, ethnicity and gender, and thus have little access to opposition and agency. To broaden the picture it is necessary to develop an innovative approach to understand what is implicated in the process of migration. The importance of considering life conditions that surrounds potential health promotion behaviors of immigrants is stressed by several researchers. However, up to now limited research guided by this perspective has been done in Norway. Therefore, this study explored how elderly Pakistani women in Norway promote their health and well-being through some distinct social interactions. The intention is to bring awareness to how health, even by so-called disadvantaged social groups, may take place. These practices are important to take into consideration when developing health-promoting policies for elderly immigrants. An ethnographic study of 15 Pakistani women, aged 53-75, was carried out in a multisided fieldwork in Oslo using participant observation and ethnographic interviews. The analytical approach was inspired by the constructivist theoretical framework of narrative ethnography. The elderly Pakistani women in Norway construct stories of living in-between cultures and experiences of acculturative stress caused by being elderly, immigrants and women. However, this analysis also suggests that through distinct social relationships, primarily in the context of a voluntary organization, elderly Pakistani women do health by the way they interact and construct a repertoire of social identities. The healing practices taking place among elderly Pakistani women may counteract the negative health outcomes associated with age, migration and gender implications for immigrant health-promoting policy in Norway may be to increase the establishment and allocate funds to sustain voluntary organizations run by and for immigrants. © 2014 the Nordic Societies of Public Health.

  16. Nursing staff competence, work strain, stress and satisfaction in elderly care: a comparison of home-based care and nursing homes.

    PubMed

    Hasson, Henna; Arnetz, Judith E

    2008-02-01

    The aims of this study were to: (1) compare older people care nursing staff's perceptions of their competence, work strain and work satisfaction in nursing homes and home-based care; and (2) to examine determinants of work satisfaction in both care settings. The shift in older people care from hospitals to community-based facilities and home care has had implications for nursing practice. Lack of competence development, high levels of work strain and low levels of work satisfaction among nursing staff in both care settings have been associated with high turnover. Few studies have compared staff perceptions of their competence and work in nursing homes as opposed to home-based care. A cross-sectional questionnaire survey. Nursing staff perceptions of their competence, work strain, stress and satisfaction were measured by questionnaire in 2003 in two older people care organizations in Sweden. Comparisons of all outcome variables were made between care settings both within and between the two organizations. Multiple regression analysis was used to determine predictors of work satisfaction in home care and nursing homes respectively. In general, staff in home-based care reported significantly less sufficient knowledge compared with staff in nursing homes. However, home care staff experienced significantly less physical and emotional strain compared with staff in nursing homes. Ratings of work-related exhaustion, mental energy and overall work satisfaction did not differ significantly between care settings. In both care settings, work-related exhaustion was the strongest (inverse) predictor of work satisfaction. Future interventions should focus on counteracting work-related exhaustion and improving competence development to improve work satisfaction among older people care nursing staff in both care settings. Relevance to clinical practice. Work-related exhaustion and lack of competence development may have significant negative implications for work satisfaction among older people care nursing staff in both home care and nursing homes.

  17. Does Consideration and Assessment of Effects on Health Equity Affect the Conclusions of Systematic Reviews? A Methodology Study

    PubMed Central

    Welch, Vivian; Petticrew, Mark; Ueffing, Erin; Benkhalti Jandu, Maria; Brand, Kevin; Dhaliwal, Bharbhoor; Kristjansson, Elizabeth; Smylie, Janet; Wells, George Anthony; Tugwell, Peter

    2012-01-01

    Introduction Tackling health inequities both within and between countries remains high on the agenda of international organizations including the World Health Organization and local, regional and national governments. Systematic reviews can be a useful tool to assess effects on equity in health status because they include studies conducted in a variety of settings and populations. This study aims to describe the extent to which the impacts of health interventions on equity in health status are considered in systematic reviews, describe methods used, and assess the implications of their equity related findings for policy, practice and research. Methods We conducted a methodology study of equity assessment in systematic reviews. Two independent reviewers extracted information on the reporting and analysis of impacts of health interventions on equity in health status in a group of 300 systematic reviews collected from all systematic reviews indexed in one month of MEDLINE, using a pre-tested data collection form. Any differences in data extraction were resolved by discussion. Results Of the 300 systematic reviews, 224 assessed the effectiveness of interventions on health outcomes. Of these 224 reviews, 29 systematic reviews assessed effects on equity in health status using subgroup analysis or targeted analyses of vulnerable populations. Of these, seven conducted subgroup analyses related to health equity which were reported in insufficient detail to judge their credibility. Of these 29 reviews, 18 described implications for policy and practice based on assessment of effects on health equity. Conclusion The quality and completeness of reporting should be enhanced as a priority, because without this policymakers and practitioners will continue lack the evidence base they need to inform decision-making about health inequity. Furthermore, there is a need to develop methods to systematically consider impacts on equity in health status that is currently lacking in systematic reviews. PMID:22427804

  18. Factors influencing how senior nurses and midwives acquire and integrate coaching skills into routine practice: a grounded theory study.

    PubMed

    Rafferty, Rae; Fairbrother, Greg

    2015-06-01

    To introduce a theory which describes the process of and explicates the factors moderating, the acquisition and integration of leadership coaching skills into the routine practice of senior nurses and midwives. Organizations invest significant resources in leadership coaching programs to ensure that coaching is embedded as a core function of the manager's role. However, even after training, many managers remain unable to undertake this role successfully. The process by which health professionals translate 'manager as coach' training into successful practice outcomes, has remained largely unexplored. A grounded theory study design. Data, collected between February 2012-May 2013, included in-depth interviews with 20 senior nurses and midwives who had attended a leadership coaching program and analysis of nine reflective practice journals. Multiple researchers coded and analysed the data using constant comparative techniques. The outcomes of coaching training ranged from inappropriate use of the coaching skills through to transformed managerial practice. These outcomes were influenced by the dynamic interaction of three central domains of the emergent theoretical model: pre-existing individual perceptions, program elements and contemporaneous experiences. Interactions occurred within the domains and between them, impacting on activators such as courage, motivation, commitment and confidence. The study offers new insights into how senior nurses and midwives acquire and integrate coaching skills into their routine practice. The process is described as multifactorial and dynamic and has implications for the training design, delivery and organizational support of future leadership coaching programs. © 2015 John Wiley & Sons Ltd.

  19. Transforming primary care training--patient-centered medical home entrustable professional activities for internal medicine residents.

    PubMed

    Chang, Anna; Bowen, Judith L; Buranosky, Raquel A; Frankel, Richard M; Ghosh, Nivedita; Rosenblum, Michael J; Thompson, Sara; Green, Michael L

    2013-06-01

    The U.S. faces a critical gap between residency training and clinical practice that affects the recruitment and preparation of internal medicine residents for primary care careers. The patient-centered medical home (PCMH) represents a new clinical microsystem that is being widely promoted and implemented to improve access, quality, and sustainability in primary care practice. We address two key questions regarding the training of internal medicine residents for practice in PCMHs. First, what are the educational implications of practice transformations to primary care home models? Second, what must we do differently to prepare internal medicine residents for their futures in PCMHs? The 2011 Society of General Internal Medicine (SGIM) PCMH Education Summit established seven work groups to address the following topics: resident workplace competencies, teamwork, continuity of care, assessment, faculty development, 'medical home builder' tools, and policy. The output from the competency work group was foundational for the work of other groups. The work group considered several educational frameworks, including developmental milestones, competencies, and entrustable professional activities (EPAs). The competency work group defined 25 internal medicine resident PCMH EPAs. The 2011 National Committee for Quality Assurance (NCQA) PCMH standards served as an organizing framework for EPAs. The list of PCMH EPAs has the potential to begin to transform the education of internal medicine residents for practice and leadership in the PCMH. It will guide curriculum development, learner assessment, and clinical practice redesign for academic health centers.

  20. How do soil properties and soil carbon stocks change after land abandonment in Mediterranean mountain areas?

    NASA Astrophysics Data System (ADS)

    Nadal Romero, Estela; Cammeraat, Erik; Pérez Cardiel, Estela; Lasanta, Teodoro

    2016-04-01

    Land abandonment and subsequent revegetation processes (due to secondary succession and afforestation practices) are global issues with important implications in Mediterranean mountain areas. Moreover, the effects of land use changes on soil carbon stocks are a matter of concern stated in international policy agendas on the mitigation of greenhouse emissions, and afforestation practices are increasingly viewed as an environmental restorative land use change prescription and are considered one of the most efficient carbon sequestration strategies currently available. The MED-AFFOREST project aims to gain more insight into the discussion by exploring the following central research questions: (i) what is the impact of land abandonment on soil properties? and (ii) how do soil organic carbon change after land abandonment? The main objective of this study is to assess the effects of land abandonment, land use change and afforestation practices on soil properties and soil organic carbon (SOC) dynamics. For this aim, five different land covers (bare soil, meadows, secondary succession, Pinus sylvestris (PS) and Pinus nigra (PN) afforestation), in the Central Spanish Pyrenees were analysed. Results showed that changes in soil properties after land abandonment were limited, even if afforestation practices were carried out and no differences were observed between natural succession and afforestation. The results on SOC dynamics showed that: (i) SOC contents were higher in the PN sites in the topsoil (10 cm), (ii) when all the profile was considered no significant differences were observed between meadows and PN, (iii) SOC accumulation under secondary succession is a slow process, and (iv) meadows should also be considered due to the relative importance in SOC stocks. The first step of SOC stabilization after afforestation is the formation of macro-aggregates promoted by large inputs of SOC, with a high contribution of labile organic matter. However, our respiration experiments did not show evidence of SOC stabilization. SOC mineralization was higher in the top layers and values decreased with depth. These results put the question forward which type of forest and landscape management is most appropriate to decide for the best practices after land abandonment for soil recovery and soil organic carbon dynamics. Acknowledgments This research was supported by a Marie Curie Intra-European Fellowship in the project "MED-AFFOREST" (PIEF-GA-2013-624974). E. Nadal-Romero was the recipient of a "Ramón y Cajal" postdoctoral contract (Spanish Ministry of Economy and Competitiveness).

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