Hydration and Cooling Practices Among Farmworkers in Oregon and Washington

PubMed Central

Bethel, Jeffrey W.; Spector, June T.; Krenz, Jennifer

2018-01-01

Objectives Although recommendations for preventing occupational heat-related illness among farmworkers include hydration and cooling practices, the extent to which these recommendations are universally practiced is unknown. The objective of this analysis was to compare hydration and cooling practices between farmworkers in Oregon and Washington. Methods A survey was administered to a purposive sample of Oregon and Washington farmworkers. Data collected included demographics, work history and current work practices, hydration practices, access and use of cooling measures, and headwear and clothing worn. Results Oregon farmworkers were more likely than those in Washington to consume beverages containing sugar and/or caffeine. Workers in Oregon more frequently reported using various cooling measures compared with workers in Washington. Availability of cooling measures also varied between the two states. Conclusions These results highlight the large variability between workers in two states regarding access to and use of methods to stay cool while working in the heat. PMID:28402203

Hydration and Cooling Practices Among Farmworkers in Oregon and Washington.

PubMed

Bethel, Jeffrey W; Spector, June T; Krenz, Jennifer

2017-01-01

Although recommendations for preventing occupational heat-related illness among farmworkers include hydration and cooling practices, the extent to which these recommendations are universally practiced is unknown. The objective of this analysis was to compare hydration and cooling practices between farmworkers in Oregon and Washington. A survey was administered to a purposive sample of Oregon and Washington farmworkers. Data collected included demographics, work history and current work practices, hydration practices, access and use of cooling measures, and headwear and clothing worn. Oregon farmworkers were more likely than those in Washington to consume beverages containing sugar and/or caffeine. Workers in Oregon more frequently reported using various cooling measures compared with workers in Washington. Availability of cooling measures also varied between the two states. These results highlight the large variability between workers in two states regarding access to and use of methods to stay cool while working in the heat.

Mission Impossible? Social Work Practice with Black Urban Youth Gangs.

ERIC Educational Resources Information Center

Fox, Jerry R.

1985-01-01

Describes the adaptation of social work practice skills to serve black urban youth gangs. Presents a model for practice which respects youths' right to self-determination and community needs. Model stages discussed include contact, rapport, setting goals, assigning roles, procuring resources, and evaluation. Model applicability is suggested. (NRB)

Listening to food workers: Factors that impact proper health and hygiene practice in food service

PubMed Central

Clegg Smith, Katherine; Neff, Roni A.; Pollack, Keshia M.; Ensminger, Margaret

2015-01-01

Background Foodborne disease is a significant problem worldwide. Research exploring sources of outbreaks indicates a pronounced role for food workers' improper health and hygiene practice. Objective To investigate food workers' perceptions of factors that impact proper food safety practice. Method Interviews with food service workers in Baltimore, MD, USA discussing food safety practices and factors that impact implementation in the workplace. A social ecological model organizes multiple levels of influence on health and hygiene behavior. Results Issues raised by interviewees include factors across the five levels of the social ecological model, and confirm findings from previous work. Interviews also reveal many factors not highlighted in prior work, including issues with food service policies and procedures, working conditions (e.g., pay and benefits), community resources, and state and federal policies. Conclusion Food safety interventions should adopt an ecological orientation that accounts for factors at multiple levels, including workers' social and structural context, that impact food safety practice. PMID:26243248

The advanced practice professionals' perspective: keys to a good working relationship between advanced practice professions and physicians.

PubMed

Polansky, Maura

2013-01-01

A strong working relationship between advanced practice professionals (APPs) and supervising oncologists is essential for reducing medical errors, retaining employees, and improving work environments. Although there is rather limited data on the unique relationship of the APP and physician, fundamental communication skills-including open communication, mutual respect, establishing expectations, and working with mutual purpose-should be the foundation of these relationships. This paper addresses various aspects of relationship building between APPs and physicians with suggestions for establishing successful working relationships.

Practicing as a Social Work Educator in International Collaboration

ERIC Educational Resources Information Center

Butterfield, Alice K., Ed.; Cohen, Carol S., Ed.

2017-01-01

The editors offer Six Promising Principles to guide successful practice by social work educators in international settings, including research, travel and study programs, technical assistance and training, and interdisciplinary efforts. These principles inform the content, which illuminates the specific role of U.S. social work educators in…

Attitudes toward working mothers: accommodating the needs of mothers in the work force.

PubMed

Albright, A

1992-10-01

More women, including mothers, are part of the work force than ever before. In the workplace, barriers often exist that restrict promotion and advancement of mothers. Mothers often are penalized in attempting to meet the demands of parent and worker roles. Parenting practices have been considered primarily the domain of mothers. However, nurturing may be done effectively by fathers or other motivated adults. Policies of employers must change to accommodate needs of families. Examples of supportive practices may include flexible working hours, parental leave, and on-site child care.

"Hand in Glove": Using Qualitative Methods to Connect Research and Practice.

PubMed

Harper, Liam D; McCunn, Robert

2017-08-01

Recent work has espoused the idea that in applied sporting environments, "fast"-working practitioners should work together with "slow"-working researchers. However, due to economical and logistical constraints, such a coupling may not always be practical. Therefore, alternative means of combining research and applied practice are needed. A particular methodology that has been used in recent years is qualitative research. Examples of qualitative methods include online surveys, 1-on-1 interviews, and focus groups. This article discusses the merits of using qualitative methods to combine applied practice and research in sport science. This includes a discussion of recent examples of the use of such methods in published journal articles, a critique of the approaches employed, and future directions and recommendations. The authors encourage both practitioners and researchers to use and engage with qualitative research with the ultimate goal of benefiting athlete health and sporting performance.

Career satisfaction of Pennsylvanian dentists and dental hygienists and their plans to leave direct patient care.

PubMed

Vick, Brandon

2016-03-01

The aim of this study is to explore a number of practice-related dynamics between dentists and dental hygienists, including their career dissatisfaction, plans to leave direct patient care, hiring difficulties, and full-time work. Data come from the 2013 Pennsylvania Health Workforce Surveys, a sample of 5,771 dentists and 6,023 dental hygienists, and logistic regression is used to estimate the relationships between outcome areas - dissatisfaction, plans to leave patient care, and hiring/job outcomes - and a number of explanatory variables, including demographic and practice characteristics. Dentists working in practices that employ hygienists have lower odds of reporting overall dissatisfaction and of leaving patient care in the next 6 years than those that do not employ hygienists. Dental hygienists that work full-time hours across two or more jobs have higher odds of dissatisfaction than those who work full-time in one job only. Part-time work in a single hygienist job is associated with higher odds of leaving the career, relative to having a single, full-time job. Results suggest that employment of dental hygienists is associated with lower career dissatisfaction and extended careers for dentists. However, a number of dentist characteristics are associated with difficulty hiring hygienists, including rural practice, nonwhite race, and solo ownership. Only 37.5 percent of hygienists work in a single, full-time job, an outcome related to lower dissatisfaction and extended careers for hygienists. Characteristics associated with this job outcome include having an associate degree, having a local anesthesia permit, and not working for a solo practice. © 2015 American Association of Public Health Dentistry.

[A Survey of the Perception of Nurses Toward the Practice Environment at a Regional Teaching Hospital in Central Taiwan].

PubMed

Hung, Jui-Tai; Lin, Ching-Wen; Wen, Wei-Chun; Lin, Esther Ching-Lan

2015-08-01

The nursing practice environment has been shown to wield significant influence on nursing retention and nursing quality of care. Because a large percentage of Taiwan nurses currently work at regional teaching hospitals, exploring the perception toward the practice environment of nurses working at this type of hospital is important. This study explored the perception of nurses working at a regional teaching hospital in central Taiwan toward their practice environment. A cross-sectional research design with a sample of 474 nurses from a regional hospital in central Taiwan was conducted. Instruments including the demographic data and the Chinese-version Practice Environment Scale-Nursing Work Index (CPES-NWI) were anonymously self-administered. Overall, participants were moderately satisfied with their practice environment, with the greatest dissatisfaction focused on staffing and resource adequacy. Work unit and nursing level, respectively, had significant impacts on perceptions regarding the practice environment. Furthermore, discriminant analysis identified two new compound variables: 1) adequate staffing resources and partnership in the workplace and 2) supportive administrative management environment. Participants who worked in medical and surgical units were significantly more dissatisfied with the adequacy of staffing resources and partnership in the workplace than participants who worked in acute/intensive and special units. Participants at the N2 level were significantly more dissatisfied with the supportive nature of the administrative management environment. These findings support that the nursing practice environment of regional hospitals may be improved using several measures, including: modifying the staffing and resource adequacy of nurses, fostering collaborative nurse-physician relationships, and further involving nurses in administrative management and decision-making.

Social Work's Role in Medicaid Reform: A Qualitative Study.

PubMed

Bachman, Sara S; Wachman, Madeline; Manning, Leticia; Cohen, Alexander M; Seifert, Robert W; Jones, David K; Fitzgerald, Therese; Nuzum, Rachel; Riley, Patricia

2017-12-01

To critically analyze social work's role in Medicaid reform. We conducted semistructured interviews with 46 stakeholders from 10 US states that use a range of Medicaid reform approaches. We identified participants using snowball and purposive sampling. We gathered data in 2016 and analyzed them using qualitative methods. Multiple themes emerged: (1) social work participates in Medicaid reform through clinical practice, including care coordination and case management; (2) there is a gap between social work's practice-level and systems-level involvement in Medicaid innovations; (3) factors hindering social work's involvement in systems-level practice include lack of visibility, insufficient clarity on social work's role and impact, and too few resources within professional organizations; and (4) social workers need more training in health transformation payment models and policy. Social workers have unique skills that are valuable to building health systems that promote population health and reduce health inequities. Although there is considerable opportunity for social work to increase its role in Medicaid reform, there is little social work involvement at the systems level.

25 tips for working through language and cultural barriers in your medical practice.

PubMed

Hills, Laura Sachs

2009-01-01

The language and cultural barriers facing medical patients with limited English language proficiency pose tremendous challenges and risks. Moreover, medical practices today are more likely than ever to employ individuals whose first language is not English or who do not possess native-like knowledge of American culture. Knowing how to work through the language and cultural barriers you are likely to encounter in your medical practice has become increasingly more important. This article is written by a practice management consultant who has graduate-level linguistics training and second-language teaching credentials and experience. It offers 25 practical tips to help you communicate more effectively with individuals who are outside of your native culture and language. These include easy-to-implement tips about English language pronunciation, grammar, and word choice. This article also suggests what you can do personally to bridge the cultural divide with your patients and co-workers. Finally, this article includes a case study of one Virginia practice in which cultural differences interfered with the practice's smooth operation. It explains how the practice eventually worked through and overcame this cultural obstacle.

Social work practice in the digital age: therapeutic e-mail as a direct practice methodology.

PubMed

Mattison, Marian

2012-07-01

The author addresses the risks and benefits of incorporating therapeutic e-mail communication into clinical social work practice. Consumer demand for online clinical services is growing faster than the professional response. E-mail, when used as an adjunct to traditional meetings with clients, offers distinct advantages and risks. Benefits include the potential to reach clients in geographically remote and underserved communities, enhancing and extending the therapeutic relationship and improving treatment outcomes. Risks include threats to client confidentiality and privacy, liability coverage for practitioners, licensing jurisdiction, and the lack of competency standards for delivering e-mail interventions. Currently, the social work profession does not have adequate instructive guidelines and best-practice standards for using e-mail as a direct practice methodology. Practitioners need (formal) academic training in the techniques connected to e-mail exchanges with clients. The author describes the ethical and legal risks for practitioners using therapeutic e-mail with clients and identifies recommendations for establishing best-practice standards.

Work Activities and Compensation of Male and Female Cardiologists.

PubMed

Jagsi, Reshma; Biga, Cathie; Poppas, Athena; Rodgers, George P; Walsh, Mary N; White, Patrick J; McKendry, Colleen; Sasson, Joseph; Schulte, Phillip J; Douglas, Pamela S

2016-02-09

Much remains unknown about experiences, including working activities and pay, of women in cardiology, which is a predominantly male specialty. The goal of this study was to describe the working activities and pay of female cardiologists compared with their male colleagues and to determine whether sex differences in compensation exist after accounting for differences in work activities and other characteristics. The personal, job, and practice characteristics of a national sample of practicing cardiologists were described according to sex. We applied the Peters-Belson technique and multivariate regression analysis to evaluate whether gender differences in compensation existed after accounting for differences in other measured characteristics. The study used 2013 data reported by practice administrators to MedAxiom, a subscription-based service provider to cardiology practices. Data regarding cardiologists from 161 U.S. practices were included, and the study sample included 2,679 subjects (229 women and 2,450 men). Women were more likely to be specialized in general/noninvasive cardiology (53.1% vs. 28.2%), and a lower proportion (11.4% vs. 39.3%) reported an interventional subspecialty compared with men. Job characteristics that differed according to sex included the proportion working full-time (79.9% vs. 90.9%; p < 0.001), the mean number of half-days worked (387 vs. 406 days; p = 0.001), and mean work relative value units generated (7,404 vs. 9,497; p < 0.001) for women and men, respectively. Peters-Belson analysis revealed that based on measured job and productivity characteristics, the women in this sample would have been expected to have a mean salary that was $31,749 (95% confidence interval: $16,303 to $48,028) higher than that actually observed. Multivariate analysis confirmed the direction and magnitude of the independent association between sex and salary. Men and women practicing cardiology in this national sample had different job activities and salaries. Substantial sex-based salary differences existed even after adjusting for measures of personal, job, and practice characteristics. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Knowledge diffusion in social work: a new approach to bridging the gap.

PubMed

Herie, Marilyn; Martin, Garth W

2002-01-01

The continuing gap between research and practice has long been a problem in social work. A great deal of the empirical practice literature has emphasized practice evaluation (usually in the form of single-case methodologies) at the expense of research dissemination and utilization. An alternative focus for social work researchers can be found in the extensive theoretical and research literature on knowledge diffusion, technology transfer, and social marketing. Knowledge diffusion and social marketing theory is explored in terms of its relevance to social work education and practice, including a consideration of issues of culture and power. The authors present an integrated dissemination model for social work and use a case example to illustrate the practical application of the model. The OPTIONS (OutPatient Treatment In ONtario Services) project is an example of the effective dissemination of two research-based addiction treatment modalities to nearly 1,000 direct practice clinicians in Ontario, Canada.

Culturally sensitive social work practice with Arab clients in mental health settings.

PubMed

al-Krenawi, A; Graham, J R

2000-02-01

Several culturally specific practical considerations should inform social work interventions with ethnic Arab peoples in Arab countries or in Western nations. These include taking into account gender relations, individuals' places in their families and communities, patterns of mental health services use, and, for practice in Western nations, the client's level of acculturation. Such aspects provide the basis for specific guidelines in working with ethnic Arab mental health clients. These include an emphasis on short-term, directive treatment; communication patterns that are passive and informal; patients' understanding of external loci of control and their use of ethnospecific idioms of distress; and, where appropriate, the integration of modern and traditional healing systems.

Grading Written Work: An Integral Part of Writing Workshop Practice

ERIC Educational Resources Information Center

Robbins, Kristen

2011-01-01

This article chronicles how the process of reviewing and grading student written work became an integral part of a middle school teacher's writing workshop practice. In addition to discussing how reading student work can bring educators back to the heart of the profession (including the belief that spending time with drafts can reap more rewards…

School-to-Work: Elements of Successful Programs.

ERIC Educational Resources Information Center

Wehman, Paul

1990-01-01

Critical elements and best practices in school-to-work transition programs for disabled youth are identified. Noted are local factors, individual student choice, shared resources, vocational rehabilitation counselors in the schools, and school-business linkages. Best practices include individualized transition planning, community-based…

Teaching Strategies for Improving Algebra Knowledge in Middle and High School Students. Educator's Practice Guide. What Works Clearinghouse.™ NCEE 2015-4010

ERIC Educational Resources Information Center

Star, Jon R.; Foegen, Anne; Larson, Matthew R.; McCallum, William G.; Porath, Jane; Zbiek, Rose Mary; Caronongan, Pia; Furgeson, Joshua,; Keating, Betsy; Lyskawa, Julia

2015-01-01

Mastering algebra is important for future math and postsecondary success. Educators will find practical recommendations for how to improve algebra instruction in the What Works Clearinghouse (WWC) practice guide, "Teaching Strategies for Improving Algebra Knowledge in Middle and High School Students". The methods and examples included in…

How do general practitioners contribute to preventing long-term work disability of their patients suffering from depressive disorders? A qualitative study.

PubMed

Sylvain, Chantal; Durand, Marie-José; Maillette, Pascale; Lamothe, Lise

2016-06-07

Depression is a major cause of work absenteeism that general practitioners (GPs) face directly since they are responsible for sickness certification and for supervising the return to work (RTW). These activities give GPs a key role in preventing long-term work disability, yet their practices in this regard remain poorly documented. The objectives of this study were therefore to describe GPs' practices with people experiencing work disability due to depressive disorders and explore how GPs' work context may impact on their practices. We conducted semi-structured individual interviews with 13 GPs and six mental healthcare professionals in two sub-regions of Quebec. The sub-regions differed in terms of availability of specialized resources offering public mental health services. Data were anonymized and transcribed verbatim. Thematic analysis was performed to identify patterns in the GPs' practices and highlight impacting factors in their work context. Our results identified a set of practices common to all the GPs and other practices that differentiated them. Two profiles were defined on the basis of the various practices documented. The first is characterized by the integration of the RTW goal into the treatment goal right from sickness certification and by interventions that include the workplace, albeit indirectly. The second is characterized by a lack of early RTW-oriented action and by interventions that include little workplace involvement. Regardless of the practice profile, actions intended to improve collaboration with key stakeholders remain the exception. However, two characteristics of the work context appear to have an impact: the availability of a dedicated mental health nurse and the regular provision of clinical information by psychotherapists. These conditions are rarely present but tend to make a significant difference for the GPs. Our results highlight the significant role of GPs in the prevention of long-term work disability and their need for support through the organization of mental health services at the primary care level.

Top-of-License Nursing Practice: Describing Common Nursing Activities and Nurses' Experiences That Hinder Top-of-License Practice, Part 1.

PubMed

Buck, Jacalyn; Loversidge, Jacqueline; Chipps, Esther; Gallagher-Ford, Lynn; Genter, Lynne; Yen, Po-Yin

2018-05-01

The aims of this study were to describe nurses' perceptions of nursing activities and analyze for consistency with top-of-license (TOL) practice. The Advisory Board Company expert panel proposed 8 TOL core nursing responsibilities representing practice at its potential. Thus far, no empirical work has examined nursing practices relative to TOL, from staff nurses' points of view. This qualitative study used focus groups to explore perceptions of typical nursing activities. We analyzed activities for themes that described nurses' work during typical shifts. Nurses' full scope of work included TOL-consistent categories, as well as categories that did not exemplify TOL practice, such as nonnursing care. A proposed model was developed, which depicts nurses' total scope of work, inclusive of all activity categories. In addition, hindrances to TOL practice were also identified. Findings from this study can inform leadership imperatives and the development of innovative, sustainable nursing practice models that support nursing practice at TOL.

Checklist Model to Improve Work Practices in Small-Scale Demolition Operations with Silica Dust Exposures

PubMed Central

Muianga, Custodio; Rice, Carol; Lentz, Thomas; Lockey, James; Niemeier, Richard; Succop, Paul

2012-01-01

A systematic approach was developed to review, revise and adapt existing exposure control guidance used in developed countries for use in developing countries. One-page employee and multiple-page supervisor guidance sheets were adapted from existing documents using a logic framework and workers were trained to use the information to improve work practices. Interactive, hands-on training was delivered to 26 workers at five small-scale demolition projects in Maputo City, Mozambique, and evaluated. A pre-and-post walkthrough survey used by trained observers documented work practice changes. Worker feedback indicated that the training was effective and useful. Workers acquired knowledge (84% increase, p < 0.01) and applied the work practice guidance. The difference of proportions between use of work practice components before and after the intervention was statistically significant (p < 0.05). Changes in work practices following training included preplanning, use of wet methods and natural ventilation and end-of-task review. Respirable dust measurements indicated a reduction in exposure following training. Consistency in observer ratings and observations support the reliability and validity of the instruments. This approach demonstrated the short-term benefit of training in changing work practices; follow-up is required to determine the long-term impact on changes in work practices, and to evaluate the need for refresher training. PMID:22470296

The Development of Vaccination and the Discoveries of Louis Pasteur.

ERIC Educational Resources Information Center

Williams, James

1992-01-01

Describes the development of vaccination and provides a brief biographical sketch of the life and work of Pasteur. Describes historical practices related to vaccination before Pasteur did his work, including variolation as practiced by the ancient Chinese and Jenner's use of smallpox. (PR)

29 CFR 1990.146 - Issues to be considered in the rulemaking.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of substances subject to the rulemaking meets the definition of a potential occupational carcinogen... engineering and work practice controls including technological and economic considerations. (j) The... engineering and work practice controls and other issues relevant to substitution; and (l) Whether the...

Video observation in HIT development: lessons learned on benefits and challenges.

PubMed

Høstgaard, Anna Marie; Bertelsen, Pernille

2012-08-22

Experience shows that the precondition for the development of successful health information technologies is a thorough insight into clinical work practice. In contemporary clinical work practice, clinical work and health information technology are integrated, and part of the practice is tacit. When work practice becomes routine, it slips to the background of the conscious awareness and becomes difficult to recognize without the context to support recall. This means that it is difficult to capture with traditional ethnographic research methods or in usability laboratories or clinical set ups. Observation by the use of the video technique within healthcare settings has proven to be capable of providing a thorough insight into the complex clinical work practice and its context - including parts of the tacit practice. The objective of this paper is 1) to argue for the video observation technique to inform and improve health-information-technology development and 2) to share insights and lessons learned on benefits and challenges when using the video observation technique within healthcare settings. A multiple case study including nine case studies conducted by DaCHI researchers 2004-2011 using audio-visual, non-participant video observation for data collection within different healthcare settings. In HIT development, video observation is beneficial for 1) informing and improving system design 2) studying changes in work practice 3) identifying new potentials and 4) documenting current work practices. The video observation technique used within healthcare settings is superior to other ethnographic research methods when it comes to disclosing the complexity in clinical work practice. The insights gained are far more realistic compared to traditional ethnographic studies or usability studies and studies in clinical set ups. Besides, the data generated through video recordings provide a solid basis for dialog between the health care professionals involved. The most important lessons learned are that a well considered methodology and clear formulated objectives are imperative, in order to stay focused during the data rich analysis phase. Additionally, the video observation technique is primarily recommended for studies of specific clinical work practices within delimited clinical settings. Overall, the video observation technique has proven to be capable of improving our understanding of the interwoven relation between clinical work practice and HIT and to inform us about user requirements and needs for HIT, which is a precondition for the development of more successful HIT systems in the future.

The Practice Environment Scale of the Nursing Work Index: An updated review and recommendations for use.

PubMed

Swiger, Pauline A; Patrician, Patricia A; Miltner, Rebecca S Susie; Raju, Dheeraj; Breckenridge-Sproat, Sara; Loan, Lori A

2017-09-01

The Practice Environment Scale of the Nursing Work Index (PES-NWI) is an instrument, which measures the nursing practice environment - defined as factors that enhance or attenuate a nurse's ability to practice nursing skillfully and deliver high quality care. The purpose of this paper is to provide an updated review of the Practice Environment Scale of the Nursing Work Index's use to date and provide recommendations that may be helpful to nursing leaders and researchers who plan to use this instrument. A narrative review of quantitative studies. PubMed, EMBASE, and the Cumulative Index to Nursing & Allied Health Literature were searched to identify relevant literature using the search terms, Practice Environment Scale of the Nursing Work Index and PES-NWI. Studies were included if they were published in English between 2010 and 2016 and focused on the relationship between the Practice Environment Scale of the Nursing Work Index and patient, nurse, or organizational outcomes. Data extraction focused on the reported survey scores and the significance and strength of the reported associations. Forty-six articles, from 28 countries, were included in this review. The majority reported significant findings between the nursing practice environment and outcomes. Although some modifications have been made, the instrument has remained primarily unchanged since its development. Most often, the scores regarding staffing and resource adequacy remained the lowest. The frequency of use of this instrument has remained high. Many researchers advocate for a move beyond the study of the connection between the Practice Environment Scale and nurse, patient, and organizational outcomes. Research should shift toward identifying interventions that improve the environment in which nurses practice and determining if changing the environment results in improved care quality. Published by Elsevier Ltd.

Work of female rural doctors.

PubMed

Wainer, Jo

2004-04-01

To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. General and specialist practice. Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3-7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Interaction of hours and type of work with family responsibilities. Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for on-call and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. Women make up less than a quarter of the rural general practice workforce and an even smaller percentage of the specialist rural medical workforce. As a result their experiences are not well articulated in research on rural medical practice and their needs are not well represented in policies and programs for rural doctors. The incoming cohort of rural general practitioners has a majority of women and it is essential that the practice styles and needs of women doctors are understood in order to attract and retain women in rural medicine. This survey identifies some of the effects of family responsibilities on the work practices of female rural doctors and the changes needed to the structure of rural practice to include the way women work.

Ready to work or not quite? Self-perception of practical skills among medical students from Serbia ahead of graduation.

PubMed

Gazibara, Tatjana; Nurković, Selmina; Marić, Gorica; Kurtagić, Ilma; Kovačević, Nikolina; Kisić-Tepavčević, Darija; Pekmezović, Tatjana

2015-08-01

To assess final year medical students' self-perception of their practical skills. The study was conducted at the Faculty of Medicine in Belgrade during compulsory practical sessions in the period December 2-9, 2013 and 390 students agreed to participate (response rate 77.8%). The questionnaire included questions on demographic characteristics, 21 questions on students' self-perception of their practical skills, and 1 question on students' self-perceived readiness to start working with patients. Cronbach's α for the entire scale was 0.891. Students felt most confident about measuring arterial pulse and blood pressure and taking patients' history (average score 10 for all three skills) and least confident about placing a urinary catheter (average score 1) and suturing a wound (average score 2). They rated their readiness to work with patients with 5.0 out of 10.0 points. The total score did not correlate with students' average mark (Spearman's ρ=0.039; P=0.460) and the average mark did not correlate with the self-perceived readiness to work with patients (Spearman's ρ=-0.048; P=0.365). Our study suggests that medical students lack confidence to perform various clinical procedures, particularly those related to surgical interventions. To improve students' confidence, clinical curriculum should include either more hours of practical work or ensure closer supervision of practical training in wards.

Social Work Practice with LGBT Elders at End of Life: Developing Practice Evaluation and Clinical Skills Through a Cultural Perspective.

PubMed

Arthur, Darren P

2015-01-01

This article focuses on culturally sensitive clinical issues related to best practices with lesbian, gay, bisexual, transgender (LGBT) elder patients at end-of-life (EOL) at key points in the therapeutic relationship. Vital concepts, including practice evaluation and clinical skills, are presented through a cultural and oncology lens. There is a paucity of LGBT research and literature as well as a shortfall of MSW graduate school education specific to social work palliative and end-of-life care (PELC) practice with LGBT elders. The content of this article is designed to be adapted and used as an educational tool for institutions, agencies, graduate programs, medical professions, social work, and students. Learning the unique elements of LGBT cultural history and their implications on EOL care can improve social work practice. This article provides an examination from assessment and engagement basics to advance care planning incorporating specific LGBT EOL issues.

Work engagement in nursing practice: a relational ethics perspective.

PubMed

Keyko, Kacey

2014-12-01

The concept of work engagement has existed in business and psychology literature for some time. There is a significant body of research that positively correlates work engagement with organizational outcomes. To date, the interest in the work engagement of nurses has primarily been related to these organizational outcomes. However, the value of work engagement in nursing practice is not only an issue of organizational interest, but of ethical interest. The dialogue on work engagement in nursing must expand to include the ethical importance of engagement. The relational nature of work engagement and the multiple levels of influence on nurses' work engagement make a relational ethics approach to work engagement in nursing appropriate and necessary. Within a relational ethics perspective, it is evident that work engagement enables nurses to have meaningful relationships in their work and subsequently deliver ethical care. In this article, I argue that work engagement is essential for ethical nursing practice. If engagement is essential for ethical nursing practice, the environmental and organizational factors that influence work engagement must be closely examined to pursue the creation of moral communities within healthcare environments. © The Author(s) 2014.

40 CFR 63.7505 - What are my general requirements for complying with this subpart?

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission limits (including operating limits) and the work practice standards in this subpart at all times... you have an applicable emission limit or work practice standard, you must develop a written startup... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR...

Factors Affecting Social Workers' Inclusion of Animals in Practice

ERIC Educational Resources Information Center

Risley-Curtiss, Christina; Rogge, Mary E.; Kawam, Elisa

2013-01-01

Experts suggest that social work practitioners can improve their client service with a more thorough understanding of the impact of other animals on individuals and families. Studies indicate that some social work practitioners are including animals in their practices through assessment and interventions. Little is known about what factors…

40 CFR 745.86 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... that no pregnant woman resides there, a declaration that the housing is not a child-occupied facility... the work practices to be used during the renovation will not necessarily include all of the lead-safe work practices contained in EPA's renovation, repair, and painting rule, the signature of the owner...

Civilian Social Work: Serving the Military and Veteran Populations

ERIC Educational Resources Information Center

Savitsky, Laura; Illingworth, Maria; DuLaney, Megan

2009-01-01

This article discusses social work practice areas for civilian social workers who provide services to military service members, veterans, and their families. These practice areas include education, child welfare, domestic violence, mental health, health care, substance abuse, and criminal justice. The authors examine the impact of the contemporary…

Artists Comment on Museum Practices.

ERIC Educational Resources Information Center

Kanatani, Kim; Prabhu, Vas

1996-01-01

Presents three works of art that examine issues of exhibition, display, culture, and access in contemporary museum practices. The works include four black mannequins dressed as security guards, a room-size installation consisting solely of objects related to the artist, and a poster highlighting the general exclusion of women artists. (MJP)

A review of best work-absence management and return-to-work practices for workers with musculoskeletal or common mental disorders.

PubMed

Durand, Marie-José; Corbière, Marc; Coutu, Marie-France; Reinharz, Daniel; Albert, Valérie

2014-01-01

Workplace absenteeism is still a curse for developed countries, and more systematic practices need to be adopted to address this issue. To review the literature on best practices for managing work absences related to musculoskeletal or common mental disorders. A review was conducted by performing a search in bibliographic databases and on work-disability research institute websites. Recommendations regarding work-absence management and return-to-work practices were extracted from all the retained documents and organized within a chronological framework. In total, 17 documents were analyzed, leading to identification of common work-absence management and return-to-work practices, the importance of a worker support approach, and recommended roles and responsibilities for stakeholders. These practices were then integrated into a six-step process: (1) time off and recovery period; (2) initial contact with the worker; (3) evaluation of the worker and his job tasks; (4) development of a return-to-work plan with accommodations; (5) work resumption, and (6) follow-up of the return-to-work process. Based on this review, we constructed a comprehensive work-absence management and return-to-work process designed to assist organizations. Our results indicate that such a process must be included within a broader policy of health promotion and job retention. Adaptations will be required for implementation in the workplace.

Developing nursing practice through work-based learning.

PubMed

Clarke, David J; Copeland, Lisa

2003-12-01

Developing nursing practice in any area demands skills, knowledge, support and a long term commitment to the achievement of best practice. It is easy to become overwhelmed by the competing demands for client care and service delivery. It is not always easy to see how good ideas, clinical concerns and professionally led objectives, can be realised in practice. Ongoing professional development activities, including formal educational programmes can contribute to individual staff members' ability to take on practice development projects. Too often however, educational programmes are seen as making little real difference to clinical practice. Work-based learning, a relatively new approach in higher education in the United Kingdom, presents opportunities for Universities and healthcare providers to work in partnership to realise the shared aims of developing nursing practice. Specific examples, drawn from the personal experiences of one of the authors, will examine the contribution of a work-based learning approach to integrating learning and developing practice in the field of cancer care. The work-based learning approach can bring about tangible benefits for patients, practitioners and organisations, but only if the organisational and contextual factors which impact on practice and its development are properly considered and managed through effective partnerships.

Development of roles for occupational therapists and physiotherapists in work related practice: An Australian perspective.

PubMed

Adam, Kerry; Gibson, Elizabeth; Lyle, Alexandra; Strong, Jenny

2010-01-01

This paper will explore the development of occupational therapists' and physiotherapists' roles in work related practice from an early focus on rehabilitation of injured workers, to one including prevention and health promotion. A review of international evidence identified the roles, tasks and employment paths for occupational therapists and physiotherapists in work related practice. The relationship between government regulation and therapists' access to the workplace was also examined. Occupational therapists and physiotherapists hold valued positions in work related professional practice. Whilst initially their roles were based on injury management through occupational rehabilitation, both professions have demonstrated a clear vision of the importance of prevention of work related injury and disease. Social and workplace changes in the late 1970s in a number of western countries, commencing with the Robens' reforms in the United Kingdom, led to improved legislation and regulation for managing occupational health and safety. The approach of both disciplines to practice in this field reflects their individual professional education. However, some role overlaps exists in consultancy activities in the industrial environment. Implementation of modern OHS regulatory programs in other western countries, including Australia, has increased and broadened the opportunities for therapists, as governments, employers and insurers support early intervention to minimise the impact of workplace injuries and diseases.

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-01-01

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

Engaging Youth in Work Experiences. Innovative Strategies Practice Brief. Issue 2

ERIC Educational Resources Information Center

Larson, Mindy

2011-01-01

Work experiences are a critical component of preparing youth for transition to adulthood. Potential benefits for youth who participate in work experiences include: 1) gaining career readiness skills including the "soft skills" that employers look for in entry level workers; 2) increasing one's knowledge of specific occupational skills…

Working appreciatively to improve services for children and families.

PubMed

Onyett, Steve

2009-10-01

Service improvement approaches are described that specifically focus on appreciating the positive that individuals bring to contexts related to children and family services. This includes application of Solution-Focused approaches, Appreciative Inquiry and other approaches that promote a positive emotional climate and focus on what works. Their conceptual foundations are explored and particularly their value in supporting working well with complex adaptive systems. Specific applications described include leadership and management practice, work in school settings, engaging clinicians in healthcare improvement, establishing clinical networks, work with homeless youth, child protection and approaches to drawing out best practice and community development. The theme that unites is a focus on developing effective relationships at all levels and a pragmatic focus on what works so that we can find opportunities to do more of it.

Aerospace Industries Association (AIA) work practices report for composites

NASA Technical Reports Server (NTRS)

Luca, Jackie

1994-01-01

In an effort to gain a better understanding of effective safety and health work practice controls for composite manufacturing operations, the Aerospace Industries Association (AIA) Occupational Safety and Health Committee established a Composites Task Group. The group's task was to provide AIA members with recommendations for minimizing occupational exposure risk and to determine research needs and information gaps. The strategy included a review of toxicological information on composites, a review of member company experience and control methods, and interaction with other professional organizations who share an interest in composite work practices.

Retaining vets in farm animal practice: a cross-sectional study.

PubMed

Adam, K; Baillie, S; Rushton, J

2015-06-20

Concerns have been raised about a potential shortage of farm animal vets in the UK. There is no apparent lack of new graduates willing to work with farm animals, but practices report difficulties in recruiting and retaining experienced farm animal vets. Retention of vets in farm animal practice has been identified as a key issue for the sustainability of veterinary businesses and livestock health. A cross-sectional study design was used to identify factors associated with vets remaining in farm animal practice. Data were collected via an online questionnaire covering employment, education, personal background and future plans. The target population was vets with experience of farm animal work in the UK. 380 responses were included in the analysis. Working in a practice where accommodation was provided and an increasing number of years since graduation were associated with significantly lower odds of remaining in farm animal practice, while working in a practice where staff appraisals were carried out; coming from a family with a commercial farm; spending more time on farm work and being on call with an experienced vet in the first job after graduation increased the odds of remaining in farm work. Gender was not significantly associated with retention. British Veterinary Association.

Hotel housekeeping work influences on hypertension management.

PubMed

Sanon, Marie-Anne

2013-12-01

Characteristics of hotel housekeeping work increase the risk for hypertension development. Little is known about the influences of such work on hypertension management. For this qualitative study, 27 Haitian immigrant hotel housekeepers from Miami-Dade County, FL were interviewed. Interview transcripts were analyzed with the assistance of the Atlas.ti software for code and theme identification. Influences of hotel housekeeping work on hypertension management arose both at the individual and system levels. Factors at the individual level included co-worker dynamics and maintenance of transmigrant life. Factors at the system level included supervisory support, workload, work pace, and work hiring practices. No positive influences were reported for workload and hiring practices. Workplace interventions may be beneficial for effective hypertension management among hotel housekeepers. These work influences must be considered when determining effective methods for hypertension management among hotel housekeepers. © 2013 Wiley Periodicals, Inc.

10 CFR 4.13 - Employment practices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... its employment practices under such program (including recruitment or recruitment advertising... commencement or continuation of their education or training, or (2) to provide work experience which...

Social Work Field Instructors' Integration of Religion and Spirituality in Clinical Practice

ERIC Educational Resources Information Center

Oxhandler, Holly K.

2017-01-01

This article describes a national sample of social work field instructors' responses to a cross-sectional survey of social workers' orientation toward integrating clients' religion and spirituality into practice and compares their responses with those of nonfield instructors. Four hundred sixty-nine social workers, including 69 MSW field…

Reclaiming and Reimagining Macro Social Work Education: A Collective Biography

ERIC Educational Resources Information Center

Netting, F. Ellen; O'Connor, Mary Katherine; Cole, Portia L.; Hopkins, Karen; Jones, Jenny L.; Kim, Youngmi; Leisey, Monica; Mulroy, Elizabeth A.; Rotabi, Karen Smith; Thomas, M. Lori; Weil, Marie O.; Wike, Traci L.

2016-01-01

The authors focus on a collective biography of 12 women social work educators, all either tenured or in tenure lines, from five different universities at the time of the study. The participants represent several aspects of macro practice including administration, planning, community practice, and policy. Beginning with reflections about coming…

40 CFR 65.3 - Compliance with standards and operation and maintenance requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

...)(4)(i) and (ii) do not apply to Group 2A or Group 2B process vents. Compliance with design, equipment, work practice, and operational standards, including those for equipment leaks, shall be determined... this part. (5) Design, equipment, work practice, or operational standards. Paragraphs (b)(5)(i) and (ii...

Supporting children with disabilities at school: implications for the advocate role in professional practice and education

PubMed Central

Ng, Stella L.; Lingard, Lorelei; Hibbert, Kathryn; Regan, Sandra; Phelan, Shanon; Stooke, Rosamund; Meston, Christine; Schryer, Catherine; Manamperi, Madhushani; Friesen, Farah

2015-01-01

Abstract Purpose: School settings are a common practice context for rehabilitation professionals; health advocacy is a common and challenging practice role for professionals in this context. This study explored how pediatric practitioners advocate for children with disabilities at school. Specifically, we examined everyday advocacy in the context of school-based support for children with disabilities. Method: Our theoretical framework and methodological approach were informed by institutional ethnography, which maps and makes visible hidden social coordinators of work processes with a view to improving processes and outcomes. We included families, educators, and health/rehabilitation practitioners from Ontario. Of the 37 consented informants, 27 were interviewed and 15 observed. Documents and texts were collected from the micro-level (e.g. clinician reports) and the macro-level (e.g. policies). Results: Pediatric practitioners' advocacy work included two main work processes: spotlighting invisible disabilities and orienteering the special education terrain. Practitioners advocated indirectly, by proxy, with common proxies being documents and parents. Unintended consequences of advocacy by proxy included conflict and inefficiency, which were often unknown to the practitioner. Conclusions: The findings of this study provide practice-based knowledge about advocacy for children with disabilities, which may be used to inform further development of competency frameworks and continuing education for pediatric practitioners. The findings also show how everyday practices are influenced by policies and social discourses and how rehabilitation professionals may enact change.Implications for RehabilitationRehabilitation professionals frequently perform advocacy work. They may find it beneficial to perform advocacy work that is informed by overarching professional and ethical guidelines, and a nuanced understanding of local processes and structures.Competency frameworks and education for pediatric rehabilitation professionals may be improved by: encouraging professionals to consider how their practices, including their written documents, may affect parental burden, (mis)interpretation by document recipients, and potential unintended consequences.Policies and texts, e.g. privacy legislation and the Diagnostic and Statistical Manual (DSM), influence rehabilitation professionals' actions and interactions when supporting children with disabilities at school.An awareness of the influence of policies and texts may enable practitioners to work more effectively within current systems when supporting individuals with disabilities. PMID:25738906

Hallmarks of the Professional Nursing Practice Environment. AACN White Paper.

ERIC Educational Resources Information Center

Journal of Professional Nursing, 2002

2002-01-01

This white paper from the American Association of Colleges of Nursing depicts the current environment of nursing practice, including supply and demand. It describes work environments that support professional practice and outlines eight indicators for the practice environment. Contains 48 references and an appendix with suggested questions for…

Preparing Current and Future Practitioners to Integrate Research in Real Practice Settings

ERIC Educational Resources Information Center

Thyer, Bruce A.

2015-01-01

Past efforts aimed at promoting a better integration between research and practice are reviewed. These include the empirical clinical practice movement (ECP), originating within social work; the empirically supported treatment (EST) initiative of clinical psychology; and the evidence-based practice (EBP) model developed within medicine. The…

Service user integration into social work education: lessons learned from nordic participatory action projects.

PubMed

Angelin, Anna

2015-01-01

Service users have lacked substantial influence, access, and participation in social work education in Norway and Sweden. In this article the author presents comparative analyses of two participatory projects that have developed and implemented practices that integrate service users into academic social work education and empower service users. The Norwegian HUSK project and the Social Work as Mobilization and Entrepreneurship course, also known as the "Mobilization course," at Lund University in Sweden demonstrate collaboration between research, social work education, and service users. The conclusions focus on the importance of the empowering processes by including recognition and dialogue, co-learning in practice, and the use of neutral venues to ensure effective user participation. The inclusion of service users in social work education can improve both practice and education.

Computer ergonomics: the medical practice guide to developing good computer habits.

PubMed

Hills, Laura

2011-01-01

Medical practice employees are likely to use computers for at least some of their work. Some sit several hours each day at computer workstations. Therefore, it is important that members of your medical practice team develop good computer work habits and that they know how to align equipment, furniture, and their bodies to prevent strain, stress, and computer-related injuries. This article delves into the field of computer ergonomics-the design of computer workstations and work habits to reduce user fatigue, discomfort, and injury. It describes practical strategies medical practice employees can use to improve their computer work habits. Specifically, this article describes the proper use of the computer workstation chair, the ideal placement of the computer monitor and keyboard, and the best lighting for computer work areas and tasks. Moreover, this article includes computer ergonomic guidelines especially for bifocal and progressive lens wearers and offers 10 tips for proper mousing. Ergonomically correct posture, movements, positioning, and equipment are all described in detail to enable the frequent computer user in your medical practice to remain healthy, pain-free, and productive.

The Five Attributes of a Supportive Midwifery Practice Climate: A Review of the Literature.

PubMed

Thumm, E Brie; Flynn, Linda

2018-01-01

A supportive work climate is associated with decreased burnout and attrition, and increased job satisfaction and employee health. A review of the literature was conducted in order to determine the unique attributes of a supportive practice climate for midwives. The midwifery literature was reviewed and synthesized using concept analysis technique guided by literature from related professions. The search was conducted primarily in PubMed, CINAHL, Web of Science, and Google Scholar. Articles were included if they were conducted between 2006 and 2016 and addressed perceptions of the midwifery practice climate as it related to patient, provider, and organizational outcomes. The literature identified 5 attributes consistent with a supportive midwifery practice climate: effective leadership, adequate resources, collaboration, control of one's work, and support of the midwifery model of care. Effective leadership styles include situational and transformational, and 9 traits of effective leaders are specified. Resources consist of time, personnel, supplies, and equipment. Collaboration encompasses relationships with all members of the health care team, including midwives inside and outside of one's practice. Additionally, the patients are considered collaborating members of the team. Characteristics of effective collaboration include a shared vision, role clarity, and respectful communication. Support for the midwifery model of care includes value congruence, developing relationships with women, and providing high-quality care. The attributes of a supportive midwifery practice climate are generally consistent with theoretical models of supportive practice climates of advanced practice nurses and physicians, with the exception of a more inclusive definition of collaboration and support of the midwifery model of care. The proposed Midwifery Practice Climate Model can guide instrument development, determining relationships between the attributes of the practice climate and outcomes, and creating interventions to improve the practice climate, workforce stability, and patient outcomes. © 2018 by the American College of Nurse-Midwives.

Hotel Housekeeping Work Influences on Hypertension Management

PubMed Central

Sanon, Marie-Anne

2013-01-01

Background Characteristics of hotel housekeeping work increase the risk for hypertension development. Little is known about the influences of such work on hypertension management. Methods For this qualitative study, 27 Haitian immigrant hotel housekeepers from Miami-Dade County, FL were interviewed. Interview transcripts were analyzed with the assistance of the Atlas. ti software for code and theme identification. Results Influences of hotel housekeeping work on hypertension management arose both at the individual and system levels. Factors at the individual level included co-worker dynamics and maintenance of transmigrant life. Factors at the system level included supervisory support, workload, work pace, and work hiring practices. No positive influences were reported for workload and hiring practices. Conclusions Workplace interventions may be beneficial for effective hypertension management among hotel housekeepers. These work influences must be considered when determining effective methods for hypertension management among hotel housekeepers. PMID:23775918

Interprofessional practices of physiotherapists working with adults with low back pain in Québec’s private sector: results of a qualitative study

PubMed Central

2014-01-01

Background Collaboration and interprofessional practices are highly valued in health systems, because they are thought to improve outcomes of care for persons with complex health problems, such as low back pain. Physiotherapists, like all health providers, are encouraged to take part in interprofessional practices. However, little is known about these practices, especially for private sector physiotherapists. This study aimed to: 1) explore how physiotherapists working in the private sector with adults with low back pain describe their interprofessional practices, 2) identify factors that influence their interprofessional practices, and 3) identify their perceived effects. Methods Participants were 13 physiotherapists, 10 women/3 men, having between 3 and 21 years of professional experience. For this descriptive qualitative study, we used face-to-face semi-structured interviews and conducted content analysis encompassing data coding and thematic regrouping. Results Physiotherapists described interprofessional practices heterogeneously, including numerous processes such as sharing information and referring. Factors that influenced physiotherapists’ interprofessional practices were related to patients, providers, organizations, and wider systems (e.g. professional system). Physiotherapists mostly viewed positive effects of interprofessional practices, including elements such as gaining new knowledge as a provider and being valued in one’s own role, as well as improvements in overall treatment and outcome. Conclusions This qualitative study offers new insights into the interprofessional practices of physiotherapists working with adults with low back pain, as perceived by the physiotherapists’ themselves. Based on the results, the development of strategies aiming to increase interprofessionalism in the management of low back pain would most likely require taking into consideration factors associated with patients, providers, the organizations within which they work, and the wider systems. PMID:24884757

Working with LGBT Individuals: Incorporating Positive Psychology into Training and Practice.

PubMed

Lytle, Megan C; Vaughan, Michelle D; Rodriguez, Eric M; Shmerler, David L

2014-10-01

This paper examines how positive psychology principles can be incorporated into clinical training and practice to work with lesbian, gay, bisexual and transgender (LGBT) clients. LGBT psychology literature has all too often relied on heterosexual and cisgender reference groups as the norm with respect to psychological health, primarily framing the experiences of LGBT individuals through the lens of psychopathology. As a result, strengths that could be ascribed to the LGBT experience have been overlooked within training and practice. While positive psychology is actively being incorporated into clinical and counseling psychology curricula, broadening the paradigm to include LGBT individuals has generally not been included in the discussion. Specific recommendations for training psychologists to incorporate and foster positive social institutions, positive subjective experiences and character strengths when working with LGBT clients and celebrating their unique experiences are provided.

Working with LGBT Individuals: Incorporating Positive Psychology into Training and Practice

PubMed Central

Lytle, Megan C.; Vaughan, Michelle D.; Rodriguez, Eric M.; Shmerler, David L.

2014-01-01

This paper examines how positive psychology principles can be incorporated into clinical training and practice to work with lesbian, gay, bisexual and transgender (LGBT) clients. LGBT psychology literature has all too often relied on heterosexual and cisgender reference groups as the norm with respect to psychological health, primarily framing the experiences of LGBT individuals through the lens of psychopathology. As a result, strengths that could be ascribed to the LGBT experience have been overlooked within training and practice. While positive psychology is actively being incorporated into clinical and counseling psychology curricula, broadening the paradigm to include LGBT individuals has generally not been included in the discussion. Specific recommendations for training psychologists to incorporate and foster positive social institutions, positive subjective experiences and character strengths when working with LGBT clients and celebrating their unique experiences are provided. PMID:25544947

Practical Reason within and across Disciplinary Borders: A Response to Longhofer and Floersch

ERIC Educational Resources Information Center

Kemp, Susan P.; Nurius, Paula S.

2014-01-01

Longhofer and Floersch argue for more expansive thinking about the modes of social science research predominant in contemporary social work science. This commentary concurs with aspects of their article that we see as compatible both with social work aims and with current trends and imperatives in research and practice, including mixed methods and…

The Invisible Realities of Welfare Reform in Wisconsin: Perspectives of African American Women and Their Employers

ERIC Educational Resources Information Center

Alfred, Mary V.

2005-01-01

This study explored the experiences of African American women as they transitioned from welfare to work and develop economic self-sufficiency. The barriers to self-sufficiency included the "work-first" philosophy and case management practices, labor market conditions and employment practices, and personal history. HRD can help minimize…

Queering the Social Work Classroom: Strategies for Increasing the Inclusion of LGBTQ Persons and Experiences

ERIC Educational Resources Information Center

Wagaman, M. Alex; Shelton, Jama; Carter, Rebecca

2018-01-01

The inclusion of lesbian, gay, bisexual, transgender, and queer (LGBTQ) perspectives and experiences in the social work classroom is necessary to adequately include LGBTQ students and prepare graduates to practice effectively. Drawing from queer theory as a theoretical framework and the authors' experiences in practice and teaching/learning spaces…

Practice Parameter for Psychodynamic Psychotherapy with Children

ERIC Educational Resources Information Center

Medicus, Jennifer

2012-01-01

This Practice Parameter describes the principles of psychodynamic psychotherapy with children and is based on clinical consensus and available research evidence. It presents guidelines for the practice of child psychodynamic psychotherapy, including indications and contraindications, the setting, verbal and interactive (play) techniques, work with…

Toward Mentoring in Palliative Social Work: A Narrative Review of Mentoring Programs in Social Work.

PubMed

Toh, Ying Pin; Karthik, R; Teo, Chia Chia; Suppiah, Sarasvathy; Cheung, Siew Li; Krishna, Lalit

2018-03-01

Mentoring by an experienced practitioner enhances professional well-being, promotes resilience, and provides a means of addressing poor job satisfaction and high burnout rates among medical social workers. This is a crucial source of support for social workers working in fields with high risk of compassion fatigue and burnout like palliative care. Implementing such a program, however, is hindered by differences in understanding and application of mentoring practice. This narrative review of mentoring practice in social work seeks to identify key elements and common approaches within successful mentoring programs in social work that could be adapted to guide the design of new mentoring programs in medical social work. Methodology and Data Sources: A literature search of mentoring programs in social work between January 1, 2000, and December 31, 2015, using Pubmed, CINAHL, OVID, ERIC, Scopus, Cochrane and ScienceDirect databases, involving a senior experienced mentor and undergraduate and/or junior postgraduates, was carried out. A total of 1302 abstracts were retrieved, 22 full-text articles were analyzed, and 8 articles were included. Thematic analysis of the included articles revealed 7 themes pertaining to the mentoring process, outcomes and barriers, and the characteristics of mentoring relationships, mentors, mentees, and host organizations. Common themes in prevailing mentoring practices help identify key elements for the design of an effective mentoring program in medical social work. We conclude with a discussion of the implications of these findings upon clinical practice in palliative care and on sustaining such a program.

Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: case study evaluation of adoption and maintenance of a complex intervention to reduce high-risk primary care prescribing

PubMed Central

Dreischulte, Tobias; Guthrie, Bruce

2017-01-01

Objective To explore how different practices responded to the Data-driven Quality Improvement in Primary Care (DQIP) intervention in terms of their adoption of the work, reorganisation to deliver the intended change in care to patients, and whether implementation was sustained over time. Design Mixed-methods parallel process evaluation of a cluster trial, reporting the comparative case study of purposively selected practices. Setting Ten (30%) primary care practices participating in the trial from Scotland, UK. Results Four practices were sampled because they had large rapid reductions in targeted prescribing. They all had internal agreement that the topic mattered, made early plans to implement including assigning responsibility for work and regularly evaluated progress. However, how they internally organised the work varied. Six practices were sampled because they had initial implementation failure. Implementation failure occurred at different stages depending on practice context, including internal disagreement about whether the work was worthwhile, and intention but lack of capacity to implement or sustain implementation due to unfilled posts or sickness. Practice context was not fixed, and most practices with initial failed implementation adapted to deliver at least some elements. All interviewed participants valued the intervention because it was an innovative way to address on an important aspect of safety (although one of the non-interviewed general practitioners in one practice disagreed with this). Participants felt that reviewing existing prescribing did influence their future initiation of targeted drugs, but raised concerns about sustainability. Conclusions Variation in implementation and effectiveness was associated with differences in how practices valued, engaged with and sustained the work required. Initial implementation failure varied with practice context, but was not static, with most practices at least partially implementing by the end of the trial. Practices organised their delivery of changed care to patients in ways which suited their context, emphasising the importance of flexibility in any future widespread implementation. Trial registration number NCT01425502. PMID:28283493

Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: case study evaluation of adoption and maintenance of a complex intervention to reduce high-risk primary care prescribing.

PubMed

Grant, Aileen; Dreischulte, Tobias; Guthrie, Bruce

2017-03-10

To explore how different practices responded to the Data-driven Quality Improvement in Primary Care (DQIP) intervention in terms of their adoption of the work, reorganisation to deliver the intended change in care to patients, and whether implementation was sustained over time. Mixed-methods parallel process evaluation of a cluster trial, reporting the comparative case study of purposively selected practices. Ten (30%) primary care practices participating in the trial from Scotland, UK. Four practices were sampled because they had large rapid reductions in targeted prescribing. They all had internal agreement that the topic mattered, made early plans to implement including assigning responsibility for work and regularly evaluated progress. However, how they internally organised the work varied. Six practices were sampled because they had initial implementation failure. Implementation failure occurred at different stages depending on practice context, including internal disagreement about whether the work was worthwhile, and intention but lack of capacity to implement or sustain implementation due to unfilled posts or sickness. Practice context was not fixed, and most practices with initial failed implementation adapted to deliver at least some elements. All interviewed participants valued the intervention because it was an innovative way to address on an important aspect of safety (although one of the non-interviewed general practitioners in one practice disagreed with this). Participants felt that reviewing existing prescribing did influence their future initiation of targeted drugs, but raised concerns about sustainability. Variation in implementation and effectiveness was associated with differences in how practices valued, engaged with and sustained the work required. Initial implementation failure varied with practice context, but was not static, with most practices at least partially implementing by the end of the trial. Practices organised their delivery of changed care to patients in ways which suited their context, emphasising the importance of flexibility in any future widespread implementation. NCT01425502. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Evidence based workplace interventions to promote breastfeeding practices among Pakistani working mothers.

PubMed

Hirani, Shela Akbar Ali; Karmaliani, Rozina

2013-03-01

Breastfeeding is an essential source of nutrition for young babies; however, it is challenging for employed mothers to continue breastfeeding with employment, especially if workplace support is minimal or missing. In Pakistan, from 1983 to 2008, the prevalence of breastfeeding at 6 months has decreased from 96% to 31%. In this region, workplace barriers have been reported as one of the reasons that result in early cessation of breastfeeding among working mothers. This paper aims at reviewing global literature to explore workplace interventions that can promote the breastfeeding practices among working mothers in Pakistan. A literature search of peer reviewed databases, including CINHAL (1980-2009), MEDLINE (1980-2009), Pub Med (1980-2009), Springer Link (1980-2008), and Cochrane Database of Systematic Reviews (3rd quarter, 2008), was undertaken. Considering the pre-set inclusion and exclusion criteria, out of more than 500 literature sources, 50 were shortlisted and reviewed. A review of global literature revealed that in order to promote breastfeeding practices among employed mothers, the most powerful workplace interventions include: educating working mothers about management of breastfeeding with employment; enhancing employers' awareness about benefits of breastfeeding accommodation at workplace; arranging physical facilities for lactating mothers (including privacy, childcare facilities, breast pumps, and breast milk storage facilities); providing job-flexibility to working mothers; and initiating mother friendly policies at workplace that support breastfeeding. In Pakistani workplace settings, where little attention is paid to sustain breastfeeding practices among working mothers, there is a need to initiate lactation support programmes. These programmes can be made effective by implementing composite interventions at the level of breastfeeding working mothers, employers, and workplace. Copyright © 2012 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Understanding clinical work practices for cross-boundary decision support in e-health.

PubMed

Tawfik, Hissam; Anya, Obinna; Nagar, Atulya K

2012-07-01

One of the major concerns of research in integrated healthcare information systems is to enable decision support among clinicians across boundaries of organizations and regional workgroups. A necessary precursor, however, is to facilitate the construction of appropriate awareness of local clinical practices, including a clinician's actual cognitive capabilities, peculiar workplace circumstances, and specific patient-centered needs based on real-world clinical contexts across work settings. In this paper, a user-centered study aimed to investigate clinical practices across three different geographical areas-the U.K., the UAE and Nigeria-is presented. The findings indicate that differences in clinical practices among clinicians are associated with differences in local work contexts across work settings, but are moderated by adherence to best practice guidelines and the need for patient-centered care. The study further reveals that an awareness especially of the ontological, stereotypical, and situated practices plays a crucial role in adapting knowledge for cross-boundary decision support. The paper then outlines a set of design guidelines for the development of enterprise information systems for e-health. Based on the guidelines, the paper proposes the conceptual design of CaDHealth, a practice-centered framework for making sense of clinical practices across work settings for effective cross-boundary e-health decision support.

Time management tips, tricks, and exercises for busy medical practice employees.

PubMed

Hills, Laura

2012-01-01

Working in a busy medical practice requires excellent time management skills and an ability to handle those unanticipated emergencies, urgencies, and monkey-wrenches that can and often do throw a well-planned day out of whack. This article offers busy medical practice employees 50 time management tips to help them manage their time well. It focuses specifically on eliminating time wasters, working more efficiently, and developing personal goals and habits that can increase productivity, reduce stress, and make working in the practice more enjoyable. This article also offers several hands-on time management exercises, including a time management self-assessment quiz, a multitasking exercise, and a time drain exercise. These can be completed individually or collaboratively with other members of the medical practice team. Finally, this article explores 12 popular time management myths and how a medical practice employee can increase his or her productivity by identifying and harnessing his or her productivity "happy hour(s)".

OVERVIEW OF THE ACTIVITIES OF THE NUCLEAR ENERGY AGENCY WORKING GROUP ON EXTERNAL EVENTS

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

Nakoski, John A.; Smith, Curtis L.; Kim, Min Kyu

The Orgranisation for Economic Cooperation and Development (OECD) Nuclear Energy Agency (NEA) has established a Working Group on External Events (WGEV) that provides a forum for subject matter experts from the nuclear industry and regulators to improve the understanding and treatment of external hazards that would support the continued safety performance of nuclear installations, and improve the effectiveness of regulatory practices, in NEA member countries. This report provides a description of the ongoing work of the WGEV. The work of the WGEV includes the collection of information and conducting a workshop on severe weather and storm surge that brought togethermore » a diverse group of subject matter experts to identify commendable practices related to the treatment of severe weather and storm surge consideration in regulatory and operational decision-making. Other work of the WGEV includes looking at science-based screening of external events that are factored into decisions on the safe operation of nuclear facilities; and identification of commendable practices and knowledge gaps on riverine flooding.« less

Nurses' perceptions of their professional practice environment: a cross-sectional study.

PubMed

Cao, Yingjuan; DiGiacomo, Michelle; Salamonson, Yenna; Li, Ye; Huai, Baosha; Davidson, Patricia M

2015-12-01

To describe nurses' perceptions concerning their professional practice environment in mainland China and identify factors associated with these views. Globally, the environments in which nurses work influence the quality of nursing practice and health care. A cross-sectional descriptive survey using both paper- and online-based delivery modes was used. A convenience sampling method was used. The survey questionnaire was composed of sociodemographic items and the 38-item Chinese version of Professional Practice Environment survey. The content of the paper-based questionnaire was identical to the online survey. Pearson's chi-square test was conducted to compare the demographic characteristics of these two data sets. Descriptive statistics analysis included frequency, percentage, mean and standard deviation. Multiple linear regression analysis using the Backwards method was applied to identify independent predictors of each subscale of the 38-item Chinese version of Professional Practice Environment. A total of 573 questionnaires were analysed. The mean score of each subscale of the 38-item Chinese version of Professional Practice Environment in this study ranged from 2·66-3·05. All subscales except work motivation (3·05, standard deviation: 0·44) scored less than 3·0. Areas rated as most in need of improvement included control over practice, interpersonal interaction, supportive leadership and handling conflict, and staff relationships with physicians and autonomy. This study has identified nurses' perspectives regarding their workplaces in contemporary China. These data have provided an important baseline for developing and implementing culturally appropriate strategies to improve the working environment of Chinese nurses. A supportive and enabling work environment promotes professional development and the safety and quality of health care. Addressing these factors is important in optimising work place environments. © 2015 John Wiley & Sons Ltd.

The role of production and teamwork practices in construction safety: a cognitive model and an empirical case study.

PubMed

Mitropoulos, Panagiotis Takis; Cupido, Gerardo

2009-01-01

In construction, the challenge for researchers and practitioners is to develop work systems (production processes and teams) that can achieve high productivity and high safety at the same time. However, construction accident causation models ignore the role of work practices and teamwork. This study investigates the mechanisms by which production and teamwork practices affect the likelihood of accidents. The paper synthesizes a new model for construction safety based on the cognitive perspective (Fuller's Task-Demand-Capability Interface model, 2005) and then presents an exploratory case study. The case study investigates and compares the work practices of two residential framing crews: a 'High Reliability Crew' (HRC)--that is, a crew with exceptional productivity and safety over several years, and an average performing crew from the same company. The model explains how the production and teamwork practices generate the work situations that workers face (the task demands) and affect the workers ability to cope (capabilities). The case study indicates that the work practices of the HRC directly influence the task demands and match them with the applied capabilities. These practices were guided by the 'principle' of avoiding errors and rework and included work planning and preparation, work distribution, managing the production pressures, and quality and behavior monitoring. The Task Demand-Capability model links construction research to a cognitive model of accident causation and provides a new way to conceptualize safety as an emergent property of the production practices and teamwork processes. The empirical evidence indicates that the crews' work practices and team processes strongly affect the task demands, the applied capabilities, and the match between demands and capabilities. The proposed model and the exploratory case study will guide further discovery of work practices and teamwork processes that can increase both productivity and safety in construction operations. Such understanding will enable training of construction foremen and crews in these practices to systematically develop high reliability crews.

The implications of the feminization of the primary care physician workforce on service supply: a systematic review.

PubMed

Hedden, Lindsay; Barer, Morris L; Cardiff, Karen; McGrail, Kimberlyn M; Law, Michael R; Bourgeault, Ivy L

2014-06-04

There is a widespread perception that the increasing proportion of female physicians in most developed countries is contributing to a primary care service shortage because females work less and provide less patient care compared with their male counterparts. There has, however, been no comprehensive investigation of the effects of primary care physician (PCP) workforce feminization on service supply. We undertook a systematic review to examine the current evidence that quantifies the effect of feminization on time spent working, intensity and scope of work, and practice characteristics. We searched Medline, Embase, and Web of Science from 1991 to 2013 using variations of the terms 'primary care', 'women', 'manpower', and 'supply and distribution'; screened the abstracts of all articles; and entered those meeting our inclusion criteria into a data abstraction tool. Original research comparing male to female PCPs on measures of years of practice, time spent working, intensity of work, scope of work, or practice characteristics was included. We screened 1,271 unique abstracts and selected 74 studies for full-text review. Of these, 34 met the inclusion criteria. Years of practice, hours of work, intensity of work, scope of work, and practice characteristics featured in 12%, 53%, 42%, 50%, and 21% of studies respectively. Female PCPs self-report fewer hours of work than male PCPs, have fewer patient encounters, and deliver fewer services, but spend longer with their patients during a contact and deal with more separate presenting problems in one visit. They write fewer prescriptions but refer to diagnostic services and specialist physicians more often. The studies included in this review suggest that the feminization of the workforce is likely to have a small negative impact on the availability of primary health care services, and that the drivers of observed differences between male and female PCPs are complex and nuanced. The true scale of the impact of these findings on future effective physician supply is difficult to determine with currently available evidence, given that few studies looked at trends over time, and results from those that did are inconsistent. Additional research examining gender differences in practice patterns and scope of work is warranted.

General practitioners and work in the Third World.

PubMed

Holden, J D

1991-04-01

In recent years the number of general practitioners who have worked in the third world before entering general practice has fallen. The reasons for this are not clear but may include worries about future career prospects. Ninety four doctors who had entered general practice since 1984, after previously working in the third world, completed a questionnaire about their career experience and views about the value of such work. They were generally widely experienced and well-qualified and work abroad had not apparently harmed their careers, rather, many believed it had enhanced it. Work in the usually arduous conditions of poor countries was often considered by the respondents to lead to a wider perspective, increased maturity, confidence, self-reliance, adaptability and initiative. Doctors who are interested and suitable for work in the third world prior to entering general practice should be encouraged to pursue this possibility.

New systems of work organization and workers' health.

PubMed

Kompier, Michiel A J

2006-12-01

This paper aims at identifying major changes in and around work organizations, their effects upon job characteristics and the health and well-being of today's employees, and related research challenges. Increased internationalization and competition, increased utilization of information and communication technology, the changing workforce configuration, and flexibility and new organizational practices are considered. As work has changed from physical to mental in nature, job characteristics have changed significantly. Meanwhile work and family life have blended. New systems of work organization have become more prevalent, but they do not represent a radical change across the whole economy. New practices may have an adverse impact upon job characteristics, but their effects depend on their design, implementation, and management. Research recommendations include improved monitoring of changes in work organization and studies into their health and safety consequences, intervention studies, studies into the motivating potential of modern work practices, studies of marginalized workers and workers in less developed countries, and "mechanism studies".

Women and Community Economic Development--Changing Knowledge, Changing Practice: A Summary of Research Results. NALL Working Paper #12.

ERIC Educational Resources Information Center

Stratton, Mary; Levine, Barbara

A preliminary study explored how Canadian practitioners who are engaged in community economic development (CED) that includes or is specific to women gain new information relevant to their work and how they incorporate that new learning into their daily practice. Interview questions focused on sources of information, learning opportunities and…

Family Therapist as Consultant in Foster Care: Expanding the Parameters of Practice.

ERIC Educational Resources Information Center

Morrissette, Patrick J.

1996-01-01

Traditionally, the role of the family therapist working in foster care has been limited to the areas of evaluation and treatment. This paper proposes that the family therapist can extend conventional boundaries to include the practice of systemic consultation. Case studies are included to exemplify family therapist microlevel consultation with…

Competencia Comunicativa em Portuges (Communicative Competence in Portuguese).

ERIC Educational Resources Information Center

Paiva, Ricardo

A textbook designed to give speech and writing practice to intermediate and advanced students of Portuguese as a second language includes 14 units intended to cover two semesters' work with approximately five hours per week of instruction. The units typically include: a text forming the basis for free conversation and practice of language…

Family-centered Care in the Outpatient General Psychiatry Clinic.

PubMed

Heru, Alison M

2015-09-01

Although family research supports family-centered care for all medical specialties, the benefit of family-centered care has not been fully realized in outpatient practice. Physicians, including psychiatrists, are not routinely taught how to work with families and may not be aware of the evidence-base for family interventions. However, some medical specialties, such as family medicine and palliative care, have a clinical practice that routinely includes the family. Clinicians working in medical clinics, such as diabetes clinics, know that successful management of chronic illness requires family involvement. Psychiatric clinics, such as The Family Center for Bipolar Disorder at Beth Israel Medical Center in New York City, also have a family-centered practice and show improved patient outcomes. This article provides guidelines, including clinical interview questions, to help psychiatrists practice family-centered care, either in a private office or in a general psychiatric outpatient clinic. The guidelines include questions that identify when to seek an in-depth family assessment or consultation. Family-centered care will become more useful when health care reimbursement focuses on patient outcome.

A new framing approach in guideline development to manage different sources of knowledge.

PubMed

Lukersmith, Sue; Hopman, Katherine; Vine, Kristina; Krahe, Lee; McColl, Alexander

2017-02-01

Contemporary guideline methodology struggles to consider context and information from different sources of knowledge besides quantitative research. Return to work programmes involve multiple components and stakeholders. If the guideline is to be relevant and practical for a complex intervention such as return to work, it is essential to use broad sources of knowledge. This paper reports on a new method in guideline development to manage different sources of knowledge. The method used framing for the return-to-work guidance within the Clinical Practice Guidelines for the Management of Rotator Cuff Syndrome in the Workplace. The development involved was a multi-disciplinary working party of experts including consumers. The researchers considered a broad range of research, expert (practice and experience) knowledge, the individual's and workplace contexts, and used framing with the International Classification of Functioning, Disability and Health. Following a systematic database search on four clinical questions, there were seven stages of knowledge management to extract, unpack, map and pack information to the ICF domains framework. Companion graded recommendations were developed. The results include practical examples, user and consumer guides, flow charts and six graded or consensus recommendations on best practice for return to work intervention. Our findings suggest using framing in guideline methodology with internationally accepted frames such as the ICF is a reliable and transparent framework to manage different sources of knowledge. Future research might examine other examples and methods for managing complexity and using different sources of knowledge in guideline development. © 2016 John Wiley & Sons, Ltd.

The Influence of Field Teaching Practice on Pre-service Teachers' Professional Identity: A Mixed Methods Study.

PubMed

Zhao, Hongyu; Zhang, Xiaohui

2017-01-01

The current study used mixed methods to research pre-service teachers' professional identity. Ninety-eight pre-service teachers were investigated and twelve teachers were interviewed in China. The results were as follows: (1) The results of quantitative data showed that compared with before the field teaching practice, pre-service teachers' professional identity increased after the field teaching practice-specifically, intrinsic value identity increased, and extrinsic value identity did not significantly change; (2) The results of qualitative data validated and elaborated the results of quantitative data in more detail with regard to changes in professional identity. Specifically, compared with before the field teaching practice, intrinsic value identity including work content, work pattern, etc., increased and extrinsic value identity including work environment, income, and social status, etc., did not significantly change after experiencing teaching practice; (3) The results of qualitative data also showed that mentor support at field school promoted the development of pre-service teachers' professional identity. Moreover, the development of pre-service teachers' professional identity during field teaching practice further promoted their professional commitment; that is, it promoted their emotional evaluation and belief in the teaching profession. The study discussed these results and proposed solutions and suggestions for future studies.

Practice environment as perceived by nurses in acute care hospitals in Sharjah and North Emirates.

PubMed

Al-Maaitah, Rowaida; AbuAlRub, Raeda F; Al Blooshi, Sumaya

2018-04-01

To explore nurses' perceptions of their practice environment in acute care hospitals in Sharjah and North Emirates in the United Arab Emirates (UAE). The health of the environment in which registered nurses' work is critical to nursing outcomes. The interest to examine the practice environment extended to the Gulf area which has a complex healthcare system including the UAE. The study used an exploratory descriptive design with a qualitative part using two focus group interviews. The sample size was 450 nurses selected through a random sampling method. A self-administered questionnaire including the Practice Environment Scale of Nursing Work Index (PES-NWI) was used. In addition, semi-structured interviews for two focus groups were done. The results showed that UAE practicing nurses reported favorable perceptions of most aspects of their practice environment. Unfavorable perceptions were only reported for Staffing and Resource Adequacy. The analysis of focus group discussions resulted in different emerged themes such as Lack of Recognition and Career Promotion, and Nurses' Workload due to Paper and Administrative Work. The findings of this study suggest that strategic interventions are needed to secure adequate staff and resources and implement an effective system for evaluation of performance. © 2018 Wiley Periodicals, Inc.

Promoting Mental Health and Preventing Mental Illness in General Practice.

PubMed

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

2016-01-01

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

Enhancing the Student Experiment Experience: Visible Scientific Inquiry Through a Virtual Chemistry Laboratory

NASA Astrophysics Data System (ADS)

Donnelly, Dermot; O'Reilly, John; McGarr, Oliver

2013-08-01

Practical work is often noted as a core reason many students take on science in secondary schools (high schools). However, there are inherent difficulties associated with classroom practical work that militate against scientific inquiry, an approach espoused by many science educators. The use of interactive simulations to facilitate student inquiry has emerged as a complement to practical work. This study presents case studies of four science teachers using a virtual chemistry laboratory (VCL) with their students in an explicitly guided inquiry manner. Research tools included the use of the Inquiry Science Implementation Scale in a `talk-aloud' manner, Reformed Teaching Observation Protocol for video observations, and teacher interviews. The findings suggest key aspects of practical work that hinder teachers in adequately supporting inquiry and highlight where a VCL can overcome many of these difficulties. The findings also indicate considerations in using the VCL in its own right.

Vocational training courses as an intervention on change of work practice among immigrant cleaners.

PubMed

Jensen, Flemming W; Frydendall, Karen B; Flyvholm, Mari-Ann

2011-11-01

The aim of the study was to examine how knowledge and skills from vocational training courses on working techniques modified for immigrant cleaners are applied in practice and to identify factors that influence the implementation. The modifications of the standard course included language support with possibilities for translation and an extension of the duration of the course. The study is a prospective intervention study based on qualitative data. Data were collected as structured interviews and observations were carried out at the workplaces before and after the course. The study population included 31 immigrant cleaners from five different workplaces. Changes were observed in the use of working techniques (i.e., positioning of hands when using the floor mop). In some cases the use of the taught techniques was incorrect, partial, or only used part of the time. Interactions between individual factors (i.e., knowledge, awareness, capability, or work orientation) and environmental factors (i.e., equipment, time, workload, or physical surroundings) influenced the use of the techniques in practice. The course provided the participants with new working techniques through which some were able to reduce work related pain. However, with regard to incorrect and partial use of the working techniques, follow-up and post-training support is recommended. Copyright © 2011 Wiley Periodicals, Inc.

Working and Learning in a Field Excursion.

PubMed

Hole, Torstein Nielsen

2018-06-01

This study aimed to discern sociocultural processes through which students learn in field excursions. To achieve this aim, short-term ethnographic techniques were employed to examine how undergraduate students work and enact knowledge (or knowing) during a specific field excursion in biology. The students participated in a working practice that employed research methods and came to engage with various biological phenomena over the course of their work. A three-level analysis of the students' experiences focused on three processes that emerged: participatory appropriation, guided participation, and apprenticeship. These processes derive from advances in practice-oriented theories of knowing. Through their work in the field, the students were able to enact science autonomously; they engaged with peers and teachers in specific ways and developed new understandings about research and epistemology founded on their experiences in the field. Further discussion about the use of "practice" and "work" as analytical concepts in science education is also included.

A qualitative study of work-life balance amongst specialist orthodontists in the United Kingdom.

PubMed

Bateman, Lindsey E; Collins, Joanne M; Cunningham, Susan J

2016-12-01

To identify factors affecting work-life balance amongst male and female orthodontists in the UK. A qualitative interview-based study with a cross-sectional design. Specialist orthodontists working in specialist practice and the hospital service in the UK were selected by purposive sampling. In-depth semi-structured interviews were conducted with 18 orthodontic specialists. Interview transcripts were analyzed using Framework Analysis. Four main themes pertaining to work-life balance in orthodontics were identified: work factors affecting work-life balance, life factors affecting work-life balance, perception and effects of work-life balance and suggestions for managing work-life balance within the profession. There was substantial variation in the work-life balance of the orthodontists interviewed in this study; however the majority reported high levels of career satisfaction despite difficulties maintaining a good work-life balance. Whilst there were some clear distinctions in the factors affecting work-life balance between the hospital environment and specialist practice (including additional professional commitments and teaching/training-related issues), there were also a number of similarities. These included, the lack of flexibility in the working day, managing patient expectations, taking time off work at short notice and the ability to work part-time.

Work-related discussions between French rheumatologists and their rheumatoid arthritis patients.

PubMed

Meunier, J; Fautrel, B; Roquelaure, Y; Claudepierre, P

2016-08-01

Rheumatoid arthritis (RA) causes significant impairment of physical function, and thus adversely affects patients' ability to work. To document how often work limitations are discussed by rheumatologists and RA patients during consultations. We conducted an observational study in a sample of French rheumatologists and in a parallel sample of patients recruited by pharmacists. We asked all rheumatologists in France practising in private practice or mixed practice (private practice and hospital) to participate in a telephone survey about their most recent consultation with an RA patient. Randomly selected pharmacists recruited RA patients to complete a questionnaire about their most recent consultation with their rheumatologist. We included patients aged 20-59, with a paid job or unemployed. We calculated the proportion of consultations including work-related discussions in both samples. Of the 1737 rheumatologists contacted, 153 (9%) described consultations with eligible patients. Of the 1200 pharmacists contacted, 39 (3%) recruited 81 RA patients. The proportion of consultations including work-related discussions was 50% [95% confidence interval (CI) 42-58%] in the rheumatologist sample and 52% (95% CI 41-63%) in the patient sample. The most frequent subject of discussion (88%) was physical problems related to work in both samples. This is the first study to document the proportion of consultations where rheumatologists and their RA patients discuss work. Both specialists and patients reported that work was discussed in one in every two consultations. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Occupational Health

MedlinePlus

Occupational health problems occur at work or because of the kind of work you do. These problems can include ... by exposure to radiation Exposure to germs in health care settings Good job safety and prevention practices ...

Practical ways to facilitate ergonomics improvements in occupational health practice.

PubMed

Kogi, Kazutaka

2012-12-01

Recent advances in participatory programs for improving workplace conditions are discussed to examine practical ways to facilitate ergonomics improvements. Participatory training programs are gaining importance, particularly in promoting occupational health and safety in small-scale workplaces. These programs have led to many improvements that can reduce work-related risks in varied situations. Recent experiences in participatory action-oriented training programs in small workplaces and agriculture are reviewed.The emphasis of the review is on training steps, types of improvements achieved, and the use of action tools by trainers and training participants. Immediate improvements in multiple technical areas are targeted, including materials handling,workstation design, physical environment, welfare facilities, and work organization. In facilitating ergonomics improvements in each local situation, it is important to focus on (a) building on local good practices; (b) applying practical, simple improvements that apply the basic principles of ergonomics; and (c) developing action-oriented toolkits for direct use by workers and managers. This facilitation process is effective when locally designed action toolkits are used by trainers, including local good examples, action checklists, and illustrated how-to guides. Intervention studies demonstrate the effectiveness of participatory steps that use these toolkits in promoting good practices and reducing work-related risks. In facilitating ergonomics improvements in small-scale workplaces, it is important to focus on practical, low-cost improvements that build on local good practices. The use of action-oriented toolkits reflecting basic ergonomics principles is helpful.The promotion of the intercountry networking of positive experiences in participatory training is suggested.

Workplace problems and solutions for employees with chronic diseases.

PubMed

Varekamp, I; van Dijk, F J H

2010-06-01

While many employees who have a chronic disease manage their jobs well, others are hampered in work performance, experience work-related problems and are at risk for job loss. To identify the practical and psychosocial barriers recognized by employees with chronic disease who experience work-related problems and to examine preferred work accommodations. A questionnaire was sent by mail and completed by current workers who have a chronic disease and experience serious problems at work. One hundred and twenty-two employees participated in this study. On average, they had been ill for 10 years and 44% had more than one disease. The most outstanding work-related problems were psychosocial, including work-home interference and a lack of acceptance of the chronic disease. Performing and finishing work tasks and social relationships with supervisors or colleagues were also felt to be slightly problematic. The most preferred work accommodations included fewer work hours, working from home, a slower work pace and more autonomy in planning work tasks. Almost three-quarters of the respondents were so fatigued that they were at risk of sickness absence or work disability. A chronic physical disease may lead to both practical and psychosocial problems and serious fatigue. Managing psychosocial problems may decrease fatigue.

Experiences of burnout and coping strategies utilized by occupational therapists.

PubMed

Gupta, Sangeeta; Paterson, Margo L; Lysaght, Rosemary M; von Zweck, Claudia M

2012-04-01

Work-related stress and burnout have been found to lead to job dissatisfaction, low-organizational commitment, absenteeism, and high turnover. The purpose of this study was to examine the burnout experiences of occupational therapists practicing in Ontario and to describe the practice implications and coping strategies employed. Data for this mixed methods study were collected using the Maslach Burnout Inventory-General Survey, Areas of Worklife Survey, focus groups, and interviews in the hermeneutics tradition. High levels of emotional exhaustion were reported by 34.8% of participants, high levels of cynicism by 43.5%, and low professional efficacy by 24.6%. Practice issues included excessive demands on time, conflict, and lack of autonomy and respect. Coping strategies included spending time with family and maintaining professional/personal balance, control of work responsibilities, maintaining a sense of humor, and self-awareness/self-monitoring. This study contributes to understanding the practice challenges for occupational therapists, factors that contribute to therapist burnout, and strategies employed to maintain competent practice.

Strengthening the rural dietetics workforce: examining early effects of the Northern Ontario Dietetic Internship Program on recruitment and retention.

PubMed

Hill, Mary Ellen; Raftis, Denise; Wakewich, Pamela

2017-01-01

As with other allied health professions, recruitment and retention of dietitians to positions in rural and isolated positions is challenging. The aim of this study was to examine the early effects of the Northern Ontario Dietetic Internship Program (NODIP) on recruitment and retention of dietitians to rural and northern dietetics practice. The program is unique in being the only postgraduate dietetics internship program in Canada that actively selects candidates who have a desire to live and work in northern and rural areas. Objectives of the survey were to track the early career experiences of the first five cohorts (2008-2012) of NODIP graduates, with an emphasis on employment in underserviced rural and northern areas of Ontario. NODIP graduates (62) were invited to complete a 27-item, self-administered, mailed questionnaire approximately 22 months after graduation. The survey, reflecting issues identified in the rural allied health and dietetics literature, documented their work history, practice locations, employment settings, roles, future career intentions and rural background. Aggregated data were analyzed descriptively to assess their early work experiences, with a focus on their acceptance of positions in rural and northern communities. Items also assessed professional and personal factors influencing their most recent decisions concerning practice locations. Three-quarters of graduates chose organizations serving rural or northern communities for their first employment positions and two-thirds were practicing in rural and underserviced areas when surveyed. Most worked as clinical, community health or public health dietitians, in diverse settings including clinics, hospitals and diabetes care programs. Although most had found permanent positions, working for more than one employer at a time was not uncommon. Factors affecting practice choices included prior awareness of employers, prospects for full-time employment, flexible working conditions, access to interprofessional practice and continuing education, as well as community and family concerns. Intentions to remain in current positions were also shaped by a mixture of professional and personal considerations. Some would relocate in search of opportunities for specialization; a few would leave due to dissatisfaction with employment conditions and disinterest in work; others would move due to personal and family commitments. This study provides early evidence that the NODIP distributed and community-engaged learning model has been very successful in its goal of augmenting the rural and northern dietetics workforce, with a majority of graduates accepting and remaining in rural positions during their first 2 years of practice. Whether graduates remain in rural practice, however, depends on a number of other factors, including career aspirations, availability of professional supports and personal commitments. This suggests that additional supports, above and beyond the NODIP internship, may be needed to encourage graduate dietitians to stay in rural and northern practice locations over the longer term.

The work of nurses in Australian general practice: A national survey.

PubMed

Joyce, Catherine M; Piterman, Leon

2011-01-01

Following recent reforms to Australia's health system, nurses now comprise a significant and growing sector of the Australian primary care workforce, but there is little data describing the services they provide. This study aimed to describe the patient consultations of nurses in Australian general practice, including patient characteristics, reasons for the consultation, treatments provided and other actions taken. The study was a national cross-sectional survey, with each participating nurse collecting information about 50 nurse-patient encounters. General practice settings in all regions of Australia. 108 nurses volunteered in response to advertisements and 104 returned completed study materials. Participants included Registered (Division 1) and Enrolled (Division 2) nurses working in a general practice setting. Data were collected between May 2007 and May 2008 using a profile questionnaire and a series of encounter forms. Information was gathered on reasons for encounter, patient characteristics, and actions taken. Data were classified using the International Classification of Primary Care. The final data set included 5,253 nurse-patient encounters. 37.2% of patients (95% CI 33.3-41.2) were aged 65 and over, and 57.1% were female (95% CI 54.9-59.5). The majority of encounters (90.7%) were with existing patients of the practice (95% CI 89.1-92.7). The most common reasons for encounter were general and unspecified problems (35.4 per 100 encounters; 95% CI 31.8-39.1), followed by skin-related problems (20.0; 95% CI 17.3-22.8), and cardiovascular problems (11.0; 95% CI 8.7-13.3). Common management actions included medical examinations (20.7 per 100 encounters), immunisations (22.5), diagnostic tests (10.6), and dressings (15.8). Approximately 30% of encounters involved advice-giving. The findings confirm the generalist nature of the General Practice Nurse role, with a wide range of patient types and clinical conditions. There is a clear influence of current funding and organisational arrangements on work patterns, with tasks that have specific funding (including immunisations and wound care) featuring prominently in nurses' work. Whilst nurses' rates for presenting conditions were similar to doctors at a general level, specific actions taken and problems managed differed. New policy reforms in Australia are supporting greater flexibility in the General Practice Nurse role, maximising efficient use of nurses' skills in the primary health care context. Copyright © 2010 Elsevier Ltd. All rights reserved.

P-12 Engineering Education Research and Practice

ERIC Educational Resources Information Center

Moore, Tamara; Richards, Larry G.

2012-01-01

This special issue of "Advances in Engineering Education" explores recent developments in P-12 Engineering Education. It includes papers devoted to research and practice, and reports some of the most exciting work in the field today. In our Call of Papers, we solicited two types of papers: Research papers and Practice papers. The former…

Teaching and Learning Communication, Language and Literacy

ERIC Educational Resources Information Center

Browne, Ann

2007-01-01

In this book, Ann Browne draws on research findings and good practice to provide practical and guidance about working with young children aged 3-5 years in nursery and reception classes. The author covers all of the key theoretical issues, providing a wealth of classroom examples. Practical suggestions for activities and resources include ways of…

Towards a Theory of the Ecology of Reflection: Reflective Practice for Experiential Learning in Higher Education

ERIC Educational Resources Information Center

Harvey, Marina; ; Coulson, Debra; McMaugh, Anne

2016-01-01

Reflective practice is widely adopted across the field of experience-based learning subjects in higher education, including practicums, work-integrated learning, internships, service learning and community participation. This adoption of reflective practice implies that it supports student learning through experience. When reviewing the evidence…

Developing Inquiry-as-Stance and Repertoires of Practice: Teacher Learning across Two Settings

ERIC Educational Resources Information Center

Braaten, Melissa L.

2011-01-01

Sixteen science educators joined a science teacher video club for one school year to collaboratively inquire into each other's classroom practice through the use of records of practice including classroom video clips and samples of student work. This group was focused on developing ambitious, equitable science teaching that capitalizes on…

Research: Reflecting Practice. Papers from the SCUTREA Annual Conference (23rd, Manchester, England, July 6-8, 1993).

ERIC Educational Resources Information Center

Miller, Nod, Ed.; Jones, David J., Ed.

The following papers are included: "Social Classification of Women's Work" (Benn, Burton); "Developing Models of Learning from Experience" (Boud, Walker); "'Research Reflecting Practice?'" (Edwards, Usher); "Metaphors and Their Implications for Research and Practice in Adult and Community Education" (Hunt); "'Common-Sense' Approach to Reflection"…

Knowledge Transfer in Social Work: The Role of Grey Documentation.

ERIC Educational Resources Information Center

Berman, Yitzhak

1995-01-01

Discusses scholarly journals in the field of social work, information sources for social work practitioners versus researchers, and grey documentation as an alternative means of knowledge transfer. Highlights include research versus practice; grey documentation and scientific credibility; and dissemination of grey literature. (LRW)

Interdisciplinary team working in physical and rehabilitation medicine.

PubMed

Neumann, Vera; Gutenbrunner, Christoph; Fialka-Moser, Veronika; Christodoulou, Nicolas; Varela, Enrique; Giustini, Alessandro; Delarque, Alain

2010-01-01

Effective team working plays a crucial role in Physical and Rehabilitation Medicine (PRM). As part of its role of optimizing and harmonizing clinical practice across Europe, the Professional Practice Committee of Union of European Medical Specialists (UEMS) Physical and Rehabilitation Medicine (PRM) Section reviewed patterns of team working and debated recommendations for good practice at a meeting of national UEMS delegates held in Riga, Latvia, in September 2008. This consensus statement is derived from that discussion and from a review of the literature concerning team working. Effective team working produces better patient outcomes (including better survival rates) in a range of disorders, notably following stroke. There is limited published evidence concerning what constitute the key components of successful teams in PRM programmes. However, the theoretical basis for good team working has been well-described in other settings and includes agreed aims, agreement and understanding on how best to achieve these, a multi-professional team with an appropriate range of knowledge and skills, mutual trust and respect, willingness to share knowledge and expertise and to speak openly. UEMS PRM Section strongly recommends this pattern of working. PRM specialists have an essential role to play in interdisciplinary teams; their training and specific expertise enable them to diagnose and assess severity of health problems, a prerequisite for safe intervention. Training spans 4-5 years in Europe, and includes knowledge and critical analysis of evidence-based rehabilitation strategies. PRM physicians are therefore well-placed to coordinate PRM programmes and to develop and evaluate new management strategies. Their broad training also means that they are able to take a holistic view of an individual patient's care.

Promoting Mental Health and Preventing Mental Illness in General Practice

PubMed Central

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

2016-01-01

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

The characteristics of general practice and the attractiveness of working as a GP: medical students' views.

PubMed

Landstrom, Bjorn; Mattsson, Bengt; Nordin, Per; Rudebeck, Carl E

2014-03-15

The aim of the study was to investigate medical students' views on general practice based on their experiences in training, and to find out whether there were certain views associated with the intention to become a GP. A questionnaire, based on our earlier studies about GP working behaviour, was handed out to medical students in terms 1, 3, 5, 7, 10 and 11 of undergraduate studies in Gothenburg, Sweden. The analysis comprised statistical descriptions and comparisons. The students regarded general practice positively. They found the work environment good, the GP's awareness of patients' living conditions necessary, and that GP work requires medical breadth. The status of the GP in the medical profession was not considered high. One-fourth of the students strongly agreed with the possibility of a future as a GP. This attitude was statistically associated with support to the statements that general practice offers a good work environment and should be a major component in undergraduate training. Students with a negative attitude to working as GPs were also negative to having a major component of general practice in undergraduate training. Medical students with a positive stated attitude towards becoming GPs support changes in undergraduate training to include more general practice. The risk of increasing a negative attitude should be considered when changes are discussed.

Young worker safety in construction: do family ties and workgroup size affect hazard exposures and safety practices?

PubMed

Rauscher, Kimberly J; Myers, Douglas J; Runyan, Carol W; Schulman, Michael

2012-01-01

Little is known about how social aspects of the work environment influence exposures or safety practices affecting young construction workers. Our objective was to investigate whether working on a construction site with a small number of workers (≤10 vs. 11-50) or having a family-firm connection (working in a family-owned firm or one in which a family member also works) impacts hazard exposures and safety practices. Participants included 187 North Carolina construction workers 14 to 17 years old who were surveyed about their jobs. We conducted stratified analyses using cross-tabulations and chi-square statistics to measure associations between workgroup size (i.e., the total number of workers on a jobsite) and family-firm connections (yes/no) and hazard exposures (e.g., saws) and safety practices (e.g., supervision). Having a family-firm connection was associated with fewer hazard exposures and greater safety practices. Youth who worked on jobsites with a larger workgroup (11-50 workers) reported more hazards but also more safety practices. Family-firm connections, in particular, may have a protective effect for youth in construction. Even though the statistical significance of our findings on workgroup size was limited in places, the pattern of differences found suggest that further research in this area is warranted.

Solar Access to Public Capital (SAPC) Working Group: Best Practices in PV System Installation; Version 1.0, March 2015; Period of Performance, October 2014 - September 2015

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

Doyle, C.; Truitt, A.; Inda, D.

The following Photovoltaics Installation Best Practices Guide is one of several work products developed by the Solar Access to Public Capital (SAPC) working group, which works to open capital market investment. SAPC membership includes over 450 leading solar developers, financiers and capital managers, law firms, rating agencies, accounting and engineering firms, and other stakeholders engaged in solar asset deployment. SAPC activities are directed toward foundational elements necessary to pool project cash flows into tradable securities: standardization of power purchase and lease contracts for residential and commercial end customers; development of performance and credit data sets to facilitate investor due diligencemore » activities; comprehension of risk perceived by rating agencies; and the development of best practice guides for PV system installation and operations and maintenance (O&M) in order to encourage high-quality system deployment and operation that may improve lifetime project performance and energy production. This PV Installation Best Practices Guide was developed through the SAPC Installation Best Practices subcommittee, a subgroup of SAPC comprised of a wide array of solar industry leaders in numerous fields of practice. The guide was developed over roughly one year and eight months of direct engagement by the subcommittee and two working group comment periods.« less

Blood pressure monitoring: theory and practice. European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability Teaching Course Proceedings.

PubMed

Stergiou, George S; Palatini, Paolo; Asmar, Roland; Bilo, Grzegorz; de la Sierra, Alejandro; Head, Geoff; Kario, Kazuomi; Mihailidou, Anastasia; Wang, Jiguang; Mancia, Giuseppe; O'Brien, Eoin; Parati, Gianfranco

2018-02-01

The European Society of Hypertension (ESH) Working Group on Blood Pressure (BP) Monitoring and Cardiovascular Variability organized a Teaching Course on 'Blood Pressure Monitoring: Theory and Practice' during the 2017 ESH Meeting in Milan, Italy. This course performed by 11 international BP monitoring experts covered key topics of BP monitoring, including office BP measurement, ambulatory BP monitoring, home BP monitoring, ambulatory versus home BP, white-coat and masked hypertension, cuff use, and BP variability. This article presents a summary of the proceedings of the ESH BP Monitoring Teaching Course, including essential information, practical issues, and recommendations on the clinical application of BP monitoring methods, aiming to the optimal management of patients with suspected or diagnosed hypertension.

Implementation of a health data-sharing infrastructure across diverse primary care organizations.

PubMed

Cole, Allison M; Stephens, Kari A; Keppel, Gina A; Lin, Ching-Ping; Baldwin, Laura-Mae

2014-01-01

Practice-based research networks bring together academic researchers and primary care clinicians to conduct research that improves health outcomes in real-world settings. The Washington, Wyoming, Alaska, Montana, and Idaho region Practice and Research Network implemented a health data-sharing infrastructure across 9 clinics in 3 primary care organizations. Following implementation, we identified challenges and solutions. Challenges included working with diverse primary care organizations, adoption of health information data-sharing technology in a rapidly changing local and national landscape, and limited resources for implementation. Overarching solutions included working with a multidisciplinary academic implementation team, maintaining flexibility, and starting with an established network for primary care organizations. Approaches outlined may generalize to similar initiatives and facilitate adoption of health data sharing in other practice-based research networks.

Implementation of a Health Data-Sharing Infrastructure Across Diverse Primary Care Organizations

PubMed Central

Cole, Allison M.; Stephens, Kari A.; Keppel, Gina A.; Lin, Ching-Ping; Baldwin, Laura-Mae

2014-01-01

Practice-based research networks bring together academic researchers and primary care clinicians to conduct research that improves health outcomes in real-world settings. The Washington, Wyoming, Alaska, Montana, and Idaho region Practice and Research Network implemented a health data-sharing infrastructure across 9 clinics in 3 primary care organizations. Following implementation, we identified challenges and solutions. Challenges included working with diverse primary care organizations, adoption of health information data-sharing technology in a rapidly changing local and national landscape, and limited resources for implementation. Overarching solutions included working with a multidisciplinary academic implementation team, maintaining flexibility, and starting with an established network for primary care organizations. Approaches outlined may generalize to similar initiatives and facilitate adoption of health data sharing in other practice-based research networks. PMID:24594564

Differentiating Instruction: Providing the Right Kinds of Worked Examples for Individual Students

ERIC Educational Resources Information Center

Booth, Julie L.; Koedinger, Kenneth R.; Newton, Kristie J.; Lange, Karin E.

2013-01-01

A plethora of laboratory studies have shown that including the study of worked examples during problem-solving practice improves learning (Sweller, 1999; Sweller & Cooper, 1985). While most worked-example research focuses on the use of correct examples, recent work suggests that asking children to explain a combination of correct and incorrect…

Back to Work: A Guide for Expectant and New Working Parents.

ERIC Educational Resources Information Center

O'Brien, Mary Parys

This guide for expectant and new working parents addresses practical and emotional issues that complicate the task of balancing work and family. Chapter 1, which addresses maternity and paternity leave, and the Pregnancy Disability Act, provides information regarding preparation for maternity leave after childbirth. Included are a worksheet to aid…

Clinical Social Work Practice and Education: What Would Flexner Think Now?

ERIC Educational Resources Information Center

Tosone, Carol

2016-01-01

A century has passed since Abraham Flexner posed the question on whether social work is a profession. This article attempts to answer that question, and considers several definitions put forth by global and national social work professional organizations, including a definition of clinical social work. Addressing the current state of social work…

A cross-national comparison of Hong Kong and U.S. student beliefs and preferences in end-of-life care: implications for social work education and hospice practice.

PubMed

Reese, Dona J; Chan, Cecilia L W; Chan, Wallace C H; Wiersgalla, Diane

2010-01-01

In this mixed methods study, the authors explored differences and similarities in beliefs about death and dying as well as end-of-life care preferences among social work students in Hong Kong and the United States. A convenience sample of 176 social work students from Hong Kong and 58 from the United States was recruited to complete a quantitative questionnaire with three open-ended questions. Findings revealed differences as well as similarities in beliefs about death and dying and that a larger proportion of Hong Kong students as compared to U.S. students preferred curative rather than palliative care. Implications for social work education and hospice practice in both countries include the need for social work student and practitioner self-awareness in order to prepare for culturally competent practice and policies that are relevant across cultures.

A survey of environmental and occupational work practices in the automotive refinishing industry of a developing country: Sonora, Mexico.

PubMed

Velázquez, Luis; Bello, Dhimiter; Munguia, Nora; Zavala, Andrea; Marin, Amina; Moure-Eraso, Rafael

2008-01-01

The automotive repair and refinishing industry has been studied intensively in industrialized countries, in part due to use of hazardous chemicals such as isocyanates and solvents, but little is known about industry practices in the developing world. The main objective of this paper was to investigate environmental and occupational work practices of this industry in a developing region, Sonora, Mexico. An integrated survey approach maximizes the opportunity for identifying risks as well as reducing risks. This investigation included detailed workplace visits to 41 body shops and 6 paint suppliers, as well as a survey of shop owners and 24 workers. Information was collected on work practices, level of technology in the shops, use of personal protective equipment, consumption and handling of hazardous chemicals and waste, hazard communication, and environmental consciousness. Most shops had little capital, outdated technology for exposure control, poor working conditions, high potential for exposure to hazardous chemicals, and little awareness of environmental and occupational health and safety. We concluded that work practices in the Sonoran auto refinishing industry are unsustainable and may pose a health risk to workers and the environment.

A pilot study to rate determinants of exposure from videotaped work activities of farmers' use of pesticides.

PubMed

Prince, J R; Stewart, P A; Nam, J M; Blair, A

2001-10-01

Industrial hygienists often observe workers to determine who should be measured based on a predicted exposure level. Such evaluations are usually based on real-time observation, yet surprisingly little research has been conducted on what determinants of exposure industrial hygienists use to rank workers and whether the ranking is accurate. Accuracy of the ranking may also be affected by the observation process, which is limited when conditions in the workers' immediate environment are rapidly changing. An alternative to real-time observation is videotaping workers and evaluating the tapes at a later date. A pilot study was conducted using previously collected data to determine if workers could be ranked by exposure level utilizing a scoring system to rate videotaped work practices. Six farmers had been videotaped and their dermal exposures measured as they applied insecticide to hogs. In this study, scores were developed to rate the farmers' working conditions by exposure level. Two types of determinants were used to describe exposure: touching and work practices. Touching included the number of times parts of the body had contact with surfaces possibly contaminated with insecticide. Work practices included the types of clothing and protective equipment worn as well as specific practices used by the farmer (e.g., application method). Two raters conducted independent assessments of the videotape using the same criteria. One rater reviewed the tape twice. Agreement between the raters for the "touching" score was weak (intra-class coefficient (ICC) = 0.28), but there was excellent agreement between the two raters (ICC = 0.92) for overall quality of work practices. As expected, a greater number of touches was moderately correlated with an increase in total exposure (rs = 0.60) and there was a weak inverse relationship between protective work practices and the exposure under the clothing (rs = -0.26). All other relationships with exposure level were contrary to what was expected. Since videotapes provide the industrial hygienist with a record of work events and can capture details that might otherwise be missed or not considered they may play a useful role in exposure assessment, especially if carefully developed procedures are followed to overcome the limitations found by this pilot study.

A Thematic Inquiry into the Burnout Experience of Australian Solo-Practicing Clinical Psychologists.

PubMed

Hammond, Trent E; Crowther, Andrew; Drummond, Sally

2017-01-01

Objective: Burnout is conceptualized as a syndrome that consists of emotional exhaustion, depersonalization, and decreased personal accomplishment. Despite the increased frequency and severity of burnout in the Western world, there is limited published research regarding the experiences of clinical psychologists who have had burnout. The present study examines clinical psychologists' different experiences of burnout in Australia. Design and Methods: In the year 2015, six privately practicing and solo-employed clinical psychologists provided rich qualitative data by participating in semi-structured interviews. Thematic analysis was the method used to analyze clinical psychologists' natural accounts of their burnout experiences. Using NVivo, emerging themes were identified through coding 'first order constructs' and then axial code 'second order constructs.' Findings: Clinical psychologists indicated that their roles are demanding and a diverse range of symptoms, including the enduring effects of burnout, mental stress, fatigue, decreased personal accomplishment, negative affect, depersonalization, reduced productivity and motivation, and insomnia. They identified precursors of burnout, including excessive workload and hours of work, life stresses, mismanaged workload, and transference. Clinical psychologists suggested that protective factors of burnout include knowledge and years worked in direct care, and trusting and long-term relationships. They indicated that the barriers to overcoming burnout include the fallacy that their clients' expectations and needs are more important than their own, the financial cost of working in private practice, contemporary knowledge and inadequate education regarding self-care, and time constraints. Discussion and Conclusion: The findings presented in this study provide psychologists and other health professionals with an insight about the burnout experience and inform professionals of the mental shortcomings of working as a solo-practicing clinical psychologist. Findings from this study should lead to an increased understanding of the complexities of burnout, and ultimately reduced cases of burnout, absenteeism, and staff disengagement.

Contractor-, steward-, and coworker-safety practice: associations with musculoskeletal pain and injury-related absence among construction apprentices.

PubMed

Kim, Seung-Sup; Dutra, Lauren M; Okechukwu, Cassandra A

2014-07-01

This paper sought to assess organizational safety practices at three different levels of hierarchical workplace structure and to examine their association with injury outcomes among construction apprentices. Using a cross-sectional sample of 1,775 construction apprentices, three measures of organizational safety practice were assessed: contractor-, steward-, and coworker-safety practice. Each safety practice measure was assessed using three similar questions (i.e., on-the-job safety commitment, following required or recommended safe work practices, and correcting unsafe work practices); the summed average of the responses ranged from 1 to 4, with a higher score indicating poorer safety practice. Outcome variables included the prevalence of four types of musculoskeletal pain (i.e., neck, shoulder, hand, and back pain) and injury-related absence. In adjusted analyses, contractor-safety practice was associated with both hand pain (OR: 1.27, 95 % CI: 1.04, 1.54) and back pain (OR: 1.40, 95 % CI: 1.17, 1.68); coworker-safety practice was related to back pain (OR: 1.42, 95 % CI: 1.18, 1.71) and injury-related absence (OR: 1.36, 95 % CI: 1.11, 1.67). In an analysis that included all three safety practice measures simultaneously, the association between coworker-safety practice and injury-related absence remained significant (OR: 1.68, 95 % CI: 1.20, 2.37), whereas all other associations became non-significant. This study suggests that organizational safety practice, particularly coworker-safety practice, is associated with injury outcomes among construction apprentices.

Workplace violence: protecting your practice from an epidemic.

PubMed

Calway, R C

2001-01-01

Workplace violence, in the form of verbal threats and/or intimidation and physical aggression, is commonplace in medical practices today. The practice must be prepared to respond to this disaster in the same manner with which they prepare for responses to a medical emergency, fire, or loss of electricity. The risks and liabilities of failing to build a robust program include low staff morale and productivity, employee injury, lost work time, regulatory fines and sanctions, and the risk of civil judgments against the practice. The most successful programs receive commitment (read: involvement) from management and include staff in program development and implementation.

The Influence of Field Teaching Practice on Pre-service Teachers’ Professional Identity: A Mixed Methods Study

PubMed Central

Zhao, Hongyu; Zhang, Xiaohui

2017-01-01

The current study used mixed methods to research pre-service teachers’ professional identity. Ninety-eight pre-service teachers were investigated and twelve teachers were interviewed in China. The results were as follows: (1) The results of quantitative data showed that compared with before the field teaching practice, pre-service teachers’ professional identity increased after the field teaching practice—specifically, intrinsic value identity increased, and extrinsic value identity did not significantly change; (2) The results of qualitative data validated and elaborated the results of quantitative data in more detail with regard to changes in professional identity. Specifically, compared with before the field teaching practice, intrinsic value identity including work content, work pattern, etc., increased and extrinsic value identity including work environment, income, and social status, etc., did not significantly change after experiencing teaching practice; (3) The results of qualitative data also showed that mentor support at field school promoted the development of pre-service teachers’ professional identity. Moreover, the development of pre-service teachers’ professional identity during field teaching practice further promoted their professional commitment; that is, it promoted their emotional evaluation and belief in the teaching profession. The study discussed these results and proposed solutions and suggestions for future studies. PMID:28790956

Partnerships for better mental health worldwide: WPA recommendations on best practices in working with service users and family carers

PubMed Central

WALLCRAFT, JAN; AMERING, MICHAELA; FREIDIN, JULIAN; DAVAR, BHARGAVI; FROGGATT, DIANE; JAFRI, HUSSAIN; JAVED, AFZAL; KATONTOKA, SYLVESTER; RAJA, SHOBA; RATAEMANE, SOLOMON; STEFFEN, SIGRID; TYANO, SAM; UNDERHILL, CHRISTPHER; WAHLBERG, HENRIK; WARNER, RICHARD; HERRMAN, HELEN

2011-01-01

WPA President M. Maj established the Task Force on Best Practice in Working with Service Users and Carers in 2008, chaired by H. Herrman. The Task Force had the remit to create recommendations for the international mental health community on how to develop successful partnership working. The work began with a review of literature on service user and carer involvement and partnership. This set out a range of considerations for good practice, including choice of appropriate terminology, clarifying the partnership process and identifying and reducing barriers to partnership working. Based on the literature review and on the shared knowledge in the Task Force, a set of ten recommendations for good practice was developed. These recommendations were the basis for a worldwide consultation of stakeholders with expertise as service users, families and carers, and the WPA Board and Council. The results showed a strong consensus across the international mental health community on the ten recommendations, with the strongest agreement coming from service users and carers. This general consensus gives a basis for Task Force plans to seek support for activities to promote shared work worldwide to identify best practice examples and create a resource to assist others to begin successful collaboration. PMID:21991284

Knowledge brokering: an innovative model for supporting evidence-informed practice in respiratory care.

PubMed

Hoens, Alison M; Reid, W Darlene; Camp, Pat G

2013-01-01

The process of adopting research findings in the clinical setting is challenging, regardless of the area of practice. One strategy to facilitate this process is the use of knowledge brokering. Knowledge brokers (KBs) are individuals who work to bridge the gap between researchers and knowledge users. In the health care setting, KBs work closely with clinicians to facilitate enhanced uptake of research findings into clinical practice. They also work with researchers to ensure research findings are translatable and meaningful to clinical practice. The present article discusses a KB's role in a respiratory care setting. Working closely with both researchers and clinicians, the KB has led teams in the process of conceptualizing, developing, testing, disseminating and evaluating several projects related to respiratory care, including projects related to mobility in critical care settings and acute exacerbations of chronic obstructive pulmonary disease; inspiratory muscle training; and the use of incentive spirometry in postsurgical populations. The KB role has provided an important communication link between researcher and knowledge user that has facilitated evidence-informed practice to improve patient care.

Nurse managers' strategies for feeling less drained by their work: an action research and reflection project for developing emotional intelligence.

PubMed

Taylor, Bev; Roberts, Sue; Smyth, Therese; Tulloch, Moira

2015-10-01

To raise nurse managers' critical awareness of practice problems; uncover practice constraints and improve work effectiveness. Nurse management requires skills and knowledge, underscored by emotional intelligence. The research improved participants' practice and personal insights. Purposive sampling targeted nurse managers interested in improving their practice. Three experienced female nurse managers met fortnightly in a group, for 1 hour, for 10 meetings. The methods included: writing and sharing de-identified journal reflections; critically analysing practice stories; identifying a thematic concern; generating action strategies; and instituting and revising the action plan. Phase One resulted in the identification of the issue of 'being drained by the intensity of nurse managers' work'. The participants adopted five strategies: debriefing problematic situations; deflecting multiple requests; diffusing issues; naming dysfunctional behaviours; and regrouping. In Phase Two, participants implemented and revised the action plan strategies, which resulted in them feeling less drained by their work. Strategies can lessen nurse managers' sense of personal depletion. However, strategies cannot guarantee success every time because the emotional intelligence is integral to nurse management. Action research and reflection assist nurse managers to improve their practice and develop their emotional intelligence. © 2014 John Wiley & Sons Ltd.

Leadership of Learning in Early Years Practice: A Professional Learning Resource [Includes DVD

ERIC Educational Resources Information Center

Hallet, Elaine

2014-01-01

This book focuses upon effective pedagogical leadership and practice in the leadership of learning within early years settings and children's centres. The book and accompanying DVD, containing real-life examples of early years leaders, provides a framework for reflective thinking and learning for those leading practice and working with children,…

Distance Education in Southern Africa Conference, 1987. Papers 4.2: Professional Education and Practical Training at a Distance.

ERIC Educational Resources Information Center

Adey, David, Comp.; And Others

Fifteen papers from the University of South Africa's Conference on Distance Education are presented on professional education and practical training. They include: "The Art Work: From Concept to Realization" (Leon du Plessis and Koos van der Watt); "Distance Education for Industrial, Professional, and Practical Training" (Jacob…

Organisational characteristics associated with shift work practices and potential opportunities for intervention: findings from a Canadian study.

PubMed

Hall, Amy L; Smit, Andrea N; Mistlberger, Ralph E; Landry, Glenn J; Koehoorn, Mieke

2017-01-01

Shift work is a common working arrangement with wide-ranging implications for worker health. Organisational determinants of shift work practices are not well characterised; such information could be used to guide evidence-based research and best practices to mitigate shift work's negative effects. This exploratory study aimed to describe and assess organisational-level determinants of shift work practices thought to affect health, across a range of industry sectors. Data on organisational characteristics, shift work scheduling, provision of shift work education materials/training to employees and night-time lighting policies in the workplace were collected during phone interviews with organisations across the Canadian province of British Columbia. Relationships between organisational characteristics and shift work practices were assessed using multivariable logistic regression models. The study sample included 88 participating organisations, representing 30 700 shift workers. Long-duration shifts, provision of shift work education materials/training to employees and night-time lighting policies were reported by approximately one-third of participating organisations. Odds of long-duration shifts increased in larger workplaces and by industry. Odds of providing shift work education materials/training increased in larger workplaces, in organisations reporting concern for shift worker health and in organisations without seasonal changes in shift work. Odds of night-time lighting policies in the workplace increased in organisations reporting previous workplace accidents or incidents that occurred during non-daytime hours, site maintenance needs and client service or care needs. This study points to organisational determinants of shift work practices that could be useful for targeting research and workplace interventions. Results should be interpreted as preliminary in an emerging body of literature on shift work and health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Managing the Right Projects: Best Practices to Align Project and Corporate Strategies

NASA Technical Reports Server (NTRS)

Watkins, Bobby

2012-01-01

If there's a human endeavor that exemplifies teamwork, it is space exploration. And that teamwork absolutely cannot happen effectively if the boots on the ground the people doing the work - don't understand how their work aligns with the larger goal. This presentation will discuss some best management practices from NASA's Marshall Space Flight Center that have succeeded in helping employees become informed, engaged and committed to the space agency's important missions. Specific topics include: Alignment Criteria: Linking Projects To Corporate Strategy. Resource Management: Best Practices For Resource Management. Strategic Analysis: Supporting Decision Making In A Changing Environment. Communication Strategies: Best Practices To Communicate Change. Benefits Achieved And Lessons Learned.

Moderators and Mediators in Social Work Research: Toward a More Ecologically Valid Evidence Base for Practice

PubMed Central

Magill, Molly

2012-01-01

Summary Evidence-based practice involves the consistent and critical consumption of the social work research literature. As methodologies advance, primers to guide such efforts are often needed. In the present work, common statistical methods for testing moderation and mediation are identified, summarized, and corresponding examples, drawn from the substance abuse, domestic violence, and mental health literature, are provided. Findings While methodologically complex, analyses of these third variable effects can provide an optimal fit for the complexity involved in the provision of evidence-based social work services. While a moderator may identify the trait or state requirement for a causal relationship to occur, a mediator is concerned with the transmission of that relationship. In social work practice, these are questions of “under what conditions and for whom?” and of the “how?” of behavior change. Implications Implications include a need for greater attention to these methods among practitioners and evaluation researchers. With knowledge gained through the present review, social workers can benefit from a more ecologically valid evidence base for practice. PMID:22833701

Green shoots of recovery: a realist evaluation of a team to support change in general practice.

PubMed

Bartlett, Maggie; Basten, Ruth; McKinley, Robert K

2017-02-08

A multidisciplinary support team for general practice was established in April 2014 by a local National Health Service (NHS) England management team. This work evaluates the team's effectiveness in supporting and promoting change in its first 2 years, using realist methodology. Primary care in one area of England. Semistructured interviews were conducted with staff from 14 practices, 3 key senior NHS England personnel and 5 members of the support team. Sampling of practice staff was purposive to include representatives from relevant professional groups. The team worked with practices to identify areas for change, construct action plans and implement them. While there was no specified timescale for the team's work with practices, it was tailored to each. In realist evaluations, outcomes are contingent on mechanisms acting in contexts, and both an understanding of how an intervention leads to change in a socially constructed system and the resultant changes are outcomes. The principal positive mechanisms leading to change were the support team's expertise and its relationships with practice staff. The 'external view' provided by the team via its corroborative and normalising effects was an important mechanism for increasing morale in some practice contexts. A powerful negative mechanism was related to perceptions of 'being seen as a failing practice' which included expressions of 'shame'. Outcomes for practices as perceived by their staff were better communication, improvements in patients' access to appointments resulting from better clinical and managerial skill mix, and improvements in workload management. The support team promoted change within practices leading to signs of the 'green shoots of recovery' within the time frame of the evaluation. Such interventions need to be tailored and responsive to practices' needs. The team's expertise and relationships between team members and practice staff are central to success. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Work Sharing Case Studies.

ERIC Educational Resources Information Center

McCarthy, Maureen E.; And Others

Designed to provide private sector employers with the practical information necessary to select and then to design and implement work sharing arrangements, this book presents case studies of some 36 work sharing programs. Topics covered in the case studies include the circumstances leading to adoption of the program, details of compensation and…

Education and Training for Work. Volume 1--Planning Programs.

ERIC Educational Resources Information Center

Campbell, Clifton P., Ed.

This book, which is intended for practicing or aspiring instructors, curriculum developers, and others engaged in work force development at the secondary and postsecondary levels, contains eight papers explaining how to plan education and training for work. The following papers are included: "Determining the Market Demand for Skilled Workers"…

Biosocial Research in Social Work Journals: A Systematic Review

ERIC Educational Resources Information Center

Maynard, Brandy R.; Boutwell, Brian B.; Vaughn, Michael G.; Naeger, Sandra; Dell, Nathaniel

2018-01-01

Background: Despite an emphasis on a biopsychosocial understanding of human behavior and the relevance of biosocial research to social work practice, it is unclear whether social work is contributing to biosocial research and knowledge. Methods: Systematic review procedures were employed to locate studies that included biological variables (e.g.,…

Designing and Assessing Productive Group Work in Secondary Schools

ERIC Educational Resources Information Center

Vaca, Javier; Lapp, Diane; Fisher, Douglas

2011-01-01

A history teacher examines what is successful and not successful in group work in his high school classroom and gives concrete suggestions for improving group practice. Topics discussed include preparing students for group work, supporting collaboration, inviting critical analysis, and assessing both group and individual performance. (Contains 2…

Edward W. Jennings | NREL

Science.gov Websites

practices promoting a safe and supportive working environment. His research interests include environmental, safety, and health (ESH) and facility issues, he is responsible for implementing safe work plan; working directly with awardees by performing on-site validations to collect and analyze enzyme

Psychotherapeutic issues with "kinky" clients: clinical problems, yours and theirs.

PubMed

Nichols, Margaret

2006-01-01

People whose sexual repertoire includes BDSM, fetish, or other "kinky" practices have become increasingly visible, on the Internet, in the real world, and in psychotherapists' offices. Unfortunately, the prevailing psychiatric view of BDSM remains a negative one: These sexual practices are usually considered paraphilias, i.e., de facto evidence of pathology. A different, affirming view of BDSM is taken in this paper. After defining BDSM and reviewing common misconceptions, a variety of issues the practitioner will face are described. These include problems of countertransference, of working with people with newly emerging sexual identities, working with spouses and partners, and discriminating between abuse and sexual "play."

Judgements about fellow professionals and the management of patients receiving palliative care in primary care: a qualitative study.

PubMed

Walshe, Catherine; Todd, Chris; Caress, Ann-Louise; Chew-Graham, Carolyn

2008-04-01

Policies emphasise the importance of collaborative working in community palliative care. Collaborations are generally formed through formal and informal referral processes, but little is known about what influences professionals' decisions to refer to such services. To explore the influences on referrals within general and specialist community palliative care services. Qualitative, multiple-case study. Three primary care trusts in the north-west of England. Multiple data collection methods were employed, including documentary analysis, observation of referral team meetings and interviews. This paper primarily reports data from interviews with 47 health professionals, including GPs, district nurses, and specialist palliative care professionals. Judgements -- positive and negative -- about aspects of fellow professionals' performances appeared to influence referral decisions and ongoing collaboration and care. Attributes upon which these judgements were based included professional responsiveness and communication, respect, working and workload management practices, perceived expertise, and notions of elite practice. The effects of such judgements on referral and healthcare practices were altered by professional "game playing" to achieve professionals' desired outcomes. Palliative care policies and protocols need to take account of these complex and subtle influences on referrals and collaboration. In particular, teamwork and partnership are encouraged within palliative care work, but critical judgements indicate that such partnerships may be difficult or fragile. It is likely that such judgemental attitudes and practices affect many aspects of primary care, not just palliative care.

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

PubMed

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

2016-02-29

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

A work-based learning approach for clinical support workers on mental health inpatient wards.

PubMed

Kemp, Philip; Gilding, Moorene; Seewooruttun, Khooseal; Walsh, Hannah

2016-09-14

Background With a rise in the number of unqualified staff providing health and social care, and reports raising concerns about the quality of care provided, there is a need to address the learning needs of clinical support workers. This article describes a qualitative evaluation of a service improvement project that involved a work-based learning approach for clinical support workers on mental health inpatient wards. Aim To investigate and identify insights in relation to the content and process of learning using a work-based learning approach for clinical support workers. Method This was a qualitative evaluation of a service improvement project involving 25 clinical support workers at the seven mental health inpatient units in South London and Maudsley NHS Foundation Trust. Three clinical skills tutors were appointed to develop, implement and evaluate the work-based learning approach. Four sources of data were used to evaluate this approach, including reflective journals, qualitative responses to questionnaires, three focus groups involving the clinical support workers and a group interview involving the clinical skills tutors. Data were analysed using thematic analysis. Findings The work-based learning approach was highly valued by the clinical support workers and enhanced learning in practice. Face-to-face learning in practice helped the clinical support workers to develop practice skills and reflective learning skills. Insights relating to the role of clinical support workers were also identified, including the benefits of face-to-face supervision in practice, particularly in relation to the interpersonal aspects of care. Conclusion A work-based learning approach has the potential to enhance care delivery by meeting the learning needs of clinical support workers and enabling them to apply learning to practice. Care providers should consider how the work-based learning approach can be used on a systematic, organisation-wide basis in the context of budgetary restrictions.

Burnout and Scope of Practice in New Family Physicians.

PubMed

Weidner, Amanda K H; Phillips, Robert L; Fang, Bo; Peterson, Lars E

2018-05-01

Family physicians report some of the highest levels of burnout, but no published work has considered whether burnout is correlated with the broad scope of care that family physicians may provide. We examined the associations between family physician scope of practice and self-reported burnout. Secondary analysis of the 2016 National Family Medicine Graduate Survey respondents who provided outpatient continuity care (N = 1,617). We used bivariate analyses and logistic regression to compare self-report of burnout and measures of scope of practice including: inpatient medicine, obstetrics, pediatric ambulatory care, number of procedures and/or clinical content areas, and providing care outside the principal practice site. Forty-two percent of respondents reported feeling burned out from their work once a week or more. In bivariate analysis, elements of scope of practice associated with higher burnout rates included providing more procedures/clinical content areas (mean procedures/clinical areas: 7.49 vs 7.02; P = .02) and working in more settings than the principal practice site (1+ additional settings: 57.6% vs 48.4%: P = .001); specifically in the hospital (31.4% vs 24.2%; P = .002) and patient homes (3.3% vs 1.5%; P = .02). In adjusted analysis, practice characteristics significantly associated with lower odds of burnout were practicing inpatient medicine (OR = 0.70; 95% CI, 0.56-0.87; P = .0017) and obstetrics (OR = 0.64; 95% CI, 0.47-0.88; P = .0058). Early career family physicians who provide a broader scope of practice, specifically, inpatient medicine, obstetrics, or home visits, reported significantly lower rates of burnout. Our findings suggest that comprehensiveness is associated with less burnout, which is critical in the context of improving access to good quality, affordable care while maintaining physician wellness. © 2018 Annals of Family Medicine, Inc.

Nursing Practice Environment and Outcomes for Oncology Nursing

PubMed Central

Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.

2012-01-01

Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101

Mediation of adoption and use: a key strategy for mitigating unintended consequences of health IT implementation.

PubMed

Novak, Laurie L; Anders, Shilo; Gadd, Cynthia S; Lorenzi, Nancy M

2012-01-01

Without careful attention to the work of users, implementation of health IT can produce new risks and inefficiencies in care. This paper uses the technology use mediation framework to examine the work of a group of nurses who serve as mediators of the adoption and use of a barcode medication administration (BCMA) system in an inpatient setting. The study uses ethnographic methods to explore the mediators' work. Data included field notes from observations, documents, and email communications. This variety of sources enabled triangulation of findings between activities observed, discussed in meetings, and reported in emails. Mediation work integrated the BCMA tool with nursing practice, anticipating and solving implementation problems. Three themes of mediation work include: resolving challenges related to coordination, integrating the physical aspects of BCMA into everyday practice, and advocacy work. Previous work suggests the following factors impact mediation effectiveness: proximity to the context of use, understanding of users' practices and norms, credibility with users, and knowledge of the technology and users' technical abilities. We describe three additional factors observed in this case: 'influence on system developers,' 'influence on institutional authorities,' and 'understanding the network of organizational relationships that shape the users' work.' Institutionally supported clinicians who facilitate adoption and use of health IT systems can improve the safety and effectiveness of implementation through the management of unintended consequences. Additional research on technology use mediation can advance the science of implementation by providing decision-makers with theoretically durable, empirically grounded evidence for designing implementations.

E-health to improve work functioning in employees with rheumatoid arthritis in rheumatology practice: a feasibility study.

PubMed

Hoving, J L; Zoer, I; van der Meer, M; van der Straaten, Y; Logtenberg-Rutten, C; Kraak-Put, S; de Vries, N; Tak, P P; Sluiter, J K; Frings-Dresen, M H W

2014-01-01

To evaluate the feasibility of an e-health intervention in rheumatology practice for employees with rheumatoid arthritis (RA) who experience problems with work functioning. Twenty-three out of 90 patients with RA from a hospital rheumatology department, invited by letter, participated in a feasibility study. The 3-month internet e-health programme consisted of a self-management programme using a three-step problem-solving strategy: (step 1) analyse your work problems and opportunities; (step 3) identify solutions; and (step 3) work out a strategy (action plan). Support and personal feedback was provided by a rheumatology nurse. Patients completed assignments, received information, and actively worked on their goals. The main feasibility outcome included satisfaction with the programme. Other feasibility outcomes included usefulness, suitability, website use, and work functioning measured at baseline and/or 3 months using questionnaires, semi-structured interviews, and website data. In total, 95% of the participants were satisfied with the programme, and 96% thought the programme was useful for working RA patients and would recommend the programme to other working RA patients (91%). On the website, all patients at least partially completed the assignments in step 1 and 12 patients completed at least one assignment in step 3. Patients judged the website as well arranged with clear tasks. Patients worked on a range of (individual) goals, resolving work challenges using different strategies and actions. The e-health intervention is a feasible intervention for rheumatology practice justifying further effectiveness evaluation while allowing for further improvements in the selection of RA patients and shaping the intervention.

Practice Innovation for Care Integration, Opioid Management, and Quality Measurement in Family Medicine.

PubMed

Neale, Anne Victoria; Bowman, Marjorie A; Seehusen, Dean A

Ringing in the new year 2017! This may finally be the year of real practice improvement after many false starts. Research into practice transformation has informed both local work and national policy. Human factors and payment structures are key. And payment structures depend on how quality is measured. Large gaps between practicing physician recommendations for the most important quality measures and those currently imposed externally are exposed in this issue. Also see information on in-practice social work consultations and their outcomes and recommendations from innovators in integrated care, and for chronic opioid therapy management based on visits to many family medicine offices. Visit entropy is negative for hospital readmissions. Another article reaffirms the importance of family physicians in rural obstetrics, including Cesarean deliveries. Two articles address changing Latino health care access. New Mexico's innovative health extension agent implementation now includes research in ways that benefit all. And a glass half-full: the growth in the diversity of family medicine faculty is above average, but is not occurring as quickly as in the general population. © Copyright 2017 by the American Board of Family Medicine.

Employment experiences of vocationally trained doctors.

PubMed Central

Osler, K

1991-01-01

OBJECTIVES--To investigate the expectations and employment experiences of male and female doctors who completed vocational training in East Anglia during 1981-7 and to examine the factors which had influenced those who had changed direction early in their careers. DESIGN--Survey conducted by confidential postal questionnaire. SETTING--Britain. SUBJECTS--281 doctors, 233 (83%) of whom responded. MAIN OUTCOME MEASURES--Ideal choice of work on completion of vocational training; present employment; factors which had restricted present choice of work; factors associated with reported satisfaction with job. RESULTS--77/83 (93%) men and 130/150 (87%) women had hoped to work in general practice (p = 0.75). A smaller proportion of women (71%; 106) than men (89%; 74) were in general practice posts (p less than 0.01); only 6% (nine) of women were on maternity leave or caring for children without paid employment. More women than men were working in medical jobs other than general practice (18% (27) women v 4% (three) men; p less than 0.01). 44/91 (49%) women with children had achieved their employment goals compared with 47/59 (80%) women without children and 55/71 (78%) men with children. 87% (72/83) of men and 65% (98/150) of women had achieved the status of principal (p less than 0.01). 162/193 (84%) doctors who had worked in general practice reported satisfaction with their jobs. Dissatisfaction was linked with doing a job different from that hoped for and with perceiving that the share of practice income did not accurately reflect their share of the practice workload. CONCLUSIONS--Steps need to be taken to retain women in general practice, including a statutory part time pay allowance and incentives for practices to allow flexible working hours for doctors with young children. PMID:1932939

Employment experiences of vocationally trained doctors.

PubMed

Osler, K

1991-09-28

To investigate the expectations and employment experiences of male and female doctors who completed vocational training in East Anglia during 1981-7 and to examine the factors which had influenced those who had changed direction early in their careers. Survey conducted by confidential postal questionnaire. Britain. 281 doctors, 233 (83%) of whom responded. Ideal choice of work on completion of vocational training; present employment; factors which had restricted present choice of work; factors associated with reported satisfaction with job. 77/83 (93%) men and 130/150 (87%) women had hoped to work in general practice (p = 0.75). A smaller proportion of women (71%; 106) than men (89%; 74) were in general practice posts (p less than 0.01); only 6% (nine) of women were on maternity leave or caring for children without paid employment. More women than men were working in medical jobs other than general practice (18% (27) women v 4% (three) men; p less than 0.01). 44/91 (49%) women with children had achieved their employment goals compared with 47/59 (80%) women without children and 55/71 (78%) men with children. 87% (72/83) of men and 65% (98/150) of women had achieved the status of principal (p less than 0.01). 162/193 (84%) doctors who had worked in general practice reported satisfaction with their jobs. Dissatisfaction was linked with doing a job different from that hoped for and with perceiving that the share of practice income did not accurately reflect their share of the practice workload. Steps need to be taken to retain women in general practice, including a statutory part time pay allowance and incentives for practices to allow flexible working hours for doctors with young children.

10 CFR 4.13 - Employment practices.

Code of Federal Regulations, 2013 CFR

2013-01-01

... practices. (a) Where a primary objective of the Federal financial assistance to a program to which this... compensation, and use of facilities), including programs where a primary objective of the Federal financial... commencement or continuation of their education or training, or (2) to provide work experience which...

Online Collaborative Learning: Theory and Practice

ERIC Educational Resources Information Center

Roberts, Tim, Ed.

2004-01-01

"Online Collaborative Learning: Theory and Practice" provides a resource for researchers and practitioners in the area of online collaborative learning (also known as CSCL, computer-supported collaborative learning), particularly those working within a tertiary education environment. It includes articles of relevance to those interested in both…

Doctor of Professional Counseling: The Next Step

ERIC Educational Resources Information Center

Southern, Stephen; Cade, Rochelle; Locke, Don W.

2012-01-01

Professional doctorates have been established in the allied health professions by clinicians seeking the highest levels of independent practice. Allied health professional doctorates include nursing practice (DNP), occupational therapy (OTD), psychology (PsyD), social work (DSW), and marriage and family therapy (DMFT). Lessons learned from the…

The Practice of Water Pollution Biology.

ERIC Educational Resources Information Center

Mackenthun, Kenneth M.

Water pollution techniques and practices, including data analysis, interpretation and display are described in this book intended primarily for the biologist inexperienced in this work, and for sanitary engineers, chemists, and water pollution control administrators. The characteristics of aquatic environments, their biota, and the effects of…

A Changing World of Work.

ERIC Educational Resources Information Center

Gysbers, Norman C.; And Others

This seventh chapter in "Elementary School Counseling in a Changing World" discusses theoretical and practical issues related to career development and offers suggestions to help elementary school counselors promote students' career exploration. Four journal articles are included. "Major Trends in Career Development Theory and Practice" by Norman…

Strategies for Postsecondary Students in Developmental Education: A Practice Guide for College and University Administrators, Advisors, and Faculty. NCEE 2017-4011

ERIC Educational Resources Information Center

Bailey, Thomas; Bashford, Joanne; Boatman, Angela; Squires, John; Weiss, Michael; Doyle, William; Valentine, Jeffrey C.; LaSota, Robin; Polanin, Joshua R.; Spinney, Elizabeth; Wilson, Wesley; Yelde, Martha; Young, Sarah H.

2016-01-01

This practice guide presents six evidence-based recommendations for college and university faculty, administrators, and advisors working to improve the success of students academically underprepared for college. Each recommendation includes an overview of the practice, a summary of evidence used in support of the evidence rating, guidance on how…

Blind Seer: A Scalable Private DBMS

DTIC Science & Technology

2014-05-01

searchable index terms per DB row, in time comparable to (insecure) MySQL (many practical queries can be privately executed with work 1.2-3 times slower...than MySQL , although some queries are costlier). We support a rich query set, including searching on arbitrary boolean formulas on keywords and ranges...index terms per DB row, in time comparable to (insecure) MySQL (many practical queries can be privately executed with work 1.2-3 times slower than MySQL

Nursing practice environment, quality of care, and morale of hospital nurses in Japan.

PubMed

Anzai, Eriko; Douglas, Clint; Bonner, Ann

2014-06-01

The purpose of this study was to describe Japanese hospital nurses' perceptions of the nursing practice environment and examine its association with nurse-reported ability to provide quality nursing care, quality of patient care, and ward morale. A cross-sectional survey design was used including 223 nurses working in 12 acute inpatient wards in a large Japanese teaching hospital. Nurses rated their work environment favorably overall using the Japanese version of the Practice Environment Scale of the Nursing Work Index. Subscale scores indicated high perceptions of physician relations and quality of nursing management, but lower scores for staffing and resources. Ward nurse managers generally rated the practice environment more positively than staff nurses except for staffing and resources. Regression analyses found the practice environment was a significant predictor of quality of patient care and ward morale, whereas perceived ability to provide quality nursing care was most strongly associated with years of clinical experience. These findings support interventions to improve the nursing practice environment, particularly staffing and resource adequacy, to enhance quality of care and ward morale in Japan. © 2013 Wiley Publishing Asia Pty Ltd.

Instituting systems-based practice and practice-based learning and improvement: a curriculum of inquiry.

PubMed

Wilper, Andrew P; Smith, Curtis Scott; Weppner, William

2013-09-16

The Accreditation Council for Graduate Medical Education (ACGME) requires that training programs integrate system-based practice (SBP) and practice-based learning and improvement (PBLI) into internal medicine residency curricula. CONTEXT AND SETTING: We instituted a seminar series and year-long-mentored curriculum designed to engage internal medicine residents in these competencies. Residents participate in a seminar series that includes assigned reading and structured discussion with faculty who assist in the development of quality improvement or research projects. Residents pursue projects over the remainder of the year. Monthly works in progress meetings, protected time for inquiry, and continued faculty mentorship guide the residents in their project development. Trainees present their work at hospital-wide grand rounds at the end of the academic year. We performed a survey of residents to assess their self-reported knowledge, attitudes and skills in SBP and PBLI. In addition, blinded faculty scored projects for appropriateness, impact, and feasibility. We measured resident self-reported knowledge, attitudes, and skills at the end of the academic year. We found evidence that participants improved their understanding of the context in which they were practicing, and that their ability to engage in quality improvement projects increased. Blinded faculty reviewers favorably ranked the projects' feasibility, impact, and appropriateness. The 'Curriculum of Inquiry' generated 11 quality improvement and research projects during the study period. Barriers to the ongoing work include a limited supply of mentors and delays due to Institutional Review Board approval. Hospital leadership recognizes the importance of the curriculum, and our accreditation manager now cites our ongoing work. A structured residency-based curriculum facilitates resident demonstration of SBP and practice-based learning and improvement. Residents gain knowledge and skills though this enterprise and hospitals gain access to trainees who help to solve ongoing problems and meet accreditation requirements.

Building community and public health nursing capacity: a synthesis report of the National Community Health Nursing Study.

PubMed

Underwood, Jane M; Mowat, David L; Meagher-Stewart, Donna M; Deber, Raisa B; Baumann, Andrea O; MacDonald, Mary B; Akhtar-Danesh, Noori; Schoenfeld, Bonnie M; Ciliska, Donna K; Blythe, Jennifer M; Lavoie-Tremblay, Mélanie; Ehrlich, Anne S; Knibbs, Kristin M; Munroe, Valerie J

2009-01-01

1) To describe the community health nursing workforce in Canada; 2) To compare, across political jurisdictions and community health sectors, what helps and hinders community nurses to work effectively; 3) To identify organizational attributes that support one community subsector--public health nurses--to practise the full scope of their competencies. Our study included an analysis of the Canadian Institute for Health Information nursing databases (1996-2007), a survey of over 13,000 community health nurses across Canada and 23 focus groups of public health policy-makers and front-line public health nurses. Over 53,000 registered and licensed practical nurses worked in community health in Canada in 2007, about 16% of the nursing workforce. Community nurses were older on average than the rest of their profession. Typical practice settings for community nurses included community health centres, home care and public health units/departments. To practise effectively, community nurses need professional confidence, good team relationships, supportive workplaces and community support. Most community nurses felt confident in their practice and relationships with other nurses and professionals, though less often with physicians. Their feelings about salary and job security were mixed, and most community nurses would like more learning opportunities, policy and practice information and chances to debrief about work. They needed their communities to do more to address social determinants of health and provide good quality resources. Public health nursing needs a combination of factors to succeed: sound government policy, supportive organizational culture and good management practices. Organizational attributes identified as supports for optimal practice include: flexibility in funding, program design and job descriptions; clear organizational vision driven by shared values and community needs; coordinated public health planning across jurisdictions; and strong leadership that openly promotes public health, values their staff's work and invests in education and training. The interchangeable and inconsistent use of titles used by community nurses and their employers makes it difficult to discern differences within this sector such as home care, public health, etc. Our studies also revealed that community nurses: thrive in workplaces where they share the vision and goals of their organization and work collaboratively in an atmosphere that supports creative, autonomous practice; work well together, but need time, flexible funding and management support to develop relationships with the community and their clients, and to build teams with other professionals; could sustain their competencies and confidence in their professional abilities with more access to continuing education, policies, evidence and debriefing sessions.

Contractor-, steward-, and coworker-safety practice: associations with musculoskeletal pain and injury-related absence among construction apprentices

PubMed Central

Dutra, Lauren M.; Okechukwu, Cassandra A.

2013-01-01

Objectives This paper sought to assess organizational safety practices at three different levels of hierarchical workplace structure and to examine their association with injury outcomes among construction apprentices. Methods Using a cross-sectional sample of 1,775 construction apprentices, three measures of organizational safety practice were assessed: contractor-, steward-, and coworker-safety practice. Each safety practice measure was assessed using three similar questions (i.e., on-the-job safety commitment, following required or recommended safe work practices, and correcting unsafe work practices); the summed average of the responses ranged from 1 to 4, with a higher score indicating poorer safety practice. Outcome variables included the prevalence of four types of musculoskeletal pain (i.e., neck, shoulder, hand, and back pain) and injury-related absence. Results In adjusted analyses, contractor-safety practice was associated with both hand pain (OR: 1.27, 95 % CI: 1.04, 1.54) and back pain (OR: 1.40, 95 % CI: 1.17, 1.68); coworker-safety practice was related to back pain (OR: 1.42, 95 % CI: 1.18, 1.71) and injury-related absence (OR: 1.36, 95 % CI: 1.11, 1.67). In an analysis that included all three safety practice measures simultaneously, the association between coworker-safety practice and injury-related absence remained significant (OR: 1.68, 95 % CI: 1.20, 2.37), whereas all other associations became non-significant. Conclusions This study suggests that organizational safety practice, particularly coworker-safety practice, is associated with injury outcomes among construction apprentices. PMID:23748366

Changes in Veterinary Students' Attitudes Toward the Rural Environment and Rural Veterinary Practice: A Longitudinal Cohort Study.

PubMed

Hashizume, Cary T; Woloschuk, Wayne; Hecker, Kent G

2015-01-01

There is a paucity of research regarding veterinary students' attitudes toward the rural environment and rural veterinary practice and how these attitudes might change over the course of a veterinary medicine program that includes rural clinical experience. Using a 23-item questionnaire, attitudes toward rural lifestyle, rural work-life balance, opportunities for career and skill development in rural veterinary practice, and inter-professional teamwork in the rural environment were assessed at the beginning and completion of a four-year veterinary medicine program. Eighty-six students (74.4% female) were included in this Canadian study over a six-year period. Thirty-one participants (36.1%) were rural students. Overall, students' attitudes toward the rural lifestyle, rural work-life balance, and inter-professional teamwork in rural veterinary practice all significantly decreased (p<.001) over the course of the program. As compared to urban students, rural students had significantly higher rural lifestyle scores at both the beginning (p<.001) and end (p<.01) of the veterinary medicine program. A less positive attitude toward living and working in a rural environment could influence students to exclude rural veterinary practice as a career choice. Rural clinical experiences designed to sustain or increase veterinary student interest in rural practice may not be sufficient to support positive rural attitudes. Given the demand for rural veterinary services in developed countries, the implications of this study may extend beyond Canada.

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

PubMed

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

2013-12-01

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

Unpaid work in health economic evaluations.

PubMed

Krol, Marieke; Brouwer, Werner

2015-11-01

Given its societal importance, unpaid work should be included in economic evaluations of health care technology aiming to take a societal perspective. However, in practice this does not often appear to be the case. This paper provides an overview of the current place of unpaid work in economic evaluations in theory and in practice. It does so first by summarizing recommendations regarding the inclusion of unpaid labor reported in health economic textbooks and national guidelines for economic evaluations. In total, three prominent health economic text-books were studied and 28 national health economic guidelines. The paper, moreover, provides an overview of the instruments available to measure lost unpaid labor and reports on a review of the place of unpaid labor in applied economic evaluations in the area of rheumatoid arthritis. The review was conducted by examining methodology of evaluations published between 1 March 2008 and 1 March 2013. The results of this study show that little guidance is offered regarding the inclusion of unpaid labor in economic evaluations in textbooks and guidelines. The review identified five productivity costs instruments including questions about unpaid work and 33 economic evaluations of treatments for rheumatoid arthritis of which only one included unpaid work. The results indicate that unpaid work is rarely included in applied economic evaluations of treatments for rheumatoid arthritis, despite this disease expecting to be associated with lost unpaid work. Given the strong effects of certain diseases and treatments on the ability to perform unpaid work, unpaid work currently receives less attention in economic evaluations than it deserves. Copyright © 2015 Elsevier Ltd. All rights reserved.

Understanding Work-Related Stress and Practice of Professional Self-Care--An Innovative Pedagogical Approach

ERIC Educational Resources Information Center

Kwong, Kenny

2016-01-01

Social workers experience tremendous work-related stress--particularly among those providing direct services in healthcare settings. A review of related literature summarized several critical challenges faced by social workers who work with highly difficult clients in these settings, including (a) clients who engage in manipulative high-risk…

Statistics and Data Interpretation for Social Work

ERIC Educational Resources Information Center

Rosenthal, James A.

2011-01-01

Written by a social worker for social work students, this is a nuts and bolts guide to statistics that presents complex calculations and concepts in clear, easy-to-understand language. It includes numerous examples, data sets, and issues that students will encounter in social work practice. The first section introduces basic concepts and terms to…

Strict Slaves of Slogans: Response to ''The Social Work Cartel''

ERIC Educational Resources Information Center

Epstein, William M.

2016-01-01

The corruption of the social work enterprise is not simply episodic but systemic and long-standing including education, research, governance, and practice. Reform is unlikely since the constituency within the field and outside of it that wishes to change the situation is small and ineffective. The corruption of social work reflects the unfortunate…

Getting Things Done Key to Utilization of People.

ERIC Educational Resources Information Center

Pollok, Ted

1979-01-01

Presented are 16 practical rules based upon the experiences of successful managers that can help executives get more things accomplished by their subordinates. The rules include: delegate responsibility, acknowledge good work, schedule work breaks, encourage suggestions, and handle grievances promptly. (JMD)

Work Force Information and Career-Technical Education. In Brief: Fast Facts for Policy and Practice No. 10.

ERIC Educational Resources Information Center

Sommers, Dixie

To prepare young people and adults for labor market success, career-technical education (CTE) practitioners must know how to find and use work force information. Recent federal legislation, including the Workforce Investment Act of 1998, underscores the importance of work force education. The nationwide work force information system makes data on…

14 CFR 1250.103-3 - Employment practices.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Employment practices. (a) Where a primary objective of the Federal financial assistance to a program to which... compensation, and use of facilities), including programs where a primary objective of the Federal financial... or continuation of their education or training, or (2) to provide work experience which contributes...

14 CFR 1250.103-3 - Employment practices.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Employment practices. (a) Where a primary objective of the Federal financial assistance to a program to which... compensation, and use of facilities), including programs where a primary objective of the Federal financial... or continuation of their education or training, or (2) to provide work experience which contributes...

40 CFR 60.103a - Work practice standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... becomes an affected flare subject to this subpart. The plan must include: (1) A diagram illustrating all connections to the flare; (2) Methods for monitoring flow rate to the flare, including a detailed description...

40 CFR 60.103a - Work practice standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... becomes an affected flare subject to this subpart. The plan must include: (1) A diagram illustrating all connections to the flare; (2) Methods for monitoring flow rate to the flare, including a detailed description...

Critical thinking: Reported enhancers and barriers by nurses in long-term care: implications for staff development.

PubMed

Raterink, Ginger

2011-01-01

Nursing acknowledges critical thinking as an important guide to clinical decision making. Agreement on how to define, teach, and evaluate this skill is lacking. The purpose of this study was to evaluate critical thinking in practice using a survey that asked nurses to evaluate work-related factors that enhance or pose barriers to the use of critical thinking in practice. Results indicated that enhancers and barriers to practice included teamwork, staffing patterns, and staff and administrator support. A relationship with patients was the most satisfying factor, whereas paperwork was the least. Staff development educators must consider the work environment aspects that affect performance and create the life long learning needed for increased competency in practice.

Nursing practice in stroke rehabilitation: systematic review and meta-ethnography.

PubMed

Clarke, David J

2014-05-01

To identify and synthesise the available research evidence in order to generate an explanatory framework for nursing practice in stroke rehabilitation. Although nurses are the largest professional group working with stroke survivors, there is limited understanding of nursing practice in stroke units. In particular, there is currently very little evidence in respect of nurses' involvement in poststroke rehabilitation. Meta-ethnography. A systematic review was undertaken. The review question was: 'What is the nature of nursing practice in the care and rehabilitation of inpatient stroke survivors?' Searches of 12 electronic databases identified 14,655 publications, and after screening, 778 remained; 137 papers were obtained and 54 retained for mapping. Sixteen qualitative studies were included in the meta-ethnography. Nurses' involvement in poststroke rehabilitation was limited. Contextual factors impacted on nurses' perceptions and practice. Nurses' integration of rehabilitation skills was perceived to be contingent on adequate nurse staffing levels and management of demands on nurses' time. Team working practices and use of the built environment indicated separation of nursing and therapy work. Physical care and monitoring were prioritised. Stroke-specific education and training was evident, but not consistent in content or approach. Stroke survivors and families needed help to understand nurses' role in rehabilitation. The review provides compelling evidence that there is an need to re-examine the role of nurses in contributing to poststroke rehabilitation, including clarifying when this process can safely begin and specifying the techniques that can be integrated in nurses' practice. Integrating stroke-specific rehabilitation skills in nurses' practice could contribute substantially to improving outcomes for stroke survivors. The explanatory framework developed from the review findings identifies issues which will need to be addressed in order to maximise nurses' contribution to the rehabilitation of stroke survivors. © 2013 John Wiley & Sons Ltd.

Utilisation of strategic communication to create willingness to change work practices among primary care staff: a long-term follow-up study.

PubMed

Morténius, Helena; Fridlund, Bengt; Marklund, Bertil; Palm, Lars; Baigi, Amir

2012-04-01

To evaluate the long-term utilisation of strategic communication as a factor of importance when changing work practices among primary care staff. In many health care organisations, there is a gap between theory and practice. This gap hinders the provision of optimal evidence-based practice and, in the long term, is unfavourable for patient care. One way of overcoming this barrier is systematically structured communication between the scientific theoretical platform and clinical practice. This longitudinal evaluative study was conducted among a primary care staff cohort. Strategic communication was considered to be the intervention platform and included a network of ambassadors who acted as a component of the implementation. Measurements occurred 7 and 12 years after formation of the cohort. A questionnaire was used to obtain information from participants. In total, 846 employees (70%) agreed to take part in the study. After 12 years, the 352 individuals (60%) who had remained in the organisation were identified and followed up. Descriptive statistics and multivariate analysis were used to analyse the data. Continuous information contributed to significant improvements over time with respect to new ideas and the intention to change work practices. There was a statistically significant synergistic effect on the new way of thinking, that is, willingness to change work practices. During the final two years, the network of ambassadors had created a distinctive image for itself in the sense that primary care staff members were aware of it and its activities. This awareness was associated with a positive change with regard to new ways of thinking. More years of practice was inversely associated with willingness to change work practices. Strategic communication may lead to a scientific platform that promotes high-quality patient care by means of new methods and research findings.

Beyond parenting practices: extended kinship support and the academic adjustment of African-American and European-American teens.

PubMed

Pallock, Linda L; Lamborn, Susie D

2006-10-01

This study examined adolescents' perceptions of parenting practices and extended kinship support in relation to academic adjustment for 104 African American and 60 European American 9th and 10th graders (14 and 15 year olds). For African-American teens, parental acceptance was associated with school values, teacher bonding, and work orientation. Higher levels of behavioral control and lower levels of psychological control were associated with a stronger work orientation. After accounting for the demographic variables and the three parenting practices, higher levels of extended kinship support related to stronger school values, higher teacher bonding, and a stronger work orientation. For European-American teens, parental acceptance related to academic adjustment, including stronger school values, higher teacher bonding, and a stronger work orientation. European-American adolescents with stronger extended kinship networks reported higher teacher bonding and a stronger work orientation. Results indicate the importance of extended kinship support for both African-American and European-American adolescents.

Implementing AORN recommended practices for prevention of transmissible infections.

PubMed

Patrick, Marcia R; Hicks, Rodney W

2013-12-01

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

Criteria for the assessment of analyser practicability

PubMed Central

Biosca, C.; Galimany, R.

1993-01-01

This article lists the theoretical criteria that need to be considered to assess the practicability of an automatic analyser. Two essential sets of criteria should be taken into account when selecting an automatic analyser: ‘reliability’ and ‘practicability’. Practibility covers the features that provide information about the suitability of an analyser for specific working conditions. These practibility criteria are classsified in this article and include the environment; work organization; versatility and flexibility; safely controls; staff training; maintenance and operational costs. PMID:18924972

Incorporating organisational safety culture within ergonomics practice.

PubMed

Bentley, Tim; Tappin, David

2010-10-01

This paper conceptualises organisational safety culture and considers its relevance to ergonomics practice. Issues discussed in the paper include the modest contribution that ergonomists and ergonomics as a discipline have made to this burgeoning field of study and the significance of safety culture to a systems approach. The relevance of safety culture to ergonomics work with regard to the analysis, design, implementation and evaluation process, and implications for participatory ergonomics approaches, are also discussed. A potential user-friendly, qualitative approach to assessing safety culture as part of ergonomics work is presented, based on a recently published conceptual framework that recognises the dynamic and multi-dimensional nature of safety culture. The paper concludes by considering the use of such an approach, where an understanding of different aspects of safety culture within an organisation is seen as important to the success of ergonomics projects. STATEMENT OF RELEVANCE: The relevance of safety culture to ergonomics practice is a key focus of this paper, including its relationship with the systems approach, participatory ergonomics and the ergonomics analysis, design, implementation and evaluation process. An approach to assessing safety culture as part of ergonomics work is presented.

Social Work’s Role in Medicaid Reform: A Qualitative Study

PubMed Central

Wachman, Madeline; Manning, Leticia; Cohen, Alexander M.; Seifert, Robert W.; Jones, David K.; Fitzgerald, Therese; Nuzum, Rachel; Riley, Patricia

2017-01-01

Objectives. To critically analyze social work’s role in Medicaid reform. Methods. We conducted semistructured interviews with 46 stakeholders from 10 US states that use a range of Medicaid reform approaches. We identified participants using snowball and purposive sampling. We gathered data in 2016 and analyzed them using qualitative methods. Results. Multiple themes emerged: (1) social work participates in Medicaid reform through clinical practice, including care coordination and case management; (2) there is a gap between social work’s practice-level and systems-level involvement in Medicaid innovations; (3) factors hindering social work’s involvement in systems-level practice include lack of visibility, insufficient clarity on social work’s role and impact, and too few resources within professional organizations; and (4) social workers need more training in health transformation payment models and policy. Conclusions. Social workers have unique skills that are valuable to building health systems that promote population health and reduce health inequities. Although there is considerable opportunity for social work to increase its role in Medicaid reform, there is little social work involvement at the systems level. PMID:29236537

Multiagent Work Practice Simulation: Progress and Challenges

NASA Technical Reports Server (NTRS)

Clancey, William J.; Sierhuis, Maarten; Shaffe, Michael G. (Technical Monitor)

2001-01-01

Modeling and simulating complex human-system interactions requires going beyond formal procedures and information flows to analyze how people interact with each other. Such work practices include conversations, modes of communication, informal assistance, impromptu meetings, workarounds, and so on. To make these social processes visible, we have developed a multiagent simulation tool, called Brahms, for modeling the activities of people belonging to multiple groups, situated in a physical environment (geographic regions, buildings, transport vehicles, etc.) consisting of tools, documents, and a computer system. We are finding many useful applications of Brahms for system requirements analysis, instruction, implementing software agents, and as a workbench for relating cognitive and social theories of human behavior. Many challenges remain for representing work practices, including modeling: memory over multiple days, scheduled activities combining physical objects, groups, and locations on a timeline (such as a Space Shuttle mission), habitat vehicles with trajectories (such as the Shuttle), agent movement in 3D space (e.g., inside the International Space Station), agent posture and line of sight, coupled movements (such as carrying objects), and learning (mimicry, forming habits, detecting repetition, etc.).

Multiagent Work Practice Simulation: Progress and Challenges

NASA Technical Reports Server (NTRS)

Clancey, William J.; Sierhuis, Maarten

2002-01-01

Modeling and simulating complex human-system interactions requires going beyond formal procedures and information flows to analyze how people interact with each other. Such work practices include conversations, modes of communication, informal assistance, impromptu meetings, workarounds, and so on. To make these social processes visible, we have developed a multiagent simulation tool, called Brahms, for modeling the activities of people belonging to multiple groups, situated in a physical environment (geographic regions, buildings, transport vehicles, etc.) consisting of tools, documents, and computer systems. We are finding many useful applications of Brahms for system requirements analysis, instruction, implementing software agents, and as a workbench for relating cognitive and social theories of human behavior. Many challenges remain for representing work practices, including modeling: memory over multiple days, scheduled activities combining physical objects, groups, and locations on a timeline (such as a Space Shuttle mission), habitat vehicles with trajectories (such as the Shuttle), agent movement in 3d space (e.g., inside the International Space Station), agent posture and line of sight, coupled movements (such as carrying objects), and learning (mimicry, forming habits, detecting repetition, etc.).

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.

A conceptual model of physician work intensity: guidance for evaluating policies and practices to improve health care delivery.

PubMed

Horner, Ronnie D; Matthews, Gerald; Yi, Michael S

2012-08-01

Physician work intensity, although a major factor in determining the payment for medical services, may potentially affect patient health outcomes including quality of care and patient safety, and has implications for the redesign of medical practice to improve health care delivery. However, to date, there has been minimal research regarding the relationship between physician work intensity and either patient outcomes or the organization and management of medical practices. A theoretical model on physician work intensity will provide useful guidance to such inquiries. To describe an initial conceptual model to facilitate further investigations of physician work intensity. A conceptual model of physician work intensity is described using as its theoretical base human performance science relating to work intensity. For each of the theoretical components, we present relevant empirical evidence derived from a review of the current literature. The proposed model specifies that the level of work intensity experienced by a physician is a consequence of the physician performing the set of tasks (ie, demands) relating to a medical service. It is conceptualized that each medical service has an inherent level of intensity that is experienced by a physician as a function of factors relating to the physician, patient, and medical practice environment. The proposed conceptual model provides guidance to researchers as to the factors to consider in studies of how physician work intensity impacts patient health outcomes and how work intensity may be affected by proposed policies and approaches to health care delivery.

Designing Clinical Space for the Delivery of Integrated Behavioral Health and Primary Care.

PubMed

Gunn, Rose; Davis, Melinda M; Hall, Jennifer; Heintzman, John; Muench, John; Smeds, Brianna; Miller, Benjamin F; Miller, William L; Gilchrist, Emma; Brown Levey, Shandra; Brown, Jacqueline; Wise Romero, Pam; Cohen, Deborah J

2015-01-01

This study sought to describe features of the physical space in which practices integrating primary care and behavioral health care work and to identify the arrangements that enable integration of care. We conducted an observational study of 19 diverse practices located across the United States. Practice-level data included field notes from 2-4-day site visits, transcripts from semistructured interviews with clinicians and clinical staff, online implementation diary posts, and facility photographs. A multidisciplinary team used a 4-stage, systematic approach to analyze data and identify how physical layout enabled the work of integrated care teams. Two dominant spatial layouts emerged across practices: type-1 layouts were characterized by having primary care clinicians (PCCs) and behavioral health clinicians (BHCs) located in separate work areas, and type-2 layouts had BHCs and PCCs sharing work space. We describe these layouts and the influence they have on situational awareness, interprofessional "bumpability," and opportunities for on-the-fly communication. We observed BHCs and PCCs engaging in more face-to-face methods for coordinating integrated care for patients in type 2 layouts (41.5% of observed encounters vs 11.7%; P < .05). We show that practices needed to strike a balance between professional proximity and private work areas to accomplish job tasks. Private workspace was needed for focused work, to see patients, and for consults between clinicians and clinical staff. We describe the ways practices modified and built new space and provide 2 recommended layouts for practices integrating care based on study findings. Physical layout and positioning of professionals' workspace is an important consideration in practices implementing integrated care. Clinicians, researchers, and health-care administrators are encouraged to consider the role of professional proximity and private working space when creating new facilities or redesigning existing space to foster delivery of integrated behavioral health and primary care. © Copyright 2015 by the American Board of Family Medicine.

Maternity Protection at Work.

ERIC Educational Resources Information Center

World of Work, 1998

1998-01-01

Discusses the need for maternity benefits for working women. Suggests that although most countries provide paid maternity leave by law, there is a gap between that law and practice. Includes a chart depicting maternity protection (length of leave, cash benefits, who pays) around the world. (JOW)

75 FR 52701 - Approval and Promulgation of Implementation Plans; State of Missouri

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... information claimed to be Confidential Business Information (CBI) or other information whose disclosure is.... Ventilation Limits 5. Ongoing Ventilation Testing and Reporting Requirements 6. Winter Construction Work..., including building enclosure and ventilation projects, implementation of work practice standards, process...

What Are You Assuming?

ERIC Educational Resources Information Center

Kennedy, Nadia Stoyanova

2012-01-01

Students are often encouraged to work on problems "like mathematicians"--to be persistent, to investigate different approaches, and to evaluate solutions. This behavior, regarded as problem solving, is an essential component of mathematical practice. Some crucial aspects of problem solving include defining and interpreting problems, working with…

Meeting the religious needs of residents with dementia.

PubMed

Higgins, Patricia

2013-11-01

This article considers practical strategies to help nurses working in care homes meet the religious needs of people with dementia, including attending services in homes or churches, supporting them in private prayer and at the end of life. It also considers the characteristics of person-centred care for such residents and how the Mental Capacity Act 2005 may be called on to support religious needs as dementia advances. To achieve good practice in all these aspects, staff in care homes should work in partnership with local faith communities and ensure they are aware of residents' life histories and preferences, including their faith practices. The focus of the article is on meeting the needs of Christian residents. For residents from other faith groups living in care homes not affiliated to their faith, the same general approach to meeting religious needs could be adopted as a starting point.

High-Performance Classrooms for Women? Applying a Relational Frame to Management/Organizational Behavior Courses.

ERIC Educational Resources Information Center

Buttner, E. Holly

2002-01-01

Attributes of relational theory, based on women's development, include preventive connecting, mutual empowering, achieving, and team building. These attributes are compatible with the practices of high performance work organizations. Relational practices should be integrated into management and organizational behavior courses. (Contains 53…

Institutional Silence: Experiences of Australian Lesbian Teachers Working in Catholic High Schools

ERIC Educational Resources Information Center

Ferfolja, Tania

2005-01-01

This article, based on the author's doctoral research, examines the ways in which some religious schools in New South Wales (NSW), via institutional practices, maintain and perpetuate discrimination in relation to lesbian teachers and lesbian sexualities. These institutional practices, which included threats of dismissal, forced resignations,…

Low-Cost Air Quality Monitoring Tools: From Research to Practice (A Workshop Summary)

EPA Science Inventory

In May 2017, a two-day workshop was held in Los Angeles (California, U.S.A.) to gather practitioners who work with low-cost sensors used to make air quality measurements. The community of practice included individuals from academia, industry, non-profit groups, community-based or...

Where Critical Postmodern Theory Meets Practice: Working in the Intersection of Instrumental, Social, and Cultural Education.

ERIC Educational Resources Information Center

Grace, Andre P.

1997-01-01

Outlines a critical postmodern adult education practice that is inclusive of peoples and knowledges and inhabits a dynamic space. Key concepts include identity difference; intersection of power relations; community as a social contract; and conflict, voice, and dialog for transformative learning. (SK)

Creating Effective Video to Promote Student-Centered Teaching

ERIC Educational Resources Information Center

Gainsburg, Julie

2009-01-01

Training and investing teachers at all career levels in student-centered practices is widely recognized as a significant challenge. Various studies document the failure of student-centered teaching practices to take hold in K-12 mathematics classrooms in significant ways, including collaborative work; problems that are cognitively demanding or…

Building Blocks for School IPM: A Least-Toxic Pest Management Manual.

ERIC Educational Resources Information Center

Crouse, Becky, Ed.; Owens, Kagan, Ed.

This publication is a compilation of original and republished materials from numerous individuals and organizations working on pesticide reform and integrated pest management (IPM)--using alternatives to prevailing chemical-intensive practices. The manual provides comprehensive information on implementing school IPM, including a practical guide to…

Reflective Practice: Origins and Interpretations

ERIC Educational Resources Information Center

Reynolds, Michael

2011-01-01

The idea of reflection is central to the theory and practice of learning--especially learning which is grounded in past or current experience. This paper proposes a working definition of reflection and reviews its origins and recent developments. The author also provides an account of "critical reflection", including its rationale and…

Professionalization of Family Life Education: Defining the Field

ERIC Educational Resources Information Center

Darling, Carol A.; Fleming, Wm. Michael; Cassidy, Dawn

2009-01-01

An online professional practice analysis of family life educators was conducted resulting in responses from 522 Certified Family Life Educators (CFLEs) and a comparison group of 369 noncertified family practitioners. This survey included questions about the characteristics of CFLEs, their work environments, and practice-related tasks within 10…

Predictors of Job Satisfaction in Dental Professionals of the Bosnia and Herzegovina Federation.

PubMed

Muhic, Edin; Plancak, Darije; Lajnert, Vlatka; Muhic, Asja

2016-09-01

Working in a healthy work environment is the ultimate goal of every employee. Dentistry is a stressful career, and the reasons for dissatisfaction are numerous. The aim of this study was to determine the factors of work satisfaction in dental professionals of the Bosnia and Herzegovina Federation. A total of 134 dental professionals selected randomly from the Registry of Dental Chamber of Bosnia and Herzegovina Federation were included in the study. All of them filled out the Demographic Questionnaire and Job Satisfaction Scale (JSS). An increase in the influence of work on the quality of life as well as an increase in its frequency results in leaving the job and significantly reducing the overall job satisfaction. General dental practitioners are significantly more satisfied as compared with specialists. Significant predictors of the job satisfaction are employment status, type of the practice, and availability of dental assistants. General dental practitioners with a dental assistant employed at a private practice are more likely to be satisfied with their jobs. Employment status, practice type and availability of dental assistants are significant predictors of job satisfaction. General dental practitioners working in a private practice with a dental assistant are most likely to be satisfied.

Advances in participatory occupational health aimed at good practices in small enterprises and the informal sector.

PubMed

Kogi, Kazutaka

2006-01-01

Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential.

Profiles of eight working mothers who practiced exclusive breastfeeding in Depok, Indonesia.

PubMed

Februhartanty, Judhiastuty; Wibowo, Yulianti; Fahmida, Umi; Roshita, Airin

2012-02-01

Exclusive breastfeeding practice is generally low because of multifaceted factors internally within mothers themselves and also the surroundings. In addition, studies have consistently found that maternal employment outside the home is related to shorter duration of exclusive breastfeeding. With all these challenges, it is interesting that there are some mothers who manage to exclusively breastfeed their infants. Therefore, this report aims at exploring the characteristics of working mothers who are able to practice exclusive breastfeeding. The original study population was non-working and working mothers who have infants around 1 to 6 months old. The study design is an observational study with a mixed methods approach using a quantitative study (survey) and qualitative methods (in-depth interview) in sequential order. In addition, in-depth interviews with family members, midwives, supervisors at work, and community health workers were also included to accomplish a holistic picture of the situation. The study concludes that self-efficacy and confidence of the breastfeeding mothers characterize the practice of exclusive breastfeeding. Good knowledge that was acquired way before the mothers got pregnant suggests a predisposing factor to the current state of confidence. Home support from the father enhances the decision to sustain breastfeeding.

Impact of postgraduate education on advanced practice nurse activity - a national survey.

PubMed

Wilkinson, J; Carryer, J; Budge, C

2018-03-22

There is a wealth of international evidence concerning the contribution post-registration master's level education makes to advancing the discipline of nursing. There are approximately 277 nurse practitioners registered in NZ, but they account for only a small portion of nurses who have undertaken master's level education. The additional contribution these nurses make to the work environment through advanced practice activities has not, hitherto, been documented. To report the extent of advanced practice nurse activity associated with various levels of nursing education in a sample of nurses working in clinical practice in New Zealand. A replication of recent Australian research was done via a national cross-sectional survey of 3255 registered nurses and nurse practitioners in New Zealand using an online questionnaire to collect responses to the amended Advanced Practice Delineation survey tool. In addition, demographic data were collected including position titles and levels of postgraduate education. A positive association was found between postgraduate education at any level and more time spent in advanced practice activities. Independent of level of postgraduate education, the role a nurse holds also effects the extent of involvement in advanced practice activities. There is an additional contribution made to the work environment by nurses with master's level education which occurs even when they are not employed in an advanced practice role. These findings are of significance to workforce policy and planning across the globe as countries work to sustain health services by increasing nursing capacity effectively within available resources. © 2018 International Council of Nurses.

Mediation of adoption and use: a key strategy for mitigating unintended consequences of health IT implementation

PubMed Central

Anders, Shilo; Gadd, Cynthia S; Lorenzi, Nancy M

2012-01-01

Objective Without careful attention to the work of users, implementation of health IT can produce new risks and inefficiencies in care. This paper uses the technology use mediation framework to examine the work of a group of nurses who serve as mediators of the adoption and use of a barcode medication administration (BCMA) system in an inpatient setting. Materials and methods The study uses ethnographic methods to explore the mediators' work. Data included field notes from observations, documents, and email communications. This variety of sources enabled triangulation of findings between activities observed, discussed in meetings, and reported in emails. Results Mediation work integrated the BCMA tool with nursing practice, anticipating and solving implementation problems. Three themes of mediation work include: resolving challenges related to coordination, integrating the physical aspects of BCMA into everyday practice, and advocacy work. Discussion Previous work suggests the following factors impact mediation effectiveness: proximity to the context of use, understanding of users' practices and norms, credibility with users, and knowledge of the technology and users' technical abilities. We describe three additional factors observed in this case: ‘influence on system developers,’ ‘influence on institutional authorities,’ and ‘understanding the network of organizational relationships that shape the users' work.’ Conclusion Institutionally supported clinicians who facilitate adoption and use of health IT systems can improve the safety and effectiveness of implementation through the management of unintended consequences. Additional research on technology use mediation can advance the science of implementation by providing decision-makers with theoretically durable, empirically grounded evidence for designing implementations. PMID:22634157

The cost to successfully apply for level 3 medical home recognition

PubMed Central

Mottus, Kathleen; Reiter, Kristin; Mitchell, C. Madeline; Donahue, Katrina E.; Gabbard, Wilson M.; Gush, Kimberly

2016-01-01

BACKGROUND The NCQA Patient Centered Medical Home (PCMH) recognition program provides practices an opportunity to implement Medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. METHODS Practice coaches identified 5 exemplar practices that received level 3 recognition (3 pediatric and 2 family medicine practices). This analysis focuses on 4 that received 2011 recognition. Clinical, informatics and administrative staff participated in 2–3 hour interviews. We collected the time required to develop, implement and maintain required activities. We categorized costs as: 1) non-personnel, 2) developmental 3) those to implement activities 4) those to maintain activities, 5) those to document the work and 6) consultant costs. Only incremental costs were included and are presented as costs per full-time equivalent provider (pFTE) RESULTS Practice size ranged from 2.5 – 10.5 pFTE’s, payer mixes from 7–43 % Medicaid. There was variation in the distribution of costs by activity by practice; but the costs to apply were remarkably similar ($11,453–$15,977 pFTE). CONCLUSION The costs to apply for 2011 recognition were noteworthy. Work to enhance care coordination and close loops were highly valued. Financial incentives were key motivators. Future efforts to minimize the burden of low value activities could benefit practices. PMID:26769879

Patient safety culture in Norwegian primary care: a study in out-of-hours casualty clinics and GP practices.

PubMed

Bondevik, Gunnar Tschudi; Hofoss, Dag; Hansen, Elisabeth Holm; Deilkås, Ellen Catharina Tveter

2014-09-01

This study aimed to investigate patient safety attitudes amongst health care providers in Norwegian primary care by using the Safety Attitudes Questionnaire, in both out-of-hours (OOH) casualty clinics and GP practices. The questionnaire identifies five major patient safety factors: Teamwork climate, Safety climate, Job satisfaction, Perceptions of management, and Working conditions. Cross-sectional study. Statistical analysis included multiple linear regression and independent samples t-tests. Seven OOH casualty clinics and 17 GP practices in Norway. In October and November 2012, 510 primary health care providers working in OOH casualty clinics and GP practices (316 doctors and 194 nurses) were invited to participate anonymously. To study whether patterns in patient safety attitudes were related to professional background, gender, age, and clinical setting. The overall response rate was 52%; 72% of the nurses and 39% of the doctors answered the questionnaire. In the OOH clinics, nurses scored significantly higher than doctors on Safety climate and Job satisfaction. Older health care providers scored significantly higher than younger on Safety climate and Working conditions. In GP practices, male health professionals scored significantly higher than female on Teamwork climate, Safety climate, Perceptions of management and Working conditions. Health care providers in GP practices had significant higher mean scores on the factors Safety climate and Working conditions, compared with those working in the OOH clinics. Our study showed that nurses scored higher than doctors, older health professionals scored higher than younger, male GPs scored higher than female GPs, and health professionals in GP practices scored higher than those in OOH clinics - on several patient safety factors.

Are characteristics of team members important for quality management of chronic patients at primary care level?

PubMed

Klemenc-Ketis, Zalika; Poplas-Susič, Antonija

2017-12-01

To determine the possible associations between higher levels of selected quality indicators and the characteristics of providers. In 2011, an ongoing project on a new model of family medicine practice was launched in Slovenia; the family physicians' working team (a family physician and a practice nurse) was extended by a nurse practitioner working 0.5 full-time equivalents. This was an example of a personalised team approach to managing chronic patients. We included all family medicine practices in the six units of the Community Health Centre Ljubljana which were participating in the project in December 2015 (N = 66). Data were gathered from automatic electronic reports on quality indicators provided monthly by each practice. We also collected demographic data. There were 66 family medicine teams in the sample, with 165 members of their teams (66 family physicians, 33 nurse practitioners and 66 practice nurses). Fifty-six (84.4%) of the family physicians were women, as were 32 (97.0%) of the nurse practitioners, and 86 (95.5%) of the practice nurses. Multivariate analysis showed that a higher level of the quality indicator "Examination of diabetic foot once per year" was independently associated with nurse practitioners having attended additional education on diabetes, duration of participation in the project, age and years worked since graduation of nurse practitioners, working in the Center unit and not working in the Bezigrad unit. Characteristics of team members are important in fostering quality management of chronic patients. Nurse practitioners working in new model family practices need obligatory, continuous professional education in the management of chronic patients. The quality of care of chronic patients depends on the specific characteristics of the members of the team, which should be taken into account when planning quality improvements. © 2017 John Wiley & Sons Ltd.

Effective Informal Learning: Considerations for the Workplace.

ERIC Educational Resources Information Center

Yannie, Mark

2002-01-01

Offers practical advice for learning more effectively on the job. Highlights include types of communication, including written and verbal; informal learning; a work environment that is conducive to informal learning, including organizational culture, job responsibilities, performance requirements, time and scheduling factors, and career stage;…

Nursing competency standards in primary health care: an integrative review.

PubMed

Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine

2016-05-01

This paper reports an integrative review of the literature on nursing competency standards for nurses working in primary health care and, in particular, general practice. Internationally, there is growing emphasis on building a strong primary health care nursing workforce to meet the challenges of rising chronic and complex disease. However, there has been limited emphasis on examining the nursing workforce in this setting. Integrative review. A comprehensive search of relevant electronic databases using keywords (e.g. 'competencies', 'competen*' and 'primary health care', 'general practice' and 'nurs*') was combined with searching of the Internet using the Google scholar search engine. Experts were approached to identify relevant grey literature. Key websites were also searched and the reference lists of retrieved sources were followed up. The search focussed on English language literature published since 2000. Limited published literature reports on competency standards for nurses working in general practice and primary health care. Of the literature that is available, there are differences in the reporting of how the competency standards were developed. A number of common themes were identified across the included competency standards, including clinical practice, communication, professionalism and health promotion. Many competency standards also included teamwork, education, research/evaluation, information technology and the primary health care environment. Given the potential value of competency standards, further work is required to develop and test robust standards that can communicate the skills and knowledge required of nurses working in primary health care settings to policy makers, employers, other health professionals and consumers. Competency standards are important tools for communicating the role of nurses to consumers and other health professionals, as well as defining this role for employers, policy makers and educators. Understanding the content of competency standards internationally is an important step to understanding this growing workforce. © 2016 John Wiley & Sons Ltd.

Judgements about fellow professionals and the management of patients receiving palliative care in primary care: a qualitative study

PubMed Central

Walshe, Catherine; Todd, Chris; Caress, Ann-Louise; Chew-Graham, Carolyn

2008-01-01

Background Policies emphasise the importance of collaborative working in community palliative care. Collaborations are generally formed through formal and informal referral processes, but little is known about what influences professionals' decisions to refer to such services. Aim To explore the influences on referrals within general and specialist community palliative care services. Design of study Qualitative, multiple-case study. Setting Three primary care trusts in the north-west of England. Method Multiple data collection methods were employed, including documentary analysis, observation of referral team meetings and interviews. This paper primarily reports data from interviews with 47 health professionals, including GPs, district nurses, and specialist palliative care professionals. Results Judgements — positive and negative — about aspects of fellow professionals' performances appeared to influence referral decisions and ongoing collaboration and care. Attributes upon which these judgements were based included professional responsiveness and communication, respect, working and workload management practices, perceived expertise, and notions of elite practice. The effects of such judgements on referral and healthcare practices were altered by professional ‘game playing’ to achieve professionals' desired outcomes. Conclusion Palliative care policies and protocols need to take account of these complex and subtle influences on referrals and collaboration. In particular, teamwork and partnership are encouraged within palliative care work, but critical judgements indicate that such partnerships may be difficult or fragile. It is likely that such judgemental attitudes and practices affect many aspects of primary care, not just palliative care. PMID:18494176

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.

Impact of organisational characteristics on turnover intention among care workers in nursing homes in Korea: a structural equation model.

PubMed

Ha, Jong Goon; Man Kim, Ji; Hwang, Won Ju; Lee, Sang Gyu

2014-09-01

The aim of the present study was to analyse the impact of organisational characteristics on the turnover intention of care workers working at nursing homes in Korea. Study participants included 504 care workers working at 14 nursing homes in Korea. The variables measured were: high-performance work practices, consisting of five subfactors (official training, employment stability, autonomy, employee participation and group-based payment); organisational commitment, consisting of three subfactors (affective, normative and continuance commitment); organisational support; and turnover intention. The inter-relationship between high-performance work practices, organisational support, organisational commitment and turnover intention and the fit of the hypothetical model were analysed using structural equation modelling. According to our analysis, high-performance work practices not only had a direct effect on turnover intention, but also an indirect effect by mediating organisational support and commitment. The factor having the largest direct influence on turnover intention was organisational commitment. The results of the present study suggest that to improve health conditions for frail elderly patients at nursing homes, as well as the efficiency of nursing homes through the continuance of nursing service and enhancement of quality of service, long-term care facilities should reduce the turnover intention of care workers by increasing their organisational commitment by actively implementing high-performance work practices.

How high-performance work systems drive health care value: an examination of leading process improvement strategies.

PubMed

Robbins, Julie; Garman, Andrew N; Song, Paula H; McAlearney, Ann Scheck

2012-01-01

As hospitals focus on increasing health care value, process improvement strategies have proliferated, seemingly faster than the evidence base supporting them. Yet, most process improvement strategies are associated with work practices for which solid evidence does exist. Evaluating improvement strategies in the context of evidence-based work practices can provide guidance about which strategies would work best for a given health care organization. We combined a literature review with analysis of key informant interview data collected from 5 case studies of high-performance work practices (HPWPs) in health care organizations. We explored the link between an evidence-based framework for HPWP use and 3 process improvement strategies: Hardwiring Excellence, Lean/Six Sigma, and Baldrige. We found that each of these process improvement strategies has not only strengths but also important gaps with respect to incorporating HPWPs involving engaging staff, aligning leaders, acquiring and developing talent, and empowering the front line. Given differences among these strategies, our analyses suggest that some may work better than others for individual health care organizations, depending on the organizations' current management systems. In practice, most organizations implementing improvement strategies would benefit from including evidence-based HPWPs to maximize the potential for process improvement strategies to increase value in health care.

Adolescent mothers: resilience, family health work and health-promoting practices.

PubMed

Black, Claire; Ford-Gilboe, Marilyn

2004-11-01

This paper reports a study examining the relationships among mother's resilience, family health promotion (i.e. health work) and mother's health-promoting lifestyle practices in single-parent families led by adolescent mothers by testing hypotheses derived from the Developmental Model of Health and Nursing. Research on families led by adolescent mothers has focussed primarily on negative maternal and child outcomes while ignoring the capacities of these families, including their efforts to promote the health and well-being of both mothers and children. This replication study was conducted with convenience sample of 41 adolescent mothers recruited using a variety of strategies. Mothers were asked to provide verbal responses to items on three study instruments: The Resilience Scale, a measure of mother's resilience, the Health Options Scale, a measure of family health work and the Health Promoting Lifestyle Profile a measure of mother's health promoting lifestyle practices, as well as a demographic questionnaire. Consistent with the theory, moderate positive relationships were observed between mothers' resilience and both family health work (r = 0.34, P = 0.01) and mothers' health-promoting lifestyle practices (r = 0.42, P < 0.001). As predicted, moderate correlations were also observed between health work and mother's health promoting lifestyle practices (r = 0.62, P < 0.001). With the effects of employment status and professional support held constant, mother's resilience and health work explained 30.2% of the variance in mother's health-promoting lifestyle practices. The study validates theoretical relationships among concepts in the developmental model of health and nursing and contributes to better understanding health promotion in families led by adolescent mothers.

How Do Organizational Policies and Practices Affect Return to Work and Work Role Functioning Following a Musculoskeletal Injury?

PubMed

Amick, Benjamin C; Lee, Hyunmi; Hogg-Johnson, Sheilah; Katz, Jeffrey N; Brouwer, Sandra; Franche, Renée-Louise; Bültmann, Ute

2017-09-01

Purpose Organizational-level policies and practices that promote safety leadership and practices, disability management and ergonomic policies and practices are considered key contextual determinants of return to work. Our objective was to examine the role of worker-reported organizational policies and practices (OPPs) in return to work (RTW) and work role functioning (WRF) and the mediating role of pain self-efficacy and work accommodation. Methods A worker cohort (n = 577) in Ontario, Canada was followed at 1, 6 and 12 months post injury. Both RTW (yes/no) and WRF (WLQ-16) status (3 levels) were measured. OPPs were measured (high vs. low) at 1 month post-injury. Pain self-efficacy (PSE) and work accommodation (WA) were included in mediation analyses. Results OPPs predicted RTW at 6 months (adjusted OR 1.77; 95 % CI 1.07-2.93) and 12 months (adjusted OR 2.07; 95 % CI 1.18-3.62). OPPs predicted WRF at 6 months, but only the transition from working with limitations to working without limitations (adjusted OR 3.21; 95 % CI 1.92-5.39). At 12 months, OPPs predicted both the transition from not working to working with and without limitations and from not working or working with limitations to working without limitations (adjusted OR 2.13; 95 % CI 1.37-3.30). Offers of WA mediated the relationship between OPPs and both RTW and WRF at 6 months follow-up. PSE mediated the relationship between OPPs and RTW and WRF at 6 months. At 12 months neither mediated the relationship. Conclusions The findings support worker-reported OPPs as key determinants of both RTW and WRF. These results point to the importance of WA and PSE in both RTW and WRF at 6 months.

Prepolymer Characterization

DTIC Science & Technology

1988-10-01

and ZIP Code) 10 SOURCE OF FUNDING NUMBERS PROGRAM PROJECT TASK WORK UNIT ELEMENT NO. NO. NO ACCESSION NO. 62302f ---5730 - o 00 AN 11. TITLE (Include...32 Preparative-Scale Reverse-Phase LC Fractionation of Polystyrene Homologs ..................................... 35 Work -Up of...were also employed. In addition, much of the work was based upon R-45M. However, the fundamental analytical developments and resultant practical

Working with Teams and Organizations to Help Them Involve Family Members

ERIC Educational Resources Information Center

Orford, Jim; Templeton, Lorna; Copello, Alex; Velleman, Richard; Ibanga, Akanidomo

2010-01-01

In this article we describe our work in trying to influence whole service teams to move their practice towards greater involvement of affected family members. Work with five teams is described. The process varied but in all cases it included recruitment of the team, training, continued support and evaluation of results. Use of a standard…

Why do some physicians in Portuguese-speaking African countries work exclusively for the private sector? Findings from a mixed-methods study.

PubMed

Russo, Giuliano; de Sousa, Bruno; Sidat, Mohsin; Ferrinho, Paulo; Dussault, Gilles

2014-09-11

Despite the growing interest in the private health sector in low- and middle-income countries, little is known about physicians working outside the public sector. The present work adopts a mixed-methods approach to explore characteristics, working patterns, choices, and motivations of the physicians working exclusively for the private sector in the capital cities of Cape Verde, Guinea Bissau, and Mozambique. The paper's objective is to contribute to the understanding of such physicians, ultimately informing the policies regulating the medical profession in low- and middle-income countries. The qualitative part of the study involved 48 interviews with physicians and health policy-makers and aimed at understanding the practice in the three locations. The quantitative study included a survey of 329 physicians, and multivariate analysis was conducted to analyse characteristics, time allocation, earnings, and motivations of those physicians working only for the private sector, in comparison to their public sector-only and dual practice peers. Our findings showed that only a limited proportion of physicians in the three locations work exclusively for the private sector (11.2%), with members of this group being older than those practicing only in the public or in both sectors. They were found to work fewer hours per week (49 hours) than their public (56 hours) and dual practice peers (62 hours) (P <0.001 and P = 0.011, respectively). Their median earnings were USD 4,405 per month, with substantial variations across the three locations. Statistically significant differences were found with the earnings of public-only physicians (P <0.001), but not with those of the dual practice group (P = 0.340). The qualitative data from the interviews showed private-only physicians' preference for an independent and more flexible work modality, and this was quoted as a determining factor for their choice of sector. This group appears to include those working in the more informal sector, and those who decided to leave the civil service following a disagreement with the public employer. The study shows the importance of understanding the relation between health professionals' characteristics, motivations, and their engagement with the private sector to develop effective policies to regulate the profession. This may ultimately contribute to achieving universal access to medical services in low- and middle-income countries.

Time to talk, time to see: changing microeconomies of professional practice among nurses and doctors in Australian general practice.

PubMed

Phillips, Christine; Dwan, Kathryn; Pearce, Christopher; Hall, Sally; Porritt, Julie; Yates, Rachel; Sibbald, Bonnie

2007-08-01

In Australia, more nurses are entering general practice, and nurses' work is being funded in increasingly complex ways through Medicare. Little research has explored the ways doctors and nurses realign their priorities and activities when working together in general practice. We undertook rapid, intensive multimethod studies of 25 general practices to explore the ways in which the labour of nurses and doctors was structured, and the implicit decisions made by both professions about the values placed on different ways of working and on their time. Data collected included photographs, floor-plans, interviews with 37 nurses, 24 doctors and 22 practice managers, and 50 hours of structured observation. Nursing time was constructed by both nurses and doctors as being fluid and non-contingent; they were regarded as being 'available' to patients in a way that doctors were not. Compared to medical time, nursing time could be disposed more flexibly, underpinning a valorized attribute of nursing: deep clinical and personal contact with patients. The location of practice nurses' desks in areas of traffic, such as administrative stations, or in the treatment room, underpinned this valuable unstructured contact with patients. Changes to the practice nurse role through direct fee-for-service items for nurses may lead to greater congruence between the microeconomies of nursing and medicine in general practice. In a time of pressure upon a primary care workforce, this is likely to lead to more independent clinical work by nurses, but may also lead to a decrease in flexible contact with patients.

Hydrological Forecasting Practices in Brazil

NASA Astrophysics Data System (ADS)

Fan, Fernando; Paiva, Rodrigo; Collischonn, Walter; Ramos, Maria-Helena

2016-04-01

This work brings a review on current hydrological and flood forecasting practices in Brazil, including the main forecasts applications, the different kinds of techniques that are currently being employed and the institutions involved on forecasts generation. A brief overview of Brazil is provided, including aspects related to its geography, climate, hydrology and flood hazards. A general discussion about the Brazilian practices on hydrological short and medium range forecasting is presented. Detailed examples of some hydrological forecasting systems that are operational or in a research/pre-operational phase using the large scale hydrological model MGB-IPH are also presented. Finally, some suggestions are given about how the forecasting practices in Brazil can be understood nowadays, and what are the perspectives for the future.

7 CFR 1724.32 - Inspection and certification of work order construction.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND DESIGN POLICIES AND PROCEDURES Engineering Services § 1724.32 Inspection and certification of work order... accordance with acceptable engineering practice. (2) A certification must also include the name of the...

7 CFR 1724.32 - Inspection and certification of work order construction.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND DESIGN POLICIES AND PROCEDURES Engineering Services § 1724.32 Inspection and certification of work order... accordance with acceptable engineering practice. (2) A certification must also include the name of the...

7 CFR 1724.32 - Inspection and certification of work order construction.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND DESIGN POLICIES AND PROCEDURES Engineering Services § 1724.32 Inspection and certification of work order... accordance with acceptable engineering practice. (2) A certification must also include the name of the...

Libraries and Literacy: Making It Work. An Annotated Bibliography

ERIC Educational Resources Information Center

Lamontagne, Manon

2007-01-01

This bibliography was compiled for The Centre for Literacy's 2007 Summer Institute--"Libraries and Literacy: Making It Work." The literature represented here includes research studies, descriptive articles, guides and manuals. Selections address the principles, "best practices" and assessment of library involvement in literacy…

Ergonomic practices within patient care units are associated with musculoskeletal pain and limitations

PubMed Central

Dennerlein, Jack T.; Hopcia, Karen; Sembajwe, Grace; Kenwood, Christopher; Stoddard, Anne M.; Tveito, T. Helene; Hashimoto, Dean M.; Sorensen, Glorian

2013-01-01

Background With the high prevalence of musculoskeletal disorders (MSDs) for patient care unit workers, prevention efforts through ergonomic practices within units may be related to symptoms associated with typical work-related MSDs. Methods We completed a cross-sectional survey of patient care workers (n=1572) in two large academic hospitals in order to evaluate relationships between self-reported musculoskeletal pain, work interference due to this pain, and limitations during activities of daily living (functional limitations) and with ergonomic practices and other organizational policy and practices metrics within the unit. Bivariate and multiple logistic regression analyses tested the significance of these associations. Results Prevalence of self-reported musculoskeletal symptoms in the past 3-months was 74% with 53% reporting pain in the low back. 32.8% reported that this pain interfered with their work duties and 17.7% reported functional limitations in the prior week. Decreased ergonomic practices were significantly associated with reporting pain in four body areas (low back, neck/shoulder, arms, and lower extremity) in the previous 3-months, interference with work caused by this pain, symptom severity and limitations in completing activities of daily living in the past week. Except for low back pain and work interference, these associations remained significant when psychosocial covariates such as psychological demands were included in multiple logistic regressions, Conclusions Ergonomic practices appear to be associated with many of the musculoskeletal symptoms denoting their importance for prevention efforts in acute health care settings. PMID:22113975

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.

A Thematic Inquiry into the Burnout Experience of Australian Solo-Practicing Clinical Psychologists

PubMed Central

Hammond, Trent E.; Crowther, Andrew; Drummond, Sally

2018-01-01

Objective: Burnout is conceptualized as a syndrome that consists of emotional exhaustion, depersonalization, and decreased personal accomplishment. Despite the increased frequency and severity of burnout in the Western world, there is limited published research regarding the experiences of clinical psychologists who have had burnout. The present study examines clinical psychologists’ different experiences of burnout in Australia. Design and Methods: In the year 2015, six privately practicing and solo-employed clinical psychologists provided rich qualitative data by participating in semi-structured interviews. Thematic analysis was the method used to analyze clinical psychologists’ natural accounts of their burnout experiences. Using NVivo, emerging themes were identified through coding ‘first order constructs’ and then axial code ‘second order constructs.’ Findings: Clinical psychologists indicated that their roles are demanding and a diverse range of symptoms, including the enduring effects of burnout, mental stress, fatigue, decreased personal accomplishment, negative affect, depersonalization, reduced productivity and motivation, and insomnia. They identified precursors of burnout, including excessive workload and hours of work, life stresses, mismanaged workload, and transference. Clinical psychologists suggested that protective factors of burnout include knowledge and years worked in direct care, and trusting and long-term relationships. They indicated that the barriers to overcoming burnout include the fallacy that their clients’ expectations and needs are more important than their own, the financial cost of working in private practice, contemporary knowledge and inadequate education regarding self-care, and time constraints. Discussion and Conclusion: The findings presented in this study provide psychologists and other health professionals with an insight about the burnout experience and inform professionals of the mental shortcomings of working as a solo-practicing clinical psychologist. Findings from this study should lead to an increased understanding of the complexities of burnout, and ultimately reduced cases of burnout, absenteeism, and staff disengagement. PMID:29403402

Nursing practice environment and registered nurses' job satisfaction in nursing homes.

PubMed

Choi, JiSun; Flynn, Linda; Aiken, Linda H

2012-08-01

 Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs in nursing homes.   The sample included 863 RNs working as staff RNs in 282 skilled nursing facilities in New Jersey. Two-level hierarchical linear modeling was used to account for the RNs nested by nursing homes.   Controlling for individual and nursing home characteristics, staff RNs' participation in facility affairs, supportive manager, and resource adequacy were positively associated with RNs' job satisfaction. Ownership status was significantly related to job satisfaction; RNs working in for-profit nursing homes were less satisfied.   A supportive practice environment is significantly associated with higher job satisfaction among RNs working in nursing homes. Unlike other nursing home characteristics, specific dimensions of the nursing practice environment can be modified through administrative actions to enhance RN job satisfaction.

Ready for Work? How Afterschool Programs Can Support Employability through Social and Emotional Learning. Beyond the Bell: Research to Practice in the Afterschool and Expanded Learning Field

ERIC Educational Resources Information Center

Devaney, Elizabeth; Moroney, Deborah

2015-01-01

Understanding the knowledge, attitudes, and skills that ultimately contribute to success in school, work, and life is a priority for educators and employers. Young people need a variety of important skills to be ready to work, including understanding key work habits and having a strong work ethic. But another aspect of employability has gained…

An Australian investigation of emotional work, emotional well-being and professional practice: an emancipatory inquiry.

PubMed

Rose, Jayln; Glass, Nel

2010-05-01

This study set out to explore the relationship between emotional work, emotional well-being and professional practice of generalist community health nurses who provided palliative care to clients living at home. Research suggests that palliative care practice is emotionally demanding and at times challenging. Whilst nurses find their palliative practice a source of job satisfaction the associated stresses can impact on nurses emotional well-being. A qualitative emancipatory methodology informed this study. Semi-structured interviews/storytelling and reflective journaling were the two methods applied. Sixteen community health nurses including the researcher participated. Thematic analysis of the data was undertaken. The concept of emotional well-being is associated with nurses' feelings of being balanced or out of balance. There is a pervasive interconnectedness between emotional work, emotional well-being and professional practice that is influenced by factors such as organisational and workplace issues; communication with health professionals, professional boundaries; education and professional development. Three major interwoven themes emerged highlighting that palliative care provision was demanding and rewarding, yet dependent on the nurse's comfortability within practice. Self-care is also important to the generalist nurses and strategies to enhance well-being include healthy lifestyle choices, debriefing, self-validation, assertiveness and emotional support. Emotional well-being is complex and multifaceted. The value of emotional well-being to professional practice is important. Palliative care provision is associated with demands, rewards and comfortability. It is essential that attention be given to the experiences of generalist community health nurses who engage in palliative care provision. As the demand for community palliative care increases, the issues that limit and enhance the emotional well-being of generalist palliative care nurses' become critical. The findings have international relevance to generalist and specialist palliative care nurses, academics and researchers alike.

Inter-professional work based learning within an MSc in Advanced Practice: lessons from one UK higher education programme.

PubMed

Gaskell, Lynne; Beaton, Susan

2010-09-01

This paper will describe the implementation of inter-professional work based education (IPE) in one postgraduate Advanced Practitioner programme in the UK. The concept of Advanced Practice has developed as a response of a number of drivers including change in junior doctor training; government policy and increasing demands on the central government funded UK health service (the NHS). The programme was commissioned by the then greater Manchester Strategic Health Authority (now NHS North West) to meet service needs. The educational philosophy underpinning the MSc Advanced Practice (health and social care) provided by the University of Salford is IPE linked to work based learning. The process of work based learning (WBL) and inter-professional learning underpinning the programme will be discussed in relation to feedback from university staff, Advanced Practitioner (AP) students and employer feedback taken from programme and module evaluations. We argue that IPE at this level facilitates a greater understanding of the connectivity between professionals working in the health care system in the UK; a better understanding of the skills and knowledge base of colleagues; more inter-professional working and appropriate referrals in the work place. This has raised the profile of Advanced Practice (AP) in the region and ultimately resulted in better patient care with more effective and efficient use of resources (Acton Shapiro, 2006, 2008). (c) 2009 Elsevier Ltd. All rights reserved.

Engaging Direct Care Providers in Improving Infection Prevention and Control Practices Using Participatory Visual Methods.

PubMed

Backman, Chantal; Bruce, Natalie; Marck, Patricia; Vanderloo, Saskia

2016-01-01

The purpose of this quality improvement project was to determine the feasibility of using provider-led participatory visual methods to scrutinize 4 hospital units' infection prevention and control practices. Methods included provider-led photo walkabouts, photo elicitation sessions, and postimprovement photo walkabouts. Nurses readily engaged in using the methods to examine and improve their units' practices and reorganize their work environment.

After the Biomedical Technology Revolution: Where to Now for a Bio-Psycho-Social Approach to Social Work?

PubMed Central

Healy, Karen

2016-01-01

In the late twentieth century, the bio-psycho-social framework emerged as a powerful influence on the conceptualisation and delivery of health and rehabilitation services including social work services in these fields. The bio-psycho-social framework is built on a systems view of health and well-being ( Garland and Howard, 2009). The systems perspective encourages medical and allied health professions, including social work, to recognise and to respond to the multiple systems impacting on individual health and well-being ( Engel, 2003). This paper analyses how advances in biomedical technology, particularly in the fields of neuroscience and human genomics, are challenging the bio-psycho-social approach to practice. The paper examines the pressures on the social work profession to embrace biomedical science and points to the problems in doing so. The conclusion points to some tentative ways forward for social workers to engage critically with biomedical advances and to strengthen the bio-psycho-social framework in the interests of holistic and ethical approaches to social work practice. PMID:27559237

After the Biomedical Technology Revolution: Where to Now for a Bio-Psycho-Social Approach to Social Work?

PubMed

Healy, Karen

2016-07-01

In the late twentieth century, the bio-psycho-social framework emerged as a powerful influence on the conceptualisation and delivery of health and rehabilitation services including social work services in these fields. The bio-psycho-social framework is built on a systems view of health and well-being ( Garland and Howard, 2009). The systems perspective encourages medical and allied health professions, including social work, to recognise and to respond to the multiple systems impacting on individual health and well-being ( Engel, 2003). This paper analyses how advances in biomedical technology, particularly in the fields of neuroscience and human genomics, are challenging the bio-psycho-social approach to practice. The paper examines the pressures on the social work profession to embrace biomedical science and points to the problems in doing so. The conclusion points to some tentative ways forward for social workers to engage critically with biomedical advances and to strengthen the bio-psycho-social framework in the interests of holistic and ethical approaches to social work practice.

Nursing practices in the primary health care context: a scoping review 1

PubMed Central

Barbiani, Rosangela; Nora, Carlise Rigon Dalla; Schaefer, Rafaela

2016-01-01

ABSTRACT Objective: to identify and categorize the practices performed by nurses working in Primary Health Care and Family Health Strategy Units in light of responsibilities established by the profession's legal and programmatic frameworks and by the Brazilian Unified Health System. Method: a scoping review was conducted in the following databases: LILACS, IBECS, BDENF, CINAHL and MEDLINE, and the Cochrane and SciELO libraries. Original research papers written by nurses addressing nursing practices in the primary health care context were included. Results: the review comprised 30 studies published between 2005 and 2014. Three categories emerged from the analysis: practices in the service; practices in the community; and management and education practices. Conclusion: the challenges faced by nurses are complex, as care should be centered on the population's health needs, which requires actions at other levels of clinical and health responsibility. Brazilian nursing has achieved important advancements since the implementation of policies intended to reorganize work. There is, however, a need to shift work processes from being focused on individual procedures to being focused on patients so that an enlarged clinic is the ethical-political imperative guiding the organization of services and professional intervention. PMID:27579928

Position statement: hypoglycemia management in patients with diabetes mellitus. Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition.

PubMed

Mezquita-Raya, Pedro; Reyes-García, Rebeca; Moreno-Pérez, Óscar; Muñoz-Torres, Manuel; Merino-Torres, Juan Francisco; Gorgojo-Martínez, Juan José; Jódar-Gimeno, Esteban; Escalada San Martín, Javier; Gargallo-Fernández, Manuel; Soto-Gonzalez, Alfonso; González Pérez de Villar, Noemí; Becerra Fernández, Antonio; Bellido Guerrero, Diego; Botella-Serrano, Marta; Gómez-Peralta, Fernando; López de la Torre Casares, Martín

2013-11-01

To provide practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus. Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition. Recommendations were formulated according to the Grading of Recommendations, Assessment, Development, and Evaluation system to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (PubMed). Papers in English and Spanish with publication date before 15 February 2013 were included. For recommendations about drugs only those approved by the European Medicines Agency were included. After formulation of recommendations, they were discussed by the Working Group. The document provides evidence-based practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

The Development and Evaluation of a Vocational Rehabilitation Training Programme for Rheumatology Occupational Therapists†

PubMed Central

O'Brien, Rachel; Woodbridge, Sarah; Hammond, Alison; Adkin, Julie; Culley, June

2013-01-01

People with inflammatory arthritis rapidly develop work disability, yet there is limited provision of vocational rehabilitation (VR) in rheumatology departments. As part of a randomized, controlled trial, ten occupational therapists (OTs) were surveyed to identify their current VR provision and training needs. As a result, a VR training course for OTs was developed which included both taught and self-directed learning. The course included: employment and health and safety legislation, work assessment and practical application of ergonomic principles at work. Pre-, immediately post- and two months post-training, the ten OTs completed a questionnaire about their VR knowledge and confidence On completion, they reported a significant increase (p < 0.01)in their knowledge and confidence when delivering vocational rehabilitation. They rated the course as very or extremely relevant, although seven recommended more practical sessions. The preference for practical sessions was highlighted, in that the aspects they felt most beneficial were role-playing assessments and sharing ideas through discussion and presentations. In conclusion, the course was considered effective in increasing both knowledge and confidence in using VR as an intervention, but, due to time constraints within the working day, some of the self-directed learning should be incorporated into the training days. Copyright © 2013 John Wiley & Sons, Ltd. PMID:23703966

The development and evaluation of a vocational rehabilitation training programme for rheumatology occupational therapists.

PubMed

O'Brien, Rachel; Woodbridge, Sarah; Hammond, Alison; Adkin, Julie; Culley, June

2013-06-01

People with inflammatory arthritis rapidly develop work disability, yet there is limited provision of vocational rehabilitation (VR) in rheumatology departments. As part of a randomized, controlled trial, ten occupational therapists (OTs) were surveyed to identify their current VR provision and training needs. As a result, a VR training course for OTs was developed which included both taught and self-directed learning. The course included: employment and health and safety legislation, work assessment and practical application of ergonomic principles at work. Pre-, immediately post- and two months post-training, the ten OTs completed a questionnaire about their VR knowledge and confidence On completion, they reported a significant increase (p < 0.01)in their knowledge and confidence when delivering vocational rehabilitation. They rated the course as very or extremely relevant, although seven recommended more practical sessions. The preference for practical sessions was highlighted, in that the aspects they felt most beneficial were role-playing assessments and sharing ideas through discussion and presentations. In conclusion, the course was considered effective in increasing both knowledge and confidence in using VR as an intervention, but, due to time constraints within the working day, some of the self-directed learning should be incorporated into the training days. Copyright © 2013 John Wiley & Sons, Ltd.

[Preference Changes Regarding Future Work Area and Intended Position Among German Residents after Four Years of Residency].

PubMed

Ziegler, Stine; van den Bussche, Hendrik; Römer, Farina; Krause-Solberg, Lea; Scherer, Martin

2017-06-01

Introduction  We investigated the preferences of medical residents in Germany with regard to future working place (hospital or private practice) and position (employment/self-employment in private practice; resp. specialist/senior or chief physician in the hospital). This is analysed in a gender comparative perspective, including the influence of parenthood. Methods  Annual postal surveys among graduates of seven medical faculties in Germany from their last year ("Practical Year") until after four years of postgraduate training. The return rate at baseline was 48 % and the four surveys after reached rates from 85 % up. In all samples about two thirds were women, which corresponds to the actual gender differentiation in under- and postgraduate training. Descriptive statistics and regression analyses were performed. Results  Compared to private practice the hospital is clearly preferred, although the attraction of hospital jobs decreased over the years. The decision for or against the hospital is connected to the discipline. Working in private practice is seen as possibility for part time work. Men prefer self-employment whereas women prefer to work under an employment contract. In the hospital, male doctors prefer to work in leading positions. Those positions are associated with full-time work. Leadership training especially takes place in university hospitals. Discussion  Three trends are recognized: Reluctance against leading positions, growing interest for part time work and rising popularity of work as an employee in private practice. Those trends can be understood as a rejection of traditional professional role models. The realization of these preferences is easily feasible because of the current labour market situation. Therefore, emerging problems have to be faced in another way. A change of gender-typical role models was rarely detected. © Georg Thieme Verlag KG Stuttgart · New York.

Taking stock of youth organizing: an interdisciplinary perspective.

PubMed

Christens, Brian D; Kirshner, Ben

2011-01-01

Youth organizing combines elements of community organizing, with its emphasis on ordinary people working collectively to advance shared interests, and positive youth development, with its emphasis on asset-based approaches to working with young people. It is expanding from an innovative, but marginal approach to youth and community development into a more widely recognized model for practice among nonprofit organizations and foundations. Along the way, it has garnered attention from researchers interested in civic engagement, social movements, and resiliency. A growing body of published work evidences the increasing interest of researchers, who have applied an assortment of theoretical perspectives to their observations of youth organizing processes. Through an appraisal of the current state of this still-emerging area of practice and research, including case examples, the authors identify common elements of the practice of youth organizing--relationship development, popular education, social action, and participatory research and evaluation--and conclude with a discussion of promising future directions for research and practice. Copyright © 2011 Wiley Periodicals, Inc., A Wiley Company.

Can half-day trainings motivate small contractors to address lead safety?

PubMed

Harrington, David; Scholz, Peter; Lomax, Geoffrey; Stahlschmidt, Hans; Vannoy, Jim; Materna, Barbara

2004-07-01

There is a real need to educate small painting and remodeling contractors about lead-safe work practices to protect the health of occupants (especially small children) and employees. From 1996 to 2000, 34 half-day lead awareness trainings were held throughout California to increase contractors' use of lead-safe practices. Educational methods included focusing on best practices, utilizing a peer educator, and working with stakeholders to do outreach to this hard-to-reach audience. We report on the evaluation of 18 of these seminars where we found that 30% to 49% of the interviewed contractors began doing many of the lead-safe work practices after attendance. We conclude that this program can have a modest impact in areas that contractors are more familiar with; new areas not part of their experience do not fare as well. However, without a more integrated public health educational and enforcement strategy, educational efforts such as ours can have only a limited impact.

International and cross-cultural issues: six key challenges for our professions.

PubMed

Marshall, Julie

2003-01-01

This paper discusses a number of key challenges facing professionals who work with people who have communication disabilities. The challenges are related to working internationally and in a cross-culturally competent way. Each challenge is discussed, drawing on material from a range of sources, including the papers in the final 2003 edition of FOLIA PHONIATRICA ET LOGOPAEDICA ('International and Cross-Cultural Issues'). The challenges discussed cover how experiences from majority world countries can be used to benefit services elsewhere, 'mainstreaming' commitment to cross-cultural competence, learning from relationships with other professionals, influencing research practice, responding to requests to work internationally and finally, dealing with cultural differences that challenge working practices. Some solutions are suggested and additional questions posed. Copyright 2003 S. Karger AG, Basel

Working Memory and Neurofeedback.

PubMed

YuLeung To, Eric; Abbott, Kathy; Foster, Dale S; Helmer, D'Arcy

2016-01-01

Impairments in working memory are typically associated with impairments in other cognitive faculties such as attentional processes and short-term memory. This paper briefly introduces neurofeedback as a treatment modality in general, and, more specifically, we review several of the current modalities successfully used in neurofeedback (NF) for the treatment of working memory deficits. Two case studies are presented to illustrate how neurofeedback is applied in treatment. The development of Low Resolution Electromagnetic Tomography (LORETA) and its application in neurofeedback now makes it possible to specifically target deep cortical/subcortical brain structures. Developments in neuroscience concerning neural networks, combined with highly specific yet practical NF technologies, makes neurofeedback of particular interest to neuropsychological practice, including the emergence of specific methodologies for treating very difficult working memory (WM) problems.

Precautionary practices for administering anesthetic gases: A survey of physician anesthesiologists, nurse anesthetists and anesthesiologist assistants.

PubMed

Boiano, James M; Steege, Andrea L

2016-10-02

Scavenging systems and administrative and work practice controls for minimizing occupational exposure to waste anesthetic gases have been recommended for many years. Anesthetic gases and vapors that are released or leak out during medical procedures are considered waste anesthetic gases. To better understand the extent recommended practices are used, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted in 2011 among members of professional practice organizations representing anesthesia care providers including physician anesthesiologists, nurse anesthetists, and anesthesiologist assistants. This national survey is the first to examine self-reported use of controls to minimize exposure to waste anesthetic gases among anesthesia care providers. The survey was completed by 1,783 nurse anesthetists, 1,104 physician anesthesiologists, and 100 anesthesiologist assistants who administered inhaled anesthetics in the seven days prior to the survey. Working in hospitals and outpatient surgical centers, respondents most often administered sevoflurane and, to a lesser extent desflurane and isoflurane, in combination with nitrous oxide. Use of scavenging systems was nearly universal, reported by 97% of respondents. However, adherence to other recommended practices was lacking to varying degrees and differed among those administering anesthetics to pediatric (P) or adult (A) patients. Examples of practices which increase exposure risk, expressed as percent of respondents, included: using high (fresh gas) flow anesthesia only (17% P, 6% A), starting anesthetic gas flow before delivery mask or airway mask was applied to patient (35% P; 14% A); not routinely checking anesthesia equipment for leaks (4% P, 5% A), and using a funnel-fill system to fill vaporizers (16%). Respondents also reported that facilities lacked safe handling procedures (19%) and hazard awareness training (18%). Adherence to precautionary work practices was generally highest among nurse anesthetists compared to the other anesthesia care providers. Successful management of waste anesthetic gases should include scavenging systems, hazard awareness training, availability of standard procedures to minimize exposure, regular inspection of anesthesia delivery equipment for leaks, prompt attention to spills and leaks, and medical surveillance.

A Deliberate Practice Instructional Approach for Upper Division Physics Courses

NASA Astrophysics Data System (ADS)

Jones, David

2015-05-01

In upper division physics courses, an overarching educational goal is to have students think about and use the material much as a practicing physicist in the field does. Specifically, this would include knowledge (such as concepts, formalism, and instruments), approaches, and metacognitive skills that physicists use in solving ``typical'' (research context) problems to both understand and predict physical observations and accompanying models. Using an interactive instructional approach known as deliberate practice (described earlier in this session) we will discuss our work on how to provide students with the necessary practice and feedback to achieve these skills in a core DAMOP course of modern optics. We present the results of a direct and explicit comparison between this approach and traditional lecture-based instruction revealing evidence that a significant improvement of the students' mastery of these skills occurs when deliberate practice is employed. Our work was supported by the University of British Columbia through the CWSEI.

Management Tools for Bus Maintenance: Current Practices and New Methods. Final Report.

ERIC Educational Resources Information Center

Foerster, James; And Others

Management of bus fleet maintenance requires systematic recordkeeping, management reporting, and work scheduling procedures. Tools for controlling and monitoring routine maintenance activities are in common use. These include defect and fluid consumption reports, work order systems, historical maintenance records, and performance and cost…

Gender and Social Work Education: Directions for the 1990s.

ERIC Educational Resources Information Center

Tice, Karen

1990-01-01

To move beyond the incomplete curricular reform that characterized compliance with Council on Social Work Education curriculum policy standards on women, it is proposed that a gender-inclusive curriculum be developed, including changes in the knowledge base, teaching strategies, and departmental practices. (Author/MSE)

Teaching Spiritual Synchronicity in a Business Leadership Class

ERIC Educational Resources Information Center

Pielstick, C. Dean

2005-01-01

Business leaders and business workers are increasingly interested in bringing their whole selves to work, including the spiritual. Students, as prospective leaders, need to understand issues of reasonable accommodation, religious holidays, display of religious objects, religious practices at work, and so forth. Students may also benefit from…

Incorporating Risk Assessment and Inherently Safer Design Practices into Chemical Engineering Education

ERIC Educational Resources Information Center

Seay, Jeffrey R.; Eden, Mario R.

2008-01-01

This paper introduces, via case study example, the benefit of including risk assessment methodology and inherently safer design practices into the curriculum for chemical engineering students. This work illustrates how these tools can be applied during the earliest stages of conceptual process design. The impacts of decisions made during…

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

ERIC Educational Resources Information Center

Coughlin, April B.; Dotger, Benjamin H.

2016-01-01

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

Visions of What Inclusive Education Can Be--With Emphasis on Kindergartens

ERIC Educational Resources Information Center

Andresen, Ragnhild

2013-01-01

The research questions of the article are: What takes place in the professional cooperative work of including children with special needs in kindergartens and in counteracting exclusive process? How are views on children and ethics expressed through practice and in reflections on practice among the staff in kindergarten? What constitutes…

The Rise of Applied Geography.

ERIC Educational Resources Information Center

Philpponneau, Michel

1981-01-01

Presents an historical overview of the use of the science of geography for practical purposes. Topics discussed include British schools of geography during the 19th century, contributions of many of the founders of applied geography, forms in which geographical work can be used for practical purposes, and the status of applied geography in various…

Instructional Supervision: Applying Tools and Concepts. 2nd Edition

ERIC Educational Resources Information Center

Zepeda, Sally J.

2007-01-01

The first edition of this book was highly regarded by both professors and students for its practicality and its: (1) coverage of tools & strategies to help supervisors work effectively with teachers; (2) up-to-date approach to clinical supervision which includes teacher portfolios, action research, peer coaching, and other innovative practices;…

Toward a Social Practice Perspective on the Work of Reading Inscriptions in Science Texts

ERIC Educational Resources Information Center

Pozzer-Ardenghi, Lilian; Roth, Wolff-Michael

2010-01-01

In the social studies of science, visuals and graphical representations are theorized by means of the concept of inscription, a term that denotes all representations other than text inscribed in some medium including graphs, tables, photographs, and equations. Inscriptions constitute an intrinsic and integral part of scientific practice; their…

Succeeding in the City: Challenges and Best Practices on Urban Commuter Campuses

ERIC Educational Resources Information Center

Clark, Marcia Roe

2006-01-01

The work of helping students succeed on urban commuter campuses may be some of the most complicated in higher education. Even in understanding their tasks, educators at city-based institutions must typically draw on research and practice from an amalgam of other types of institutions, including community colleges, metropolitan universities, urban…

Contemporary Practice in the Elementary Classroom: A Study of Change

ERIC Educational Resources Information Center

Thulson, Anne

2013-01-01

Elementary school is not too early to introduce contemporary art; young students are especially adept at learning by mimicry and embracing contemporary art practices, including site-specific works. Elementary students are poised and capable to comprehend and respond to contemporary art. Tangible products can be made within a conceptual,…

State Education Activities to Support Mission Growth. NGA Center for Best Practices. Issue Brief

ERIC Educational Resources Information Center

Butler, Tara A.

2009-01-01

The National Governors Association Center for Best Practices (NGA Center) leads a Mission Growth Working Group, which consists of states that are significantly impacted by the growth of military bases. The group includes state representatives appointed by the governors of Alabama, Colorado, Florida, Georgia, Hawaii, Kansas, Kentucky, Louisiana,…

Examining a Program Designed to Improve Supervisory Knowledge and Practices of Cooperating Teachers

ERIC Educational Resources Information Center

Erbilgin, Evrim

2014-01-01

This article reports on how a program based on educative supervision supported the supervisory knowledge and practices of three cooperating teachers. The program was planned as a kind of practicum: the cooperating teachers participated in the program while working with a student teacher. The program included activities where the cooperating…

Case to Cause: Back to the Future

ERIC Educational Resources Information Center

Abramovitz, Mimi; Sherraden, Margaret S.

2016-01-01

This article reopens the historic debate about the roles of micro and macro practice in social work and encourages the profession to find ways to achieve a better balance between case and cause in education, practice, and research. To this end, it traces the history of the case versus cause debate including conceptual frameworks for rebalancing…

Narrative, Poststructuralism, and Social Justice: Current Practices in Narrative Therapy

ERIC Educational Resources Information Center

Combs, Gene; Freedman, Jill

2012-01-01

This paper is a review of current practice in narrative therapy with a focus on how it is attractive and useful for therapists who wish to work for social justice. The authors describe narrative therapy's roots in poststructuralist philosophy and social science. They illustrate its major theoretical constructs, including the "narrative metaphor,"…

Nurses who work outside nursing.

PubMed

Duffield, Christine; Pallas, Linda O'Brien; Aitken, Leanne M

2004-09-01

The desire to care for people, a family history of professional health care work, and security in career choice are documented reasons for entering nursing. Reasons for leaving include workload, unsafe work environments and harassment. The relationship between these factors and the time nurses spend in the profession has not been explored. This paper reports a study with people who have left nursing, to investigate why they became a nurse, how long they stayed in nursing, and their reasons for leaving. A questionnaire was mailed to Registered Nurses currently working outside nursing, seeking respondents' reasons for entering and leaving nursing, and perceptions of the skills gained from nursing and the ease of adjustment to working in a non-nursing environment. Data analysis included descriptive statistics, exploratory and confirmatory factor analysis, correlational analysis and linear and multiple regression analysis. A model incorporating the factors 'altruistic reasons', 'default choice' and 'stepping stone' explained 36.2% of the variance in reasons for becoming a nurse. A model incorporating the factors 'legal and employer', 'external values and beliefs about nursing', 'professional practice', 'work life/home life' and 'contract requirements' explained 55.4% of the variance in reasons for leaving nursing. Forty-eight per cent of the variance in tenure in nursing practice was explained through personal characteristics of nurses (36%), reasons for becoming a nurse (7%) and reasons for leaving (6%). The reasons why nurses entered or left the profession were varied and complex. While personal characteristics accounted for a large component of tenure in nursing, those managing the nursing workforce should consider professional practice issues and the balance between work life and home life.

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

PubMed

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

2017-03-01

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

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2012-05-10

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

Work-based assessment: qualitative perspectives of novice nutrition and dietetics educators.

PubMed

Palermo, C; Beck, E J; Chung, A; Ash, S; Capra, S; Truby, H; Jolly, B

2014-10-01

The assessment of competence for health professionals including nutrition and dietetics professionals in work-based settings is challenging. The present study aimed to explore the experiences of educators involved in the assessment of nutrition and dietetics students in the practice setting and to identify barriers and enablers to effective assessment. A qualitative research approach using in-depth interviews was employed with a convenience sample of inexperienced dietitian assessors. Interviews explored assessment practices and challenges. Data were analysed using a thematic approach within a phenomenological framework. Twelve relatively inexperienced practice educators were purposefully sampled to take part in the present study. Three themes emerged from these data. (i) Student learning and thus assessment is hindered by a number of barriers, including workload demands and case-mix. Some workplaces are challenged to provide appropriate learning opportunities and environment. Adequate support for placement educators from the university, managers and their peers and planning are enablers to effective assessment. (ii) The role of the assessor and their relationship with students impacts on competence assessment. (iii) There is a lack of clarity in the tasks and responsibilities of competency-based assessment. The present study provides perspectives on barriers and enablers to effective assessment. It highlights the importance of reflective practice and feedback in assessment practices that are synonymous with evidence from other disciplines, which can be used to better support a work-based competency assessment of student performance. © 2013 The British Dietetic Association Ltd.

40 CFR 262.102 - What special definitions are included in this subpart?

Code of Federal Regulations, 2011 CFR

2011-07-01

... implementation of the Environmental Management Plan as measured against policy, objectives and targets... potential hazards to human health or the environment and which must include RCRA “P” wastes, and may include... work practices that both protect human health and the environment from the hazards presented by...

Responses to concerns about child maltreatment: a qualitative study of GPs in England

PubMed Central

Woodman, Jenny; Gilbert, Ruth; Allister, Janice; Glaser, Danya; Brandon, Marian

2013-01-01

Objectives To provide a rich description of current responses to concerns related to child maltreatment among a sample of English general practitioners (GPs). Design In-depth, face-to-face interviews (November 2010 to September 2011). Participants selected and discussed families who had prompted ‘maltreatment-related concerns’. Thematic analysis of data. Setting 4 general practices in England. Participants 14 GPs, 2 practice nurses and 2 health visitors from practices with at least 1 ‘expert’ GP (expertise in child safeguarding/protection). Results The concerns about neglect and emotional abuse dominated the interviews. GPs described intense and long-term involvement with families with multiple social and medical problems. Narratives were distilled into seven possible actions that GPs took in response to maltreatment-related concerns. These were orientated towards whole families (monitoring and advocating), the parents (coaching) and children (opportune healthcare), and included referral to or working with other services and recording concerns. Facilitators of the seven actions were: trusting relationships between GPs and parents, good working relationships with health visitors and framing the problem/response as ‘medical’. Narratives indicated significant time and energy spent building facilitating relationships with parents with the aim of improving the child's well-being. Conclusions These GPs used core general practice skills for on-going management of families who prompted concerns about neglect and emotional abuse. Policy and research focus should be broadened to include strategies for direct intervention and on-going involvement by GPs, such as using their core skills during consultations and practice systems for monitoring families and encouraging presentation to general practice. Exemplars of current practice, such as those identified in our study, should be evaluated for feasibility and acceptability in representative general practice settings as well as tested for efficacy, safety and cost. The seven actions could form the basis for the ‘lead professional’ role in general practice as proposed in the 2013 version of ‘Working Together ’guidance. PMID:24302506

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

PubMed

Oddsdóttir, Elín Jakobína; Sveinsdóttir, Herdís

2011-05-01

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

A practical multilayered conducting polymer actuator with scalable work output

NASA Astrophysics Data System (ADS)

Ikushima, Kimiya; John, Stephen; Yokoyama, Kazuo; Nagamitsu, Sachio

2009-09-01

Household assistance robots are expected to become more prominent in the future and will require inherently safe design. Conducting polymer-based artificial muscle actuators are one potential option for achieving this safety, as they are flexible, lightweight and can be driven using low input voltages, unlike electromagnetic motors; however, practical implementation also requires a scalable structure and stability in air. In this paper we propose and practically implement a multilayer conducting polymer actuator which could achieve these targets using polypyrrole film and ionic liquid-soaked separators. The practical work density of a nine-layer multilayer actuator was 1.4 kJ m-3 at 0.5 Hz, when the volumes of the electrolyte and counter electrodes were included, which approaches the performance of mammalian muscle. To achieve air stability, we analyzed the effect of air-stable ionic liquid gels on actuator displacement using finite element simulation and it was found that the majority of strain could be retained when the elastic modulus of the gel was kept below 3 kPa. As a result of this work, we have shown that multilayered conducting polymer actuators are a feasible idea for household robotics, as they provide a substantial practical work density in a compact structure and can be easily scaled as required.

The difficulty of professional continuation among female doctors in Japan: a qualitative study of alumnae of 13 medical schools in Japan.

PubMed

Nomura, Kyoko; Yamazaki, Yuka; Gruppen, Larry D; Horie, Saki; Takeuchi, Masumi; Illing, Jan

2015-03-27

To investigate the difficulties Japanese female doctors face in continuing professional practice. A qualitative study using the Kawakita Jiro method. A survey conducted in 2011 of 13 private Japanese medical school alumni associations. 359 female doctors. Barriers of balancing work and gender role. The female doctors reported that professional practice was a struggle with long working hours due to a current shortage of doctors in Japan. There was also a severe shortage of childcare facilities in the workplace. Some women appeared to have low confidence in balancing the physician's job and personal life, resulting in low levels of professional pursuit. There appeared to be two types of stereotypical gender roles, including one expected from society, stating that "child rearing is a woman's job", and the other perceived by the women themselves, that some women had a very strong desire to raise their own children. Male doctors and some female doctors who were single or older were perceived to be less enthusiastic about supporting women who worked while raising children because these coworkers feared that they would have to perform additional work as a result of the women taking long periods of leave. Important factors identified for promoting the continuation of professional practice among female doctors in Japan were the need to improve working conditions, including cutting back on long working hours, a solution to the shortage of nurseries, a need for the introduction of educational interventions to clarify professional responsibilities, and redefinition of the gender division of labour for male and female doctors. In addition, we identified a need to modernise current employment practices by introducing temporary posts to cover maternity leave and introducing flexible working hours during specialist training, thus supporting and encouraging more women to continue their medical careers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The difficulty of professional continuation among female doctors in Japan: a qualitative study of alumnae of 13 medical schools in Japan

PubMed Central

Nomura, Kyoko; Yamazaki, Yuka; Gruppen, Larry D; Horie, Saki; Takeuchi, Masumi; Illing, Jan

2015-01-01

Objectives To investigate the difficulties Japanese female doctors face in continuing professional practice. Design A qualitative study using the Kawakita Jiro method. Setting A survey conducted in 2011 of 13 private Japanese medical school alumni associations. Participants 359 female doctors. Primary outcome measures Barriers of balancing work and gender role. Results The female doctors reported that professional practice was a struggle with long working hours due to a current shortage of doctors in Japan. There was also a severe shortage of childcare facilities in the workplace. Some women appeared to have low confidence in balancing the physician's job and personal life, resulting in low levels of professional pursuit. There appeared to be two types of stereotypical gender roles, including one expected from society, stating that “child rearing is a woman's job”, and the other perceived by the women themselves, that some women had a very strong desire to raise their own children. Male doctors and some female doctors who were single or older were perceived to be less enthusiastic about supporting women who worked while raising children because these coworkers feared that they would have to perform additional work as a result of the women taking long periods of leave. Conclusions Important factors identified for promoting the continuation of professional practice among female doctors in Japan were the need to improve working conditions, including cutting back on long working hours, a solution to the shortage of nurseries, a need for the introduction of educational interventions to clarify professional responsibilities, and redefinition of the gender division of labour for male and female doctors. In addition, we identified a need to modernise current employment practices by introducing temporary posts to cover maternity leave and introducing flexible working hours during specialist training, thus supporting and encouraging more women to continue their medical careers. PMID:25818268

Occupational health, cognitive disorders and occupational neuropsychology

PubMed Central

Caixeta, Leonardo; da Silva Júnior, George Martins Ney; Caixeta, Victor de Melo; Reimer, Cláudio Henrique Ribeiro; Azevedo, Paulo Verlaine Borges e

2012-01-01

Work can be an important etiologic factor in the genesis of some mental disorders including cognitive disability. Occupational neuropsychology constitutes an intriguing new but neglected area of research and clinical practice which deals with the neurocognitive consequences of the work environment and work habits. Neuropsychological knowledge is fundamental to understand cognitive requirements of work competence. Work can impact sleep patterns and mental energy, which in turn can cause neuropsychological symptoms. This report presents relevant evidence to illustrate the relationship between work and cognitive dysfunction. PMID:29213798

Occupational health hazards in a prosthodontic practice: review of risk factors and management strategies

PubMed Central

Arunachalam, Kuthalingam Subbiah; Solomon, EGR

2012-01-01

The intent of this article was to analyze the potential hazards and risks involved in persons exposed to prosthodontic practice. These risks include exposure to physical and chemical hazards, dental materials, infectious environment, inappropriate working pattern and psychosocial stress. The potential harm of these hazards and its prevention is highlighted. Prosthodontists, students, dental technicians, and others working in the prosthodontic clinics and laboratory should be aware of the specific risk factors and take measures to prevent and overcome these hazards. PMID:23236581

ACOG committee opinion number 398, February 2008: fatigue and patient safety.

PubMed

2008-02-01

It has long been recognized that fatigue can affect human cognitive and physical function. Although there are limited published data on the effects of fatigue on health care providers, including full-time practicing physicians, there is increasing awareness within the patient safety movement that fatigue, even partial sleep deprivation, impairs performance. Most of the current literature reviews resident function after recent work reform changes. However, the information available from many studies in health care and other occupations can be applied to the work habits of practicing obstetrician-gynecologists.

Work-related activities associated with injury in occupational and physical therapists.

PubMed

Darragh, Amy R; Campo, Marc; King, Phyllis

2012-01-01

The purpose of this study was to examine work activities associated with work-related injury (WRI) in occupational and physical therapy. 1,158 occupational and physical therapists in Wisconsin responded to a mailed survey, from a total of 3,297 OTs and PTs randomly selected from the State licensure list. The study used a cross-sectional, survey design. Participants reported information about WRI they sustained between 2004 and 2006, including the activities they were performing when injured. Investigators analyzed 248 injury incidents using qualitative and quantitative analysis. Data were examined across OT and PT practice in general, and also by practice area. Manual therapy and transfers/lifts were associated with 54% of all injuries. Other activities associated with injury were distinct to practice area, for example: floor work in pediatrics; functional activities in acute care; patient falls in skilled nursing facilities; and motor vehicle activities in home care. Injury prevention activities must address transfers and manual therapy, but also must examine setting-specific activities influenced by environment and patient population.

Nursing students' experiences of ethical issues in clinical practice: A New Zealand study.

PubMed

Sinclair, J; Papps, E; Marshall, B

2016-03-01

Nursing students experience ethical problems in clinical practice in a different way from registered nurses. In order to develop ethical reasoning and competence in nursing students, nurse educators must recognise the unique issues students face. This research described the occurrence of ethical issues in clinical practice for 373 undergraduate nursing students who responded to a national questionnaire investigating the frequency of pre-determined ethical issues and the corresponding level of distress. Over two thirds of respondents experienced breaches of a patient's right to confidentiality, privacy, dignity or respect and 87% experienced unsafe working conditions. The most distressing issues were those that compromised patient safety, including unsafe healthcare practices, working conditions and suspected abuse or neglect. Themes that emerged from an open-ended question included lack of support and supervision, bullying and end of life issues. This research found the frequency at which ethical issues are experienced was highest in year three participants. However, the overall distress levels were lower for the majority of issues for those participants in the later part of their degree. Recommendations from this research include developing ethics education around the main concerns that students face in order to enhance students' understanding, resilience and ability to respond appropriately. Copyright © 2016 Elsevier Ltd. All rights reserved.

A qualitative investigation of specialist orthodontists in New Zealand: part 2. Orthodontists' working lives and work-life balance.

PubMed

Soma, Kieran J; Thomson, W Murray; Morgaine, Kate C; Harding, Winifred J

2012-11-01

Orthodontics is the most widely practised form of specialist dentistry in New Zealand. To date, no known qualitative research has been published examining the work-life balance of practitioners. The aim of this study was to investigate the working lives and work-life balance of NZ orthodontists in order to generate an understanding of the reality of orthodontic specialist practice and its effects on orthodontists' professional and personal lives. Semi-structured interviews were conducted involving 19 practising orthodontists (four females, 15 males; mean age 50 years) from throughout New Zealand and selected for maximum variation in the sample. Transcribed interviews were analysed for themes using an applied grounded theory approach. A core category of 'practising orthodontist' was derived, and related themes were grouped under the sub-categories of: (a) NZ orthodontic specialist practice; (b) NZ specialist orthodontists; and (c) Work-life balance. The present paper reports on the final sub-category. Themes emerging from the work-life sub-category were further divided into two sub-themes of 'work' and 'life'. Themes in the 'work' subgroup included time off, injuries and illness, regrets, personality traits, job stress and criticism, establishing a practice, peer support and contact, and success in orthodontics. Themes in the 'life' sub-group were personal development, family life, life balance and interests outside work, and financial security. This was the first qualitative investigation of the orthodontic profession in New Zealand. The findings provided a valuable insight into the working lives of New Zealand orthodontists and effects on their day-today lives. It will be revealing and interesting to observe how the modernisation of orthodontic practice will affect the work-life balance of New Zealand orthodontists in the future.

Interweaving Objects, Gestures, and Talk in Context

ERIC Educational Resources Information Center

Brassac, Christian; Fixmer, Pierre; Mondada, Lorenza; Vinck, Dominique

2008-01-01

In a large French hospital, a group of professional experts (including physicians and software engineers) are working on the computerization of a blood-transfusion traceability device. By focusing on a particular moment in this slow process of design, we analyze their collaborative practices during a work session. The analysis takes a…

The Collaborative School: A Work Environment for Effective Instruction.

ERIC Educational Resources Information Center

Smith, Stuart C.; Scott, James J.

The benefits of a collaborative work setting--including such practices as mutual help, exchange of ideas, joint planning, and participative decision-making--have been consistently confirmed by studies of effective schools and successful businesses. However, teacher isolation remains the norm. Drawing on recent research and educators' firsthand…

The Distribution of Family Oriented Benefits.

ERIC Educational Resources Information Center

EBRI Issue Brief, 1992

1992-01-01

This issue of a monthly newsletter is devoted to an overview of employee benefits that assist families, including child care, extended unpaid personal leave, and flexible work options. Findings are discussed from a recent study analyzing the distribution of two of those family benefits (child care assistance and flexible work practices) among…

Social Work with Religious Volunteers: Activating and Sustaining Community Involvement

ERIC Educational Resources Information Center

Garland, Diana R.; Myers, Dennis M.; Wolfer, Terry A.

2008-01-01

Social workers in diverse community practice settings recruit and work with volunteers from religious congregations. This article reports findings from two surveys: 7,405 congregants in 35 Protestant congregations, including 2,570 who were actively volunteering, and a follow-up survey of 946 volunteers. It compares characteristics of congregation…

Working towards Skills: Perspectives on Workforce Development in SMEs. Research Report.

ERIC Educational Resources Information Center

Hughes, Maria; Keddie, Vince; Webb, Peter; Corney, Mark

Research into workforce development (WD) considered the relationship between corporate assessments of workers' development needs and WD strategies; how learning at work takes place; and what learning methods are used and their effectiveness. Focus was on practice in small and medium-sized enterprises (SMEs). Methodology included a literature…

Working Together? Partnership Approaches to 14-19 Education in England

ERIC Educational Resources Information Center

Higham, Jeremy; Yeomans, David

2010-01-01

Partnership working between institutions and organisations is currently commonly seen as providing solutions to meeting multiple, interrelated needs in areas of social policy including health, social welfare and education. This article examines and discusses the policy and practice of such collaboration in an educational context. Drawing on…

40 CFR 63.7700 - What work practice standards must I meet?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Iron and Steel Foundries Work..., slitter, or other materials that do not include post-consumer automotive body scrap, post-consumer engine... written plan for the selection and inspection of iron and steel scrap to minimize, to the extent...

40 CFR 63.7700 - What work practice standards must I meet?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Iron and Steel Foundries Work..., slitter, or other materials that do not include post-consumer automotive body scrap, post-consumer engine... written plan for the selection and inspection of iron and steel scrap to minimize, to the extent...

40 CFR 63.7700 - What work practice standards must I meet?

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Iron and Steel Foundries Work..., slitter, or other materials that do not include post-consumer automotive body scrap, post-consumer engine... written plan for the selection and inspection of iron and steel scrap to minimize, to the extent...

75 FR 54524 - Defense Federal Acquisition Regulation Supplement; Guidance on Personal Services (DFARS Case 2009...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... parts 211 and 237 are being amended to (1) require that statements of work or performance work statements clearly distinguish between Government employees and contractor employees and (2) ensure that... Department, including several checklists currently used. This interim rule adopts best practices and...

Community-Based Participatory Study Abroad: A Proposed Model for Social Work Education

ERIC Educational Resources Information Center

Fisher, Colleen M.; Grettenberger, Susan E.

2015-01-01

Study abroad experiences offer important benefits for social work students and faculty, including global awareness, practice skill development, and enhanced multicultural competence. Short-term study abroad programs are most feasible but typically lack depth of engagement with host communities and may perpetuate existing systems of power and…

The CEIC Review, 2001. A Catalyst for Merging Research, Policy, and Practice.

ERIC Educational Resources Information Center

Hartman, Bonnie, Ed.; Rohland, Mark, Ed.

2001-01-01

These three volumes contain articles related to (1) improving educational productivity (lessons from economics); (2) school-to-work (STW); and (3) reduced class size, offering recommendations from national invitational conferences. Topics include making schools work; tax revolts and school performance; market pressure and the impact on…

Community psychology practice: expanding the impact of psychology's work.

PubMed

Wolff, Tom

2014-11-01

This article introduces the reader to community psychology practice by defining the field and its key principles and then illustrating through brief case stories what community psychology practice looks like in various employment settings. An exploration of the development of the field includes a review of the competencies of community psychology practice. Finally, the emerging opportunities for community psychology practice for psychologists are outlined. Well-publicized issues such as health disparities give psychologists an opportunity to bring social problems such as racism, sexism, homophobia, and income inequality to the forefront and to create community-wide efforts to improve the ways in which people live. Community psychology practice offers psychologists a format and a set of competencies for moving forward on this work by focusing on approaches that are ecological, community centered, population based, preventive, focused on systems change and empowerment, and multidisciplinary and that bring those most affected by the issues to the heart of the decision making. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Causal Impact of Employee Work Perceptions on the Bottom Line of Organizations.

PubMed

Harter, James K; Schmidt, Frank L; Asplund, James W; Killham, Emily A; Agrawal, Sangeeta

2010-07-01

Perceptions of work conditions have proven to be important to the well-being of workers. However, customer loyalty, employee retention, revenue, sales, and profit are essential to the success of any business. It is known that these outcomes are correlated with employee attitudes and perceptions of work conditions, but the research into direction of causality has been inconclusive. Using a massive longitudinal database that included 2,178 business units in 10 large organizations, we found evidence supporting the causal impact of employee perceptions on these bottom-line measures; reverse causality of bottom-line measures on employee perceptions existed but was weaker. Managerial actions and practices can impact employee work conditions and employee perceptions of these conditions, thereby improving key outcomes at the organizational level. Perceptions of specific work conditions that engage employees in their work provide practical guidance in how best to manage people to obtain desired results. © The Author(s) 2010.

Karma yoga: A path towards work in positive psychology

PubMed Central

Kumar, Arun; Kumar, Sanjay

2013-01-01

Karma yoga is the path that leads to salvation through action. Salvation is the ultimate state of consciousness. Work is the central and defining characteristic of life. It may have intrinsic value, instrumental value, or both. Instrumental value includes incentive, dignity and power, etc., which is the result expected from the work. The Gita teaches us to do work without thinking of result (work with intrinsic value). Attachment with the result leads to stress, competition and aggression. Stress further gives rise to heart ailments, depression and suicide. Positive psychology studies the factors and conditions leading to pleasurable and satisfying life. Understanding Karma yoga and its practice has a similar role that lead an individual towards work and leading to a satisfied life. This may play a unique role towards practical aspects of positive psychology to improve one's lifestyle and aid in the treatment of stress disorders. PMID:23858246

The Cost to Successfully Apply for Level 3 Medical Home Recognition.

PubMed

Halladay, Jacqueline R; Mottus, Kathleen; Reiter, Kristin; Mitchell, C Madeline; Donahue, Katrina E; Gabbard, Wilson M; Gush, Kimberly

2016-01-01

The National Committee for Quality Assurance patient-centered medical home recognition program provides practices an opportunity to implement medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. Practice coaches identified 5 exemplar practices (3 pediatric and 2 family medicine practices) that received level 3 recognition. This analysis focuses on 4 that received recognition in 2011. Clinical, informatics, and administrative staff participated in 2- to 3-hour interviews. We determined the time required to develop, implement, and maintain required activities. We categorized costs as (1) nonpersonnel, (2) developmental, (3) those used to implement activities, (4) those used to maintain activities, (5) those to document the work, and (6) consultant costs. Only incremental costs were included and are presented as costs per full-time equivalent (pFTE) provider. Practice size ranged from 2.5 to 10.5 pFTE providers, and payer mixes ranged from 7% to 43% Medicaid. There was variation in the distribution of costs by activity by practice, but the costs to apply were remarkably similar ($11,453-15,977 pFTE provider). The costs to apply for 2011 recognition were noteworthy. Work to enhance care coordination and close loops were highly valued. Financial incentives were key motivators. Future efforts to minimize the burden of low-value activities could benefit practices. © Copyright 2016 by the American Board of Family Medicine.

Factors influencing evidence-based practice in prosthetics and orthotics.

PubMed

Andrysek, Jan; Christensen, James; Dupuis, Annie

2011-03-01

The importance of evidence-based practice is being recognized across a broad range of healthcare disciplines as a means for improving patient outcomes and also efficiently managing healthcare resources. The objective of this work was to obtain information from clinicians about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Cross sectional survey. An internet survey was developed and distributed to 300 prosthetists and orthotists currently practicing in Canada. A principal component factor analysis of the survey results revealed ten primary factors affecting evidence-based practice. These include time constraints, workload and system demands, limited relevant evidence from research, and gaps in skills and knowledge required to perform evidence-based practice. Clinicians value research as a means of improving clinical practice, but they are faced with a number of practical barriers in performing evidence-based practice. This study provides empirical data about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Such data are essential in order to inform those involved in improving existing clinical practices, including educators, professional organizations, and governing bodies.

Planning for the Rheumatologist Workforce: Factors Associated With Work Hours and Volumes.

PubMed

Barber, Claire E H; Nasr, Mina; Barnabe, Cheryl; Badley, Elizabeth M; Lacaille, Diane; Pope, Janet; Cividino, Alfred; Yacyshyn, Elaine; Baillie, Cory; Mosher, Dianne; Thomson, John G; Charnock, Christine; Thorne, J Carter; Zummer, Michel; Brophy, Julie; Ruban, Thanu Nadarajah; Ahluwalia, Vandana; McDougall, Robert; Marshall, Deborah A

2018-05-25

The aim of this study was to evaluate factors associated with rheumatologists' clinical work hours and patient volumes based on a national workforce survey in rheumatology. Adult rheumatologists who participated in a 2015 workforce survey were included (n = 255). Univariate analysis evaluated the relationship between demographics (sex, age, academic vs. community practice, billing fee for service vs. other plan, years in practice, retirement plans) and workload (total hours and number of ½-day clinics per week) or patient volumes (number of new and follow-up consults per week). Multiple linear regression models were used to evaluate the relationship between practice type, sex, age, and working hours or clinical volumes. Male rheumatologists had more ½-day clinics (P = 0.05) and saw more new patients per week (P = 0.001) compared with females. Community rheumatologists had more ½-day clinics and new and follow-up visits per week (all P < 0.01). Fee-for-service rheumatologists reported more ½-day clinics per week (P < 0.001) and follow-ups (P = 0.04). Workload did not vary by age, years in practice, or retirement plans. In multivariate analysis, community practice remained independently associated with higher patient volumes and more clinics per week. Female rheumatologists reported fewer clinics and fewer follow-up patients per week than males, but this did not affect the duration of working hours or new consultations. Age was not associated with work volumes or hours. Practice type and rheumatologist sex should be considered when evaluating rheumatologist workforce needs, as the proportion of female rheumatologists has increased over time and alternative billing practices have been introduced in many centers.

Transforming nursing education: a review of current curricular practices in relation to Benner's latest work.

PubMed

Handwerker, Sarah M

2012-09-12

Current societal and healthcare system trends highlight the need to transform nursing education to prepare nurses capable of outstanding practice in the 21st century. Patricia Benner and colleagues urged nurse educators to transform their practice in the 2010 publication Educating Nurses, A Call to Radical Transformation. Frequently utilized pedagogical frameworks in nursing education include behaviorism and constructivism. Much of the structure and basis for instruction and evaluation can be found rooted in these philosophies. By first exploring both behaviorism and constructivism and then relating their use in nursing education to the call to transform, educators can be encourage to examine current practice and possibly modify aspects to include more rich experiential learning.

Government crackdown of sex work in China: responses from female sex workers and implications for their health.

PubMed

Huang, Yingying; Pan, Suiming

2014-01-01

The Chinese Government periodically enforces anti-prostitution laws through regular police presence in red light districts and through the arrests of brothel managers and sex workers. One of the most intense crackdowns on prostitution occurred throughout China in 2010. Using the 'structure-agency' framework and ethnographic approach, this paper examines the influence of the 2010 government anti-prostitution crackdown on female sex workers (FSWs). We observed 10 red light districts (6 cities and 2 counties) and interviewed 107 FSWs, 26 managers and 37 outreach workers working with FSWs. The findings describe variations in police practices and diverse strategies adopted by FSWs in response to police actions. The strategies include: soliciting sex outside of establishments in less visible channels, increasing the mobility and flexibility of sex work, changing sexual practices, sharing knowledge of how to identify policemen disguised as male clients and building personal relationships with local police. Our study suggests that, rather than disappearing as a result of crackdowns, the terms and content of sex work changed as a result of the FSWs' responses to police practices. Some of these responses potentially increased the health risks associated with sex work, but others laid the foundation for an effective response to police practices.

Government crackdown of sex work in China: Responses from female sex workers and implications for their health

PubMed Central

Huang, Yingying; Pan, Suiming

2015-01-01

The Chinese Government periodically enforces anti-prostitution laws through regular police presence in red light districts and through the arrests of brothel managers and sex workers. One of the most intense crackdowns on prostitution occurred throughout China in 2010. Using the ‘structure-agency’ framework and ethnographic approach, this paper examines the influence of the 2010 government anti-prostitution crackdown on female sex workers (FSWs). We observed 10 red light districts (6 cities and 2 counties) and interviewed 107 FSWs, 26 managers and 37 outreach workers working with FSWs. The findings describe variations in police practices and diverse strategies adopted by FSWs in response to police actions. The strategies include: soliciting sex outside of establishments in less visible channels, increasing the mobility and flexibility of sex work, changing sexual practices, sharing knowledge of how to identify policemen disguised as male clients and building personal relationships with local police. Our study suggests that, rather than disappearing as a result of crackdowns, the terms and content of sex work changed as a result of the FSWs’ responses to police practices. Some of these responses potentially increased the health risks associated with sex work, but others laid the foundation for an effective response to police practices. PMID:25226069

Predictors of Job Satisfaction in Dental Professionals of the Bosnia and Herzegovina Federation

PubMed Central

Muhic, Edin; Plancak, Darije; Muhic, Asja

2016-01-01

Introduction Working in a healthy work environment is the ultimate goal of every employee. Dentistry is a stressful career, and the reasons for dissatisfaction are numerous. Aim The aim of this study was to determine the factors of work satisfaction in dental professionals of the Bosnia and Herzegovina Federation. Materials and methods A total of 134 dental professionals selected randomly from the Registry of Dental Chamber of Bosnia and Herzegovina Federation were included in the study. All of them filled out the Demographic Questionnaire and Job Satisfaction Scale (JSS). Results An increase in the influence of work on the quality of life as well as an increase in its frequency results in leaving the job and significantly reducing the overall job satisfaction. General dental practitioners are significantly more satisfied as compared with specialists. Significant predictors of the job satisfaction are employment status, type of the practice, and availability of dental assistants. General dental practitioners with a dental assistant employed at a private practice are more likely to be satisfied with their jobs. Conclusions Employment status, practice type and availability of dental assistants are significant predictors of job satisfaction. General dental practitioners working in a private practice with a dental assistant are most likely to be satisfied. PMID:27847395

Instituting systems-based practice and practice-based learning and improvement: a curriculum of inquiry

PubMed Central

Wilper, Andrew P.; Smith, Curtis Scott; Weppner, William

2013-01-01

Background The Accreditation Council for Graduate Medical Education (ACGME) requires that training programs integrate system-based practice (SBP) and practice-based learning and improvement (PBLI) into internal medicine residency curricula. Context and setting We instituted a seminar series and year-long-mentored curriculum designed to engage internal medicine residents in these competencies. Methods Residents participate in a seminar series that includes assigned reading and structured discussion with faculty who assist in the development of quality improvement or research projects. Residents pursue projects over the remainder of the year. Monthly works in progress meetings, protected time for inquiry, and continued faculty mentorship guide the residents in their project development. Trainees present their work at hospital-wide grand rounds at the end of the academic year. We performed a survey of residents to assess their self-reported knowledge, attitudes and skills in SBP and PBLI. In addition, blinded faculty scored projects for appropriateness, impact, and feasibility. Outcomes We measured resident self-reported knowledge, attitudes, and skills at the end of the academic year. We found evidence that participants improved their understanding of the context in which they were practicing, and that their ability to engage in quality improvement projects increased. Blinded faculty reviewers favorably ranked the projects’ feasibility, impact, and appropriateness. The ‘Curriculum of Inquiry’ generated 11 quality improvement and research projects during the study period. Barriers to the ongoing work include a limited supply of mentors and delays due to Institutional Review Board approval. Hospital leadership recognizes the importance of the curriculum, and our accreditation manager now cites our ongoing work. Conclusions A structured residency-based curriculum facilitates resident demonstration of SBP and practice-based learning and improvement. Residents gain knowledge and skills though this enterprise and hospitals gain access to trainees who help to solve ongoing problems and meet accreditation requirements. PMID:24044686

Instituting systems-based practice and practice-based learning and improvement: a curriculum of inquiry.

PubMed

Wilper, Andrew P; Smith, Curtis Scott; Weppner, William

2013-01-01

Background The Accreditation Council for Graduate Medical Education (ACGME) requires that training programs integrate system-based practice (SBP) and practice-based learning and improvement (PBLI) into internal medicine residency curricula. Context and setting We instituted a seminar series and year-long-mentored curriculum designed to engage internal medicine residents in these competencies. Methods Residents participate in a seminar series that includes assigned reading and structured discussion with faculty who assist in the development of quality improvement or research projects. Residents pursue projects over the remainder of the year. Monthly works in progress meetings, protected time for inquiry, and continued faculty mentorship guide the residents in their project development. Trainees present their work at hospital-wide grand rounds at the end of the academic year. We performed a survey of residents to assess their self-reported knowledge, attitudes and skills in SBP and PBLI. In addition, blinded faculty scored projects for appropriateness, impact, and feasibility. Outcomes We measured resident self-reported knowledge, attitudes, and skills at the end of the academic year. We found evidence that participants improved their understanding of the context in which they were practicing, and that their ability to engage in quality improvement projects increased. Blinded faculty reviewers favorably ranked the projects' feasibility, impact, and appropriateness. The 'Curriculum of Inquiry' generated 11 quality improvement and research projects during the study period. Barriers to the ongoing work include a limited supply of mentors and delays due to Institutional Review Board approval. Hospital leadership recognizes the importance of the curriculum, and our accreditation manager now cites our ongoing work. Conclusions A structured residency-based curriculum facilitates resident demonstration of SBP and practice-based learning and improvement. Residents gain knowledge and skills though this enterprise and hospitals gain access to trainees who help to solve ongoing problems and meet accreditation requirements.

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

PubMed

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

2016-05-01

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

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

PubMed Central

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

2016-01-01

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

Adaptive trials for tuberculosis: early reflections on theory and practice.

PubMed

Montgomery, C M

2016-08-01

Adaptive designs (ADs) have been proposed for anti-tuberculosis treatment trials. This call for innovation occurs against the backdrop of fundamental changes in the acceptable evidence base in anti-tuberculosis treatment. To contextualise ADs for tuberculosis (TB) and explore early responses from those working in the field. In this qualitative study investigating processes of theoretical and practical change in randomised controlled trials, 24 interviews were conducted with professionals involved in AD trials, half of whom worked in the TB field. Clinical trialists working on AD trials in TB are positive about the efficiency these designs offer, but remain cautious about their suitability. In addition to technical concerns, informants discussed the challenges of implementing AD in developing countries, including limited regulatory capacity to evaluate proposals, investments needed in infrastructure and site capacity, and challenges regarding informed consent. Respondents identified funding, interdisciplinary communication and regulatory and policy responses as additional concerns potentially affecting the success of AD for TB. Empirical research is needed into patient experiences of AD, including informed consent. Further consideration of the contexts of innovation in trial design is needed. These are fundamental to the successful translation of theory into practice.

Burnout, career satisfaction, and well-being among US neurologists in 2016

PubMed Central

Shanafelt, Tait D.; Keran, Christopher M.; Levin, Kerry H.; Schwarz, Heidi B.; Molano, Jennifer R.; Vidic, Thomas R.; Kass, Joseph S.; Miyasaki, Janis M.; Sloan, Jeff A.; Cascino, Terrence L.

2017-01-01

Objective: To study prevalence of and factors that contribute to burnout, career satisfaction, and well-being in US neurologists. Methods: A total of 4,127 US American Academy of Neurology member neurologists who had finished training were surveyed using validated measures of burnout, career satisfaction, and well-being from January 19 to March 21, 2016. Results: Response rate was 40.5% (1,671 of 4,127). Average age of participants was 51 years, with 65.3% male and nearly equal representation across US geographic regions. Approximately 60% of respondents had at least one symptom of burnout. Hours worked/week, nights on call/week, number of outpatients seen/week, and amount of clerical work were associated with greater burnout risk. Effective support staff, job autonomy, meaningful work, age, and subspecializing in epilepsy were associated with lower risk. Academic practice (AP) neurologists had a lower burnout rate and higher rates of career satisfaction and quality of life than clinical practice (CP) neurologists. Some factors contributing to burnout were shared between AP and CP, but some risks were unique to practice setting. Factors independently associated with profession satisfaction included meaningfulness of work, job autonomy, effectiveness of support staff, age, practicing sleep medicine (inverse relationship), and percent time in clinical practice (inverse relationship). Burnout was strongly associated with decreased career satisfaction. Conclusions: Burnout is common in all neurology practice settings and subspecialties. The largest driver of career satisfaction is the meaning neurologists find in their work. The results from this survey will inform approaches needed to reduce burnout and promote career satisfaction and well-being in US neurologists. PMID:28122905

Burnout, career satisfaction, and well-being among US neurologists in 2016.

PubMed

Busis, Neil A; Shanafelt, Tait D; Keran, Christopher M; Levin, Kerry H; Schwarz, Heidi B; Molano, Jennifer R; Vidic, Thomas R; Kass, Joseph S; Miyasaki, Janis M; Sloan, Jeff A; Cascino, Terrence L

2017-02-21

To study prevalence of and factors that contribute to burnout, career satisfaction, and well-being in US neurologists. A total of 4,127 US American Academy of Neurology member neurologists who had finished training were surveyed using validated measures of burnout, career satisfaction, and well-being from January 19 to March 21, 2016. Response rate was 40.5% (1,671 of 4,127). Average age of participants was 51 years, with 65.3% male and nearly equal representation across US geographic regions. Approximately 60% of respondents had at least one symptom of burnout. Hours worked/week, nights on call/week, number of outpatients seen/week, and amount of clerical work were associated with greater burnout risk. Effective support staff, job autonomy, meaningful work, age, and subspecializing in epilepsy were associated with lower risk. Academic practice (AP) neurologists had a lower burnout rate and higher rates of career satisfaction and quality of life than clinical practice (CP) neurologists. Some factors contributing to burnout were shared between AP and CP, but some risks were unique to practice setting. Factors independently associated with profession satisfaction included meaningfulness of work, job autonomy, effectiveness of support staff, age, practicing sleep medicine (inverse relationship), and percent time in clinical practice (inverse relationship). Burnout was strongly associated with decreased career satisfaction. Burnout is common in all neurology practice settings and subspecialties. The largest driver of career satisfaction is the meaning neurologists find in their work. The results from this survey will inform approaches needed to reduce burnout and promote career satisfaction and well-being in US neurologists. © 2017 American Academy of Neurology.

Swedish midwives' perception of their practice environment - A cross sectional study.

PubMed

Hildingsson, Ingegerd; Fenwick, Jennifer

2015-10-01

There is a shortage of midwives in Sweden. Evidence suggests that the work environment is likely to play a part in retention and attrition rates. To explore the practice environment of Swedish midwives and factors associated with the perception of an unfavorable work environment. 475/1000 (48.6%) members of the Swedish Midwifery association completed a questionnaire including the Practice Environment Scale (PES). Differences in mean scores were calculated for the subscales of PES and midwives' background characteristics. Logistic regression was used to investigate factors most strongly associated with unfavorable working environment. The two domains that showed significant differences in terms of participant characteristics were the Staffing and resources adequacy subscale and the Foundations of quality care subscale. Midwives younger than 40 years, those with less than 10 years' experience and those with an additional academic degree rated these two domains more unfavorably. Protective factors for assessing the work environment unfavorable were mainly internal such as high quality of life and high self-efficacy. Swedish midwives were most satisfied with the midwife-doctor relationship and least satisfied with their participation in work place or hospital affairs. Midwives suffering from burnout, those who provided hospital based care and those without leadership position were more likely to assess their work environment as unfavorable. This study identified personal factors as well as work related factors to be associated with midwives' assessment of their practice work environment. Establishing healthy work places where midwives feel recognized and valued could prevent midwives from leaving the profession. Copyright © 2015 Elsevier B.V. All rights reserved.

Arkansas People Participating in Lead Education (APPLE): results of a lead-safe training program.

PubMed

Ferguson, Alesia; Bursac, Zoran; Kern, David F

2011-06-01

Lead is still seen as one of the most harmful environmental toxins for young children, with the predominant source being deteriorating lead-based paint. Those at continued risk include those living in homes built before 1978, renovators and remodelers, and especially those with limited access to proper healthcare and diets. Proper training on lead-safe work practices focused on preventing and reducing the spread of lead dust can help reduce lead exposure. Presented in this paper are experiences in delivering lead-safe work practices training in six Arkansas cities, and results from pre- and post- surveys delivered before and immediately after the training. Pre- and post-surveys assess strong and weak areas of training. Participants demonstrated positive shifts in attitude and behavior towards lead-safe work practices following training. However, our research found that more emphasis should be focused on clarifying current lead exposure sources and routes for children.

Work Life Stress and Career Resilience of Licensed Nursing Facility Administrators.

PubMed

Myers, Dennis R; Rogers, Rob; LeCrone, Harold H; Kelley, Katherine; Scott, Joel H

2018-04-01

Career resilience provided a frame for understanding how Licensed Nursing Facility Administrators (LNFAs) sustain role performance and even thrive in stressful skilled nursing facility work environments. Quantitative and qualitative analyses of in-depth interviews with18 LNFAs, averaging 24 years of experience were conducted by a five-member research team. Analysis was informed by evidence-based frameworks for career resilience in the health professions as well as the National Association of Long-Term Care Administrator Boards' (NAB) five domains of competent administrative practice. Findings included six sources of work stressors and six sources of professional satisfaction. Also, participants identified seven strategic principles and 10 administrative practices for addressing major sources of stress. Recommendations are provided for research and evidence-based application of the career resilience perspective to LNFA practice aimed at reducing role abandonment and energizing the delivery of the quality of care that each resident deserves.

Hospital-based group: ideal practice for the future?

PubMed

Matloff, J M; Denton, T A

1995-11-01

The format for future cardiothoracic surgical practices includes the option of a hospital-based group where provider groups and the hospital share the responsibilities and obligations of clinical care and the cost of that care. Based on personal experience at the Cedars-Sinai Medical Center, Los Angeles, three separate contract relationships during our tenure have reflected the evolution of cardiothoracic surgeons' relationship to our patients and the hospital in which we work. Although other organizational modes may prove equally successful, the hospital-based group practice is a viable structure that supports the preservation of quality in the work performed. This relationship helps to maintain a steady volume of patients enabling research endeavors, which are primarily funded through practice incomes, to continue and it also provides a platform for networking with defined patient referrals, shared services, and bench-marking with other centers.

Developing an Addictions Nursing Competency Framework Within a Canadian Context.

PubMed

Ling, Sara; Watson, Alison; Gehrs, Margaret

Clients with substance use disorders access care in all areas of the health care system, yet the Canadian nursing literature lacks content on the knowledge, skills, and judgment needed by nurses who work with this population. To address this literature gap, two Advanced Practice Nurses adapted the Canadian Centre on Substance Abuse's Technical Competencies for Canada's Substance Abuse Workforce to include nursing content and theory. This article describes the adaptation process and validation method used by the Advanced Practice Nurses at a large, Canadian urban teaching hospital and includes discussion about actual and potential opportunities for practical application of the adapted framework.

From theory to practice: integrating instructional technology into veterinary medical education.

PubMed

Wang, Hong; Rush, Bonnie R; Wilkerson, Melinda; Herman, Cheryl; Miesner, Matt; Renter, David; Gehring, Ronette

2013-01-01

Technology has changed the landscape of teaching and learning. The integration of instructional technology into teaching for meaningful learning is an issue for all educators to consider. In this article, we introduce educational theories including constructivism, information-processing theory, and dual-coding theory, along with the seven principles of good practice in undergraduate education. We also discuss five practical instructional strategies and the relationship of these strategies to the educational theories. From theory to practice, the purpose of the article is to share our application of educational theory and practice to work toward more innovative teaching in veterinary medical education.

Work-based learning in health and social care.

PubMed

Phillips, Sue

This article examines some of the issues encountered in helping to develop and facilitate work-based learning (WBL) in clinical areas from the author's perspective of APEL/WBL co-ordinator. The advantages of work-based learning to both organisations and practitioners are discussed, together with possible drawbacks. The article concludes by identifying the positive aspects, including that of practice development, but suggests caution in attempting to use work-based learning in all circumstances.

Experiences and Practices of General Education Teachers Supporting Students with Emotional Disturbance

ERIC Educational Resources Information Center

Weisling, Nina Fitzsimmons

2012-01-01

This study describes the classroom practices of middle school general education teachers working with students with and without emotional disturbance (ED), including the predictability of those teacher behaviors for both groups of students. The data collected in this study describe the ways in which the beliefs and experiences of this group of…

A Survey and Evaluation of Simulators Suitable for Teaching Courses in Computer Architecture and Organization

ERIC Educational Resources Information Center

Nikolic, B.; Radivojevic, Z.; Djordjevic, J.; Milutinovic, V.

2009-01-01

Courses in Computer Architecture and Organization are regularly included in Computer Engineering curricula. These courses are usually organized in such a way that students obtain not only a purely theoretical experience, but also a practical understanding of the topics lectured. This practical work is usually done in a laboratory using simulators…

Re-Defining Language Teacher Cognition through a Data-Driven Model: The Case of Three EFL Teachers

ERIC Educational Resources Information Center

Öztürk, Gökhan; Gürbüz, Nurdan

2017-01-01

This study examined the main sources of the participant English as a foreign language (EFL) teachers' cognitions, their classroom practices and the impact of institutional context on these practices. The participants included three Turkish EFL instructors working at English preparatory programs at university level. The data were collected through…

Inclusive Practices in the Teaching of Mathematics: Supporting the Work of Effective Primary Teachers

ERIC Educational Resources Information Center

Clarke, Barbara; Faragher, Rhonda

2015-01-01

The practices of effective primary school teachers including students with Down syndrome in their mathematics classes are largely unexplored and many teachers feel unprepared to teach students with intellectual disabilities. A study with cohorts in Victoria and the ACT is underway and here we report a subset of findings concerning the support…

Factors Influencing M.S.W. Students' Interest in Clinical Practice

ERIC Educational Resources Information Center

Perry, Robin

2009-01-01

This study utilizes linear and log-linear stochastic models to examine the impact that a variety of variables (including graduate education) have on M.S.W. students' desires to work in clinical practice. Data was collected biannually (between 1992 and 1998) from a complete population sample of all students entering and exiting accredited graduate…

Teaching about Love and Practicing Feminist Pedagogy in a College Classroom

ERIC Educational Resources Information Center

Mei-Hui, You

2014-01-01

Being a feminist teacher, working on gender equity education, including teaching, reading, writing, and doing research on this topic, has become a commitment for me. I have frequently reflected my teaching practices and occasionally found new teaching strategies in the classroom. I always try to bring new topics or issues into the classroom in…

Progressive Educational Practices and Environments in Sweden: Preparing Students to Live and Work in the Global Age

ERIC Educational Resources Information Center

Nordgren, R. D.

2006-01-01

A multi-site case study of three Swedish schools examined the dimensions of trust, responsibility, shared power (democracy), and global workforce competence as required by a decade-old national education reforms. A key finding was the existence of progressive educational practices including constructivist epistemology, evidenced by the schools'…

Theory to Practice through Teacher Inquiry Courses in a Graduate Program: Two Teachers' Perspectives

ERIC Educational Resources Information Center

Keat, Jane Blakely

2005-01-01

Our graduate degree program includes a component of six one-credit courses, in which teachers find ways to bring into their own classroom practices theory learned in related three-credit courses. Prior research indicates that taking course work alone may not bring about changes in teachers' decision-making. Prior research also encourages higher…

Practical Approaches to Early Childhood Professional Development: Evidence, Strategies, and Resources [with CD-ROM

ERIC Educational Resources Information Center

Winton, Pamela J., Ed; McCollum, Jeanette A., Ed.; Catlett, Camille, Ed.

2007-01-01

The key to improving the early education of all young children, including those with special needs, is the effective preparation and development of the professionals who work with them. "Practical Approaches to Early Childhood Professional Development" is a comprehensive planning resource for college faculty and consultants engaged in preservice …

Transformation through Repetition: Walking, Listening and Drawing on Tlicho Lands

ERIC Educational Resources Information Center

Ruiz, Adolfo

2017-01-01

As part of my PhD practice-based research on Tlicho lands (a self-governed Indigenous region in Canada's Northwest Territories), drawing is being used to embody intangible cultural heritage (which includes activities such as oral history and the social practice of walking). Recent work to emerge from this research consists of two drawings created…

Creating Mentoring Programs as a Means of Retaining Qualified Special Education Personnel. Practice Brief. Winter 2011

ERIC Educational Resources Information Center

Muller, Eve

2011-01-01

In response to high rates of attrition, increasing numbers of states and localities are developing mentoring programs as a means of retaining qualified special education personnel. Based on examples drawn from around the country, including states and localities with which the Personnel Improvement Center (PIC) has worked, this practice brief…

Supporting Pupils' Mental Health through Everyday Practices: A Qualitative Study of Teachers and Head Teachers

ERIC Educational Resources Information Center

Maelan, Ellen Nesset; Tjomsland, Hege Eikeland; Baklien, Børge; Samdal, Oddrun; Thurston, Miranda

2018-01-01

This study aimed to explore teachers' and head teachers' understandings of how they work to support pupils' mental health through their everyday practices. A qualitative study, including individual interviews with head teachers and focus groups with teachers, was conducted in lower secondary schools in Norway. Rich descriptions of teachers' and…

The undergraduate research fellows program: a unique model to promote engagement in research.

PubMed

Vessey, Judith A; DeMarco, Rosanna F

2008-01-01

Well-educated nurses with research expertise are needed to advance evidence-based nursing practice. A primary goal of undergraduate nursing curricula is to create meaningful participatory experiences to help students develop a research skill set that articulates with rapid career advancement of gifted, young graduates interested in nursing research and faculty careers. Three research enrichment models-undergraduate honors programs, research assistant work-for-hire programs, and research work/mentorship programs-to be in conjunction with standard research content are reviewed. The development and implementation of one research work/mentorship program, the Boston College undergraduate research fellows program (UGRF), is explicated. This process included surveying previous UGRFs followed by creating a retreat and seminars to address specific research skill sets. The research skill sets included (a) how to develop a research team, (b) accurate data retrieval, (c) ethical considerations, (d) the research process, (e) data management, (f) successful writing of abstracts, and (g) creating effective poster presentations. Outcomes include evidence of involvement in research productivity and valuing of evidenced-based practice through the UGRF mentorship process with faculty partners.

Reimbursement and costs of pediatric ambulatory diabetes care by using the resource-based relative value scale: is multidisciplinary care financially viable?

PubMed

Melzer, Sanford M; Richards, Gail E; Covington, Maxine L

2004-09-01

The ambulatory care for children with diabetes mellitus (DM) within an endocrinology specialty practice typically includes services provided by a multidisciplinary team. The resource-based relative value scale (RBRVS) is increasingly used to determine payments for ambulatory services in pediatrics. It is not known to what extent resource-based practice expenses and physician work values as allocated through the RBRVS for physician and non-physician practice expenses cover the actual costs of multidisciplinary ambulatory care for children with DM. A pediatric endocrinology and diabetes clinic staffed by faculty physicians and hospital support staff in a children's hospital. Data from a faculty practice plan billing records and income and expense reports during the period from 1 July 2000 to 30 June 2001 were used to determine endocrinologist physician ambulatory productivity, revenue collection, and direct expenses (salary, benefits, billing, and professional liability (PLI)). Using the RBRVS, ambulatory care revenue was allocated between physician, PLI, and practice expenses. Applying the activity-based costing (ABC) method, activity logs were used to determine non-physician and facility practice expenses associated with endocrine (ENDO) or diabetes visits. Of the 4735 ambulatory endocrinology visits, 1420 (30%) were for DM care. Physicians generated $866,582 in gross charges. Cash collections of 52% of gross charges provided revenue of $96 per visit. Using the actual Current Procedural Terminology (CPT)-4 codes reported for these services and the RBRVS system, the revenue associated with the 13,007 total relative value units (TRVUs) produced was allocated, with 58% going to cover physician work expenses and 42% to cover non-physician practice salary, facility, and PLI costs. Allocated revenue of $40.60 per visit covered 16 and 31% of non-physician and facility practice expenses per DM and general ENDO visit, respectively. RBRVS payments ($35/RVU) covered 46% of all expenses ($76.74/RVU), including 132% of physician expenses for the time worked in the clinic ($27/RVU), and only 23% of actual incurred practice expenses ($152/TRVU). Clinical revenues in a pediatric endocrinology practice, allocated by using the RBRVS system, do cover physician expenses for the time spent working in a hospital ENDO and DM clinic, but do not closely approximate non-physician and facility practice expenses while delivering multidisciplinary care to children with DM. Using payment based on the RBRVS system, and without additional payments to compensate for increased practice expenses incurred in the delivery of multidisciplinary care, this care model may not be financially viable.

Using the electronic health record to build a culture of practice safety: evaluating the implementation of trigger tools in one general practice.

PubMed

Margham, Tom; Symes, Natalie; Hull, Sally A

2018-04-01

Identifying patients at risk of harm in general practice is challenging for busy clinicians. In UK primary care, trigger tools and case note reviews are mainly used to identify rates of harm in sample populations. This study explores how adaptions to existing trigger tool methodology can identify patient safety events and engage clinicians in ongoing reflective work around safety. Mixed-method quantitative and narrative evaluation using thematic analysis in a single East London training practice. The project team developed and tested five trigger searches, supported by Excel worksheets to guide the case review process. Project evaluation included summary statistics of completed worksheets and a qualitative review focused on ease of use, barriers to implementation, and perception of value to clinicians. Trigger searches identified 204 patients for GP review. Overall, 117 (57%) of cases were reviewed and 62 (53%) of these cases had patient safety events identified. These were usually incidents of omission, including failure to monitor or review. Key themes from interviews with practice members included the fact that GPs' work is generally reactive and GPs welcomed an approach that identified patients who were 'under the radar' of safety. All GPs expressed concern that the tool might identify too many patients at risk of harm, placing further demands on their time. Electronic trigger tools can identify patients for review in domains of clinical risk for primary care. The high yield of safety events engaged clinicians and provided validation of the need for routine safety checks. © British Journal of General Practice 2018.

Violence prevention and municipal licensing of indoor sex work venues in the Greater Vancouver Area: narratives of migrant sex workers, managers and business owners.

PubMed

Anderson, Solanna; Jia, Jessica Xi; Liu, Vivian; Chattier, Jill; Krüsi, Andrea; Allan, Sarah; Maher, Lisa; Shannon, Kate

2015-01-01

Using a socio-ecological, structural determinants framework, this study assesses the impact of municipal licensing policies and related policing practices across the Greater Vancouver Area (Canada) on the risk of violence within indoor sex work venues. Qualitative interviews were conducted with 46 migrant/immigrant sex workers, managers and owners of licensed indoor sex work establishments and micro-brothels. Findings indicate that policing practices and licensing requirements increase sex workers' risk of violence and conflict with clients and result in heightened stress, an inability to rely on police support, lost income and the displacement of sex workers to more hidden informal work venues. Prohibitive licensing and policing practices prevent sex workers, managers and owners from adopting safer workplace measures and exacerbate health and safety risks for sex workers. This study provides critical evidence of the negative public health implications of prohibitive municipal licensing in the context of a criminalised and enforcement-based approach to sex work. Workplace safety recommendations include the decriminalisation of sex work and the elimination of disproportionately high fees for licences, criminal record restrictions, door lock restrictions, employee registration requirements and the use of police as licensing inspectors.

Improving the health care work environment: implications for research, practice, and policy.

PubMed

Harrison, Michael I; Henriksen, Kerm; Hughes, Ronda G

2007-11-01

Despite the gains to date, we need better understanding of practices for implementing and sustaining improvements in health care work environments and further study of organizational conditions affecting implementation of improvements. Limiting work hours, improving schedules, and providing sleep hygiene training will help combat clinician fatigue. Hospital crowding can be reduced through systemwide improvement of patient flow and capacity management, coupled with management support, measurement, and reporting on crowding. Long-term solutions to nurse staffing shortfalls include process redesign to enhance efficiency. Improvement of organizational climate, human resource management, and interoccupational relations will also contribute to staff retention. Evidence-based enhancements to patient rooms and other physical features in hospitals contribute directly to safety and quality and also affect staff performance. POLICY: Landrigan and his colleagues call for external restrictions on residents' work shifts. Clarke examines prospects for mandated nursing-staff ratios. Public reporting on staffing, crowding, and other risks may incent change. Reporting and pay for performance require standardized measures of targeted conditions. Organizations promoting care quality can help spread safe work practices; they can also support collaborative learning and other strategies that may enhance implementation of improvements in work environments.

Fundamental constructs in food parenting practices: a content map to guide future research

PubMed Central

Ward, Dianne S.; Fisher, Jennifer O.; Faith, Myles S.; Hughes, Sheryl O.; Kremers, Stef P.J.; Musher-Eizenman, Dara R.; O’Connor, Teresia M.; Patrick, Heather; Power, Thomas G.

2016-01-01

Although research shows that “food parenting practices” can impact children’s diet and eating habits, current understanding of the impact of specific practices has been limited by inconsistencies in terminology and definitions. This article represents a critical appraisal of food parenting practices, including clear terminology and definitions, by a working group of content experts. The result of this effort was the development of a content map for future research that presents 3 overarching, higher-order food parenting constructs – coercive control, structure, and autonomy support – as well as specific practice subconstructs. Coercive control includes restriction, pressure to eat, threats and bribes, and using food to control negative emotions. Structure includes rules and limits, limited/guided choices, monitoring, meal- and snacktime routines, modeling, food availability and accessibility, food preparation, and unstructured practices. Autonomy support includes nutrition education, child involvement, encouragement, praise, reasoning, and negotiation. Literature on each construct is reviewed, and directions for future research are offered. Clear terminology and definitions should facilitate cross-study comparisons and minimize conflicting findings resulting from previous discrepancies in construct operationalization. PMID:26724487

Implementing and evaluating an interprofessional minority health conference for social work and healthcare professionals.

PubMed

Washington, Tiffany R; Ward, Trina Salm; Young, Henry N; Orpinas, Pamela; Cornelius, Llewellyn J

2017-11-01

Interprofessional education (IPE) is one strategy for addressing health inequities; however, little attention has been paid to continuing IPE for practicing social work and healthcare professionals. This article offers guidance to faculty in social work and health-related academic units on offering continuing IPE on the topic of minority health. An interprofessional group of faculty offered a day-long conference on minority health, ethics, and social justice. The conference goal was to promote interprofessional communication in a co-learning environment and promote dialogue on social determinants of health and health equity in the state. Data were obtained from surveys and analysis of work plans developed during the conference. Workshop participants were majority White (62%), social workers (79%), and practiced for 14 years on average. The most useful topics were dementia and polypharmacy. Takeaway strategies included interprofessional work, being mindful of access to resources, and engagement in continuing education. Lessons learned include plan in advance for all professions; recruit faculty and students from multiple departments to increase interprofessional diversity; offer strategies and incentives to increase student participation; be strategic about conference location and format; and identify a strategic format and theme. IPE is a means of preparing learners for working together in their future careers to provide high-quality patient-centred care and reduce health disparities. Professional development can provide an opportunity to enhance skills to address health disparities, and learning can be significantly enhanced when participants connect with colleagues from different professions, discuss diverse opinions, and share successful practices.

Writing a group practice business plan.

PubMed

Reiboldt, J M

1999-07-01

A business plan offers group practices a blueprint to accomplish a variety of goals, such as securing capital, marketing the practice's services, recruiting new employees, developing a strategic plan or a budget, or planning for growth. A business plan should be informative, specific, and visionary. Elements that every business plan should address are a mission statement, strategy, planning, management information, and action scheme. A business plan should include certain information in a prescribed order. By writing a realistic business plan, group practices can work more efficiently and minimize the risk of not meeting their financial projections.

The Roles of Pharmacy Schools in Bridging the Gap Between Law and Practice.

PubMed

Adams, Alex J; Dering-Anderson, Allison; Klepser, Michael E; Klepser, Donald

2018-05-01

Progressive pharmacy laws do not always lead to progressive pharmacy practice. Progressive laws are necessary, but not sufficient for pharmacy services to take off in practice. Pharmacy schools can play critical roles by working collaboratively with community pharmacies to close the gap between law and practice. Our experiences launching pharmacy-based point-of-care testing services in community pharmacy settings illustrate some of the roles schools can play, including: developing and providing standardized training, developing template protocols, providing workflow support, sparking collaboration across pharmacies, providing policy support, and conducting research.

Developing a general practice library: a collaborative project between a GP and librarian.

PubMed

Pearson, D; Rossall, H

2001-12-01

The authors report on a self-completed questionnaire study from a North Yorkshire based general practice regarding the information needs of its clinicians. The work was carried out with a particular focus on the practice library, and the findings identified that a new approach to maintaining and developing the library was needed. The literature regarding the information needs of primary care clinicians and the role of practice libraries is considered, and compared to those of the clinicians at the practice. Discussion follows on how a collaborative project was set up between the practice and a librarian based at the local NHS Trust library in order to improve the existing practice library. Difficulties encountered and issues unique to the project are explored, including training implications presented by the implementation of electronic resources. Marketing activities implemented are discussed, how the library will operate in its new capacity, and how ongoing support and maintenance of the library will be carried out. It is concluded that although scepticism still exists regarding librarian involvement in practice libraries, collaboration between clinicians and librarians is an effective approach to the successful development and maintenance of a practice library, and recommendations are therefore made for similar collaborative work.

Roles and responsibilities of the nursing scholar.

PubMed

Conard, Patricia L; Pape, Tess Theresa

2014-01-01

Scholarship is an important facet of the nursing profession. There are many components, virtues, and roles and responsibilities of a nursing scholar practicing in today's ever-changing health care environment. Scholarship was redefined by Boyer to include scholarly activities in addition to research. Boyer's Model of Scholarship includes four interrelated and overlapping domains of discovery, integration, application, and teaching. Each domain is explained with examples for the pediatric nurse scholar, which includes roles in academia as well as in the practice setting. Pediatric nurses are key to scholarship in nursing because they work to improve the care of children.

Using the Practice Environment Scale of the Nursing Work Index on Asian nurses.

PubMed

Liou, Shwu-Ru; Cheng, Ching-Yu

2009-01-01

Researchers have used the Practice Environment Scale of the Nursing Work Index (PES-NWI) to examine the perception of practice environment among U.S. nurses in general; however, the scale has not been used to measure perceptions specifically among Asian nurses working in the United States, the largest group of international nurses in the nation. The purpose of this study was to test the reliability and the validity of the PES-NWI scale when applied to Asian nurses working in the United States. The study used a cross-sectional design with snowball sampling. Data from 230 Asian nurses who were born in Far Eastern countries and had worked at least 6 months in their current job at a U.S. hospital were analyzed, using Cronbach's alpha, item-total and interitem correlation, and factor analysis. The Cronbach's alpha for the PES-NWI was.96, and the item-total correlation coefficients ranged from.49 to.79. Five factors, which explained 59.12% of variance in the perception of practice environment, emerged: Nurse Participation and Development; Nurse Manager Ability, Leadership, and Support of Nurses; Nursing Foundations for Quality of Care; Staffing and Resource Adequacy; and Collegial Nurse-Physician Relations. Four derived factors were reconstructed, and one factor was renamed based on the meanings of scale items that were included in the factor. Study findings demonstrate that the PES-NWI is a reliable and a valid scale when applied to Asian nurses working in the United States. Findings also indicate that Asian nurses perceive practice environments differently than do American nurses, most likely due to dissimilar cultural beliefs. A better understanding of these differences may help develop more individualized support for Asian nurses as they adapt to working in the United States.

[Knowledge, practices and attitudes toward volunteer work in an influenza pandemic: cross-sectional study with Peruvian medical students].

PubMed

Huapaya, Julio A; Maquera-Afaray, Julio; García, Patricia J; Cárcamo, César; Cieza, Javier A

2015-05-08

Reductions in health personnel during disasters or epidemics such as an influenza pandemic may need to include volunteer students. The aim of this article is to determine knowledge and practices about pandemic influenza and the attitudes towards volunteer work in Peruvian medical students. We performed a cross-sectional analytic study by simple sampling using a survey regarding “"knowledge and practices"” about pandemic influenza and the attitudes to volunteer work. From the group of 865 students who were surveyed, 848 accepted to participate in the investigation (54% were male and their mean age was 22.1 ± 3.0). Ninety-seven percent correctly identified the spread routes of influenza and 81% knew its treatment. Regarding preventive measures, covering the mouth when coughing/sneezing and hand-washing were the most commonly recognized options (95% y 92%, respectively), and vaccination was the less recognized one (54%). The most common practice, readily acknowledged as preventive, was covering when coughing/sneezing (86%). Regarding volunteer works, students answered that it is a moral/ethical/professional obligation (77%); that a contingency university service needs to be established (88%), that it does not have to substitute for the lack of workers (49%), and that its role should be related to hospital work (83%). Coming from a public university was more associated to the concept that volunteer work was a moral obligation and that the student should be punished if he/she refuses to be a volunteer, whereas being from a private university was more related to a history of been involved in volunteering programs. In general, medical students have good knowledge and practices toward influenza. There is a good disposition to volunteer their work and skills, recognizing it as a moral/ethical/professional obligation.

Attitudes of Austrian veterinarians towards euthanasia in small animal practice: impacts of age and gender on views on euthanasia.

PubMed

Hartnack, Sonja; Springer, Svenja; Pittavino, Marta; Grimm, Herwig

2016-02-04

Euthanasia of pets has been described by veterinarians as "the best and the worst" of the profession. The most commonly mentioned ethical dilemmas veterinarians face in small animal practice are: limited treatment options due to financial constraints, euthanizing of healthy animals and owners wishing to continue treatment of terminally ill animals. The aim of the study was to gain insight into the attitudes of Austrian veterinarians towards euthanasia of small animals. This included assessing their agreement with euthanasia in exemplified case scenarios, potentially predicted by demographic variables (e.g. gender, age, working in small animal practice, employment, working in a team, numbers of performed euthanasia). Further describing the veterinarians' agreement with a number of different normative and descriptive statements, including coping strategies. A questionnaire with nine euthanasia scenarios, 26 normative and descriptive statements, and demographic data were sent to all members of the Austrian Chamber of Veterinary Surgeons (n = 2478). In total, 486 veterinarians answered sufficiently completely to enable analyses. Responses were first explored descriptively before being formally analysed using linear regression and additive Bayesian networks - a multivariate regression methodology - in order to identify joint relationships between the demographic variables, the statements and each of the nine euthanasia scenarios. Mutual dependencies between the demographic variables were found, i.e. female compared to male veterinarians worked mostly in small animal practice, and working mostly in small animal practice was linked to performing more euthanasia per month. Gender and age were found to be associated with views on euthanasia: female veterinarians and veterinarians having worked for less years were more likely to disagree with euthanasia in at least some of the convenience euthanasia scenarios. The number of veterinarians working together was found to be the variable with the highest number of links to other variables, demographic as well as ethical statements. This highlights the role of a team potentially providing support in stressful situations. The results are useful for a better understanding of coping strategies for veterinarians with moral stress due to euthanasia of small animals.

Meeting the needs of our best and brightest: curriculum acceleration in tertiary mathematics

NASA Astrophysics Data System (ADS)

Hannah, John; James, Alex; Montelle, Clemency; Nokes, Jacqui

2011-04-01

For many years, it has been a common practice to recognize students with high potential by according them targeted privileges and opportunities. This includes the practice of allowing students to accelerate their high school programme and, in the case of New Zealand students, to take university courses during their final school years. This work assesses the wisdom of this practice of acceleration in mathematics both for the student and the tertiary institution.

Current thinking in qualitative research: evidence-based practice, moral philosophies, and political struggle.

PubMed

Papadimitriou, Christina; Magasi, Susan; Frank, Gelya

2012-01-01

In this introduction to the special issue on current thinking in qualitative research and occupational therapy and science, the authors focus on the importance of rigorous qualitative research to inform occupational therapy practice. The authors chosen for this special issue reflect a "second generation of qualitative researchers" who are critical, theoretically sophisticated, methodologically productive, and politically relevant to show that working with disabled clients is political work. Three themes emerged across the articles included in this special issue: (1) recognizing and addressing social justice issues; (2) learning from clients' experiences; and (3) critically reframing occupational therapy's role. These themes can inform occupational therapy practice, research, and education to reflect a more client-centered and politically engaging approach. Copyright 2012, SLACK Incorporated.

The Impact of Urban US Policing Practices on Black Men Who Have Sex with Men's HIV Vulnerability: Ethnographic Findings and a Conceptual Model for Future Research.

PubMed

Parker, Caroline M; Parker, Richard G; Philbin, Morgan M; Hirsch, Jennifer S

2018-04-01

This paper advances research on racism and health by presenting a conceptual model that delineates pathways linking policing practices to HIV vulnerability among Black men who have sex with men in the urban USA. Pathways include perceived discrimination based on race, sexuality and gender performance, mental health, and condom-carrying behaviors. The model, intended to stimulate future empirical work, is based on a review of the literature and on ethnographic data collected in 2014 in New York City. This paper contributes to a growing body of work that examines policing practices as drivers of racial health disparities extending far beyond violence-related deaths.

Career satisfaction of Jordanian dental hygienists.

PubMed

Malkawi, Z A

2016-11-01

The aim of this study was to determine the factors that affect Jordanian dental hygienists with their career satisfaction including financial issues, employment settings and policies. Randomized sample of 102 dental hygienists with a bachelor's degree were selected from the entire population of Jordanian dental hygienists. Participants received a cover letter with a questionnaire. Findings were analysed using descriptive data techniques. Chi-square test was used to determine the statistically significant differences across demographic variables and career satisfaction's factors. About 22.5% of the participants are not working as dental hygienist. Dental hygiene profession in Jordan includes predominantly (74.0%) females. Majority of them (51.9%) were employed in JUST, and minority (6.3%) in MOH. Most of them (56.4%) were aged 24-29 years old, and mostly 62.2% with ≤1 child. About 53.1% employed by general dentist. Almost 35.3% had ≥4 years' job experience. Majority (47.6%) expressed high level of satisfaction with dental materials and equipment to practice work; however, only 2.0% expressed very high level of satisfaction with employment policies. Almost 32.4% expressed low level of satisfaction with salary level. Minority (2.0%) expressed dissatisfaction with quality of dentist's work. Statistically significant association was found between workplace, and dental materials and equipment to practice work, salary level, employment policies (P = 0.003, P = 0.003, P = 0.026), and number of children with flexibility in work hours (P = 0.001). Jordanian dental hygienists' workplacesatisfaction w as significantly associated with dental materials and equipment to practice work, salary level, and employment policies. Understanding the working patterns of dental hygienists in Jordan is important to increase their career satisfaction levels. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Microprocessors in Schools?

ERIC Educational Resources Information Center

Cuthbert, L. G.

1981-01-01

Examines reasons for including microprocessors in school curricula. Indicates that practical work with microprocessors is not easy and discusses problems associated with using and constructing these control and processing devices of microcomputers. (SK)

Future Career Plans and Practice Patterns of Canadian Obstetrics and Gynaecology Residents in 2011.

PubMed

Burrows, Jason; Coolen, Jillian

2016-01-01

The practice patterns of Obstetricians and Gynaecologists continue to evolve with each new generation of physicians. Diversifying subspecialties, changes in resident duty hours, job market saturation, and desire for work-life balance are playing stronger roles. Professional practice direction and needs assessment may be aided by awareness of future Obstetrics and Gynaecology physician career plans and expectations. The objective of this study was to determine the expected career plans and practice patterns of Canadian Obstetrics and Gynaecology residents following residency. The SOGC Junior Member Committee administered its third career planning survey to Canadian Obstetrics and Gynaecology residents electronically in December 2011. The data collected was statistically analyzed and compared to previous surveys. There were 183 responses giving a response rate of 43%. More than one half of all residents were considering postgraduate training (58%). Projected practice patterns included: 84% maintaining obstetrical practice, 60% locuming, and 50% job-sharing. The majority of residents expected to work in a 6 to 10 person call group (48%), work 3 to 5 call shifts per month (72%), work 41 to 60 hours weekly (69%), and practise in a city with a population greater than 500 000 (45%). Only 18% of residents surveyed were in favour of streaming residency programs in Obstetrics and Gynaecology. Canadian resident career plan and expected practice pattern assessment remains an important tool for aiding in resource allocation and strategic development of care and training in Obstetrics and Gynaecology in Canada. Copyright © 2016 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

Surveys on minimum practical abilities required by nonspecialist occupational physicians in Japan

PubMed Central

Nagata, Masako; Mori, Koji; Ishikawa, Asako; Nagata, Tomohisa

2016-01-01

Objectives: This study aimed to identify the practical abilities required by nonspecialist occupational physicians and specify the priorities for training programs. Methods: A practical abilities list was developed through a focus group meeting of specialists. We created a survey questionnaire and asked three groups, namely, occupational physicians, occupational health nurses, and health officers, to rate the importance of each practical ability. Results: The mean scores for all 45 items were greater than 4, i.e., in the middle of the 7-point Likert scale, for all the three groups. The occupational physicians' responses had a correlation with the other groups' responses. However, there were differences with regard to some practical abilities between the three groups. Five practical abilities from the top quartile were marked "A" by all the three groups: "Submit opinions on fitness for duty and work accommodation on the basis of data from health examination," "Respect employee privacy," "Submit opinion on fitness for duty and work accommodation on the basis of data from face-to-face interviews with employees," "Submit opinions on fitness for duty and work accommodation on the basis of data from health surveillance," and "Implement face-to-face interviews for employees who have worked overtime and evaluate the subjects' conditions including mental and physical health status, degree of accumulated fatigue, and depression." Conclusions: This study resulted in a rank-ordered list of 45 practical abilities that are required by nonspecialist occupational physicians. This result may be useful to review and redesign the existing training program for nonspecialist occupational physicians. PMID:27108644

Moving into Management: How 360[degrees] Appraisal Worked for Me

ERIC Educational Resources Information Center

Scott, Heather

2004-01-01

Being interested in how being led and leading others was working in practice, the author undertook an evaluation of different leadership styles (including his) and their effectiveness in the context of the school. The author detailed the management structure of the school, recorded and analysed the different leadership styles in the light of…

What Consultation and Freelance Writing Can Do for You and for Your Students.

ERIC Educational Resources Information Center

Muller, John A.

This paper advises teachers of technical writing to "practice what they preach" by occasionally doing field work in technical communication. The possibilities for off-campus work include consultation, perhaps for an in-house manual of technical writing procedures and skills, editing assignments for businesses and public agencies, and freelance…

"Academic Freedom" or "Bottom Line": Public College Healthcare Professionals Teaching in a Global Economy

ERIC Educational Resources Information Center

McKnight, Kelly; Muzzin, Linda

2014-01-01

College faculty teaching in the health professions work within a unionized, neoliberal system designed to produce competent graduates trained to work in the health care hierarchy. The workers trained include community care assistants, two levels of nurses (practical nurses and baccalaureate nurses, the latter in collaboration with university…

Contrasting Visions: Identity, Literacy, and Boundary Work in a Fan Community

ERIC Educational Resources Information Center

Korobkova, Ksenia A.; Black, Rebecca W.

2014-01-01

This article focuses on learning and identity-related practices of young female fans of a popular British boy band called One Direction. Drawing on qualitative inquiry into a fanfiction community formed around the band, analysis highlights (a) the literate work fans engage in, including writing, reading, critiquing, and collaborating on multimodal…

The Learning Institute: Promoting Social Justice Advocacy within a Continuing Education Program

ERIC Educational Resources Information Center

Rice, Karen; Girvin, Heather; Frank, Jennifer; Foels, Leonora

2016-01-01

The pursuit of social justice is an overarching framework that defines the social work profession. The goals of macro social work practice are centered on issues of social justice with strategies that include changing community conditions and creating a sense of solidarity, with particular emphasis on broadening the opportunities for marginalized…

Preparing Urban Teachers as Public Professionals through a University-Community Partnership

ERIC Educational Resources Information Center

Onore, Cynthia; Gildin, Bonny

2010-01-01

Despite progress in urban teacher preparation over the past 40 years, concerns still remain about transforming programs and practices in order to affect teachers' capacities to work with culturally diverse communities. These concerns include time in course curricula for discussion and reflection on field-based work, adequate supervision in…

46 CFR 58.25-40 - Arrangement of the steering-gear compartment.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., separated from any machinery space; (2) Ensure working access to machinery and controls in the compartment; and (3) Include handrails and either gratings or other non-slip surfaces to ensure a safe working environment if hydraulic fluid leaks. Note: Where practicable, all steering gear should be located in the...

Action Research and Academic Writing: A Conversation

ERIC Educational Resources Information Center

Winter, Richard; Badley, Graham

2007-01-01

Here is a conversation between two former colleagues about action research and academic writing. Richard Winter opens the discussion with a series of reflections on his work as an action researcher. These reflections include the key argument that action research is a noble cause because it is relevant to working life, has a practical impact and…

Practice patterns, satisfaction, and demographics of reproductive endocrinologists: results of the 2014 Society for Reproductive Endocrinology and Infertility Workforce Survey.

PubMed

Barnhart, Kurt T; Nakajima, Steven T; Puscheck, Elizabeth; Price, Thomas M; Baker, Valerie L; Segars, James

2016-05-01

To identify the current and future state of the practice of reproductive medicine. Cross-sectional survey. Not applicable. None. Not applicable. The survey included 57 questions designed to assess practice patterns/metrics and professional satisfaction and morale. A total of 336/1,100 (31%) responded, and they were 38% women, 61% men, and 76% Caucasian, with a mean age of 54. Respondents averaged 2.3 jobs and averaged 53 hours of work per week: 44% work in academia and 50% in private groups. Average practice size was 5.5, with an average of 470 fresh IVF cycles performed per year. Percent effort included 63% infertility, 10% endocrinology, 10% surgery, and 9% research. Respondents performed an average of 13 major surgeries, 69 minor surgeries, and 128 oocyte retrievals per year. A total of 60% were salaried, and 40% were equity partners. Compensation was highly skewed. Greater than 84% had a positive morale and had a positive view of the future, and 92% would again choose REI as a career. The most satisfying areas of employment were patient interactions, intellectual stimulation, interactions with colleagues, and work schedule. The least satisfying areas were work schedule and financial compensation. Training was felt to be too focused on female factor infertility and basic research with insufficient training on embryology, genetics, male factor infertility, and clinical research. In the next 5 years, 57% suggested that the need for specialists would stay the same, while 20% predicted a decrease. A total of 58% felt we are training the correct number of fellows (37% felt we are training a surplus). Compared with academia, those in private practice reported higher compensation, less major surgery, more IVF, less endocrinology, and less research. Men worked more hours, conducted more surgery and IVF cycles, and had higher compensation than women. Morale was similar across age, gender, practice type, and geography. Our subspecialty has an extremely high morale. We are a middle-aged subspecialty with disparate compensation and a focused practice. Some respondents sense a need for a change in our training, and most anticipate only mild growth in our field. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Predictors of professional and personal satisfaction with a career in psychiatry.

PubMed

Garfinkel, Paul E; Bagby, R Michael; Schuller, Deborah R; Dickens, Susan E; Schulte, Fiona S

2005-05-01

Many factors, including personal experience and personality traits, contribute to the emotional difficulties that psychiatrists experience in their professional work. The nature of the work itself also plays a significant role. To determine those personal and professional characteristics that predict satisfaction with the practice of psychiatry. We mailed a questionnaire that included items pertaining to aspects of personal and professional life to the entire population of psychiatrists in Ontario (N = 1574). Of the 1574, 52% (n = 802) responded. We conducted a series of regression analyses to determine factors related to career satisfaction or regret. A belief in the intrinsic value of psychiatry, a low perceived degree of emotional burden from patients, financial success, and satisfaction with psychotherapeutic work emerged consistently as significant predictors. A subsequent discriminant function analysis indicated that all 4 of these variables accurately predicted those psychiatrists with extreme satisfaction or dissatisfaction with work. These results reveal several variables associated with career satisfaction in the practice of psychiatry that might be useful to discuss with residents who are beginning their careers.

Time to unsafe sexual practice among cross-border female sex workers in Metemma Yohannes, North West Ethiopia.

PubMed

Gezie, Lemma Derseh; Taye, Belaynew Wassie; Ayele, Tadesse Awoke

2015-07-28

Because of the nature of their work, female sex workers are at risk of sexually transmitted diseases. Cross-border areas are places where this situation becomes worse. In Ethiopia, there has been a serious scarcity of studies on the time at which unsafe sexual practice starts and on factors which determine the practice among female sex workers there. Therefore, this study aimed to fill this identified gap. A total of 467 women who had been sex workers at least for three months prior to the resumption of the study were included. A structured and pre-tested questionnaire was used to collect data from July-August, 2010. Descriptive statistics was used to explore the data, and the Extended Cox-Regression model was employed to identify the predictors of time-to-unsafe sexual practice. The study participants were followed for 6, 643 person-months. The overall incidence density of unsafe sexual practice was 44.71 persons per 1000 persons-months. The hazard of unsafe sexual practice increased by 3.0 % every month (p-value =0.040) due to problem-drinking. Those female sex workers with familiarized clients had a two-fold hazard of practicing unsafe sex compared to their counterparts (AHR = 1.94 95 % CI 1.49, 2.53). The predominant sexual client type and the work place of sex workers were the other significant predictors of unsafe sexual practice. The incidence of unsafe sexual practice was found to be high among sex workers in the cross-border area. Time-to-unsafe sexual practice was significantly associated with female sex workers' status of familiarity with their clients, predominant sexual client type, their work place, and the interaction term of time and problem-drinking. Interventions need to be made on these controllable social and behavioral characteristics to help sex workers extend the duration of their safe sexual practice beyond the time they will quit sex work.

Calling to Nursing: Concept Analysis.

PubMed

Emerson, Christie

The aims of this article are (a) to analyze the concept of a calling as it relates nursing and (b) to develop a definition of calling to nursing with the detail and clarity needed to guide reliable and valid research. The classic steps described by Walker and Avant are used for the analysis. Literature from several disciplines is reviewed including vocational psychology, Christian career counseling, sociology, organizational management, and nursing. The analysis provides an operational definition of a calling to nursing and establishes 3 defining attributes of the concept: (a) a passionate intrinsic motivation or desire (perhaps with a religious component), (b) an aspiration to engage in nursing practice, as a means of fulfilling one's purpose in life, and (c) the desire to help others as one's purpose in life. Antecedents to the concept are personal introspection and cognitive awareness. Positive consequences to the concept are improved work meaningfulness, work engagement, career commitment, personal well-being, and satisfaction. Negative consequences of having a calling might include willingness to sacrifice well-being for work and problems with work-life balance. Following the concept analysis, philosophical assumptions, contextual factors, interdisciplinary work, research opportunities, and practice implications are discussed.

Returning home to work: Malaysian students who studied medicine overseas.

PubMed

Chur-Hansen, Anna

2004-06-01

International students' medical training often includes an elective placement in their home country to prepare them for practice on graduation. Seven Malaysian students in their final year of medicine were interviewed pre- and post-graduation and asked to reflect on whether they felt adequately prepared for working in Malaysia. These seven international students, who studied medicine in Australia, all returned to Malaysia for six weeks for their elective, and the interviews canvassed their perceptions of this experience, along with their thoughts on how well their training in Australia had prepared them for working in their country of origin. The interview data were qualitatively analysed, and case studies were constructed. Main themes were identified and tabulated. Students voiced similar concerns about how ready they were for working at home. These included a lack of practical skills relative to their Malaysian-trained counterparts, language difficulties, medical communication skill incompatibilities across cultures, expectations to perform complex or unfamiliar tasks with minimal supervision and substantial burdens of responsibility with long working hours. These students did not feel greatly prepared for their return home to practise medicine. The elective placement was not well utilized by the majority of students in this study.

Bi-directional Exchange: the Cornerstone of Globally Focused Social Work.

PubMed

Parker, Gary; Ali, Samira; Ringell, Kassia; McKay, Mary

2014-03-01

Social work holds a unique place relative to other professions in that it prioritizes the elimination of human suffering as its primary goal. The roots of the profession are firmly planted in Western theories, historically and culturally specific perspectives, and knowledge. History has repeatedly demonstrated an association between the arrival of Westerners and the subsequent control of natural resources. Some argue that the development of global social work practice has serious pitfalls, including diverting needed resources away from local contexts and inadvertently spreading western world-views, paradigms and practices. However, the social work profession is uniquely positioned to offer expertise and collaborate with those experiencing the serious consequences of social inequity and the dearth of economic and social resources locally and across the globe. Grounded in anti-oppressive theory, guided by the difficult, yet acute awareness of western privilege and racism, and drawing from social/collective action and collaborative paradigms, a bi-directional exchange and action are detailed as the foundations for globally focused social work. The skills and knowledge base for global social work are essential as populations locally and worldwide are impacted by a global economic system that innately increases serious social inequity. Comprehensive training and preparation for globally focused social work, critical to successful engagement in global practice are outlined.

'The artist's piece is already in the stone': constructing creativity in paleontology laboratories.

PubMed

Wylie, Caitlin Donahue

2015-02-01

Laboratory technicians are typically portrayed as manual workers following routine procedures to produce scientific data. However, technicians in vertebrate paleontology laboratories often describe their work in terms of creativity and artistry. Fossil specimens undergo extensive preparation--including rock removal, damage repair, and reconstruction of missing parts--to become accessible to researchers. Technicians called 'fossil preparators' choose, apply, and sometimes invent these preparation methods. They have no formal training, no standard protocols, and few publications to consult on techniques. Despite the resulting diversity of people and practices, preparators and their work are usually absent from research publications, making them 'invisible technicians' in Steven Shapin's sense. But preparators reject the view of their work as predictable or simple; in particular, many preparators value art training, the aesthetics of prepared fossils, and the process of creative problem-solving in their work. Based on interviews and participant observation and drawing from literature in science studies, sociology of work, and anthropology of craft, I ask why these technicians compare themselves with artists and how this portrayal affects scientific practice and social order in laboratories. I argue that associating artistry and creativity with their work distances preparators from ideas of unskilled technical work and technicians' low status, thus improving their social role in the laboratory community and preserving their power over laboratory practices.

Bi-directional Exchange: the Cornerstone of Globally Focused Social Work

PubMed Central

Ali, Samira; Ringell, Kassia; McKay, Mary

2014-01-01

Social work holds a unique place relative to other professions in that it prioritizes the elimination of human suffering as its primary goal. The roots of the profession are firmly planted in Western theories, historically and culturally specific perspectives, and knowledge. History has repeatedly demonstrated an association between the arrival of Westerners and the subsequent control of natural resources. Some argue that the development of global social work practice has serious pitfalls, including diverting needed resources away from local contexts and inadvertently spreading western world-views, paradigms and practices. However, the social work profession is uniquely positioned to offer expertise and collaborate with those experiencing the serious consequences of social inequity and the dearth of economic and social resources locally and across the globe. Grounded in anti-oppressive theory, guided by the difficult, yet acute awareness of western privilege and racism, and drawing from social/collective action and collaborative paradigms, a bi-directional exchange and action are detailed as the foundations for globally focused social work. The skills and knowledge base for global social work are essential as populations locally and worldwide are impacted by a global economic system that innately increases serious social inequity. Comprehensive training and preparation for globally focused social work, critical to successful engagement in global practice are outlined. PMID:25346884

Prevention and treatment of low back pain: evidence, challenges, and promising directions.

PubMed

Foster, Nadine E; Anema, Johannes R; Cherkin, Dan; Chou, Roger; Cohen, Steven P; Gross, Douglas P; Ferreira, Paulo H; Fritz, Julie M; Koes, Bart W; Peul, Wilco; Turner, Judith A; Maher, Chris G

2018-06-09

Many clinical practice guidelines recommend similar approaches for the assessment and management of low back pain. Recommendations include use of a biopsychosocial framework to guide management with initial non-pharmacological treatment, including education that supports self-management and resumption of normal activities and exercise, and psychological programmes for those with persistent symptoms. Guidelines recommend prudent use of medication, imaging, and surgery. The recommendations are based on trials almost exclusively from high-income countries, focused mainly on treatments rather than on prevention, with limited data for cost-effectiveness. However, globally, gaps between evidence and practice exist, with limited use of recommended first-line treatments and inappropriately high use of imaging, rest, opioids, spinal injections, and surgery. Doing more of the same will not reduce back-related disability or its long-term consequences. The advances with the greatest potential are arguably those that align practice with the evidence, reduce the focus on spinal abnormalities, and ensure promotion of activity and function, including work participation. We have identified effective, promising, or emerging solutions that could offer new directions, but that need greater attention and further research to determine if they are appropriate for large-scale implementation. These potential solutions include focused strategies to implement best practice, the redesign of clinical pathways, integrated health and occupational interventions to reduce work disability, changes in compensation and disability claims policies, and public health and prevention strategies. Copyright © 2018 Elsevier Ltd. All rights reserved.

Association Between Maternal Stress, Work Status, Concern About Child Weight, and Restrictive Feeding Practices in Preschool Children.

PubMed

Swyden, Katheryn; Sisson, Susan B; Morris, Amanda S; Lora, Karina; Weedn, Ashley E; Copeland, Kristen A; DeGrace, Beth

2017-06-01

Objectives To examine the relationship between maternal stress, work status, concern about child weight, and the use of restrictive feeding practices among mothers of preschool children. Methods 285 mothers of 2-to-5-year-old children completed an on-line survey. Questions included demographics, items from the Depression Anxiety Stress Scale, and the Child Feeding Questionnaire. Linear regression and ANOVA examined the relationship between maternal stress, work hours, concern about child weight, and the use of restrictive practices for one 2-to-5-year-old child living within the home. Results Mothers were 32.6 ± 5.2 years of age and spent 39.7 ± 12.0 h/week at work. Seventy-one percent worked full time. Children were 3.4 ± 1.0 years of age and 51% male. Stress (3.41 ± 0.77, p ≤ 0.001) and concern about child weight (3.41 ± 0.77, p ≤ 0.00) were associated with the use of restrictive feeding practices. Mothers with severe/extremely severe stress used restriction more than mothers with normal stress, respectively (3.63 ± 0.80, 3.30 ± 0.81, p = 0.03). No difference was found among mothers with mild/moderate stress (3.50 ± 0.63, p = 0.06). There was no association between work hours (p = 0.50) or work status (p = 0.91) and the use of restrictive feeding practices. Conclusions Maternal stress and concern about child weight were associated with the use of restrictive feeding practices. Considering the current rates of childhood obesity in the United States, understanding factors that influence a child's food environment is advantageous and can help improve maternal and child health.

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.

Practical Tips for Working as an Expedition Doctor on High-Altitude Expeditions.

PubMed

Brants, Anne; Metcalfe, Tracee

2017-09-01

Brants, Anne, and Tracee Metcalfe. Practical tips for working as an expedition doctor on high-altitude expeditions. High Alt Med Biol. 18:193-198, 2017.-With the explosion of adventure travel over the past decade, there has been a concurrent increase in mountaineering expeditions to extreme elevations, including many of the 8000-m peaks. This trend has created an increased demand for qualified expedition doctors to provide specialized medical advice and care to climbers and expedition staff. This review is intended to help physicians prepare for work on such expeditions. The authors rely heavily on their own experience and discuss the types of work available on high-altitude expeditions; how to identify a safe and reputable guiding company; personal and medical preparation; priorities in selecting or building an appropriate medical kit; and medical conditions commonly encountered on expeditions. The review concludes by considering ethical dilemmas and other difficult issues unique to this work.

33 CFR 150.615 - What safe practices are required?

Code of Federal Regulations, 2010 CFR

2010-07-01

... work they perform, including the use of electrical personal protective equipment appropriate to protect... not feasible. (b) The deepwater port operator must ensure that personnel turning off equipment...

33 CFR 150.615 - What safe practices are required?

Code of Federal Regulations, 2011 CFR

2011-07-01

... work they perform, including the use of electrical personal protective equipment appropriate to protect... not feasible. (b) The deepwater port operator must ensure that personnel turning off equipment...

Supporting clinician educators to achieve "work-work balance".

PubMed

Maniate, Jerry; Dath, Deepak; Cooke, Lara; Leslie, Karen; Snell, Linda; Busari, Jamiu

2016-10-01

Clinician Educators (CE) have numerous responsibilities in different professional domains, including clinical, education, research, and administration. Many CEs face tensions trying to manage these often competing professional responsibilities and achieve "work-work balance." Rich discussions of techniques for work-work balance amongst CEs at a medical education conference inspired the authors to gather, analyze, and summarize these techniques to share with others. In this paper we present the CE's "Four Ps"; these are practice points that support both the aspiring and established CE to help improve their performance and productivity as CEs, and allow them to approach work-work balance.

Prevalence of hazardous exposures in veterinary practice

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

Wiggins, P.; Schenker, M.B.; Green, R.

1989-01-01

All female graduates of a major U.S. veterinary school were surveyed by mailed questionnaire to obtain details of work practice and hazard exposure during the most recent year worked and during all pregnancies. Exposure questions were based on previously implicated occupational hazards which included anesthetic gases, radiation, zoonoses, prostaglandins, vaccines, physical trauma, and pesticides. The response rate was 86% (462/537). We found that practice type and pregnancy status were major determinants of hazard exposure within the veterinary profession. Small-animal practitioners reported the highest rates of exposure to anesthetic gas (94%), X-ray (90%), and pesticides (57%). Large-animal practitioners reported greater ratesmore » of trauma (64%) and potential exposure to prostaglandins (92%), Brucella abortus vaccine (23%), and carbon monoxide (18%). Potentially hazardous workplace practices or equipment were common. Forty-one percent of respondents who reported taking X-rays did not wear film badges, and 76% reported physically restraining animals for X-ray procedures. Twenty-seven percent of the respondents exposed to anesthetic gases worked at facilities which did not have waste anesthetic gas scavenging systems. Women who worked as veterinarians during a pregnancy attempted to reduce exposures to X-rays, insecticides, and other potentially hazardous exposures. Some potentially hazardous workplace exposures are common in veterinary practice, and measures to educate workers and to reduce these exposures should not await demonstration of adverse health effects.« less

Women in dentistry in South Africa: a survey of their experiences and opinions.

PubMed

Naidoo, S

2005-08-01

Women form an increasingly important part of the dentally trained workforce in South Africa. However, little is known about the professional issues and work-related problems affecting women dentists. A postal survey was undertaken of registered female dental practitioners in the country, with the aim to document their experiences. The survey (i) ascertained their current pattern of work, (ii) identified factors influencing their work patterns and (iii) identified factors that would help women remain in the profession or re-enter it more easily after an absence. A self-administered 50-item questionnaire containing open and closed-ended questions was used. Questions related to professional status, working patterns, practice ownership, postgraduate qualifications and career satisfaction. Nine hundred and sixty questionnaires were sent out and 280 were returned (29% response rate). Although a significant majority were currently practicing (96%), about 20% were employed or worked part-time and 7 reported that they were not in practice at the time of the survey for various reasons including maternity leave, ill-health, retirement or that they were now working outside the dental field. Major factors identified in this study were the women's dual responsibility at home and at work. Few women find themselves in specialist practice, although 68% indicated that they would liked to have specialised. Home responsibilities and inflexible working conditions were commonly reported difficulties experienced with further studies. In addition, the lack of part-time training and the geographical location of training facilities also played a role. Women dentists need more flexible working schedules and conditions of employment. Part-time training and part-time career options should be extended. Retraining and refresher courses for Women dentists who have had a break in their careers should be available to enable them to return sooner and more easily to practice. Tertiary training dental facilities throughout the country should take up this challenge and run courses that are tailored to the local need and domestic commitments of the women involved.

Judicial astrology in theory and practice in later medieval Europe.

PubMed

Carey, Hilary M

2010-06-01

Interrogations and elections were two branches of Arabic judicial astrology made available in Latin translation to readers in western Europe from the twelfth century. Through an analysis of the theory and practice of interrogations and elections, including the writing of the Jewish astrologer Sahl b. Bishr, this essay considers the extent to which judicial astrology was practiced in the medieval west. Consideration is given to historical examples of interrogations and elections mostly from late medieval English manuscripts. These include the work of John Dunstaple (ca. 1390-1453), the musician and astrologer who is known have served at the court of John, duke of Bedford. On the basis of the relatively small number of surviving historical horoscopes, it is argued that the practice of interrogations and elections lagged behind the theory.

Unpacking the burden: gender issues in anaesthesia.

PubMed

Strange Khursandi, D C

1998-02-01

A survey carried out by the Australian Society of Anaesthetists explored gender issues in the personal and professional lives of anaesthetists. Issues highlighted include training and career paths, combining anaesthetic training with domestic responsibilities, personal relationships, pregnancy and childrearing, private practice, part-time work, parental leave, the single anaesthetist, doctor spouses, sexual harassment, and negative attitudes in colleagues. Particular problems were identified in the training years, in part-time work, in private practice, and in combining parental and domestic responsibilities with a career in anaesthesia. Strategies to address relevant issues are discussed, with reference to the increasing proportion of women in medicine and anaesthesia.

A community of practice: librarians in a biomedical research network.

PubMed

De Jager-Loftus, Danielle P; Midyette, J David; Harvey, Barbara

2014-01-01

Providing library and reference services within a biomedical research community presents special challenges for librarians, especially those in historically lower-funded states. These challenges can include understanding needs, defining and communicating the library's role, building relationships, and developing and maintaining general and subject specific knowledge. This article describes a biomedical research network and the work of health sciences librarians at the lead intensive research institution with librarians from primarily undergraduate institutions and tribal colleges. Applying the concept of a community of practice to a collaborative effort suggests how librarians can work together to provide effective reference services to researchers in biomedicine.

A National Longitudinal Survey of Medical Students' Intentions to Practice Among the Underserved.

PubMed

O'Connell, Thomas F; Ham, Sandra A; Hart, Theodore G; Curlin, Farr A; Yoon, John D

2018-01-01

To explore students' intentions to practice in medically underserved areas. In January 2011, 960 third-year medical students from 24 MD-granting U.S. medical schools were invited to participate in a survey on their intention to practice in a medically underserved area. A follow-up survey was sent to participants in September 2011. Covariates included student demographics, medical school characteristics, environmental exposures, work experiences, sense of calling, and religious characteristics. Adjusted response rates were 564/919 (61.4%, first survey) and 474/564 (84.0%, follow-up survey). Among fourth-year medical students, an estimated 34.3% had an intention to practice among the underserved. In multivariate logistic regression modeling, predictors for intentions to practice among the underserved included growing up in an underserved setting (odds ratio [OR] range: 2.96-4.81), very strong sense of calling (OR range: 1.86-3.89), and high medical school social mission score (in fourth year: OR = 2.34 [95% confidence interval (CI), 1.31-4.21]). International experience was associated with favorable change of mind in the fourth year (OR = 2.86 [95% CI, 1.13-7.24]). High intrinsic religiosity was associated with intentions to practice primary care in underserved settings (in fourth year: OR = 2.29 [95% CI = 1.13-4.64]). Growing up in medically underserved settings, work experience in religiously affiliated organizations, very strong sense of calling, and high medical school social mission score were associated with intentions to practice in underserved areas. Lack of formative educational experiences may dissuade students from considering underserved practice.

Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Oncology Nutrition.

PubMed

Charuhas Macris, Paula; Schilling, Karen; Palko, Raymond

2018-04-01

Oncology nutrition encompasses nutrition care for individuals along the cancer care continuum. Nutrition is a vital component of prevention, treatment, and healthy survivorship. The practice of an oncology registered dietitian nutritionist (RDN) reflects the setting and population served with diverse cancer diagnoses, including expanded roles and responsibilities reflecting the RDN's interests and organization's activities. Provision of nutrition services in oncology requires that RDNs have advanced knowledge in the focus area of oncology nutrition. Thus, the Oncology Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance as tools for RDNs currently in practice or interested in working in oncology nutrition, to address their current skill level and to identify areas for additional professional development in this practice area. The Standards of Practice address and apply the Nutrition Care Process and workflow elements, which are screening, assessment, diagnosis, intervention, evaluation/monitoring, and discharge planning and transitions of care. The Standards of Professional Performance consist of the following six domains of professionalism including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements and describe three skill levels (competent, proficient, and expert) for RDNs working in oncology nutrition. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Educating Pupils with Autistic Spectrum Disorders: A Practical Guide

ERIC Educational Resources Information Center

Hanbury, Martin

2005-01-01

The book is written for educators in both mainstream and special provision schools, as well as teachers who are new to the field or those who are working in isolation from other specialists, the book gives practical advice on how to employ appropriate teaching and learning strategies. The book includes: (1) an overview of autism and how it affects…

Mindfulness in the Academy--Transforming Our Work and Ourselves "One Moment at a Time"

ERIC Educational Resources Information Center

Gardner, Paula; Grose, Jill

2015-01-01

In this paper, we (a faculty member and an educational developer) discuss our attempts to be more mindful in the academy with attention to mindfulness practices in the classroom and the development of a community of practice at our institution as ways to foster community and deepen learning. Included within the paper is an introduction to…

Washback Effects of a High-Stakes Exam on Lower Secondary School English Teachers' Practices in the Classroom

ERIC Educational Resources Information Center

Kilickaya, Ferit

2016-01-01

The aim of the article is to investigate the effects of the foreign language section of TEOG (Transition Examination from Primary to Secondary Education) on language teacher practices in the classroom. The participants of the study include 30 English language teachers working at lower secondary schools in Turkey. The results of the study indicate…

El Aprendizaje de la Lectura y la Escritura: Practicas Apropiadas para el Desarrollo Infantil (Learning To Read and Write: Developmentally Appropriate Practices for Young Children).

ERIC Educational Resources Information Center

Neuman, Susan B.; Copple, Carol; Bredekamp, Sue

This Spanish language edition of "Learning To Read and Write: Developmentally Appropriate Practices for Young Children," presents effective research-based strategies for promoting children's literacy learning in preschool, kindergarten, and elementary classrooms and infant/toddler settings. Including classroom photos and children's work,…

Truth in Publishing: Federal Regulation of the Press's Business Practices, 1880-1920.

ERIC Educational Resources Information Center

Lawson, Linda

Examining the other side of the textbook image of the role of the early 20th century press as "crusader," this book presents a policy history of government regulation of the print media's business practices in the early 20th century. The first part of the book documents the press's inner workings,including its excesses and abuses, as it…

The marginalisation of dreams in clinical psychological practice.

PubMed

Leonard, Linda; Dawson, Drew

2018-04-22

The longstanding human interest in dreams has led to a significant body of psychological and philosophical discourse, including research. Recently, however, dreams have been relegated to the periphery of clinical psychological practice. This is potentially problematic as clients continue to bring dreams to therapy and many psychologists lack the confidence or competence to respond effectively to dream material. Building on the structural, professional and research cultures surrounding psychology using a cultural-historical activity theory framework, we argue the marginalisation of dreams is due to cultural-historical factors. These factors include the political and economic context in which psychology developed; psychology's early attempts to differentiate from psychoanalysis by identifying with behaviourism and the natural sciences; and a discipline-specific definition of what constitutes evidence-based practice. These factors led to professional discourses within which dreams are seen as of little clinical or therapeutic value, or that dream work is only for long-term therapy and requires extensive therapist training. However, there are diverse models of dream work consistent with most theoretical orientations within contemporary psychological practice. We conclude with recommendations on how to rebuild clinical confidence and competence in the use of dream material within the current professional environment. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

PubMed Central

Winkler, Susan R.; Mai, Thy

2012-01-01

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

Leadership by collaboration: Nursing's bold new vision for academic-practice partnerships.

PubMed

Sebastian, Juliann G; Breslin, Eileen T; Trautman, Deborah E; Cary, Ann H; Rosseter, Robert J; Vlahov, David

In 2016 the American Association of Colleges of Nursing issued a report, Advancing Healthcare Transformation: A New Era for Academic Nursing that included recommendations for more fully integrating nursing education, research, and practice. The report calls for a paradigm shift in how nursing leaders in academia and practice work together and with other leaders in higher education and clinical practice. Only by doing so can we realize the full benefits of academic nursing in this new era in which integration and collaboration are essential to success. In this paper we: 1) examine how academic nursing can contribute to healthcare innovation across environments; 2) explore leadership skills for deans of nursing to advance the goals of academic nursing in collaboration with clinical nursing partners, other health professions and clinical service leaders, academic administrators, and community members; and, 3) consider how governance structures and policy initiatives can advance this work. Copyright © 2017 Elsevier Inc. All rights reserved.

Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the International Society of Urological Pathology consensus conference.

PubMed

Amin, Mahul B; Epstein, Jonathan I; Ulbright, Thomas M; Humphrey, Peter A; Egevad, Lars; Montironi, Rodolfo; Grignon, David; Trpkov, Kiril; Lopez-Beltran, Antonio; Zhou, Ming; Argani, Pedram; Delahunt, Brett; Berney, Daniel M; Srigley, John R; Tickoo, Satish K; Reuter, Victor E

2014-08-01

Members of the International Society of Urological Pathology (ISUP) participated in a half-day consensus conference to discuss guidelines and recommendations regarding best practice approaches to use of immunohistochemistry (IHC) in differential diagnostic situations in urologic pathology, including bladder, prostate, testis and, kidney lesions. Four working groups, selected by the ISUP leadership, identified several high-interest topics based on common or relevant challenging diagnostic situations and proposed best practice recommendations, which were discussed by the membership. The overall summary of the discussions and the consensus opinion forms the basis of a series of articles, one for each organ site. This Special Article summarizes the overall recommendations made by the four working groups. It is anticipated that this ISUP effort will be valuable to the entire practicing community in the appropriate use of IHC in diagnostic urologic pathology.

Escaping the healthcare leadership cul-de-sac.

PubMed

Edmonstone, John Duncan

2017-02-06

Purpose This paper aims to propose that healthcare is dominated by a managerialist ideology, powerfully shaped by business schools and embodied in the Masters in Business Administration. It suggests that there may be unconscious collusion between universities, healthcare employers and student leaders and managers. Design/methodology/approach Based on a review of relevant literature, the paper examines critiques of managerialism generally and explores the assumptions behind leadership development. It draws upon work which suggests that leading in healthcare organisations is fundamentally different and proposes that leadership development should be more practice-based. Findings The way forward for higher education institutions is to include work- or practice-based approaches alongside academic approaches. Practical implications The paper suggests that there is a challenge for higher education institutions to adopt and integrate practice-based development methods into their programme designs. Originality/value The paper provides a challenge to the future role of higher education institutions in developing leadership in healthcare.

Thinking about Practical Work in Chemistry: Teachers' Considerations of Selected Practices for the Macroscopic Experience

ERIC Educational Resources Information Center

Lewthwaite, Brian

2014-01-01

This study explores teachers' thinking about practical work, especially in regards to the types of practical work they privilege in their teaching of chemistry to support students in their learning. It seeks to investigate the view that practical work, especially the type of practical work selected, is "unthinkingly" and…

Situational Transitions and Military Nurses: A Concept Analysis Using the Evolutionary Method.

PubMed

Chargualaf, Katie A

2016-04-01

Situational transitions in nursing remain a significant issue for both new graduates and experienced nurses. Although frequently discussed in current nursing literature, nursing research has exclusively focused on the transition experience of civilian (nonmilitary) nurses. With differing role and practice expectations, altered practice environments, and the risk of deployment, the outcome of negative transition experiences for military nurses is significant. The purpose of this analysis is to clarify the concept of transition, in a situational context, as it relates to military nurses by investigating the attributes, antecedents, and consequences. Rodgers' evolutionary method served as the framework to this study. The sample included 41 studies, published in English, between 2000 and 2013. Data were retrieved from the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, ProQuest, Ovid, and PsycINFO databases. Antecedents of situational transitions include any change in work roles or work environments. Attributes of situational transitions include journey, disequilibrium, finding balance, conditional, and pervasive. Consequences of transition range from successful to unsuccessful. Additional research that investigates the specific needs and challenges unique to nurses practicing in a military environment is needed. © 2015 Wiley Periodicals, Inc.

Perceptions on the essential competencies for intraprofessional practice.

PubMed

Jelley, Wilma; Larocque, Nathalie; Borghese, Michael

2013-01-01

To gather the perspectives of physiotherapists and physiotherapist assistants on essential competencies for intraprofessional (physiotherapist-physiotherapist assistant) collaboration. A survey was developed to gather physiotherapist and physiotherapist assistant perceptions of the essential elements of effective and efficient intraprofessional collaborative practice. Participants were asked to rate the importance of 36 elements in 6 different categories (communication, collaboration, consultation, assignment of tasks, conflict management, and roles/responsibilities) involved in intraprofessional practice. A total of 1049 physiotherapists and 121 physiotherapist assistants responded to the survey. Analysis identified 10 competency elements perceived by participants as essential to effective and efficient intraprofessional collaboration. Comparisons using demographic variables consistently yielded the same top 10 elements. Our results indicated that physiotherapists and physiotherapist assistants working in private and public practice share very similar views on what is essential for effective intraprofessional practice. The consensus is that communication is key; open lines of communication help to determine responsibilities. Physiotherapy pre-licensure and continuing education programmes should include opportunities to work on communication, listening, and the skills needed to interact and collaborate effectively.

The private-practice perspective of the manpower crisis in radiology: greener pastures?

PubMed

Swayne, Lawrence C

2004-11-01

Rising consumer expectations and a rapidly aging population point to a long-term shortage of all physicians, including radiologists. While attention has been drawn to the escalating manpower crisis in academic radiology departments, the private-practice perspective has been generally overlooked. Although clinical workloads and income are higher in private practice, studies have shown higher satisfaction levels (likely because of a greater variety of work) among academic radiologists. As the distinction between community and teaching hospitals has become increasingly blurred, there is now considerable overlap in the skill sets, sources of job satisfaction, and stresses that are encountered in both practice settings. Perhaps more than at any time in the recent past, diagnostic radiologists in academic and private practice share more in common than any perceived differences. Both groups must work together in concert with the ACR to address the growing manpower shortage, as well as the other challenges that confront diagnostic radiology at the beginning of the 21st century.

Communication is the key to success in pragmatic clinical trials in Practice-based Research Networks (PBRNs).

PubMed

Bertram, Susan; Graham, Deborah; Kurland, Marge; Pace, Wilson; Madison, Suzanne; Yawn, Barbara P

2013-01-01

Effective communication is the foundation of feasibility and fidelity in practice-based pragmatic research studies. Doing a study with practices spread over several states requires long-distance communication strategies, including E-mails, faxes, telephone calls, conference calls, and texting. Compared with face-to-face communication, distance communication strategies are less familiar to most study coordinators and research teams. Developing and ensuring comfort with distance communications requires additional time and use of different talents and expertise than those required for face-to-face communication. It is necessary to make sure that messages are appropriate for the medium, clearly crafted, and presented in a manner that facilitates practices receiving and understanding the information. This discussion is based on extensive experience of 2 groups who have worked collaboratively on several large, federally funded, pragmatic trials in a practice-based research network. The goal of this article is to summarize lessons learned to facilitate the work of other research teams.

Intravaginal and Menstrual Practices among Women Working in Food and Recreational Facilities in Mwanza, Tanzania: Implications for Microbicide Trials

PubMed Central

Desmond, Nicola; Chiduo, Betty; Medard, Lemmy; Lees, Shelley S.; Vallely, Andrew; Francis, Suzanna C.; Ross, David A.; Hayes, Richard J.

2010-01-01

Intravaginal and menstrual practices may potentially influence results of trials of microbicides for HIV prevention through effects on the vaginal environment and on adherence to microbicide and placebo products. As part of the feasibility study for the Microbicides Development Programme Phase 3 trial of a vaginal microbicide in Mwanza, a variety of quantitative and qualitative methods were used to describe these practices, associations with behaviour and underlying social norms among women working in food and recreational facilities. Intravaginal cleansing by inserting fingers and either water alone or soap and water was thought necessary to remove “uchafu” (dirt), referring to vaginal secretions, including menstrual blood and post-coital discharge. Vaginal cleansing was carried out within 2 hours after 45% of sex acts. Sexual enhancement practices were less common. Intravaginal and menstrual practices and associated behaviours and demographic factors should be measured and monitored throughout microbicide trials to enable analyses of their impacts on microbicide effectiveness. PMID:20665101

[A review of measures taken to improve organizational wellbeing in Italy].

PubMed

Bentivenga, Rosina; Deitinger, Patrizia; Ghelli, Monica

2014-01-01

The Italian Decree Law D. Lgs. no. 81 dated 9 April 2008, dealing with the implementation of Article 1 of Law No. 123 dated 3 August 2007, on the topic of health and safety in the workplace, indicated that work-related stress (art. 28, section 1) was to be assessed in accordance with the European Agreement of 8 October 2004. It recalled the employer's legal obligation to safeguard workers' health and safety, and included psychosocial risk, in order to improve their wellbeing at work. The Decree Law specified that when risks had been assessed the employer could take all necessary measures, with reference to the "good practice", defined in the Law as organizational or procedural solutions coherent with current regulations and good technical rules, adopted voluntarily with the aim of promoting safety and health in the workplace by reducing risk and improving working conditions [...]" (art. 2, section 1 v); the practical solutions identified were to aim at eliminating, or at least reducing, psychosocial risk in the enterprise. On the basis of the studies most widely accepted in Europe and the indications issued by the European Agency for Safety and Health at Work, we identified the good practice measures adopted by companies in Italy and other countries. The aim was to make known some of the practical solutions regarding psychosocial risk that companies can put in place with a view to improving their workers' health and wellbeing. We examined measures related to the content and context of work. Measures affecting the work content mainly involved the workplace itself and equipment, work planning and working hours. For the work context the measures centered mostly on organizational function and culture, career progress, and home/work interface. In accordance with good safety practice, the practical measures taken by the enterprises examined cantered on some potentially stressful features of work, indicating the growing attention being paid to workers' wellbeing. However, organizational wellbeing is a multifaceted concept and the European Agency points out that measures taken must cover all the aspects of the work that appear particularly critical in risk assessment; from the primary prevention viewpoint, this means all the organizational aspects that might affect a person's wellbeing. As we become increasingly aware of the problems, and of the measures that have proved successful, it is to be hoped that further solutions will be identified and developed in organizations.

Challenges and Opportunities for Advancing Work on Climate Change and Public Health.

PubMed

Gould, Solange; Rudolph, Linda

2015-12-09

Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change's health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities.

Challenges and Opportunities for Advancing Work on Climate Change and Public Health

PubMed Central

Gould, Solange; Rudolph, Linda

2015-01-01

Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change’s health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities. PMID:26690194

Cultural Astronomy in Elementary and Secondary School

NASA Astrophysics Data System (ADS)

Jafelice, Luiz Carlos

2015-07-01

This work is addressed to educators and geography, science, biology and physics teachers who deal with elementary, middle and high school education. It discusses the importance of adopting the anthropological perspective regarding issues that are considered within the astronomy area. It also presents practical proposals for those who intend to introduce cultural astronomy in elementary, middle and high school education - from the beginning of the 1st grade in Elementary school to the end of the 3rd grade in Secondary school, in formal as well as in informal education. This work is proposed within the context of the holistic and transdisciplinary environmental education. Our approach values above all the experience and aims at a humanistic education that includes epistemological and cultural diversities. The suggested practical proposals can be also beneficially used to address works that include contents related to Brazilian indigenous and Afro-descent cultures in the school curriculum, as the new law requires. The guidelines presented here were tested in real school situations.

Voluntary autonomous simulator based training in minimally invasive surgery, residents' compliance and reflection.

PubMed

van Empel, Pieter J; Verdam, Mathilde G E; Strypet, Magnus; van Rijssen, Lennart B; Huirne, Judith A; Scheele, Fedde; Bonjer, H Jaap; Meijerink, W Jeroen

2012-01-01

Knot tying and suturing skills in minimally invasive surgery (MIS) differ markedly from those in open surgery. Appropriate MIS training is mandatory before implementation into practice. The Advanced Suturing Course (ASC) is a structured simulator based training course that includes a 6-week autonomous training period at home on a traditional laparoscopic box trainer. Previous research did not demonstrate a significant progress in laparoscopic skills after this training period. This study aims to identify factors determining autonomous training on a laparoscopic box trainer at home. Residents (n = 97) attending 1 of 7 ASC courses between January 2009 and June 2011 were consecutively included. After 6 weeks of autonomous, training a questionnaire was completed. A random subgroup of 30 residents was requested to keep a time log. All residents received an online survey after attending the ASC. We performed outcome comparison to examine the accuracy of individual responses. Out of 97 residents, the main motives for noncompliant autonomous training included a lack of (training) time after working hours (n = 80, 83.3%), preferred practice time during working hours (n = 76, 31.6%), or another surgical interest than MIS (n = 79, 15.2%). Previously set training goals would encourage autonomous training according to 27.8% (n = 18) of residents. Thirty participants submitted a time log and reported an average 76.5-minute weekly training time. All residents confirmed that autonomous home practice on a laparoscopic box trainer is valuable. Autonomous practice should be structured and inclusive of adequate and sufficient feedback points. A minimally required practice time should be set. An obligatory assessment, including corresponding consequence should be conducted. Compliance herewith may result in increased voluntary (autonomous) simulator based (laparoscopic) training by residents. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Persistence of unsafe practice in everyday work: an exploration of organizational and psychological factors constraining safety in the operating room.

PubMed

Espin, S; Lingard, L; Baker, G R; Regehr, G

2006-06-01

This paper explores the factors that influence the persistence of unsafe practice in an interprofessional team setting in health care, towards the development of a descriptive theoretical model for analyzing problematic practice routines. Using data collected during a mixed method interview study of 28 members of an operating room team, participants' approaches to unsafe practice were analyzed using the following three theoretical models from organizational and cognitive psychology: Reason's theory of "vulnerable system syndrome", Tucker and Edmondson's concept of first and second order problem solving, and Amalberti's model of practice migration. These three theoretical approaches provide a critical insight into key trends in the interview data, including team members' definition of error as the breaching of standards of practice, nurses' sense of scope of practice as a constraint on their reporting behaviours, and participants' reports of the forces influencing tacit agreements to work around safety regulations. However, the relational factors underlying unsafe practice routines are poorly accounted for in these theoretical approaches. Incorporating an additional theoretical construct such as "relational coordination" to account for the emotional human features of team practice would provide a more comprehensive theoretical approach for use in exploring unsafe practice routines and the forces that sustain them in healthcare team settings.

On-going collaborative priority-setting for research activity: a method of capacity building to reduce the research-practice translational gap.

PubMed

Cooke, Jo; Ariss, Steven; Smith, Christine; Read, Jennifer

2015-05-07

International policy suggests that collaborative priority setting (CPS) between researchers and end users of research should shape the research agenda, and can increase capacity to address the research-practice translational gap. There is limited research evidence to guide how this should be done to meet the needs of dynamic healthcare systems. One-off priority setting events and time-lag between decision and action prove problematic. This study illustrates the use of CPS in a UK research collaboration called Collaboration and Leadership in Applied Health Research and Care (CLAHRC). Data were collected from a north of England CLAHRC through semi-structured interviews with 28 interviewees and a workshop of key stakeholders (n = 21) including academics, NHS clinicians, and managers. Documentary analysis of internal reports and CLAHRC annual reports for the first two and half years was also undertaken. These data were thematically coded. Methods of CPS linked to the developmental phase of the CLAHRC. Early methods included pre-existing historical partnerships with on-going dialogue. Later, new platforms for on-going discussions were formed. Consensus techniques with staged project development were also used. All methods demonstrated actual or potential change in practice and services. Impact was enabled through the flexibility of research and implementation work streams; 'matched' funding arrangements to support alignment of priorities in partner organisations; the size of the collaboration offering a resource to meet project needs; and the length of the programme providing stability and long term relationships. Difficulties included tensions between being responsive to priorities and the possibility of 'drift' within project work, between academics and practice, and between service providers and commissioners in the health services. Providing protected 'matched' time proved difficult for some NHS managers, which put increasing work pressure on them. CPS is more time consuming than traditional approaches to project development. CPS can produce needs-led projects that are bedded in services using a variety of methods. Contributing factors for effective CPS include flexibility in use and type of available resources, flexible work plans, and responsive leadership. The CLAHRC model provides a translational infrastructure that enables CPS that can impact on healthcare systems.

Assessment and treatment of short-term and working memory impairments in stroke aphasia: a practical tutorial.

PubMed

Salis, Christos; Kelly, Helen; Code, Chris

2015-01-01

Aphasia following stroke refers to impairments that affect the comprehension and expression of spoken and/or written language, and co-occurring cognitive deficits are common. In this paper we focus on short-term and working memory impairments that impact on the ability to retain and manipulate auditory-verbal information. Evidence from diverse paradigms (large group studies, case studies) report close links between short-term/working memory and language functioning in aphasia. This evidence leads to the hypothesis that treating such memory impairments would improve language functioning. This link has only recently been acknowledged in aphasia treatment but has not been embraced widely by clinicians. To examine the association between language, and short-term and working memory impairments in aphasia. To describe practical ways of assessing short-term and working memory functioning that could be used in clinical practice. To discuss and critically appraise treatments of short-term and working memory reported in the literature. Taking a translational research approach, this paper provides clinicians with current evidence from the literature and practical information on how to assess and treat short-term and working memory impairments in people with aphasia. Published treatments of short-term and/or working memory in post-stroke aphasia are discussed through a narrative review. This paper provides the following. A theoretical rationale for adopting short-term and working memory treatments in aphasia. It highlights issues in differentially diagnosing between short-term, working memory disorders and other concomitant impairments, e.g. apraxia of speech. It describes short-term and working memory assessments with practical considerations for use with people with aphasia. It also offers a description of published treatments in terms of participants, treatments and outcomes. Finally, it critically appraises the current evidence base relating to the treatment of short-term and working memory treatments. The links between short-term/working memory functioning and language in aphasia are generally acknowledged. These strongly indicate the need to incorporate assessment of short-term/working memory functioning for people with aphasia. While the supportive evidence for treatment is growing and appears to highlight the benefits of including short-term/working memory in aphasia treatment, the quality of the evidence in its current state is poor. However, because of the clinical needs of people with aphasia and the prevalence of short-term/working memory impairments, incorporating related treatments through practice-based evidence is advocated. © 2015 Royal College of Speech and Language Therapists.

Making interprofessional education work: the strategic roles of the academy.

PubMed

Ho, Kendall; Jarvis-Selinger, Sandra; Borduas, Francine; Frank, Blye; Hall, Pippa; Handfield-Jones, Richard; Hardwick, David F; Lockyer, Jocelyn; Sinclair, Doug; Lauscher, Helen Novak; Ferdinands, Luke; MacLeod, Anna; Robitaille, Marie-Anik; Rouleau, Michel

2008-10-01

Faculties (i.e., schools) of medicine along with their sister health discipline faculties can be important organizational vehicles to promote, cultivate, and direct interprofessional education (IPE). The authors present information they gathered in 2007 about five Canadian IPE programs to identify key factors facilitating transformational change within institutional settings toward successful IPE, including (1) how successful programs start, (2) the ways successful programs influence academia to bias toward change, and (3) the ways academia supports and perpetuates the success of programs. Initially, they examine evidence regarding key factors that facilitate IPE implementation, which include (1) common vision, values, and goal sharing, (2) opportunities for collaborative work in practice and learning, (3) professional development of faculty members, (4) individuals who are champions of IPE in practice and in organizational leadership, and (5) attention to sustainability. Subsequently, they review literature-based insights regarding barriers and challenges in IPE that must be addressed for success, including barriers and challenges (1) between professional practices, (2) between academia and the professions, and (3) between individuals and faculty members; they also discuss the social context of the participants and institutions. The authors conclude by recommending what is needed for institutions to entrench IPE into core education at three levels: micro (what individuals in the faculty can do); meso (what a faculty can promote); and macro (how academic institutions can exert its influence in the health education and practice system).

Family practice residents' maternity leave experiences and benefits.

PubMed

Gjerdingen, D K; Chaloner, K M; Vanderscoff, J A

1995-09-01

A growing number of residents are having babies during residency training. While many businesses are working to improve maternity conditions and benefits for their employees, residency programs are often not prepared to accommodate pregnant residents. This study was conducted to examine the maternity leave experiences of women who delivered infants during their family practice residency training. Program directors from each of the 394 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs were asked to distribute surveys to female residents who gave birth during their residency training and had returned to work by the time of the study. Of 199 known eligible residents, 171 (86%) completed surveys; these women represented 127 programs located in 36 states and Puerto Rico. Only 56.8% of women were aware of their program having a written maternity leave policy. The average length of maternity leave was 8 weeks; 76% had leaves of 10 weeks or less. For many, the maternity leave was derived from more than one source, including vacation, sick time, or a mother-child elective. Nearly all (88.3%) the women breast-fed, and the mean duration of breast-feeding was more than 19 weeks. In general, participants believed that having a baby during residency was somewhat difficult. Problems frequently encountered by women after their return to work included sleep deprivation and tiredness, difficulty arranging for child care, guilt about child care, and breast-feeding. Factors that detracted most from the childbirth experience were too little sleep, problems arranging for child care, and lack of support from the partner, residency faculty, and other residents. Having a baby during residency is somewhat difficult for the average female resident. Factors that may ease this difficulty include getting adequate sleep and receiving support from one's partner, faculty, and other residents.

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.

The research potential of practice nurses.

PubMed

Davies, Jacqueline; Heyman, Bob; Bryar, Rosamund; Graffy, Jonathan; Gunnell, Caroline; Lamb, Bryony; Morris, Lana

2002-09-01

Little is known about the research aspirations and experiences of practice nurses. The study discussed in the present paper had three main aims: (1) to assess the level of research interest among practice nurses working in Essex and East London, UK; (2) to identify practice nurses' research priorities; and (3) to explore factors which facilitate and impede the development of practice nursing research. All practice nurses (n = 1,054) in the above areas were sent a questionnaire, and a total of 40% (n = 426) responded after two follow-up letters. Fifty-five respondents who volunteered for further participation were interviewed, either individually or in focus groups. About half (n = 207) of the survey respondents expressed an interest in undertaking research. One-third (n = 145) reported previous participation in research, and 20% (n = 85) had initiated their own research. Logistic regression showed that practice nurses educated to graduate level, and those working in practices with nurse training or participation in external research, were most likely to want to undertake research. Working in a medical training practice was found to be a negative predictor of research interest. Respondents prioritised research into long-term health problems with a high prevalence in the local population; for example, diabetes. Their reasons for wishing to engage in research included improving the service, career development, making work more interesting and reducing isolation. The main barriers identified were lack of time, lack of support from some general practitioners and poor access to higher education resources outside formal courses. The development of practice nurse research would provide a distinctive perspective on health need and service provision. It would contribute to the achievement of the national strategic objective of improving the quality of primary care, enhance the status of the profession, utilise the enthusiasm of individuals, increase job satisfaction and staff retention, and answer real questions.

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.

Lifestyle practices and the health promoting environment of hospital nurses.

PubMed

Hope, A; Kelleher, C C; O'Connor, M

1998-08-01

Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.

"Re-Making" Jobs: Enacting and Learning Work Practices

ERIC Educational Resources Information Center

Price, Oriana Milani; Scheeres, Hermine; Boud, David

2009-01-01

This paper takes up understandings of organisations where practices constitute and frame past and present work, as well as future work practice possibilities. Within this view, work practices, and thus organisations, are both perpetuated and varied through employees' enactments of work. Using a practice lens, we are particularly interested in the…

Indoor Air Quality Manual.

ERIC Educational Resources Information Center

Baldwin Union Free School District, NY.

This manual identifies ways to improve a school's indoor air quality (IAQ) and discusses practical actions that can be carried out by school staff in managing air quality. The manual includes discussions of the many sources contributing to school indoor air pollution and the preventive planning for each including renovation and repair work,…

Managing School Social Work Records

ERIC Educational Resources Information Center

Garrett, Kendra J.

2012-01-01

This article documents results of a survey of 73 school social workers regarding their record-keeping practices. These social workers indicated that time pressures are a major challenge to documentation; they struggle to know what to include, and they worry about privacy. More than half fail to consistently include assessment information, progress…

Food Service.

ERIC Educational Resources Information Center

Furneisen, Barbara K.

Written to teach deaf students skills in food services, this guide and the two related documents (see note) present practical skills needed to work in a school dining room setting serving approximately two hundred students and faculty. Eleven units are included, with each unit containing from three to eleven lessons. Each lesson includes an…

Taking Stock of Gender Reform Policies for Australian Schools: Past, Present and Future.

ERIC Educational Resources Information Center

Kenway, Jane

1997-01-01

Narrates 20 years of gender reform in Australian schools, including boys' education. Discusses the practices and processes of schools' gender reform work, indicating strengths and limitations. Identifies current contexts of gender reform, including the fields of educational policy and politics. Mentions larger cultural shifts affecting gender…

Work, organisational practices, and margin of manoeuver during work reintegration.

PubMed

O'Hagan, Fergal

2017-09-29

Many individuals of working age experience cardiovascular disease and are disabled from work as a result. The majority of research in cardiac work disability has focused on individual biological and psychological factors influencing work disability despite evidence of the importance of social context in work disability. In this article, the focus is on work and organisational features influencing the leeway (margin of manoeuvre) workers are afforded during work reintegration. A qualitative method was used. A large auto manufacturing plant was selected owing to work, organisational, and worker characteristics. Workplace context was assessed through site visits and meetings with stakeholders including occupational health, human resources and union personnel and a review of collective agreement provisions relating to seniority, benefits and accommodation. Worker experience was assessed using a series of in-depth interviews with workers (n = 12) returning to work at the plant following disabling cardiac illness. Data was analysed using qualitative content analysis. Workers demonstrated variable levels of adjustment to the workplace that could be related to production expectations and work design. Policies and practices around electronic rate monitoring, seniority and accommodation, and disability management practices affected the buffer available to workers to adjust to the workplace. Work qualities and organisational resources establish a margin of manoeuver for work reintegration efforts. Practitioners need to inform themselves of the constraints on work accommodation imposed by work organisation and collective agreements. Organisations and labour need to reconsider policies and practices that creates unequal accommodation conditions for disabled workers. Implications for rehabilitation Margin of manoeuvre offers a framework for evaluating and structuring work reintegration programmes. Assessing initial conditions for productivity expectations, context and ways and means to support work reintegration can be integrated with worker perceptions of work ability and possibilities for adaptation to structure and then monitor work reintegration programmes. Margin of manoeuvre can be used to evaluate sustainability of work at the end of rehabilitation. Cause-based workers' compensation schemes, collective agreement provisions, and organisational approaches to non-compensable disability create two tiers of disabled workers and make certain workers more vulnerable to occupational disability.

A collaborative approach to facilitate professionals to support the breathless patient.

PubMed

Shaw, Vanessa; Davies, Alison; Ong, Bie Nio

2017-07-22

Breathlessness is a major problem for people in their last weeks of life. Breathlessness is considered to be multidimensional with physical, psychological, emotional, social and spiritual factors all playing a part. It has been recognised that specific training to health professionals is beneficial in order to improve the care for patients with breathlessness.Breathlessness courses have tended to focus on senior nurses. A new flexible and collaborative training course was designed to include a wider range of nurses and other health professionals in hospital, hospice, primary care and community settings. The aim of the 'Practical Skills to Support the Breathless Patient' programme was to make patients and carers feel better supported in their breathlessness, for health professionals to develop confidence and skills in using proven interventions, and to adopt a flexible educational design that could be adapted to different contexts. The course is learner-centred and teaching methods encourage interaction and participation via a mix of lectures and discussions with practical skills-focused, experiential workshops in smaller groups. Case study work was included to integrate learning with participants' practice environment. Evaluation is built in during the course, so adaptations can be made throughout to respond to changing learner needs. Participants reported increased confidence in terms of knowledge and applying this within everyday practice. The theory-practice dynamic worked well within each participant' specific work context in particular through the case study approach. The course developed a number of innovative approaches, such as multi-disciplinary learning groups, regular feedback loops, reflexive learning about putting theory into practice and long-term follow-up. Combining these elements increases professionals' confidence and sustains new clinical practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Interprofessional teamwork innovations for primary health care practices and practitioners: evidence from a comparison of reform in three countries

PubMed Central

Harris, Mark F; Advocat, Jenny; Crabtree, Benjamin F; Levesque, Jean-Frederic; Miller, William L; Gunn, Jane M; Hogg, William; Scott, Cathie M; Chase, Sabrina M; Halma, Lisa; Russell, Grant M

2016-01-01

Context A key aim of reforms to primary health care (PHC) in many countries has been to enhance interprofessional teamwork. However, the impact of these changes on practitioners has not been well understood. Objective To assess the impact of reform policies and interventions that have aimed to create or enhance teamwork on professional communication relationships, roles, and work satisfaction in PHC practices. Design Collaborative synthesis of 12 mixed methods studies. Setting Primary care practices undergoing transformational change in three countries: Australia, Canada, and the USA, including three Canadian provinces (Alberta, Ontario, and Quebec). Methods We conducted a synthesis and secondary analysis of 12 qualitative and quantitative studies conducted by the authors in order to understand the impacts and how they were influenced by local context. Results There was a diverse range of complex reforms seeking to foster interprofessional teamwork in the care of patients with chronic disease. The impact on communication and relationships between different professional groups, the roles of nursing and allied health services, and the expressed satisfaction of PHC providers with their work varied more within than between jurisdictions. These variations were associated with local contextual factors such as the size, power dynamics, leadership, and physical environment of the practice. Unintended consequences included deterioration of the work satisfaction of some team members and conflict between medical and nonmedical professional groups. Conclusion The variation in impacts can be understood to have arisen from the complexity of interprofessional dynamics at the practice level. The same characteristic could have both positive and negative influence on different aspects (eg, larger practice may have less capacity for adoption but more capacity to support interprofessional practice). Thus, the impacts are not entirely predictable and need to be monitored, and so that interventions can be adapted at the local level. PMID:26889085

Considerations for practice-based research: a cross-sectional survey of chiropractic, acupuncture and massage practices.

PubMed

Floden, Lysbeth; Howerter, Amy; Matthews, Eva; Nichter, Mark; Cunningham, James K; Ritenbaugh, Cheryl; Gordon, Judith S; Muramoto, Myra L

2015-05-02

Complementary and alternative medicine (CAM) use has steadily increased globally over the past two decades and is increasingly playing a role in the healthcare system in the United States. CAM practice-based effectiveness research requires an understanding of the settings in which CAM practitioners provide services. This paper describes and quantifies practice environment characteristics for a cross-sectional sample of doctors of chiropractic (DCs), licensed acupuncturists (LAcs), and licensed massage therapists (LMTs) in the United States. Using a cross-sectional telephone survey of DCs (n = 32), LAcs (n = 70), and LMTs (n = 184) in the Tucson, AZ metropolitan area, we collected data about each location where practitioners work, as well as measures on practitioner and practice characteristics including: patient volume, number of locations where practitioners worked, CAM practitioner types working at each location, and business models of practice. The majority of practitioners reported having one practice location (93.8% of DCs, 80% of LAcs and 59.8% of LMTs) where they treat patients. Patient volume/week was related to practitioner type; DCs saw 83.13 (SD = 49.29) patients/week, LAcs saw 22.29 (SD = 16.88) patients/week, and LMTs saw 14.21 (SD =10.25) patients per week. Practitioners completed surveys for N = 388 practice locations. Many CAM practices were found to be multidisciplinary and/or have more than one practitioner: 9/35 (25.7%) chiropractic practices, 24/87 (27.6%) acupuncture practices, and 141/266 (53.0%) massage practices. Practice business models across CAM practitioner types were heterogeneous, e.g. sole proprietor, employee, partner, and independent contractor. CAM practices vary across and within disciplines in ways that can significantly impact design and implementation of practice-based research. CAM research and intervention programs need to be mindful of the heterogeneity of CAM practices in order to create appropriate interventions, study designs, and implementation plans.

Work-Related Activities Associated with Injury in Occupational and Physical Therapists

PubMed Central

Campo, Marc; King, Phyllis

2013-01-01

Objective The purpose of this study was to examine work activities associated with work-related injury (WRI) in occupational and physical therapy. Participants 1,158 occupational and physical therapists in Wisconsin responded to a mailed survey, from a total of 3,297 OTs and PTs randomly selected from the State licensure list. Methods The study used a cross-sectional, survey design. Participants reported information about WRI they sustained between 2004 and 2006, including the activities they were performing when injured. Investigators analyzed 248 injury incidents using qualitative and quantitative analysis. Results Data were examined across OT and PT practice in general, and also by practice area. Manual therapy and transfers/lifts were associated with 54% of all injuries. Other activities associated with injury were distinct to practice area, for example: floor work in pediatrics; functional activities in acute care; patient falls in skilled nursing facilities; and motor vehicle activities in home care. Conclusions Injury prevention activities must address transfers and manual therapy, but also must examine setting-specific activities influenced by environment and patient population. PMID:22523031

Project-based teaching in health informatics: a course on health care quality improvement.

PubMed

Moehr, J R; Berenji, G R; Green, C J; Kagolovsky, Y

2001-01-01

Teaching the skills and knowledge required in health informatics [1] is a challenge because the skill of applying knowledge in real life requires practice. We relate the experience with introducing a practice component to a course in "Health Care Quality Improvement". Working health care professionals were invited to bring an actual quality problem from their place of work and to work alongside students in running the problem through a quality improvement project lifecycle. Multiple technological and process oriented teaching innovations were employed including project sessions in observation rooms, video recording of these sessions, generation of demonstration examples and distance education components. Both students and their collaborators from the work place developed proficiency in applying quality improvement methods as well as in experiencing the realities of group processes, information gaps and organizational constraints. The principles used to achieve high involvement of the whole class, the employed resources and technical support are described. The resulting academic and practical achievements are discussed in relation to the alternative instructional modalities, and with respect to didactic implications for similar endeavors and beyond to other fields such as systems engineering.

Experiences of undergraduate nursing students in peer assisted learning in clinical practice: a qualitative systematic review.

PubMed

Carey, Matthew C; Kent, Bridie; Latour, Jos M

2018-05-01

The objective of this qualitative systematic review was to identify and synthesize the best available evidence on experiences of peer assisted learning (PAL) among student nurses in clinical practice so as to understand the value of PAL for this population. Peer-assisted learning considers the benefits of peers working in collaboration and supporting each other in professional roles. This approach to facilitate learning is effective within universities, but there is limited exploration within the clinical practice environment. Within the UK, 50% of student nurses' learning is undertaken within clinical practice, providing a large portion of student allocation within these areas, but is unexplored in relation to PAL. Therefore, existing evidence examining PAL in clinical practice needs further exploration for a better understanding of its value to student nurses' learning. The systematic review considered studies that included male and female nursing students aged 18-50 years that explored undergraduate nursing students' experiences of PAL within the clinical practice environment. Studies that utilized designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered. Other text such as opinion papers and reports were to be considered if no qualitative studies could be located. The review excluded quantitative studies, as well as those addressing PAL outside the nursing profession and students within the nursing profession but not including undergraduate student nurses. This review considered studies that included aspects related to experiences of PAL in the clinical practice setting, as seen by undergraduate nursing students and the researcher. A three-step search strategy was undertaken to find both published and unpublished studies in English from 2003 to 2017 in various databases, and included searching of reference lists within articles selected for appraisal. Each of the included studies were assessed for methodological quality independently by two reviewers, using the Joanna Briggs Institute Critical Appraisal Form for Interpretive and Critical Research. Qualitative data was extracted using the standardized JBI qualitative data extraction tool. Qualitative research findings were synthesized using JBI methodology. From the eight included studies, 37 findings were extracted. These findings were further aggregated into seven categories, and then into three synthesized findings. These three synthesized findings are: 1) Challenges of clinical practice are mitigated by peer support; 2) Peers are role models for enhancing clinical knowledge; and 3) Support and feedback develop competence and confidence, and reduce stress and anxiety. Peer-assisted learning exists in clinical practice in both formal and informal circumstances. Friendship and community are often expressed as occurring when peers work together. Support and feedback help students develop in their clinical role and enhance clinical knowledge. Outcomes include enhancing the competency and confidence of peers, and reducing stress and anxiety. Challenges of clinical practice are mitigated through PAL.

Mental health/illness and prisons as place: frontline clinicians׳ perspectives of mental health work in a penal setting.

PubMed

Wright, Nicola; Jordan, Melanie; Kane, Eddie

2014-09-01

This article takes mental health and prisons as its two foci. It explores the links between social and structural aspects of the penal setting, the provision of mental healthcare in prisons, and mental health work in this environment. This analysis utilises qualitative interview data from prison-based fieldwork undertaken in Her Majesty׳s Prison Service, England. Two themes are discussed: (1) the desire and practicalities of doing mental health work and (2) prison staff as mental health work allies. Concepts covered include equivalence, training, ownership, informal communication, mental health knowledge, service gatekeepers, case identification, and unmet need. Implications for practice are (1) the mental health knowledge and understanding of prison wing staff could be appraised and developed to improve mental healthcare and address unmet need. Their role as observers and gatekeepers could be considered. (2) The realities of frontline mental health work for clinicians in the penal environment should be embraced and used to produce and implement improved policy and practice guidance, which is in better accord with the actuality of the context - both socially and structurally. Copyright © 2014 Elsevier Ltd. All rights reserved.

Work-related musculoskeletal disorders among Brazilian dental students.

PubMed

de Carvalho, Marcus Vitor Diniz; Soriano, Evelyne Pessoa; de França Caldas, Arnaldo; Campello, Reginaldo Inojosa Carneiro; de Miranda, Hênio Ferreira; Cavalcanti, Francisco Ivo Dantas

2009-05-01

The aim of this analytical cross-sectional study was to evaluate the presence of work-related musculoskeletal disorders (WMSD) among dental students in two Brazilian dental schools. The sample included 227 randomized subjects from fifth to ninth semesters who were developing clinical activities. Each student signed an informed consent form. A self-reporting questionnaire was used to obtain data on the practice of physical exercise, the presence of pain during or soon after treating patients, and the adoption of preventive measures related to clinical activities. Results were analyzed using the Statistical Package for Social Sciences 13.0. The chi(2) test was used to identify associations between variables. The presence of pain during or after clinical work was reported by 173 participants (76.2 percent). Statistically significant differences were found between gender and the occurrence of pain. Pain was present during clinical activities (p=0.006) and imposed limitations on the work routine (p=0.011). Among those who practiced physical exercise, eighty-eight (74.6 percent) reported pain. The high percentage of pain reported by dental students suggests the value of reviewing work conditions in dental practices in order to minimize the exposure of all workers to WMSD.

Storying the world: a posthumanist critique of phenomenological-humanist representational practices in mental health nurse qualitative inquiry.

PubMed

Grant, Alec J

2016-10-01

The purpose of this study was to build on my previously published critique of phenomenological-humanist representational practices in mental health nursing qualitative inquiry. I will unpack and trouble these practices from an explicitly posthumanist philosophical position on the basis of seminal posthumanist texts and my own single- and co-authored work. My argument will be that researchers in mental health nurse qualitative inquiry, who display a phenomenological-humanist narrative bent in their writing, continually endorse the validity of the institutional psychiatric assumptions, practices, and ways of representing human psychological distress. These are all explicitly rejected in more critical forms of qualitative inquiry in mental health, including in my own work. I will conclude that the use of phenomenological-humanist representational practices, in mental health nursing and by implication and extension other healthcare disciplines, is unethical, un-empathic, and morally compromised. This is because such practices present accounts of the worlds of mental health service users, survivors, and carers that lack necessary and sufficient levels of criticality and context. © 2016 John Wiley & Sons Ltd.

Understanding partnership practice in primary health as pedagogic work: what can Vygotsky's theory of learning offer?

PubMed

Hopwood, Nick

2015-01-01

Primary health policy in Australia has followed international trends in promoting models of care based on partnership between professionals and health service users. This reform agenda has significant practice implications, and has been widely adopted in areas of primary health that involve supporting families with children. Existing research shows that achieving partnership in practice is associated with three specific challenges: uncertainty regarding the role of professional expertise, tension between immediate needs and longer-term capacity development in families, and the need for challenge while maintaining relationships based on trust. Recently, pedagogic or learning-focussed elements of partnership practice have been identified, but there have been no systematic attempts to link theories of learning with the practices and challenges of primary health-care professionals working with families in a pedagogic role. This paper explores key concepts of Vygotsky's theory of learning (including mediation, the zone of proximal development, internalisation, and double stimulation), showing how pedagogic concepts can provide a bridge between the policy rhetoric of partnership and primary health practice. The use of this theory to address the three key challenges is explicitly discussed.

Do sleep disturbances mediate the association between work-family conflict and depressive symptoms among nurses? A cross-sectional study.

PubMed

Zhang, Y; Duffy, J F; De Castillero, E Ronan

2017-10-01

Nurses are at a high risk for work-family conflict due to long and irregular work hours and multiple physical and psychosocial stressors in their work environment. Nurses report higher rates of depressive symptoms than the general public, leading to a high rate of burnout, absenteeism, and turnover. Work-family conflict is associated with negative consequences in nurses including physical illnesses and mental disorders. Past research on this topic has not examined the mechanisms for the effect of work family conflict on depression. Studies rarely examine the influence of health behaviors such as sleep in explaining this association. Our study identified significant association of sleep disturbances with both work-family conflict and depressive symptoms in nurses. Our main contribution is reporting the important role of sleep disturbances in translating the effect of work-family conflict on depressive symptoms among nurses. Nurses need to receive training in best practices for maintaining their own sleep and mental health. Organizations should include sleep health education and training in workplace health programs. Evidence-based interventions to promote healthy sleep practices such as cognitive behavioral therapy and complementary and integrative approaches should be evaluated for their effectiveness in addressing the impact of work-family conflict on the mental health of nurses. Healthcare organizations should incorporate mental health services as part of their Employee Assistance Program for nurses and include psychological and sleep disorders screening, counseling, and follow-up. Introduction Depression has been identified as the leading cause of disability worldwide. Nurses report higher rates of depression than the general public. Work-family conflict is challenging for nurses and may lead to depression and poor health. However, the mechanisms for the effect of work-family conflict on depression have not been well understood. Aim The objective is to use a cross-sectional design to examine the role of sleep disturbances in the association between work-family conflict and depressive symptoms in nurses. Methods Questionnaires, measuring working conditions, work-family conflict, sleep disturbances and depressive symptoms were collected from 397 nurses at a not-for-profit community hospital in the north-eastern United States. Results We observed a significant association between work-family conflict and depressive symptoms (β = 2.22, p < .001) among nurses. Sleep disturbances partially mediated this association by 40.54%. Discussion Sleep disturbances play an important role in translating work-family conflict into depressive symptoms. Implications Evidence-based interventions to promote healthy sleep practices should be evaluated for their effectiveness in addressing the impact of work-family conflict on mental health. Organizations should include sleep education and training as a component of workplace health promotion and employee assistance programmes to mitigate the effect of work-family conflict and promote overall health in nurses. © 2017 John Wiley & Sons Ltd.

40 CFR 35.937-7 - Profit.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.937-7 Profit. The objective of negotiations shall be the exercise of sound business judgment and good administrative practice including the...

40 CFR 35.937-7 - Profit.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.937-7 Profit. The objective of negotiations shall be the exercise of sound business judgment and good administrative practice including the...

40 CFR 35.937-7 - Profit.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.937-7 Profit. The objective of negotiations shall be the exercise of sound business judgment and good administrative practice including the...

40 CFR 35.937-7 - Profit.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.937-7 Profit. The objective of negotiations shall be the exercise of sound business judgment and good administrative practice including the...

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Patient-Centered Outcomes Working Group Report.

PubMed

Bevans, Margaret; El-Jawahri, Areej; Tierney, D Kathryn; Wiener, Lori; Wood, William A; Hoodin, Flora; Kent, Erin E; Jacobsen, Paul B; Lee, Stephanie J; Hsieh, Matthew M; Denzen, Ellen M; Syrjala, Karen L

2017-04-01

In 2015, the National Institutes of Health convened six working groups to address the research needs and best practices for late effects of hematopoietic stem cell transplantation survivors. The Patient-Centered Outcomes Working Group, charged with summarizing the HRQOL evidence base, used a scoping review approach to efficiently survey the large body of literature in adult and pediatric HCT survivors over 1 year after transplantation. The goals of this paper are to (1) summarize the current literature describing patient-centered outcomes in survivors, including the various dimensions of health-related quality of life affected by HCT, and describe interventions tested to improve these outcomes; (2) highlight areas with sufficient evidence allowing for integration into standard practice; (3) address methodological issues that restrict progress in this field; (4) identify major gaps to guide future research; and (5) specify priority research recommendations. Patient-centered outcomes were summarized within physical, psychological, social, and environmental domains, as well as for adherence to treatment, and health behaviors. Interventions to improve outcomes were evaluated for evidence of efficacy, although few interventions have been tested in long-term HCT survivors. Methodologic issues defined included lack of consistency in the selection of patient-centered outcome measures, along with the absence of a standard for timing, frequency, and mode of administration. Recommendations for HCT survivorship care included integration of annual screening of patient-centered outcomes, use of evidence-based practice guidelines, and provision of treatment summaries and survivorship care plans after HCT. Three priority research recommendations included the following: (1) design and test risk-targeted interventions with dose-intensity modulation matching the needs of HCT survivors with priority domains, including sexual dysfunction, fatigue, sleep disruption, nonadherence to medications and recommended health care, health behaviors including physical inactivity and healthy eating, and psychological dysfunction, with particular consideration of novel technologies to reach HCT survivors distant from their transplantation centers; (2) design a consensus-based methodologic framework for outcomes evaluation; and (3) evaluate and compare existing practices for integrating patient-centered outcome screening and interventions across HCT survivorship programs. Published by Elsevier Inc.

The social worker as moral citizen: ethics in action.

PubMed

Manning, S S

1997-05-01

Social workers today face some of the most complex ethical dilemmas in the history of the profession. This article presents a framework of moral citizenship to guide ethical social work practice. The framework includes the action philosophies of philosopher Hannah Arendt and Lutheran theologian Paul Tillich integrated with concepts of professional responsibility and the unique contributions of social work pioneer Charlotte Towle. Social conscience and social consciousness, including awareness, thinking, feeling, and action, are major components of the framework.

Twenty years of multidisciplinary research and practice: the Journal of Occupational Rehabilitation then and now.

PubMed

Shaw, William S; Findley, Patricia A; Feuerstein, Michael

2011-12-01

Early research of work disability in the 1980s showed a complexity of factors influencing pain and health-related functional limitation at work; hence, multidisciplinary perspectives were necessary to understand the complex interplay between biomechanical, organizational, social, and psychological factors impacting work disability. To address this need, the Journal of Occupational Rehabilitation was founded in 1991 with the goal of providing a scientific, yet practical forum for presenting multidisciplinary research and practice in work disability. Now, the 20-year collection of articles in the Journal reflects important trends and directions in the field of occupational rehabilitation. We conducted a retrospective summary of the past 20 years of the Journal of Occupational Rehabilitation, including its inaugural goals and intent, rates of submission and acceptance, trends in the types of articles published, study topics, global distribution of authors, and future directions. The original goal of providing a multidisciplinary scientific and practical forum has been met, but current trends reflect a maturing scientific evidence base, with less representation of employer-based case studies and practical innovations. There has been a dramatic increase in the international representation of studies, authors, and peer reviewers outside of the US. Also, published studies now address work disability for a larger number of health concerns. Contributions to the Journal continue to reflect a multidisciplinary perspective, but the Journal has seen significant changes with respect to international representation, the expanding study of non-musculoskeletal sources of work disability, and the maturing scientific evidence base in the field of occupational rehabilitation. Future volumes of the Journal will likely reflect continuing changes in the global economy, workforce fitness, and job demands.

Rural origin plus a rural clinical school placement is a significant predictor of medical students' intentions to practice rurally: a multi-university study.

PubMed

Walker, Judith H; Dewitt, Dawn E; Pallant, Julie F; Cunningham, Christine E

2012-01-01

Health workforce shortages are a major problem in rural areas. Australian medical schools have implemented a number of rural education and training interventions aimed at increasing medical graduates' willingness to work in rural areas. These initiatives include recruiting students from rural backgrounds, delivering training in rural areas, and providing all students with some rural exposure during their medical training. However there is little evidence regarding the impact of rural exposure versus rural origin on workforce outcomes. The aim of this study is to identify and assess factors affecting preference for future rural practice among medical students participating in the Australian Rural Clinical Schools (RCS) Program. Questionnaires were distributed to 166 medical students who had completed their RCS term in 2006; 125 (75%) responded. Medical students were asked about their preferred location and specialty for future practice, their beliefs about rural work and life, and the impact of the RCS experience on their future rural training and practice preferences. Almost half the students (47%; n=58) self-reported a 'rural background'. Significantly, students from rural backgrounds were 10 times more likely to prefer to work in rural areas when compared with other students (p<0.001). For those preferring general practice, 80% (n=24) wished to do so rurally. Eighty-five per cent (n=105) of students agreed that their RCS experience increased their interest in rural training and practice with 62% (n=75) of students indicating a preference for rural internship/basic training after their RCS experience. A substantial percentage (86%; n=108) agreed they would consider rural practice after their RCS experience. This baseline study provides significant evidence to support rural medical recruitment and retention through education and training, with important insights into the factors affecting preference for future rural practice. By far the most significant predictor of rural practice intention is recruitment of students with a rural background who also undertake an RCS placement. This research also demonstrates significant demand for post-graduate rural training places, including specialty places, as RCS graduates become junior doctors and vocational trainees.

Latent Learning in the Work Place: The Placement Experiences of Student-Coaches

ERIC Educational Resources Information Center

Gomes, Rúben; Jones, Robyn L.; Batista, Paula; Mesquita, Isabel

2018-01-01

The aim of this study was to investigate the work-based internship experiences of eight student-coaches. This was particularly in terms of what precisely such coaches learned within the practical context, and how they engaged with unexpected situational events. The methods employed within the project included focus group interviews and participant…

The Role of Work-Related Learning in the Identity Transformation of Canadian Workers with Low Literacy Skills

ERIC Educational Resources Information Center

Taylor, Maurice C.; Trumpower, David L.; Purse, Edward R.

2015-01-01

Workplaces are settings where power, knowledge and self are brought together in a complex social environment which includes various forms of struggle related to identity, agency, socio-cultural norms, political structures and functional practices. The purpose of this article is to uncover how formal and informal work-related learning processes…

The Application of a Model of Turnover in Work Organizations to the Student Attrition Process. Air Forum 1981 Paper.

ERIC Educational Resources Information Center

Bean, John P.

A theoretical model of turnover in work organizations was applied to the college student dropout process at a major midwestern land grant university. The 854 freshmen women subjects completed a questionnaire that included measures for 14 independent variables: grades, practical value, development, routinization, instrumental communication,…

Critical Thought within the Social Welfare Policy Course

ERIC Educational Resources Information Center

Steen, Julie A.

2012-01-01

Critical thought is a necessary element for proficient practice in social work at both the micro and macro levels. For this reason, social work educators must seek to integrate critical thought in BSW and MSW curricula. This article provides a method for achieving this integration in the social welfare policy course. The method includes the four…

Building Trusting Relationships in the Medical Practice Team: Thirty Rules to Live By for You and Your Staff.

PubMed

Hills, Laura

2015-01-01

A medical practice team without trust isn't really a team; it's just a group of individuals who work together in a medical practice, often making disappointing progress. This is true no matter how capable or talented the individuals are. Your staff may never reach its full potential if trust is not present. This article offers medical practice managers 30 rules for building trust in their practices: 15 rules that will help them in their leadership roles, and 15 rules to teach and discuss with their employees. It suggests a trust-building screening question to include in job interviews to determine if applicants have a high capacity for trust. It also describes Reina and Reina's "Three C's of Trust," a model that practice managers may find useful as they develop trust competencies in their staffs. This article also includes 10 inspiring quotes that will help medical practice employees build trust and five easy-to-facilitate trust-building exercises that managers can use with the medical practice team.

Full practice authority--effecting change and improving access to care: the Nevada journey.

PubMed

VanBeuge, Susan S; Walker, Tomas

2014-06-01

In 2013, Nevada shifted from a collaborative practice model to full practice authority. Given the challenges many states still face, this article provides an outline of the evolution of the "nurse practitioner" (NP) in Nevada. Reviewing the path Nevada took toward full practice authority, we hope to provide insight including lessons learned and opposition encountered to assist other states working toward full practice authority. Literature searches were conducted on PubMed and MEDLINE. Search terms included "autonomous practice," "nurse practitioner," and "full practice authority." Healthcare reform will require nurse practitioners committed to legislative change. Nurse practitioners have the knowledge and ability to affect the legislative process and improve patients' access to care. With careful planning, full engagement, and team building, making a statute change is possible and should be seriously considered in states still struggling with collaborative relationships. Nurse practitioners are well situated to provide primary care in the United States. Removing barriers to practice through statute change will empower NPs to effect positive change in our struggling healthcare system. ©2014 The Author(s) ©2014 American Association of Nurse Practitioners.

Systematic review of the qualitative literature on return to work after injury.

PubMed

MacEachen, Ellen; Clarke, Judy; Franche, Renée-Louise; Irvin, Emma

2006-08-01

This paper reports on a systematic review of the international qualitative research literature on return to work. This review was undertaken in order to better understand the dimensions, processes, and practices of return to work. Because return to work often includes early return before full recovery while a person is undergoing rehabilitation treatment, physical recovery is embedded in complicated ways with workplace processes and practices and social organization. These process-oriented dimensions of return to work are well described in the qualitative literature. This systematic review of the literature covered peer-reviewed papers that focused on musculoskeletal and pain-related injuries and were published in English or French between 1990 and 2003. Findings from papers meeting relevance and quality criteria were synthesized using the meta-ethnographic approach. This review found that return to work extends beyond concerns about managing physical function to the complexities related to beliefs, roles, and perceptions of many players. Good will and trust are overarching conditions that are central to successful return-to-work arrangements. In addition, there are often social and communication barriers to return to work, and intermediary players have the potential to play a key role in facilitating this process. This paper identifies key mechanisms of workplace practice, process, and environment that can affect the success of return to work. The findings illustrate the contribution that qualitative literature can make to important aspects of implementation in relation to return to work.

Teaching long-term science investigations: A matter of talk, text, and time

NASA Astrophysics Data System (ADS)

Bills, Patricia Susan

Science educators regard long-term investigations as one impactful form of teaching science through inquiry in K-12 classrooms. While we have idealized notions of what this work looks like, we have few, if any, descriptive studies about investigations that engage students in sustained, focused work over a period of time longer than a few days or even weeks. In a policy context that calls for teachers to develop strategies for engaging students in authentic science practices, such as those that can come from long-term science investigations, we would do well to learn from experienced teachers. This study followed three middle school science teachers in a large U. S. urban school district as they conducted long-term investigations. Using discourse analysis and taking a sociocultural perspective, this study documented the classroom talk and interaction of teachers and their students. The study's goals were to describe how teachers engage students in long-term investigations and the ways that classroom interaction involved specific reform-based science practices. Data include field notes and transcripts of audio recordings from 15 observations of three experienced middle school science teachers, three semi-structured interviews with each teacher, curriculum materials, student work, and classroom demographic data. Teachers engaged students in whole group, small group, and one-on-one conversations about several stages of the long-term investigations. Teachers most often discussed two of the eight science practices: 1) planning and carrying out investigations; and 2) obtaining, evaluating, and communicating information. The planning discussions involved conversations about identifying and describing variables, measuring and recording data, and concerns about data collection procedures. Conversations about using and communicating scientific information included talk about formal science writing conventions, and using background information to support all other parts of the investigation process. In all of the observed lessons, regardless of the practice or types of investigations students were to engage, teachers used curricular tools to support students' work, scaffolding students' introduction to and use of scientific content, practices, and discourse. In these ways, teachers helped students master a science-specific vocabulary and set of practices that allow for the authentic exploration of science concepts. This study describes how teachers who generate opportunities for students to experience two science practices more often than others, which may have implications for science education and science education research - especially concerning how science practices are engaged in classrooms - moving forward.

The Psychosomatic Disorders Pertaining to Dental Practice with Revised Working Type Classification

PubMed Central

2014-01-01

Psychosomatic disorders are defined as disorders characterized by physiological changes that originate partially from emotional factors. This article aims to discuss the psychosomatic disorders of the oral cavity with a revised working type classification. The author has added one more subset to the existing classification, i.e., disorders caused by altered perception of dentofacial form and function, which include body dysmorphic disorder. The author has also inserted delusional halitosis under the miscellaneous disorders classification of psychosomatic disorders and revised the already existing classification proposed for the psychosomatic disorders pertaining to dental practice. After the inclusion of the subset (disorders caused by altered perception of dentofacial form and function), the terminology "psychosomatic disorders of the oral cavity" is modified to "psychosomatic disorders pertaining to dental practice". PMID:24478896

The psychosomatic disorders pertaining to dental practice with revised working type classification.

PubMed

Shamim, Thorakkal

2014-01-01

Psychosomatic disorders are defined as disorders characterized by physiological changes that originate partially from emotional factors. This article aims to discuss the psychosomatic disorders of the oral cavity with a revised working type classification. The author has added one more subset to the existing classification, i.e., disorders caused by altered perception of dentofacial form and function, which include body dysmorphic disorder. The author has also inserted delusional halitosis under the miscellaneous disorders classification of psychosomatic disorders and revised the already existing classification proposed for the psychosomatic disorders pertaining to dental practice. After the inclusion of the subset (disorders caused by altered perception of dentofacial form and function), the terminology "psychosomatic disorders of the oral cavity" is modified to "psychosomatic disorders pertaining to dental practice".

Effect of occupational health nursing practice on musculoskeletal pains among hospital nursing staff in South Korea.

PubMed

Kim, Yeon-Ha; Jung, Moon-Hee

2016-01-01

The purpose of this study was to identify whether occupational health nursing variables serve as the contributing factors to musculoskeletal pains (MSP). A self-administered questionnaire composed of demographic characteristics, the practice of occupational health nursing and information regarding MSP was designed based on in-depth interviews with eight nurses. This study included 226 hospital nursing staff who worked at three university hospitals located in Seoul, South Korea. Statistical analysis was performed by using SPSS and AMOS 19.0. Shoulder and neck pains occurred when subjects worked more than 46 h/week. Subjects who performed 'work-time adjustment' had lesser chance of having shoulder, leg/foot and wrist/finger pains. Overtime work hours showed an indirect effect on multiple sites of MSP by mediator variable, which was 'work-time adjustment'. Organized night duty days eventually decreased multiple sites of MSP. Administration strategies for nurses to adjust work-time within 46 h/week should be considered.

Promotion of a healthy work life at small enterprises in Thailand by participatory methods.

PubMed

Krungkraiwong, Sudthida; Itani, Toru; Amornratanapaichit, Ratanaporn

2006-01-01

The major problems of small enterprises include unfavourable working conditions and environment that affect safety and health of workers. The WISE (Work Improvement in Small Enterprises) methodology developed by the ILO has been widely applied to improve occupational safety and health in small enterprises in Thailand. The participatory methods building on local good practices and focusing on practicable improvements have proven effective in controlling the occupational hazards in these enterprises at their sources. As a result of applying the methods in small-scale industries, the frequency of occupational accidents was reduced and the working environment actually improved in the cases studied. The results prove that the participatory approach taken by the WISE activities is a useful and effective tool to make owner/managers and workers in small enterprises voluntarily improve their own working conditions and environment. In promoting a healthy work life at small enterprises in Thailand, it is important to further develop and spread the approach.

Fatigue, Work Schedules, and Perceived Performance in Bedside Care Nurses.

PubMed

Sagherian, Knar; Clinton, Michael E; Abu-Saad Huijer, Huda; Geiger-Brown, Jeanne

2017-07-01

Hospital nurses are expected to maintain optimal work performance; yet, fatigue can threaten safe practice and result in unfavorable patient outcomes. This descriptive cross-sectional study explored the association between fatigue, work schedules, and perceived work performance among nurses. The study sample included 77 bedside nurses who were mostly female, single, and between 20 and 29 years of age. The majority worked 8-hour shifts and overtime. Nurses who worked during off days reported significantly higher chronic fatigue compared with those nurses who took time off. Nurses who reported feeling refreshed after sleep had significantly less chronic and acute fatigue and more intershift recovery. Nurses with acute and chronic fatigue perceived poorer physical performance. Also, nurses who reported chronic fatigue perceived they were less alert and less able to concentrate when providing patient care. Less effective communication was also associated with acute and chronic fatigue. In conclusion, fatigue has safety implications for nurses' practice that should be monitored by nursing management.

Work-based learning experiences help students with disabilities transition to careers: a case study of University of Washington projects.

PubMed

Bellman, Scott; Burgstahler, Sheryl; Ladner, Richard

2014-01-01

This case study describes evidence-based practices employed by a collection of University of Washington projects that engage high school and postsecondary students with disabilities in work-based learning experiences such as industry and research internships, career development activities, job shadows, field trips, and mock interviews. The purpose of the article is two-fold. First, authors share best practices with others who wish to increase the participation of students with disabilities in work-based learning and thereby contribute to their academic and career success. The article discusses methods used to recruit students, employers and mentors, match students with specific opportunities, and prepare students for success. Second, authors share outcomes from studies regarding participation in these work-based learning opportunities, which include increased employment success, motivation to work toward a career, knowledge about careers and the workplace, job-related skills, ability to work with supervisors and coworkers, skills in self-advocating for accommodations, and perceived career options.

Burnout syndrome in pediatric practice.

PubMed

Al-Youbi, Reem A; Jan, Mohammed M

2013-07-01

Burnout is a common work-related syndrome consisting of emotional exhaustion, depersonalization and diminished feelings of personal accomplishment. Burnout influences the performance and efficiency of the healthcare professionals and therefore the quality of the care provided. This study aims to assess the burnout rates and potential determinants in pediatrics. A cross-sectional, descriptive study involving physicians practicing pediatrics in the Jeddah area of Saudi Arabia was conducted utilizing the Maslach Burnout Inventory in addition to questions regarding work-related and lifestyle-related factors. One hundred and thirty pediatricians (55% females) were included with age ranging between 25 and 45 years (mean: 30). Most (46%) were consultants and 54% practiced in a university based setting. Burnout scores were abnormal in 107 (82%) and in 45 (34%) the syndrome was severe. Males were more likely to reach a severe burnout category compared to females (40% vs. 31%; p=0.012). Academic pediatricians working in a university setting were much more likely to experience severe burnout compared to their counterparts working in other hospitals (50% vs. 19%; p=0.0005). Consultants were also more likely to experience severe burnout compared to residents and assistants (46% vs. 27%; p=0.03). At least one third of practicing pediatricians suffer from burnout syndrome. Specific strategies should be developed and implemented to limit and prevent professional burnout.

Implementing high-performance work practices in healthcare organizations: qualitative and conceptual evidence.

PubMed

McAlearney, Ann Scheck; Robbins, Julie; Garman, Andrew N; Song, Paula H

2013-01-01

Studies across industries suggest that the systematic use of high-performance work practices (HPWPs) may be an effective but underused strategy to improve quality of care in healthcare organizations. Optimal use of HPWPs depends on how they are implemented, yet we know little about their implementation in healthcare. We conducted 67 key informant interviews in five healthcare organizations, each considered to have exemplary work practices in place and to deliver high-quality care, as part of an extensive study of HPWP use in healthcare. We analyzed interview transcripts inductively and deductively to examine why and how organizations implement HPWPs. We used an evidence-based model of complex innovation adoption to guide our exploration of factors that facilitate HPWP implementation. We found considerable variability in interviewees' reasons for implementing HPWPs, including macro-organizational (strategic level) and micro-organizational (individual level) reasons. This variability highlighted the complex context for HPWP implementation in many organizations. We also found that our application of an innovation implementation model helped clarify and categorize facilitators of HPWP implementation, thus providing insight on how these factors can contribute to implementation effectiveness. Focusing efforts on clarifying definitions, building commitment, and ensuring consistency in the application of work practices may be particularly important elements of successful implementation.

Practical Work Activities as a Method of Assessing Learning in Chemistry Teaching

ERIC Educational Resources Information Center

Sedumedi, Thomas D. T.

2017-01-01

Practical work activities have been used for many purposes in science teaching. However, its use for assessment purposes has been limited. This study highlights the role of practical work activities in assessment. Practical work activities present various advantages as an assessment tool. Practical work activities allow the assessor access to a…

Uranium mining industry views on ICRP statement on radon.

PubMed

Takala, J

2012-01-01

In 2009, the International Commission on Radiological Protection issued a statement on radon which stated that the dose conversion factor for radon progeny would likely double, and the calculation of risk from radon should move to a dosimetric approach, rather than the longstanding epidemiological approach. Through the World Nuclear Association, whose members represent over 90% of the world's uranium production, industry has been examining this issue with a goal of offering expertise and knowledge to assist with the practical implementation of these evolutionary changes to evaluating the risk from radon progeny. Industry supports the continuing use of the most current epidemiological data as a basis for risk calculation, but believes that further examination of these results is needed to better understand the level of conservatism in the potential epidemiological-based risk models. With regard to adoption of the dosimetric approach, industry believes that further work is needed before this is a practical option. In particular, this work should include a clear demonstration of the validation of the dosimetric model which includes how smoking is handled, the establishment of a practical measurement protocol, and the collection of relevant data for modern workplaces. Industry is actively working to address the latter two items. Copyright © 2012. Published by Elsevier Ltd.

Violence prevention and municipal licensing of indoor sex work venues in the Greater Vancouver Area: narratives of migrant sex workers, managers and business owners

PubMed Central

Anderson, Solanna; Jia, Jessica Xi; Liu, Vivian; Chattier, Jill; Krüsi, Andrea; Allan, Sarah; Maher, Lisa; Shannon, Kate

2015-01-01

Using a socio-ecological, structural determinants framework, this study assesses the impact of municipal licensing policies and related policing practices across the Greater Vancouver Area (Canada) on the risk of violence within indoor sex work venues. Qualitative interviews were conducted with 46 migrant/immigrant sex workers, managers and owners of licensed indoor sex work establishments and micro-brothels. Findings indicate that policing practices and licensing requirements increase sex workers’ risk of violence and conflict with clients, and result in heightened stress, an inability to rely on police support, lost income and the displacement of sex workers to more hidden informal work venues. Prohibitive licensing and policing practices prevent sex workers, managers and owners from adopting safer workplace measures and exacerbate health and safety risks for sex workers. This study provides critical evidence of the negative public health implications of prohibitive municipal licensing in the context of a criminalised and enforcement-based approach to sex work. Workplace safety recommendations include the decriminalisation of sex work and the elimination of disproportionately high fees for licenses, criminal record restrictions, door lock restrictions, employee registration requirements and the use of police as licensing inspectors. PMID:25686777

Observing the work of the Clinical Nurse Specialist: a pilot study.

PubMed

Darmody, Julie V

2005-01-01

The Clinical Nurse Specialist (CNS) is an advanced practice nurse (APN) with graduate preparation as a clinical expert within a specialty area of nursing practice. There is a need for information about the work of the CNS in order to link CNS activities to outcomes and costs of care. To describe the work of the CNS in the acute care setting using the National Association of Clinical Nurse Specialists (NACNS) model as an organizing framework. Descriptive pilot study of the work of the CNS in acute care. A 500-bed academic medical center located in the Midwestern United States. Five masters-prepared APNs in a unit-based CNS role. Direct observation and time study were used to record activities and time for 4 hours with each CNS (n = 5) for a total of 20 hours of observation. CNS activity and time within each practice domain included patient/client (30%), nursing (44%), organization/system (10%), and other activities (16%). Specific activities observed were linked to possible outcomes in the NACNS framework. The NACNS model provided a useful framework for developing a data collection tool that can be used in a larger study that analyzes the work of the acute care CNS. Describing the work of the CNS is an important preliminary step to measuring outcomes and costs of care.

29 CFR 401.6 - Employee.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., and includes any individual whose work has ceased as a consequence of, or in connection with, any current labor dispute or because of any unfair labor practice or because of exclusion or expulsion from a...

29 CFR 401.6 - Employee.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and includes any individual whose work has ceased as a consequence of, or in connection with, any current labor dispute or because of any unfair labor practice or because of exclusion or expulsion from a...

The Flexibility Hypothesis of Healing.

PubMed

Hinton, Devon E; Kirmayer, Laurence J

2017-03-01

Theories of healing have attempted to identify general mechanisms that may work across different modalities. These include altering expectations, remoralization, and instilling hope. In this paper, we argue that many forms of healing and psychotherapy may work by inducing positive psychological states marked by flexibility or an enhanced ability to shift cognitive sets. Healing practices may induce these states of cognitive and emotional flexibility through specific symbolic interventions we term "flexibility primers" that can include images, metaphors, music, and other media. The flexibility hypothesis suggests that cognitive and emotional flexibility is represented, elicited, and enacted through multiple modalities in healing rituals. Identifying psychological processes and cultural forms that evoke and support cognitive and emotional flexibility provides a way to understand the cultural specificity and potential efficacy of particular healing practices and can guide the design of interventions that promote resilience and well-being.

OJPOT: online judge & practice oriented teaching idea in programming courses

NASA Astrophysics Data System (ADS)

Wang, Gui Ping; Chen, Shu Yu; Yang, Xin; Feng, Rui

2016-05-01

Practical abilities are important for students from majors including Computer Science and Engineering, and Electrical Engineering. Along with the popularity of ACM International Collegiate Programming Contest (ACM/ICPC) and other programming contests, online judge (OJ) websites achieve rapid development, thus providing a new kind of programming practice, i.e. online practice. Due to fair and timely feedback results from OJ websites, online practice outperforms traditional programming practice. In order to promote students' practical abilities in programming and algorithm designing, this article presents a novel teaching idea, online judge & practice oriented teaching (OJPOT). OJPOT is applied to Programming Foundation course. OJPOT cultivates students' practical abilities through various kinds of programming practice, such as programming contests, online practice and course project. To verify the effectiveness of this novel teaching idea, this study conducts empirical research. The experimental results show that OJPOT works effectively in enhancing students' practical abilities compared with the traditional teaching idea.

Fundamental constructs in food parenting practices: a content map to guide future research.

PubMed

Vaughn, Amber E; Ward, Dianne S; Fisher, Jennifer O; Faith, Myles S; Hughes, Sheryl O; Kremers, Stef P J; Musher-Eizenman, Dara R; O'Connor, Teresia M; Patrick, Heather; Power, Thomas G

2016-02-01

Although research shows that "food parenting practices" can impact children's diet and eating habits, current understanding of the impact of specific practices has been limited by inconsistencies in terminology and definitions. This article represents a critical appraisal of food parenting practices, including clear terminology and definitions, by a working group of content experts. The result of this effort was the development of a content map for future research that presents 3 overarching, higher-order food parenting constructs--coercive control, structure, and autonomy support--as well as specific practice subconstructs. Coercive control includes restriction, pressure to eat, threats and bribes, and using food to control negative emotions. Structure includes rules and limits, limited/guided choices, monitoring, meal- and snacktime routines, modeling, food availability and accessibility, food preparation, and unstructured practices. Autonomy support includes nutrition education, child involvement, encouragement, praise, reasoning, and negotiation. Literature on each construct is reviewed, and directions for future research are offered. Clear terminology and definitions should facilitate cross-study comparisons and minimize conflicting findings resulting from previous discrepancies in construct operationalization. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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

PubMed

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

2018-03-01

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

Breaking the silence: nurses' understandings of change in clinical practice.

PubMed

Copnell, Beverley; Bruni, Nina

2006-08-01

This paper reports a study exploring critical care nurses' understandings of change in their practice. In contemporary nursing literature, change in clinical nursing practice is generally understood to be a rational process, synonymous with progress. It is seen as invariably contested, and hence difficult to achieve. It is represented as occurring infrequently. This literature effectively silences clinicians as this discourse of change does not recognize or incorporate their views or practices. This study was informed by a Foucauldian poststructuralist framework. The participants were 12 critical care nurses who engaged in three individual in-depth, focused interviews. The transcripts were deconstructed to reveal participants' discourses of change and the implications of these discourses for nursing work. The data were generated between 1996 and 1998 as part of a study whose in-depth analysis was completed in 2003. Change was revealed as a highly complex phenomenon, closely intertwined with understandings of clinical nursing work. Participants showed difficulty in identifying or recalling clinical changes. Several dichotomies shaped their understandings of change, including change/stasis, formal/informal and dramatic/subtle. Their experiences of change frequently conflicted with prevailing dominant understandings, but they did not openly challenge them. Rather, they employed dichotomies, such as abstract/concrete and other/self, to enable them to work with these conflicts. As a result, they engaged in practices such as naming other nurses as 'irrational'. The data provide new understandings of change in clinical nursing practice, some of which challenge many widely held views (for example, that such change is a rare occurrence). It is argued that a lack of open challenge by clinical nurses contributes to their silencing, promotes disharmony amongst nurses and, hence, works against a collaborative approach to decisions about clinical practice.

Exploring work-life issues in provincial corrections settings.

PubMed

Almost, Joan; Doran, Diane; Ogilvie, Linda; Miller, Crystal; Kennedy, Shirley; Timmings, Carol; Rose, Don N; Squires, Mae; Lee, Charlotte T; Bookey-Bassett, Sue

2013-01-01

Correctional nurses hold a unique position within the nursing profession as their work environment combines the demands of two systems, corrections and health care. Nurses working within these settings must be constantly aware of security issues while ensuring that quality care is provided. The primary role of nurses in correctional health care underscores the importance of understanding nurses' perceptions about their work. The purpose of this study was to examine the work environment of nurses working in provincial correctional facilities. A mixed-methods design was used. Interviews were conducted with 13 nurses and healthcare managers (HCMs) from five facilities. Surveys were distributed to 511 nurses and HCMs in all provincial facilities across the province of Ontario, Canada. The final sample consisted of 270 nurses and 27 HCMs with completed surveys. Participants identified several key issues in their work environments, including inadequate staffing and heavy workloads, limited control over practice and scope of practice, limited resources, and challenging workplace relationships. Work environment interventions are needed to address these issues and subsequently improve the recruitment and retention of correctional nurses.

Practice management--warts and all.

PubMed

Fleming, G J

1993-02-01

A recent survey, part of a Practice Management Study, asked 100 doctors how their businesses were going. From the responses, it was evident that there were many areas of concern, including working long hours looking after patients; no time for the family; the accountant does the tax, but that's all; and accountants, solicitors and consultants are too expensive. This article sets out some of the issues raised in the survey.

2014 Code of Practice: How Research Evidence on the Role and Impact of Teaching Assistants Can Inform Professional Practice

ERIC Educational Resources Information Center

Webster, Rob

2014-01-01

In this article, the author reflects on findings from research on the role and impact of teaching assistants and experience of working as a special educational needs (SEN) officer. Research evidence suggests the reliance on teaching assistants to include pupils with Statements of SEN in mainstream settings masks a collective, though unintentional,…

Something That Works for Me: 100 More Teaching Practices Used in Our Schools. Grades K-12. No. 2.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

This guide, published by the New York City Board of Education, presents teaching practices that have been used in New York City schools in grades K-12. Subject areas covered include: (1) communication arts; (2) mathematics; (3) social studies; (4) art; (5) music; (6) English as a second language; (7) bilingual education; (8) reading; (9) writing;…

DoD Product Line Practice Workshop Report

DTIC Science & Technology

1998-05-01

capability. The essential enterprise management practices include ensuring sound business goals providing an appropriate funding model performing...business. This way requires vision and explicit support at the organizational level. There must be an explicit funding model to support the development...the same group seems to work best in smaller organizations. A funding model for core asset development also needs to be developed because the core

Learning to Look beyond the Boundaries of Representation: Using Technology to Examine Teaching (Overview for a Digital Exhibition: Learning from the Practice of Teaching)

ERIC Educational Resources Information Center

Hatch, Thomas; Grossman, Pam

2009-01-01

Leading a classroom discussion involves multiple components, including establishing norms for participation, assisting students in engaging in careful readings of text ahead of time, and modeling features of academic discourse. In other work, Grossman and her colleagues refer to this as the "decomposition" of practice--breaking down complex…

Interdisciplinary Interactions During R&D and Early Design of Large Engineered Systems

NASA Technical Reports Server (NTRS)

McGowan, Anna-Maria Rivas

2014-01-01

Designing Large-Scale Complex Engineered Systems (LaCES) such as aircraft and submarines requires the input of thousands of engineers and scientists whose work is proximate in neither time nor space. Comprehensive knowledge of the system is dispersed among specialists whose expertise is in typically one system component or discipline. This study examined the interactive work practices among such specialists seeking to improve engineering practice through a rigorous and theoretical understanding of current practice. This research explored current interdisciplinary practices and perspectives during R&D and early LaCES design and identified why these practices and perspectives prevail and persist. The research design consisted of a three-fold, integrative approach that combined an open-ended survey, semi-structured interviews, and ethnography. Significant empirical data from experienced engineers and scientists in a large engineering organization were obtained and integrated with theories from organization science and engineering. Qualitative analysis was used to obtain a holistic, contextualized understanding. The over-arching finding is that issues related to cognition, organization, and social interrelations mostly dominate interactions across disciplines. Engineering issues, such as the integration of hardware or physics-based models, are not as significant. For example, organization culture is an important underlying factor that guided researchers more toward individual sovereignty over cross-disciplinarity. The organization structure and the engineered system architecture also serve as constraints to the engineering work. Many differences in work practices were observed, including frequency and depth of interactions, definition or co-construction of requirements, clarity or creation of the system architecture, work group proximity, and cognitive challenges. Practitioners are often unaware of these differences resulting in confusion and incorrect assumptions regarding work expectations. Cognitively, the enactment and coconstruction of knowledge are the fundamental tasks of the interdisciplinary interactions. Distributed and collective cognition represent most of the efforts. Argument, ignorance, learning, and creativity are interrelated aspects of the interactions that cause discomfort but yield benefits such as problem mitigation, broader understanding, and improved system design and performance. The quality and quantity of social interrelations are central to all work across disciplines with reciprocity, respectful engagement, and heedful interrelations being significant to the effectiveness of the engineering and scientific work.

Experiences of mental health nursing staff working with voice hearers in an acute setting: An interpretive phenomenological approach.

PubMed

McMullan, E; Gupta, A; Collins, S C

2018-04-01

WHAT IS KNOWN ON THE SUBJECT?: Community mental health staff and their service users have reported mixed views on the importance of talking about the content of voices. Community staff have reported feeling that they do not have the skills to explore voice content and worry about making things worse. Voice hearers experiencing extreme distress due to the content of their voices can access support through acute inpatient mental health services. No previous studies have focused on the experiences of staff who nurse voice hearers at a time of acute distress. WHAT DOES THIS STUDY ADD TO EXISTING KNOWLEDGE?: MHNs and HSWs working with voice hearers in acute distress report feeling powerless and helpless, as they feel that they cannot lessen the distress experienced by the voice hearer. Despite these difficult feelings, staff report finding ways of coping, including using structured tools to help make sense of their service users' voice-hearing experiences and accessing reflective practice forums. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Due to the current context of increased acuity and limited resources in acute services, there may be a need to further protect time for staff to access reflective practice groups and supervision forums to help them manage the difficult feelings arising from their work with voice hearers. Introduction Mental health nursing (MHN) staff in acute settings work with voice hearers at times of crises when they experience high levels of distress. Previous research has focused on community mental health staff's experiences and their service users views on exploring the content of voices. No studies have explored this from an acute mental health service perspective. Aim This study therefore sought to explore the experiences of staff working with voice hearers in an acute mental health service. Method Due to the exploratory nature of the research, a qualitative design was chosen. Three MHNs and five healthcare support workers (HSWs) were interviewed. The data were analysed using Interpretative Phenomenological Analysis. Results A group analysis elicited three master themes: "It's quite scary really, not unlike a horror movie;" "I can only influence what's in front of me;" and "Just chipping away". Discussion Staff working with voice hearers in acute settings experience feelings of powerlessness and helplessness, as they feel unable to reduce the distress experienced by voice hearers in their care. Staff employ coping strategies to help manage these difficult feelings, including using structured tools in their work with voice hearers and attending reflective practice forums. Implications for Practice Acute mental health services may need to protect time for staff to access regular reflective practice and other supervision forums to help manage their feelings of powerlessness and helplessness arising from their work with voice hearers. © 2017 John Wiley & Sons Ltd.

Whole-system evaluation research of a scheme to support inner city recruitment and retention of GPs.

PubMed

Bellman, Loretta

2002-12-01

The GP Assistant/Research Associate scheme developed in the Guy's, King's and St Thomas' School of Medicine, London, aims to attract and recruit young GPs (GP Assistants) and develop their commitment to work in local inner city practices. Continuing professional development for both young and established GPs is a key feature of the scheme. The objectives of the whole-system evaluation research were to explore the perspectives of 34 stakeholders in the academic department, the practices and the PCGs, and to investigate the experiences of 19 GP Assistants who have participated in the scheme. Qualitative methods included semi-structured interviews, non-participant observations in the practices, audio-taped meetings and personal journals. Data collection also included reviewing documentation of the scheme, i.e. the previous quantitative evaluation report, publications and e-mails. The multi-method approach enabled individual, group and team perspectives of the scheme and triangulation of the data through comparing dialogue with observations and documentary evidence. Thematic analysis was undertaken to elicit the complex experiences of the GP Assistants. Wide-ranging findings included enthusiastic support for the continuation of the scheme. The GP Assistants' personal and professional development was clearly evident from the themes 'eye opener', new knowledge, managing multiple roles, feeling vulnerable, time constraints and empowering processes. Seven of the GP Assistants have become partners and ten chose to remain working in local practices. Significant challenges for managing and leading the scheme were apparent. Greater co-operation and collaborative working between the academic department and the practices is required. The scheme provides a highly valued visible means of support for GPs and could act as a model for a career pathway aimed at enhancing recruitment and retention of GPs. The scheme is also at the forefront of national initiatives aimed at supporting single-handed practices and helping GPs with their continuing professional development. An integrated approach to change, education, research and development is advocated to enable recruitment and retention of GPs, their academic development, and to underpin the evolution of PCTs as learning organizations.

Psychotherapy Termination Practices with Older Adults: Impact of Patient and Therapist Characteristics.

PubMed

Sullivan, Daniel J; Zeff, Patricia; Zweig, Richard A

2018-02-06

The aims of this study were to survey clinicians' opinions regarding psychotherapy practices in mutual termination with a specified population (depressed older adult outpatients) and to examine the patient and therapist characteristics that may influence such practices. We surveyed psychologists' (N = 96) psychotherapy termination practices, using a hypothetical depressed older adult as a referent, to assess consensus on the appropriateness of various guidelines to termination and to examine whether these differ as a function of patient and therapist characteristics. Several practices were generally agreed to be "extremely appropriate" when terminating psychotherapy with older adults, including collaborating to determine the end date of treatment and discussing patient growth. Data also indicate that patient factors, such as personality pathology, and therapist factors, such as having an Integrative theoretical orientation were associated with differential endorsement of termination practices. Identification as a geropsychologist or working regularly with older adults were associated with a more cautious approach to termination. There is substantial consensus regarding many approaches to termination, but modifications might be appropriate depending on patient characteristics. Clinicians agree on a set of fundamental termination practices when working with older adults, but modify these based on orientation and diagnosis.

Exploring the organizational culture of exemplary community health center practices.

PubMed

Craigie, Frederic C; Hobbs, Richard F

2004-01-01

A 1999 precursor to this study, published in Family Medicine, suggested that the organizational culture of practices was potentially important to health care providers and patients. In this research, we examined the experiences of people working in exemplary community health center practices to explore the components and maintaining factors of positive medical organizational culture. Two exemplary practices were identified through a process of nominations and selection with respect to a presumptive definition of positive organizational culture. Interpretive categories and themes were developed through qualitative content analysis of semi-structured interviews, along with field observation. Categories of culture in these practices included Community Mission and Values, Leadership and Organizational Dynamics, Relationships, and Physical Space. Cultural qualities were nurtured by leadership approaches, collaborative staff meetings, and shared values about mission and workplace relationships. Staff consistently indicated that the spirit or culture in their practices was beneficial for employees, patients, and the process of clinical care. The positive organizational culture in these practices was substantially characterized and cultivated by specific values, attitudes, behaviors, and relationships of employees. Further work is indicated in approaches to assessment and intervention with organizational culture in medical settings and in evaluating associations with medical outcomes.

In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices

PubMed Central

Sinsky, Christine A.; Willard-Grace, Rachel; Schutzbank, Andrew M.; Sinsky, Thomas A.; Margolius, David; Bodenheimer, Thomas

2013-01-01

We highlight primary care innovations gathered from high-functioning primary care practices, innovations we believe can facilitate joy in practice and mitigate physician burnout. To do so, we made site visits to 23 high-performing primary care practices and focused on how these practices distribute functions among the team, use technology to their advantage, improve outcomes with data, and make the job of primary care feasible and enjoyable as a life’s vocation. Innovations identified include (1) proactive planned care, with previsit planning and previsit laboratory tests; (2) sharing clinical care among a team, with expanded rooming protocols, standing orders, and panel management; (3) sharing clerical tasks with collaborative documentation (scribing), nonphysician order entry, and streamlined prescription management; (4) improving communication by verbal messaging and in-box management; and (5) improving team functioning through co-location, team meetings, and work flow mapping. Our observations suggest that a shift from a physician-centric model of work distribution and responsibility to a shared-care model, with a higher level of clinical support staff per physician and frequent forums for communication, can result in high-functioning teams, improved professional satisfaction, and greater joy in practice. PMID:23690328

Goal setting education and counseling practices of diabetes educators.

PubMed

Malemute, Charlene L; Shultz, Jill Armstrong; Ballejos, Miriam; Butkus, Sue; Early, Kathaleen Briggs

2011-01-01

The purpose of this study was to identify goal setting education practices used by diabetes educators working with type 2 diabetes patients. Data were collected by a mail questionnaire with 179 diabetes educators purposively selected from the 2008 American Association of Diabetes Educators membership listing. Many diabetes educators (52%) reported that more than 75% of their patients set goals for diabetes control. Independent factor patterns for the frequency of information collected from the patient for the first diabetes education session showed that educators either focused on patients' self-management practices (exercise and dietary practices, knowledge, and social impacts of diabetes) or issues with learning about self-management, such as understanding the patient's learning style and motivation for managing diabetes. Factor patterns overall showed diverse approaches to working with patients, including strategies used with patients struggling with dietary goals and the importance of tasks to complete during the first patient session. Although most educators reported practices that were largely patient centered as promoted by the American Diabetes Association (ADA) and models of chronic disease management, patterns of practice suggest that diabetes educators vary considerably in how they apply education practices, especially with dietary self-management education.

The work and challenges of care managers in the implementation of collaborative care: A qualitative study.

PubMed

Overbeck, G; Kousgaard, M B; Davidsen, A S

2018-04-01

WHAT IS KNOWN ON THE SUBJECT?: In collaborative care models between psychiatry and general practice, mental health nurses are used as care managers who carry out the treatment of patients with anxiety or depression in general practice and establish a collaborating relationship with the general practitioner. Although the care manager is the key person in the collaborative care model, there is little knowledge about this role and the challenges involved in it. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Our study shows that before the CMs could start treating patients in a routine collaborative relationship with GPs, they needed to carry out an extensive amount of implementation work. This included solving practical problems of location and logistics, engaging GPs in the intervention, and tailoring collaboration to meet the GP's particular preferences. Implementing the role requires high commitment and an enterprising approach on the part of the care managers. The very experienced mental health nurses of this study had these skills. However, the same expertise cannot be presumed in a disseminated model. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: When introducing new collaborative care interventions, the care manager role should be well defined and be well prepared, especially as regards the arrival of the care manager in general practice, and supported during implementation by a coordinated leadership established in collaboration between hospital psychiatry and representatives from general practice. Introduction In collaborative care models for anxiety and depression, the care manager (CM), often a mental health nurse, has a key role. However, the work and challenges related to this role remain poorly investigated. Aim To explore CMs' experiences of their work and the challenges they face when implementing their role in a collaborative care intervention in the Capital Region of Denmark. Methods Interviews with eight CMs, a group interview with five CMs and a recording of one supervision session were analysed by thematic analysis. Results The CM carried out considerable implementation work. This included finding suitable locations; initiating and sustaining communication with the GPs and maintaining their engagement in the model; adapting to the patient population in general practice; dealing with personal security issues, and developing supportive peer relations and meaningful supervision. Discussion We compare our findings to previous studies of collaborative care and advanced nursing roles in general practice. The importance of organizational leadership to support the CM's bridge-building role is emphasized. Implications for practice The planners of new collaborative care interventions should not only focus on the CM's clinical tasks but also on ensuring the sufficient organizational conditions for carrying out the role. © 2017 John Wiley & Sons Ltd.

Hospital nurses' wellbeing at work: a theoretical model.

PubMed

Utriainen, Kati; Ala-Mursula, Leena; Kyngäs, Helvi

2015-09-01

To develop a theoretical model of hospital nurses' wellbeing at work. The concept of wellbeing at work is presented without an exact definition and without considering different contents. A model was developed in a deductive manner and empirical data collected from nurses (n = 233) working in a university hospital. Explorative factor analysis was used. The main concepts were: patients' experience of high-quality care; assistance and support among nurses; nurses' togetherness and cooperation; fluent practical organisation of work; challenging and meaningful work; freedom to express diverse feelings in the work community; well-conducted everyday nursing; status related to the work itself; fair and supportive leadership; opportunities for professional development; fluent communication with other professionals; and being together with other nurses in an informal way. Themes included: collegial relationships; enhancing high-quality patient care; supportive and fair leadership; challenging, meaningful and well organised work; and opportunities for professional development. Object-dependent wellbeing was supported. Managers should focus on strengthening the positive aspect of wellbeing at work, focusing on providing fluently organised work practices, fair and supportive leadership and togetherness while allowing nurses to implement their own ideas and promote the experience of meaningfulness. © 2014 John Wiley & Sons Ltd.

Developing measures for information ergonomics in knowledge work.

PubMed

Franssila, Heljä; Okkonen, Jussi; Savolainen, Reijo

2016-03-01

Information ergonomics is an evolving application domain of ergonomics focusing on the management of workload in the real-world contexts of information-intensive tasks. This study introduces a method for the evaluation of information ergonomics in knowledge work. To this end, five key dimensions of information ergonomics were identified: contextual factors of knowledge work, multitasking, interruptions at work, practices for managing information load, and perceived job control and productivity. In total, 24 measures focusing on the above dimensions were constructed. The measures include, for example, the number of fragmented work tasks per work day. The measures were preliminarily tested in two Finnish organisations, making use of empirical data gathered by interviews, electronic questionnaires and log data applications tracking work processes on personal computers. The measures are applicable to the evaluation of information ergonomics, even though individual measures vary with regard to the amount of work and time needed for data analysis. Practitioner Summary: The study introduces a method for the evaluation of information ergonomics in knowledge work. To this end, 24 measures were constructed and tested empirically. The measures focus on contextual factors of knowledge work, multitasking, interruptions at work, practices for managing information load, and perceived job control and productivity.

Operationalizing a Nursing Innovation Center Within a Health Care System.

PubMed

Albert, Nancy M

In nursing, the terms "innovation" and "innovative" are used freely, especially when individuals or groups either develop something new or improve upon current practice. Innovation is often considered adjunct work, not part of foundational work that aims to meet the vision, mission, and values of the organization. Nurse leaders must include innovation as an important theme of this foundational work. Innovation must become a core expectation of all nurses and nursing team members. Team members can provide ideas that lead to innovations. They can also carry out roles that enhance or cultivate ideas, promote prototyping, ensure innovative ideas are efficacious and effective, and facilitate dissemination and diffusion into practice. To ensure that innovation is incorporated as part of nursing practice and then sustained over time, horizontal (elemental) and vertical (global) infrastructure and processes are needed. In this article, operationalization of a Nursing Innovation Center is described and rationale for specific horizontal and vertical services and features is discussed.

Implementation of cardiovascular disease prevention in primary health care: enhancing understanding using normalisation process theory.

PubMed

Volker, Nerida; Williams, Lauren T; Davey, Rachel C; Cochrane, Thomas; Clancy, Tanya

2017-02-24

The reorientation of primary health care towards prevention is fundamental to addressing the rising burden of chronic disease. However, in Australia, cardiovascular disease prevention practice in primary health care is not generally consistent with existing guidelines. The Model for Prevention study was a whole-of-system cardiovascular disease prevention intervention, with one component being enhanced lifestyle modification support and addition of a health coaching service in the general practice setting. To determine the feasibility of translating intervention outcomes into real world practice, implementation work done by stakeholders was examined using Normalisation Process Theory as a framework. Data was collected through interviews with 40 intervention participants and included general practitioners, practice nurses, practice managers, lifestyle advisors and participants. Data analysis was informed by normalisation process theory constructs. Stakeholders were in agreement that, while prevention is a key function of general practice, it was not their usual work. There were varying levels of engagement with the intervention by practice staff due to staff interest, capacity and turnover, but most staff reconfigured their work for required activities. The Lifestyle Advisors believed staff had varied levels of interest in and understanding of, their service, but most staff felt their role was useful. Patients expanded their existing relationships with their general practice, and most achieved their lifestyle modification goals. While the study highlighted the complex nature of the change required, many of the new or enhanced processes implemented as part of the intervention could be scaled up to improve the systems approach to prevention. Overcoming the barriers to change, such as the perception of CVD prevention as a 'hard sell', is going to rely on improving the value proposition for all stakeholders. The study provided a detailed understanding of the work required to implement a complex cardiovascular disease prevention intervention within general practice. The findings highlighted the need for multiple strategies that engage all stakeholders. Normalisation process theory was a useful framework for guiding change implementation.

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

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.

Applying Best Practices to Florida Local Government Retrofit Programs

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

McIlvaine, J.; Sutherland, K.

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multi-year field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the 'current best practices.' A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. Our new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

Existing Whole-House Solutions Case Study: Applying Best Practices to Florida Local Government Retrofit Programs - Central Florida

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

None

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multiyear field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15%-30% and higher. This case study describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. The new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

Applying Best Practices to Florida Local Government Retrofit Programs, Central Florida (Fact Sheet)

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

None, None

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multi-year field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. Our new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

Applying Best Practices to Florida Local Government Retrofit Programs

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

McIlvaine, J.; Sutherland, K.

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multiyear field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15%-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. The new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

[Opinion of the primary care veterinarians of Andalusia concerning the management of their professional practice].

PubMed

Conti Cuesta, F; Baena Parejo, M I; Pinzón Pulido, S A

1999-01-01

This study describes the opinion of the veterinarians in Andalusia regarding the organization and management of their professional practice and pinpoints solutions to the problems found for the purpose of providing planning and management aspects in view of the reforms undertaken in the Andalusian Health Service Strategy Plan. Descriptive opinion poll employing a questionnaire filled out by each individual among all of the Primary Care (PC) veterinarians in Andalusia (including those who have been currently employed who possess at least one year's experience, except substitutes). A description was provided of their personal traits, their opinion of the management-related factors involved in their professional practice. A description was also provided of the suggestions for improving the problems found to exist. Over 70% said they were aware of the objectives, although only the coordinators found them to be clearly motivating the practice. Their opinion was that the indicators of activity neither include any quality-related criteria nor afford the possibility of evaluating the activity they are carrying out. They believed that the contributions from other members of the multidisciplinary team improve their work and are in favor of continuing their involvement therein. They were satisfied with doing their work (the coordinators to a greater degree). They found the productivity pay to be too low and not useful as regards providing them with any incentive. They were not satisfied with the training with which they are provided and thought that what they are offered is far less than their other colleagues in the health care field. Most were of the opinion that they should remain under the authority of the Andalusian Health Service. This group prefers to continue working for the same organization, but improving the following management aspects: training offer, practice incentives and activity indicators.

Hot and steamy: outbreak of Bacillus cereus in Singapore associated with construction work and laundry practices.

PubMed

Balm, M N D; Jureen, R; Teo, C; Yeoh, A E J; Lin, R T P; Dancer, S J; Fisher, D A

2012-08-01

A sudden increase in invasive infections caused by Bacillus cereus group organisms prompted an investigation at the National University Hospital in Singapore. To describe the investigation and management and subsequent difficulties controlling the outbreak. Clinical case reviews were performed on all patients with B. cereus group recovered from clinical samples. Widespread environmental sampling was performed followed by review of hospital ventilation systems, domestic cleaning and laundry practices. B. cereus was recovered from 171 patients during a six-month period coinciding with large-scale construction work beside the hospital. Most patients presented with bacteraemia (146/171; 85.4%) with 46/171 (26.9%) requiring extended treatment courses with vancomycin or other interventions. Sampling confirmed extensive airborne dispersal inside the hospital, including isolation rooms and air-conditioned wards. Hospital linen was heavily contaminated [7403 cfu/cm(2); 95% confidence interval (CI): 6349-8457; for 30 towels sampled], encouraged by inappropriate storage in airtight plastic bags (4437 cfu/cm(2); CI: 3125-5750) compared with storage in porous canvas bags (166 cfu/cm(2); CI: 76-256; P < 0.001). Interventions introduced included revision of laundry practices, transport and storage of hospital linen and towels; bleach-based environmental cleaning; and upgrading of ventilation systems throughout the hospital. Clinical case numbers returned to baseline levels within three months, only to rise again following relaxation of laundry practices. Construction work beside this Singapore hospital encouraged heavy contamination of air and environment with Bacillus spp., assumed to be responsible for the outbreak described. Failure to maintain revised laundry practices allowed resurgence of clinical cases, particularly among immunocompromised patients. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Workplace Interventions to Prevent Disability from Both the Scientific and Practice Perspectives: A Comparison of Scientific Literature, Grey Literature and Stakeholder Observations.

PubMed

Williams-Whitt, Kelly; Bültmann, Ute; Amick, Benjamin; Munir, Fehmidah; Tveito, Torill H; Anema, Johannes R

2016-12-01

Purpose The significant individual and societal burden of work disability could be reduced if supportive workplace strategies could be added to evidence-based clinical treatment and rehabilitation to improve return-to-work (RTW) and other disability outcomes. The goal of this article is to summarize existing research on workplace interventions to prevent disability, relate these to employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, Improving Research of Employer Practices to Prevent Disability, held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with an expert panel with direct employer experience. Results Evidence from randomized trials and other research designs has shown general support for job modification, RTW coordination, and organizational support, but evidence is still lacking for interventions at a more granular level. Grey literature reports focused mainly on job re-design and work organization. Panel feedback focused on organizational readiness and the beliefs and values of senior managers as critical factors in facilitating changes to disability management practices. While the scientific literature is focused on facilitating improved coping and reducing discomforts for individual workers, the employer-directed grey literature is focused on making group-level changes to policies and procedures. Conclusions Future research might better target employer practices by tying interventions to positive workplace influences and determinants, by developing more participatory interventions and research designs, and by designing interventions that address factors of organizational change.

Burnout in Australasian Younger Fellows.

PubMed

Benson, Sarah; Sammour, Tarik; Neuhaus, Susan J; Findlay, Bruce; Hill, Andrew G

2009-09-01

Burnout is the state of prolonged physical, emotional and psychological exhaustion characteristic of individuals working in human service occupations. This study examines the prevalence of burnout among Younger Fellows of the Royal Australasian College of Surgeons and its relationship to demographic variables. In March 2008, a survey was sent via email to 1287 Younger Fellows. This included demographic questions, a measure of burnout (Copenhagen Burnout Inventory), and an estimate of social desirability (Marlowe-Crowne Social Desirability Scale - Form C). Females exhibited higher levels of personal burnout (P < 0.001) and work-related burnout (P < 0.025), but no significant difference in patient-related burnout. Younger Fellows in hospitals with less than 50 beds reported significantly higher patient-related burnout levels (mean burnout 37.0 versus 22.1 in the rest, P = 0.004). An equal work division between public and private practice resulted in higher work-related burnout than concentration of work in one sector (P < 0.05). Younger Fellows working more than 60 hours per week reported significantly higher personal burnout than those who worked less than this (P < 0.05). There was no significant correlation between age, country of practice, surgical specialty and any of the burnout subscales. Female surgeons, surgeons that work in smaller hospitals, those that work more than 60 h per week, and those with practice division between the private and public sectors, are at a particularly high risk of burnout. Further enquiry into potentially remediable causes for the increased burnout in these groups is indicated.

Radiation safety knowledge and practices among Irish orthopaedic trainees.

PubMed

Nugent, M; Carmody, O; Dudeney, S

2015-06-01

Fluoroscopy is frequently used in orthopaedic surgery, particularly in a trauma setting. Exposure of patients and staff to ionising radiation has been studied extensively; however, little work has been done to evaluate current knowledge and practices among orthopaedic trainees. This study aimed to investigate the knowledge and practices of Irish orthopaedic trainees regarding use of ionising radiation. A confidential internet-based survey on workplace radiation safety practices was distributed via email to 40 higher specialist trainees. Questions included related to radiation safety training and regular work practices. A total of 26 trainees completed the questionnaire (65% response rate). All reported regular exposure to ionising radiation. Compliance with body shields was high (25, 96%), however, other protective measures such as thyroid shields were less frequently employed. The 'as low as reasonably achievable principle' was practised regularly by 14 (54%). Radiation safety training was variable-while just over half (14) respondents felt adequately trained in radiation safety, 17 (65%) had attended a radiation protection course. Use of dosimeters was particularly poor, with only 4 (15%) using them regularly and most citing lack of availability as the main barrier. Although most Irish orthopaedic trainees have some knowledge regarding radiation safety, many do not regularly use all available measures to reduce exposure to ionising radiation. Barriers to use of protective mechanisms include lack of availability and perceived impracticality.

Item generation and pilot testing of the Comprehensive Professional Behaviours Development Log.

PubMed

Bartlett, Doreen J; Lucy, S Deborah; Bisbee, Leslie

2006-01-01

The purpose of this project was to generate and refine criteria for professional behaviors previously identified to be important for physical therapy practice and to develop and pilot test a new instrument, which we have called the Comprehensive Professional Behaviours Development Log (CPBDL). Items were generated from our previous work, the work of Warren May and his colleagues, a competency profile for entry-level physical therapists, our regulatory code of ethics, and an evaluation of clinical performance. A group of eight people, including recent graduates, clinical instructors and professional practice leaders, and faculty members, refined the items in two iterations using the Delphi process. The CPBDL contains nine key professional behaviors with a range of nine to 23 specific behavioral criteria for individuals to reflect on and to indicate the consistency of performance from a selection of "not at all," "sometimes," and "always" response options. Pilot testing with a group of 42 students in the final year of our entry-to-practice curriculum indicated that the criteria were clear, the measure was feasible to complete in a reasonable time frame, and there were no ceiling or floor effects. We believe that others, including health care educators and practicing professionals, might be interested in adapting the CPBDL in their own settings to enhance the professional behaviors of either students in preparation for entry to practice or clinicians wishing to demonstrate continuing competency to professional regulatory bodies.